36C26119Q0925-0003000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 08-14-2019 None

612MCP

Department of Veterans Affairs Network Contracting Office (NCO 21) VA Northern California HealthCare System 5342 Dudley Blvd., Bldg. 209 McClellan

CA

95652-2609

612MCP

Department of Veterans Affairs Department of Veterans Affairs VA Northern California HealthCare System 3230 Peacekeeper Way, Bldg. 209 McClellan

CA

95652-1012 To all Offerors/Bidders

36C26119Q0925 08-06-2019

X X X

X The purpose of this amendment is to revise VAAR 852.273-73 Evaluation-Health-Care Resources (attached).

Changes are shown in red font.

Second, the Questions and Answers document was also revised and updated. See following pages for responses to 40 questions.

Third, this amendment revises the Performance Work Statement. Changes are shown in red font.

Lastly, Attachment 4, Past Performance Questionnaire has been revised. Changes has been highlighted in yellow.

IMPORTANT: Offeror must sign and acknowledge this amendmentand return with quote.

JOLEO B. DIANALA

Contracting Specialist

VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003)

August 14, 2019

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer, conforming to the solicitation, will be most advantageous to the Government, price and other factors considered. The following information or factors shall be used to evaluate offers:

In accordance with FAR 13.106-2(b)(3), the quotes will undergo a comparative evaluation to determine which vendor provides the best value to the government in terms of the information provided in response to the non-priced factors while also providing a competitive price. Moreover, the Government is not assigning weight to the factors or listing them in any particular order.

1. Experience. The government will consider the experience indicated to see how recent and relevant it is to the current requirement. Experience that is considered recent (within the last 3 years) will be rated more favorably than those that are not recent. Experience in providing Certified Nursing Assistant will be rated more favorably than Experience with other health care staffing. Experience that is considered highly relevant will be rated more favorably than less relevant experience. Experience providing staffing in the same geographic area as the current requirement will be considered more relevant than experience providing staffing in other geographic areas. Experience recruiting from the area local to the referenced project will be more favorable than providing travelling staff.

2. Recruiting/Hiring. The Government will rate more favorably quotes that demonstrate a thorough vetting process of prospective employees. Vendors who rely extensively on subcontractors for recruiting/hiring temporary medical staff will be rated less favorably than vendors who self-perform. Offerors that demonstrate various means to recruit employees, identify excellent methods for recruiting and retaining employees will be rated more favorably. Offerors utilizing more extensive background checks will also be rated more favorably.

3. Past Performance. The Government will consider the reference information submitted by the vendor. It may also reach out to each reference listed to receive feedback about performance. In addition to information received by the reference(s), the Government may also consider any other information available to it including Contractor Performance Assessment Reports (CPARS), Federal Awardee Integrity Information System (FAPIIS), System for Award Management (SAM), Past Performance Information Retrieval System (PPIRS), and any other sources of information. Vendors who have a superior performance records will be more favorably than those with less than superior performance.

4. Candidates. The qualifications and experience of the candidates will be evaluated. Candidates that have more than the minimum required experience and credentials will be rated more favorably in comparison with those with less experience. Candidates with prior VA experience will be rated more favorably than those without prior VA experience. Any other relevant information about the candidate reflected on the resume that is favorable will also be considered. Candidates who are local to the area of service will be rated more favorably than traveling candidates.

5. Price. The quote should contain the vendor’s best terms from a price standpoint. The Government will evaluate quotes for award purposes by adding the total price for all contract line items, including options, for a total price. The Government will also evaluate the price to assess the vendor’s ability to attract and retain staff for the geographic area.

This acquisition is set-aside for Service-Disabled Veteran-Owned Small Businesses. To be considered for award, your company must be certified by Center for Verification and Evaluation (CVE) at the time the quote is submitted. The Government will validate certification at https://www.vip.vetbiz.gov upon receipt of quotes. Any vendors not registered will not be evaluated as ineligible.

Quotes that fail to provide all the requested information may be excluded from evaluation and therefore ineligible for award.

NURSING ASSISTANTS

FOR VA PALO ALTO HEALTHCARE SYSTEM (VAPAHCS)

QUESTIONS AND ANSWERS

36C26119Q0925 / PR# 640-19-1-040-0001

Question 1: The 1449 says closeout date is 8/19/2019 at 5PM, but the FBO webpage indicates 08/14/2019?

Answer 1: The solicitation closeout due date is Monday, August 19, 2019.

Question 2: Is there an incumbent contractor for the subject solicitation or is this a new requirement? If the former, could you please provide the contractor name and contractor number?

Answer 2: This is a new requirement and there is no current contract or incumbent in place.

Question 3: This solicitation describes nursing assistants providing the service, yet the description of services describes the services a (CNA) certified nursing assistant provides. Can we the contractor provide caregivers who have their current active (CNA) certified nursing assistant licensure?

Answer 3: We will accept both NA’s and CNA.

Question 4: Can the (CNA) certified nursing assistants have their Licensure from another state beside California?

Answer 4: Yes.

Question 5: Page 19 of 82 5.3.7.1 Staffing Meetings/Rounds. Is there a predetermined schedule of these meeting that can be provided to the contractor? Example one a week, twice monthly?

Answer 5: Monthly.

Question 6: Page 61 of 82 Candidates If awarded the contract, we the contractor would normally start providing candidates after we are awarded the contract. Will that be acceptable with this solicitation?

Answer 6: You must identify at least five (5) potential candidates meeting the qualifications in the PWS with your response to the solicitation.

Question 7: Page 18 of 82 5.3.6.2 "Serves as member of the nursing staff and carries out routine nursing care and other assigned patients on any word of tour assigned." Will the VA have registered nurses who are acting as the immediate supervisors for the certified nursing assistants we the contractor are providing?

Answer 7: There will be an Assistant Nurse Manager and/or Nurse Manager available on duty. However, this is a non-personal healthcare services contract IAW para. 2.3 of the PWS, VAAR 852.237-7, and FAR 37.101. “Personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees” (FAR 37.101).

Question 8: This solicitation specifically states there is no overtime to be paid and that the VA recognizes Federal Holidays meaning there is no scheduled work. My question is are the Nursing Assistants or (CNA) to be paid while off on the Federal Holidays?

Answer 8: Nursing Assistants or (CNA) will only be paid for the hours they work. There is a CLIN for Federal Holidays in the price schedule should they be scheduled to work on those days. See Attachment 3, Price Worksheet for estimated quantity.

Question 9: When submitting our bid, do we the contractor have to complete the Price Workbook along with the Price Schedule Form?

Answer 9: Please fill the price schedule and the price worksheet.

Question 10: Are there any amendments associated with this solicitation and if so please provide?

Answer 10: Please check FBO daily for the latest amendments.

Question 11: Which Background Investigation Level will be required for this contract? (page 25) Answer 11: VA HR Department will conduct a Tier 1/NACI background investigations.

Question 12: Are subcontractors required to send out the Past Performance Questionnaires? If so, how will the Agency know which Prime the sub will be working with?

Answer 12: Please reference Addendum to FAR 52.212-1, page 59 - 61 of the solicitation if you intend on subcontracting.

Question 13: In reference to page 27 (Invoice and Payment); it states that “Payment for services rendered by the Contractor shall be made weekly upon receipt of a proper invoice”; whereas on page 4 it states that invoices are submitted monthly in arrears. Please clarify if contactor is to invoice weekly or monthly?

Answer 13: Monthly.

Question 14: Will contractors with past performance providing healthcare providers such as RNs and LPNs be considered?

Answer 14: The Government will consider the reference information submitted by the vendor, but experience in providing Certified Nursing Assistant will be rated more favorably than experience with other health care staffing.

Question 15: Can the contractor employee’s health examinations be considered valid if they were within the past 6 months of the contract start date?

Answer 15: Yes.

Question 16: Please provide more information about the duties of the contract liaison?

Answer 16: Please reference para. 1.8.13 and 6.1.3 of the PWS for the definition and duties of a Contracting Officer’s Representative.

Question 17: In reference to the Post-award/Pre-performance Conference; can the contractor attend the conference telephonically? Or does the contractor need to attend in person?

Answer 17: Post-award conference will be held via telephonically.

Question 18: Page 1 of 82, 1.2-1.5, Place of performance is VA Palo Alto Health Care System, will the CNAs have to float between all three facilities or will they be assigned to just one??

Answer 18: They will be placed in one facility and float within the units in that facility.

Question 19: It does not look like there are enough hours in the contract to support 24/7 operations at each clinic. Can the government clarify which of the clinics will be operating 24/7 and can the government provide a breakdown of staffing levels at each clinic per shift?

Answer 19: The Government has established the estimated hours it needs, and it is listed in Attachment 3 Price Worksheet. The place of performance could be any of the facilities listed in para. 1.2 of the Performance Work Statement. The estimated quantity may change any time.

Question 20: Will the government please consider allowing Contractors to use copies of their latest CPARs reports in lieu of a PPQ? We have highly relevant contracts that have CPARs reports but we may not be able to use them due to the ongoing administrative burden of government POCs having to complete PPQs for each procurement. As a SDVOSB, we consistently have to use the same contracts for past performance and have gotten pushback recently from our POCs.

Answer 20: The Government may also consider any other information available to it including Contractor Performance Assessment Reports (CPARS), Federal Awardee Integrity Information System (FAPIIS), System for Award Management (SAM), Past Performance Information Retrieval System (PPIRS), and any other sources of information as reflected in the updated VAAR 852.273-73 Evaluation, Health Care Resources clause, dated August 12, 2019.

Question 21: How much estimated staffing will each facility - Menlo Park, Livermore, and Palo Alto - need, respectively.

Answer 21: Please see answer to Question 19.

Question 22: Is the contractor responsible for making the NA schedule? If so, will the contractor work with the nurse managers at each location to set the schedule? Also, how far in advance would the contractor receive the staffing needs of each facility to create the schedule?

Answer 22: The Nurse manager & Assistant Nurse Manager will create the schedule for each facility and will be posted one month in advance.

Question 23: If the contractor is not responsible for making the NA schedule how would the process work? Would it be different at each facility?

Answer 23: The contractor will be notified by either the CO or the COR of the schedule and it will be the same process for each facility.

Question 24: What is the expectation of coverage if a contract NA calls out for a shift?

Answer 24: Please reference 2.7.3 of the PWS.

Question 25: What is the difference in the VA System between a Nursing Assistant I, II, III, & IV? What Nursing Assistant designation is preferred for this contract?

Answer 25: The higher the level, the more experience the NA has. Please reference 2.1.2 of the PWS.

Question 26: If low census or another reason causes site to cancel contract NA shift, how much advance notice will be given?

Answer 26: The schedule is posted one month in advance and at this time, census is not low as these are long term care & extended care patients.

Question 27: Does this contact follow California Labor Law?

Answer 27: Contractors are required to comply with applicable Federal and CA Labor Law.

Question 28: When does the Government anticipate an award to be made for this solicitation?

Answer 28: The anticipated award date is August 30, 2019.

Question 29: What is the expected timeline for the credentialing process/onboarding of the Nursing Assistants?

Answer 29: It may take up to 120 days to complete the onboarding process.

Question 30: On PWS page 10, Section 2.1.4 Training – Can the Government please confirm that all trainings will be during regularly scheduled shifts and at no additional cost to the contractor?

Answer 30: Most computer-based training called VA Talent Management System (TMS) training will be completed during shift.

Question 31: My company hasn't had any contracted past performances and all my performances are personal, will I be able to submit this in the response?

Answer 31: Please see item #3 of Addendum to FAR 52.212-1, Instruction to Offerors-Commercial Items, page 60 of the solicitation.

Question 32: Please provide a page limit for the evaluation information: 1. Experience/2. Recruiting/Hiring/3. Past Performance/4. Candidates?

Answer 32: There are no page limit.

Question 33: Is there a preferable font size? Are tables and graphics allowed?

Answer 33: There are no preferable font size. Tables and graphics presented with the quote to meet the provisions described in Addendum to FAR 52.212-1 Instructions to Offerors—Commercial Items are welcome.

Question 34: Should subcontractor information only be included in a cover letter?

Answer 34: Please reference Addendum to FAR 52.212-1, page 61 of the solicitation if you intend on subcontracting.

Question 35: If the price quote/proposal is larger than 5MB is the offeror allowed to submit the offer in multiple emails?

Answer 35: Yes.

Question 36: Please provide the applicable wage determination for this contract requirement?

Answer 36: Please refer to 52.222-42, page 54 and Attachment 1 of the solicitation.

Question 37: Can the Government confirm if the Nursing Assistants will have opportunity to perform venipuncture responsibilities?

Answer 37: No, however NA will assist with finger sticks.

Question 38: Can the Government confirm if previously completed Past Performance Questionnaires may be accepted from the offeror?

Answer 38: Please refer to para. a.3 of VAAR 852.273-73, Evaluation-Health-Care Resources, page 64 of the solicitation.

Question 39: I have a question regarding the Past Performance. On the first page it says, “Offeror must include a copy of each requested Past Performance Information page with proposal submission.” At the bottom, it contradicts it with saying “DO NOT return survey to the company you are evaluating”. How am I supposed to include a copy in the proposal submission if it says not to return the survey to the company it is evaluating?

Answer 39: Modification A0003 has removed this restriction.

Question 40: Page 8 of 82, Section 1.2, Place of Performance: VA Palo Alto Health Care System (VAPAHCS). But you also list different areas as the following: 1.3. Menlo Park Division 795 Willow Road, Menlo Park, CA 94025 1.4. Livermore Division 4951 Arroyo Rd., Livermore, CA 94550 1.5. Palo Alto Division 3801 Miranda Ave., Palo Alto, CA 94304. Does it mean you need 24 hours a day coverage at each of the three locations, every day and every week?

Answer 40: The Government has established the estimated hours it needs, and it is listed in Attachment 3 Price Worksheet. The place of performance could be any of the facilities listed in para. 1.2 of the Performance Work Statement. The estimated quantity may change any time.

B.2 PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT

FOR

NURSING ASSISTANT (NA)

August 14, 2019

1. GENERAL:

1.1. Services Provided: The Contractor shall provide approximately 30 FTE Nursing Assistants services for one three-year ordering period with pricing listed for each CLIN in the pricing schedule to beneficiaries of the Department of Veterans Affairs (VA) located at VA Palo Alto Health Care System in the Community Living Centers at Menlo Park Division, Livermore Division and Palo Alto Division. Contractor personnel will have use of all required patient care equipment, supplies, and computer access for performing services required by this contract. All services shall be provided in accordance with the specifications, terms and conditions contained herein.

1.2. Place of Performance: VA Palo Alto Health Care System (VAPAHCS)

1.3. Menlo Park Division 795 Willow Road, Menlo Park, CA 94025

1.4. Livermore Division 4951 Arroyo Rd., Livermore, CA 94550

1.5. Palo Alto Division 3801 Miranda Ave., Palo Alto, CA 94304

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

1.7. Policy/Handbooks: The Contractor shall comply with all applicable policy and regulations, including, but not limited to the following:

1.7.1. VHA Directive 2006-041 “Veterans’ Health Care Service Standards’ (expired but still in effect pending revision) https://www.1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

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

1.7.3. Privacy Act of 1974 (5 U.S.C. 552a) as amended http://vaww.vhaco.va.gov/privacy/Documents/5USC552a.htm

1.8. 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.

1.8.1. ACLS: Advanced Cardiac Life Support

1.8.2. ACO: Administrative Contracting Officer

1.8.3. AOA: American Osteopathic Association

1.8.4. BAA : Business Associate Agreement

1.8.5. BLS: Basic Life Support

1.8.6. CARF: Commission on Accreditation of Rehabilitation Facilities

1.8.7. CBOC: Community Based Outpatient Clinic

1.8.8. CDC: Centers for Disease Control and Prevention

1.8.9. CEU: Certified Education Unit

1.8.10. CME: Continuing Medical Education

1.8.11. CMS: Center for Medicare and Medicaid Services

1.8.12. CO: Contracting Officer – 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.

1.8.13. COR: Contracting Officer’s Representative – 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 non-compliance in order that appropriate action can be taken.

1.8.14. COS: Chief of Staff

1.8.15. CPARS: Contractor Performance Assessment Reporting System

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

1.8.17. FSMB: Federation of State Medical Boards

1.8.18. HHS: Department of Health and Human Services

1.8.19. HIPAA: Health Insurance Portability and Accountability Act

1.8.20. ISO: Information Security Officer

1.8.21. TJC: The Joint Commission

1.8.22. POP: Period of Performance

1.8.23. PWS: Performance Work Statement

1.8.24. QA/QI: Quality Assurance/Quality Improvement

1.8.25. QM/PI: Quality Management/Performance Improvement

1.8.26. QASP: Quality Assurance Surveillance Plan

1.8.27. VA: Veterans Affairs

1.8.28. 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.

1.8.29. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in California and Hawaii.

1.8.30. 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.

1.8.31. VETPro: a federal web-based credentialing program for healthcare providers.

1.8.32. VA Palo Alto Health Care System (VAPAHCS): Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the VA Palo Alto Health Care System.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. Certification - All nursing assistants must have completed an accredited training course in at least one state, territory, or commonwealth in the US or the District of Columbia through the State of California and be currently certified through American Heart Association in Basic Life Support (BLS), though Advanced Cardiac Life Support (ACLS) is preferred. All continuing education courses required for maintaining certification must be kept up to date at all times. The Contractor shall provide documentation verifying current certification to the VA COR upon request.

2.1.2. Nursing Assistant Experience: All nursing assistant shall have a minimum of 2 years of nursing assistant experience.

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. 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.

2.1.4. Training (ACLS, BLS and VA MANDATORY): Contract personnel shall meet all VA educational requirements and mandatory course requirements defined herein; all trainings must be completed by the contract personnel as required by the VA. VA trainings include.

2.1.4.1. Basic Life Support (BLS) is required and Advanced Cardiac Life Support is preferred.

2.1.5. Citizenship related Requirements:

2.1.5.1. 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;

2.1.5.2. 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.

2.1.5.3. 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.

2.1.5.4. 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.

2.1.5.5. 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.

2.1.6. 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.

2.1.6.1. 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 personnel 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.

2.2. 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 VAPAHCS 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 personnel shall not be considered VA employees for any purpose.

2.4. Inherent Government Functions: Contractor and Contract 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.

2.5. No Employee status: The Contractor shall be responsible for protecting Contract personnel 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:

2.5.1. Workers’ compensation

2.5.2. Professional liability insurance

2.5.3. Health examinations

2.5.4. Income tax withholding, and

2.5.5. Social security payments.

2.6. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract personnel. When a Contractor or contract personnel 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 contract personnel) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.7. Personnel:

2.7.1. The VA Full Time Equivalency (FTE) for the nursing assistant services required is approximately thirty (30) to provide a total of 62400 hours of coverage, during the period of performance. The estimated quantity may change any time.

2.7.2. The number of nursing assistants to provide service on a daily basis (be on site) is two as defined in paragraph Hours of Operation in this section.

2.7.3. The Contractor shall be responsible for providing coverage to the VA during extended periods of vacancies of the Contractor’s personnel due to sick leave and personal leave.

2.8. Emergency Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar days 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.

2.8.1. 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 15 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 personnel.

2.8.2. 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 contract physician(s), s/he may request, without cause, immediate replacement of said contract physician(s).

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

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

3. HOURS OF OPERATION

3.1. VA Business Hours: see table below:

3.1.1. Contract personnel shall be available and present during normal VAPAHCS hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff or designee.

3.1.2. Coverage hours: Multiple shifts: NO OVERTIME WILL BE PERMITTED

4. Weekday Coverage

a) Day Shift 7:30am – 4:00pm

b) Evening Shift 3:30pm – 12:00 Midnight

c) Night Shift 11:30pm – 8:00am

Weekend Coverage (Non-Holiday)

a) Day Shift 7:30am – 4:00pm

b) Evening Shift 3:30pm – 12:00 Midnight

c) Night Shift 11:30pm – 8:00am

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

4.1.1. New Year’s Day

4.1.2. President’s Day

4.1.3. Martin Luther King’s Birthday

4.1.4. Memorial Day

4.1.5. Independence Day

4.1.6. Labor Day

4.1.7. Columbus Day

4.1.8. Veterans Day

4.1.9. Thanksgiving

4.1.10. Christmas

4.1.11. On days the President of the United States declares a federal employee holiday, but is not considered federal holiday, contractor employees will not be paid holiday rates for working on those days.

4.2. Unless a state of emergency has been declared by the VAPAHCS, the Contractor shall be responsible for providing services.

5. CONTRACTOR RESPONSIBILITIES

5.1. Clinical Personnel Required: The Contractor shall provide contract personnel who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

5.1.1. Contract personnel 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.

5.1.2. The Contractor and/or contract personnel shall return required Background Investigation paperwork within 10 calendar days of receipt from the COR.

5.2. Standards of Care: The contract personnel’s care shall cover the range of nursing assistant 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 current national standards recognized by:

4.2.1 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

4.2.2 The requirements contained in this PWS.

5.3. MEDICAL RECORDS:

5.3.1. Authorities: Contract personnel 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).

5.3.2. 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.

5.3.3. Disclosure: Contract personnel 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.

5.3.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAPAHCS.

5.3.5. 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. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address:

TBD

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5.3.6. Direct Patient Care: 90% of the time involved in direct patient care. The contract personnel shall perform the following and remain within their scope of practice/privilege at all times:

5.3.6.1. The NA functions within the policies and procedures of the VA facility where assigned and provides the following services.

5.3.6.2. Serves as a member of the nursing staff and carries out routine nursing care and other personal services to assigned patients on any ward or tour assigned.

5.3.6.3. Performs a range of personal nursing care which includes activities of daily living, such as feeding, bathing, lifting and turning patients, providing oral, nail, hair related hygiene care, and performing preventive, rehabilitative, and therapeutic care/procedures within the scope of a Nursing Assistant

5.3.6.4. Records in appropriate clinical records all care provided.

5.3.6.5. Observes, significant conditions, both physical and emotional, relevant to the health status of the patient. Providing timely and accurate reports to their team leader or designated superior and records all relevant information in the clinical record. Gives special attention to details of care since patients are often too ill or confused to speak for themselves.

5.3.6.6. Performs a range of diagnostic support duties, which includes taking vital signs, neurological checks, collecting specimens, and preparing patients for tests, examinations, treatments and/or surgery according to established procedures.

5.3.6.7. Performs a range of treatment procedures that include changing dressings, giving enemas, colostomy care, tracheotomy care, and caring for patients in isolation, and/or continuous observation status.

5.3.6.8. Maintains a safe and therapeutic environment; observes all policies pertaining to universal precautions. Provides for safety needs of patients.

5.3.6.9. Recognizes emergency situations (cardiopulmonary arrest, choking, seizures, dysreflexia, etc.), takes appropriate action and reports situation in a timely fashion.

5.3.6.10. Accompanies patients on diagnostic or therapeutic trips assuming responsibility for basic decisions within the scope of a Nursing Assistant while away from nursing units.

5.3.6.11. Initiates emergency measures to control disruptive or violent behavior.

5.3.6.12. Assists in the delivery of patient care as directed by the RN or LPN/LVN.

5.3.6.13. Respects patient’s rights, including but not limited to visual and auditory privacy.

5.3.6.14. Consistently apply VA Customer Services Standards, demonstrating helpful, courteous, and respectful conduct at all times.

5.3.7. ADMINISTRATIVE: 10% of time not involved in direct patient care

5.3.7.1. Quality Improvement Meetings: If applicable, the contract personnel shall participate in continuous quality improvement activities and meetings with committee participation as required by the VAPAHCS Chief of Service, Chief of Staff, or designee. Meetings will be on an as-needed basis and will occur during regular working hours.

5.3.7.1.1. Staff Meetings/Rounds: The contract personnel shall attend staff meetings as required by the VAPAHCS Chief of Service, Chief of Staff, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.

5.3.7.1.2. QA/QI documentation: The contract personnel shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations as needed.

5.3.7.1.3. Patient Safety Compliance and Reporting: The contract personnel shall follow all established patient safety and infection control standards of care. Contract personnel shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.

5.3.7.1.4. Medical Records: The contract personnel shall complete all required clinical and medical record documentation for echocardiography services within the required timeframe. The contract personnel shall utilize VA’s electronic medical record system for all patient care documentation, where applicable, including the Computerized Patient Record System (CPRS).

5.3.7.1.5. Invoicing/Billing: In order to adequately document services provided under this contract, a record keeping system of Contractor work hours shall be established and implemented by the COR. Payment for services will not be made until all required documentation related to the services has been submitted. Contractor shall submit monthly invoices within 30 days.

5.4. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT (QI)

5.4.1. Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

5.4.2. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that The Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

5.4.3. The Government reserves the right to refuse acceptance of any contract 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. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

5.4.4. Performance Standards:

5.4.4.1. Measure: Provider Quality Performance

Performance Requirement: All contract personnel shall perform in accordance with clinical standards of care.

Standard: All services performed within clinical standards of care.

Acceptable Quality Level: 90% compliance.

Surveillance Method: Random Inspection Frequency: Annually or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation.

5.4.4.2. Measure: Qualifications of Personnel

Performance Requirement: All contract personnel shall be certified in accordance with ARDMS or CCI Standards.

Standard: All contract personnel are certified.

Acceptable Quality Level: 90% compliance.

Surveillance Method: Direct Observation of…