36C26119Q0974-001.docx

36C26119Q0974

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

640-19-3-040-0045 36C26119Q0974 08-06-2019 Joleo B. Dianala, joleo.dianala@va.gov

(916) 923-4575 08-20-2019 5:00

612MCP

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609 X X 561320 $27.5 Million N/A X Reference Performance Work Statement

612MCP

Department of Veterans Affairs VA Northern California HealthCare System 3230 Peacekeeper Way, Bldg. 209 McClellan CA 95652-1012

Department of Veterans Affairs FMS VA-9(101) Financial Services Center PO Box 149971 Austin TX 78714-9971 This is a Request for Quote for Surgical Technicians to result in an Indefinite Delivery Indefinite Quantity (IDIQ) contract for one-year ordering period.

Please see the Performance Work Statements for details.

Please refer to the Addendum to the Instructions to Offerors for details on how to respond.

Please refer to the Evaluation Commercial Items for information on how quotes will be evaluated.

Point of Contact is Joleo B. Dianala Email questions to joleo.dianala@va.gov X X Joleo B.

Dianala 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 (90C) Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address:

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 Price Schedule

The guaranteed minimum award amount for this contract is $1,000. The maximum aggregate value of orders that can be placed under this contract is $1,000,000. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

Performance Period One: September 30, 2019 – September 29, 2020

(10 FTEs, 2080 X 5 = 10,400)

Hour

B.3 Performance Work Statement

PERFORMANCE WORK STATEMENT

FOR

SURGICAL TECHNICIAN (ST)

1. GENERAL:

1.1. Services Provided: The Contractor shall provide approximately five 1.0 FTE Surgical Technicians to provide services on site to beneficiaries of the Department of Veterans Affairs (VA) located at VA Palo Alto Health Care System . The estimated quantity may change any time. 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) 3801 Miranda Avenue, Palo Alto, CA 94304 and/or 795 Willow Road, Menlo Park, CA 94025

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

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

1.4.1. 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

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

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

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

1.5.1. ABHES: Accrediting Bureau of Health Education Schools

1.5.2. ACLS: Advanced Cardiac Life Support

1.5.3. ACO: Administrative Contracting Officer

1.5.4. AOA: American Osteopathic Association

1.5.5. BAA : Business Associate Agreement

1.5.6. BLS: Basic Life Support

1.5.7. CAAHEP: Commission on Accreditation of Allied Health Education Programs

1.5.8. CARF: Commission on Accreditation of Rehabilitation Facilities

1.5.9. CBOC: Community Based Outpatient Clinic

1.5.10. CDC: Centers for Disease Control and Prevention

1.5.11. CEU: Certified Education Unit

1.5.12. CME: Continuing Medical Education

1.5.13. CMS: Center for Medicare and Medicaid Services

1.5.14. 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.

1.5.15. 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.

1.5.16. COS: Chief of Staff

1.5.17. CPARS: Contractor Performance Assessment Reporting System

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

1.5.19. FSMB: Federation of State Medical Boards

1.5.20. HHS: Department of Health and Human Services

1.5.21. HIPAA: Health Insurance Portability and Accountability Act

1.5.22. ISO: Information Security Officer

1.5.23. TJC: The Joint Commission

1.5.24. POP: Period of Performance

1.5.25. PWS: Performance Work Statement

1.5.26. QA/QI: Quality Assurance/Quality Improvement

1.5.27. QM/PI: Quality Management/Performance Improvement

1.5.28. QASP: Quality Assurance Surveillance Plan

1.5.29. VA: Veterans Affairs

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

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

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

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

1.5.34. 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. Surgical Technician Experience: All Surgical Technician shall have a minimum of 2 years of Surgical Technician experience.

2.1.2. 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.

2.1.3. Training (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: Annual Government Ethics Training; Compliance and Business Integrity; Emergency Preparedness; GEMS; Infection Control; Hazardous Material; Medical Equipment Management; Prevention of Workplace Harassment/NO FEAR;

Privacy and HIPAA Training; Safety; Security; Staff and Patient Boundaries; Utilities Management; VA Privacy and Information Security Awareness; and Visitation.

2.1.3.1. Basic Life Support (BLS) is required

2.1.4. Citizenship related Requirements:

2.1.4.1. 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;

2.1.4.2. 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.

2.1.4.3. 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.

2.1.4.4. 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.

2.1.4.5. 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.

2.1.5. 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.

2.1.5.1. 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.

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

2.2. Clinical/Professional Direction: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional direction of all clinical personnel covered by this contract for quality purposes will be provided by the 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 Surgical Technician services required is approximately five FTE at VA Palo Alto – Operating Room to provide a total of 20800 hours of service coverage, or 2080 hours for each Surgical Technician, during the ordering period. The estimated quantity may change any time.

2.7.2. The number of Surgical Technicians to provide service on a daily basis (be on site) is approximately five 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. For other requested time off, the contract personnel shall discuss with and obtain approval from the Palo Alto and Menlo Park VA Surgical Technicians.

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: Multiple shifts: 6:30 AM – 3:00 PM; 7:30 AM – 4:00 PM; 8:00 AM – 4:30 PM; and 12:00 PM – 8:30 PM

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 Nurse Executive or designee. Currently, normal hours are Monday – Friday 6:00AM – 8:00 PM.

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

3.2.1. New Year’s Day

3.2.2. President’s Day

3.2.3. Martin Luther King’s Birthday

3.2.4. Memorial Day

3.2.5. Independence Day

3.2.6. Labor Day

3.2.7. Columbus Day

3.2.8. Veterans Day

3.2.9. Thanksgiving

3.2.10. Christmas

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

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

4. CONTRACTOR RESPONSIBILITIES

4.1. 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.

4.1.1. 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.

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

4.2. Standards of Care: The contract personnel’s care shall cover the range of Surgical Technician 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 the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or Accrediting Bureau of Health Education Schools (ABHES).

4.3. MEDICAL RECORDS:

4.3.1. 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).

4.3.2. 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.

4.3.3. 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.

4.3.4. 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.

4.3.5. 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:

Privacy Officer Office of the Director VA Palo Alto Health Care System 3801 Miranda Avenue Palo Alto, CA 94304 Tel: 650-493-5000 ext. 64616 Fax: 650-849-0325

4.3.6. 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:

4.3.6.1. The Surgical Technician functions within the policies and procedures of the VA facility where assigned and provides the following services.

4.3.6.2. Functions as a primary scrub person responsible for handling instruments, supplies, and equipment during all surgical procedures such as: open heart, thoracic, major vascular, neurosurgery, microsurgery, and total joint replacement surgery.

4.3.6.2.1. Sets up sterile field with all required items for each procedure such as air-powered equipment, fiber optic equipment, laparoscopic equipment, microscopes, lasers, arthroscopy equipment, urologic equipment, and other operating room supplies and equipment.

4.3.6.2.2. Plans and discusses each procedure with surgical professionals and assures that all supplies and equipment are available prior to the surgical procedure.

4.3.6.2.3. Prepares, organizes, and maintains highly complex sterile surgical set-ups.

4.3.6.2.4. Observes and responds promptly to each stage of the surgical procedure and anticipates the needs of the surgeon by maintaining a high level of concentration for extended periods of time.

4.3.6.2.5. Utilizes universal precautions and follows all infection control policies and procedures when handling specimens, supplies, and equipment.

4.3.6.2.6. Assists the team members with care of the patient, i.e., positioning, prepping, and obtaining supplies.

4.3.6.2.7. Handles all specimens appropriately.

4.3.6.2.8. In conjunction with the circulating Registered Nurse (RN), performs sponge and instrument counts to verify accuracy. Responsible for the accountability for all surgical instruments and equipment during the surgical procedure.

4.3.6.2.9. Assists the surgeon by performing such procedures as preparing skin grafts, suctioning, holding retractors, applying skin staples, and cutting sutures Prepares prosthesis and surgical devices during procedures.

4.3.6.2.10. Assists residents, medical students, nursing students, operating room technology students, and new Operating Room (OR) staff in the operation of equipment, sterile technique, handling of instruments, and OR procedures to include the scrub role in surgical procedures.

4.3.6.2.11. Provides support to on-call staff during emergency surgeries by obtaining supplies and instruments from Sterile Processing Service (SPS) during off-shifts.

4.3.6.3. Maintains Equipment and Work Areas

4.3.6.3.1. Performs non-technical maintenance of equipment to prevent malfunctions.

4.3.6.3.2. Maintains OR area.

4.3.6.3.3. Assesses equipment needs and maintains adequate stock of supplies and materials.

4.3.6.3.4. Recognizes potentially hazardous situations (e.g., frayed cords, water on floor) and takes corrective action.

4.3.6.4. Provides Guidance/Supervision

4.3.6.4.1. Provides guidance and support to Nursing Assistants and other Surgical Technicians.

4.3.6.4.2. Provides guidance and support to students, registry surgiCal technologists, and RN trainees.

4.3.6.5. Other Duties

4.3.6.5.1. Assists surgical team members in quality improvement activities.

4.3.6.5.2. Updates personal knowledge regarding current trends in surgical technology through continuing education courses.

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

4.3.7.1. 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, Nurse Executive, or designee. Meetings will be on an as-needed basis and will occur during regular working hours.

4.3.7.1.1. 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.

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

4.3.7.1.3. 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.

4.3.7.1.4. 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).

4.3.7.1.5. 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.

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

4.4.1. 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.

4.4.2. 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.

4.4.3. 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.

4.4.4. Performance Standards:

4.4.4.1. 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: 100% No deviations accepted.

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

Disincentive: Unfavorable contractor performance evaluation.

4.4.4.2. Measure: Scope of Practice

Performance Requirement: All contract personnel shall provide services within their scope of practice.

Standard: All contract personnel perform within their scope of practice/privileges 100% of the time.

Acceptable Quality Level: All contract personnel perform within their scope of practice/privileges 100% of the time. No deviations accepted.

Surveillance Method: Random Inspection of records.

Frequency: Annually or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation.

4.4.4.3. Measure: Patient Access

Performance Requirement: The Contractor shall provide contract personnel in accordance with the operating hours and VA clinical schedule outlined in this PWS.

Standard: All contract personnel are on time and available to perform services.

Acceptable Quality Level: Contract personnel is on time and available to perform and provide services 90% of the time Surveillance Method: Periodic Sampling of Time and Attendance Sheets Frequency: Monthly or when itemized invoices are submitted Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation.

Deduction: No monetary incentive for work not performed. Contractor will be paid for actual hours worked.

4.4.4.4. Measure: Patient Safety

Performance Requirement: Patient safety incidents shall be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)

Standard: All patient safety incidents are reported using Patient Safety Report within 24 hours of incident.

Acceptable Quality Level: All patient safety incidents are reported using Patient Safety Report within 24 hours of incident. No acceptable deviation.

Surveillance Method: Direct Observation, Validated Patient Complaints Frequency: Annual, per incident, or as needed.

Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation

4.4.4.5. Measure: Maintains licensing, registration, and certification Performance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current.

Standard: All (100%) licensing, registration(s) and certification(s) for contract personnel shall be provided as they are renewed. Licensing and registration information kept current.

Acceptable Quality Level: All (100%) licensing, registration(s) and certification(s) for contract personnel shall be provided as they are renewed. Licensing and registration information kept current. No acceptable deviation.

Surveillance Method: Periodic Sampling and Random inspection of records Frequency: Annually or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation. Removal from contract until such time the contract personnel meet qualification standard.

4.4.4.6. Measure: Mandatory Training

Performance Requirement: Contract personnel shall complete all required training on time per VAPAHCS policy Standard: All (100%) of required training is complete on time by contract personnel.

Acceptable Quality Level: 100% completions, no deviations.

Surveillance Method: Periodic Sampling and Random inspection of records Frequency: Annually or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation, Suspension or termination of all physical and/or electronic access privileges and removal from contract until such time as the training is complete.

4.4.4.7. Measure: Timely Invoice

Performance Requirement: Monthly invoices shall be submitted within 30 days.

Standard: Monthly invoices shall be submitted within 30 days.

Acceptable Quality Level: 75% compliance Surveillance Method: Periodic Sampling Frequency: Monthly or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contactor performance evaluation.

4.4.4.8. Measure: Privacy, Confidentiality and HIPAA

Performance Requirement:

Standard: All (100%) contractor personnel comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA Acceptable Quality Level: 100% compliance; no deviations.

Surveillance Method: Periodic Sampling; Contractor shall provide evidence of annual training required by VAPAHCS, reports violations per VA Directive 6500.6.

Frequency: Annually or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contactor performance evaluation. Immediate removal from contract.

4.4.5. Registration with Contractor Performance Assessment Reporting System

4.4.5.1. As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information.

4.4.5.2. Each Contractor whose contract award is estimated to exceed $150,000 requires a CPARS evaluation. A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations). Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690.

4.4.5.3. For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the Contractor’s performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the Contractor’s designated representative for comment. The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO.

4.4.5.4. Failure for the Contractor’s representative to respond to the evaluation within those sixty (60) days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor’s representative will be “locked out” of the evaluation and may no longer send comments.

5. GOVERNMENT RESPONSIBILITIES

5.1. Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to:

5.1.1. CO RESPONSIBILITIES:

CO – Joleo B. Dianala Department of Veterans Affairs Network Contracting Officer (NCO) 21 5342 Dudley Blvd, Building 209 McClellan, CA 95652-2609

5.1.2. CS RESPONSIBILITIES:

Department of Veterans Affairs Network Contracting Officer (NCO) 21 5342 Dudley Blvd, Building 209 McClellan, CA 95652-2609

5.1.2.1. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract.

5.1.2.2. The Contracting Officer shall resolve complaints concerning Contractor relations with the Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof.

5.1.2.3. In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for Contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract.

5.1.3. COR Responsibilities:

COR – TBD

5.1.3.1. The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

5.1.3.2. The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected.

5.1.3.3. The COR will maintain a record-keeping system of services by reviewing the QASP, CPRS, and invoices submitted by the Contractor. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the Contractor’s non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

5.1.3.4. The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference.

5.1.3.5. All contract administration functions will be retained by the VA.

6. SPECIAL CONTRACT REQUIREMENTS

6.1. Billing:

6.1.1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th workday of the month. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:

6.1.1.1. Name and Address of Contractor

6.1.1.2. Invoice Date and Invoice Number

6.1.1.3. Contract Number and Purchase/Task Order Number

6.1.1.4. Date of Service

6.1.1.5. Name of contract physician(s)

6.1.1.6. Hourly Rate

6.1.1.7. Quantity of hours worked

6.1.1.8. Total price

6.2. Vendor Electronic Invoice Submission Methods

6.2.1. Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below:

6.2.1.1. VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, OB10, to transition vendors from paper to electronic invoice submission. Please go to this website: http://ob10.com/us/en/veterans-affairs-us/ to begin submitting electronic invoices, free of charge.

6.2.1.2. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI). The X12 EDI Web site (http://www.x12.org).

6.2.1.3. The Contract may contact FSC at the phone number or email address listed below with any questions about the e-invoicing program or OB10:

6.2.1.3.1. OB10 e-Invoice Setup Information: 1-877-489-6135

6.2.1.3.2. OB10 e-Invoice email: VA.Registration@ob10.com

6.2.1.3.3. FSC e-Invoice Contact Information: 1-877-353-9791

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

6.3. Payment Adjustments/Performance Related Payment Deductions:

6.3.1. Invoices will be prorated for partial days/hours worked. The contractor shall be paid only for actual work performed onsite. Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed. In the event that the Contract providers work a portion of an hour, the government may adjust payments by 15-minute increments.

6.4. Payments in full/no billing VA beneficiaries: The Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Contractor, even if VA does not pay for those services. This provision shall survive the termination or ending of the contract.

6.4.1. To the extent that the Veteran desires services which are not a VA benefit or covered under the terms of this contract, the Contractor must notify the Veteran that there will be a…