36C26122Q0189 0002.pdf

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)

1 21

640-22-1-040-0017

N/A

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

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

36C26122Q0189

01-31-2022

X

X 1

This amendment is to revise the response to question #8 posted on Amendment 1 and revise the PWS section 2.1 from

"nesting" to "nursing."

No follow up questions will be accepted.

David J. Alvarez

Contracting Officer

#8. As non-personal services, mustn’t the RN hold a valid, unrestricted California RN license?

Response: The VA will accept an unrestricted nursing license from any state.

PERFORMANCE WORK STATEMENT

OPERATING ROOM REGISTERED NURSES

1. GENERAL:

1.1. Services Provided: The Contractor shall provide five 1.0 FTE Registered Operating Room

Nurses to provide services on site to beneficiaries of the Department of Veterans Affairs (VA) located at VA Palo Alto Health Care System. 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.

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. ACLS: Advanced Cardiac Life Support

1.5.2. ACO: Administrative Contracting Officer

1.5.3. AOA: American Osteopathic Association

1.5.4. BAA : Business Associate Agreement

1.5.5. BLS: Basic Life Support

1.5.6. CARF: Commission on Accreditation of Rehabilitation Facilities

1.5.7. CBOC: Community Based Outpatient Clinic

1.5.8. CDC: Centers for Disease Control and Prevention

1.5.9. CEU: Certified Education Unit

1.5.10. CME: Continuing Medical Education

1.5.11. CMS: Center for Medicare and Medicaid Services

https://www.1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://vaww.vhaco.va.gov/privacy/Documents/5USC552a.htm

1.5.12. 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.

1.5.13. 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.

1.5.14. COS: Chief of Staff

1.5.15. CPARS: Contractor Performance Assessment Reporting System

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

1.5.17. FSMB: Federation of State Medical Boards

1.5.18. HHS: Department of Health and Human Services

1.5.19. HIPAA: Health Insurance Portability and Accountability Act

1.5.20. ISO: Information Security Officer

1.5.21. TJC: The Joint Commission

1.5.22. POP: Period of Performance

1.5.23. PWS: Performance Work Statement

1.5.24. QA/QI: Quality Assurance/Quality Improvement

1.5.25. QM/PI: Quality Management/Performance Improvement

1.5.26. QASP: Quality Assurance Surveillance Plan

1.5.27. VA: Veterans Affairs

1.5.28. 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.

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

1.5.30. 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.

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

1.5.32. 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. License: Current, full, active and unrestricted licensure as a graduate professional nurse in a State, Territory, or Commonwealth (i.e., Puerto Rico) of the US or in the District of Colombia. All RN’s have completed an accredited training course in nursing through the State of California and be currently certified in Basic Life Support (BLS). 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. Registered Nurse Experience: All RN’s shall have a minimum of 2 years recent

Operating Room 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 (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.

2.1.4.1. Basic Life Support (BLS) is required.

2.1.5. Citizenship related Requirements: Citizen of the United States

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.

2.1.6.2. 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 Nurse Executive 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 Nurse Executive 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.

http://oig.hhs.gov/exclusions/index.asp

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 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. Key Personnel:

2.7.1. The VA Full Time Equivalency (FTE) for the Operating Room RN services required is

FIVE 1.0 VA FTE (VAPAHCS Operating Room, Palo Alto) to provide a total of 10400 hours of service coverage, or 2080 hours for each OR RN, during the period of performance.

2.7.2. 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 RN’s.

2.8. Emergency Substitutions: During the first ninety (90) calendar days of performance, the

Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar 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 key 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: 07:00 AM – 3:30 PM; 7:30 AM – 4:00 PM; 8:00 AM –

4:30 PM; 10:30 AM – 7:00 PM, 11:30 AM – 8:00 PM; and 12:30 PM – 9:00 P.M.

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 24/7.

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 OR RN 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

Association of perioperative Registered Nurses (AORN).

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 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 http://www.rms.oit.va.gov/SOR_Records/24VA19.asp 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:

Nancy C. Ungson, RN

Privacy Officer

Office of the Director http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf

VA Palo Alto Health Care System

3801 Miranda Avenue

Palo Alto, CA 94304

Tel: 650-493-5000 ext. 69245

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. Functions as an integral member of the surgical team .

4.3.6.2. Interfacing with patients, surgeons, and anesthesia staff in the surgical setting.

4.3.6.3. Implement the pre-operative plan of care demonstrating knowledge of the responsibilities of the RN pre-operatively, intra-operatively and post-operatively.

4.3.6.4. Scrubs and circulates surgical procedures independently. .

4.3.6.5. Works in partnership with the health care team in implementing standards of care during the operative and immediate post-operative phase in accordance with the purpose, philosophy and objectives of nursing, while being a positive team player.

4.3.6.6. Supervise care given and services rendered in the OR by other professional and non-professional staff.

4.3.6.7. Responsible for maintenance, care and use of equipment used, applying principles of asepsis, therapeutic and technical knowledge to ensure a safe environment for patients and staff.

4.3.6.8. Assists in orientation of rotating surgical and anesthesia residents, and other nursing staff.

4.3.6.9. Documents nursing interventions incorporating use of Deliverex, DHCP and

GUI.

4.3.6.10. Provides family and patient teaching.

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, Nurse

Executive, 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: 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. If 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: Qualifications of Key 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: 100% No deviations accepted.

Surveillance Method: Direct Observation of qualification documents

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.

4.4.4.3. 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

Disincentive: Unfavorable contractor performance evaluation.

4.4.4.4. 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.

4.4.4.5. 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.

Disincentive: Unfavorable contractor performance evaluation

4.4.4.6. 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.

4.4.4.7. 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.

4.4.4.8. 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

Disincentive: Unfavorable contactor performance evaluation.

4.4.4.9. 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 – David J. Alvarez

Department of Veterans Affairs

Network Contracting Officer (NCO) 21

5342 Dudley Blvd, Building 209

McClellan, CA 95652-2609

5.1.2. CS RESPONSIBILITIES:

CS – David J. Alvarez

Department of Veterans Affairs

Network Contracting Officer (NCO) 21

5342 Dudley Blvd, Building 209

McClellan, CA 95652-2609 http://www.cpars.gov/

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 – Kristina C. Kleyer

Program Analyst, Nursing Service

3801 Miranda Avenue

Palo Alto, CA 94304

650-441-9866

Kristina.kleyer@va.gov

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.

mailto:Kristina.kleyer@va.gov

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

http://ob10.com/us/en/veterans-affairs-us/ http://ob10.com/us/en/veterans-affairs-us/ http://www.x12.org/ http://VA.Registration@ob10.com http://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 charge for such service and that the VA will not be responsible for payment.

6.4.2. The Contractor shall not bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against, any person or entity other than VA for services provided pursuant to this contract. It shall be considered fraudulent for the Contractor to bill other third-party insurance sources

(including Medicare) for services rendered to Veteran enrollees under this contract.

VHA Supplemental Contract Requirements for Ensuring Adequate COVID-19 Safety Protocols for

Federal Contractors (Amended October 25, 2021)

1. Contractor employees who work in or travel to VHA locations must comply with the following:

a. Documentation requirements:

1) If fully vaccinated, shall show proof of vaccination.

i. NOTE: Acceptable proof of vaccination includes a signed record of immunization from a health care provider or pharmacy, a copy of the COVID-19 Vaccination Record Card

(CDC Form MLS-319813_r, published on September 3, 2020), or a copy of medical records documenting the vaccination.

2) If unvaccinated and granted a medical or religious exception, shall show negative

COVID-19 test results dated within three calendar days prior to desired entry date.

Test must be approved by the Food and Drug Administration (FDA) for emergency use or full approval. This includes tests available by a doctor’s order or an FDA approved over-the-counter test.

3) Documentation cited in this section shall be digitally or physically maintained on each contractor employee while in a VA facility and is subject to inspection prior to entry to

VA facilities and after entry for spot inspections by Contracting Officer

Representatives (CORs) or other hospital personnel.

4) Documentation will not be collected by the VA; contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

2. Contractor employees are subject to daily screening for COVID-19 and may be denied entry to VA facilities if they fail to pass screening protocols. As part of the screening process contractors may be asked screening questions found on the COVID-19

Screening Tool. Check regularly for updates.

a. Contractor employees who work away from VA locations, but who will have direct contact with

VA patients shall self-screen utilizing the COVID-19 Screening Tool, in advance, each day that they will have direct patient contact and in accordance with their person or persons who coordinate COVID-19 workplace safety efforts at covered contractor workplaces.

Contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

3. Contractor must immediately notify their COR or Contracting Officer if contract performance is jeopardized due to contractor employees being denied entry into VA

Facilities.

For indefinite delivery contracts: Contractor agrees to comply with FAR 52.232-99 and VHA

Supplemental Contract Requirements for any task or delivery orders issued prior to this modification when performance has already commenced.

VHA COs shall not take any action to enforce FAR clause 52.223-99 in any contract or contract-like instrument.

https://www.va.gov/covid19screen/ https://www.va.gov/covid19screen/ https://www.va.gov/covid19screen/