S02 36C26123Q0003 Psychiatrist VAPAHCS RFQ.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C26123Q0003 08-30-2022

Larry Facio (916) 923-4553 09-15-2022 1:00pm PDT

612MCP

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) Network Contracting Office (NCO) 21 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609

X 100

X

561320

$30 Million

N/A

X

VA Palo Alto Health Care System VAPAHCS 3801 Miranda Ave

Palo Alto CA 94304

612MCP

Department of Veterans Affairs

Network Contracting Office (NCO) 21 3230 Peacekeeper Way, Bldg. 209 McClellan CA 95652-1012

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

PO Box 149971 Austin TX 78714-9971

Contracting Shall Provide 2.0 Board Certified Psychiatrist IAW Performance Work Statement.

Period of Performance: 11/01/22 to 10/31/23

640-3630160-058-820300-2560 0100203D1

X X

Larry Facio

36C26123Q0003

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

SECTION C - CONTRACT CLAUSES

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.2 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.3 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.4 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.5 VAAR 852.219-77 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (SEP 2021)

(DEVIATION)

C.6 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) ... 22

C.7 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.8 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAY 2022) (JUL 2020) (DEVIATION)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.2 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.3 52.216-1 TYPE OF CONTRACT (APR 1984)

E.4 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.5 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003)

E.6 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2022) (JUL 2020)

(DEVIATION)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C261 LARRY FACIO Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) Network Contracting Office (NCO) 21 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] MONTHLY

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.

SEE PWS SECTION P. INVOICING/PAYMENT

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

4,160.00 HR

2.0 Full-Time Equivalent (FTE) Psychiatrists

Contract Period: Base POP Begin: 11-01-2022 POP End: 10-31-2023 PRINCIPAL NAICS CODE: 561320 - Temporary Help Services PRODUCT/SERVICE CODE: Q519 - Medical - Psychiatry

0001A

____ HR __________________ __________________

____ Full-Time Equivalent (FTE) Psychiatrists for inpatient mental health units at VAPAHCS locations listed in Performance Work Statement.

Contract Period: Base POP Begin: 11-01-2022 POP End: 10-31-2023 PRINCIPAL NAICS CODE: 561320 - Temporary Help Services PRODUCT/SERVICE CODE: Q519 - Medical - Psychiatry (Line-Item are for LOCAL RESIDING providers. Vendor must insert the number of FTE in fill-in along with annotating the quantity of hours stipulating the number of FTE; 2,080 for 1.0 FTE, 4,160 for 2.0 Local FTE).

0001B

____ HR __________________ __________________

____ Full-Time Equivalent (FTE) Onsite Psychiatrists for inpatient mental health units at VAPAHCS locations listed in Performance Work Statement.

Contract Period: Base POP Begin: 11-01-2022 POP End: 10-31-2023 PRINCIPAL NAICS CODE: 561320 - Temporary Help Services PRODUCT/SERVICE CODE: Q519 - Medical - Psychiatry (Line-Item are for NON-LOCAL providers. Vendor must declare if non-local hourly pricing is inclusive to lodging and meals. Vendor must insert the number of FTE in fill-in along with annotating the quantity of hours stipulating the number of FTE; 2,080 for 1.0 FTE, 4,160 for 2.0 FTE. )

____ DY __________________ __________________

__________ (Days) Lodging and Meals (7 days a week).

(Pricing Shall Not Exceed GSA Daily Lodging and Meal Rates).

Contract Period: Base POP Begin: 11-01-2022 POP End: 10-31-2023 PRINCIPAL NAICS CODE: 561320 - Temporary Help Services PRODUCT/SERVICE CODE: Q519 - Medical - Psychiatry

1.0 FTE Lodging and Meals = 365 days. 2.0 FTE Lodging and Meals = 730 days.

(CONTRACTOR SHALL NOT INVOICE LODGING AND MEALS

FOR PROVIDERS RESIDING WITHIN 50 MILES OF VAPAHCS)

GRAND TOTAL __________________

2.0 FTE Psychiatrist for

VA Palo Alto Health Care System (VAPAHCS)

Performance Work Statement

Non-Personal Service to provide legal services to specified Veterans as specified by the Network Contracting Officer (NCO) representing the VA Palo Alto Health Care System (VAPAHCS) in accordance with commercial standard practice as required by public law. The contractor will provide the services of two (2) Board Certified/Board Eligible Psychiatrist(s) to provide psychiatry physician services at VAPAHCS, 3801 Miranda Avenue, Palo Alto, California 94304, and/or the associated Community Based Outpatient Clinics (CBOC) at any of the following locations:

VAPAHCS-Menlo Park Division 795 Willow Road Menlo Park, CA 94025-2539

VAPAHCS-Livermore Division 4951 Arroyo Road Livermore, CA 94550-9650

Fremont VA Clinic 39199 Liberty Street, Building B Fremont, CA 94538-1501

Major General William H. Gourley VA-DoD Outpatient Clinic 201 9th Street Marina, CA 93933-6039

San Jose VA Clinic 5855 Silver Creek Valley Place San Jose, CA 95138-1059

The general assignment will be 5 days a week at the VAPAHCS Outpatient Mental Health Clinic, location to be determined based on need. The normal work schedule will be Monday through Friday from 8:00am to 4:30pm., with a ½ hour non-paid lunch break. Federal holidays are excluded from normal work schedule hours of operation. Contract provider will generally work (8) hours per day, (40) hours per week. The Director for Outpatient Mental Health Services, or designee, will provide the work assignments for the psychiatrist/s and will provide clinical direction.

Psychiatrist(s) will not provide on-call evening, weekend and holiday psychiatric coverage.

* Note: No premium payment will be made for working federal holidays *

Per Diem: Providers living outside the 50 mile radius from the contracted place of duty per the PWS shall claim the stated per diem rate located in Per Diem Rates. Per Diem Rates | GSA https://www.gsa.gov/travel/plan-book/per-diem-rates/per-diem-rates-results/?action=perdiems_report&state=CA&fiscal_year=2022&zip=95138&city=

Work will commence immediately upon completion of credentialing and privileging as well as orientation. Orientation at the VAPAHCS is approximately one week.

The psychiatrist/s will be required to work cooperatively with other psychiatrists, nurse practitioners, psychologists, social workers, registered nurses, and a variety of allied health professionals to deliver comprehensive health care services to adult patients.

Work Environment: VAPAHCS-Menlo Park Division has one separate patient care building for mental health and is a one floor building. The Livermore Division is a six floor building that also includes primary care, medical services, and lab facilities. The Major General William H. Gourley VA-DoD Outpatient Clinic (Monterey CBOC) and San Jose VA Clinic each have a three floor building that also includes primary care. The Fremont VA Clinic is a one floor building that also includes primary care. Much of the work occurs within a typical office setting, either individually or in meeting with others, or in meeting rooms. Some time will be spent walking to and from the treatment rooms and or offices with time spent on involved with patients, nursing staff or other staff in activities typical of a mental health care facility.

Physical Requirements: The contractor must provide documentation that demonstrates that the contractor employee has a current physical that includes a current TB test and Hepatitis B vaccination. Proof that a two-step tuberculosis skin testing is up to date must be received prior to starting employment. If the psychiatrist has had a negative test within the past 12 months, a single step test will be done. In both instances, documentation must be received prior to starting employment. Contractor must also provide documentation that demonstrates that the contractor employee has a history of chicken pox, varicella vaccine, or a positive immune status for Varicella.

A. DUTIES AND RESPONSIBILITIES: Perform all duties and responsibilities of a staff psychiatrist. Duties include but are not limited to: admission/discharge, diagnostic evaluations, treatment and professional direction of outpatient care, psychiatric consultations, completion of required forms and letters, attending treatment team meetings and huddles.

Mental Health Services include:

General Outpatient Mental Health Telemental Health Primary Care Mental Health Integrated Care

Primary work assignment will be: Outpatient Mental Health at VAPAHCS and/or CBOCs, where needed.

Must be clinically competent to perform examinations, diagnosis, therapeutic treatment, be effective in handling emergencies, patient management and timely documentation in patient records. Must be effective in teaching (patient education, co-workers, consultation to other teams, interaction with trainees). Must be effective in planning and should have sound decision making skills.

Individual to provide professional direction and participate in the treatment team (which includes clinical staff – psychologists, nurses, nursing assistants, licensed practical nurses, social workers, social work associates, dietitians, recreation therapists); evaluate, develop and implement treatment plans; complete intake evaluations, follow up care; prepare examining physician’s reports for outside agencies, in rare circumstances may include attending court hearings to provide testimony as needed. A progress note must be completed for each episode of patient care, coverage of care and medication refills. Enroll in State prescription monitoring database and run CURES report on patients on controlled prescriptions at recommended intervals.

B. MISCELLANEOUS DUTIES AND RESPONSIBILITIES:

a. Individual will follow and meet all medical center policies, rules and regulations.

b. Individual will participate in organization meetings as requested.

c. Maintains patient confidentiality and security of operations.

d. The medical center utilizes a computerized medical record system. The psychiatrist must be familiar with personal computers, have adequate typing skills to perform data entry (progress notes, psychiatrist orders, and clinical reminders), and be able to navigate through windows-based computer programs. Training on the computerized medical record system will be provided by the medical center.

e. Psychiatrists are encouraged to type their own notes into the electronic patient record.

However, dictation technology can be utilized at the request of the provider.

Credentials Requested: Application package provided by VAPAHCS to be completed by the candidate. This includes: Curriculum vitae, current references, signed release of information from candidate, and statement that candidate does not have any physical or mental health condition that would adversely affect his/her ability to carry out assigned duties, and additional credentialing and privileging forms. Candidate will also be required to make application through the VET-PRO Internet process. Candidate will need to be enrolled in VET-PRO by our Credentialing and Privileging Coordinator at VAPAHCS, Angela Boese. The website address is:

https://fcp.vetpro.org. Our facility ID number is: 640.

National Practitioner Identification: Prior to starting work or on the first day of work the contracted individual or contractor must provide the VA with the contracted individual's National Practitioner Identification (NPI) number. If the contracted individual does not have a NPI number he/she must make application and receive the number prior to beginning work at the VA. The website for an on-line application is: https://nppes.cms.hhs.gov/NPPES/Welcome.do. It may take up to a few weeks to receive the NPI number - so early application is advised.

C. QUALIFICATIONS:

Personnel assigned by the contractor to perform the services covered by this task order must be a citizen of the United States and have a Degree of Doctor of Medicine or an equivalent degree resulting from a course of education in medicine or osteopathic medicine. Provider must also possess a current, full and unrestricted license in a State, Territory, or Commonwealth of the United States or the District of Columbia (or be Board Certified/Eligible) to practice medicine or surgery. The psychiatrist is required to be currently certified in Basic Life Support (BLS) and to maintain the certification during their work at the medical center. BLS Certification must be obtained through an organization as recognized by the American Heart Association.

https://fcp.vetpro.org/ https://nppes.cms.hhs.gov/NPPES/Welcome.do

Personnel assigned by the contractor to perform the services covered by this task order shall be proficient in written and spoken English (38 USC 7402). Contractor’s assigned personnel must be computer literate as patient documentation is directly inputted in the patient’s electronic medical record.

The qualifications of such personnel shall also be subject to review by the VA Chief of Staff and approved by the VA Facility Director. The Contracting Officer will be notified prior to any changes in personnel. VA reserves the right to approve the assignment of individual personnel furnished by the contractor to perform the functions specified in the task order. The personnel assigned by the Contractor must complete VA credentialing process for delineation of clinical privileges in accordance with VHA Handbook 1100.19.

The contracted individual will be required to show two proofs of identification on their first day of work. Acceptable proof of identification is listed below:

Acceptable PICTURE IDs:

• State-Issued Driver’s License

• State DMV-Issued ID Card

• US Passport

• Military ID/Dependents Card

• Foreign Passport

• Permanent Resident Card/Alien

Registration Card w/Photo

Acceptable NON-PICTURE IDs:

• Social Security Card

• Certified Birth Certificate

• State Voter Registration Card

• Native American Tribal Document

• Certificate of US Citizenship

Certificate of Birth Abroad Issued by Dept of State

D. NATIONAL HOLIDAYS

The 11 holidays observed by the Federal Government are: New Year’s Day (January 1st), Martin Luther King’s Birthday (3rd Monday in January), Presidents’ Day (3rd Monday in February), Memorial Day (last Monday in May), Juneteenth National Independence (June 19th), Independence Day (July 4th), Labor Day (1st Monday in September), Columbus Day (2nd Monday in October), Veterans Day (November 11), Thanksgiving Day (4th Thursday in November), Christmas Day (December 25th) and any other day specifically declared by the President of the United States to be a national holiday.

When one of the above designated legal holidays falls on a Sunday, the following Monday will be observed as a legal holiday. When a legal holiday falls on a Saturday, the preceding Friday is observed as a holiday by U.S. Government agencies.

E. SERVICES:

1. The services specified may be changed by written modification to this task order.

The VA contracting officer will prepare the modification.

2. This is a non-personnel services contract. There is no employer-employee relationship between the VA and the contractor or the contractor’s employee(s).

3. The services to be performed by the contractor will be performed in accordance with VA policies and procedures and the regulations of the medical staff bylaws of the VA facility.

4. Other necessary personnel for the operation for the operation of the services contracted for at the VA will be provided by the VA at levels mutually agreed upon which are compatible with the safety of the patient and personnel and with quality medical care programming.

5. Contractor is required to maintain medical liability insurance for the duration of this task order. Contractor must indemnify the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance.

6. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered.

F. JOINT COMMISSION (JC) STANDARDS: Where the task order does not require JC accreditation or other regulatory requirements regarding work competency, the Contractor must perform the required work in accordance with JC standards. The contractor is required to develop and maintain the following documents for each contractor employee working on the task order;

credentials and qualifications for the job; a current competence assessment checklist (an assessment of knowledge, skills, abilities and behaviors to perform a job correctly and skillfully;

includes knowledge and skills required to provide care for certain patient populations, as appropriate); a current performance evaluation supporting ability of the contractor employee to successfully perform the work required in this solicitation and the listing of relevant continuing education for the last two years. The contractor will provide current copies of these records at the time of task order award and annually on the anniversary date of task order award to the VA COR, or upon request, for each Contractor employee working on the task order.

G. HHS/OIG

To ensure that the individuals providing services under the task order have not engaged in fraud or abuse regarding Sections 1128 and 1128A of the Social Security Act regarding federal health care programs, the contractor is required to check the Health and Human Services - Office of Inspector General (HHS/OIG), List of Excluded Individuals/Entities on the OIG Website (www.hhs.gov/oig) for each person providing services under this task order. Further the Contractor is required to certify in its proposal that all persons listed in the contractor’s proposal have been compared against the OIG list and are NOT listed. During the performance of this task order the Contractor is prohibited from using any individual or business listed on the List of Excluded Individuals/Entities.

H. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996

(HIPAA)

Contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). As required by HIPAA, the Department of Health and

Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs (VA). In accordance with HIPAA, the Contractor may be required to enter into a Business Associate Agreement (BAA) with VA. VA has recognized Locum Providers as entities that do not require a BAA with their contractors as long as they are conducting health care on VA’s behalf – Psychiatrist qualifies as a medical service – therefore, no BAA is required.

I. CONFIDENTIALITY OF PATIENT RECORDS

a. The Contractor, as a VA provider, will assist in the provision of health care to patients seeking such care from or through VA. As such, the Contractor is considered as being part of the Department health care activity. Contractor is considered to be a VA provider for purposes of the Privacy Act, Title 5 U.S.C. 552a. Further, for the purpose of VA records access and patient confidentiality, Contractor is considered to be a VA contractor for the following provisions: Title 38 U.S.C. 5701, 5705, and 7362. Therefore, Contractor may have access, as would other appropriate components of VA, to patient medical records including patient treatment records pertaining to drug and alcohol abuse, HIV, and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. However, like other components of the Department, and not withstanding any other provisions of the task order, the Contractor is restricted from making disclosures of VA records, or information contained in such records, to which it may have access, except to the extent that explicit disclosure authority from VA has been received. The Contractor is subject to the same penalties and liabilities for unauthorized disclosures of such records as VA.

b. The records referred to above shall be and remain the property of VA and shall not be removed or transferred from VA except in accordance with 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) and federal laws, rules and regulations. 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.

J. CONTRACTOR PERSONNEL SECURITY REQUIREMENTS: (required if order exceeds 180 days)

All contractor employees who require access to the Department of Veterans Affairs' computer systems shall be the subject of a background investigation and must receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to task order performance.

This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed prior to the start of the task order, the contractor will be responsible for the actions of those individuals they provide to perform work for VA.

1. Position Sensitivity - The position sensitivity has been designated as low risk.

2. Background Investigation - The level of background investigation commensurate with the required level of access is National Agency Check with Written Inquiries.

3. Contractor Responsibilities

a. The contractor shall bear the expense of obtaining background investigations. If the Office of Personnel Management (OPM) conducts the investigation, the contractor shall reimburse VA within 30 days. If timely payment is not made within 30 days from date of bill for collection, then VA shall deduct the cost incurred from the contractor’s 1st month’s invoice(s) for services rendered.

b. The contractor shall submit or have their employees submit the following required forms to the VA Office of Security and Law Enforcement within 30 days of receipt:

(i) Standard Form 85P, Questionnaire for Public Trust Positions

(ii) Standard Form 85P-S, Supplemental Questionnaire for Selected Positions

(iii) FD 258, U.S. Department of Justice Fingerprint Applicant Chart

(iv) VA Form 0710, Authority for Release of Information Form

(v) Optional Form 306, Declaration for Federal Employment

(vi) Optional Form 612, Optional Application for Federal Employment

c. The Contractor shall inform the contract employee that when filling out Standard Form 85P, that there should be no gaps in employment history. Any gaps in employment history on Standard Form 85P may result in OPM rejecting the documentation for investigation.

d. The contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the task order.

e. Failure to comply with the contractor personnel security requirements may result in termination of the task order for default.

f. The contractor awarded the task order will provide after task order award notification and prior to contract performance a listing of contractor personnel that will be performing services under the task order that will require access to VA computer systems to the Contracting Officer within two business days. This list will include names, social security numbers, and home addresses of contractor’s personnel.

g. The contractor may utilize a private investigating agency if such agency possesses an OPM and Defense Security Service certification. A Cage Code number must be provided to the VA Office of Security and Law Enforcement. VA Office of Security and Law Enforcement will verify the information and advise the contracting officer whether contractor’s access to the computer systems can be authorized.

h. The contractor shall be responsible to provide evidence to the Contracting Officer that investigations have been completed or in the process of being requested within 30 calendar days from receipt of award.

i. All contractor employees and subcontractors requiring access to VA computer network are required to complete VA’s Security Awareness Training course annually either on-line or hard copy.

j. The contractor will notify the COR immediately when their employee(s) no longer require access to VA computer systems.

4. Government Responsibilities

a. The contracting officer will forward the names, social security numbers, and addresses of the contractor’s employees to the Office of Security and Law Enforcement.

b. The Office of Security and Law Enforcement will provide the necessary investigative forms to the contractor or to the contractor's employees, coordinate the background investigations, and notify the contracting officer and contractor of the results of the investigations.

c. The VA facility will pay for requested investigations in advance. A bill for collection will be sent to the contractor to reimburse the VA facility. The contractor will reimburse the VA facility within 30 days. If timely payment is not made within 30 days from date of bill for collection, then VA shall deduct the cost incurred from the contractor’s 1st month’s invoice(s) for services rendered.

d. The current fees associated with background investigations are $225.00 each for low level investigation, $900.00 each for medium level investigation, and $2,950 each for high level investigation. See paragraph one (1) above for the position sensitivity that has been assigned to this task order.

K. SECURITY TRAINING:

Contractor employee is required to complete security training and sign a VA Computer Access Agreement prior to having access to VA computer system. In addition, if providing medical services, Contractor employee will attend Computerized Patient Record System (CPRS) training prior to providing any patient care services, including on-call/emergency coverage at VA. The contractor employee will document patient care in CPRS to comply with all VA and JCAHO standards.

As VA routinely reviews and updates policies and procedures covering contractor computer access, security requirements may change during the term of this contact and new policies and procedures may be implemented unilaterally during the term of this agreement.

L. PERSONNEL POLICY:

The contractor shall be responsible for protecting the personnel furnishing services under this task order. To carry out this responsibility, the contractor shall provide the following for these personnel:

- Workers compensation

- Professional liability insurance

- Health examinations and evidence including:

a. Evidence of a current physical examination (within one year)

b. Evidence of Hepatitis B immunity (hepatitis immune titer, if provider has had the series of shots; if no immunity, evidence that provider has started the Hepatitis B vaccination series.)

c. Evidence of a current TB Skin Test and recent (within the last year) chest X-ray if there is a history of positive TB skin test

d. Evidence of history of chicken pox, varicella vaccine, or a positive immune status for Varicella

- Income tax withholding, and

- Social security payments.

The parties agree that such personnel shall not be considered VA employees for any purpose and shall be considered employees of the contractor.

M. RECORD KEEPING:

The VA shall establish and maintain a record keeping system that will record the hours worked by the contractor's employee(s). Contractor's employee(s) shall report to the Clinical Director for Mental Health Services or designee, upon arrival at VAPAHCS. The payments for any leave including sick leave, holiday or vacation time are the responsibility of the Contractor.

N. VA MONITORING:

Contracting Officer's Representative will designate appropriate VA personnel to monitor Contractor employee work hours/services through one or a combination of the following mechanisms:

(a) Departments being served will monitor Contractor employee work hours through time and attendance logs similar to VA staff positions, to ensure that services called for in the contract have been received by VA. The Contracting Officer's Representative (COR) will be responsible for verifying contract compliance. Any incidents of Contractor noncompliance as evidenced by the monitoring procedures will be forwarded immediately to the Contracting Officer.

(b) Chief of Staff's office reviews monitoring data. An internal time-keeping form is maintained and reviewed for total number of hours worked per month against monthly average of hours. Part-time personnel's cards are reviewed against their VA tour-of-duty to verify that the services were received.

(c) Documentation of services performed will be reviewed prior to certifying payment. The COR will perform periodic spot checks and document with the using service to ensure records monitoring. VA will pay only for services actually performed at VA, and in strict accordance with the schedule of prices/costs shown in the Schedule of Items. Contract monitoring and recordkeeping procedures will be sufficient to ensure proper payment and allow audit verification that services were provided.

(d) Monthly invoices are generated to VA Fiscal Service who forwards to Service's Administrative Assistant for review. The Administrative Assistant verifies services were actually performed against the schedule and logs. Only after verification are invoices certified for payment.

O. KEY PERSONNEL AND TEMPORARY EMERGENCY SUBSTITUTIONS:

The Contractor shall assign to this purchase order the following key personnel: Board Certified/Board Eligible Psychiatrist(s) ____________________________.

1. During the first ninety (90) days of performance, the Task orderor shall make NO substitutions of key personnel unless the substitution is necessitated by the individual’s illness, death, or termination of employment or if mutually agreed upon by the Task ordering Officer and the task orderor. The Contractor shall notify the Contracting Officer, in writing, within 15 calendar days after the occurrence of any of these events and provide the information required by paragraph (2) below. After the initial 90-day period of the task order, the Contractor shall submit the information required by paragraph (2) to the Contracting Officer at least 15 days prior to making any permanent substitutions.

2. 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 Contracting Officer. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The Contracting Officer will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The task order will be modified to reflect any approved changes of key personnel.

3. For temporary substitutions where the key person will not be reporting to work for three

(3) consecutive workdays or more, the Contractor will provide a qualified replacement for the key person, unless it is determined that no substitute is necessary. This substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure stated in paragraph (2) above.

4. Prior to rendering services, substitutes must obtain medical staff appointment and clinical privileges, in accordance with VA Bylaws, Rules and Regulations.

P. INVOICING/PAYMENT

All invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

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

More information on the VA Financial Services Center is available at http://www.fsc.va.gov/einvoice.asp Vendor e-Invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:

• Tungsten e-Invoice Setup Information: 1-877-489-6135

• Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

• FSC e-Invoice Contact Information: 1-877-353-9791

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

Q. DESIGNATION OF CONTRACT REPRESENTATIVE

A VA representative of the Contracting Officer will be designated to represent the Contracting Officer in furnishing technical guidance and advice regarding the work being performed under this task order. The foregoing is not to be construed as authorization to interpret or furnish advice and information to the Contractor relative to the financial or legal aspects of the task order.

Enforcement of these segments is vested in and is the responsibility of the Contracting Officer.

http://www.fsc.va.gov/einvoice.asp mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov

SECTION C - CONTRACT CLAUSES

ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

The following clauses are incorporated into 52.212-4 as an addendum to this contract:

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

http://www.acquisition.gov/far/index.html http://www.va.gov/oal/library/vaar/

(End of Clause)

FAR

Number

Title Date

52.203-16 PREVENTING PERSONAL CONFLICTS OF INTEREST JUN 2020

52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS

AND REQUIREMENT TO INFORM EMPLOYEES OF

WHISTLEBLOWER RIGHTS

JUN 2020

52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON

POSTCONSUMER FIBER CONTENT PAPER

MAY 2011

52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL

JAN 2011

52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE OCT 2018

52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE

MAINTENANCE

AUG 2020

52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

NOV 2021

52.217-8 OPTION TO EXTEND SERVICES NOV 1999

52.224-1 PRIVACY ACT NOTIFICATION APR 1984

52.224-2 PRIVACY ACT APR 1984

52.228-5 INSURANCE—WORK ON A GOVERNMENT

INSTALLATION

JAN 1997

52.232-18 AVAILABILITY OF FUNDS APR 1984

52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL

BUSINESS SUBCONTRACTORS

NOV 2021

52.237-3 CONTINUITY OF SERVICES JAN 1991

852.204-70 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL

MAY 2020

C.2 SUPPLEMENTAL INSURANCE REQUIREMENTS

In accordance with FAR 28.307-2 and FAR 52.228-5, the following minimum coverage shall apply to this contract:

(a) Workers' compensation and employers liability: Contractors are required to comply with applicable Federal and State workers' compensation and occupational disease statutes. If occupational diseases are not compensable under those statutes, they shall be covered under the employer's liability section of the insurance policy, except when contract operations are so commingled with a Contractor's commercial operations that it would not be practical to require this coverage. Employer's liability coverage of at least $100,000 is required, except in States with exclusive or monopolistic funds that do not permit workers' compensation to be written by private carriers.

(b) General Liability: $500,000.00 per occurrences.

(c) Automobile liability: $200,000.00 per person; $500,000.00 per occurrence and $20,000.00 property damage.

(d) The successful bidder must present to the Contracting Officer, prior to award, evidence of general liability insurance without any exclusionary clauses for asbestos that would void the general liability coverage.

(End of Clause)

C.3 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

(a) The Contractor agrees to comply with any provision or clause that is incorporated herein by reference to implement agency policy applicable to acquisition of commercial items or components. The following provisions and clauses that have been checked by the Contracting Officer are incorporated by reference.

[X] 852.203–70, Commercial Advertising.

[] 852.209–70, Organizational Conflicts of Interest.

[] 852.211–70, Equipment Operation and Maintenance Manuals.

[] 852.214–71, Restrictions on Alternate Item(s).

[] 852.214–72, Alternate Item(s). [Note: this is a fillable clause.]

[] 852.214–73, Alternate Packaging and Packing.

[] 852.214–74, Marking of Bid Samples.

[] 852.215–70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors.

[] 852.215–71, Evaluation Factor Commitments.

[] 852.216–71, Economic Price Adjustment of Contract Price(s) Based on a Price Index.

[] 852.216–72, Proportional Economic Price Adjustment of Contract Price(s) Based on a Price Index.

[] 852.216–73, Economic Price Adjustment—State Nursing Home Care for Veterans.

[] 852.216–74, Economic Price Adjustment—Medicaid Labor Rates.

[] 852.216–75, Economic Price Adjustment—Fuel Surcharge.

[] 852.219–9, VA Small Business Subcontracting Plan Minimum Requirements.

[X] 852.219–10, VA Notice of Total Service-Disabled Veteran-Owned Small Business Set- Aside.

[] 852.219–11, VA Notice of Total Veteran-Owned Small Business Set-Aside.

[] 852.222–70, Contract Work Hours and Safety Standards—Nursing Home Care for Veterans.

[] 852.228–70, Bond Premium Adjustment.

[] 852.228–71, Indemnification and Insurance.

[] 852.228–72, Assisting Service-Disabled Veteran-Owned and Veteran-Owned Small Businesses in Obtaining Bonds.

[X] 852.232–72, Electronic Submission of Payment Requests.

[X] 852.233–70, Protest Content/Alternative Dispute Resolution.

[X] 852.233–71, Alternate Protest Procedure.

[X] 852.237–70, Indemnification and Medical Liability Insurance.

[] 852.246–71, Rejected Goods.

[] 852.246–72, Frozen Processed Foods.

[] 852.246–73, Noncompliance with Packaging, Packing, and/or Marking Requirements.

[X] 852.270–1, Representatives of Contracting Officers.

[] 852.271–72, Time Spent by Counselee in Counseling Process.

[] 852.271–73, Use and Publication of Counseling Results.

[] 852.271–74, Inspection.

[] 852.271–75, Extension of Contract Period.

[X] 852.273–70, Late Offers.

[] 852.273–71, Alternative Negotiation Techniques.

[] 852.273–72, Alternative Evaluation.

[X] 852.273–73, Evaluation—Health-Care Resources.

[] 852.273–74, Award without Exchanges.

(b) All requests for quotations, solicitations, and contracts for commercial item services to be provided to beneficiaries must include the following clause:

[X] 852.237–74, Nondiscrimination in Service Delivery.

(End of Clause)

C.4 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—

MONITORING AND COMPLIANCE (JUL 2018)

(a) This solicitation includes FAR 52.219-4 Notice of Price Evaluation Preference for HUBZone Small Business Concerns.

(b) Accordingly, any contract resulting from this solicitation is subject to the limitation on subcontracting requirements in 13 CFR 125.6, or the limitations on subcontracting requirements in the FAR clause, as applicable. The Contractor is advised that in performing contract administration functions, the Contracting Officer may use the services of a support contractor(s) retained by VA to assist in assessing the Contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to Contractor's offices where the Contractor's business records or other proprietary data are retained and to review such business records regarding the Contractor's compliance with this requirement.

(c) All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the Contractor's business records or other proprietary data reviewed or obtained in the course of assisting the Contracting Officer in assessing the Contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs.

(d) Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the Contractor to protect proprietary information as required by FAR 9.505-4, Obtaining access to proprietary information, paragraph (b). The Contractor is required to cooperate fully and make available any records as may be required to enable the Contracting Officer to assess the Contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

C.5 VAAR 852.219-77 VA NOTICE OF LIMITATIONS ON

SUBCONTRACTING—CERTIFICATE OF COMPLIANCE FOR SERVICES AND

CONSTRUCTION (SEP 2021) (DEVIATION)

(a) Pursuant to 38 U.S.C. 8127(k)(2), the offeror certifies that—

(1) If awarded a contract (see FAR 2.101 definition), it will comply with the limitations on subcontracting requirement as provided in the solicitation and the resultant contract, as follows:

(i) [] Services. In the case of a contract for services (except construction), the contractor will not pay more than 50% of the amount paid by the government to it to firms that are not VIP-listed SDVOSBs as set forth in 852.219-10 or VOSBs as set forth in 852.219-11. Any work that a similarly situated VIP-listed subcontractor further subcontracts will count towards the 50% subcontract amount that cannot be exceeded. Other direct costs may be excluded to the extent they are not the principal purpose of the acquisition and small business concerns do not provide the service as set forth in 13 CFR 125.6.

(ii) [] General construction. In the case of a contract for general construction, the contractor will not pay more than 85% of the amount paid by the government to it to firms that are not VIP-listed SDVOSBs as set forth in 852.219-10 or VOSBs as set forth in 852.219-11. Any work that a similarly situated VIP-listed subcontractor further subcontracts will count towards the 85% subcontract amount that cannot be exceeded. Cost of materials are excluded and not considered to be subcontracted.

(iii) [] Special trade construction contractors. In the case of a contract for special trade contractors, the contractor will not pay more than 75% of the amount paid by the government to it to firms that are not VIP-listed SDVOSBs as set forth in 852.219-10 or VOSBs as set forth in 852.219-11. Any work that a similarly situated subcontractor further subcontracts will count towards the 75% subcontract amount that cannot be exceeded. Cost of materials are excluded and not considered to be subcontracted.

(2) The offeror acknowledges that this certification concerns a matter within the jurisdiction of an Agency of the United States. The offeror further acknowledges that this certification is subject to Title 18, United States Code, Section 1001, and, as such, a false, fictitious, or fraudulent certification may render the offeror subject to criminal, civil, or administrative penalties, including prosecution.

(3) If VA determines that an SDVOSB/VOSB awarded a contract pursuant to 38 U.S.C. 8127 did not act in good faith, such SDVOSB/VOSB shall be subject to any or all of the following:

(i) Referral to the VA Suspension and Debarment Committee;

(ii) A fine under section 16(g)(1) of the Small Business Act (15 U.S.C. 645(g)(1)); and

(iii) Prosecution for violating section 1001 of title 18.

(b) The offeror represents and understands that by submission of its offer and award of a contract it may be required to provide copies of documents or records to VA that VA may review to determine whether the offeror complied with the limitations on subcontracting requirement specified in the contract. The Contracting Officer may, at their discretion, require the Contractor to demonstrate its compliance with the limitations on subcontracting at any time during performance and upon completion of a contract if the information regarding such compliance is not already available to the Contracting Officer. Evidence of compliance includes, but is not limited to, invoices, copies of subcontracts, or a list of the value of tasks performed.

(c) The offeror further agrees to cooperate fully and make available any documents or records as may be required to enable VA to determine compliance with the limitations on subcontracting requirement. The offeror understands that failure to provide documents as requested by VA may result in remedial action as the Government deems appropriate.

(d) Offeror completed certification/fill-in required. The formal certification must be completed, signed, and returned with the offeror’s bid, quotation, or proposal. The Government will not consider offers for award from offerors that do not provide the certification, and all such responses will be deemed ineligible for evaluation and award.

Certification:

I hereby certify that if awarded the contract, [insert name of offeror] will comply with the limitations on subcontracting specified in this clause and in the resultant contract. I further certify that I am authorized to execute this certification on behalf of [insert name of offeror].

Printed Name of Signee:________________________________________

Printed Title of…