36C26123Q0129_1.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

36C26123Q0129 03-21-2023

Cynthia Diezel 916-923-4567 04-05-2023

10:00 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

621492

$41.5 Million

N/A

Reference the Performance Work Statement

612MCP

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

FMS VA-9(101) Financial Services Center

PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page

Contractor shall provide Inpatient Hemodialysis and Outpatient Peritoneal Dialysis Services for the VA Sierra Nevada Health Care System in accordance with the Performance Work Statement

Services to be completed at Reno VA Medical Center located at 975 Kirman Ave, Reno, NV 89502

See Schedule at pages 6-15 See PWS at pages 16-29

Questions regarding this RFQ are due 03/28/2023 by 10:00 am PST by email to cynthia.diezel@va.gov

See CONTINUATION Page

X 1

Cynthia Diezel

CONTRACTING OFFICER

36C26123Q0129

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 PERFORMANCE WORK STATEMENT

B.4 IT SECURITY

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (DEC 2022)

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

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984) 54

C.8 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.9 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.10 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-OWNED SMALL

BUSINESS EVALUATION FACTORS—ORDERS OR BPAs (NOV 2022)

C.11 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-OWNED SMALL

BUSINESS EVALUATION FACTOR COMMITMENTS—ORDERS AND BPAs

NOV 2022

C.12 VAAR 852.228-71 INDEMNIFICATION AND INSURANCE (MAR 2018)

C.13 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE (OCT

2019)

C.14 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

C.15 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (DEC 2022)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2021)

E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.5 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.6 VAAR 852.252-70 SOLICITATION PROVISIONS OR CLAUSES INCORPORATED BY

REFERENCE (JAN 2008)

E.7 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003)

E.8 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES (DEC 2022)

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 Cynthia Diezel

Network Contracting Office (NCO) 21 5342 Dudley Blvd., Bldg. 209 McClellan CA 95652

c. ADMINISTRATION: Contract Specialist 36C261 Cynthia Diezel

Network Contracting Office (NCO) 21 5342 Dudley Blvd., Bldg. 209 McClellan CA 95652

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 in arrears

4. GOVERNMENT INVOICE ADDRESS: Invoices will be electronically submitted to the Tungsten website at http://www.tungstennetwork.com/uk/en/ Tungsten direct vendor support number is 877-489- 6135 for VA contracts. The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA-FSC.

This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. In order to successfully submit an invoice to VA- FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying

Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact:

Tungsten Support Phone: 1-877-489-6135

Website: http://www.tungsten-network.com/uk/en/ Department of Veterans Affairs Financial Service Center

Phone: 1-877-353-9791 Email: vafscched@va.gov

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

The Contractor shall furnish all personnel to provide services necessary to perform onsite Dialysis Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, VA Sierra Nevada Healthcare System (hereinafter referred to as VASNHCS).

The guaranteed minimum, for the contract is $1,000.00. The maximum of the contract, inclusive of ordering periods, shall not exceed $6,900,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

Place of Performance: Services shall be provided on site, VAMC Emergency Department (Basement Floor) @ VASNHCS, 975 Kirman Ave, Reno, NV 89502

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

800.00 EA __________________ __________________

Hemodialysis treatment up to 4 hours duration.

Contract Period: Ordering Period 1 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers PRODUCT/SERVICE CODE: Q999 - Medical - Other

MANUFACTURER PART NUMBER (MPN): N/A

450.00 EA __________________ __________________

Hemodialysis treatment beyond 4 hours; per 30 minutes.

Contract Period: Ordering Period 1 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

500.00 HR __________________ __________________

After hours or weekend/holiday Service

Contract Period: Ordering Period 1 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

300.00 EA __________________ __________________

Waiting time; Nurse waiting for patient, per 30 minutes.

Contract Period: Ordering Period 1 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

25.00 EA __________________ __________________

Chronic Peritoneal Dialysis Treatment (CCPD)

Contract Period: Ordering Period 1 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

15.00 EA __________________ __________________

Chronic Ambulatory Dialysis Treatment (CAPD)

Contract Period: Ordering Period 1 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Continuous Renal Replacement Therapy (CRRT) with support staff from vendor; inpatient, per day

Contract Period: Ordering Period 1 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

10.00 EA __________________ __________________

Plasmapheresis; inpatient and outpatient, per day

Contract Period: Ordering Period 1 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 2 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 2 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 2 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Waiting time; Nurse waiting for patient, per 30 minutes.

Contract Period: Ordering Period 2 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 2 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 2 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers from vendor; inpatient, per day

Contract Period: Ordering Period 2 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 2 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 3 POP Begin: 05-01-2025 POP End: 04-30-2026

Contract Period: Ordering Period 3 POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 3 POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 3 POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 3 POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 3

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers from vendor; inpatient, per day

Contract Period: Ordering Period 3 POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 3 POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 4 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 4 POP Begin: 05-01-2026 POP End: 04-30-2027

Contract Period: Ordering Period 4 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 4 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 4 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 4 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers from vendor; inpatient, per day

Contract Period: Ordering Period 4 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 4 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 5 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 5 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 5 POP Begin: 05-01-2027 POP End: 04-30-2028

Contract Period: Ordering Period 5 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 5 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 5 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers from vendor; inpatient, per day

Contract Period: Ordering Period 5 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

Contract Period: Ordering Period 5 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621492 - Kidney Dialysis Centers

GRAND TOTAL __________________

B.3 PERFORMANCE WORK STATEMENT

DIALYSIS SERVICES

Dialysis and VA Sierra Nevada Health Care System

1. Scope of Work:

The contractor shall provide all personnel, transportation, and equipment (machines must have dialysis alarm) to perform emergent and/or urgent dialysis services in the emergency department and/or inpatient setting at VA Sierra Nevada Health Care System (VASNHCS). The contractor shall provide the necessary nurses and certified technicians who have certifications, experience, knowledge, abilities, and skills in operating a dialysis machine to provide hemodialysis, CRRT (continuous renal replacement therapy), plasmapheresis, and PD (peritoneal dialysis) treatments to Veteran patients. Contractor shall maintain a minimum of five (5) Registered Nurses and three (3) Medical technicians fully credentialed by VASNHCS

All services will be performed at VASNHCS in the ICU/Stepdown Unit, Medical/Surgical Ward, in the Dialysis Suite, or ED (Emergency Department). Emergent and/or urgent services will be performed at any time, 24 hours/7 days a week. Routine services will be performed on a pre-scheduled basis during business hours. The services will be coordinated by the staff nurse at VASNHCS. The payment of services shall be per patient, per treatment/procedure. The contractor dialysis nurse/certified technician will generally consult with the Charge Nurse, Staff Nephrologist or Chief of Medical Service at VASNHCS when unusual circumstances arise. VASNHCS will provide physician oversight services and retain ultimate authority over and responsibility for each patient’s care and treatment.

Also included in this contract, the contractor is to provide a patient-pathways onsite liaison. The individual will coordinate education, post discharge care, outpatient clinic appointment and any necessary outpatient dialysis treatment. The liaison shall conform to VA policies in coordinating the services needed for the patient upon discharge. This may require understanding the processes of the VA social work, health care benefits, and other care services for veterans.

2. Specific Contractor Tasks include:

2.1. Perform all dialysis treatments that include Hemodialysis, CRRT, plasmapheresis, and PD with registered nurses/certified technicians in accordance with standard healthcare dialysis treatment procedure. Each nurse performing those services shall be responsible for the composition of the dialysate, administering IV solutions, blood and blood products including lab draws, and medications (as ordered by the VA attending physician) placed into the dialyzer blood line system necessary for inpatient treatments.

Contractor’s personnel shall be responsible for provision of the following ordered services:

Provide, set-up and safety check of machine and water treatment system;

initiating treatment, monitoring of treatment, and termination of treatment;

provide hand-off direct report, to the VA staff nurse for continuity of patient care;

and cleaning and disinfection of dialysis equipment and proper storage of machine and supplies.

Any changes in the laws, regulations, or VA/VHA policies or procedures governing the information covered by this section of the contract, during the term of this contract, shall be deemed to be incorporated into this contract.

2.2. Conduct all operator water testing and operator maintenance, including cleaning and disinfection of dialysis equipment. Contractor shall keep all water, cleaning and maintenance logs per regulatory compliance criteria. Contractor nurse shall be responsible for patient monitoring during the procedure.

2.2.1. Collect, process and test water specimens for bacterial growth, endotoxin, and heavy metal. The intervals for testing and the accepted level of water quality shall conform to AAMI standards.

2.2.2. The Contractor shall forward a copy of all water quality tests to the Infection Control Coordinator, Contracting Officer Representative (COR), and the Chief of Medicine Services or their designee at the VASNHCS. The Contractor shall be responsible, together with VA for any follow-up action required by the results of the bacteriological or chemical testing. Provide copy of water report in Dialysis room, per

JCAHO.

2.3. Provide 24 hours per day, seven days per week coverage as necessary, including holidays.

2.3.1. Respond to the VA facility within four (4) hours of calls for emergent dialysis from the ordering VA physician; ready to begin dialysis treatment. Emergent care coverage is 24 hours per day, seven days per week.

2.4. Provide hand-off report to the VA nurse for documentation of patient treatment. As a minimum documentation shall include 1) start time and completion time of treatment,

2) labs, including all Hepatitis Panel, 3) vitals, 4) site used, 5) procedure and schedule for bacteriological and chemical water testing, 6) procedure and schedule to assure sterility and/or cleanliness of the equipment before each dialysis, and 7) infection control procedure for the prevention and control of hepatitis. Also include medications, significant findings, and others.

2.4.1. Maintain patient information and medical records, including results of test, and follow appropriate procedures to ensure that patient confidentiality rights are not violated in accordance with applicable state and federal confidentiality laws.

2.4.2. Contractor personnel shall be provided training by the VA in the use of the CPRS;

and document appropriately. See Paragraphs 6, 7, 8, and 9 below for additional information regarding medical records.

2.5. The Contractor shall designate in writing a coordinator who shall facilitate scheduling, problem solving and other communication needs related to this contract. To facilitate an effective transition, the coordinator will work with the COR to process Contractor nurses into the facility. COR will then facilitate with human resources and VISN security office regarding personnel background/security check, fingerprinting, orientation, license verification, and employee health records. The Contractor is to keep 75% of their staff credentialed with the VA. The Contractor is to inform the VA of staffing changes to continue credentialing. The Contractor is to send monthly staffing report updates to the COR.

2.6. Provide summary results each quarter of quality control data on all VA dialysis patients. Individual patient data shall be required more frequently as requested.

2.7. The contractor shall assure compliance with all relevant regulatory agencies and standards for their personnel, including but not limited to The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the State of Nevada for all dialysis services rendered under this contract. The contractor shall at all times maintain full accreditation status through The Joint Commission. The contractor shall comply with the requirements of VA inspections and surveys that include the VA Office of the Inspector General (OIG), and others; and shall respond to request for information. The Contractor shall be notified immediately of any change to VA policies by the VA or The Joint Commission regarding the delivery or charting of inpatient/outpatient dialysis treatments to ensure compliance with the new policy. The contractor shall provide a letter of current accreditation to the COR and CO, upon award of contract and upon request.

2.8 The standard of care provided by the contractor shall be equal to or greater than that provided by VASNHCS.

2.9. The contractor shall notify VASNHCS Charge Nurse and the physician for any situations wherein the services cannot be performed, including equipment problems, and any situations wherein there may be a concern about the patient’s care.

2.10 The contractor shall provide documentation of patient pathways rendered to each patient.

3. Qualifications.

The contractor shall be responsible for ensuring that each registered nurse providing services under this contract is fully trained and completely competent to perform the required services covered by this contract. The contractor will be responsible for the Registered Nurses to maintain current Nevada licenses and shall be in good standing and practice with the standards of nursing care within the medical community. Copy of the competency record and completed training must be provided to VASNHCS. The Registered Nurses must have a Basic Life Support (BLS) certification. Documentation must be updated on an annual basis. Safety orientation will be completed for all contracted staff, while shadowing.

4. Specific VASNHCS Tasks.

4.1. Provide space for the Contractor to perform dialysis treatments at the VA facility.

4.2. Provide associated laboratory services.

4.3. Provide supplies necessary that are not provided by the Contractor as part of the treatment procedures, including blood and medications.

4.4. Safeguard and protect dialysis equipment and supplies owned by the Contractor while the equipment and supplies are on VA premises.

4.5. Provide patient information as requested by the Contractor that is reasonable and necessary in order to perform dialysis services.

4.6. Assume joint responsibility for any follow-up action required as a result of the bacteriological or chemical testing of the water. See Paragraph 2.2.2 above.

4.7. A qualified VA physician will be responsible for selection of suitable treatment modality and dialysis setting for each patient. The charge nurse for the respective patient care location, shall be the contact person for clinical issues relating to nursing.

4.8. Provide unit safety orientation for Contractor personnel newly assigned. Safety orientation will be provided before being assigned to do treatment procedure.

4.9. A cancelled procedure charge will be paid at the rate listed in the Price Schedule for cancelled service when a call is cancelled and the Contractor incurs a cost as a result of cancelled Services.

4.10. A charge will be paid when same day service is requested after regular working hours and at any time on weekends and holidays at the rate listed in the Price Schedule.

4.11. A nurse waiting time charge will be paid at the rate listed in the Price Schedule when initiation of services are delayed by the VA for more than 30 minutes with documentation for reason for the delay in CPRS.

5. Contractor Personnel Security Requirements - Information Systems Access

All contract employees will complete the PIV process.

5.1 Contractor Responsibilities. In order to conduct a background investigation, the Contractor shall submit the following required forms to the COR. These will eventually be submitted to the Human Resources Management Service (HR) for processing. This will include the requirements for fingerprinting and badge issuance.

5.1.1. VA Form 10-2850a, Application for Nurse Positions

5.1.2. Optional Form 306, Declaration for Federal Employment

5.1.3 Optional Form 612, Optional form for Federal Employment

5.1.4 Electronic Fingerprint Verification OR FD 258, U.S. Department of Justice Fingerprint Applicant Chart

6. Access to and Safeguard of VA Information/Computer Systems

6.1. VA may provide contract personnel with access to Computerized Patient Records System (CPRS) and/or other general files maintained on VA computer systems via personalized VA access codes. These access codes are confidential and are to be protected by the end user. Sharing of these access codes or misuse of VA information/computer systems is a Federal crime and may result in criminal penalties.

When contract personnel no longer provides services to VA under the contract or no longer needs access to VA information systems, the Contractor shall immediately inform the COR so that the appropriate contract person’s access codes can be deactivated. The COR will be responsible for ensuring that such access codes are deactivated.

6.2. All contract personnel accessing CPRS, or any other VA information/computer system, will be required to complete the following VA training: Computer Security, Rules of Behavior, Privacy Act, and HIPAA annually and sign all applicable computer user agreements (e.g. Rules of Behavior) prior to accessing VA systems. The COR will be responsible for ensuring and documenting that this requirement is satisfied. Contract personnel shall maintain, access, release, and otherwise manage the information contained on VA information/computer systems in accordance with all VA/VHA security policies, applicable VA confidentiality statutes (Title 38 U.S.C. Section 5701 and Title 38 U.S.C Section 7332) and the respective regulations implementing these statutes, and Federal statutes and/or regulations applicable to Federal agency records. Copies of this information discussed in the aforementioned paragraphs can be provided to the Contractor and contract personnel upon request.

6.3. Contract personnel with access to VA information/computer systems shall take reasonable safeguards, both physical and electronic, to safeguard the information and prevent unauthorized disclosures. Should contract personnel know, or suspect, that VA information/computer security was compromised or that VA information was, or could possibly be, disclosed to an unauthorized party, contract personnel must immediately report such knowledge or suspicion to the COR, who will then immediately notify the appropriate VA officials.

6.4. The Contractor shall follow all of the previously mentioned statutes and respective regulations implementing these statutes as well as VA Directive 6504 - Restrictions on Transmission, Transportation and Use of, and Access to VA Data Outside a VA Facility, VA Directive 6601 – Removable Storage Media, and any other VA/VHA policies and procedures governing the information discussed in this section of the contract. Copies of the information discussed in the aforementioned paragraphs may be viewed by contract personnel in the Office of Information Security (see the Information Security Officer).

6.5. Any changes in the laws, regulations, or VA/VHA policies or procedures governing the information covered by this section of the contract, during the term of this contract, shall be deemed to be incorporated into this contract.

7. Computerized Patient Records System (CPRS)

7.1. Contract personnel are required to provide information on the treatment procedure for all patients. This is provided to the VASNHCS staff which will be entered in the

CPRS.

7.2. The staff Nephrologist will be responsible for ensuring and documenting that these requirements are satisfied. If information for documentation in is not properly provided, VA reserves the right to withhold payment to the Contractor until such records are properly documented.

8. Handling of Records

8.1. By performing services under this contract, the Contractor is considered part of the VA healthcare activity for purposes of the following statutes and respective regulations implementing these statutes: Title 5 U.S.C Section 552a (Privacy Act), Title 38 U.S.C.

Section 5701, Title 38 U.S.C. Section 5705, Title 38 U.S.C Section 7332, and Public Law 104-191 (HIPAA). Contract personnel shall have access to patient medical records and general files only to the extent necessary to perform their contractual duties.

Contract personnel shall only release medical information obtained during the course of this contract to those VA medical staff members involved in the necessary care and treatment of the individual patient in which the information pertains. Notwithstanding any other clause and/or provision of this contract, if a request for release or disclosure of information is not necessary for the care and treatment of an individual patient, the Contractor and contract personnel shall not disclose any information contained in general files, patient records, and/or any other individually identifiable health information, including information and records generated by the Contractor in performance of this contract, except pursuant to explicit instruction and written approval from VA. For the purposes of this paragraph, instruction to disclose or copy such records and/or information may only be provided by the following: VA Regional Counsel and Chief, Health Information Management Service/Privacy Officer through the VA Contracting Officer. Violation of the aforementioned statutes may result in criminal and/or civil penalties.

8.2. Contract personnel who obtain access to hardware or media which may manipulate or store drug or alcohol abuse data, sickle cell anemia treatment records, records or tests or treatment for or infection with HIV, medical quality assurance records, or any other sensitive information protected under the statues and implementing regulations previously mentioned in paragraph 6, above, shall not have access to the records unless absolutely necessary to perform their contractual duties. Any contract person who has access to the previously mentioned data and/or information must not disclose it to anyone, including other contract personnel not involved in the performance of the particular contractual duty for which access to this data and/or information was obtained.

8.3. Information or records accessed and/or created by the Contractor in the course of performing services under this contract are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable federal law, regulations, and/or VA/VHA policy. The Contractor will not copy information contained in VA information systems, either by printing to paper or by copying to another digital format, without the explicit instruction and written approval from of the VA officials, except as is necessary to make single copies in the ordinary course of providing patient care. The Contractor will not commingle the data from VA information systems with information from other sources. Contractor shall report any unauthorized disclosure of VA information to the VA officials.

8.4. If this contract is terminated for any reason, the Contractor will provide VA with all individually identifiable VA patient treatment records or other information in its possession, as well as any copies made pursuant to paragraph 6 above, within seven

(7) calendar days of the termination of this contract.

8.5. The Contractor shall follow all VA policies regarding the retention of records. As an alternative, the Contractor may deliver the records to VA for retention.

8.6. The Contractor shall follow all of the previously mentioned statutes and respective regulations implementing these statutes as well as VHA Handbook 1605.1 - Privacy and Release of Information and any other VA/VHA policies and procedures governing the information discussed in this section of the contract. Copies of the information discussed in the aforementioned paragraphs may be viewed by contract personnel in the Office of Health Information Management (see the Privacy Officer). All contract personnel with access to any of the previously mentioned records (electronic or paper) will be required to complete VHA Privacy Policy Training before accessing such record systems. This training must also be completed annually. The COR will be responsible for ensuring and documenting that this requirement is satisfied.

8.7. Any changes in the laws, regulations, or VA/VHA policies or procedures governing the information covered by this section of the contract, during the term of this contract, shall be deemed to be incorporated into this contract.

8.8. VA has unrestricted access to the records generated by the contractor pursuant to this contract.

9. HIPAA Compliance

Under HIPAA Privacy and Security Rules, the Contractor providing services under this contract is considered to be a “covered entity,” and thus is not required to enter into a Business Associate Agreement with VA. However, the Contractor must observe Public Law 104-191 and all respective regulations implementing this law while providing services under this contract.

10. Invoicing and Payment:

10.1. A record-keeping system of the contractor’s services performed shall be established by VASNHCS. Payment made during all periods of performance of this agreement shall constitute the total cost for services rendered by the contractor, and shall not exceed the amounts specified in the “Schedule of Supplies and Services” without written request and the written approval from the Contracting Officer.

10.2. Invoices rendered by the contractor to VASNHCS for services furnished under this agreement, will be invoiced in full for each month in which services were performed.

All payments made under this contract will be made monthly in arrears in accordance with FAR Clause 52.212-4. No advance payments will be authorized. Invoices shall be electronically sent using the form OB10 e-Invoice to the Department of Veterans Affairs, PO Box 149971 Financial Services Center, Austin, TX. For more information on how to send invoices electronically, visit http://www.fsc.va.gov.

10.3. Invoices submitted will show the dates of the services, patient, type of dialysis or service provided. All invoices applicable to this agreement must be submitted no later than thirty (30) days after the end of the contract period. Any problems regarding unpaid invoices should be directed to the COR.

10.4. At a minimum, each invoice must contain the following: Patient name, dates and hours of services provided, unit price, and total cost of services provided, contract number, and remittance address. All invoices must include the name, title and phone number of person to be notified in the event of defective invoicing.

10.5. All invoices must be submitted for actual services performed by the contractor.

Invoices shall be submitted in accordance with, and at the prices specified in the continuation of SF Form 1449, Schedule of Supplies and Services of this agreement.

11. Quality Assurance and Contract Performance Monitoring:

11.1. In accordance with VA regulations, a record-keeping system will be established and maintained by the COR to ensure contract compliance. The contractor will provide the quality assurance information during the joint oversight meeting with the contractor.

11.2. The contractor will provide copies of charge sheet with the patient information, date, etc. to be used for reconciliation with CPRS records, these in turn will be verified for certification of invoices by the COR for payment of services.

11.3. Contractor agrees to provide services which meet or exceed the standards as established by The Joint Commission and the Department of Veterans Affairs policies.

11.4. The services specified herein may be changed by mutual written agreement of the parties, in accordance with the terms and conditions set forth herein.

12. Safety Orientation:

12.1. Contractors who have not received a safety orientation shall be oriented to the VASNHCS, prior to providing services. Safety orientation will be properly documented, and VA Staff will assess the competency of the contract nurses.

13. Terms of the Agreement:

13.1. This agreement is effective for the period identified in the “Schedule of Supplies and Service” and is subject to the availability of VA funds. Services will not be performed by the contractor beyond the expiration date, unless specifically authorized to do so in writing by the Contracting Officer.

13.2. Contractor personnel performing services under this agreement will not be considered VASNHCS employees for any purpose. VA will not make payment for any holidays or leave including sick leave or any other benefits financial or other. In addition, the contractor shall be required to provide their own worker’s compensation, liability insurance, health examinations, income tax withholdings and social security payments.

14. Estimated Quantities:

The quantities of services and cost specified in this agreement are estimates, based upon the projected workload during the period of performance. VASNHCS will not be obligated to reimburse the contractor for any specified amount of services; but will be obligated to make payment for any services received in the quality and quantity as requested.

15. VASNHCS Responsibilities:

15.1. After award, the Contracting Officer will designate a VA employee as the Contracting Officer’s Representative (COR). The COR will be responsible for overseeing and directing the services to be performed by under this agreement.

15.2. Other necessary personnel for performance of the services at the VASNHCS, will be provided by the VASNHCS at levels mutually agreed upon which are compatible with the safety of patients and personnel and with quality medical care programming.

Adequate and appropriate support staff will be available to assist the contract nurses.

15.3. Other personnel and equipment necessary for the operation of the services provided will be provided by the VA at levels compatible with the safety of patients, staff, and quality medical care programming. In the event that the contractor deems that the staffing, facilities, equipment, supplies and/or ancillary services at the VASNHCS site are materially inadequate for the satisfactory performance of services, the contractor will so notify VASNHCS COR and the Contracting Officer in writing.

16. Emergency Health Services:

16.1 The VA will render emergency health services for an incapacitating injury or otherwise serious illness occurring while on duty. All services, to include wages earned during the period of initial medical evaluation provided by the VA, shall be reimbursed by the contractor. The contractor shall furnish the VA with the necessary injury/illness form(s) for reporting purposes. The VA for statistical and/or billing purposes will retain a copy of the complete form(s).

17. Infection Control Requirements:

17.1. Health Tests – Contractor attests that he/she has fulfilled all testing and screening requirements as described below prior to providing services at first duty shift.

Evaluations and tests shall be current within the past year, except as noted. At VA’s request, the contractor shall provide proof that all requirements are current and fully met as described, within 2 days of request.

18. Tuberculosis Screening and Testing -

18.1 For those with previous documented positive purified protein derivative (PPD) test results: All contractor personnel shall provide a note from their physician, dated within the past three months stating they are free of any signs and symptoms of tuberculosis.

This evaluation will be renewed annually.

18.2. For those with previously negative PPD skin test results: personnel shall provide proof of a negative reaction to PPD testing, performed in accordance with the latest

CDC standards and CDHS/California Tuberculosis Controllers Association guidelines, with the past six (6) months. This test shall be renewed annually.

18.3. For PPD skin converters (a change from a previously negative skin test to positive; defined as an increase in duration of 10mm or more within 2 years): An evaluation from their physician within 30 days of the positive test stating they are free from signs/symptoms of TB and indicating whether prophylactic treatment is indicated. If treatment is indicated, a note from the physician stating it was satisfactorily completed.

18.4. Rubella Testing - All contractor personnel shall provide proof of immunization for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation provided to the

COR.

18.5. Varicella (chicken pox) testing -. Provide a history' of varicella or, if unknown, results of a varicella antibody test; and if non-immune, vaccination with varivax.

18.6. Hepatitis B (Hepatitis B-Surface Antibody Titer).

18.7. The contractor will provide documentation of all their employees Hepatitis B vaccinations records.

18.8. Unvaccinated contractor employees will be offered Hepatitis B vaccine at no cost to the contractor. A signed consent or declination forms is required in the employee refuses vaccination.

18.9. COVID-19 vaccine is required.

18.10. The contractor shall have completed basic life support (BLS) training.

19. OSHA Regulations - Occupational Exposure to Blood Borne Pathogens:

19.1 Health Tests - Contractor personnel shall provide, upon VASNHCS request to review, proof of the following tests within five (5) days prior to providing services. Tests shall be current within the past year.

19.2 Tuberculosis Testing - All Contractor personnel shall provide proof of a negative reaction to purified protein derivative (PPD) testing. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

19.3 Rubella Testing - All contractor personnel shall provide proof of immunization for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization must be administered with follow-up documentation to the COR.

19.4. OSHA regulation concerning occupational exposure to blood-borne pathogens - The contractor shall provide a generic self study training module to its personnel;

provide Hepatitis B vaccination series at no cost to its personnel who elect to receive it;

maintain and distribute an exposure determination and control plan to its personnel;

maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

19.5. Contracted nurses shall receive training in universal precautions and blood borne pathogens, TB education, hazardous material management and life safety management (fire preparedness). Training will be provided prior to initial assignment, at annually thereafter and as needed.

19.6 VA will notify the contractor of any significant communicable disease exposures as appropriate. The contractor’s occupational health provider shall adhere to current CDC/HICPAC Guideline for “infection control” in health care personnel (AJIC 1998;

26:289-354) for disease control. The contracting agency shall provide follow up documentation of employee’s clearance to return to the workplace prior to their return.

20. Identification, Parking, Smoking and VA Regulations:

20.1. Contractor personnel shall wear visible identification at all times while on the premises of any VA facility.

20.2. It is the responsibility of contractor personnel to park in the appropriate designated parking areas. Information on parking is available from VA Police. VA will not validate or make reimbursement for parking violations under any conditions.

20.3. Smoking is prohibited in any VASNHCS building and the surrounding grounds, including the parking lots. Smoking is permitted only in a designated shelter.

20.4. Intoxication, debilitation resulting from drug use, insubordination, theft, patient abuse, dereliction or negligence in performing directed tasks and possession of weapons is prohibited and grounds for immediate removal from VA facility. Enclosed containers, of any nature, are subject to search.

20.5. Violations of VA regulations may result in a citation answerable in the U.S.

Federal District Court, not a local district, state or municipal court.

End of Statement

VHA Supplemental Contract Requirements for Combatting COVID-19

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

a. Documentation requirements:

1) If fully vaccinated, contractors 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, contractors 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 that includes an affiliated telehealth service.

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.

4. For indefinite delivery contracts: Contractor agrees to comply with VHA Supplemental Contract Requirements for any task or delivery orders issued prior to this modification when performance has already commenced.

VA Handbook 6500.6, Contract Security

APPENDIX C

B.4 IT SECURITY

VA INFORMATION AND INFORMATION SYSTEM

SECURITY/PRIVACY LANGUAGE FOR INCLUSION INTO

CONTRACTS, AS APPROPRIATE

1. GENERAL

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

2. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS

a. A contractor/subcontrator shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order.

b. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures.

c. Contract personnel who require access to national security programs must have a valid…