36C26126Q0568_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

662-26-1-412-0011

36C26126Q0568 04-30-2026

Cynthia Diezel cynthia.diezel@va.gov 916-923-4567 05-15-2026

10AM PDT

612MCP

Department of Veterans Affairs

Network Contracting Office (NCO) 21

X 100

X

561320

$34 Million

N/A

Reference the Performance Work Statement

612MCP

FMS VA-9(101) Financial Services Center

PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

Contractor shall provide 1.0 FTE Cardiothoracic Physician

Assistant. The requirement shall not exceed 6 hours per day, two days per week in accordance with the Performance

Work Statement.

Period of Performance: 07/01/2026 - 06/30/2031

Base Year: 07/01/2026 - 06/30/2027

Option Year 1: 07/01/2027 - 06/30/2028

Option Year 2: 07/01/2028 - 06/30/2029

Option Year 3: 07/01/2029 - 06/30/2030

Option Year 4: 07/01/2030 - 06/30/2031

See CONTINUATION Page

640-3670160-034-822300-2560 010022300

Cynthia Diezel

Contracting Officer

36C26126Q0568

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 CONTRACT SECURITY

SECTION C - CONTRACT CLAUSES

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

C.2 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.3 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.4 52.222-90 Addressing DEI Discrimination by Federal Contractors

C.5 52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS (NOV 2025)

(DEVIATION)

C.6 52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES (NOV 2020)

C.7 VAAR 852.204-72 PERSONNEL VETTING AND CREDENTIALING (MAR 2026)

(DEVIATION)

C.8 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.9 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

C.10 SUPPLEMENTAL INSURANCE REQUIREMENTS

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 52.212-2 Evaluation—Commercial Products and Commercial Services. (DEVIATION) OCT

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS(DEVIATION)

(NOV 2025)

E.4 52.219-1 SMALL BUSINESS PROGRAM REPRESENTATIONS (NOV 2025)

(DEVIATION)

E.5 52.233-2 Service of Protest

E.6 52.240-90 SECURITY PROHIBITIONS AND EXCLUSIONS REPRESENTATIONS

AND CERTIFICATIONS (NOV 2025) (DEVIATION)

E.7 52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS (NOV 2020)

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

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:

mailto:vafscched@va.gov

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

624.00 HR __________________ __________________

CTPA Services

Two days per week, 6 hours per day

Contract Period: Base POP Begin: 07-01-2026 POP End: 06-30-2027 PRINCIPAL NAICS CODE: 561320 - Temporary Help Services PRODUCT/SERVICE CODE: Q524 - Medical - Cardiothoracic Surgery

MANUFACTURER PART NUMBER (MPN): N/A

Contract Period: Option 1 POP Begin: 07-01-2027 POP End: 06-30-2028 PRINCIPAL NAICS CODE: 561320 - Temporary Help Services PRODUCT/SERVICE CODE: Q524 - Medical - Cardiothoracic

Contract Period: Option 2 POP Begin: 07-01-2028 POP End: 06-30-2029 PRINCIPAL NAICS CODE: 561320 - Temporary Help Services PRODUCT/SERVICE CODE: Q524 - Medical - Cardiothoracic

Contract Period: Option 3 POP Begin: 07-01-2029 POP End: 06-30-2030 PRINCIPAL NAICS CODE: 561320 - Temporary Help Services

PRODUCT/SERVICE CODE: Q524 - Medical - Cardiothoracic

Contract Period: Option 4 POP Begin: 07-01-2030 POP End: 06-30-2031 PRINCIPAL NAICS CODE: 561320 - Temporary Help Services PRODUCT/SERVICE CODE: Q524 - Medical - Cardiothoracic

GRAND TOTAL __________________

B.3 PERFORMANCE WORK STATEMENT

Cardiothoracic PA Assistant Services

1. GENERAL:

1.1. Services Provided: The contractor shall provide Cardiothoracic

Physician Assistant (CTPA) Services on site and in accordance with the terms and conditions contained herein to beneficiaries of the

Department of Veterans Affairs (VA), and the VA San Francisco

Health Care System (SFVAHCS).

1.2. Critical services include: endoscopic radial and saphenous vein harvesting (must have documented experience of >100 endoscopic procedures in each location); ultrasound guided arterial and venous access for central line placement; chest tube and pigtail insertion and removal; insertion and removal of Swan-Ganz catheter, removal of pacing wires, cardioversion, performance of first and second assistant responsibilities in cardiothoracic surgery in the operating room, as well as bedside assistant for robotic procedures.

1.3. Place of Performance - Contractor shall furnish services at the San

Francisco Veterans Affairs Health Care System, 4150 Clement Street, SF, CA 94121.

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

1.5. Policy/Handbooks - The contractor shall be subject to the following policies, including any subsequent updates during the period of performance: (include

Handbook 5005 PA Qualifications and Directive 1063 PA Utilization )

1.5.1. VA Directive 1663: Health Care Resources Contracting - Buying https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.5.2. VHA Directive 2010-018 “Facility Infrastructure”

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227

1.5.3. VHA Directive 1192 “Seasonal Influenza Prevention Program” https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472

1.5.4. VHA Handbook 1100.17: National Practitioner Data Bank Reports -https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.5.5. VHA Handbook 1100.18 Reporting And Responding To State Licensing

Boards -https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.5.6. VHA Handbook 1100.19 Credentialing and Privileging -

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.5.7. VHA Handbook 1907.01 Health Information Management and Health

Records:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

1.5.8. Privacy Act of 1974 (5 U.S.C. 552a) as amended

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5.9. Joint Commission – http://www.jointcommission.org/standards/

1.5.10. HHS OIG Website –

http://oig.hhs.gov/exclusions/index.asp https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.jointcommission.org/standards/ http://oig.hhs.gov/exclusions/index.asp

1.5.11. American Journal for Infection Control - AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

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

Definitions and other sections of this contract, the language in this section shall govern.

1.6.1. NCCA National Commission on Certification of Physician Assistants

1.6.2. ACGME: Accreditation Council for Graduate Medical Education

1.6.3. ACLS: Advanced Cardiac Life Support

1.6.4. BLS: Basic Life Support

1.6.5. CDC: Centers for Disease Control and Prevention

1.6.6. CDR: Contract Discrepancy Report

1.6.7. CEU: Certified Education Unit

1.6.8. CME: Continuing Medical Education-

1.6.9. CMP: Civil Monetary Penalty

1.6.10. CMS: Centers for Medicare and Medicaid Services

1.6.11. CO: Contracting Officer – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

1.6.12. COR: Contracting Officer’s Representative – A person appointed by the

CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non- compliance in order that appropriate action can be taken.

1.6.13. COS: Chief of Staff

1.6.14. CPARS: Contractor Performance Assessment Reporting System

1.6.15. DEA: Drug Enforcement Agency

1.6.16. ED: Emergency Department

1.6.17. ECMO: Extracorporeal Membrane Oxygenation

1.6.18. EHR: Electronic Health Record - electronic health record system used by the VA

1.6.19. EMR: Electronic Medical Record

1.6.20. FSMB: Federation of State Medical Boards

1.6.21. FTEE: Full Time Equivalency Employee is defined by VA as a minimum of 80 hours every two weeks and does not include holidays

1.6.22. HHS: Department of Health and Human Services

1.6.23. HIPAA: Health Insurance Portability and Accountability Act

1.6.24. HR: Human Resources

1.6.25. ISO: Information Security Officer

1.6.26. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health

Administration must use NPIs in all HIPAA- standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.6.27. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf http://www.nlnac.org/

1.6.28. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors.

1.6.29. NP: Nurse Practitioner

1.6.30. NPPES: National Plan and Provider Enumeration System

1.6.31. OSHA: Occupational Safety and Health Administration

1.6.32. OIT: Office of Information and Technology

1.6.33. OPM: Office of CTPA Management

1.6.34. OPPE: Ongoing Provider Practice Evaluation

1.6.35. OR: Operating Room

1.6.36. PA: Physician Assistant/Associate

1.6.37. PIV: Personal Identity Verification

1.6.38. POP: Period of Performance

1.6.39. PPD: Purified Protein Derivative

1.6.40. PWS: Performance Work Statement

1.6.41. QASP: Quality Assurance Surveillance Plan

1.6.42. RFP: Request for Proposal

1.6.43. VAMC: Veterans Affairs Medical Center

1.6.44. Veterans Health Administration (VHA): The central office for administration of the VA medical centers throughout the United States.

The VHA is located in Washington, D.C.

1.6.45. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.

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

1.6.47. VetPro: a federal web-based credentialing program for healthcare providers.

1.6.48. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA Medical Center, for the purpose of this contract, this term shall mean the San Francisco Veterans Affairs Health Care System.

2. QUALIFICATIONS

2.1. Staff/Facility – The contractor shall provide a CTPA who can work in the operating room two days per week, 6 hours per day located at the

SFVAHCS.

2.1.1. License - All licenses held by the CTPA working on this contract shall be full and unrestricted license to the services covered by this contract issued in any State, Territory, or Commonwealth of the

United States or the District of Columbia. Contract CTPA shall submit evidence of current, full and unrestricted licenses, registration, certification, and/or other relevant credentials for verification prior to appointment and throughout the employment process, as requested by the COR. Contractor is responsible for keeping the COR informed of anything that would adversely affect or otherwise limit their clinical privileges. Failure to meet this requirement may result in termination of the contract.

2.1.2. Board Certification – The contractor’s employees and any subcontractors shall have all licenses, permits, and certifications as required by law and this contract.

2.1.3. Credentialing and Privileging - Contract CTPA fulfilling the conditions of the contract shall be subject to all bylaws, rules and regulations of the VAHCS. Each CTPA must be found acceptable by the Medical

Executive committee and Governing Body. Credentialing and privileging through the Medical Staff Office is required. (PAs must be credentialed under a PA SOP). The ability for an individual CTPA to continue to render services under the contract shall be dependent upon demonstration of clinical competence. Clinical competency shall be assessed on an ongoing basis, is true for all CTPA’s and to the reported as provider specific practice information at the time or an accreditation body with equal or better standards Joint Commission.

2.2. Technical Proficiency - The Section Chief of Cardiothoracic Surgery at the SFVA is the program manager of this contract and has the right to replace any CTPA that is not performing to standards set forth by the contract terms. All CTPAs shall be vetted by the program manager prior to working under the contract. Contract personnel (s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract CTPA(s) and contract CTPA (s) shall be responsible for abiding by the Facility's

Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior. Necessary proficiencies include:

endoscopic radial and saphenous vein harvesting (must have documented experience of >100 endoscopic procedures in each location); ultrasound guided arterial and venous access for central line placement; chest tube and pigtail insertion and removal; insertion and removal of Swan-Ganz catheter, removal of pacing wires, cardioversion, performance of first and second assistant responsibilities in cardiothoracic surgery in the operating room, as well as bedside assistant for robotic procedures.

2.2.1. Continuing Medical Education (CME)/ Certified Education Unit (CEU)

Requirements: Contractor shall provide the COR copies of current

CMEs as required or requested by the VAMC. Contract CTPA (s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current.

Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract CTPA (s). Tracking is kept and can be checked by employer at the National Commission on Certification of Physician Assistants

(NCCPA) website. PAs are certified every 2 years under NCCPA.

2.2.2. Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s PA(s) as required by the VA.

Other training may become required. VA will communicate any changes to the training requirement to the contractor.

Training Frequency (once a year, etc)

Annual Hours

Prevention of Workplace Harassment/No Fear Act

Annually 1.5

VA Privacy and Information

Security Awareness and Rules of Behavior

Annually 1

VHA Privacy and HIPAA Focused Training

Annually 1

2.2.3. Standard CTPA Testing (PPD, etc.): Contractor shall provide proof of the following tests within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

2.2.3.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s PA’s {This is applicable to all health care workers}. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results.

The TST or IGRA testing shall be repeated annually.

2.2.3.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor PA’s {This is applicable to all health care workers}.

2.2.3.3. VARICELLA: Contractors shall provide proof of immunity for all

Contractor PA’s {This is applicable to all health care workers}.

2.2.3.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor PA’s {This is applicable to all health care workers}.

2.2.3.5. INFLUENZA: Contractors shall provide proof that all Contractor PA’s have received the annual Influenza vaccine unless it is contraindicated. If the Contractor PA has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.2.3.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE

TO BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s PA(s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.2.3.7. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current

CDC/HICPAC Guideline for Infection Control in health care CTPA ( as published in American Journal for Infection Control- AJIC 1998;

26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.2.4. National Provider Identification (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health

Administration must use NPIs in all HIPAA- standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services

(CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.2.5. Conflict of Interest: The Contractor and all contract CTPA (s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70

Organizational Conflicts of Interest (Jan 2008) and fully outlined in http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf response to the subject attachment in Section D of the solicitation document.

2.2.6. Citizenship related Requirements:

2.2.6.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality

Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs

Enforcement and the U.S Department of Labor as these may relate to non- immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to

Department of Veterans Affairs patient referrals;

2.2.6.2. While performing services for the Department of Veterans Affairs, the

Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, because of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent

Amendments, as well as applicable Federal Acquisition Regulations.

2.2.6.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of

Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs

Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the

Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.2.6.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.2.6.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.2.7. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the

Department of Health and Human Services (HHS) Office of Inspector

General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.2.7.1. Therefore, Contractor shall review the HHS OIG List of Excluded

Individuals/Entities on the HHS OIG web site referenced above to ensure that the proposed contract PA (s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty

(CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.2.7.2. By submitting their proposal, the Contractor certifies that the HHS OIG

List of Excluded Individuals/Entities has been reviewed and that the

Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2.8. Clinical/Professional Performance: The qualifications of Contractor

CTPA are subject to review by the program manager. In especially difficult cases, the program manager can select the most knowledgeable staff to work those cases. Clinical/Professional performance monitoring and review of all clinical CTPA covered by this contract for quality purposes will be provided by the program manager, VAMC COS and/or the Chief of the Service or his designee. A clinical

COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non- Personal Healthcare Services: The parties agree that the

Contractor and all contract CTPA (s) shall not be considered VA employees for any purpose.

2.4. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.

2.5. Prohibition Against Self-Referral: Contractor’s PAs are prohibited from referring VA patients to contractor’s or their own practice(s).

2.6. Inherent Government Functions: Contractor and Contract CTPA(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No Employee status: The Contractor shall be responsible for protecting

Contract CTPA(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations to include:

2.7.4. Annual TB Skin Test and recent chest X-ray if there is a history of positive

TB skin test

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

2.7.6. Evidence of a Hepatitis C titer

2.7.7. Varicella titer if contracted employee has not had chicken pox

2.7.8. Income tax withholding, and

2.7.9. Social security payments

2.8. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract CTPA (s). When a Contractor or contract CTPA (s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract provider (s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Emergency Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key CTPA unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar days after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions. No substitutions shall be made without Chief of Cardiothoracic Surgery vetting. The substitution must be proctored by the senior CTPA and cleared by the Chief of CT surgery prior to working the case.

2.9.1. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key

CTPA.

2.9.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive workdays or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.9.3. The Government reserves the right to refuse acceptance of any

Contractor CTPA at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal CTPA regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contract CTPA (s), s/he may request, without cause, immediate replacement of said contract CTPA(s).

2.9.4. The CO and COR shall deal with issues raised concerning Contract

CTPA (s) conduct. The final arbiter on questions of acceptability is the program manager or Chief of Cardiothoracic Surgery who can best attest to the clinical competence of the staff in question.

2.9.5. Contingency Plan: Because continuity of care is an essential part of

VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the contract CTPA (s) leaves

Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

2.9.6. Note: Evidence of completion of required licensure, credentials, required training, current competencies and background investigations must be validated for all contractor CTPA referred to perform services under this contract prior to providing direct patient care. Contractor shall not have any CTPA report to duty until written notification is received from the Contracting Officer advising that the candidate (s) presented has met all requirements for contract performance.

3. HOURS OF OPERATION:

3.1.1. VA Business Hours: VA business hours/hours of operation are

Monday through Friday, 8:00 a.m. – 4:30 p.m.

3.1.2. Work Schedule: Services shall be available from the Contractor 2 days per week, 6 hours per day.

3.1.3. Off-hours Coverage: There is no off-hours coverage required

3.2. Federal Holidays:

• New Year’s Day

• Martin Luther King’s Birthday

• President’s Day

• Memorial Day

• Juneteenth Day

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving Day

• Christmas Day

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

3.3. Cancellations: Cancellations must be made to the Chief of Surgical

Service and COR at least 30 days in advance of the first business day that the cancellation begins.

3.4. Unless a state of emergency has been declared or clinics are otherwise cancelled by the VAMC, the Contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES:

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

4.1.1. Contract personnel (s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

4.2. Standards of Care: The contractor’s CTPA (s)’ care shall cover the range of CTPA services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1. American Board of Physician Assistants: https://www.aapa.org/

4.2.2. The professional standards of The Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

4.2.3. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

4.2.4. The requirements contained in this PWS

4.3 MEDICAL RECORDS

4.3.1 Authorities: Contract personnel (s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5

U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance

Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. §

522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164

(HIPAA).

4.3.2 HIPAA: This contract and its requirements meet exception in 45 CFR

164.502(e), and do not require a BAA for Covered Entity to disclose

Protected Health Information to:

a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered https://www.aapa.org/ http://www.jointcommission.org/standards_information/standards.aspx http://www.hpoe.org/resources?show=100&type=8 by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA10P2).

Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the

Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

4.3.3 Disclosure: Contract personnel (s) may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health

Information management and Health Records and VHA Directive

1605.01, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.3.4 Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA

Handbook 1907.01 Health Information Management and Health

Records:

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAMC.

4.3.5 Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the

VA authorizing the Contractor to release patient information, the

Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to

Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the

Contractor with assistance in completing forms. Additionally, the

Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332.

http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

4.3.6 Confidentiality - VA will provide the contract CTPA (s) access to pertinent patient medical information, within the existing privacy rules and regulations, for the purpose of providing coordinated comprehensive primary care. Contract CTPA (s) shall ensure the confidentiality of all patient information and shall be held liable in the event of the breach of confidentiality.

4.3.7 Personal Identity Verification (PIV) - Contract personnel (s) shall participate in computer security and documentation training as is all

CTPA practicing within the VA Medical Center. Contract CTPA (s) shall comply with facility requirements to obtain personal security investigations, installation access and participate in the computer security and documentation training.

4.3.8 Contract personnel (s) shall provide medical record documentation in accordance with rules and regulations of the medical staff and medical staff by laws. Reference Policy Memorandum No. 136-1, Change 2 to Appendix B dated Sept. 29, 2000, Control of Medical

Records and in accordance with Policy Memorandum 136-1, Change 2 to Appendix A dated September 29, 2000, Completion of

Medical Records.

4.3.9 Records created by contract personnel (s) in the course of treating VA patients under this agreement are the property of the VA and shall not be accessed, released, transferred or destroyed except in accordance with applicable federal law and regulations. Contract personnel (s) shall maintain computer access and prepare for cases the following day by obtaining the patient information and record within the current electronic health record system for review.

4.3.10 Contract CTPA(s)shall participate in quality improvement projects, initiatives, and reporting as requested/required.

4.3.10.1 VA utilizes a fully automated electronic medical record. The

EMR consists of two primary components. The first is the

Veterans Health Information System and Technology

Architecture (VISTA), which consists of commercial hardware and software developed by the VA. VISTA is a collection of over

100 applications that make up a comprehensive hospital information system. It includes both medical records and clinical applications or packages such as order entry, progress note, laboratory, radiology, and scheduling/admission-discharge-transfer and discharge summary. The present VISTA packages combined comprise an estimated 80 percent of the information maintained in the EMR. Contract personnel (s) shall be responsible for viewing the patient record within the EHR and writing a Perfusion note after each case.

4.3.10.2 VA will provide the necessary training to contract CTPA (s) on the proper use and operation of the current computerized medical records system (Electronic Health Record - EHR). Contractor agrees and shall instruct their employees in signing computer security access agreements and is bound by confidentiality and release of information restrictions. For purposes of clarity, where the VA Forms reference “Contracted Employee Name” it shall mean

“Contractor’s Employee Name.”

4.4 Direct Patient Care: 99.8% of the time involved in direct patient care.

Contractor shall be responsible for

4.5 Scope of Care: Contractor’s CTPA(s) shall be responsible for providing PA services for cardiothoracic surgeries as stated in the PA

SOP. including but not limited to endoscopic graft harvesting for cardiac bypass surgery. Necessary skills include: endoscopic radial and saphenous vein harvesting (must have documented experience of

>100 endoscopic procedures in each location); ultrasound guided arterial and venous access for central line placement; chest tube and pigtail insertion and removal; insertion and removal of Swan-Ganz catheter, removal of pacing wires, cardioversion, performance of first and second assistant responsibilities in cardiothoracic surgery in the operating room, as well as bedside assistant for robotic procedures.

4.5.1 Patient Care Responsibilities: Contractor’s personnel (s) shall be present on time at scheduled OR start times as documented by physical presence in the OR at the scheduled start time.

4.6 ADMINISTRATIVE: estimated_0.2% of time not involved in direct patient care

Training Frequency Hours

Prevention of Workplace Harassment/No Fear Annually 1.5

Privacy and HIPPA Training Annually 1

VA Privacy and Information Awareness and Rules of Behavior

Annually 1

4.6.1 QA/QI documentation: The Contractor’s personnel (s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations.

4.6.2 Patient Safety Compliance and Reporting: Contractor’s

personnel (s) shall follow all established patient safety and infection control standards of care. Contractor’s personnel (s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within

24 hours) Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.

4.7 PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA)

SURVEILLANCE PLAN AND QUALITY IMPROVEMENT(QI)

4.7.1 Quality Management/Quality Assurance Surveillance: Contract

CTPA shall be subject to Quality Management measures.

Contractor performance will be monitored by the government using the standards as outlined in this Performance Work

Statement (PWS) and methods of surveillance detailed in the

Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted. Contract monitoring will be accomplished through a record keeping system (attendance log) maintained on the Surgical Service to reconcile payments. The attendance log indicates the dates and times worked and procedures undertaken. The

COR/designee reviews this attendance log as well as the

CTPA Note to ensure proper documentation. All adverse actions shall be reported to the Contracting Officer immediately. The Contracting Officer and COR shall examine methodologies and quality control procedures during the contract term. All activities shall comply with Joint Commission standards and the policies and procedures of the VAMC.

4.7.2 Patient Complaints: The CO will resolve complaints concerning

Contractor relations with the Government employees or patients. The CO is the final authority on validating complaints. If the Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such CTPA. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

4.7.3 The Government reserves the right to refuse acceptance of any

Contractor CTPA at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility.

Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives.

Standards for conduct shall mirror those prescribed by current federal PA regulations. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

4.7.4 Performance Standards:

4.7.4.1 Measure: Provider Quality Performance

Performance Requirement: Ongoing Provider Performance

Evaluation (OPPE) shall perform in accordance with clinical standards

Standard: OPPE documentation for all (100%) staff providing services under the contract

Acceptable Quality Level: 100%

Surveillance Method: OPPE

a. Patience Care Performance

b. Medical/Clinical knowledge

c. Practiced Based Learning & Improvement

d. Interpersonal & Communication Skills

e. Professionalism

f. System Based Practice Frequency: Quarterly

4.7.4.2 Measure: Qualifications of Key Personnel

Performance Requirement: All contract CTPAs must receive a passing score on the Physician Assistant…