36C26219R0006-002.docx

36C26219R0006

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.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO 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. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C26219R0006 11-07-2018 Wanamaker, Timothy, Contract Specialist 562-766-2212 11-30-2018

3:00 PM (PDT)

00262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815 X X 621111 $11 Million N/A X Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815 00262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815

Department of Veterans Affairs Financial Services Center P.O. Box 149971 Austin TX 78714-9971 http://www.tungsten-network.com/

877-353-9791 See CONTINUATION Page Please see the enclose d Schedule of Services for Locum Tenens Emergency Physician services (pgs. 7-9).

See CONTINUATION Page X Don Weerasinghe Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(Continuation from Standard Form 1449, block 18A.)

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

1.1. CONTRACTOR:

1.2. GOVERNMENT:

Contracting Officer (CO), 36C262, Don Weerasinghe Care of: Contract Specialist (CS), 36C262, Timothy Wanamaker timothy.wanamaker@va.gov or 562-766-2212 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive, Suite 600 Long Beach, CA 90815

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with (IAW) Federal Acquisition Regulation (FAR):

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with Veteran Affairs Acquisition Regulation (VAAR) Clause 852.232-72 Electronic Submission of Payment Requests.

4.1. Billing:

4.1.1. Invoice requirements and supporting documentation: supporting documentation and invoice(s) must be submitted not later than the 20th workday of the month. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4(g), all invoices must include:

4.1.1.1. Contractor Tax Payer ID Number (TIN);

4.1.1.2. Contractor’s “Remit Address” information;

4.1.1.3. The VA Purchase Order (PO) number;

4.1.1.4. Contractor’s contact information: (Personal Name, Email, and Phone);

4.1.1.5. VA point of contact information: (Personal Name, Email, and Phone);

4.1.1.6. The Period of Performance dates (Beginning and Ending);

4.1.1.7. All discount information if applicable (Percent and Date Terms);

4.1.1.8. Contractor’s physician(s) (Name of Contractor’s employee);

4.1.1.9. Hourly Rate;

4.1.1.10. Quantity of hours worked;

4.1.1.11. Total price;

4.1.2. Vendor Electronic Invoice Submission Methods:

4.1.2.1. Invoices will be electronically submitted to the Tungsten website at: http://www.tungsten-network.com/

4.1.2.2. 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 five (5) business days to complete; ensure a Contractor’s invoice is automatically routed to its Certifying Official for approval and payment. 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 the current submission of invoice with the above-referenced items required. The Contractor should clarify and confirm additional requirements with its certifying official. The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements.

4.1.2.3. For additional information, please contact:

Tungsten Support Phone: 1-877-489-6135 Website: http://www.tungsten-network.com/

Department of Veterans Affairs Financial Service Center Phone: 1-877-353-9791 Email: vafscched@va.gov

5. SECURE FAX: Please review VA Handbook 6500 that requires the following statement on all fax cover sheets be included: “This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.”

6. ACKNOWLEDGMENT OF AMENDMENTS: The Offeror acknowledges receipt of amendments to Solicitation: RFP 36C26219R0006, numbered and dated as follows:

B.2 NOTIFICATION TO OFFERORS

1. Authority: Under the authority of 38 U.S.C. 7409 – Contracts for scarce medical specialist services; 38 U.S.C. 8153 – Sharing of healthcare resources; Federal Acquisition Regulation (FAR) Part 12—Acquisition of Commercial Items, and; FAR Part 15—Contracting by Negotiation, the VA San Diego Healthcare System (VASDHS) requires a Contractor to provide Contract Emergency Department Board-Certified/Board-Eligible physicians for daily onsite Emergency Department shift coverage.

2. Offerors shall complete and return all information designated in the enclosed FAR clause 52.212-1, Instructions to Offerors – Commercial Items, paragraph b, and the addendum to 52.212-1, prior to the time specified in block 8 of standard form (SF) 1449 to be considered eligible for award. Offerors shall also respond to each evaluation factor listed in the enclosed FAR clause 52.212-2, Evaluation—Commercial Items. Failure to do so may preclude the Offeror from consideration for award.

3. TECHNICAL INQUIRES: Direct all technical inquiries via email to the Contract Specialist (CS), Timothy Wanamaker at timothy.wanamaker@va.gov not later than November 21th, 2018, 3:00 PM, Pacific Daylight Time (PDT). An amendment will be posted to www.Fbo.gov to address any questions received on or about November 23rd, 2018, by 4:00 PM, PDT.

4. DUNS NUMBER: Provide the Dun and Bradstreet Number assigned to your business in the space provided below (refer to FAR Provision 52.212-1, Instructions to Offerors – Commercial Items):

5. This requirement is set-aside 100% for Service-Disabled, Veteran-Owned Small Businesses (SDVOSBs); only SDVOSBs verified in the VA’s Vendor Information Pages (VIP) site at https://www.vip.vetbiz.gov/ at the time of proposal submission will be considered for award.

6. Post-Award Conference. The Indefinite-Delivery, Indefinite-Quantity (IDIQ)-Awardee(s) shall participate in a post-award orientation conference to review the on-boarding process for candidates and other post-award management procedures. The conference will include the Contracting Officer (CO), CS, Contracting Officer Representative (COR), IDIQ-Awardee(s), and others designated.

B.3 SCHEDULE OF SERVICES

1. The IDIQ-awardee (herein called Contractor) shall furnish all personnel to provide services necessary to perform On-site Emergency Department Physician Services at the Department of Veterans Affairs Medical Center, VA San Diego Healthcare System (VASDHS), Emergency Department.

2. VASDHS Emergency Services are accredited by The Joint Commission (TJC) and follow the standards and guidelines set forth by the American College of Emergency Physicians (ACEP). A Contractor providing on-site Emergency Department Physician Services shall provide services that meet or exceed the ACEP Guidelines, available at: http://www.ACEP.org/ and incorporated herein for reference.

3. Ordering Instructions. The Government will issue orders via email, and, if multiple awards may be made, the CO will announce procedures and selection criteria that the Government will use to provide awardees a fair opportunity to be considered for each order. Individual orders shall clearly describe all services to be performed or supplies to be delivered so the full cost or price for the performance of the work can be established when the order is placed. Orders shall be within the scope, issued within the period of performance, and be within the maximum value of the contract. Orders placed under indefinite-delivery contracts shall contain the following information:

3.1. Date of order;

3.2. Contract number and order number;

3.3. For services, line item number, subline item number (if applicable), description, quantity, and unit price. The corresponding line item number and subline item number from the base contract shall also be included;

3.4. Delivery or performance schedule;

3.5. Place of delivery or performance;

3.6. Accounting and appropriation data;

3.7. Method of payment and payment office, if not specified in the contract (see FAR 32.1110(e)).

4. IDIQ Minimum and Maximum Ordering Aggregates. This is a IDIQ fixed-price contract. Prices in this schedule represent an all-inclusive rate including labor, incidental costs, overhead, and insurance premium payments for applicable insurance coverage. Costs not incorporated into the contractor’s price will not be reimbursed by the Government.

4.1. The current year pricing will apply to any extension pursuant to FAR 52.217-8 or FAR 52.217-9.

4.2. The guaranteed minimum award amount for this contract is $1,000.00.

4.3. The maximum aggregate value of orders—including any option—that can be placed under this contract cannot exceed $12,000,000.00.

4.4. The Government does not guarantee that it will place any orders under this contract in an amount more than the guaranteed minimum award amount.

5. PLACE OF PERFORMANCE: Services shall be provided on-site at the VASDHS; EMERGENCY ROOM, 3350 LA JOLLA VILLAGE DR., SAN DIEGO, CA 92161.

6. PERIOD OF PERFORMANCE:

BASE YEAR: JANUARY 1, 2019 THROUGH DECEMBER 31, 2019

CLIN NO.

SUB-CLIN

ED Physician Services;

ED Board-Certified/Board-Eligible Physician

[NOTE: Services to includes ED coverage for weekend; nights; weekday coverages; contingency coverage during call-outs and illnesses]

OPTION YEAR ONE (1): JANUARY 1, 2020 THROUGH DECEMBER 31, 2020

CLIN NO.

ED Physician Services;

ED Board-Certified/Board-Eligible Physician

[NOTE: Services to includes ED coverage for weekend; nights; weekday coverages; contingency coverage during call-outs and illnesses]

OPTION YEAR TWO (2): JANUARY 1, 2021 THROUGH DECEMBER 31, 2021

CLIN NO.

ED Physician Services;

ED Board-Certified/Board-Eligible Physician

[NOTE: Services to includes ED coverage for weekend; nights; weekday coverages; contingency coverage during call-outs and illnesses]

OPTION YEAR THREE (3): JANUARY 1, 2022 THROUGH DECEMBER 31, 2022

CLIN NO.

ED Physician Services;

ED Board-Certified/Board-Eligible Physician

[NOTE: Services to includes ED coverage for weekend; nights; weekday coverages; contingency coverage during call-outs and illnesses]

OPTION YEAR FOUR (4): JANUARY 1, 2023 THROUGH DECEMBER 31, 2023

CLIN NO.

ED Physician Services;

ED Board-Certified/Board-Eligible Physician

[NOTE: Services to includes ED coverage for weekend; nights; weekday coverages; contingency coverage during call-outs and illnesses]

--THIS AREA IS INTENTIONALLY LEFT BLANK--

B.4 PERFORMANCE WORK STATEMENT (PWS)—ON-SITE EMERGENCY DEPARTMENT PHYSICIAN SERVICES

1. DESCRIPTION OF SERVICES:

1.1. The Department (Dept.) of Veteran Affairs (VA) seeks to establish an IDIQ contract to provide recurring Emergency Care Physician Services in estimated quantities; Emergency Board-Certified/Board-Eligible Physicians for the VASDHS ED. The Contractor’s care shall cover the range of services normally provided in a similar civilian healthcare facility, in accordance with the specifications and requirements contained herein.

1.2. The Contractor shall provide Board-Certified/Board-Eligible Emergency Department Physician Services on-site in accordance with the specifications contained herein to Veteran-beneficiaries of the Dept. of VA and the VASDHS.

1.3. The Contractor shall provide on-site emergency department physician services that meet or exceed the American College of Emergency Physician Guidelines http://www.ACEP.org/

1.4. Place of Performance: Contractor shall furnish services at: VASDHS, Emergency Department, 3350 La Jolla Village Dr., San Diego, CA 92161.

1.5. Authority: 38 U.S.C. 7409 – Contracts for scarce medical specialist services; 38 U.S.C. 8153 – Sharing of healthcare resources.

1.6. Policy/Handbooks: The Contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.6.1. VHA Directive 1101.05(2): Emergency Medicine

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3236

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

1.6.3. VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.6.4. VHA Directive 2010-018 “Facility Infrastructure”

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

1.6.5. VHA Directive 1192 “Seasonal Influenza Prevention Program” https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep

1.6.6. VHA Handbook 1100.17: National Practitioner Data Bank Reports - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.6.7. VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.6.8. VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

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

1.6.10. Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.7. ACRONYMS/DEFINITIONS: Terms used in this task order 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.

1.7.1. ABIM: American Board of Internal Medicine http://www.abim.org/

1.7.2. ACEP: American College of Emergency Physicians

1.7.3. ACGME: Accreditation Council for Graduate Medical Education

1.7.4. ACLS: Advanced Cardiac Life Support

1.7.5. ATLS: Advanced Trauma Life Support

1.7.6. AOD: Admitting Officer of the Day

1.7.7. BLS: Basic Life Support

1.7.8. CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

1.7.9. CDC: Centers for Disease Control and Prevention

1.7.10. CR: Contract Discrepancy Report

1.7.11. CEU: Certified Education Unit

1.7.12. CME: Continuing Medical Education

1.7.13. CMS: Centers for Medicare and Medicaid Services

1.7.14. CONTRACTING OFFICER (CO) – 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.

1.7.15. CONTRACTING OFFICER’S REPRESENTATIVE (COR) – 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.

1.7.16. COS: Chief of Staff

1.7.17. CPARS: Contractor Performance Assessment Reporting System

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

1.7.19. CREDENTIALING: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.7.20. DEA: Drug Enforcement Agency

1.7.21. ED: Emergency Department

1.7.22. FSMB: Federation of State Medical Boards

1.7.23. HHS: Department of Health and Human Services

1.7.24. HIPAA: Health Insurance Portability and Accountability Act

1.7.25. HR: Human Resources

1.7.26. ISO: Information Security Officer

1.7.27. MEDICAL EMERGENCY: a sudden onset of a medical condition, manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or Causing serious or permanent dysfunction of any body-organ or part.

1.7.28. MOD: Medical Officer of the Day

1.7.29. 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).

1.7.30. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

1.7.31. NON-CONTRACT PROVIDER: any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors.

1.7.32. NP: Nurse Practitioner

1.7.33. NPPES: National Plan and Provider Enumeration System

1.7.34. PA: Physician Assistant

1.7.35. PALS: Pediatric Advanced Life Support

1.7.36. POP: Period of Performance

1.7.37. PPD: Purified Protein Derivative

1.7.38. PWS: Performance Work Statement

1.7.39. PRIVILEGING (CLINICAL PRIVILEGING): Privileging is the process by which a practitioner, licensed for independent practice (e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration) is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.7.40. QA/QI: Quality Assurance/Quality Improvement

1.7.41. QM/PI: Quality Management/Performance Improvement

1.7.42. QASP: Quality Assurance Surveillance Plan

1.7.43. VETERANS’ HEALTH ADMINISTRATION (VHA): The central office for administration of the VA medical centers through throughout the United States (U.S.) located in Washington, D.C.

1.7.44. VETERANS INTEGRATED SERVICES NETWORK (VISN): The regional oversight for VA medical centers.

1.7.45. VISTA (Veterans Integrated Systems Technology Architecture): A PC-based system which captures and store clinical imagery, scanned documents, and other non-textual data files and integrates them into patient’s medical record, and VA Medical Center information system.

1.7.46. VETPRO: a federal web-based credentialing program for healthcare providers.

1.7.47. VETERANS AFFAIRS MEDICAL CENTER (VAMC): Unless identified with the name of a different VA Medical Center, for purposes of this contract this term shall mean the VASDHS.

2. QUALIFICATIONS:

2.1. Physicians shall be duly licensed in a State, Territory, or Commonwealth of the U.S. or the District of Columbia (D.C.) and residency trained in the specialty of service/Emergency Room Medicine they are providing (THE CONTRACT PHYSICIAN(S) MUST HAVE GRADUATED FROM AN APPROVED SCHOOL AND COMPLETED A RESIDENCY OR FELLOWSHIP ACCEPTABLE TO THE SURGEON GENERAL), credentialed by the appropriate civilian American Medical Association specialty association, and indemnified by an appropriate/legal third party corporate entity for their professional activities.

2.1.1. License – The Contractor’s physician (s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the U.S. or D.C.) when services are performed on-site at the VASDHS facility.

2.1.1.1. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor’s physician(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board-Certification - All Contractor’s physician(s) shall be Board-Certified or Board-Eligible in Emergency Medicine and be currently certified in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification shall be kept up to date always. Documentation verifying current certification shall be provided by the Contractor to the VASDHS COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging – Physicians may perform services at the VASDHS only when the credentialing process is completed by the VASDHS Medical Staff Office as outlined in VA Regulation and Station 664 Memorandum. The privileging process shall be in accordance with all pre-privileging and privileging requirements in VA Regulations and local VA Medical Staff Bylaws. The credentials required and privileges granted by the Government must be sufficient to allow for performance of all the requirements under this contract.

2.1.3.1. Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above (section 1.5.5.). The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Contractor’s physician(s) prior to obtaining approval by the VASDHS Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.3.2. If an Contractor’s physician(s) is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.4. Technical Proficiency: The Contractor’s physician(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. The 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 Contractor’s physician(s) and Contractor’s physician(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.5. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by VASDHS. Contractor’s physician(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 physician(s).

2.1.6. Training (ACLS, BLS, CPRS and VA-MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training (listed below) must be completed by the Contractor’s physician(s) as required by VASDHS. Other training may become required; the VASDHS COR will communicate any training requirement changes to the Contractor.

Frequency:

(e.g., once a year, quarterly, etc.)

Annual Hours:

2.1.7. Standard Personnel Testing (e.g., purified protein derivative (PPD)): Contractor shall provide proof of the following tests for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and CO. {Contractor tests shall be current within the past 12 months}.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician(s). 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. {This is applicable to all healthcare workers}.

2.1.7.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians. {This is applicable to all healthcare workers}.

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians. {This is applicable to all healthcare workers}.

2.1.7.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians. {This is applicable to all healthcare workers}.

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all healthcare workers}.

2.1.7.6. 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 physician(s); 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 a proper follow-up evaluation is provided following an exposure incident.{This is applicable to all healthcare workers}.

2.1.7.7. The COR shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in healthcare personnel (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 return.

2.1.8. 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). 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.

2.1.9. DEA: Contractor shall provide copy of current DEA certificate.

2.1.10. Conflict of Interest: The Contractor and all Contractor’s physician (s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal submission and during the entirety of contract performance. At the time of proposal submission, 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 VA Acquisition Regulation (VAAR) provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.11. Citizenship-related Requirements:

2.1.11.1. The Contractor certifies that the Contractor shall comply with all legal provisions contained in the Immigration and Nationality Act of 1952, as amended; its related laws and regulations enforced by Homeland Security, Immigration and Customs Enforcement, and the U.S. Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.11.2. While performing services for the Dept. of VA, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien or foreign national non-immigrant who is in violation their status as a result of their failure to maintain or comply with the terms and conditions of their admission into the U.S. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.11.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Dept. of VA may, at its discretion, require that the foreign national who failed to maintain their legal status in the U.S. 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 Dept. of VA and shall form the basis for termination of this contract for breach.

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

2.1.11.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the Contractors response to the RFQ using the subject attachment in Section D.3 (citizenship-related document section) of the solicitation document.

2.1.12. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.12.1. The Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed Contractor’s physician (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.

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

2.2. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by the VASDHS COS or clinical designee, and approval by the VASDHS Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional performance monitoring and review of all Contractor physician personnel covered by this contract—for quality purposes—will be provided by the appointed VASDHS COS, and/or the Chief of the Service or designee. Note: 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 Contractor’s physician(s) shall not be considered Dept. of 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 physicians are prohibited from referring VA Veteran-patients to Contractor’s or their own practice(s).

2.6. Inherently Government Functions: Contractor and Contractor’s physician(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 Contractor’s physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or shall certify 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;

2.7.4. Income tax withholding, and;

2.7.5. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover Contractor or Contract physician(s). When a Contractor or Contractor’s physician(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 physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. KEY PERSONNEL:

2.9.1. The VA Full Time Equivalency (FTE) for the services required is 2080 hours = One (1) FTEE (Full Time Equivalency Employee)). An FTE is defined by VA as a minimum of 80 hours every two (2) weeks and excludes holidays.

2.9.2. The Contractor shall propose a minimum of SIX (6) key personnel to be credentialed and available for scheduling to meet the requirements of THREE (3) on-site key personnel per the IDIQ for BASE YEAR, OPTION YEAR ONE (1) AND OPTION YEAR TWO (2).

2.9.3. The Contractor shall propose a minimum of FOUR (4) key personnel to be credentialed and available for scheduling to meet the requirements of TWO (2) on-site key personnel per the IDIQ for OPTION YEAR THREE (3) AND OPTION YEAR FOUR (4).

2.9.4. The Contractor shall be required to provide as a minimum, enough appropriately qualified physicians to be credentialed and privileged that meet or exceed twice (2x) the number of Full Time Equivalent Employee (FTEE) required to fulfill contract obligations.

2.9.5. IN THE EVENT A SCHEDULED PHYSICIAN IS UNABLE TO BEGIN OR COMPLETE AN ASSIGNED SHIFT: THE CONTRACTOR SHALL PROVIDE REPLACEMENT PHYSICIAN COVERAGE WITHIN TWO (2) HOURS AND NOTIFY THE COR AT THE VASDHS IMMEDIATELY OF THE SCHEDULE CHANGE.

2.9.6. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within five (5) calendar days after the occurrence of any of these events and provide the information required. After 90 days, the Contractor shall submit the information to the CO at least five (5) calendar days prior to making any permanent substitutions. The Contractor shall provide scheduled services throughout the contract period. In the event of the absence of Contractor’s personnel for any reason, the Contractor shall bear the responsibility of providing replacement personnel to provide the scheduled services. The Contractor point of contact shall arrange for pre-credentialed locum tenens coverage when primary Physicians will be unable to provide services for one (1) or more consecutive scheduled shift.

2.9.6.1. It is essential that continuity of services is maintained to the maximum degree possible, hence, substitution of Contractor provided Physicians shall be limited to urgent/emergent absences of approved, assigned providers. The Contractor shall be responsible for providing coverage to VASDHS during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations, exhaustion, and additional coverage as required.

2.9.6.2. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within five (5) calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.9.6.3. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive work days 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 (2) weeks will require the procedure as stated above.

2.9.6.4. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the VASDHS facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s physician(s), the COR may request, without cause, immediate replacement of said Contractor’s physician(s). The CO and COR shall address issues concerning a Contractor’s physician(s) conduct; the final arbiter on questions of acceptability is the CO.

2.9.7. Contingency Plan: Continuity of care is an essential part of VASDHS’ medical services. As such, the Contractor shall have a contingency plan in place to be utilized if the Contractor’s physician(s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the contract.

3. HOURS OF OPERATION: 24 HOURS, SEVEN (7) DAYS-PER-WEEK, 365 DAYS-PER-YEAR; ON-SITE VASDHS EMERGENCY ROOM COVERAGE.

3.1.1. Veteran-patients must be seen by a Contractor’s physician(s) on-site at VASDHS in a timely manner in accordance with VA Rules and Regulations on clinic wait-times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.1.2. Contractor’s Physician(s) shall be available and present in the ED during normal VASDHS ED Hours of Operation, which will be established, and may be revised, as deemed appropriate for Veteran-patient care by the Chief of Staff. Currently, normal clinic hours entail 12-hour shift coverage.

4. CONTRACTOR RESPONSIBILITIES:

4.1. Clinical Personnel Required: The Contractor shall provide Contractor’s physician(s) who are competent, qualified per this PWS and adequately trained to perform assigned duties.

4.1.1. Contractor’s physician(s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm working hours per day and services provided against the Contractor’s invoices.

4.2. Standards of Care: The Contractor’s physician(s) care shall cover the range of Emergency services as would be provided in a state-of-the-art healthcare 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. The American Board of Emergency Medicine;

4.2.2. American Board of Osteopathic Emergency Medicine;

4.2.3. Relevant professional societies including ACEP. SAEM, AAEM American College of Emergency Physicians: http://www.acep.org;

4.2.4. The American Board of Internal Medicine http://www.abim.org/;

4.2.5. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443;

4.2.6. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/emergency_department/;

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

4.2.8. The requirements contained in this PWS.

4.3. MEDICAL RECORDS:

4.3.1. Authorities: Contractor’s physician(s) providing healthcare services to Veteran-patients shall be considered as part of the VASDHS Healthcare Activity and shall comply with the U.S.C.551a…