36C26220R0106-001.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. 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 84

36C26220R0106 04/09/2020

Flora Ceponis – Contract Specialist 562-766-2257 05/08/2020

3:00pm PST

36C262

Department of Veterans Affairs

Network Contracting Office 22

4811 Airport Plaza Drive

Suite 600

Long Beach CA 90815

X 100 x

621399

$7.5 Million

X

N/A

X

36C691

Department of Veterans Affairs

Greater Los Angeles Healthcare System

11301 Wilshire Blvd

Los Angeles CA 90073

36C691

Department of Veterans Affairs

Greater Los Angeles Healthcare System

11301 Wilshire Blvd

Los Angeles CA 90073

Department of Veterans Affairs

Financial Services Center

P.O. Box 149971

Austin TX 78714-9971

See CONTINUATION Page

The Department of Veterans Affairs Greater Los Angeles

Healthcare Healthcare System requires onsite Radiation Oncology -

Radiation Therapy Technologist (RTT) Support Services.

Proposed Period of Performance: 12-Month Base with

Government’s option to extend up to four (4) years.

Please see Price Schedule on pages 5-8

Please see Performance Work Statement (PWS) on Pages 9-33

X X

X X x 1

Don Weerasinghe

Contracting Officer

36C26220R0106

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.3 SCHEDULE OF SERVICES AND PRICE

B.4 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

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

CONTINUITY OF SERVICES

C.3 FAR 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2020)

C.4 FAR 52.216-18 ORDERING (OCT 1995)

C.5 FAR 52.216-19 ORDERING LIMITATIONS (OCT 1995)

C.6 FAR 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.7 FAR 52.217-5 EVALUATION OF OPTIONS (JULY 1990)

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

C.9 FAR 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ... 48

C.10 FAR 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.11 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.12 VAAR 852.219-10 VA NOTICE OF TOTAL SERVICE-DISABLED VETERAN-OWNED

SMALL BUSINESS SET-ASIDE (JUL 2019) (DEVIATION)

C.13 VAAR 852.219-11 - VA NOTICE OF TOTAL VETERAN-OWNED SMALL BUSINESS

SET-ASIDE

C.14 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.15 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.16 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(JAN 2008)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 CANDIDATE QUESTIONNAIRE

D.2 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

D.3 ORGANIZATIONAL CONFLICT OF INTEREST

D.4 IMMIGRATION AND NATIONALITY ACT OF 1952 CERTIFICATION

SECTION E - SOLICITATION PROVISIONS

E.1 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.2 FAR 52.216-1 TYPE OF CONTRACT (APR 1984)

E.3 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION (SEP

2018)

E.4 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (SEP 2018)

E.5 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008)

E.6 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (OCT 2018)

E.7 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.8 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (OCT 2018)

E.10 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008)

E.11 FAR 52.233-2 SERVICE OF PROTEST (SEP 2006)

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: Don Weerasinghe, Contracting Officer (NCO22)

Network Contracting Office 22

4811 Airport Plaza Drive

Suite 600

Long Beach CA 90815

Email: Don.Weerasinghe@va.gov

Phone: (562) 766-2276

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

[X] 52.232-33, Payment by Electronic Funds Transfer—System for Award

Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly

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

Financial Services Center

P.O. Box 149971

Austin TX 78714-9971

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

AMENDMENT NO DATE

mailto:Don.Weerasinghe@va.gov

B.3 SCHEDULE OF SERVICES AND PRICE

The Contractor shall furnish all personnel to provide services necessary to perform the onsite Radiation Oncology –

Radiation Therapy Technologist (RTT) Support Services described in the Performance Work Statement to eligible beneficiaries of the Department of Veterans Affairs Greater Los Angeles Healthcare System (hereinafter referred to as

VAGLAHS).

The Government intends to award one (1) Firm Fixed-Price Indefinite Delivery Indefinite Quantity (IDIQ) 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.

The guaranteed minimum amount for this contract is $1,000.00. The maximum aggregate value of the orders that can be placed under this contract is $4,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum amount.

***The previous option year pricing will apply to any extension pursuant to FAR 52.217-8. ***

Base Year: Period of Performance: July 1, 2020 to June 30, 2021

CLIN

No.

SUB-

Description Qty. Unit Unit Cost

0001 None Radiation Therapy

Technologist

6240 Hours $

CANDIDATES

0001a None Radiation Therapy

Technologists (RTT) with

ARRT certification and registration in Radiation

Therapy ARRT(T)

***PRIMARY FTEE***

0001b None Radiation Therapy

Technologists (RTT) with

ARRT certification and registration in Radiation

***ALTERNATE FTEE***

Estimated Base Year Cost: $________________________

Option Year 1: Period of Performance: July 1, 2021 to June 30, 2022

10001 None Radiation Therapy

Technologist

6240 Hours $

CANDIDATES

10001a None Radiation Therapy

Technologists (RTT) with

ARRT certification and registration in Radiation

10001b None Radiation Therapy

ARRT certification and registration in Radiation

Estimated Option Year 1 Cost: $________________________

Option Year 2: Period of Performance: July 1, 2022 to June 30, 2023

20001 None Radiation Therapy

Technologist

6240 Hours $

CANDIDATES

20001a None Radiation Therapy

Technologists (RTT) with

ARRT certification and registration in Radiation

20001b None Radiation Therapy

ARRT certification and registration in Radiation

Estimated Option Year 2 Cost: $________________________

Option Year 3: Period of Performance: July 1, 2023 to June 30, 2024

30001 None Radiation Therapy

Technologist

6240 Hours $

CANDIDATES

30001a None Radiation Therapy

Technologists (RTT) with

ARRT certification and registration in Radiation

30001b None Radiation Therapy

ARRT certification and registration in Radiation

Estimated Option Year 3 Cost: $________________________

Option Year 4: Period of Performance: July 1, 2024 to June 30, 2025

40001 None Radiation Therapy

Technologist

6240 Hours $

CANDIDATES

40001a None Radiation Therapy

Technologists (RTT) with

ARRT certification and registration in Radiation

40001b None Radiation Therapy

ARRT certification and registration in Radiation

Estimated Option Year 4 Cost: $________________________

Estimated Value - Base Year $

Estimated Value – Option Year 1 $

Estimated Value – Option Year 2 $

Estimated Value – Option Year 3 $

Estimated Value – Option Year 4 $

Total Estimated Value of Base + All Option Years $

B.4 PERFORMANCE WORK STATEMENT

ONSITE RADIATION THERAPY TECHNOLOGIST SERVICES

1. GENERAL:

1.1. SERVICES REQUIRED: The VA Radiation Oncology Services are accredited by ACR and follow the standards & guidelines set forth by American College of Radiology (ACR). As such any Contractor providing on-site radiation oncology services must adhere to all the American College of Radiology Guidelines &

Technical Standards for Radiation Oncology: A contractor providing on-site radiation oncology services must provide evidence the radiation oncology practice meets or exceeds the American College of Radiology

Guidelines for Radiation Oncology.

o http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-

Oncology o http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised

1.2. PLACE OF PERFORMANCE: All services shall be provided at the VA Greater Los Angeles Healthcare

System (VAGLAHS), 11301 Wilshire Boulevard, Los Angeles, California 90073.

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

1.4. Policy/Handbooks:

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

1.4.2. VHA Directive 2010-018 “Facility Infrastructure”

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

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

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

1.4.5. VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards -https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.6. VHA Handbook 1100.19 Credentialing and Privileging -

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

1.4.7. VHA Directive 2012-030 Credentialing of Health Care Professionals – https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2815

1.4.8. VHA Handbook 1105.04, Fluoroscopy Safety -

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2764

1.4.9. VHA Handbook 1907.01 Health Information Management and Health Records:

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

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

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

1.4.11. US Nuclear Regulatory Commission for management and use of radioactive materials for medical use and radiation safety requirements, to include (but not limited to) 10 CFR Parts 19, 20, 30, 33, 35, and 71 http://www.nrc.gov/reading-rm.html

1.5. DEFINITIONS/ACRONYMS:

http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised 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=2815 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2764 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.nrc.gov/reading-rm.html

1.5.1. ACR: American College of Radiology (www.acr.org/)

1.5.2. ACO: Administrative Contracting Officer

1.5.3. ARRT: American Registry of Radiologic Technologists

1.5.4. ASRT: American Society of Radiologic Technologists

1.5.5. CDC: Centers for Disease Control and Prevention

1.5.6. CEU: Certified Education Unit

1.5.7. CE: Continuing Education

1.5.8. CMS: Centers for Medicare and Medicaid Services

1.5.9. CO: Contracting Officer

1.5.10. COR: Contracting Officer’s Representative

1.5.11. COS: Chief of Staff

1.5.12. CPARS: Contractor Performance Assessment Reporting System

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

1.5.14. Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.5.15. HHS: Department of Health and Human Services

1.5.16. HICPAC: Healthcare Infection Control Practices Advisory Committee- a federal advisory committee made up of 14 external infection control experts who provide advice and guidance to the CDC and the

Secretary of HHS regarding the practice of health care infection control, strategies for surveillance and prevention and control of health care associated infections in United States health care facilities.

1.5.17. HIPAA: Health Insurance Portability and Accountability Act

1.5.18. IGRT: Image Guided Radiation Therapy is the process of frequent two and three-dimensional imaging, during a course of radiation treatment, used to direct radiation therapy utilizing the imaging coordinates of the actual radiation treatment plan.

1.5.19. IMRT: Intensity Modulated Radiation Therapy is the process of delivering highly conformal radiotherapy to the tumor while sparing the surrounding normal tissues by varying radiation intensity across treatment portals.

1.5.20. ISO: Information Security Officer

1.5.21. MU: Monitor Unit is a measure of machine output of a linear accelerator in radiation therapy.

1.5.22. NROP: National Radiation Oncology Program

1.5.23. NRSC: National Radiation Safety Committee

1.5.24. POP: Period of Performance

1.5.25. PWS: Performance Work Statement

1.5.26. QA/QI: Quality Assurance/Quality Improvement

1.5.27. QM/PI: Quality Management/Performance Improvement

1.5.28. QASP: Quality Assurance Surveillance Plan

1.5.29. QMP: Quality Management Program

1.5.30. RTT: Radiation Therapy Technologist

1.5.31. SPE: Senior Procurement Executive

1.5.32. SRS: Stereotactic Radio Surgery: a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinated system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation, radiosurgery (SRS) etc.

1.5.33. SRT: Stereotactic Radio Therapy

1.5.34. TJC: The Joint Commission

1.5.35. TLD: Thermoluminescent Dosimeter- a device that measures radiation dose

1.5.36. VA: Department of Veterans Affairs

1.5.37. VAGLAHS: Veterans Affairs Greater Los Angeles Healthcare System

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

1.5.39. VHA: Veterans Health Administration

2. QUALIFICATIONS:

http://www.acr.org/

2.1. Staff and Facility:

2.1.1. American Registry of Radiologic Technologists (ARRT) Certification and Registration in Radiation

Therapy: - All technologists shall be licensed and ARRT Certified. All continuing education courses required for maintaining certification must always be kept up to date. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.1.1 Radiation Therapy Technologist (RTTs): The Contractor shall provide American Registry of

Radiologic Technologists (ARRT) certified RTTs in the area of Radiation Oncology and shall maintain certification throughout the period of performance. Due to current protocols for SRS and SBRT, RTTs need to meet the training requirement and a minimum 2 years of continuous work as a Radiation Therapy Technologist using these techniques with specialized linear accelerator machines – the Novalis with Brain Lab, True beam and Tomotherapy. If RTTs is/are not directly employed by the treating facility, documentation must be provided to ensure adequate certification.

2.1.2. Credentialing –Credentialing of Health Care Professional other than Physicians. In accordance with VHA

Directive 201-030, all health care professionals who claim licensure, certification or registration, as applicable to the position (this applies to all who are appointed or utilized on a full-time, part-time, intermittent, consultant, without compensation, on-station fee basis, on station contract, or on-station sharing agreement basis) and who are not currently credentialed in accordance with VHA Handbook 1100.19, must be credentialed with this directive.

2.1.2.1 The Contractor is responsible to ensure that proposed RTT’s possess requisition credentials of

ARRT(T) in order to provide required services. If at any time during this contract’s period of performance a RTT has their ARRT(T) registration suspended or revoked, the RTT must be removed from service and the Contractor is responsible to replace with a qualified RTT.

2.1.3. Technical Proficiency - RTTs 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.

RTTs shall have knowledge of professional care theories, principles, practices, and procedures to serve radiation oncology patient population. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational and work history for all RTTs shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.4. Continuing CE Requirements - Contractor shall provide the COR copies of current CEs as required or requested by the VAGLAHS. Contractors registered or certified by national/medical associations shall continue to meet the minimum standards for CE to remain current. CE hours shall be reported to the credential’s office for tracking. These documents are required for initial and renewal privileging. Failure to provide shall result in loss of privileges.

2.1.5. Training (BLS, CPRS and VA MANDATORY) - RTTs shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the RTTs as required by the

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

Training (The following training is mandatory per VHACO)

Frequency (once a year, etc.)

Active Threat Training Annual

Government Ethics Annual

Hospice and Palliative Care for

VA Clinicians

Annual

Military Sexual Trauma (MST) for Medical Providers

Annual

Prevention of Workplace

Harassment/No Fear Act

Annual

VA Core Values Training

(ICARE Recommitment)

Annual

VA Privacy and Information

Security Awareness and Rules of Behavior

Annual

VHA Privacy and HIPAA

Focused Training

Annual

BLS Annual

Patient Safety Annual

Patient Rights Annual

Patient Abuse Annual

Prevention/Management of

Disruptive Behavior/Violence

Prevention Level I

Annual

Suicide Prevention: Suicide

Risk Management Training for

Clinicians

Annual

SUX Infection Control and

Blood Borne Pathogens

Annual

CPRS As required

VISTA Imaging As required

2.1.6. Standard Personnel Testing (PPD, etc.) - Contractor shall provide proof of the following tests for their

RTTs 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.

2.1.6.1 TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin

Test (TST) or interferon-gamma release assays (IGRA) for all RTTs. 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.

2.1.6.2 MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunization for all Contractor staff for measles, mumps, rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

2.1.6.3 VARICELLA: Contractors shall provide proof of immunity for all RTTs.

2.1.6.4 ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all RTTs.

2.1.6.5 INFLUENZA: Contractors shall provide proof that all RTTs have received the annual

Influenza vaccine unless it is contraindicated. If the RTT has a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season.

2.1.6.6 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 RTTs; 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.

2.1.6.7 The VAGLAHS 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 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 their return.

2.1.7. Conflict of Interest: The Contractor and all RTTs 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 response to the subject attachment in Section D of the solicitation document.

2.1.8. Citizenship related Requirements:

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

Department of Veterans Affairs patient referrals.

2.1.8.2 While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract 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.

2.1.8.3 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 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans

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

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

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

Section D of the solicitation document.

2.1.9. 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.

2.1.9.1 Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the

HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed RTTs is 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.

2.1.9.2 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

VAGLAHS COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA

Handbook 1100.19. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes, will be provided by the VAGLAHS 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 RTTs 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. Inherent Government Functions: Contractor and RTTs 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 http://oig.hhs.gov/exclusions/index.asp contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

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

2.6.1 Workers’ compensation2.6.2 Professional liability insurance

2.6.3 Health examinations

2.6.4 Income tax withholding, and

2.6.5 Social security payments.

2.7. Tort Liability: The Federal Tort Claims Act does not cover Contractor or RTTs. When a Contractor or RTTs have 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 RTT’s) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.8. Key Personnel:

Contractor shall provide the number of qualified staffs to include a primary and alternate as is necessary to perform the services required under this contract, at the staffing level determined to be professionally acceptable by the VAGLAHS COS and in accordance with American College of Radiology staffing guidelines.

2.8.1 The minimum number of ARRT Certified RTTs required to be on site daily is three (3) as defined in paragraph Hours of Operation in this section

2.8.2 The VA Full Time Equivalency (FTE): FTE is defined by the VA as a minimum of 80 hours every two weeks and does not include holidays.

2.8.3 The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the

Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled RTT is unable to complete an assigned shift, the contractor shall provide replacement RTT coverage within 2 hours and notify the Contracting Office Representative (COR) at the VAGLAHS immediately of the schedule change.

2.8.4. 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 15 calendar days after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions.

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

2.8.4.2 For temporary substitutions where the key person shall not be reporting to work for any reason the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person.

2.8.4.3 The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA

COS or designee show documented clinical problems or continual unprofessional behavior/actions with any RTTs, s/he may request, without cause, immediate replacement of said RTT. The CO and COR shall deal with issues raised concerning RTT’s conduct. The final arbiter on questions of acceptability is the CO.

2.8.5 Contingency Plan: Continuity of care and uninterrupted operations of a Radiation Oncology Program are essential components of this contract and will be primary factors in Contractor’s assignment of staff and frequency of substitutions. Because continuity of care is an essential part of VAGLAHS’s medical services, The Contractor shall have a contingency plan in place to be utilized if the RTT leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours/Work Schedule: RTTs shall be scheduled for duty during normal business hours for the

VAGLAHS Radiology Oncology Department from 8:00am – 4:30pm, Monday through Friday. However, there may be circumstances when RTTs and/or will be scheduled to work before/after those hours and/or on weekends and holidays.

3.1.1. Patients must be seen by an RTT on-site at VAGLAHS 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. RTT(s) shall be available and present in clinic during normal VAGLAHS clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are Monday through Friday, 8:00 a.m. to 4:30 p.m.

3.1.3. Contractor shall provide RTTs to accommodate a flexible work schedule based upon patient workload, including shifts after normal VA business hours, weekends and/or holidays.

3.1.4. The COR or his/her designee shall provide the Contractor with bi-weekly shift schedules at least two days in advance of the scheduled time.

3.1.5. RTTs shall not work additional hours over their assigned shifts as depicted on the bi-weekly shift schedule without prior written approval of the COR or his/her designee.

3.1.6. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

• New Year’s Day

• President’s Day

• Martin Luther King’s Birthday

• Memorial Day

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

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

3.2. Cancellation/Rescheduling: If a VAGLAHS treatment machine is not functional and requires service, the patient’s treatment may be rescheduled, and the radiation therapy technologists work hour may be rescheduled accordingly. The RTTs will only be paid for the time they have worked according to the rescheduled work hours;

however, a minimum of 4 hours will be paid to the Contractor if the provider reported for duty at the normally scheduled time. In case of pre-scheduled machine down time due to service or hardware/software upgrade, the work hours of the contract RTTs will be rescheduled without pay.

3.2.1. Unless a state of emergency has been declared, the Contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES

4.1. SERVICES REQUIRED:

4.1.1. 6240 hours Certified Radiation Therapy Technologists. The department has one CT-Simulator for patient setup simulation and three linear accelerators for patient treatments. The CT-Simulator requires one to two RTTs to operate and each of the linear accelerator always requires three RTTs. The successful RTT candidate shall meet the minimum qualification as stated above and have experiences in the specific treatment modalities, such as SRS, SRT, SBRT, IGRT, Rapid Arc, and Gated Breathing, implemented in the department. They must be proficient in Aria Software. They must have minimum of continuous 2 years’ experience on the Novalis, True Beam, Tomotherapy and 21 ex linear accelerators machines

4.2. Standards of Practice: The patient care provided by Contractor shall be evidence based best practices that meet or exceed all standards of professional practice and performance measures applicable to VAGLAHS medical professionals, including, but not limited to, TJC standards and ACR current practice guidelines in radiation oncology.

Contractor’s care shall cover the range of services as would be provided in a state-of-the-art civilian medical treatment facility. Contractor shall provide evidence the Contractor’s radiation oncology standard of care is of a quality that meets or exceeds currently recognized VA and ACR national standards as established by:

4.2.1. The American College of Radiology (ACR) Guidelines for Radiation Oncology.

▪ http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-

Oncology

▪ http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised

4.2.2. The professional standards of the TJC or equivalent accreditation http://www.jointcommission.org/standards_information/hap_requirements.aspx .

4.2.3. 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

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

4.2.5. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. AUTHORITIES: Contractor’s physician (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).

http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised http://www.jointcommission.org/standards_information/hap_requirements.aspx https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.hpoe.org/resources?show=100&type=8

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a

BAA for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or 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: Contractor’s physician (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 Handbook

1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the

Contractor.

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

1907.01 Health Information Management and Health Records:

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

4.3.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to

Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and

Authorization to Release Medical Records or Health Information, when releasing records protected by

38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed

Release of Information requests will be forwarded to the VAGLAHS Privacy Officer, Joann Wortham at Joann.Wortham@va.gov.

4.4. DIRECT PATIENT CARE: 95% of the time RTTs shall be involved in direct patient care.

4.4.1 Radiation Therapy Technologist: Contractor shall provide, at a minimum, the following Radiation

Oncology services for Veteran patients in accordance with the terms and standards specified herein

4.4.1.1 Contract RTTs shall provide evaluation and follow the prescribed treatment plans provided by the Physicist and Radiation Oncologist. Delivery of high dose radiation therapy with precision. Follow patients for treatment management, Contract Radiation Therapy Technologist shall complete any documentation associated with the treatment provided to VA patients treated by them.

4.4.1.2 Radiation Treatment: Use of the following modalities shall be fully justified in accordance with the appropriateness criteria of the American College of Radiology (ACR).: KV/KV Matching, CBCT, 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=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf mailto:Joann.Wortham@va.gov

Portal Images, IMRT, IGRT, Stereotactic Radiosurgery, Stereotactic Radiotherapy, as well as the use of

Novalis, Brain Lab, Tomotherapy, True Beam, and 21 ex machines. Use of the following on Aria, Eclipse software. ACR Quality-Safety Appropriateness Criteria may be accessed at:

http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised.

4.4.2 Contract radiation RTTs shall maintain written policies and procedures that clearly define guidelines for protecting patients and employees from all unnecessary radiation exposure, provisions for the safe use.

4.4.2.1. Inclusion of correct Current Procedural Terminology (CPT) and diagnoses codes, and service connection of condition being treated on encounters;

4.4.2.2. Assist in and oversee fabrication of compensating filters, custom shields, wedges, and other beam modifying devices.

4.4.2.3. Electronic signature on all entries; timeframes for electronic signing, completion and closing of entries and encounters.

4.4.2.4. Review Aria and CPRS documents are done correctly, check that billing charges are correct and billed to the correct patient, check prescribed dose, check daily dose, patient encounter documentation and patient schedules to make sure all tasks are sent to MD and Physics staff.

Completion deadlines met as assigned by Chief Technologist/COR

4.5 Administrative: Estimated 5% time not involved in direct patient care, contracted RTTs shall perform the following:

4.5.1 Contractor’s staff shall attend service staff meetings as required by the VA Chief, Radiation

Oncology Service, COS or designee. Contractor to communicate with COR on this requirement.

Meeting Frequency (monthly, once a year etc.)

Annual Hours

Weekly Chart Rounds 1X a week 0.5 hours a week

4.6 Patient Safety:

4.6.1Patient safety incidents must be reported within 24 hours using Patient Safety Report. 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.

4.6.2 Adverse events will be reported to the VA Quality & Patient Safety Office to the Patient Safety Manager or

Patient Safety Coordinator and entered into the Patient Safety Reporting System, as outlined in the National

Center for Patient Safety Handbook (http://www.va.gov/ncps/Pubs/NCPShb.doc). Adverse events will be scored utilizing the Safety Assessment Code for determination of the need for conducting a Root Cause Analysis (RCA).

Report adverse events to Lead Patient Safety Manager Edwin Moralez at 413-584-4040; or if unavailable, contact Patient Safety Coordinator at Jerilyn Higa at 310-478-3711 X48326.

4.6.3 The Contractors shall report all incidents involving radiation misadministration to the NRC in accordance with National Radiation Safety Committee SOP #5: NRC Reporting Requirements (10 CFR 20, 21, 30, 35).

4.6.4 Adverse drug reactions, allergies, and adverse drug events should be appropriately and promptly entered into CPRS.

4.7 PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT (QI):

The Government may evaluate the quality of professional and administrative services provided in accordance with the standards (ACR standards and others) as outlined in this document, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments), in accordance with Federal Acquisition http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised http://www.va.gov/ncps/Pubs/NCPShb.doc

Regulation (FAR) 37.401(b). The following measures represent the performance standards required to be met and will be included on the government’s Quality Assurance Surveillance Plan:

4.7.1 Measure: Quality Improvement Plans Staff meetings…