36C26318Q0634-015.docx

36C26318Q0634

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

36C26318Q0634 07/13/2018 Daniel Reinke 651-293-3037 08/03/2018

8AM CDT

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Attn: Daniel Reinke, Contract Specialist 316 Robert Street N.

St. Paul MN 55101 X X 561320 $27.5 Million N/A X N/A X Department of Veterans Affairs VA Fargo Healthcare System 2101 Elm St N Fargo, ND 58102 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Attn: Daniel Reinke, Contract Specialist 316 Robert Street N.

St. Paul MN 55101

Y Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-9971

- Endocrinology services for Fargo VAHCS.

- Period of Performance is from September 30, 2018 through March 29, 2019 with the possibility of one (1) option period.

- Reference section B.2 for Schedule of services

- Reference section E.1 for submittal instructions and E.13 for evaluation factors.

- All questions are due by email NLT 8AM CDT 07/27/2018.

X

ONE

Shea Colby Contracting Officer Table of Contents

36C26318Q9550 36C26318Q9550

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:

Name:

Address:

DUNS:

TIN:

Point of Contact:

Phone number:

Email:

b. GOVERNMENT: Contracting Officer Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Attn: Daniel Reinke, Contract Specialist 316 Robert Street N.

St. Paul MN 55101 651-293-3037 daniel.reinke@va.gov

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

3. INVOICES: Invoices shall be submitted in arrears:

[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. Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-9971 Tungsten website and phone number: http://www.tungsten-network.com/ 1 866 340 4980 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform onsite Endocrinology Physician Services to eligible beneficiaries of the Department of Veterans Affairs Health Care System, Fargo, North Dakota (hereinafter referred to as Fargo VA HCS).

The VA HCS Endocrinology Physician Services are accredited by The Joint Commission (JC) and follow the standards & guidelines set forth by American Association of Clinical Endocrinologists (AACE). A contractor providing onsite Endocrinology Physician Services shall provide services that meet or exceed the AACE Guidelines https://www.aace.com/ Place of Performance: Services shall be provided on site, VAHCS Fargo, ND 2101 N Elm Street, Fargo ND, 58102 Pricing Instructions:

The offeror is instructed to edit the number of sub-clins to correspond with the number of key personnel submitted for the contract line item number (CLIN). Affiliate Offerors shall include the “title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SUB-CLINs if adding or removing Key Personnel.

The Contractor shall propose 0.5 FTE key personnel to be credentialed and be available for scheduling to meet the requirements of the contract. 0.5 FTE is defined by Fargo VA HCS as a minimum of 40 hours every two weeks per year, totaling 1040 hours annually.

Period of Performance: BASE period Six Months: 09/30/2018 to 03/29/2019 CLIN No.

SUBCLIN

Description

Qty.

Unit

Unit Cost Total Annual Cost

Note: No on-call coverage is required

PRICE

DO NOT

PRICE

KEY PERSONNEL

None

Name: _____________

Hours

TOTAL FOR Base Period

Period of Performance: OPTION Period Six Months: 03/30/2019 to 09/29/2019

CLIN No.

SUBCLIN

Annual Cost

Note: No on-call coverage is required

PRICE

DO NOT

PRICE

KEY PERSONNEL

None

Name: ______________

Hours

TOTAL FOR Base Period

Total for base period and option period: $

* When pricing for hourly rates please round to the nearest whole dollar.

** Period of performance is based on the successful credentialing of candidates. If credentialing is not complete by the time of the period of performance start date the new period of performance will begin upon successful completion of credentialing.

B.3 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-4 Notice of Price Evaluation Preference for HubZone Small Business Concerns. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

B.4 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.

B.5 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified/Board Eligible Endocrinology Physician Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Fargo VA Health Care System (Fargo VA HCS). A contractor providing onsite Endocrinology physician services that meet or exceed the American Association of Clinical Endocrinologists (AACE). https://www.aace.com/

1.2. Statement of Need: The Fargo VA HCS is in need of a 0.5 FTE Endocrinology Physician to work onsite at the Fargo, North Dakota VA HCS. VA HCS Hours of operation at the Fargo VAHCS for Endocrinology service provider will be 8 AM to Noon (20 hours per week) Monday through Friday. An alternative work schedule (for example: 8AM to 4:30 PM with ½ hour for lunch, Monday through Friday, every other week) could be considered if it meets the needs of Fargo VAHCS and the Endocrinology service provider. Any alternative work schedule must include 40 hours per two week pay period. This contract will be for a six (6) month base period, plus one six (6) month option period.

1.3. Place of Performance: - Contractor shall furnish services at the Fargo VAHCS 2101 N Elm Street Fargo ND 58102

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

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

1.5.1. - VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

1.5.2. 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

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

1.5.4. - VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

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

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

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

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

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

1.6.2. AACE: American Association of Clinical Endocrinologists

1.6.3. ACGME: Accreditation Council for Graduate Medical Education

1.6.4. ACLS: Advanced Cardiac Life Support

1.6.5. ATLS: Advanced Trauma Life Support

1.6.6. AOD: Admitting Officer of the Day

1.6.7. BLS: Basic Life Support

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

1.6.9. CDC: Centers for Disease Control and Prevention

1.6.10. CDR: Contract Discrepancy Report

1.6.11. CEU: Certified Education Unit

1.6.12. CME: Continuing Medical Education

1.6.13. CMS: Centers for Medicare and Medicaid Services

1.6.14. 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.

1.6.15. 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.

1.6.16. COS: Chief of Staff

1.6.17. CPARS: Contractor Performance Assessment Reporting System

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

1.6.19. 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

1.6.20. DEA: Drug Enforcement Agency

1.6.21. ED: Emergency Department

1.6.22. FSMB: Federation of State Medical Boards

1.6.23. HHS: Department of Health and Human Services

1.6.24. HIPAA: Health Insurance Portability and Accountability Act

1.6.25. HR: Human Resources

1.6.26. ISO: Information Security Officer

1.6.27. 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.

1.6.28. MOD: Medical Officer of the Day

1.6.29. 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).

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

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

1.6.32. NP: Nurse Practitioner

1.6.33. NPPES: National Plan and Provider Enumeration System

1.6.34. PA: Physician Assistant

1.6.35. PALS: Pediatric Advanced Life Support

1.6.36. POP: Period of Performance

1.6.37. PPD: Purified Protein Derivative

1.6.38. PWS: Performance Work Statement

1.6.39. 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, etc.; 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.

1.6.40. QA/QI: Quality Assurance/Quality Improvement

1.6.41. QM/PI: Quality Management/Performance Improvement

1.6.42. QASP: Quality Assurance Surveillance Plan

1.6.43. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

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

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

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

1.6.47. Fargo Veterans Affairs Health Care System (VA HCS): Unless identified with the name of a different site, the Fargo Veterans Affairs Health Care System, for purposes of this contract, this term shall mean the Fargo Veterans Affairs Health Care System, based in Fargo, ND.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License - Contract physician(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in the Territory, or Commonwealth of the United States or the District of Columbia) where services are being performed. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contract 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 contract physician(s) shall be Board Certified/Board Eligible in Endocrinology, and be currently certified in Basic Life Support (BLS) or equivalency. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging –Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. 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 contract physician(s) prior to obtaining approval by the Fargo VA HCS Professional Standards Board, Medical Executive Board and Medical Center Director. If a contract 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 - Contract 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. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract physician(s) and contract 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 the Fargo VAHCS. Contract 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 (BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contract physician(s) as required by the VA.

Total Education hours

11.25

2.1.7. Standard Personnel Testing (PPD, etc.): 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 Contracting Officer. Tests shall be current within the past year.

2.1.7.1.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract physician(s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

2.1.7.1.2. RUBELLA TESTING: Contractor shall provide proof of immunization for all contract physician(s) for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

2.1.7.1.3. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contract physician(s); provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care 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.

2.1.8. 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 quote.

2.1.9. DEA - Contractor shall provide copy of current DEA certificate acceptable to the Fargo VAHCS where services will be provided under this contract.

2.1.10. Conflict of Interest: The Contractor and all contract physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of quote and during the entirety of contract performance. At the time of the quote, 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.

2.1.11. Citizenship related Requirements:

2.1.11.1. 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;

2.1.11.2. While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result 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.

2.1.11.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.11.4. 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.

2.1.11.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFQ using the subject attachment in Section D 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. 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 contract 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 quote, 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 Direction: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Fargo VAHCS Director as provided in VHA Handbook 1100.19. The Fargo VAHCS reserves the right to contact the proposed contractor physician and their references prior to contract award. Clinical/Professional direction of all clinical personnel covered by this contract for quality purposes will be provided by the Fargo VAHCS 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 contractor’s physician(s) shall not be considered VA employees for any purpose.

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

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

2.6. Inherent Government Functions: Contractor and Contract 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 certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.4.1.1.1. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s). When a Contractor or contract 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:

2.9.1.1. The VA Full Time Equivalency (FTE) for the services required is 0.5 FTE. An Endocrinologist 0.5 FTE is defined as 40 hours every two weeks and does not include holidays. The 40-hour requirement is expressed as follows: VA HCS Hours of operation at the Fargo VAHCS for Endocrinology service provider will be 8 AM to Noon (20 hours per week) Monday through Friday. An alternative work schedule (for example: 8AM to 4:30 PM with ½ hour for lunch, Monday through Friday, every other week) could be considered if it meets the needs of Fargo VAHCS and the Endocrinology service provider. Any alternative work schedule must include 40 hours per two weeks pay period.

2.9.1.2. The number of Board Certified/Board eligible Endocrinologist physicians required to be on site on a daily basis is one. 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 the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required.

2.10. 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 7 day(s) 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 7 calendar days prior to making any permanent substitutions

2.10.1. 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 7 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

2.10.2. For temporary substitutions where the key person shall not be reporting to work for three 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 weeks will require the procedure as stated above.

2.10.3. 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 contract physician(s), s/he may request, without cause, immediate replacement of said contract physician(s).

2.10.4. The CO and COR shall deal with issues raised concerning Contract physician(s) conduct. The final arbiter on questions of acceptability is the CO.

2.10.5. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the contract physician(s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. HOURS OF OPERATION:

3.1.1. VA Business Hours: Hours of operation at the Fargo VAHCS for Endocrinology service provider will be 8 AM to Noon (20 hours per week) Monday through Friday. An alternative work schedule (for example: 8AM to 4:30 PM with ½ hour for lunch, Monday through Friday, every other week) could be considered if it meets the needs of Fargo VAHCS and the Endocrinology service provider. Any alternative work schedule must include 40 hours per two week pay period.

3.1.2. Patients must be seen by a contract physician(s) on-site at Fargo VAHCS 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.

3.1.3. Contractor’s physician(s) shall be available and present at the Fargo VAHCS during the required shift at the Fargo VAHCS which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff.

3.1.4. Off-hours Coverage: There will be no off-hours on call coverage needed

3.1.4.1.1. Contract physicians must be available at all times for phone consultations with VA residents and physicians while onsite

4. CONTRACTOR RESPONSIBILITIES

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

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

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

4.2.1. American Association of Clinical Endocrinologists (AACE). https://www.aace.com/

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

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

4.2.5. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contract 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).

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

4.3.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer Laurel Peterson at the following address Fargo VAHCS 2101 N Elm Street Fargo ND 58102.

4.4. Direct Patient Care: Estimated at 80% direct patient care, and 20% charting/documentation.

4.4.1. Per the qualification section of this PWS, the Contractor shall provide the following staff:

4.4.1.1.1. Board Certified/Board Eligible Endocrinologist will be assigned to the VA facility.

4.4.2. Scope of Care: Contractor’s physician(s) (As appropriate, within scope of practice/privileging, and capabilities of the Fargo VAHCS) shall be responsible for providing Endocrinology service care, including, but not limited to:

4.4.2.1.1. Evaluation, Emergent Treatment and Management: Employment of the principles of Endocrinology care to include but not limited to Diabetes, Thyroid disease, Menopause, Pituitary Tumors, testosterone therapy and treatment or research of other disorders that affect the endocrine system.

4.4.2.1.2. Evaluation, treatment of multiple glands throughout the body that can cause problems with reproduction, growth, bone health or metabolism.

4.4.2.1.3. Evaluation, treatment and management of patients. Endocrinologists must be able to translate symptoms into conditions, so that a proper diagnosis and treatment plan can be prescribed for each patient.

4.4.2.1.4. In addition to physical examinations, evaluation and testing to diagnose hormonal imbalances that contribute to or cause conditions to include but are not limited to osteoporosis, hypertension, weight loss or gain, diabetes and infertility. Evaluations to include but not limited to bone density readings, magnetic resonance images (MRIs), ultrasounds and other lab and imaging modalities as appropriate.

4.4.2.1.5. Evaluation, treatment and management in conjunction with other specialties to coordinate care of emergent disorders of endocrine, metabolic and nutritional natures relating to acid-base disturbances, adrenal, parathyroid and thyroid disturbances.

4.4.2.2. Duty: Contractor physician(s) shall be present on time for any scheduled tours as documented by physical presence in the appropriate location of the Fargo VAHCS, at the scheduled start time.

4.4.2.3. Consultation and Referral Responsibilities: Contractor physician(s) shall provide consultation with, and instruction to, referring physicians on an in-patient and out-patient basis. Contractor physician(s) shall determine the appropriate course of treatment and document same in the electronic medical record (CPRS). Contractor physician will communicate in person or by phone for in-patients with the referring clinicians.

4.4.2.4. Medications: Contractor physician(s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients.

4.4.2.5. Discharge education: Contractor physician(s) shall provide discharge education, medication reconciliation, and follow up instructions that are coordinated with the next care setting for all Inpatient Hospitalist patients.

4.4.3. ADMINISTRATIVE: Up to 10% of time not involved in direct patient care, however, patient care is the priority.

4.4.3.1. Quality Improvement Meetings: The contractor’s physician(s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the Fargo VAHCS Chief of Service, Chief of Staff, or designee.

List all meetings, associated time and frequency.

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

4.4.3.3. Specialized CPRS Documentation…