36C26318R0695-001.docx

36C26318R0695

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

656-19-2-066-0005 36C26318R0695 10-31-2018 Steven Yale

(651) 293-3043 11-15-2018

09:00EST

36C618 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Attention: Daniel Vagts 316 Robert Street N. STE. 506 St. Paul MN 55101 X X 561320 $27.5 Million X N/A X Department of Veterans Affairs NCO 23 - Minneapolis 4801 Veterans Drive St. Cloud MN 56303 Department of Veterans Affairs

NCO 23

Attention: Steven Yale 316 N. Robert St., Suite 506 St. Paul MN 55101

Y Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-9971 See CONTINUATION Page This procurement is to secure 2.0FTE Internal Medicine Physician Services on-site at the St. Cloud VA Health Care System The period of performance on this requirement will start on 01-21-2019 - 07-20-2019.

There will be a 6-month option period to be exercised at the Governments discretion.

See CONTINUATION Page 656-3690160-066-820400-2560 010040100 X X

ONE

Daniel Vagts Contract Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C263 Charles Hurry Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Attention: Daniel Vagts 316 Robert Street N. STE. 506 St. Paul MN 55101

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:

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

B.2 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.3 SCHEDULE OF SERVICES

The Contractor shall furnish personnel to provide services necessary to perform onsite Primary and Specialty Medicine Outpatient and Urgent Care Clinic Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, St. Cloud, Minnesota.

St. Cloud VA Health Care System physician will be Board Eligible/Certified in Internal Medicine/Family Practice throughout the period of the contract. The physician will be under the direct supervision of the Primary Care Director and shall perform all requirements stated within this contract.

Place of Performance: Services shall be provided on site in Primary and Specialty Medicine Service Line at the St. Cloud VA Health Care System, 4801 Veterans Drive, St. Cloud, Minnesota, 56301.

Period of Performance: Base Period: January 21, 2019 to July 20, 2019

Period Cost

Sub CLIN 0001a

Name:

Title/Level of Experience:

Period Cost

Sub CLIN 0001b

Name:

Title/Level of Experience:

Period of Performance: Option Period One: July 21, 2019 to January 20, 2020

Period Cost

Sub CLIN 1001a

Name:

Title/Level of Experience:

Period Cost

Sub CLIN 0001b

Name:

Title/Level of Experience:

Total for Base and Option Period: $__________

B.4 PERFORMANCE WORK STATEMENT

1. GENERAL

SERVICES REQUIRED: The Primary and Specialty Medicine Outpatient Clinic has a need for 2.0 FTEE internal Medicine/Family Practice Physician working within a Patient Aligned Care Team (PACT) or Urgent Care when coverage is needed. The Physician assigned by the contractor must cooperate with all VA Credentialing and Privileging requirements. Physician is a member of the medical staff of the St. Cloud VA Health Care System and will be bound by the medical staff bylaws and standards of care and practice.

1.1. PLACE OF PERFORMANCE: St. Cloud VA Health Care System, 4801 Veterans Drive, St. Cloud, Minnesota 56301 within the Primary and Specialty Medicine Outpatient Clinic or Urgent Care

1.2. Policy/Handbooks:

1.2.1. VA Handbook 1101.10: Patient Aligned Care Team (PACT) Handbook Http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2977

1.2.2. VHA Directive 1101.05: Emergency Medicine

http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=3236

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

1.2.4. VHA Handbook 1100.19: Credentialing and Privileging

http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID2910

1.2.5. VHA Directive 2013-001, Extended Hours Access for Veterans Requiring Primary Care Including Women’s Health and Mental Health Services at Department of Veterans Affairs Medical Centers and Selected Community Based Outpatient Clinics http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID2854

1.2.6. VHA Directive 1232: Consult Processes and Procedures

http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID3230

1.2.7. Health Care System Memorandum CD11-05: Bylaws, Rules, and Regulations of the Medical and Clinical Professional Staff, March, 2016

2. QUALIFICATIONS:

2.1. 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 any State, Territory, or Commonwealth of the United States or the District of Columbia. 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.

2.2. Board Certification - All contract physician(s) shall be board certified. 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.

2.3. Credentialing and Privileging –Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 and Health Care System Memorandum CD11-05 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 St. Cloud VA Health Care System Professional Standards Board, Medical Executive Board and Medical Center Director.

2.3.1. If a contract physician(s) and/or other contract provider (s) are 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.

2.4. Technical Proficiency - Contract physician(s) and other contract provider (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’s physicians and other contract provider(s) shall have knowledge of professional care theories, principles, practices, and procedures to service primary care outpatient clinic patient population. Contractor’s physician and other contract provider(s) shall demonstrate knowledge of growth and development, pathophysiology of disease processes, and chronic disease management. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract physician(s) and other contract provider(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (HCSM CD11-05) that govern medical staff behavior.

2.5. Continuing CME/CMU Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VA. Contractors registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentials office for tracking. These documents are required for initial and renewal privileging. Failure to provide shall result in loss of privileges.

2.6. Training: Contract physician (s) and other contract provider (s) shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contract physician (s) and other contract provider (s) as required by the VA. A copy of certifications listed below must be giving to the COR.

2.6.1. BLS: Physician must be certified and current in Basic Life Support. Government will not be held accountable to pay for re-certification if ACLS is due within the contract period.

2.7. Standard Personnel Testing/Infection Control: Contractor shall provide statement that all required infection control testing is current and that the contractor is compliant with OSHA regulations concerning occupational exposure to blood borne pathogens. Contractor shall provide proof of the following tests for their staff 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.

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

2.7.2. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractors 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. Contractors shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.8. National Provider Identifier (NPI): Contract physician (s) and other contract provider (s) who provide billable healthcare services to VA; VHA, shall obtain a NPI as required by the Health Insurance Portability and Accountability Act (HIPPA) National Provider Identifier Final Rule, administered by the CMS. This rule establishes assignment of a 10-digit numeric identifier for Contractor staff, intended to replace the many identifiers currently assigned by various health plans. Contract physician (s) needs only one NPI, valid for all employers and health plans. Contract physician (s) must also designate their Specialties/Subspecialties by means of Taxonomy Codes on the NPI application. The NPI may be obtained via a secure website at: https://nppes.cms.hhs.gov/NPPES

2.9. DEA (as required) - Contractor shall provide copy of current DEA certificate.

2.10. Conflict of Interest: The Contractor and all contract physician (s) and other contract provider (s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.11. Citizenship related Requirements:

2.11.1. 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;

2.11.2. 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.

2.11.3. 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.

2.11.4. 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.

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

2.12. 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.

2.12.1. 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) 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.

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

2.13. 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 Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional direction of all clinical personnel covered by this contract will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.14. Non Personal Healthcare Services: The parties agree that the Contractor and all contract physician (s) and other contract provider (s) shall not be considered VA employees for any purpose.

2.15. Inherent Government Functions: Contractor and Contract physician (s) and other contract provider (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.

2.16. No Employee status: The Contractor shall be responsible for protecting Contract physician (s) and other contract provider (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:

2.16.1. Workers’ compensation

2.16.2. Professional liability insurance

2.16.3. Health examinations

2.16.4. Income tax withholding, and

2.16.5. Social security payments.

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

2.18. Key Personnel: (Contracting for Coverage to meet ACR Standards) Contractor shall provide the number of qualified staff as is necessary to perform the services required under this contract, at the staffing level determined to be professionally acceptable by the St. Cloud VA Health Care System Chief of Staff and in accordance with staffing guidelines.

2.18.1. The number of Board Certified Internal Medicine/Family Practice Physicians required to be on site on a daily basis is 2.0 as defined in paragraph Hours of Operation in this section.

2.19. Contingency Plan: Continuity of care and uninterrupted operations of a Outpatient Clinic Program are essential components of this contract and will be primary factors in Contractor’s assignment of staff. The Contractor shall have a contingency plan in place to be utilized if the contract physician (s) and other contract provider (s) 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: St. Cloud VA Health Care System Primary and Specialty Medicine Clinic hours are Monday through Friday 8:00 a.m. – 4:30 p.m. except Federal holidays. Urgent Care business hours are 8:00 a.m. – 6:30 p.m. everyday including weekends and holiday.

3.2. Work Schedule: Monday thru Friday 8:00 a.m. – 4:30 p.m., unless covering within Urgent Care physician will work 8:00 a.m. – 6:30 p.m.

3.2.1. Patients must be seen by a contract physician (s) on-site at St. Cloud VA Health Care System 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.

3.2.2. Contract Physicians shall be available and present in clinic during normal St. Cloud VA Health Care System 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.

3.2.3. 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.

3.3. Cancellation/Rescheduling: Physician is required to give advanced notice, at least 45 days, of requested leave. If patients are scheduled within the clinic on requested day, physician must make appropriate arrangements prior to leave to ensure continuity and patient’s care is not compromised prior to leave. This may mean overbooking the physician’s clinic to ensure patient is seen within the timeframe specified by the Return to Clinic Order or request made by the patient.

4. CONTRACTOR RESPONSIBILITIES

4.1. SERVICES REQUIRED: St. Cloud VA Health Care System requests 2.0 FTEE (2080 hours) Board Certified in Internal Medicine/Family Practice Physician to work within the Outpatient Primary Care Clinic or Urgent Care as needed Monday through Friday 8:00 a.m. to 4:30 p.m. unless otherwise specified by the Director or designee of Primary and Specialty Medicine.

4.2. Standards of Practice: The medical practice and 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 St. Cloud VA Health Care System medical professionals, including, but not limited to, TJC standards and ACP current practice guidelines.

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 primary care standard of care is of a quality that meets or exceeds currently recognized VA and ACP national standards as established.

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

4.2.2. 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

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

4.2.4. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contract 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 at the following address: St. Cloud VA Health Care System, Attn: Julie Kraus, 4801 Veterans Drive, St. Cloud, MN 56301

4.4. DIRECT PATIENT CARE: 81% of the time involved in direct patient care.

4.4.1. Board Certified Internal Medicine/Family Practice Physician: Contractor shall provide, at a minimum, the following Primary and Specialty Medicine Physician services for Veteran patients in accordance with the terms and standards specified herein

4.4.1.1. Services shall include diagnosis, evaluation treatment, and provide consultation across all settings including the following areas: General and Subspecialty Internal Medicine or Family Practice, neurology, office Gynecology, geriatrics, musculoskeletal, common mental illness, dermatologic, and other chronic ambulatory conditions. Includes preventative health, health promotions, chronic disease management, and counseling. Including diagnosis, evaluations, and treatment of acute conditions to include admitting.

4.4.1.2. Peer Review and meetings: Contract Staff shall participate in administrative reviews as requested and attend provider staff meetings as assigned within clinic time.

4.5. ADMINISTRATIVE: 19% of time not involved in direct patient care

4.5.1. Contractor’s staff shall attend service staff meetings as required by the VA Chief, Primary and Specialty Medicine Service Line or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.

4.5.2. Contractor is responsible for assisting in a protected peer review program in compliance with The Joint Commission and ACP standards and to maintain documentation of appropriate peer review statistics as needed for quality management and credentialing.

4.5.3. Patient Safety:

4.5.3.1. Patient 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.

4.5.3.2. 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 Patient Safety Manager.

4.6. 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 as outlined in this document, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment), in accordance with Federal Acquisition 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:

4.6.1. Measure: Qualifications and Availability of Key Personnel Performance Requirement: Physicians shall be board certified.

Standard: All (100%) of Physicians shall be board certified in accordance with Standards and available to provide the required scheduled services to veterans 100% of the time.

Acceptable Quality Level: No deviations from the standard (100%).

Surveillance Method: Periodic Sampling of qualification documentation and medical records submitted in accordance with contractor reporting requirements.

Frequency: During Credentialing/privileging of physician Incentive: Positive Past Performance Disincentive: Negative Past Performance

4.6.2. Measure: Provider Quality Performance

Performance Requirement:

Standard: OPPE documentation for all (100%) staff providing services under the contract. All staff (100%) meet stated Standards noted on OPPE.

Acceptable Quality Level: The target stated on OPPE Surveillance Method: Ongoing Provider Performance Evaluation (OPPE) data pertinent to care performed for each provider working under this contract. The Contractor shall furnish OPPE data on new providers added as requested.

Service: OPPE data should include the following elements:

Frequency: Quarterly Incentive: Positive Past Performance Disincentive: Negative Past Performance

4.7. 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. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

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

4.9. REQUIRED REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS)

4.9.1. As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information.

4.9.2. Each Contractor whose contract award is estimated to exceed $150,000 is required to register with CPARS database at the following web address: www.cpars.csd.disa.mil. Help in registering can be obtained by contacting Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690. Registration should occur no later than thirty days after contract award, and must be kept current should there be any change to the Contractor’s registered representative.

4.9.3. For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the Contractor’s performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the Contractor’s designated representative for comment. The Contractor representative will have thirty days to submit any comments and re-assign the report to the CO.

4.9.4. Failure to have a current registration with the CPARS database, or to re-assign the report to the CO within those thirty days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond.

5. GOVERNMENT RESPONSIBILITIES:

5.1. VA Support Personnel, Services or Equipment: St. Cloud VA Health Care System will provide needed equipment including, but not limited to, computer, phone, exam room, examination equipment and support staff including, but not limited to, Registered Nurse, Licensed Practical Nurse, Medical Support Assistant, etc. needed to complete clinical work within the facility.

5.2. CPRS TRAINING: COR will arrange and government will provide appropriate opportunity for Contractor staff to take CPRS training.

5.3. Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to:

Contracting Officer: NCO23 Contracting Officer Representative: Matthew Anderson, COR Medical Acting Service Line Director: Richard Linares, MD Nurse Administrator: Breta Monroe, APRN Administrative Assistant: Stacy Wittrock

5.4. CO Responsibilities:

5.4.1. The CO is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the CO on all matters pertaining to contract administration. Only the CO is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract.

The CO shall resolve complaints concerning Contractor’s provider relations with the Government employees or patients. The CO is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the CO without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof.

In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for the contract staff to be provided by the VA; replacement of the contract staff and/or renegotiation of the contract terms or termination of the contract.

5.5. COR Responsibilities: Matthew Anderson, (320) 252-1670 ext 6558, Matthew.Anderson2@va.gov

5.5.1. The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

5.5.2. The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected.

5.5.3. The COR will maintain a record-keeping system of services. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the Contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

5.5.4. The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference.

5.5.5. All contract administration functions will be retained by the VA.

6. SPECIAL CONTRACT REQUIREMENTS

6.1 The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each. Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required.

The following are brief descriptions of required documents that must be submitted by Contractor: upon award; weekly; monthly; quarterly’; annually, etc. identified throughout the PWS and are provided here as a guide for Contractor convenience. If an item is within the PWS and not listed here, the Contractor remains responsible for the delivery of the item.

6.2. Billing:

6.2.1. Professional services invoiced under contract shall be provided by attending physicians and not by residents. The Contractor shall certify in writing that the service was provided by an attending physician prior to VA processing payment.

6.2.2. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than three days after the end of a week. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:

6.2.2.1. Name and Address of Contractor

6.2.2.2. Invoice Date and Invoice Number

6.2.2.3. Contract Number and Purchase/Task Order Number

6.2.2.4. Date of Service

6.2.2.5. Contract physician (s)

6.2.2.6. Hourly Rate

6.2.2.7. Quantity of hours worked

6.2.2.8. Total price

6.3. Vendor Electronic Invoice Submission Methods

Facsimile, e-mail, and scanned documents are not acceptable forms of submission for…