36C26319R0041-001.docx

36C26319R0041

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

618-19-2-3801-0010

36C263-19-AP-1466

36C26319R0041 01-31-2019 Steven Porwoll 651-293-3049 02-15-2019

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 621112 $11 Million X N/A X VA Central Iowa Health Care System 3600 30th Street Des Moines IA 50310 Department of Veterans Affairs

NCO 23

Attention: Steven Porwoll 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 2.0 FTE Psychiatrists, services on-site at the VA Central Iowa Health Care System.

The period of performance on this requirement will start on 03-01-2019 - 08-31-2019.

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

See CONTINUATION Page 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 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Attention: Steve Porwoll 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 SCHEDULE OF SERVICES

(BASE Period) Period of Performance: March 1, 2019 through August 31, 2019 POP: Could be changed depending on when key personnel clears credentialing and background requirements.

Annual Cost

NAME:_________________________________

TITLE/LEVEL OF EXPERIENCE:____________

NAME:_________________________________

TITLE/LEVEL OF EXPERIENCE:____________

(OPTION Period 1) Period of Performance: September 1, 2019 through February 29, 2020

Annual Cost

NAME:_________________________________

TITLE/LEVEL OF EXPERIENCE:____________

NAME:_________________________________

TITLE/LEVEL OF EXPERIENCE:____________

Performance Period and all Option Periods: $_________________________

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL

1.1. SERVICES REQUIRED/ PROVIDED: The Department of Veterans Affairs (VA) requires a Contractor to provide psychiatric services at the Des Moines VA, 40 hours per week. The Contractor shall provide two (2) Board Certified or Board Eligible Psychiatrist(s) (in this case meaning a graduate from a psychiatric residency and having a valid license to practice medicine) on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and VA Central Iowa Health Care System, Des Moines Iowa (VACIH Des Moines).

1.2. PLACE OF PERFORMANCE: Contractor shall furnish services at the

VA CENTRAL IOWA, DES MOINES VA

3600 30th Street Des Moines, Iowa 50310

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

1.4. POLICY/HANDBOOKS: the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

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

1.4.2. 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

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

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

1.4.5. VHA Handbook 1100.19 Credentialing and Privileging - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

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

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

1.4.8. VA-CIHCS Medical Staff By-laws (20OCT2014):

https://vaww.visn23.portal.va.gov/cih/SiteDirectory/MCoS/Shared%20Documents/Medical%20Staff%20%20Bylaws%20-%20October%202014.pdf

1.5. DEFINITIONS/Acronym: 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.

1.5.1. APA: American Psychiatric Association

1.5.2. ACLS: Advanced Cardiac Life Support

1.5.3. AOD: Admitting Officer of the Day

1.5.4. BLS: Basic Life Support

1.5.5. CARF: Commission on the Accreditation of Rehabilitation Facilities (now known as CARF International or just CARF.

1.5.6. CDC: Centers for Disease Control

1.5.7. CDR: Contract Discrepancy Report

1.5.8. CEU: Certified Education Unit

1.5.9. CME: Continuing Medical Education

1.5.10. CMS: Centers for Medicare and Medicaid Services

1.5.11. 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.

1.5.12. 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.

1.5.13. COS: Chief of Staff

1.5.14. CPARS: Contractor Performance Assessment Reporting System

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

1.5.16. 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.

1.5.17. DEA: Drug Enforcement Agency

1.5.18. ED – Emergency Department

1.5.19. HHS: Department of Health and Human Services

1.5.20. HIPAA: Health Insurance Portability and Accountability Act

1.5.21. ISO: Information Security Officer

1.5.22. 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.

1.5.23. MOD: Medical Officer of the Day

1.5.24. NPI (National Provider Identifier): 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).

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

1.5.26. NP: Nurse Practitioner

1.5.27. NPPES – National Plan and Provider Enumeration System

1.5.28. PA: Physician Assistant

1.5.29. OPM: Office of Personnel Management

1.5.30. POP: Period of Performance

1.5.31. PPD – Purified Protein Derivative

1.5.32. PWS: Performance Work Statement

1.5.33. 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. Company shall ultimately be responsible for providing necessary information to the facility credentialing department.

1.5.34. QASP: Quality Assurance Surveillance Plan

1.5.35. QMP: Quality Management Program

1.5.36. SPE: Senior Procurement Executive

1.5.37. TJC: The Joint Commission

1.5.38. VA: Department of Veterans Affairs

1.5.39. VAMC: Veterans Affairs Medical Center

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

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

1.5.42. VetPro: A federal web-based credentialing program for healthcare providers.

1.5.43. 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.

2. QUALIFICATIONS:

2.1. Facility Information: The Central Iowa VA Health Care System services Veterans from all over central Iowa bringing together quality care and services designed to meet the needs of our nation’s Veterans.. The main medical center is in Des Moines, we have six CBOCs (Community Based Outpatient Clinics), and one CRRC (Community Resource and Referral Center) that deals with the homeless populations in the area. Our Mental Health program provides consultation, evaluation, and treatment for a variety of issues that can impact emotional well-being.

Staffing: The Mental Health Department has various mental health professionals to go about daily operations of the service line. This contract is for psychiatry services.

2.1.1 LICENSE: Contract psychiatrist(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice psychiatry/medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia. (Special Note: For procurements that require a Drug Enforcement Agency (DEA) registration, contract providers must have a medical license as stated above, be individually registered with the DEA (which is Federal), and have correct controlled substance licenses according to the state in which they are licensed. For example: If a psychiatrist has a medical license from the State of Iowa, then that prescribing provider must have a Controlled Substance License from Iowa to prescribe controlled substances. If a psychiatrist has a license from another state, they must follow DEA and the licensing state’s guidance in regards to holding a controlled dangerous substance license. See link at the end of this paragraph for US Department of Justice –Drug Enforcement website specifying requirements for different states. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contract psychiatrists 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 may or may not be considered for the purposes of this contract. Contractor staff must submit evidence of at least one full, active, current and unrestricted licensure, registration, certification, and/or other relevant credentials, for verification prior to appointment and throughout the employment process, as requested by the COR. Such personnel shall be subject to review by the VA Chief of Staff and approval by the VA Director. Current copies of all licenses shall be provided to the VA with bid or upon request. Contractor is responsible for keeping the VA COR apprised of anything that would adversely affect or otherwise limit their clinical privileges. Note: Failure to keep VA fully informed on these matters may result in administrative or disciplinary action. Link to guide for practitioner’s state licensing requirements below: http://www.deadiversion.usdoj.gov/drugreg/reg_apps/pract_state_lic_require.htm

2.1.2 BOARD CERTIFICATION /ELIGIBILITY: All contract psychiatrists shall be board certified or board eligible in Psychiatry and be currently certified in Basic Life Support (BLS). Board eligibility in this case will mean graduating from a psychiatric residency and having a valid license to practice medicine. All continuing education courses required for maintaining certification must be kept up to date at all times. Documents verifying the current certification or eligibility 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. This VHA Handbook provides updated VHA procedures regarding credentialing and privileging, to include incorporating: VHA policy concerning VetPro; the Expedited Medical Staff Appointment Process; credentialing during activation of the facility Disaster Plan; requirements for querying the FSMB; credentialing and privileging requirements for Telemedicine and remote health care; clarifications for the Summary Suspension of Privileges process in order to ensure both patient safety and practitioner rights; and the credentialing requirements for other required providers. The Contractor is responsible to ensure that proposed psychiatrist possess the requisite credentials enabling the granting of privileges. No services shall be provided by any contract psychiatrist prior to obtaining approval by VACIH Des Moines Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.3.1 The process of credentialing and privileging is a lengthy process that could take anywhere from 6 to 12 weeks to complete. The contracted company shall ultimately be responsible for providing to the VA, the necessary paperwork for this process (that includes credentialing, privileging, and security paperwork).

2.1.3.2 If a contract psychiatrist 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 psychiatrists 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 submitting bid package or at the 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 psychiatrists, and contract psychiatrist 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)/CERIFIED EDUCATION UNIT(CEU) REQUIREMENTS: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractors 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 will result in loss of privileges.

2.1.6 TRAINING (VA MANDATORY): Contractors shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contract psychiatrist as required by the VA.

2.1.6.1 VA Privacy and Information Security Awareness and Rules of Behavior – must be completed before candidate can have computer access. Will be done before candidate comes to the site to provide services. Each Contractor and subcontractor assigned work under the contract are required to receive and document completion of VA training on Cyber Security prior to having access to the VA computer system. Security training will be accomplished annually or in accordance with Office of Cyber and Information Security requirements. Initially, the module will be sent by the facility Education Department to the provider directly for completion. This information will go to the facility ISO at award.

2.1.6.2 Privacy and HIPAA Focused Training – Must be completed before candidate can have computer access. Will be done before candidate comes to the site to provide services. Contractor personnel having access to VA information systems are required to read and sign a Rules of Behavior statement which outlines rules of behavior related to VA Automated information systems. This also will be sent for contractor to complete before being able to work under the contract. Initially, the module will be sent to the contractor by the facility Education Department to the provider directly for completion. This information will go to the facility ISO at award.

2.1.6.3 Prevention and Management of Disruptive Behavior – Will be completed once provider is on board. This combines a computer course and some hands-on training.

2.1.6.4 Other mandatory trainings may be assigned in TMS system, which is the VA learning system.

2.1.6.5 All contracted staff shall complete a service line VAMC orientation. This orientation will be set up by service line personnel and given to contractor upon first day of work.

2.1.6.6 Contractor staff presented must have current BLS training and certification. Must be produced with the bid package and must not be expired. BLS training will only be accepted through the American Heart Association(AHA) itself, or the Military Training Network( MTN )both which follows the AHA guidelines. No other training course will be accepted at this facility. Note that even if provider has ACLS (advanced), the provider must have a BLS(basic) as well.

2.1.6.7 The Contractor shall assign to this contract, personnel that by education and training, certification or licensure, are qualified to provide services. Contractor will be responsible for maintaining all trainings that pertain to keeping a current license. Contractor will furnish current license, education verification, and training certifications to the CO or COR.

2.1.6.8 Documentation such as completed competency checklists or educational training records shall be maintained by the Contractor and available for VAMC review upon request

2.1.6.9 Contractor personnel will obtain a PIV/Non- PIV badge in order to work in the facility. Contractor will set up all fingerprinting at a VA closest to the Contractor’s residence and furnish document to the COR. Contractor or company will ensure the credentialing and privileging paperwork needed from the Contractor is filled out and sent to the credentialing department within a 2-week time frame of receiving it, as well as the security paperwork required to obtain a PIV badge. Contractor or company will work with the CO or COR, and the credentialing and privileging department to obtain the necessary information for this badge.

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

2.1.7.2 RUBELLA TESTING: Contractor shall provide proof of immunization for all contract psychiatrists 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.

2.1.7.3 OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractors shall provide generic self- study training for all Contractor staff; 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. 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.

2.1.8 National Provider Identification (NPI) – NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent, the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal. The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers for health care providers and health plans. The purpose of these provisions is to improve the efficiency and effectiveness of the electronic transmission of health information. The Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider enumeration system (NPPES) to assign these unique identifiers. If you are a health care provider, you must have an NPI number. The NPI number is a part of credentialing process that the Des Moines VA Credentialing department will access to look up provider numbers.

2.1.9 DEA (as required)

2.1.9.1 Contractor must have their own DEA number.

2.1.9.1.1 Two ways/types of DEA

Exempt – limited to federal employees Non- Exempt – for non- federal employees (for fee, contract and locum’s employees)

2.1.9.2 Contractor should be able to prescribe schedule 2-5 medications.

2.1.9.3 Controlled Substance license – psychiatrist must have a controlled substance license according to the regulations of the state in which they are licensed. For more information on licensing and controlled substances, the credentialing coordinator of Central Iowa is the best resource for questions of this nature. Jimmy McDowell is the credentialing and privileging point of contact for VA Central Iowa at 515-699-5999, ext. 4043, Jimmy.McDowell@va.gov

2.1.10 CONFLICT OF INTEREST: Contractor and all Contractor staff 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 sub-Contractors 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.

2.1.10.1 Prohibition against self-referral. Contractor’s physicians are prohibited from referring VA patients to contractor’s or their own practice(s).

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 VA, 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. The Contractor must return a signed certification at the time of proposal 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 the VA. 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 and is applicable to the entire POP.

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 RFP 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 VA 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, all Contractors shall review the HHS OIG List of Excluded Individuals/Entities on the OIG web site at http:oig.hhs.gov/exclusions/index.asp to ensure that the proposed Contractor psychiatrists and/or firm(s) are not listed. Contractors 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 or entity 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 Contractors and entities that employ or enter into contracts with excluded individuals or entities to provide items or services to Federal program beneficiaries.

2.1.12.2 By submitting their proposal, the Contractor certifies that the 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 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 during the administration of the resultant contract.

2.3 NON- PERSONAL SERVICES: The parties agree that The Contractor, all Contractor staff, agents and sub- Contractors shall not be considered VA employees for any purpose.

2.4 INHERENT GOVERNMENT FUNCTIONS: Contractor and Contractor staff 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.

2.5 NO EMPLOYEE STATUS: The Contractor shall be responsible for protecting the Contractor’s staff 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:

Health examinations Income tax withholding, and Social security payments

2.6 TORT LIABILITY: The Federal Tort Claims Act does not cover Contractors or Contractor’s staff. When a Contractor or a member of their staff has been identified as a provider in a tort claim, The Contractor is responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or Contractor’s staff) action or non-action is the responsibility of The Contractor and/or insurance carrier.

2.7 KEY PERSONNEL

2.7.1 The number of board certified or board eligible psychiatrists required to be on site on a daily basis will be two psychiatrists.

2.7.1.1 Credentialing, privileging, and security clearances are required to be done before any contractor can come into the facility. It can take 6-12 weeks to accomplish credentialing and security clearances. Candidates must be available any time during that period as the process is variable. Company will ultimately be responsible for the submission of all necessary documents needed for credentialing, privileging, and security clearance. Documents required need to be submitted to the correct personnel within 2 weeks of receiving them.

2.7.2 Vendor must be able to provide key personnel to work the task order dates required.

2.8. PERSONNEL SUBSTITUTIONS: During the first ninety (90) days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar days after the occurrence of any of these events and provided the information required below. After the initial 90-day period of the contract the Contractor shall submit the information required below to the CO at least 90 calendar days prior to making any permanent substitutions.

2.8.1 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 (shall be a qualified psychiatrist). The CO will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.8.2 For temporary substitutions where the key person will not be reporting to work for three (3) consecutive work weeks or more, the Contractor will provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding three weeks will require the procedure as stated above. If contractor has leave under 3 work weeks, then the existing psychiatrists or psychiatric nurse practitioners on board, will cover the contractor clinics as needed. Contractor will not be paid for hours, per diem, lodging, or other when not on site providing services.

2.8.3 The Government reserves the right to refuse acceptance of Contractor if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include but are not limited to, intoxication or debilitations resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patients 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 psychiatrist, she or he may request, without cause, immediate replacement of said contract psychiatrist.

2.8.4 Contractor and Contracting Officers Representative shall deal with issues raised concerning contract personnel conduct. The final arbiter on questions of acceptability is the Contracting Officer.

2.8.5 Government reserves the right to have a Contractor employee removed from performing under this contract for sexual harassment of any patients and/or VA employees.

2.8.6 Contractor will employ sufficient personnel to carry out the policies, responsibilities, and the program for the Des Moines VA.

2.9. CONTINGENCY PLAN: Because continuity of care is an essential part of VAMC’s medical services, The Contractor is to have a contingency plan in place to be utilized if and Contractor staff member(s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract. A copy of this contingency plan shall be submitted with the proposal and updated throughout the period of performance.

2.9.1 The qualifications of the contracted personnel shall be subject to review by the Program Office.

2.9.2 Contractor shall submit a listing of key personnel in the following format:

Provider Name:___________________ Title/Rank:__________________.

Curriculum Vitae of each key personnel shall be submitted with the proposal. Certificates of trainings or specialized trainings that would be beneficial to the population served at the VA should be submitted as well as BLS card (non-expired).

3 VA HOURS OF OPERATION:

BUSINESS HOURS: The operational hours of the Des Moines VA Mental Health Outpatient Department are Monday - Friday 0800-1630 and Saturdays half days from 0800-noon.

3.1 WORK SCHEDULE:

No on call. No holidays. Estimated 40 hours per week. Estimated 2080 hours per year or 1040 per six months.

3.1.2 Note: When time off is needed, the psychiatrist will inform the Clinical Coordinator or MH Director of planned leave and work with clinical staff to keep clinic interruption to a minimum. The contractor will not be paid for time off hours by the Des Moines VA.

3.1.3 Contracted outpatient psychiatrists will have a clinic set up for them in the computer system. Usually, clinics start at 0830-1600 with 30 minutes before and after to do administrative notes (0800-0830, 1600-1630). Contracted psychiatrist will have a 30- minute non- paid lunch with 30 minutes mid- day (after lunch period) to do administrative notes also. Clinic coordinator or MH Director will approve the clinic set ups and clinics will be opened to the Medical Support Assistants who schedule into the available spaces. Once a patient is seen, the provider can send a text order on when to bring the person back in to be seen. The MSAs will receive it and schedule when the provider wants the person to come back.

3.2 FEDERAL HOLIDAYS

The following holidays are observed by the Department of Veterans Affairs:

3.3.1 New Year’s Day

3.3.2 President’s Day

3.3.3 Martin Luther King’s Birthday Day

3.3.4 Memorial Day

3.3.5 Independence Day

3.3.6 Labor Day

3.3.7 Columbus Day

3.3.8 Veterans Day

3.3.9 Thanksgiving Day

3.3.10 Christmas Day

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

3.3 CANCELLATION POLICY: Unless a state of emergency has been declared or clinics are otherwise cancelled by the VAMC, the Contractor shall be responsible for providing services. If the need for clinic cancellation by the Contractor is required, the Clinical Coordinator shall be informed in advance of at least two weeks before planned absence, unless sickness or unusual circumstances arise. If unforeseen circumstances arise that clinics are cancelled by the service line, such as power outage lasting more than an hour, building damages, etc., the psychiatrist will be sent home and not paid since the clinic is not in session. This would be at the discretion of the Clinical Coordinator or MH Director.

4 CONTRACTOR RESPONSIBILITIES

4.1 CLINICAL PERSONNEL REQUIRED: The Contractor shall provide contract psychiatrist(s) who is competent, qualified per this performance work statement and adequately trained to perform assigned duties. This contract will be for two outpatient psychiatrists.

4.1.1 Contract psychiatrists shall be responsible for keeping their own time sheet for attendance and turning them in to the COR. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

4.1.2 Psychiatrists designated to be present daily will be specified in each order. See section 3.1 for work schedule. Credentialing and Privileging will be completed before candidate will be allowed to start work under this contract. See section 2.7.1.1.

4.1.3 Contractor shall provide a Board Certified or Board Eligible Psychiatrist. See 2.1.2 for definition of Board Eligible for this contract. Designation of the psychiatrist appointed to the Des Moines VA will be the responsibility of the contractor.

4.1.4 Contractor should have active, current, unrestricted license. Past restrictions on licenses will be reviewed by the MH Medical Director and the MH Director. Decisions to allow or not allow such candidates will be decided upon between the two of them or their designees.

4.1.5 Contract psychiatrist will see adult patients who are 18 years of age or older who have mental health conditions.

4.1.6 Contract psychiatrist will see a range of problems in the adult population of the VA and should have a wide variety of therapeutic experience to provide treatments to said populations.

4.1.7 Contractor must be familiar with electronic medical records. Provide examples with proposal.

4.1.8 Contractor employee must be present at the VA facility and must perform the required services for payment. Contractor employee will be paid for actual performance of duties. Payment for any type of leave will be responsibility of the Contractor. The VA has the right to refuse to accept any Contractor employee who does not meet requirements or who fails to perform adequately or adapt to VA work environments.

4.2 STANDARDS OF CARE: Contractors care shall cover the range of services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1. American Psychiatric Association

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 professional standards of the Joint Commission (TJC).

http://www.jointcommission.org/standards information/standards.aspx

4.2.4. Commission on Accreditation of Rehabilitation Facilities (CARF) http://vaww.oqsv.med.va.gov/functions/integrity/accred/carf.aspx

4.2.5. Performance shall be according to the requirements contained in this PWS and equal to that of the professional standards of the TJC and of CARF.

4.3 RESIDENT SUPERVISTION AND TEACHING – NOT APPLICABLE

4.4 MEDICAL RECORDS

4.4.1 Authorities: Contractor psychiatrists 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).

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

4.4.3 HIPAA, HHS/OIG, Access to ADP Files - To ensure that the individuals providing services under the contract have not engaged in fraud or abuse regarding Sections 1128 and 1128A of the Social Security Act regarding Federal Health Care Programs, the contractor is required to check the Health and Human Services – Office of Inspector General, List of excluded individuals/entities on the OIG website (www.hhs.gov/oig) for each person providing services under the contract.