36C26319R0100-001.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 93

618-20-1-4002-0002

36C26319R0100 06-27-2019

Contract Specialist – Charles Morin 651-293-3035

07-29-2019 / 11:00PM

36C263

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506

St. Paul MN 55101

X 100

X

621340

$7.5 Million

N/A

Minneapolis VA Medical Center

One Veterans Drive, Building 70

Minneapolis MN 55417

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506

Y

Financial Services Center

PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

Audiology Health Technician Services for the

Minneapolis VA Health Care System

Period of Performance: 12/12/2019 – 12/11/2020

See Section B.3 Schedule of Services page 8.

See Section B.4 Performance Work Statement page 12.

X one

36C26319R0100

Table of Contents

SECTION A

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

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SPECIAL CONTRACT REQUIREMENTS

B.3 SCHEDULE OF SERVICES

B.4 PERFORMANCE WORK STATEMENT

B.5 IT CONTRACT SECURITY

SECTION C - CONTRACT CLAUSES

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

2018)

C.2 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL

(JAN 2011)

C.2 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS (JUN 2016)

C.3 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.6 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984) 59

C.7 VAAR 852.219-9 VA SMALL BUSINESS SUBCONTRACTING PLAN MINIMUM

REQUIREMENTS (DEC 2009)

C.8 VAAR 852.219-10 VA NOTICE OF TOTAL SERVICE-DISABLED VETERAN-OWNED

SMALL BUSINESS SET-ASIDE (JUL 2016)(DEVIATION)

C.9 VAAR 852.219-76 SUBCONTRACTING PLANS MONITORING AND COMPLIANCE

(JUL 2018)

C.10 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.11 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(JAN 2008)

C.12 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.13 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.14 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2019)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 List of Attachments

SECTION E - SOLICITATION PROVISIONS

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

E.2 PROPOSAL SUBMITTAL INSTRUCTIONS

E.2 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.3 52.216-1 TYPE OF CONTRACT (APR 1984)

E.5 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

36C26319R0100

E.4 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.5 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008)

E.6 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.7 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.8 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

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

ITEMS (OCT 2018)

Page 4 of 93 version 0005 Dated 12/1/2016

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 / Contract Specialist

Contracting Officer is Charles Hurry at charles.hurry@va.gov

Contract Specialist is Charles Morin at charles.morin@va.gov

Department of Veterans Affairs

NCO 23 – St. Paul

316 Robert Street N.

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly, See Billing Instructions, PWS 6.2 Billing:

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

Financial Services Center

PO Box 149971

Austin TX 78714-9971

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

AMENDMENT NO DATE

Page 5 of 93 version 0005 Dated 12/1/2016

6. TYPE OF CONTRACT: Resultant contract shall be a Firm Fixed Price contract effective for the period stated in the Schedule of Services.

7. TERM OF CONTRACT: The contract period is effective December 12, 2019 through December 11, 2020 with four (4) option periods.

8. POINT OF CONTACT: The Contractor shall provide a point of contact (POC) who shall be responsible for the performance of the work under this contract. The POC shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The POC may be a contract health care provider performing under this contract. An alternate may be designated, but the

Contractor shall identify, in writing, those times when the alternate shall act as the POC. The Contractor shall identify the POC and alternate in writing to the Contracting Officer’s Representative (COR) and

Contracting Officer (CO). The Contractor shall give written notification to the COR and CO of the time when the alternate will act as the POC. The POC shall be available by telephone Monday through Friday, 8:00 AM through 4:30 PM, excluding Federal holidays.

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

10. POST AWARD ORIENTATION: The Contracting Officer shall follow the guidance in FAR

Subpart 42.5 and note Information Letter (IL) 003A3-12-04 that provides documentation requirements for orientation conducted for such awards. A hyperlink to the IL is provided for your information.

http://www.va.gov/oal/docs/library/ils/il12-04.pdf

B.2 SPECIAL CONTRACT REQUIREMENTS

Under the authority of Public Law 104-262 and 38 USC 8153, the contractor agrees to provide Health

Care Resources in accordance with the terms and conditions stated herein, to furnish to and at the

Department of Veterans Affairs Medical Center, , the services and prices specified in the Section entitled

Schedule of Supplies/Services of this contract.

1. SERVICES:

a. The services specified in the Sections entitled Schedule of Supplies/Services and Special Contract

Requirements may be changed by written modification to this contract.

b. Other necessary personnel for the operation of the services contracted for at the VA will be provided by the VA at levels mutually agreed upon which are compatible with the safety of the patient and personnel and with quality medical care programming.

c. The services to be performed by the contractor will be performed in accordance with VA policies and procedures and the regulations of the medical staff by laws of the VA facility.

2. TERM OF CONTRACT:

This contract is effective one year from date of award plus four (4) one-year options that may be exercised by the VA. The contract is subject to the availability of funds. The contractor shall perform no services after September 30 of any year until the Contracting Officer authorizes such services in writing.

http://www.va.gov/oal/docs/library/ils/il12-04.pdf

Page 6 of 93 version 0005 Dated 12/1/2016

3. QUALIFICATIONS:

Personnel assigned by the Contractor to perform the services covered by this contract shall be licensed in a 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. The qualifications of such personnel shall also be subject to review by the VA Chief of Staff and approval by the VA Facility

Director. Each person assigned to work under this contract shall be properly licensed.

4. WORK HOURS:

a. The services covered by this contract shall be furnished by the contractor as defined herein. The contractor will not be required, except in case of emergency, to furnish such services during off-duty hours as described below.

b. The following terms have the following meanings:

(1) National Holidays: The 10 holidays observed by the Federal Government are:

New Years Day

Martin Luther King’s Birthday

Presidents Day

Memorial Day

Independence Day

Labor Day

Columbus Day

Veterans Day

Thanksgiving

Christmas AND any other day specifically declared by the President of the United States to be a national holiday.

5. PERSONNEL POLICY:

The contractor shall be responsible for protecting the personnel furnishing services under this contract.

To carry out this responsibility, the contractor shall provide the following for these personnel:

- general liability

- workers compensation

- professional liability insurance

- health examinations

- income tax withholding, and

- social security payments.

The parties agree that the contractor, its employees, agents and subcontractors shall not be considered

VA employees for any purpose.

6. RECORD KEEPING:

The VA Medical Center, shall establish and maintain a record keeping system that will record the hours worked by the contractor employee(s). Contractor's employee(s) shall report to Administrative Officer, or designee upon arrival at the facility.

7. CONTRACT PERFORMANCE MONITORING:

Monitoring of contractors time shall be demonstrated through sign-in/ sign-out sheets. The contractor shall be required to sign an attendance log upon reporting to work and departing from work. , 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.

Page 7 of 93 version 0005 Dated 12/1/2016

8. KEY PERSONNEL AND TEMPORARY EMERGENCY SUBSTITUTIONS:

The Contractor shall assign to this contract the following key personnel:

a. 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 Contracting Officer, in writing, within 15 calendar days after the occurrence of any of these events and provide the information required by paragraph (c) below. After the initial 90-day period of the contract, the Contractor shall submit the information required by paragraph (c) to the

Contracting Officer at least 15 days prior to making any permanent substitutions.

b. 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 Contracting Officer. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The Contracting Officer 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.

c. For temporary substitutions where the key person will not be reporting to work for three (3) consecutive work days or more, the Contractor will provide a qualified replacement for the key person.

This substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

Page 8 of 93 version 0005 Dated 12/1/2016

B.3 SCHEDULE OF SERVICES

SCHEDULE OF SERVICES

The contractor shall furnish experienced Audiology Health Technicians to support the Minneapolis VA

Health Care System (MVAHCS), Audiology Services for eligible beneficiaries of the Department of

Veterans Affairs Medical Center, Minneapolis VA Health Care System (hereinafter referred to as

MVAHCS). The contractor’s personnel will work collaboratively with the Audiologists and provide support 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.

Place of Performance: Services shall be provided on site at the Minneapolis VA Health Care System

(MVAHCS), One Veterans Drive, Minneapolis, MN 55417.

Pricing Instructions:

The offeror is instructed to edit the number of sub-clins to correspond with the number of key personnel submitted for the contract line item number (CLIN).

Affiliate Offerors shall include the “title” of the personnel submitted. Other commercial health care

Offerors shall identify by title/position or level of experience the key personnel submitted. Offerors may re-number sub-CLINs if adding or removing Key Personnel. The Offeror is instructed to include all other-than-price-and-cost information supporting the proposed price, as directed in Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments.

The contractor shall propose a minimum of two (2) Audiology Health Technicians to be available for scheduling to meet the requirements of the contract.

Contract Type: The Government contemplates award of a Firm Fixed Price contract from this solicitation.

Period of Performance: Twelve (12) Month Base Period and four (4) 12-Month Option Years (to be exercised at the discretion of the Government)

Base Year: 12/12/2019 to 12/11/2020

Option Year 1 12/12/2020 to 12/11/2021

Option Year 2 12/12/2021 to 12/11/2022

Option Year 3 12/12/2022 to 12/11/2023

Option Year 4 12/12/2023 to 12/11/2024

CONTRACT TOTAL COST (BASE YEAR AND ALL OPTIONS)

Base Year Cost:

Option Year 1 Cost:

Option Year 2 Cost:

Option Year 3 Cost:

Option Year 4 Cost:

Total Contract Cost:

Page 9 of 93 version 0005 Dated 12/1/2016

Period of Performance: BASE PERIOD: December 12, 2019 to December 11, 2020

OPTION YEAR 1: December 12 ,2020 to December 11, 2021

CLIN

No.

SUB-

Description Qty. Unit

Unit Cost

Total Annual Cost

0001 None

Audiology Health Technician Services

4,160 Hours

KEY PERSONNEL

None 0001a

Audiology Health Technician Services

NAME:

TITLE:

$_______/hr $_________

None 0001b

Audiology Health Technician Services

None 0001c

Audiology Health Technician Services

TOTAL FOR BASE

No.

Unit Cost

Total Annual Cost

1001 None

Audiology Health Technician Services

None 1001a

None 1001b

Audiology Health Technician Services

None 1001c

Audiology Health Technician Services

TOTAL FOR Option Year 1

Page 10 of 93 version 0005 Dated 12/1/2016

OPTION YEAR 2: December 12 ,2021 to December 11, 2022

OPTION YEAR 3: December 12 ,2022 to December 11, 2023

Unit Cost

Total Annual Cost

2001 None

Audiology Health Technician Services

None 2001a

None 2001b

Audiology Health Technician Services

None 2001c

Audiology Health Technician Services

TOTAL FOR Option Year 2

No.

Unit Cost

Total Annual Cost

3001 None

Audiology Health Technician Services

None 3001a

None 3001b

Audiology Health Technician Services

None 3001c

Audiology Health Technician Services

TOTAL FOR Option Year 3

Page 11 of 93 version 0005 Dated 12/1/2016

OPTION YEAR 4: December 12 ,2023 to December 11, 2024

Total for base performance period and options:

The contractor will only be paid for the actual hours of service provided.

Unit Cost

Total Annual Cost

4001 None

Audiology Health Technician Services

None 4001a

None 4001b

Audiology Health Technician Services

None 4001c

Audiology Health Technician Services

TOTAL FOR Option Year 4

Page 12 of 93 version 0005 Dated 12/1/2016

B.4 PERFORMANCE WORK STATEMENT

Performance Work Statement for Onsite Audiology Health Technician Services

1. GENERAL:

1.1. Services Provided: The contractor shall provide two (2) Audiology Health Technicians on site in accordance with the specifications contained herein to beneficiaries of the Department of

Veterans Affairs (VA) and the Minneapolis VA Health Care System.

1.1.1. Place of Performance: Services will be provided for MVAHCS at the VA Medical Center, One Veterans Drive, Minneapolis, MN 55417.

1.1.2. Period of Performance: Services are required for a base period of 12-months with four (4) 12-month options.

1.2. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority and FAR 12 in combination with 15.

1.3. Policy/Handbooks: Contractor personnel providing services in a VA Health Care facility shall provide services in accordance with the following U.S. Government statutes, and VHA/VA

Regulations, Directives, Handbooks, and Policies implementing these statues. Electronic copies may be obtained at the websites listed below. This contract incorporates the below attachments by reference with the same force and effect as if they were given in full text.

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

1.3.2. 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

1.3.3. VHA Directive 2010-018 “Facility Infrastructure”

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

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

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

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

1.3.7. VHA Handbook 1100.19 Credentialing and Privileging -

http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227 https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

Page 13 of 93 version 0005 Dated 12/1/2016

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

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

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

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

1.3.10.Minneapolis VA Health Care System Policy: The Minneapolis VAHCS policies are only available on the Minneapolis VA Intranet site. This site is not available to the general public. Copies of these policies will be provided:

1.3.10.1. EC-14D – PIV Card Policy (Personnel Identification Verification – ID Badge)

1.3.10.2. IC-01F – Infection Precautions

1.3.10.3. IM-01K – Medical Records (Management of Information)

1.3.10.4. IM-06D – Information Security Policy/Procedures

1.3.10.5. Vendors (Contractors)

1.3.10.6. PE-01G – Assessment of Patients

1.3.10.7. PF-02L – BLS and ACLS Requirements for Staff

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

1.4.1. AOD: Admitting Officer of the Day

1.4.2. BLS: Basic Life Support

1.4.3. CDC: Centers for Disease Control and Prevention

1.4.4. CDR: Contract Discrepancy Report

1.4.5. CEU: Certified Education Unit

1.4.6. CME: Continuing Medical Education

1.4.7. CMS: Centers for Medicare and Medicaid Services

1.4.8. 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.

1.4.9. 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.

1.4.10. COS: Chief of Staff

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

Page 14 of 93 version 0005 Dated 12/1/2016

1.4.11. CPARS: Contractor Performance Assessment Reporting System

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

1.4.13. 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.

1.4.14. DEA: Drug Enforcement Agency

1.4.15. ED: Emergency Department

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

1.4.17. HHS: Department of Health and Human Services

1.4.18. HIPAA: Health Insurance Portability and Accountability Act

1.4.19. HR: Human Resources

1.4.20. ISO: Information Security Officer

1.4.21. 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.

1.4.22. MOD: Medical Officer of the Day

1.4.23. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.4.24. Non-Contractor’s provider(s): Any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.4.25. NP: Nurse Practitioner

1.4.26. PA: Provider Assistant

1.4.27. POP: Period of Performance

1.4.28. PPD: Purified Protein Derivative

Page 15 of 93 version 0005 Dated 12/1/2016

1.4.29. PWS: Performance Work Statement

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

Clinical privileges must be facility-specific and provider-specific.

1.4.31. QA/QI: Quality Assurance/Quality Improvement

1.4.32. QM/PI: Quality Management/Performance Improvement

1.4.33. QASP: Quality Assurance Surveillance Plan

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

1.4.35. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in Minnesota, Iowa, North Dakota, South Dakota, and Nebraska.

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

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

1.4.38. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different

VA medical Center, for purposes of this contract, this term shall mean the Minneapolis VA

Health Care System (MVAHCS).

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. Education: Contractor’s personnel assigned by the contractor to perform the services covered by this contract shall have at least one year of specialized experience in this field related to the position of Health Technician (Hearing).

2.1.2. Credentialing and Privileging: Reserved

2.1.3. Technical Proficiency: Contractor’s personnel shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed.

Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s personnel and contractor’s

Page 16 of 93 version 0005 Dated 12/1/2016 personnel shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.4. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements:

Contractor shall provide the COR copies of current CMEs as required or requested by the

MVAHCS. Contractor’s provider’s registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges fpr contractor’s provider’s.

2.1.5.

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

2.1.6.

Training Frequency Annual Hours

VA Privacy and Information

Security Awareness and Rules of

Behavior – TMS course # 10176

Once a Year 1 hour

Mandatory Training for

Transient Clinical Staff – TMS course # 20152

Once a Year 1.5 hours

ACLS/BLS – TMS course #

324129 Every 24 months 4 hours

Prevention/Management of

Disruptive Behavior/Violence

Prevention Levels 1 – TMS course # 16699

Once .75

Suicide Prevention: Suicide

Risk Management Training for

Clinicians – TMS course #

Once a year 1 hour

CPRS: Tab by Tab – TMS course # 8512 or classroom Once 4 hours

Prevention/Management of

Disruptive Behavior/Violence

Prevention Level 2 – TMS course # 23805

Every 24 months 2 hours

Prevention/Management of

Disruptive Behavior/Violence

Prevention Level 3 – TMS course # 12510

Every 24 months 4 hours

Eligibility 101 - # 4504997 Once .25 hours

Urgent Care 101 - # 4504999 Once .5 hours

What’s new in Community Care - #

4507398 Once .5 hours

Decision Support Tool (DST)

Complete Overview - # 39464 Once .75 hours

Eligibility 201 (Detailed Process

Training) - # 38465 Once .5 hours

Page 17 of 93 version 0005 Dated 12/1/2016

Emergency Care Reimbursement

101 - # 38466 Once .5 hours

Veteran Care Agreements (VCA)

101 - # 38480 Once .5 hours

Urgent Care 201 - # 38475 Once .5 hours

MISSION Act Urgent Care in

Clinical Contact Centers - # 38438 Once .5 hours

2.1.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for provider(s) 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

Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all contractor’s provider(s) {This is applicable to all health care workers}. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive

TST or IGRA results. The TST or IGRA testing shall be repeated annually.

2.1.7.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all contractor provider(s) {This is applicable to all health care workers}.

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all contractor provider(s) {This is applicable to all health care workers}.

2.1.7.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all contractor provider(s) {This is applicable to all health care workers}.

2.1.7.5. INFLUENZA: Contractors shall provide proof that all contractor provider(s) have received the annual Influenza vaccine unless it is contraindicated. If the contractor provider(s) has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season . {This is applicable to all health care workers}.

2.1.7.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all contractor’s provider(s) {This is applicable to all health care workers}; provide their own Hepatitis

B vaccination series and hepatitis B surface antigen test results following the hepatitis

B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.7.7. The VAMC shall notify the contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for

Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

Page 18 of 93 version 0005 Dated 12/1/2016

2.1.7.8. Drug Testing: All contractor provided provider’s shall be subject to the VA’s policy in regard to a Drug-Free Workplace Act of 1988. Personnel may receive a drug test and are subject to random drug testing thereafter. This includes any situation of

“reasonable suspicion” and “accident or unsafe practice testing.” Refusal to be tested or interfering with this process will result in immediate termination of the contract.

2.1.8. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and

Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.1.9. DEA (as required): Reserved

2.1.10. Conflict of Interest: The contractor and all contractor’s 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.

2.1.11. Citizenship related Requirements:

2.1.11.1. The contractor certifies that the contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended;

its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the

Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.11.2. While performing services for the Department of Veterans Affairs, the contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States.

Additionally, the contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.11.3. If the contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in

Page 19 of 93 version 0005 Dated 12/1/2016 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 Department of Health and Human Services

(HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the

Medicare and Medicaid programs.

2.1.12.1. Therefore, contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor’s provider(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil

Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.12.2. By submitting their proposal, the contractor certifies that the HHS OIG List of

Excluded Individuals/Entities has been reviewed and that the contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/Professional Performance: The qualifications of contractor personnel are subject to review by 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 performance monitoring and review of all clinical personnel covered by this contract for quality purposes 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.

2.3. Non Personal Healthcare Services: The parties agree that the contractor and all contractor’s provider(s) shall not be considered VA employees for any purpose.

http://oig.hhs.gov/exclusions/index.asp

Page 20 of 93 version 0005 Dated 12/1/2016

2.4. Indemnification: The contractor shall be liable for, and shall indemnify and hold harmless the

Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the contractor, its agents, or employees.

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

2.6. Inherent Government Functions: Contractor and contractor’s 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.

2.7. No Employee status: The contractor shall be responsible for protecting contractor’s 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:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Sick leave

2.7.5. Vacation time

2.7.6. Income tax withholding, and

2.7.7. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover contractor or contractor’s provider(s).

When a contractor or contractor’s 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 contractor’s provider(s)) action or non-action shall be the responsibility of the contractor and/or insurance carrier.

2.9. Key Personnel: Contractor will be responsible to ensure that the contractor personnel providing work on this contract are fully trained and fully competent to perform the required services for the duration of the contract period. Contractor’s personnel provided under this contract must meet the qualifications, training, and all requirements as stated in Section 2.1.

2.9.1. The VA Full Time Equivalency (FTE) for the services required is equivalent of up to two

(2.0) FTE. One FTE is defined by the VA as a person working a minimum of 80 hours every two (2) weeks and does not include holidays.

2.9.2. The minimum number of Audiology Health Technicians required to be on site on a daily basis, Monday – Friday (excluding holidays) is two (2.0) FTE. The work schedule is defined below in Section 3 - Hours of Operation.

2.9.3. The contractor shall be responsible for providing coverage to the VA during periods of vacancies of the contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required.

Page 21 of 93 version 0005 Dated 12/1/2016

2.9.4. Personnel Substitutions: During the first ninety (90) calendar days of performance, the contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The contractor shall notify the

CO, in writing, within 15 calendar day(s) after the occurrence of any of these events and provide the information required below. After 90 days, the contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions.

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

2.9.4.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive work days or more, the contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.9.4.3. The Government reserves the right to refuse acceptance of any contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility.

Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated

Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contractor’s provider(s), s/he may request, without cause, immediate replacement of said contractor’s provider(s). The CO and COR shall deal with issues raised concerning contractor’s provider(s) conduct. The final arbiter on questions of acceptability is the CO.

2.9.4.4. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, the contractor shall have a contingency plan in place to be utilized if the contractor’s 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: The Minneapolis VA Health Care System is open 24 hours per day, 7 days a week, 365 days a year. The services covered by this contract shall be furnished by the contractor as defined in the work schedule below.

3.1.1. Patients must be seen by a contractor’s personnel on-site at the Minneapolis VAHCS in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

Page 22 of 93 version 0005 Dated 12/1/2016

3.1.2. Contractor’s personnel shall be available and present in clinic during normal Audiology clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Surgery or designee.

3.1.3. Tour of Duty: Currently the Audiology clinic hours of operation are 7:30am – 6:00pm

3.1.4. Tech One Tour of Duty:

• Monday: 7:30am - 6:00pm

• Tuesday: 7:30am - 6:00pm

• Wednesday: 7:30am - 6:00pm

• Thursday: 7:30am - 6:00pm

Note: The daily tour of duty includes a 30-minute unpaid lunch break.

3.1.5. Tech Two Tour of Duty:

• Monday: 7:30am - 6:00pm

• Tuesday: 7:30am - 6:00pm

• Friday: 7:30am - 6:00pm

• Saturday: 7:30am - 6:00pm

Note: The daily tour of duty includes a 30-minute unpaid lunch break.

3.1.6. Off-hours Coverage: Reserved

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

• New Year’s Day

• Martin Luther King’s Birthday

• President’s Day

• Memorial Day

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any day specifically declared to be a national holiday.

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

4. CONTRACTOR RESPONSIBILITIES:

4.1. Clinical Personnel Required: The contractor shall provide contractor’s provider(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contractor’s provider(s) shall be responsible for signing in and out when in attendance.

Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

Page 23 of 93 version 0005 Dated 12/1/2016

4.2. Standards of Care: The contractor’s provider(s)’ care shall cover the range of Audiology Health

Technician 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 TJC, VA and national standards as established by:

4.2.1. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards”

(expired but still in effect pending revision)

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

4.2.3. The standards of the American Hospital Association (AHA) 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: Contractor’s provider(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.