36C26320R0030-001.pdf

PAGE 1 OF 81 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

636-20-2-3036-0001

36C26320R0030 12-27-2019

Andrew J. Schoenecker, Contracting Officer 651-293-3038 01-17-2020

36C263 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Attention: Andrew J. Schoenecker 316 Robert Street N. STE. 506 St. Paul MN 55101

X 100

X

621111

$12 Million

N/A

N/A

VA Central Iowa Health Care System 3600 30th St

Des Moines IA 50310

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

Y

Financial Services Center PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

Nephrology Services at the VA Central Iowa Health Care System in Des Moines, IA. Services will be performed on-site.

See Section B.2 Schedule of Services on page 6.

See Section B.3 Performance Work Statement on page 10.

ONE

Andrew J. Schoenecker Contracting Officer

36C26320R0030

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

B.2 SCHEDULE OF SERVICES

B.3 PERFORMANCE WORK STATEMENT

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.3 52.216-18 ORDERING (OCT 1995)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.8 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (OCT 2019)

C.9 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019)

C.10 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.11 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.12 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.13 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.14 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.15 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) 45

C.16 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.17 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (OCT 2019)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 PROPOSAL SUBMITTAL INSTRUCTIONS

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (AUG 2019)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.4 52.216-1 TYPE OF CONTRACT (APR 1984)

E.5 52.233-2 SERVICE OF PROTEST (SEP 2006)

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)

E.10 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014) (Tailored)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION

1. CONTRACT ADMINISTRATION DATA

List below the responsible party that may be contacted during the term of this contract for matters pertaining to the contract:

Business Name:

Point of Contact:

Address:

Telephone:

Facsimile:

E-mail:

Federal Taxpayer ID Number

Dun and Bradstreet Number

Government: Contracting Officer – Andrew Schoenecker Network Contracting Office 23 316 Robert Street N, Suite 506 Saint Paul, MN 55101 Phone (651) 293-3038 Andrew.Schoenecker@va.gov

Contracting Officer’s Representative – Bruce Trickel 3600 30th Street Des Moines, IA 50310 Phone (515) 699-599 x24552 Bruce.Trickel@va.gov

2. INVOICES: Invoices shall be submitted in arrears on a monthly basis.

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

AMENDMENT NUMBER DATE

4. 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 mailto:Andrew.Schoenecker@va.gov mailto:Bruce.Trickel@va.gov

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.

B.2 SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform on-site Nephrology Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, VA Central Iowa Health Care System (VA-CIHCS), located at 3600 30th St, Des Moines, IA 50310 (hereinafter referred to as VA-CIHCS). The Contractor’s physician(s)’ care and nurse practitioner(s)’s care shall cover the range of nephrology 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 American Society of Nephrology (ASN) http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines

Place of Performance: Services shall be provided on-site at VA-CIHCS, 3600 30th St, Des Moines, IA 50310.

Pricing Instructions: The offeror is instructed to edit the number of Contract Line Item Numbers (CLINs) to correspond with the number of key personnel submitted for the CLIN. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SUB-CLINs (SLINs) 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 one board certified/board eligible Nephrology Physician and one Nurse Practitioner (NP) who possess a minimum of five years direct Nephrology clinical work experience.

The Contractor shall propose key personnel that can be credentialed and available for scheduling to meet the requirements of the contract. The Government will require a minimum of 100 hours and a maximum of 8,000 hours under the contract.

This is an IDIQ contract with a five-year ordering period beginning on March 1, 2020, and ending on February 28, 2025.

One FTE is defined by VA as a minimum of 80 hours every two weeks (2080 hours per year) and does not include holidays.

• CLIN 1001, 2001, 3001, 4001, 5001 (Nephrology Physician Clinic Service): To provide physician on-site nephrology services with documentation of services being entered into VA- CIHCS computer system (electronic medical record) on the day of performance and encountered correctly. One four-hour clinic per week (Thursday), two four-hour clinics monthly (Friday) for an estimated 4-8 hours per week, 24-28 hours per month, 304 clinic total hours per year (12 months). Clinics run from 0800-1200 Thursday, and 0800-1200 on Friday.

• CLIN 1002, 2002, 3002, 4002, 5002 (Nephrology Nurse Practitioner (NP) Clinic Service): To provide nurse practitioner on-site nephrology services with documentation of services being entered into VA-CIHCS computer system (electronic medical record) on the day of performance and encountered correctly. Two four-hour clinics per week (Tuesday, Thursday) for an estimated 8 hours per week, 32-40 hours per month, 416 clinic total hours per year (12 months).

• CLIN 1003, 2003, 3003, 4003, 5003 (Nephrology Physician On-Call): New/return patients, inpatient, on-call consultations or question only consultations (to include phone consultations), outside of scheduled clinic hours. One hour minimum for each consult, (estimated 12 per month, 144 per year (12) months).

http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines

• CLIN 1004, 2004, 3004, 4004, 5004 (Nephrology Physician Training Hours): Time allowed for Nephrology Physicians to complete VA specific training requirements. Estimated 64 non-clinical total hours per year (12 months).

• CLIN 1005, 2005, 3005, 4005, 5005 (Nephrology Nurse Practitioner (NP) Training Hours):

Time allowed for Nephrology Nurse Practitioners to complete VA specific training requirements.

Estimated 32 non-clinical (training, reviews, meetings) total hours per year (12 months).

Period of Performance:

YEAR 1: 03-01-2020 – 02-28-2021

CLIN SLIN SUPPLIES/SERVICES QTY UNIT UNIT

PRICE AMOUNT

1001 Nephrology Physician Clinic Services

1001a

Board Certified / Board Eligible Nephrology Physician

Name: _______________________________

Title: ________________________________

304 HR $______ $________

1002 Nephrology Nurse Practitioner Clinic Services

1002a

Nephrology Nurse Practitioner

Name: _______________________________

Title: ________________________________

416 HR $______ $________

1003 Nephrology Physician On-Call 144 HR $______ $________

1004 Nephrology Physician Training Hours 64 HR $______ $________

1005 Nephrology Nurse Practitioner Training Hours 32 HR $______ $________

TOTAL $________

YEAR 2: 03-01-2021 – 02-28-2022

CLIN SLIN SUPPLIES/SERVICES QTY UNIT UNIT

PRICE AMOUNT

2001 Nephrology Physician Clinic Services

2001a

Board Certified / Board Eligible Nephrology Physician

Name: _______________________________

Title: ________________________________

304 HR $______ $________

2002 Nephrology Nurse Practitioner Clinic Services

2002a

Nephrology Nurse Practitioner

Name: _______________________________

Title: ________________________________

416 HR $______ $________

2003 Nephrology Physician On-Call 144 HR $______ $________

2004 Nephrology Physician Training Hours 64 HR $______ $________

2005 Nephrology Nurse Practitioner Training Hours 32 HR $______ $________

YEAR 3: 03-01-2022 – 02-28-2023

PRICE AMOUNT

3001 Nephrology Physician Clinic Services

3001a

Board Certified / Board Eligible Nephrology Physician

Name: _______________________________

Title: ________________________________

304 HR $______ $________

3002 Nephrology Nurse Practitioner Clinic Services

3002a

Nephrology Nurse Practitioner

Name: _______________________________

Title: ________________________________

416 HR $______ $________

3003 Nephrology Physician On-Call 144 HR $______ $________

3004 Nephrology Physician Training Hours 64 HR $______ $________

3005 Nephrology Nurse Practitioner Training Hours 32 HR $______ $________

YEAR 4: 03-01-2023 – 02-29-2024

PRICE AMOUNT

4001 Nephrology Physician Clinic Services

4001a Board Certified / Board Eligible Nephrology Physician 304 HR $______ $________

Name: _______________________________

Title: ________________________________

4002 Nephrology Nurse Practitioner Clinic Services

4002a

Nephrology Nurse Practitioner

Name: _______________________________

Title: ________________________________

416 HR $______ $________

4003 Nephrology Physician On-Call 144 HR $______ $________

4004 Nephrology Physician Training Hours 64 HR $______ $________

4005 Nephrology Nurse Practitioner Training Hours 32 HR $______ $________

YEAR 5: 03-01-2024 – 02-28-2025

PRICE AMOUNT

5001 Nephrology Physician Clinic Services

5001a

Board Certified / Board Eligible Nephrology Physician

Name: _______________________________

Title: ________________________________

304 HR $______ $________

5002 Nephrology Nurse Practitioner Clinic Services

5002a

Nephrology Nurse Practitioner

Name: _______________________________

Title: ________________________________

416 HR $______ $________

5003 Nephrology Physician On-Call 144 HR $______ $________

5004 Nephrology Physician Training Hours 64 HR $______ $________

5005 Nephrology Nurse Practitioner Training Hours 32 HR $______ $________

Total Contract Price: $_____________________________.

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Contractor shall furnish all personnel to provide services necessary to perform onsite Nephrology Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, VA Central Iowa Health Care System (VA-CIHCS), located at 3600 30th St, Des Moines, IA 50310 (hereinafter referred to as VA-CIHCS). The Contractor’s physician(s)’ and nurse practitioner(s)’ care shall cover the range of Nephrology 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 American Society of Nephrology (ASN) http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines

1.2. Place of Performance: Contractor shall furnish services at the VAMC, 3600 30th St, Des Moines, IA 50310 facility.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority and VAAR 873.

1.4. Policy/Handbooks:

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

1.4.2. VHA Directive 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 Directive 2010-018 “Facility Infrastructure” -

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

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

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

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

1.4.7. VHA Handbook 1100.19 Credentialing and Privileging -

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

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

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

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

1.5. 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.

http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 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 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5.1. ASN: American Society of Nephrology http://www.asn-

online.org/education/training/fellows/educational-resources.aspx#Guidelines

1.5.2. ASH: American Society of Nephrology

1.5.3. ACGME: Accreditation Council for Graduate Medical Education

1.5.4. ACLS: Advanced Cardiac Life Support

1.5.5. AOD: Admitting Officer of the Day

1.5.6. BLS: Basic Life Support

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

1.5.8. CDC: Centers for Disease Control and Prevention

1.5.9. CDR: Contract Discrepancy Report

1.5.10. CEU: Certified Education Unit

1.5.11. CME: Continuing Medical Education

1.5.12. CMS: Centers for Medicare and Medicaid Services

1.5.13. 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.

1.5.14. 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.

1.5.15. COS: Chief of Staff

1.5.16. CPARS: Contractor Performance Assessment Reporting System

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

1.5.18. 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.

1.5.19. DEA: Drug Enforcement Agency

1.5.20. ED: Emergency Department

1.5.21. FSMB: Federation of State Medical Boards

http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines http://www.aacn.nche.edu/accreditation

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

1.5.23. HHS: Department of Health and Human Services

1.5.24. HIPAA: Health Insurance Portability and Accountability Act

1.5.25. HR: Human Resources

1.5.26. ISO: Information Security Officer

1.5.27. Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.5.28. Mission Act: Legislation to strengthen VA’s ability to deliver health care by consolidating VA community care programs into a single program that is much easier to navigate.

Expands eligibility for Program of Comprehensive Assistance for Family Caregivers.

Strengthening VA’s ability to recruit and retain the best medical providers and strengthening of VA’s infrastructure.

1.5.29. MOD: Medical Officer of the Day

1.5.30. 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).

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

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

1.5.33. NP: Nurse Practitioner

1.5.34. NPPES: National Plan and Provider Enumeration System

1.5.35. PA: Physician Assistant

1.5.36. PALS: Pediatric Advanced Life Support

1.5.37. POP: Period of Performance

1.5.38. PPD: Purified Protein Derivative

1.5.39. PWS: Performance Work Statement

1.5.40. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for 8independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice http://www.nlnac.org/ 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.

1.5.41. QA/QI: Quality Assurance/Quality Improvement

1.5.42. QM/PI: Quality Management/Performance Improvement

1.5.43. QASP: Quality Assurance Surveillance Plan

1.5.44. 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.

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

1.5.46. 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.

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

1.5.48. 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 VA Central Iowa Health Care System (VACIHCS), Des Moines Division, located at 3600 30th St, Des Moines, IA 50310, Medical Center.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: The Contractor’s physician (s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property.

All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor’s physician (s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification: All contract Nephrology physician(s) shall be board certified/board eligible by the American Board of Internal Medicine in Nephrology http://www.abim.org/specialty/nephrology.aspx , and be currently certified in Basic Life Support (BLS) or equivalency. All continuing education courses required for maintaining certification will be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

http://www.abim.org/specialty/nephrology.aspx

2.1.3. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed provider(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract provider(s) prior to obtaining approval by the VA Central Iowa Health Care System (VACIHCS) Professional Standards Board, Medical Executive Board, and Medical Center Director.

2.1.3.1. If a Contractor’s physician(s) is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

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

Contractor’s physicians shall have knowledge of professional care theories, principles, practices, and procedures to perform assignments of Nephrology patient/critically ill patient population. Contractor’s physician shall demonstrate knowledge of growth and development, and pathophysiology of disease processes specific to the critical care/nephrology population Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for Contractor’s physician(s)shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

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

Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractor’s physician(s)registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

2.1.6. Training (BLS, CPRS, and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician(s) and nurse practitioner(s) as required by the VA.

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

Training Frequency (once a year, etc.)

Annual Hours

BLS Every two years 3 hours Privacy and HIPAA Reporting Curriculum

Annually 1 hours

VA Privacy Annually 1 hours FISMA Reporting Curriculum

Annually 0.5 hour

VA All Employee Mandatory Training

Annually 0.5 hour

VA Staff Mandatory Annually 0.5 hour

Training VA Privacy and Information Awareness Prevention of Work Place Harassment/No Fear

Annually 1 hour

CPRS Once upon starting 4 hours VISTA Imaging Once upon starting 1.5 hours Mission Act Training Once upon starting 3.0 hours

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 Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician(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 physicians {This is applicable to all health care workers}.

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {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 physicians {This is applicable to all health care workers}.

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician 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 physician(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 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf shall provide follow up documentation of clearance to return to the workplace prior to their return.

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

2.1.9. DEA and State Controlled Substance Certificate: Contractor shall provide copy of current DEA certificate and State of Iowa Controlled Substance Certificate (CSC).

2.1.10. Conflict of Interest: The Contractor and all Contractor’s physician(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 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 physician(s)are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.12.2. By submitting their 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 physician(s)shall not be considered VA employees for any purpose.

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

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

2.6. Inherent Government Functions: Contractor and Contractor’s physician(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No Employee status: The Contractor shall be responsible for protecting Contractor’s physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

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

When a Contractor or contract provider (s)has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The VA Full Time Equivalency (FTE) for the services required is 0.46 (resultant contract will provide approximately 960 hours per year coverage as identified in “Period of Performance” above, invoiced on actual services performed). Full time equivalent (FTE), 1.0, is defined by VA as a 2,080 hour per year, 80 hours every two weeks, and does not include holidays.

2.9.2. The minimum number of board certified/board eligible Nephrology physician and experienced Nurse Practitioner providers required to be on-site on a daily basis is one Nephrology physician and one Nephrology Nurse Practitioner as defined in paragraph Hours of Operation in this section.

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. In the event a scheduled physician is unable to complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) at the VA Central Iowa Health Care System (VACIHCS), Des Moines Division, located at 3600 30th St, Bldg 1, Room 2750, Des Moines, IA 50310 immediately of the schedule change.

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

2.9.4.1. 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 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 physician (s), s/he may request, without cause, immediate replacement of said Contractor’s physician (s). The CO and COR shall deal with issues raised concerning Contractor’s physician (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 physician(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: Outpatient clinics 8:00 am to 4:00 pm weekdays Monday thru Friday.

Inpatient new consults and Inpatient return visits on-call as required seven days a week.

Outpatient Clinic Services to be provided: a minimum of two ½ day (4 hours) Nephrology (renal) clinics per week (52 weeks per year) and two Friday clinics per month.

(1) Clinic Schedule –

(a) Thursday 12:00 pm – 4:00pm Nurse Practitioner Weekly

(b) Thursday 12:00 pm – 4:00pm Physician Weekly

(c) Friday 8:00 am – 12:00pm Physician *

*First & Third Friday of the Month

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

3.1.2. Patients receiving inpatient peritoneal/hemodialysis shall have it arranged by and will be followed by the Contractor’s employee. Contractor’s employee will be available on-call during all hours when the VAMC clinic is closed, including evenings, weekends, and holidays. Patient treatment orders, assessment, and treatment plan will be documented and signed within VAMC HIMS system per VA Handbook 1907.01.

3.1.3. Contractor’s physician(s) and nurse practitioner(s) shall be available and present in clinic during normal VAMC clinic hours, VAMC which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are 8:00 am to 4:00 pm weekdays, Monday thru Friday.

3.1.4. Off-hours Coverage: Contractor must make the Contractor’s physician(s) available on-call during all hours when the VAMC clinic is closed, including evenings, weekends and holidays.

3.1.4.1. On-call Contractor’s physician(s) must be available at all times for phone consultations with VA residents and physicians and call returned within 15 minutes.

3.1.4.2. Patients must be seen within 60 minutes of the page when medically indicated.

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

• New Year’s Day

• President’s Day

• Martin Luther King’s Birthday

• Memorial Day

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any day specifically declared to be a national holiday.

3.3. Cancellations: In the event of appointment cancellation, VAMC will be responsible for rescheduling patient’s appointment as per physician’s recommendation with procedures, other appointments or labs if possible using protocol in VHA Directive 2010-027.

3.3.1. 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 physician(s) who are competent, qualified per this performance work statement, and adequately trained to perform assigned duties.

4.1.1. Contractor’s providers shall be responsible for signing in and out when in attendance.

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

4.2. Standards of Care: The contractor’s providers’ care shall cover the range of Nephrology 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. American Society of Nephrology (ASN) http://www.asn-

online.org/education/training/fellows/educational-resources.aspx#Guidelines

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

4.2.5. The requirements contained in this PWS.

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contractor’s physician(s) and nurse practitioner(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to:

a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.jointcommission.org/standards_information/standards.aspx http://www.hpoe.org/resources?show=100&type=8 http://www.rms.oit.va.gov/SOR_Records/24VA19.asp 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.