36C26323Q0613 St. Cloud CRNA Services RFQ.pdf

PAGE 1 OF 75 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)

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. UEI:

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

36C26324Q0024 05 October 2023

Matthew Rose 651-293-3010

8. OFFER DUE DATE/TIME

36C263 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

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

X 100

X

621399

$10 million

X

N/A

X

36C437

Department of Veterans Affairs St. Cloud VA Health Care System 4801 Veterans Drive St. Cloud, MN 56303

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

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

Y

Department of Veterans Affairs Financial Services Center PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

This is a FAR Part 13, Service-Disabled Veteran-Owned Small Business (SDVOSB) set-aside, Request for Quotations for on-site Certified Registered Nurse Anesthetist (CRNA) and related services for the St. Cloud VA Health Care System.

A five-year indefinite-delivery indefinite-quantity contract is anticipated, with an estimated 4120 hours a year of CRNA services to be provided by a minimum of three qualified key personnel.

Period of Performance: 01 February 2024 – 31 January 2029.

See B.2 for schedule, B.3 for performance work statement.

See E.2 for detailed quote submission instructions.

See E.6 for how quotes will be evaluated.

See CONTINUATION Page

X 1

Matthew Rose Contracting Officer

20 October 2023

8 AM CDT

36C26324Q0024

Table of Contents

Section B - Continuation of SF 1449 Blocks

B.1 Contract Administration Data B.2 Schedule of Services B.3 Performance Work Statement (PWS) B.4 Records Management Obligations (NARA Language)

Section C - Contract Clauses

C.1 52.212-4 Contract Terms and Conditions—Commercial Products and Commercial Services (Dec 2022) C.2 52.216-18 Ordering (Aug 2020) C.3 52.216-19 Order Limitations (Oct 1995) C.4 52.216-22 Indefinite Quantity (Oct 1995) C.5 52.217-8 Option to Extend Services (Nov 1999) C.6 52.225-8 Insurance-Work on a Government Installation (Jan 1997) C.7 CL-120 Supplemental Insurance Requirements C.8 VAAR 852.204-71 Information and Information Systems Security (Feb 2023) C.9 VAAR 852.219-75 VA Notice of Limitations on Subcontracting – Certificate of Compliance for Services and Construction (Jan 2023) C.10 52.252-2 Clauses Incorporated by Reference (Feb 1998) C.11 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders—Commercial Products and Commercial Services (Sep 2023)

Section D - Contract Documents, Exhibits, Or Attachments

Section E - Solicitation Provisions

E.1 52.212-1 Instructions to Offerors—Commercial Products and Commercial Services (Mar 2023) E.2 Quote Submission Instructions E.3 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021) E.4 52.233-2 Service of Protest (Sep 2006) E.5 52.252-1 Solicitation Provisions Incorporated by Reference (Feb 1998) E.6 852.252-7 Evaluation- Health Care Resources (Nov 2021) E.7 52.212-3 Offeror Representations and Certifications—Commercial Products and Commercial Services (Sep 2023)

B.1 Contract Administration Data | St. Cloud CRNA | 36C26324Q0024

Section B - Continuation of SF 1449 Blocks

B.1 Contract Administration Data

Under the authority of 38 USC 8153 and FAR Part 13, the Contractor agrees to provide Health Care Resources in accordance with the terms and conditions stated herein, to furnish to and at the St. Cloud VA Health Care System (STCVAHCS), the services and prices specified in the Sections B.2 (Schedule) and B.3 (PWS).

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

Contractor: Government:

Contracting Officer:

Matthew Rose, NCO 23 316 N. Robert St. STE 506 St. Paul MN 55101 651-293-3010 Matthew.Rose3@va.gov

2. Contractor and Government points of contact can be changed by written notification to the other party.

Notification will be placed in the Contract file and will not require a modification to the Contract.

3. Contractor Remittance Address: All payments by the Government to the Contractor will be made in accordance with FAR 52.232-33, Payment by Electronic Funds Transfer – System for Award Management, and VAAR 852.232-72, Electronic Submission of Payment Requests.

4. Availability of Funds: The Contractor shall perform no service until funding is provided for the applicable performance period and the Contracting Officer authorizes such services in writing.

5. Invoices: Invoices shall be submitted monthly in arrears. The Contracting Officer’s Representative (COR) will review all invoices submitted. The COR is responsible for certifying invoices for payment for only those services received and deemed acceptable by VA. Once certified by the COR, payment can be made via the Tungsten Network.

6. Billing Instructions: See Performance Work Statement (PWS) Section 6.2 for billing instructions.

7. Amendments: Contractor acknowledges receipt of solicitation amendments listed below:

Amendment Number Date Issued

None currently N/A mailto:Matthew.Rose3@va.gov

B.2 Schedule | St. Cloud CRNA | 36C26324Q0024

B.2 Schedule of Services Pricing Instructions: **Note: Offeror may either write in all required information in the schedules for Contract Years 1 through 5 listed below or may provide the same information in the same schedules provided in excel format in Attachment 6. The excel file will automatically calculate total pricing and may be easier to complete as a result.

Provide a minimum of three Certified CRNA personnel for each of the five Contract Year schedules.

Include candidate name, proposed annual hours for each candidate, and proposed hourly rates for each candidate. Schedule blocks requiring offeror completion are colored yellow. Include total pricing for each candidate total pricing for each year, and total pricing Total proposed hours of all candidates combined must equal 4120 hours per year.

Ordering Procedures: The Contracting Officer (CO) will issue a task order at the beginning of each Contract Year. This will provide funding for the year and list a purchase order number that Contractor will reference when invoicing for that Contract Year.

CO will send a modification to Contractor at the end of each Contract Year to remove any unspent funding at the end of that Year. CO will also add additional funding as needed to Contract Years as needed and so long is total number of hours on the contract does not exceed the maximum contract value listed at the bottom of the schedule.

St. Cloud CRNA Services Contract Year 1: 01 February 2024- 31 January 2025

LIN No. Sub-LIN Description Est. Qty. Unit Unit Cost Total Est.

Cost

0001 None Certified Registered Nurse Anesthetist Services 4120 Hours See Sub-LINS

KEY PERSONNEL Sub-LINs

0001a Certified Registered Nurse Anesthetist Name: Hours

0001b Certified Registered Nurse Anesthetist Name: Hours

0001c Certified Registered Nurse Anesthetist Name: Hours

Estimated Total for Contract Year 1

St. Cloud CRNA Services Contract Year 2: 01 February 2025- 31 January 2026

LIN No. Sub-LIN Description Est. Qty. Unit Unit Cost Total Est.

Cost

1001 None Certified Registered Nurse Anesthetist Services 4120 Hours See Sub-LINS

KEY PERSONNEL Sub-LINs

1001a Certified Registered Nurse Anesthetist Name: Hours

1001b Certified Registered Nurse Anesthetist

1001c Certified Registered Nurse Anesthetist

Estimated Total for Contract Year 2

Contract Year 3: 01 February 2026- 31 January 2027

LIN No. Sub-LIN Description Est. Qty. Unit Unit Cost Total Est.

Cost

2001 None Certified Registered Nurse Anesthetist Services 4120 Hours See Sub-LINS

KEY PERSONNEL Sub-LINs

2001a Certified Registered Nurse Anesthetist Name: Hours

2001b Certified Registered Nurse Anesthetist Name: Hours

2001c Certified Registered Nurse Anesthetist

Estimated Total for Contract Year 3

Contract Year 4: 01 February 2027- 31 January 2028

LIN No. Sub-LIN Description Est. Qty. Unit Unit Cost Total Est.

Cost

3001 None Certified Registered Nurse Anesthetist Services 4120 Hours See Sub-LINS

KEY PERSONNEL Sub-LINs

3001a Certified Registered Nurse Anesthetist Name: Hours

3001b Certified Registered Nurse Anesthetist Name: Hours

3001c Certified Registered Nurse Anesthetist

Estimated Total for Contract Year 4

Contract Year 5: 01 February 2028- 31 January 2029

LIN No. Sub-LIN Description Est. Qty. Unit Unit Cost Total Est.

Cost

4001 None Certified Registered Nurse Anesthetist Services 4120 Hours See Sub-LINS

KEY PERSONNEL Sub-LINs

4001a Certified Registered Nurse Anesthetist

4001b Certified Registered Nurse Anesthetist Name: Hours

4001c Certified Registered Nurse Anesthetist

Estimated Total for Contract Year 5

Estimated Grand Total for all Five Years:

Contract minimum guarantee: 250 hours Contract maximum value: 41,000 hours

B.3 Performance Work Statement | St. Cloud CRNA | 36C26324Q0024

B.3 Performance Work Statement (PWS)

1. GENERAL:

1.1. Services Provided: The Contractor shall provide two (2) full-time (2.0 FTE) Certified Registered Nurse Anesthetist, on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the St. Cloud VA Health Care System (STCVAHCS).

1.2. Place of Performance: Contractor shall furnish services at the St. Cloud VA Health Care System, 4801 Veterans Drive, St. Cloud, MN 56303.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority and FAR 12 in combination with FAR Part 13.

1.4. 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. VA Publications VHA Publications

1.4.1. VA Directive 1663: Health Care Resources (HCR) Contracting – Buying Title 38 U.S.C.

1.4.2. VHA Directive 1003.04: VHA Patient Advocacy

1.4.3. VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider Group Practice

1.4.4. VHA Directive 1088(1): Communicating Test Results to Providers and Patients

1.4.5. VHA Directive 1100.18: Reporting and Responding to State Licensing Boards

1.4.6. VHA Directive 1100.20: Credentialing of Health Care Providers

1.4.7. VHA Directive 1100.21: Privileging

1.4.8. VHA Directive 1192.01: Seasonal Influenza Vaccination Program for VHA Health Care Personnel

1.4.9. VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures in Any Clinical Setting

1.4.10. VHA Directive 1605.01: Privacy and Release of Information

1.4.11. VHA Directive 1907.01: VHA Health Information Management and Health Records

1.4.12. VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports

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

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

1.4.14. St. Cloud VA Health Care System Policies: Copies of these policies are included in as Attachment 5 in Section D:

1.4.14.1. SSC00-02 Ambulatory Surgery Center (ASC)

1.4.14.2. SSC00-01.05 SSC Automated Information Security

1.4.14.3. SSC00-02.26 Visitors Vendors in the OR

1.4.14.4. SSC00-02.38 ASC Orientation and Education Plan

1.4.14.5. SSC00-02.39 ASC Operating Room Security

https://www.va.gov/vapubs/ https://www.va.gov/vhapublications/index.cfm http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.4.14.6. SSC00-02.69 ASC Infection Prevention

1.4.14.7. SSC00-02.88 ASC Local Anesthesia Guidelines

1.4.14.8. CD00-47.2 Records Management

1.4.14.9. CD00-51 Code of Conduct

1.4.14.10. FM-02.26.11 SSC Safety Program

1.4.14.11. MCP PSM118-07 Occupational Health

1.4.14.12. MCP FM-07 Emergency Management Plan

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.

1.5.1. ABA: American Board of Anesthesiology http://www.theaba.org/

1.5.2. ACGME: Accreditation Council for Graduate Medical Education

1.5.3. ACLS: Advanced Cardiac Life Support

1.5.4. AOD: Admitting Officer of the Day

1.5.5. APRN: Advanced Practice Registered Nurse

1.5.6. BLS: Basic Life Support

1.5.7. CCNE: Commission on Collegiate Nursing Education: CCNE Accreditation (aacnnursing.org)

1.5.8. CDC: Centers for Disease Control and Prevention

1.5.9. CR: 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. 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.

1.5.18. DEA: Drug Enforcement Administration

http://www.theaba.org/ https://www.aacnnursing.org/ccne-accreditation https://www.aacnnursing.org/ccne-accreditation

1.5.19. ED: Emergency Department

1.5.20. Electronic Health Record (EHR): Electronic health record system used by the VA

1.5.21. FSMB: Federation of State Medical Boards

1.5.22. HHS: Department of Health and Human Services

1.5.23. HIPAA: Health Insurance Portability and Accountability Act

1.5.24. HR: Human Resources

1.5.25. ISO: Information Security Officer

1.5.26. 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.

1.5.27. MOD: Medical Officer of the Day

1.5.28. NBCRNA: National Board of Certification and Recertification for Nurse Anesthetists

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

1.5.30. NLN CNEA: National League for Nursing Commission for Nursing Education Accreditation. https://cnea.nln.org

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

1.5.32. NP: Nurse Practitioner

1.5.33. NPPES: National Plan and Provider Enumeration System

1.5.34. PA: Physician Assistant

1.5.35. POP: Period of Performance

1.5.36. PWS: Performance Work Statement

1.5.37. 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.

1.5.38. QA/QI: Quality Assurance/Quality Improvement

1.5.39. QM/PI: Quality Management/Performance Improvement

1.5.40. QASP: Quality Assurance Surveillance Plan

1.5.41. 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.

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

https://cnea.nln.org/

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

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

1.5.45. Veterans Affairs Health Care System (VAHCS): Unless identified with the name of a different VA medical Center or Health Care System, for purposes of this contract, this term shall mean the St. Cloud VA Health Care System (STCVAHCS) Medical Center.

2. QUALIFICATIONS:

2.1. Staff/Facility:

2.1.1. License: Graduate from an approved School of Nursing and hold an unencumbered current state licensure as an Advanced Practice Registered Nurse.

The Contractor’s providers 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 providers 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 of Contractor’s Nurse Anesthetists must have and maintain certification by the Council on Certification of Nurse Anesthetists.

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 providers possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Contractor’s providers prior to obtaining approval by the St. Cloud VAHCS Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.3.1. If a Contractor’s providers 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 providers 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 providers and Contractor’s providers 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 VAHCS. Contractor’s providers 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 credential’s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for Contractor’s providers.

2.1.6. Training (ACLS, BLS, EHR 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 providers as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the Contractor.

Training Frequency Annual Hours

VA Privacy and Information Security Awareness and Rules of Behavior – TMS course 10176

Once a Year 1 hour

HIPAA Training TMS Course – TMS course 10203 Once a Year 1 hour

Mandatory Training for Transient Clinical Staff Once a Year 1.5 hours

ACLS/BLS Every 24 months 4 hours

Prevention/Management of Disruptive Behavior/Violence Prevention Levels 1

Once .75

Suicide Prevention: Suicide Risk Management Training for Clinicians

Once a year 1 hour

CPRS: Tab by Tab Once 4 hours

Prevention/Management of Disruptive Behavior/Violence Prevention Level 2

Every 24 months 2 hours

Prevention/Management of Disruptive Behavior/Violence Prevention Level

Every 24 months 4 hours

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

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor providers.

2.1.7.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor providers.

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor providers have received the annual Influenza vaccine unless it is contraindicated. If the Contractor provider has a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season.

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 providers; 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 VAHCS shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.7.8. Drug Testing: All Contractor provided providers shall be subject to the VA’s policy implementing the 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 quote.

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

2.1.10. Citizenship related Requirements:

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

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

2.1.10.2. 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.

2.1.10.3. 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.

2.1.10.4. 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.

2.1.10.5. 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.

2.1.11. 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.

2.1.11.1. 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 providers 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.

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

2.2. Clinical/Professional 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 VAHCS COS and/or the Chief of the Service or designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract http://oig.hhs.gov/exclusions/index.asp modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. The St. Cloud VA Surgical & Specialty Care Integrated Clinical Community provides veteran patients with anesthesia procedures for ambulatory surgical procedures. The services include rendering patients insensate for surgical procedures (general anesthesia), blocks for surgical procedures (e.g. spinal anesthesia), nerve block for surgical procedures, monitored anesthesia care, procedures to alleviate post-operative pain and resuscitation services. The department utilizes anesthesia providers. We work in an anesthesia team, while practicing independently to provide anesthesia and critical care services to the patients who are undergoing surgical procedures at the St. Cloud VAHCS.

2.4. Non-Personal Healthcare Services: The parties agree that the Contractor and all Contractor’s providers shall not be considered VA employees for any purpose.

2.5. 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.

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

2.7. Inherent Government Functions: Contractor and Contractor’s providers 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.

2.8. No Employee status: The Contractor shall be responsible for protecting Contractor’s providers 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:

2.8.1. Workers’ compensation

2.8.2. Sick leave

2.8.3. Vacation time

2.8.4. Professional liability insurance

2.8.5. Health examinations

2.8.6. Income tax withholding, and

2.8.7. Social security payments.

2.9. Tort Liability: The Federal Tort Claims Act does not cover Contractor or Contractor’s providers. When a Contractor or Contractor’s providers 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 providers) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.10. Medical Liability Insurance: The Contractor shall furnish their own medical liability insurance and will hold certificate of insurance for general liability and malpractice insurance. Prior to award of the contract, the Contractor shall furnish to the VA a certificate of insurance evidencing that all required coverage has been obtained. The Contractor shall be responsible for maintaining this certificate/coverage for the duration of the contract. Under no circumstances will contract physicians be considered a MVAHCS employee nor will Contractor personnel be covered by VA liability insurance.

2.11. Key Personnel: Contractor will be responsible to ensure that the Contractor personnel providing work on this contract are fully trained, fully competent, and practicing independently 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.

2.11.1. The VA Full Time Equivalency (FTE) for the services required is two FTE. One FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.11.2. The minimum number of Certified Registered Nurse Anesthetists required to be on site daily is 2 as defined below in section 3 – Hours of Operation.

2.11.3. 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 fifteen (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 fifteen (15) calendar days prior to making any permanent substitutions.

2.11.3.1. 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 fifteen (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.

2.11.3.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive workdays 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.

2.11.3.3. 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 providers, s/he may request, without cause, immediate replacement of said Contractor’s providers. The CO and COR shall deal with issues raised concerning Contractor’s providers conduct. The final arbiter on questions of acceptability is the

CO.

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

3. HOURS OF OPERATION:

3.1. VA Business Hours: The St. Cloud VA Health Care System’s administrative offices, clinics and the OR general hours of operation are Monday through Friday 8:00am – 4:30pm, excluding Federal Holidays. The services covered by this contract shall be furnished by the Contractor as defined in the work schedule below.

3.2. Work Schedule:

3.2.1. The Contractor’s providers shall provide services on-site at the St. Cloud VAHCS an estimated 80 hours per week, excepting weeks with Federal Holidays. The schedule and tour of duty is defined by the Service Line Leadership and may vary based on the nature of the workload, needs of the service, and patient care requirements.

3.2.2. Schedules of Duty: Daily schedules will be weekdays, Monday through Friday, except for Federal Holidays.

3.2.2.1. Contractor’s personnel shall be available and present during scheduled hours which will be established, and may be revised, as deemed appropriate for patient care by Service Line Leadership.

3.2.2.2. Contractor’s providers are required to stay until all patient care needs are completed. If schedule hours run over, the provider will be paid at the current hourly rate.

3.2.2.3. Daily schedule currently run from 7:00 AM to 3:30 PM but is subject to change by the

COR.

3.2.2.4. All daily tours will include a 30-minute non-paid lunch break.

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

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

3.3.1. New Year’s Day

3.3.2. Martin Luther King’s Birthday

3.3.3. President’s Day

3.3.4. Memorial Day

3.3.5. Juneteenth

3.3.6. Independence Day

3.3.7. Labor Day

3.3.8. Columbus Day

3.3.9. Veterans Day

3.3.10. Thanksgiving

3.3.11. Christmas

3.3.12. Any day specifically declared to be a national holiday.

3.4. Cancellations: Requests for clinic cancellations will be made in writing to the SSC Leadership team (email group) and the COR with no less than six (6) weeks’ notice accompanied by an appropriate justification, with provisions made to ensure effective implementation of patient notification and a rescheduling plan to ensure that patient access and continuity of care issues is addressed. This six-week notice policy applies to continuing education, meetings or conferences, vacations days, or other than non-emergency reasons

3.4.1. 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 providers 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. Nurse Anesthetist Functions: Contractor’s personnel must be able to perform all items listed below and any others not listed here in order to provide CRNA services in accordance with all professional standards, laws, and regulations:

4.2.1. Practicing as an independent CRNA/anesthesia provider

4.2.2. Provision of care in surgical procedure

4.2.3. Perform and document a preanesthetic evaluation of the patient before surgery including requesting consultations, additional diagnostic and/or laboratory studies.

4.2.4. Initiation of the planned anesthetic technique that may include general, regional, MAC, or local anesthesia. Interventions include administration of fluids, medications, ventilator support, provision of homeostasis, provision of adequate pain relief and management of anesthesia and surgical side effects.

4.2.5. Induction of general anesthesia and initial airway management.

4.2.6. Endotracheal intubation for surgical or procedural cases.

4.2.7. Peripheral nerve blocks.

4.2.8. Central neuraxial blocks.

4.2.9. Adjustment of anesthetic drugs and techniques utilized in the maintenance of anesthesia.

4.2.10. Sedation for field blocks or MAC as discussed in the anesthetic care plan.

4.2.11. Manages emergence from anesthesia.

4.2.12. Provide anesthetic for: ICD checks

4.2.13. Administer sedation or local anesthesia to facilitate urgent/emergent endotracheal intubation.

4.2.14. Placement of intravenous lines throughout the facility, as requested.

4.2.15. Participation in staff meetings, mortality and morbidity conferences and other committees as assigned by the SSC leadership.

4.2.16. Maintains anesthesia equipment in constant readiness and cleans equipment in accordance with hospital guidelines, SOPs, manufacturer’s recommendations and CDC guidelines.

4.2.17. Prepares drugs properly for use in anesthesia administration per department SOP

4.2.18. Ensures that OR/anesthesia safety regulations and procedures and infection control policies and procedures are observed.

4.2.19. Complies with Joint Commission National Patient Safety Goals

4.2.20. Fully complies with medical center Correct Site/Universal Protocol requirements, including pausing activities during pre-operative time-out

4.2.21. Complies with VA and Joint Commission documentation requirements

4.2.22. Labels specimens according to medical center policy

4.2.23. Participates in continuous improvement activities

4.2.24. Participates in outcomes evaluation and recommendations for practice improvements

4.2.25. Conducts in-service programs for the department and other services within the medical center

4.3. Standards of Care: The Contractor’s providers’ care shall cover the range of Anesthesiology services as would be provided in a state-of-the-art health care facility and the standard of care shall be of a quality, meeting or exceedingly currently recognized national standards as established by:

4.3.1. American Society of Anesthesiology (ASA) Guidelines: https://www.asahq.org/standards-and-guidelines

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

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

4.3.4. The requirements contained in this PWS.

4.4. Medical Records:

4.4.1. Authorities: Contractor’s providers providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C.

552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

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

A health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

4.4.3. Disclosure: Contractor’s providers may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information.

Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

https://www.asahq.org/standards-and-guidelines https://www.asahq.org/standards-and-guidelines 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 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423

4.4.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records and all guidelines provided by the VAHCS facility.

4.4.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to…