S02 - 36C26325R0004.pdf

PAGE 1 OF 1. REQUISITION NO.

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

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

TIME

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

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

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

TELEPHONE NO. UEI: EFT:

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. NOV 2021)

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

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C26325R0004 09-12-2024

Daniel Vagts 651-293-3040 10-10-2024

11 AM CDT

36C263

Department of Veterans Affairs

Network 23 Contracting Office

Daniel Vagts

316 Robert Street N. STE. 506

St Paul MN 55101

X 100

X

$10 Million

N/A

Department of Veterans Affairs

NCO 23 - Minneapolis

One Veterans Dr

Minneapolis MN 55417

Network 23 Contracting Office

316 Robert Street N. STE. 506

St. Paul MN 55415

Y

Financial Services Center

PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

Onsite Audiology Health Technician Services for the

Minneapolis VA Health Care System and Twin Ports CBOC.

See Section B.4 Schedule of Services (pg.7)

See Section B.5 Performance Work Statement (pg.14)

See CONTINUATION Page

X ONE

Daniel Vagts VA-VHA-SAOC-2019-161D3612

Contract Officer

36C26325R0004

Table of Contents

SECTION A

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

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011)

B.3 SCHEDULE OF SERVICES

B.4 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2023)

C.2 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL (JAN 2011)

C.3 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS

(NOV 2021)

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

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

C.6 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.7 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.8 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.9 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

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

BUSINESS SET-ASIDE (JUL 2019) (DEVIATION)

C.11 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018)

C.12 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (OCT 2019)

C.13 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE (OCT 2019)

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

C.15 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (NOV 2021)

C.16 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR

EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (FEB 2024)

ALTERNATE II (FEB 2024)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 LIST OF ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

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

E.2 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JAN 2017)

E.3 PROPOSAL SUBMITTAL INSTRUCTIONS

E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.5 52.216-1 TYPE OF CONTRACT (APR 1984)

E.6 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.7 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

E.8 VAAR 852.252-70 SOLICITATION PROVISIONS OR CLAUSES INCORPORATED BY REFERENCE

(JAN 2008)

E.9 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION (OCT 2018)

E.10 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.11 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

EVALUATION FACTORS

E.12 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (FEB 2024)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer

Contracting Officer is Daniel Vagts at daniel.vagts@va.gov

Department of Veterans Affairs

NCO 23 – St. Paul

316 Robert Street N.

St. Paul MN 55101

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or [] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] MONTHLY

See Billing Instructions, PWS 6.2. Billing:

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

5. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the

Solicitation numbered and dated as follows:

AMENDMENT NO DATE

mailto:daniel.vagts@va.gov

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

7. TERM OF CONTRACT: The contract period is effective December 12, 2024 through December 11, 2025 with four (4) available option periods.

8. POINT OF CONTACT: The Contractor shall provide a point of contact (POC) who shall be responsible for the performance of the work under this contract. The POC shall have full authority to act for the

Contractor on all matters relating to the daily operation of this contract. The POC may be a contract health care provider performing under this contract. An alternate may be designated, but the

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

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

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

10. POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by Procurement Policy Memorandum (PPM) 2019-01.

B.2 SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-9, Small Business Subcontracting Plan, and VAAR 852.219-9, VA Small Business Subcontracting Plan Minimum Requirement. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing the contractor's compliance with the plan, including reviewing the contractor's accomplishments in achieving the subcontracting goals in the plan. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting plan.

B.3 SCHEDULE OF SERVICES

The Contractor shall furnish all key personnel to provide services necessary to perform onsite Audiology

Health Technician Services to eligible beneficiaries of the Department of Veterans Affairs, One Veterans

Drive, Minneapolis, MN 55417 or Twin Ports CBOC, 3520 Tower Avenue, Superior WI 54880.

The services are accredited by The Joint Commission (TJC) and follow the standards & guidelines set forth by The American College of Physicians (encompassing all of internal medicine) and the Society of

Hospital Medicine: https://www.hospitalmedicine.org. A contractor providing onsite Audiology Health

Technician Services shall provide services that meet or exceed those guidelines.

Place of Performance: Services shall be provided on site, One Veterans Drive, Minneapolis, MN 55417 or

Twin Ports CBOC, 3520 Tower Avenue, Superior WI 54880.

Pricing Instructions:

The offeror is instructed to edit the number of Sub-Line Item Numbers (SLIN) to correspond with the number of key personnel submitted for the line item number (LIN). Affiliate Offerors shall include the

“title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SLINs if adding or removing Key

Personnel.

The Contractor shall propose a minimum of five (5) key personnel Audiology Health Technicians to be credentialed and be available for scheduling to meet the requirements of the contract.

Period of Performance: BASE PERIOD: 12/12/2024 to 12/11/2025

LIN

No.

SUB-

Description Qty. Unit Unit Cost Total

Annual Cost

0001 None Audiology Health Technician Services

10,400 Hours DO NOT

PRICE

DO NOT PRICE

KEY PERSONNEL

None 0001a

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $ https://www.hospitalmedicine.org/

OPTION PERIOD 1: 12/12/2025 to 12/11/2026

None 0001b

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 0001c

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 0001d

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 0001e

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: TWIN PORTS

TOTAL FOR BASE PERIOD

10,400

Hours

LIN

No.

1001 None Audiology Health Technician Services

OPTION PERIOD 2: 12/12/2026 to 12/11/2027

None 1001a

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 1001b

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 1001c

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 1001d

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 1001e

Audiology Health Technician Services

NAME:____________

TITLE:

TOTAL FOR OPTION PERIOD 1

LIN

No.

2001 None Audiology Health Technician Services

None 2001a

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 2001b

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 2001c

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 2001d

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 2001e

Audiology Health Technician Services

NAME:____________

TITLE:

TOTAL FOR OPTION PERIOD 2

OPTION PERIOD 3: 12/12/2027 to 12/11/2028

LIN

No.

3001 None Audiology Health Technician Services

None 3001a

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 3001b

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 3001c

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 3001d

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 3001e

Audiology Health Technician Services

NAME:____________

TITLE:

OPTION PERIOD 4: 12/12/2028 to 12/11/2029

TOTAL FOR PERIOD 3

LIN

No.

4001 None Audiology Health Technician Services

None 4001a

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 4001b

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 4001c

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

2,080 Hours $/hr $

None 4001d

Audiology Health Technician Services

NAME:____________

TITLE:

LOCATION: MSP

Total for base performance period and all option periods: $

None 4001e

NAME:____________

TITLE:

TOTAL FOR PERIOD 4

B.4 PERFORMANCE WORK STATEMENT

Performance Work Statement for Onsite Audiology Health Technician Services

1. GENERAL:

1.1 Services Provided: The Contractor shall provide up to five (5) FTE Audiology Health Technicians on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Minneapolis VA Healthcare System (VAHCS), the Twin Ports CBOC and any future CBOC requiring Audiology Health Technician Services.

1.2 Place of Performance: Contractor shall furnish services at the MVAHCS, One Veterans Drive, Minneapolis, MN 55417 or TP CBOC, 3520 Tower Avenue. Superior, WI 54880.

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

1.4 Policy/Directives/Handbooks. The contractor shall be subject to the following policies, including any subsequent updates during the period of performance. The policies listed below can be accessed electronically at the following: VA Publications VHA Publications

1.4.1 VA Directive 1663: Health Care Resources (HCR) Contracting – Buying Title 38 U.S.C. 8153

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

1.5 Acronyms/Definitions: 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.

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

1.5.1 ABIM: American Board of Internal Medicine http://www.abim.org/

1.5.2 ACGME: Accreditation Council for Graduate Medical Education

1.5.3 ACLS: Advanced Cardiac Life Support

1.5.4 BLS: Basic Life Support

1.5.5 CDC: Centers for Disease Control and Prevention

1.5.6 CEU: Certified Education Unit

1.5.7 Clinical Privileging: Clinical 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, and within available resources.

1.5.8 CME: Continuing Medical Education

1.5.9 CMS: Centers for Medicare and Medicaid Services

1.5.10 CO: Contracting Officer: 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.

1.5.11 COR: Contracting Officer’s Representative: 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.

1.5.12 COS: Chief of Staff

1.5.13 CPARS: Contractor Performance Assessment Reporting System

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

1.5.15 Credentialing: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health care provider to provide care or services in or for the VA health care system. Credentials are documented evidence of licensure, education, training, experience or other qualifications.

1.5.16 DEA: Drug Enforcement Agency

1.5.17 FSMB: Federation of State Medical Boards

1.5.18 FTE: Full Time Equivalent. VA’s standard definition is for full time working the equivalent of 80 hours every two weeks, 2080 hours per year. However, providers may propose using their standard FTE definition.

http://www.abim.org/

1.5.19 HHS: Department of Health and Human Services

1.5.20 HIPAA: Health Insurance Portability and Accountability Act

1.5.21 Hospital Medicine: A medical specialty dealing with the care of hospitalized patients.

1.5.22 ISO: Information Security Officer

1.5.23 Key Personnel: The individuals specified in this contract who are essential to work performance.

1.5.25 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.

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

1.5.27 POP: Period of Performance

1.5.28 PPD: Purified Protein Derivative

1.5.29 PWS: Performance Work Statement

1.5.30 QA/QI: Quality Assurance/Quality Improvement

1.5.31 QASP: Quality Assurance Surveillance Plan

1.5.32 QM/PI: Quality Management/Performance Improvement

1.5.33 VETPro: is VHA’s mandatory credentialing software platform to document the credentialing of VHA health care providers. This system facilitates completion of a uniform, accurate, and complete credentials file.

1.5.34 VHA: Veterans Health Administration

1.5.35 VISN: Veterans Integrated Services Network

1.5.36 VistA: Veterans Integrated Systems Technology Architecture

2. QUALIFICATIONS:

2.1 Staff/Facility:

2.1.1 License: The Key Personnel 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 key personnel working on this contract shall be full and unrestricted licenses. Key Personnel 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 and Experience: N/A.

2.1.3 Credentialing and Privileging: Credentialling will be required for any Key Personnel on the National Board for Certification in Hearing Instrument Sciences (NBC-HIS)

Certificate. Credentialing and privileging are to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive 1100.21 referenced above. The

Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Key

Personnel prior to obtaining approval by the Facility Medical Executive Board and

Medical Center Director.

2.1.3.1 If a Key Personnel and/or other contract provider(s) are not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

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

Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all Key Personnel and 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 facility. Key Personnel 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 contract physician(s).

2.1.6 Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the Key Personnel as required by the VA.

Training Frequency Annual Hours

BLS (324129) Every 24 months 4 hours

VA Privacy and Information Security Awareness and Rules of Behavior (10176)

Once a Year 1 hour

Mandatory Training for Transient Clinical Staff (20152)

Once a Year 1.5 hours

Additional training may be required per VHA or Medical Center directives

Unknown Unknown

2.1.7 STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.): Contractor shall provide proof of the following 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

Key Personnel upon hire in accordance with CDC guidance. (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.

2.1.7.2 MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians.

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 Key Personnel {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 facility 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

(https://www.cdc.gov/infectioncontrol/guidelines/healthcare-https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Finfectioncontrol%2Fguidelines%2Fhealthcare-personnel%2Findex.html&data=05%7C01%7C%7Cd7680a2a6e804141d0cb08da3dc81d55%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637890226930302569%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=tVJJoWuHL1TL2cTHqFwOw%2F4DalpjL2163AL8MHWeiMQ%3D&reserved=0 personnel/index.html) for disease control. Contractor 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 facilities). 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: N/A

2.1.10 Conflict of Interest: The Contractor and all Key Personnel 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 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 preparing paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Finfectioncontrol%2Fguidelines%2Fhealthcare-personnel%2Findex.html&data=05%7C01%7C%7Cd7680a2a6e804141d0cb08da3dc81d55%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637890226930302569%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=tVJJoWuHL1TL2cTHqFwOw%2F4DalpjL2163AL8MHWeiMQ%3D&reserved=0 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 Facility COS or his/her clinical designee and approval by the Medical

Facility Director as provided in VHA Directive 1100.20 and VHA Directive 1100.21.

Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the facility 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.

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

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 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: Key Personnel are prohibited from referring VA patients to contractor’s or their own practice(s).

2.6 Inherent Government Functions: Contractor and Key Personnel 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 Key Personnel 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

2.7.4 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 Key Personnel.

When a Contractor or Key Personnel 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 five (5) FTE, one of which is assigned to the Twin Ports CBOC.

2.9.2 For current MVAHCS sites the required minimum number of Audiology Health Technicians required to be on site daily is two (2) in Minneapolis and one (1) in Twin Ports as defined in paragraph Hours of Operation in this section.

2.9.3 It is essential that continuity of services is maintained to the maximum degree possible, hence, substitution of contractor provided health technicians shall be limited to urgent/emergent absences of approved, assigned providers. Planned leave should be submitted for approval to contract supervisor and communicated to VA 6-weeks in advance. If less than 6-weeks in advance, 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.

2.9.4 Personnel Substitutions: During the first ninety (90) calendar days of performance, the

Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions.

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

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

2.9.4.3 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

Key Personnel .The CO and COR shall deal with issues raised concerning Key Personnel 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 the facility’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Key Personnel leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1 VA Business Hours: The hospital operates 24 hours a day, 7 days a week, 365 days a year including Federal Holidays.

Schedule:

Minneapolis Tours of Duty:

1. Monday - Friday: 07:30 – 16:00

2. Tuesday - Saturday: 07:30 – 16:00

Note: The daily tour of duty includes a 30 minute unpaid lunch break. Tours will be subject to change based on coverage needs.

CBOC Tour of Duty:

Monday - Friday: 07:30 – 16:00

Note: The daily tour of duty includes a 30 minute unpaid lunch break. Tours will be subject to change based on coverage needs.

3.1.1 Patients must be seen by a Key Personnel on-site at the facility 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 Key Personnel shall be available to be scheduled to work during all hours of operation of the facility or as required by the facility Chief of Staff or designee.

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

• Juneteenth

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any day specifically declared to be a national holiday.

4. CONTRACTOR RESPONSIBILITIES:

4.1 Clinical Personnel Required: The Contractor shall provide Key Personnel who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

Key Personnel 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 Key Personnel’ care shall cover the range of Hospital Medicine Physician services as would be provided in a state-of-the-art health care treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1 The Society of Hospital Medicine (http://www.hospitalmedicine.org ) would be the most reasonable replacements.

4.2.3 The American Board of Internal Medicine http://www.abim.org/

4.2.4 The professional standards of The Joint Commission (TJC) http://www.jointcommission.org/

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

4.2.6 The requirements contained in this PWS.

4.3 Medical Records:

4.3.1 Authorities: Key Personnel providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 5

U.S.C.552a (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’ (24VA10A7 ). 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 provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 4.4.4.

4.3.3 Disclosure: Key Personnel may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under http://www.hospitalmedicine.org/ http://www.abim.org/ http://www.jointcommission.org/ http://www.hpoe.org/resources?show=100&type=8 http://www.rms.oit.va.gov/SOR_Records/24VA19.asp the contract; however, Contractor shall obtain permission from the VA before disclosing any patient information outside VA. VA authorizes the Contractor to discuss patient health information for coordination of care with community health care providers in compliance with VA regulations, HIPAA and VHA Directive 1605.01, Privacy and Release of Information. The VA will provide the Contractor with a copy of VHA

Directive 1907.01, Health Information Management and Health Records and VHA

Directive 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.3.4 Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Directive 1907.01 Health Information Management and Health

Records and all guidelines provided by the facility.

4.3.5 Release of Information: The VA shall maintain control of releasing any copies of patient health information or health records and will follow policies and standards as defined, but not limited to Privacy Act requirements. Contractor will not release or disclose copies of records and will refer all such requests to the Release of Information

Department at the VA facility were assigned.

4.3.6 Management for Medical Records: National Archives and Records Administration record disposition requirements are found in RCS 10-1 Chapter 6, 6000 series.

4.4 Direct Patient Care: estimated 80% of the time involved in direct patient care.

4.4.1 Per the qualification section of this PWS, the contractor shall provide the following staff:

4.4.1.1. Contractor shall provide Audiology Health Technician services for an estimated total of a minimum of 40 hours per week.

4.4.2 Scope of Care: Contractor’s personnel shall be responsible for providing Audiology Health

Technician care via face-to-face, telephone, secure message, video-telehealth, and synchronous tele-health modalities, including, but not limited to:

4.4.2.1. Hearing aid education/maintenance:

4.4.2.1.1. Responsible for taking accurate ear mold impressions, preparing the mold for shipping, and mailing the ear mold together with the hearing aid order to the vendor. The technician is responsible for tracking hearing aid orders and communicating with vendors to ensure they are received. When is determined that a hearing aid will be delayed, s/he proactively makes appropriate phone contacts to resolve the issue.

4.4.2.1.2. When hearing aids are delivered (daily) to the clinic, the technician is responsible for certifying the hearing aids and checking the hearing aids to ensure that all ordered components are present and that the hearing aids and/or accessories are ready to be issued.

4.4.2.1.3. Instructs the client in the proper maintenance, cleaning, and use of hearing aids and/or assisted listening devices (amplified phones, TV devices, etc.). S/he is responsible for documenting the patient education in the medical record.

4.4.2.2. Hearing aid repairs:

4.4.2.2.1. Responsible for routine repairs of hearing aids. During the day-to-day routine s/he may meet with veterans on a one-to-one basis in an outpatient or in-patient setting in order to solve hearing aid problems. Provides primary level troubleshooting and repair for veterans who are experiencing hearing aid problems. Services commonly provided by the technician include the evaluation of a hearing aid’s function and physical fit, changing of batteries, removal of stuck batteries, cleaning of electrical contacts, changing of wax traps, replacing ear mold tubing, modifications of the physical hearing aid shape, and counseling the veteran in the proper usage and methods of care for the instrument. All interactions are properly documented in the form of clinical progress notes.

Responsible for performing otoscopic examinations to determine if cerumen management is necessary.

4.4.2.2.2. When a hearing aid needs to be sent in for repair, the incumbent utilizes the Remote Order/Entry System (ROES) in order to prepare the proper paperwork, wraps the hearing aid, and ships it. Makes appropriate entries in the clinic’s record tracking system in order to ensure that the aid is properly tracked. S/he then either mails the hearing aid to the veteran when it returns;

sometimes first re-programming the aid back to previous settings if the settings were lost during repair.

4.4.2.2.3. As part of the repair responsibility, evaluates the operation of Assistive

Listening Devices (ALD’s). The technician determines if the ALD is working properly and performs routine repairs as can be done. When needed the ALD is sent in for repair.