Atch 2 PWS.docx

Combined Synopsis-Solicitation for Commercial Items Request for Quotation (RFQ) 36C25521Q0323

ATTACHMENT 2: PERFORMANCE WORK STATEMENT

Performance Work Statement for On-Site Nephrology Physician Services

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified/Board Eligible Nephrology Physician Services for On-Site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Robert J. Dole (RJD or Dole) VA Medical Center (VAMC).

1.1.1. The Contractor shall provide one (1) Nephrology Physician to staff Renal Clinic 2.

1.1.2. The Contractor shall provide sufficient Nephrology Physicians to be “on-call” during monthly scheduled call-dates. On-call requires Contractor Nephrology Physician to be readily available during specified times, including weekdays, weekday nights, weekends, and holidays.

1.1.2.1. Contractor-provided physicians, when on-call, are subject to call-back to the Dole VAMC to perform on-site services.

1.1.3. The Contractor’s Nephrology Physician shall perform Monthly Peer Reviews as per hospital policy.

1.2. Background: The RJD VAMC operates renal clinics with VA employed Nephrology Physicians. The VAMC requires Contractor support to staff Renal Clinic 2 for approximately 4 hours, 1 day per week, 52 weeks per year.

1.2.1. Historically and today, Renal Clinic services are performed by VA and Contractor Nephrology Physicians, on-site and serving on-call and performing call-back services as necessary. On-call is shared. Historically, Contractor-staffed on-site services are performed on Thursdays of every week, except on Federal Holidays. The date of week is subject to change according to VA needs and may accommodate Contractor availability.

1.2.2. Recent history for on-call status, being shared, includes approximately 89% by VA and 11% by Contractor for Weekdays/nights, and approximately 31% by VA and 69% by Contractor for Weekends. The scheduled weekends are subject to change according to VA needs and may accommodate Contractor availability.

1.3. Place of Performance: - Robert J. Dole VA Medical Center Outpatient Clinic, 5500 E. Kellogg, Wichita, KS 67218. Outpatient clinic is located in Building 26, 1st Floor Room No. 168.

1.4. Authority: Solicitation and Award pursuant to the Authority of FAR part 12 in combination with FAR Part 13.

1.5. Policy/Handbooks - the Contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

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

1.5.2. VHA Directive 1192 “Seasonal Influenza Prevention Program” https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472

1.5.3. VHA Handbook 1100.17: National Practitioner Data Bank Reports - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.5.4. VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.5.5. VHA Handbook 1100.19 Credentialing and Privileging - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.5.6. VHA Handbook 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

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

1.6. 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.

1.6.1. ABN: American Board of Nephrology

1.6.2. AMIM: American Board of Internal Medicine

1.6.3. ACGME: Accreditation Council for Graduate Medical Education

1.6.4. ACLS: Advanced Cardiac Life Support

1.6.5. AOD: Admitting Officer of the Day

1.6.6. BLS: Basic Life Support

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

1.6.8. CDC: Centers for Disease Control and Prevention

1.6.9. CR: Contract Report – A report of contract performance deficiencies issued to the Contractor by the Contracting Officer. See QASP

1.6.10. CEU: Certified Education Unit

1.6.11. CME: Continuing Medical Education

1.6.12. CMS: Centers for Medicare and Medicaid Services

1.6.13. 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.

1.6.14. Contracting Officer’s Representative (COR) – A person appointed by the Contracting Officer 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 reports to the Contracting Officer promptly any indication of non-compliance in order that appropriate action can be taken.

1.6.15. COS: Chief of Staff

1.6.16. CPARS: Contractor Performance Assessment Reporting System

1.6.17. 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.

1.6.18. DEA: Drug Enforcement Agency

1.6.19. ED: Emergency Department

1.6.20. EHR: Electronic Health Record - electronic health record system used by the VA

1.6.21. FSMB: Federation of State Medical Boards

1.6.22. HHS: Department of Health and Human Services

1.6.23. HIPAA: Health Insurance Portability and Accountability Act

1.6.24. HR: Human Resources

1.6.25. ISO: Information Security Officer

1.6.26. 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.

1.6.27. MOD: Medical Officer of the Day

1.6.28. 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).

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

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

1.6.31. NP: Nurse Practitioner

1.6.32. NPPES: National Plan and Provider Enumeration System

1.6.33. PA: Physician Assistant

1.6.34. PALS: Pediatric Advanced Life Support

1.6.35. POP: Period of Performance

1.6.36. PPD: Purified Protein Derivative

1.6.37. PWS: Performance Work Statement

1.6.38. 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.

1.6.39. QA/QI: Quality Assurance/Quality Improvement

1.6.40. QM/PI: Quality Management/Performance Improvement

1.6.41. QASP: Quality Assurance Surveillance Plan

1.6.42. TMS: Talent Management System – VA’s online training program

1.6.43. 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.

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

1.6.45. 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.

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

1.6.47. Veterans Affairs Medical Center (VAMC) : Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the Robert J. Dole VA Medical Center.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License – The Contractor shall perform services on VA property through use of physicians having and holding current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia). All licenses shall be full and unrestricted licenses. Contractor-provided physicians 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 shall not perform services on VA property under this contract.

2.1.2. Board Certification - All Contractor shall provide Physicians that are Board Certified/Board Eligible by the American Board of Internal Medicine (ABIM), be currently certified in Basic Life Support (BLS) or equivalency. All continuing education courses required for maintaining of certification shall be current at all times. Contractor shall provide documentation verifying current certifications to the Contracting Officer at least annually throughout contract performance.

2.1.3. Credentialing and Privileging –Credentialing and privileging shall be in accordance with the provisions of VHA Handbook 1100.19. Contractor is responsible to ensure that Physicians possesses the requisite credentials enabling the granting of privileges. Services shall not be performed by any Contractor-provided physicians prior to the Contracting Officer’s notification of approval by the Robert J. Dole VA Medical Center Professional Standards Board, Medical Executive Board and Medical Center Director, and is in possession of a VSC-sponsored Personal Identification Verification (PIV) Badge.

2.1.3.1. If a Contractor-provided physician cannot be credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute at no additional cost to the government.

2.1.4. Technical Proficiency - Contractor-provided physicians 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 Contracting Officer 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-provided physicians and Contractor, through its Physicians, 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 Contracting Officer copies of current CMEs as required or requested. Contractor-provided physicians registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentials office, through the Contracting Officer, for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for Contractor-provided physicians .

2.1.6. Training (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-provided physicians as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the Contractor.

2.1.6.1.

Active Threat Training - Military Sexual Trauma (MST) for Medical Providers - Government Ethics - Prevention of Workplace Harassment/No Fear Act - VHA MRI Safety Training Level 1 Training (all who enter MRI suites) - VA Core Values Training (ICARE Recommitment) - VHA Privacy and HIPAA Focused Training - Patient Safety - Patient Rights - Patient Abuse - Prevention / Management of Disruptive Behavior/Violence Prevention Level I - Suicide Prevention: Suicide Risk Management Training for Clinicians Infection Control and Blood Borne Pathogens - SUX Infection Control and Blood Borne Pathogens

· Basic Life Support (BLS) Training Every two years or as required to maintain certification

ACLS: not applicable unless physician orders moderate sedation

2.1.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor-provided physicians. 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-provided physicians.

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor-provided physicians.

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

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor-provided 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 .

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-provided physicians; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

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

2.1.7.8. Current and Future Vaccination(s) Requirement: If COVID-19-related vaccines are available and becomes mandatory for RJD employees, Contractors shall provide proof that all Contractor-provided physicians have received the a COVID vaccine at Contractor cost, unless it is medically contraindicated. If any key personnel contracts COVID, or tests positive through a viral test or antibody test for COVID, the Contractor shall immediately remove the physician from performance under the contract and immediately provide a substitute physician. The COVID positive Contractor may return to work, based on Dole VA employee health guidelines. Contractor shall provide evidence of Contractor-provided physicians’ vaccinations equal to those required of VA physicians, such as COVID vaccinations.

2.1.7.9. 2.1.8.9. Use of Masks, other Personal Protective Equipment (PPE): Contractor-provided physicians shall abide by all VAMC mask and PPE requirements as established by VA and RJD policies while on VAMC property, including entrances/common areas, patient exam locations, during patient encounters and duty/work areas during performance of the contract where masks and PPE requirements are indicated by the policies.

2.1.8. National Provider Identifier (NPI): 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 - Contractor shall maintain, and provide copies of, current DEA certificates for all physicians.

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

2.1.11. Citizenship related Requirements:

2.1.11.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.11.2. While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.11.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.11.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.11.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.12. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.12.1. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed Contractor-provided physicians 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 Contractor and Contractor-provided physicians are not listed as of the date of the price quote submission.

2.2. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or clinical designee and approval by the Medical Center Director, per VHA Handbook 1100.19. Clinical/Professional performance monitoring and review of all clinical personnel performing under this contract, for quality purposes, will be performed by the VAMC COS, the Chief of the Service or designee. A COR may be appointed, however, only the Contracting Officer is authorized to issue instructions to the Contractor or make changes to the contract.

2.3. Non-Personal Healthcare Services: The parties agree that the Contractor and all Contractor-provided physicians 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: Contractor and Contractor-provided physicians are prohibited from referring VA patients to the Contractor’s, or their own, medical practice(s).

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

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

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

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

2.9. Key Personnel:

2.9.1. Contractor shall provide not less than 1 Nephrology Physician to staff the Renal Clinic during the days/times stated in this Performance Work Statement. There is no specified minimum number of Board Certified/Board Eligible Nephrology Physicians to staff the Robert J. Dole VAMC for call coverage, however the Contractor shall provide a sufficient number of physicians to cover on-call coverage days and times. The maximum is 10 Nephrology Physicians. The minimum 1 key person to staff the weekly clinic shall be credentialed and be available for outpatient clinic scheduling. Outpatient Renal Clinic hours are stated in Section 3.

2.9.2. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations, and additional coverage as required. In the event a scheduled physician is unable to complete an assigned shift, the Contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Officer and COR immediately of the schedule change.

2.9.3. 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 Contracting Officer, in writing, within 30 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 Contracting at least 30 calendar days prior to making any permanent substitutions.

2.9.3.1. 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 Contracting Officer. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The Contracting Officer will notify the Contractor within 30 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.

2.9.3.2. 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.

2.9.3.3. 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-provided physicians, s/he may request, without cause, immediate replacement of said Contractor-provided physicians .The Contracting Officer and COR will deal with issues raised concerning Contractor-provided physicians conduct. The final arbiter on questions of acceptability is the Contracting Officer.

2.9.3.4. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor-provided physicians 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: Nephrology Clinic services will be provided from 1:30 P.M.to 5:30 P.M. and On-call and Call-back coverage as needed for times outside of regular clinic days and times.

3.1.1. Patients must be seen by a Contractor-provided physician on-site at Robert J. Dole VAMC in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Any identified obstacles in meeting timeliness shall be reported to the Contracting Officer immediately.

3.1.2. Contractor-provided physicians shall be available and present in clinic during normal Robert J. Dole VAMC clinic hours, at Robert J. Dole VAMC which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are ½ day, 1 day per week (1:30pm to 5:30pm).

3.1.2.1. Clinic time may require extension beyond the 1:30pm to 5:30pm schedule and varies based on patient schedules, variations in appointment times and durations. Typical scheduling includes eight (8) patients for appointment times lasting approximately 15 minutes each. Due to patient-unique variations that may extend any appointment longer than 15 minutes, the clinic will remain active and in full operation for the amount of time necessary to provide services to each scheduled patients, including “overload”, which may occur by overscheduling or including unscheduled patients. Overload also includes the time required for the Contractor physician to perform and complete “return to clinic orders”, lab order, phone calls, and patient medical records documentation of the visits and associated functions. Appointments shall be considered completed when all clinic orders, lab orders, and patient record documentation is complete for each day’s appointments serviced.

3.1.3. Off-hours Coverage: The VAMC will notify the company when call coverage needed. An on-call schedule is made up for each month with each day of the month showing when coverage is needed. Contractor must make the Contractor-provided physicians available on-call during all hours on the call schedule that they are scheduled for when the Robert J. Dole VAMC including evenings, weekends, and holidays.

3.1.3.1. On-call Contractor’s Physicians must be available at all times for phone consultations with VA residents and physicians.

3.1.3.2. Patients must be seen within 30 minutes from the time of notification.

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

· New Year’s Day

· President’s Day

· Martin Luther King’s Birthday

· Memorial Day

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

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

· Contractor-provided patient services do not apply except in cases of call-back to the Dole VAMC during on-call days and times.

3.3. Cancellations: Cancellations of clinics shall be the sole function of the VAMC. If cancellation is necessary, the VAMC will notify the Contractor at least two (2) days prior to the scheduled clinic date to the extent possible.

3.3.1. Unless a state of emergency has been declared or clinics are otherwise cancelled by the VAMC, the Contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES

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

4.1.1. Contractor-provided physicians shall be responsible for signing in and out when in attendance using the CPRS system. These sign-in/sign out sheets will be used by the COR to confirm hours/day provided against the Contractor’s invoices.

4.2. Standards of Care: The Contractor-provided physicians care shall cover the range of Nephrology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1. American Board of Internal Medicine (ABIM) Guidelines: https://www.abim.org/.

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

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

4.2.4. The requirements contained in this PWS.

4.3. MEDICAL RECORDS

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

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when 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.

4.3.3. Disclosure: Contractor-provided physicians 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.

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 Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAMC.

4.3.5. 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 Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address: Michael Richardson at 5500 E Kellogg, Wichita, KS 67218 or email Richardson, Michael R <michael.r.richardson@va.gov>

4.4. Direct Patient Care: Estimated 90% of the time is direct patient care.

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

4.4.1.1. Board Certified/Board Eligible Nephrology Physicians

4.4.2. Scope of Care: Contractor-provided physicians (as appropriate and within scope of practice/privileging) shall be responsible for providing Nephrology care, including, but not limited to :

4.4.2.1. Clinic & On Call Services: Contractor-provided physicians shall provide clinical Nephrology clinic services one ½ day a week seeing patient in the outpatient clinic setting and on call coverage for inpatient setting as needed. Contractor-provided physicians shall be present on time for any scheduled clinics at the scheduled start time.

4.4.2.2. Medications: Contractor-provided physicians shall follow all established medication policies and procedures. No sample medications shall be provided to patients.

4.4.2.3. Discharge education: Contractor-provided physicians shall provide discharge education and follow up instructions that are coordinated with the next care setting for all Nephrology clinical patients.

ADMINISTRATIVE: Estimated 10% of the time is administrative.

4.4.3. Peer Reviews: One (1) Contractor physician shall perform Ongoing Professional Practice Evaluation (OPPE) audits. OPPE audits the VA Nephrology Physician, likewise the VA Nephrology Physician performs OPPE audits of all Contractor-provided physicians. The Contractor’s physician shall evaluate the performance of the VA staff on an ongoing basis, at least 1 time per month. The OPPE will include up to five (5) patients services events for audit. A copy of the OPPE audit form is attached. See Section D. OPPE audits by Contractor-provided physicians shall be completed according the OPPE audit form requirements and requires access to the Electronic Medical Records (EHR) (also called CPRS). Audits shall be signed by the evaluator.

4.4.4. Periodic Computer Access: All Contractor-provided physicians, including on-call/call-back only physicians, shall physically access VA computers not less than 1 time per every 30 days, logging-in using their VA credentials (Personal Identification Verification)(PIV) Badge), and shall access the EHC/CPRS. Failure by any physician to log-in to the systems per this section shall result in immediate automated loss of computer access for that physician, at which time, the Contractor shall remove the physician from any clinical schedule and all on-call schedules until such time the Contractor requests renewed access. Failure to request renewed access within 60 days of the initial “lock-out” shall be deemed as Contractor removal of the physician.

4.4.4.1. QA/QI documentation: The Contractor-provided physicians shall complete the appropriate QM/PI documentation pertaining to all procedures, complications, and outcome of examinations.

4.4.4.2. Patient Safety Compliance and Reporting: Contractor-provided physicians shall follow all established patient safety and infection control standards of care. Contractor-provided physicians shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.

4.5. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI)

4.5.1. Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP will define the methods and frequency of surveillance conducted.

4.5.2. Patient Complaints: The Contracting Officer will resolve complaints concerning Contractor relations with the Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event that The Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

4.5.3. 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. The Contracting Officer and COR will deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the Contracting Officer.

4.5.4. Performance Standards:

4.5.4.1. Measure: Provider Quality Performance

Performance Requirement: Ongoing Provider Performance Evaluation (OPPE) elements – Patient care Performance, Medical/Clinical Knowledge, Practice-based Learning and Improvement, Interpersonal and Communication Skills, Professionalism and System-based Practice.

4.5.4.2. Measure: Qualifications of Key Personnel

Performance Requirement: All Contractor-provided physicians shall be board certified in accordance with American Board of Nephrology (ABN)Standards.

4.5.4.3. Measure: Scope of Practice/Privileging

Performance Requirement: Contractor-provided physicians perform within their individual scopes of practice / privileging.

4.5.4.4. Measure: Patient Access

Performance Requirement: The Contractor shall provide Contractor-provided physicians in accordance with the operating hours and VA clinical schedule outlined in this PWS.

4.5.4.5. Measure: Patient Safety

Performance Requirement: Patient safety incidents shall be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)

4.5.4.6. Measure: Maintains licensing, registration, and certification Performance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current.

4.5.4.7. Measure: Mandatory Training

Performance Requirement: Contractor shall complete all required training on time per VAMC policy

4.5.4.8. Measure: Privacy, Confidentiality and HIPAA

Performance Requirement: Contractor shall complete all required training on time per VAMC policy

4.5.5. Registration with Contractor Performance Assessment Reporting System

4.5.5.1. As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed the Simplified Acquisition Threshold and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information.

4.5.5.2. Each Contractor whose contract award is estimated to exceed the Simplified Acquisition Threshold requires a CPARS evaluation. A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations). Additional information regarding the evaluation process can be found at https://www.ppirs.gov/ or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690.

4.5.5.3. For contracts with a period of one year or less, the Contracting Officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the Contracting Officer will evaluate the Contractor’s performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the Contractor’s designated representative for comment. The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the Contracting Officer.

4.5.5.4. Failure for the Contractor’s representative to respond to the evaluation within those sixty (60) days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor’s representative will be “locked out” of the evaluation and may no longer send comments.

5. GOVERNMENT RESPONSIBILITIES

5.1. VA Support Personnel, Services or Equipment: None

5.2. Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to: Contracting Officer.

5.2.1. CO RESPONSIBILITIES:

CO – Michael Cumins, 3450 S 4th Street Trafficway, Leavenworth, KS 66048, Tele: (913) 946-1122, e-mail: michael.cumins @va.gov.

5.2.1.1. The Contracting Officer is the only person authorized to direct the Contractor and approve changes, i.e. modify the contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to, including, but not limited to, terms affecting price, quantity, or quality of performance of this contract.

5.2.1.2. The Contracting Officer will resolve complaints concerning Contractor relations with the Government employees or patients. The Contracting Officer is the final authority on validating complaints.