ATTACHMENT 3 - VISN4 DME CONTRACTOR TRAINING REPORT.docx
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About this file
This is a contractor training report template for the Department of Veterans Affairs (VA) Durable Medical Equipment (DME) services contract under VISN 4. The document outlines mandatory training requirements that must be completed by each contractor employee working on the DME contract and serves as a compliance tracking mechanism for the Contracting Officer's Representative (COR).
The training requirements include VA Privacy and Information Security Awareness and Rules of Behavior (VA 10176) for all personnel using computers; Privacy and HIPAA Training (VA 10203) for employees with access to Protected Health Information; Integrity and Compliance Awareness Training (VA 43790) for all VHA staff and contractors not in revenue-generating roles; Emergency Preparedness/Disaster Policy and Procedures training specific to the work location; initial competence assessments and product-specific training; area/program/unit-specific orientation; and Health Care Personnel Influenza Vaccination documentation. The template includes fields for recording contractor employee initials and training completion dates, COR verification initials, and allows the COR to mark training as "N/A" when not applicable to the specific contract. The document also contains sections for tracking new provider information, background checks, and last day of work for departing personnel, ensuring comprehensive personnel management and compliance documentation throughout the contract period.
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Text version
ATTACHMENT 3
VISN4 DME CONTRACTOR TRAINING REPORT
TO BE COMPLETED FOR EACH CONTRACTOR EMPLOYEE
Note: If any of the below training is not applicable to subject Contract, the COR will notate N/A, add initials and date each line.
Course / Training Requirement Contractor Employee Initials & Certificate Attached as Applicable
Date Completed
COR Initials
VA Privacy and Information Security Awareness and Rules of Behavior (VA 10176) Target audience: This course is for all VA staff, contractors and volunteers who use a computer to perform their job.
Privacy and HIPAA Training
(VA 10203)
Target audience: Any VA employee or non-VA employee with access to Protected Health Information (PHI)
Integrity and Compliance Awareness Training for all Staff
(VA 43790)
Target audience: All VHA staff, contractors, trainees, and volunteers who do not work in revenue and is mandated per VHA Directive 1030
Emergency Preparedness/Disaster Policy and Procedures (location specific)
Initial competence assessment/employee competencies/product-specific training
Area/Program/Unit Specific Orientation
Health Care Personnel Influenza Vaccination Form Appendix B Target audience: All HCP including VHA staff, contractors that work in VHA locations or who come into contact with VA patients or other HCP as part of their duties and is mandated per VHA Directive 1192.01
NEW PROVIDER
| NAME |
| DATE STARTED |
| BACKGROUND CHECK |
PROVIDER NO LONGER PROVIDING SERVICES
| NAME |
| LAST DAY OF WORK |
CRG Chapter 7 Appendix F COR Roles and Responsibilities Page 1 of 4 Revision 03 Effective Date: 09/01/2024
File details come from the government source that posted it. Updated .