Attachment 5 - Background Investigation Form.docx

Attachment 5

RFP# 36C25722R0050

Emergency Physicians

Background Investigation

The following explains the current process for Background Investigations (BI) that are required for contractor personnel to have routine access to a facility and to authorize access to VA/Federally owned information systems. This applies to all contractor personnel performing services for the facility, including Community Based Outpatient Clinics (CBOC). This must be completed prior to the start date. This is a federal law and is established under HSPD-12, FIPS Pub-201-1, EO 10450, and VA Directive 0710. The process is specific and required beyond any additional agency credentialing and vetting processes.

All contractor employees must submit the appropriate forms to the Department Sponsor, to begin the application process (OF-306 and Sponsorship Form). Facilities are switching to a paperless application system and will require additional information.

A Special Agency Check (SAC) is a process in which fingerprints are captured to establish the identity of an individual and determine if there are any outstanding actionable issues, as noted by the FBI. A SAC is the initial requirement for the entire BI program. Your sponsor can assist you with scheduling an appointment at the nearest VHA or VBA facility. It takes approximately 48 hours to 2 weeks for contracting to receive the results and adjudicate them. If the fingerprints are unidentifiable, you will need to have them retaken.

A National Agency Check with Inquiries (NACI) is the minimum BI that is required to access federal information systems and sensitive information. Contractor employee(s) shall not commence working at VA facilities under contract, until the Contracting Officer receives an email notification from the VHA Security and Investigation Center (SIC) in Little Rock, Arkansas, confirming completion of the contractor employee’s documentation. Once the documentation is received by the SIC, the Contracting Officer can authorize a tentative clearance for a contractor employee to begin work on a contract.

a. A NACI will be initiated if you have cleared the adjudication process at the local level. The NACI is a position sensitivity designation of low risk.

b. The Contractor Employee, the CO/COR, and one additional email account (Contractor’s Supervisor, COR, etc.); will receive all correspondence from the SIC.

c. Upon the NACI request, the contractor employee will be provided an emailed notice of receipt within 48 hours of the entry. This is an acknowledgement that the contractor has been adjudicated and cleared at the local level.

d. The contractor employee will receive a second email notifying of entry into OPM’s e-QIP database. Once received, the contractor employee will have 14 days to go into his or her account at www.opm.gov/e-qip and complete the background questionnaire.

e. Once the questionnaire is complete, the contractor employee must ensure the “release to agency” has been clicked and the two signature pages are printed.

f. The following forms are required for the SIC to proceed with processing your BI. They can be mailed or faxed to the secure fax @ 501-257-4055 / 4018 and ensure “Contractor” is written in the top left corner of your documents:

1) OF-306 (Declaration of Federal Employment) obtained at (http://www.va.gov/VABACKGROUND_INVESTIGATIONS/docs/of0306.pdf)

2) Two (2) Signature Pages

3) Memorandum of Fingerprinting (Received During Fingerprint Appointment)

g. Once this is completed, the CO will receive notification from the SIC. If there is missing information or further information is needed, an email will be sent to the three email addresses listed above.

h. Problems with the e-QIP database can be handled by contacting the SIC Help Desk @ 501-257-4490

The Contractor shall provide complete Background Investigation applications, for all Contract Employees, promptly and in time to meet the contract performance or delivery schedule (or: within 7 calendar days after contract award). If a delay in the notification from SIC to the Contractor that a complete application has been received is due to the failure of the Contractor to provide a complete application as soon as practicable (or: within 7 calendar days) after contract award, this delay shall not excuse the Contractor from meeting the contract performance or delivery schedule and may result in termination for cause.

Background Investigation and Special Agreement Checks:

All contractor employees are subject to the same level of investigation as VA employees who have access to VA sensitive information or routine access to VA Facilities. The level of background investigation commensurate with the level of access needed to perform the statement of work is: NACI. This requirement is applicable to all subcontractor personnel requiring the same access.

The contractor shall bear the expense of obtaining background investigations. If the investigation is conducted by the office of Personnel Management (OPM) through the VA, the contractor shall reimburse the VA in 30 days.

The Position Risk Level is: Designation Level Tier 1.