Description of Services.pdf

Diagnostic Radiology Technologist Services

VA National Teleradiology Program (NTP)

1. General Description:

a. The contactor shall provide three (3) certified Diagnostic Radiology Technologists (DRTs) in Radiology to the VA National Teleradiology Program (NTP). The contractor’s geographic coverage must include at a minimum North Carolina, though the DRTs may be stationed at any of the following NTP reading centers: Durham NC (primary location), Menlo Park CA, or Honolulu HI (optional locations if either are included within the contractor’s geographic coverage). This work will require VA network access to use the NTP Picture Archive & Communication System (PACS) medical application. Services include clinical duties in diagnostic imaging quality control, image/case review and processing, prior retrieval based on clinical history, critical callback-notification and clinical consultation. The DRTs will work closely with NTP Radiologists, NTP PACS Assistants and PACS Administrators to ensure optimum quality control, complete case processing and timely report transmissions are completed within targeted turn-around times.

b. Contractor personnel, under the direction of the Support Supervisor or their designee, shall perform in accordance with the Performance Work Statement herein (paragraph 2) and the terms and conditions of this contract.

c. Tour of duty for each DRT will typically be 3–8 hour shifts per week (Fri, Sat & Sun), but upon notification to the Contractor and with DRT availability, can be temporarily increased to 4 weekly shifts to cover critical internal staffing shortfall. Start times will be set according to NTP operational needs and can range from 8 am local reading center time (earliest start time), to 4 pm local reading center time (latest start time). Tours of duty will be set no less than 2 weeks in advance.

2. Place of Performance:

Primary

1. VA National Teleradiology Program, 3022 Croasdaile Dr, Suite 101, Durham, NC 27705

Optional

2. VA National Teleradiology Program, 795 Willow Road, Bldg 334, Menlo Park, CA 94025

3. VA National Teleradiology Program, 711 Kapiolani Blvd, Suite 200, Honolulu, HI 96813

3. Definitions/Acronyms:

ARRT: American Registry of Radiology Technologists

CEU: Continuing Education Unit

CME: Continuing Medical Education 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.

Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

DRT: Diagnostic Radiology Technologist

HIPAA: Health Insurance Portability and Accountability Act

NTP: VA National Teleradiology Program

OSHA: Occupational Safety and Health Administration

PACS: Picture Archive and Communication System

PWS: Performance Work Statement

QASP: Quality Assurance Surveillance Plan

TJC: The Joint Commission

4. Services Provided:

a. The incumbent works under the direction of senior clinical/technical staff for general guidance and directly supports NTP Radiologists in day to day image/report preparation and processing. The position also coordinates work with clinical and technical staff at sites being served by NTP to assist in resolution of technical or clinical issues.

b. The incumbent's principal responsibilities are to prepare and organize teleradiology cases sent digitally from remote sites to the NTP reading centers for interpretation. The incumbent interacts with NTP teleradiologists working from other locations. Weekend, holiday and shift work will be required for this position to ensure coverage during hours of NTP operations (24x7x365).

c. The incumbent will organize cases for NTP Radiologists; ensure case completeness including retrieval of prior exams; advise and assist remote radiologic technologists at other VA facility locations in the preparation, case edit, and transmission of images. The incumbent reviews cases sent to NTP to determine if they are complete, ensure the area of interest has been adequately imaged, validate that the expected number of images have been received, validate that the appropriate post processing reformats have been transmitted if applicable and based on clinical history, ensure that the relevant priors have been made available to NTP Radiologists. Incumbent facilitates communication between NTP Radiologists and local providers for critical callbacks and consultations. The incumbent may need to instruct remote radiologic technologists by telephone to facilitate above. In order to advise remote radiologic technologists in the proper preparation of studies for NTP, the incumbent will need to possess knowledge of the environment and day to day role of DRTs within in radiology departments.

d. The incumbent will problem-solve transmission issues from local Picture Archiving and Communication Systems (PACS) to NTP. Incumbent analyzes problems and determines the correct course of action required to correct problems based on NTP troubleshooting guides.

The position requires fundamental knowledge of computer hardware, Radiology and PACS workflow which can be obtained through education and experience in the field.

e. Contractor Personnel: Key Personnel and Temporary Emergency Substitutions-The Contractor shall assign to this contract the following key personnel (all personnel working on this contract must have Contracting Officer (CO) approval once a clearance submittal by a contract employee has been successfully accepted by the and access granted by the CO):

a. During the first ninety (90) 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 15 calendar days after the occurrence of any of these events and provide the information required by paragraph (c) below. After the initial 90-day period of the contract, the Contractor shall submit the information required by paragraph (c) to the Contracting Officer at least 15 days prior to making any permanent substitutions.

f. The contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the contractor shall provide the following for these personnel:

i. Work Compensation

ii. Professional Liability

iii. Health Examinations

iv. Income Tax Withholding

v. Social Security Payments

g. The parties agree that the contractor, its employees, agents, and subcontractors shall not be considered VA employees for any purpose.

5. Qualifications.

a. Contractor personnel shall be licensed to practice Radiology in a state, territory, or commonwealth of the United States or the District of Columbia and while not required, the Government prefers that Contractor personnel possess a current unrestricted medical license practice in the state of California, Hawaii or North Carolina.

b. Board Certification /Eligibility: Contractor personnel performing under this contract shall meet or exceed recognized national standards established by the Joint Commission (TJC) and certified by the American Registry of Radiologic Technology (ARRT). Meets the qualification standards for the GS 8 as defined in VA Handbook 5005, Part II, Appendix G “Diagnostic Radiologic Technologist Qualification Standard”.

c. Contractor Personnel assigned by the Contractor to perform services covered by this contract shall be American Registry of Radiologic Technologists (ARRT) certified and be licensed by the State of California, Hawaii or North Carolina.

d. All Contractor Personnel shall have experience with Picture Archiving Communication

System (PACS). The qualifications of such Contractor Personnel shall be subject to review by the Support Supervisor for NTP and approval by the Chief Healthcare Technology Manager NTP.

i. The Contractor shall submit a copy of ARRT certification and a copy of current Radiologic Technologist license for each candidate as required in this solicitation.

ii. Contractor Personnel assigned by the Contractor shall be a graduate of an accredited Joint Review Committee on Education of Radiologic Technologists (JRCERT) program and have a minimum of two (2) years of work experience. Student internship and training time spent in a radiology setting does not count toward the two (2) years of experience.

iii. The Chief Healthcare Technology Manager will make final determination on acceptable experience.

e. Technical Proficiency: Contractor 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 will provide documents as needed to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed.

f. Continuing Medical Education (CME) / Certified Education Unit (CEU) Requirements:

Contractor will provide the COR copies of current CME’s as required or requested by the VAMC. Contractors registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentialing office for tracking. These documents are required for both privileging and re privileging. Failure to provide will result in loss of privileges.

g. Citizenship Related Requirements: 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;

While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national nonimmigrant 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.

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.

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.

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.

h. 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.

i. Inherent Government Functions: Contractor and Contract DRT (s) 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.

6. Responsibility:

Government Responsibility: The Government may evaluate the quality of professional and administrative services provided. The government will provide contract personnel with workspace outfitted with a PACS Assistant/DRT workstation with 3 monitors and call-center enabled telephone similar to what VA staff utilize. NTP will make available training guides, internal policies and procedures and necessary information required to perform the functions outline in the contract.

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

Contracting Officer Representative (COR). All contract administration functions will be retained by the VA.

CO RESPONSIBILITIES:

The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this 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 include (but not limited to) terms affecting price, quantity or quality of performance of this contract.

The Contracting Officer shall resolve complaints concerning Contractor relations with the Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof.

In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for Contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract.

COR Responsibilities:

The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected.

The COR will maintain a record-keeping system of services by PACS Assistant/DRT shift schedule. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the Contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference.

7. Administrative Requirements:

a. Prior to providing any services under this contract, all contractor personnel must receive and acknowledge receipt (as outlined in paragraph 4) of VHA Handbook 1660.3, Conflict of Interest Aspects of Contracting for Scarce Medical Specialist Services, Enhanced Use leases, Health Care resources Sharing, Fee Basis and Intergovernmental personnel Act Agreements

(IPAS).

b. NTP reserves the right to refuse or dismiss contract personnel whose personal or professional conduct jeopardizes patient care or the regular and ordinary operation of the facility. Reasons for refusal or dismissal include, but are not limited to, unsatisfactory performance prior to and/or during the term of the contract, failure to receive favorable adjudication during a VA background investigation, failure to satisfy the requirements of the contract, physical or verbal abuse to patients, staff, or visitors, intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, ethical misconduct, conduct resulting in formal complaints by patients or other staff members, and any other valid reason considered objectionable.

8. Training:

a. Awareness Training: Contractor employees shall complete initial VA privacy security and HIPAA training prior to starting work and on an annual basis.

b. Remedial Training: When notified, contract employees must complete remedial training and education to address any detected privacy, security of HIPAA exceptions.

c. Proof of Training: Contract employees are responsible for submitting proof of awareness and remedial training completed to the Contracting Officer’s Representative (COR) for this contract. The COR will retain proof of training in accordance with applicable Records Control Schedule.

9. Handling of Records:

a. By performing services under this contract, the Contractor is considered part of the VA healthcare activity for purposes of the following statutes and respective regulations implementing these statutes: Title 5 U.S.C Section 552a (Privacy Act), Title 38 U.S.C.

Section 5701, Title 38 U.S.C. Section 5705, Title 38 U.S.C Section 7332, and Public Law 104-191 (HIPAA). Contract personnel shall have access to patient medical records and general files only to the extent necessary to perform their contractual duties. Contract personnel shall only release medical information obtained during the course of this contract to those VA medical staff members involved in the necessary care and treatment of the individual patient in which the information pertains. Notwithstanding any other clause and/or provision of this contract, if a request for release or disclosure of information is not necessary for the care and treatment of an individual patient, the Contractor and contract personnel shall not disclose any information contained in general files, patient records, and/or any other individually identifiable health information, including information and records generated by the Contractor in performance of this contract, except pursuant to explicit instruction and written approval from VA. For the purposes of this paragraph, instruction to disclose or copy such records and/or information may only be provided by the following: VA Regional Counsel and Chief, Health Information Management Service/Privacy Officer through the VA Contracting Officer. Violation of the aforementioned statutes may result in criminal and/or civil penalties.

b. Contract personnel who obtain access to hardware or media which may manipulate or store drug or alcohol abuse data, sickle cell anemia treatment records, records or tests or treatment for or infection with HIV, medical quality assurance records, or any other sensitive information protected under the statues and implementing regulations previously mentioned in paragraph 6.1, above, shall not have access to the records unless absolutely necessary to perform their contractual duties. Any contract person who has access to the previously mentioned data and/or information must not disclose it to anyone, including other contract personnel not involved in the performance of the particular contractual duty for which access to this data and/or information was obtained.

c. Information or records accessed and/or created by the Contractor in the course of performing services under this contract are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable federal law, regulations, and/or VA/VHA policy. The Contractor will not copy information contained in VA information systems, either by printing to paper or by copying to another digital format, without the explicit instruction and written approval from of the officials listed in paragraph 6.1., above, except as is necessary to make single copies in the ordinary course of providing patient care.

The Contractor will not commingle the data from VA information systems with information from other sources. Contractor shall report any unauthorized disclosure of VA information to the officials.

d. If this contract is terminated for any reason, the Contractor will provide VA with all individually identifiable VA patient treatment records or other information in its possession, as well as any copies made pursuant, above, within seven (7) calendar days of the termination of this contract.

e. The Contractor shall follow all VA policies regarding the retention of records.

f. The Contractor shall follow all of the previously mentioned statutes and respective regulations implementing these statutes as well as VHA Handbook 1605.1 - Privacy and Release of Information and any other VA/VHA policies and procedures governing the information discussed in this section of the contract. Copies of the information discussed in the aforementioned paragraphs may be viewed by contract personnel in the Office of Health Information Management (see the Privacy Officer). All contract personnel with access to any of the previously mentioned records (electronic or paper) will be required to complete VHA Privacy Policy Training before accessing such record systems. This training must also be completed annually. The COR will be responsible for ensuring and documenting that this requirement is satisfied.

g. Any changes in the laws, regulations, or VA/VHA policies or procedures governing the information covered by this section of the contract, during the term of this contract, shall be deemed to be incorporated into this contract.

h. VA has unrestricted access to the records generated by the contractor pursuant to this contract.

10. HIPAA Compliance

Under HIPAA Privacy and Security Rules, the Contractor providing services under this contract is considered to be a “covered entity,” and thus is not required to enter into a Business Associate Agreement with VA. However, the Contractor must observe Public Law 104-191 and all respective regulations implementing this law while providing services under this contract.

11. Personnel.

a. Emergency Health Services: The VA will render emergency health services for an incapacitating injury or otherwise serious illness occurring while on duty. All services, to include wages earned during the period of initial medical evaluation provided by the VA, shall be reimbursed by the contractor. The contractor shall furnish the VA with the necessary injury/illness form(s) for reporting purposes. The VA for statistical and/or billing purposes will retain a copy of the complete form(s).

b. Infection Control Requirements: In general, all contract personnel must comply with OSHA requirements for healthcare facilities. All contract personnel are required to have annual PPD/TB screenings, current immunizations, and record of having been offered Hepatitis B vaccine prior to commencement of work. All contract personnel are required to comply with VA mandated vaccinations as directed.

c. A record keeping system that confirms compliance these OSHA requirements and VA medical center memorandums shall be established and maintained by the Contractor. Such records will be made available to the COR or VA Contracting Officer upon request.

12. Identification, Parking, Smoking and VA Regulations:

a. Contract personnel shall maintain a neat personal appearance and maintain a professional decorum. Contract personnel shall wear protective clothing as required.

b. Contract personnel shall wear visible identification badges while on Government property.

c. It is the responsibility of contract personnel to park in designated parking areas only.

Parking information and parking decals and stickers will be available from the VA Police. The Government will not invalidate or make reimbursement for parking violations of the contract personnel.

d. Intoxication, debilitation resulting from drug use, insubordination, theft, patient abuse, dereliction or negligence in performing directed tasks and possession of weapons is prohibited and grounds for immediate removal from VA facility. Enclosed containers, of any nature, are subject to search.

e. Violations of VA regulations may result in a citation answerable in the U.S. Federal District Court, not a local district, state or municipal court.

13. Performance Monitoring:

The contractor is responsible for performance of ALL terms and conditions of the contract.

CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined.

Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.

The Performance Requirements are listed below. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.

14. PERFORMANCE REQUIREMENTS

Case Review Productivity – Minimum acceptable level is 90% of incoming NTP cases are accurately processed and made available for Radiologist interpretation within 5 minutes or less.

Processed includes reviewing PACS case notes to determine if the correct number of images are received, reviewing the clinical history to determine if relevant priors are available and if not, pulling the priors onto the NTP PACS and marking the case ready for dictation.

Clinical Callback Procession – Minimum acceptable level is 90% of critical callback request for critical exam and critical results communication is completed within 10 minutes of identification by a NTP Radiologist.

Qualification of Key Personnel – Minimum acceptable level is 100% of staff shall have AART certification as a DRT.

Customer Service - Minimum acceptable level is 2 instances per year where a customer or coworker makes a valid complaint about the level of customer service received or discourteous behavior.

PERFORMANCE WORK STATEMENT