DRAFT SOW Controlled Substances Disposal Statement of Work.pdf

Statement of Work

1. General Information:

The purpose of this service would be to maintain compliance with VHA Directive 1108.01 and Title 21 Code of Federal Regulations and provide proper disposal of controlled substances that are deemed damaged, expired, returned through the mail, unusable, or otherwise unwanted that are lawfully possessed by registrant. Disposal of controlled substance stock held for destruction are required to be completed at least quarterly. A

DEA‐licensed destruction company could be scheduled at least quarterly to meet this requirement but are not limited to the quarterly scheduled appointments. For purposes of this contract, the DEA‐licensed destruction company may be a registered reverse distributor, but will be contracted only for the disposal and destruction of controlled substances that render the substances non‐retrievable. For the remainder of this document, the company may be referred to as contractor or vendor.

2. Objectives/Requirements:

Any contractor must be compliant with all applicable federal, state and local laws and regulations governing controlled substance destruction. Services required under this contract shall be performed in accordance with Federal Laws including but not limited to

Title 21 Code of Federal Regulations. Contractor shall be compliant with any requirements of the VA as listed in this contract.

Contractor shall provide a representative to perform duties for each on‐site pick up of expired or unusable controlled substances at VAPIHCS pharmacy service. Contractor shall be able to accommodate up to six pick‐ups for each period of performance based on

VAPIHCS Pharmacy needs. First period of performance will be from April 30, 2022 to April

29, 2023. This contract will include a base year plus four additional option years. VAPIHCS pharmacy service shall provide contractor a minimum of a two week notice to schedule pick‐ups. Anticipated need for pick‐up services would occur about once a quarter.

3. On‐Site Process:

Prior to boxing items, a pharmacy employee shall review with contractor during on‐site service an internal list of items to ensure it matches that of what is actually acquired by contractor and ensure there are no discrepancies between the pharmacy’s list of items and contractors list of items. Contractor shall be responsible for boxing up items acquired by the pharmacy and arranging for pick‐up by carrier.

Controlled substance items held for destruction are placed in an evident tamper bag. All bags shall be opened at the time of the transfer to a DEA‐licensed destruction company and must be verified in the presence of the representative of the contractor, pharmacy staff and an Accountable Officer (AO). The AO, pharmacist and representative from destruction company must sign the document listing of the controlled substances transferred from VA to the destruction company. The contractor must provide a signed receipt for all CIII‐V and

DEA Form 222 for all CII products taken at the time of transfer. The CIII‐V receipt and DEA

Form 222 must include drug name, dosage form, strength, quantity and date of transfer.

The pharmacy must maintain these records for three years in a readily retrievable manner.

Once the on‐site representative of the contractor verifies counts with the pharmacy staff and accountable officer and completes the paperwork of the transfer, and preparation for shipping the contractor shall assume the title and responsibility to the products. Prior to boxing items, a pharmacy employee shall review with contractor during on‐site service a list of items to ensure it matches that of what is actually acquired by the contractor and ensure there are no discrepancies between the pharmacy’s list of items and contractors list of items. Contractor shall be responsible for boxing up items acquired by the pharmacy and arranging for pick‐up by carrier. On‐site representative shall arrange for immediate pick up by trusted carrier or shall have a DEA compliant transport process. The DEA registered contractor who destroys the controlled substance must submit a DEA Form 41 to the DEA when the controlled substances have been destroyed. The DEA Form 41 should not be used to document the transfer of controlled substances from the pharmacy to the contractor. A copy of the DEA Form 41 should be sent to pharmacy point of contact.

A contractor shall acquire controlled substances from a registrant at the registrant’s registered location or receive controlled substances delivered by common or contract carrier. All controlled substances shall be destroyed no later than 30 calendar days after receipt. A method of destruction shall render controlled substances for destruction non‐ retrievable in compliance with federal regulations and no items shall be pursued for credit returns.

4. Description of Items Eligible for Transfer:

Vendor shall accept any opened or unopened package of Scheduled CII‐V medications being held for destruction obtained through return mail or otherwise deemed unusable or expired. All forms of medication shall be accepted such as tablets, capsules, suppositories, liquids, refrigerated items, patches, films, topicals, unused syringes containing medication but may not be limited to this list. Scheduled CII‐V medications not contained in original manufacturer bottle packaging shall also be accepted for destruction. All controlled medications shall be counted and verified by vendor in presence of pharmacy staff member and VA accountable officer. Manufacturer and wholesaler recalled products not previously returned directly to manufacturer or wholesaler shall be returned to vendor for destruction.

5. Supplies and Services:

The vendor shall be fully licensed to perform the work and shall take responsibility to complete details of the contract from start to finish. The responsibilities of the contractor shall include the ability to provide on‐site services and off‐site requirements and provide all equipment, materials, and labor needed to arrange for proper disposal of designated pharmaceuticals, including Schedule II‐V controlled substances. The vendor shall bring all necessary supplies including equipment or software for their own use to perform their work as the contractor to each on‐site pick‐up. Vendor shall be responsible for their supplies and equipment including any loss or damage. Contractor shall be responsible for packaging products transferred to them if shipping through carrier, including but not limited to generating shipping labels and providing compliant packaging.

6. Software or Web‐based System:

Training shall be provided to COR and designated staff on utilization of any applicable software. Representative or customer service should be available and able to provide efficient service support for staff for as needed assistance or questions at no additional charge for the entire duration of the resulting contract.

Web Based platforms must conform to VA rules, regulation and policy and must be reviewed by the ISSO before any agreement can be made. In addition to ISSO review, cloud based platforms must be Fed Ramp compliant or have solidified plans to be compliant within a time frame necessary to carry out the duties of the contract.

7. Performance Standards:

Vendors shall have recent proven past experience as a pharmaceutical destruction company to perform DEA compliant waste disposal services in the volume required by VAPIHCS

Pharmacy Service.

Vendor shall meet all requirements as listed in this contract as well as perform all processes compliantly with all federal laws and regulations.

Vendor shall be able to communicate efficiently for all VAPIHCS Pharmacy needs of this contract. Vendor shall be available for any inquiries by VAPIHCS Pharmacy staff. Invoicing shall be timely and provided within ninety days of each on‐site service.

If services do not conform to contract requirements, the government may require the contractor to perform services again at no additional cost to the government. If defect in services may not be corrected by reperformance, the government shall have authority to reduce contract price to reflect the reduced value of the service performed.

8. Place of Service:

Representative shall provide on‐site service to:

Department of Veterans Affairs

VA Pacific Islands Health Care System

Pharmacy Service

459 Patterson Road

ACC Room 2A‐07

Honolulu, HI 96819‐1522

DEA BD6707751

Contractor shall provide education/training and guidance on software products used. This may be done in person, virtually, or by telephone.

9. Invoice and Charges:

The Vendor shall not add or substitute service fees without prior approval from the contracting officer.

Contract fee is to include the service fee of the vendor which includes services of the representative on the days of on‐site services, consultation/training on software use or inquiries regarding processes or requests within contract, shipping costs, and destruction fees.

Invoices shall be issued within ninety days after each on‐site service date. Each invoice fee shall not exceed previous quoted agreement as agreed to in this contract to be billed by flat service fee per pick‐up service performed. Flat service fee shall include full on‐site services, carrier pick up and transport, destruction of items and any documents requested as part of disposal services. All items should be destroyed without seeking credit, and no credit will be available to the vendor as no extra payment shall be required due to the flat service fee and destruction only process. All returned goods shall not exceed 250 pounds per service.

Payment receipts shall be confirmed by contractor in writing via email or confirmation process.

Any inquiries that VAPIHCS Pharmacy may have through representative, or customer service shall be provided at no additional charge at any time. Access to software should be available at any available time at no additional charge. Meetings in person, virtual or by phone including but not limited to discussion about destruction process shall be provided as necessary to VAPIHCS pharmacy at no additional charges.

10. Confidentiality:

Contractor shall be compliant with all security statutes including HIPAA (Health Insurance

Portability and Accountability Act). Failure to comply with security statutes and confidentiality of patient information may result in financial sanctions and contractor shall be held liable if they are the cause of the breach of information.

The C&A requirements do not apply, and that a security Accreditation Package is not required.