P01 - SOW.pdf

B.3 STATEMENT OF WORK

1. Background. The Department of Veterans Affairs (VA) has a requirement to furnish eyeglasses to those eligible veterans that require eyeglasses and are eligible for assistance at the Jesse Brown VA Medical Center, 820 South Damen, Chicago, IL 60612 (Currently room

1410A – adjacent to the Patient Advocate office); and at the Adam Benjamin Jr. VA

Outpatient Clinic, 9310 Madison Street, Crown Point, IN 46307 (Room 204). The fabrication of the eyeglasses will be performed by a VA-owned laboratory in Indianapolis, IN. The contractor will operate as the dispensing optician.

2. Scope. The contractor shall provide all labor, travel, materials and the necessary equipment to provide optical dispensing services for the Jesse Brown VA Medical Center in Chicago, IL and the Adam Benjamin Outpatient Clinic in Crown Point, IN.

3. Specific Tasks and Deliverables.

3.1 The contractor shall operate as the dispensing optician. Dispensing services will be provided at the Jesse Brown VA Medical Center, 820 S. Damen Ave, Chicago, IL

60612 (Currently room 1410A – adjacent to the Patient Advocate office); and the

Adam Benjamin Jr. VA Outpatient Clinic, 9310 Madison Street, Crown Point, IN

46307 (Room 204).

3.1.1 Dispensing services will include the fitting, adjusting, and minor repair of eyeglasses. Minor repairs are repairs that do not require replacement of major components such as fronts, temples, soldering of guard arms that hold nose pads. When these components are in need of replacement, a new pair of eyeglasses will be approved by the VA Prosthetics Service. The minor repairs however allow the Veteran continued use of their eyeglasses much faster than if total replacement would be necessary.

3.2 Contractor shall enter into a retail concession agreement with the Veteran’s Canteen

Service (VCS) to offer commercial optical services for veterans, at a significant discount below national optical chain store prices.

3.2.1 Sale of additional eyewear purchases by patients will be made at the expense of the Veteran. The contractor is prohibited from recommending upgrades or services to Veterans but may acknowledge their availability.

3.2.2 Additionally, the contractor’s concessionaire agreement with the Veteran’s

Canteen Service will handle upgrades for eligible Veterans, ineligible

Veterans, Veterans’ families, and VA employees and families. For the eligible

Veterans who are seeking upgrades (special frames, tinting, etc.) not normally provided by VA prescription, the concessionaire agreement would provide a venue for the Veteran to obtain and pay for these upgrades at a better price than at a retail eyeglass company. It also allows an alternative for the ineligible Veteran, Veteran’s families and VA employees, at their own expense.

3.2.3 In addition, the contractor shall be able to provide:

3.2.3.1 Onsite tinting and UV/scratch coating of lenses.

3.2.3.2 Own dispensing equipment / instrumentation not limited to pupilometry lensometry and adjusting tools at both locations.

3.2.3.3 Own dispensing furniture / frame boards that are in good physical condition at both locations.

4. Hours of Operation. Normal hours of coverage for the facilities are listed below, excluding holidays.

Hours of operation for Jesse Brown VA Medical Center:

Monday through Friday: 9:00am – 6:00pm; Saturday: 10:00am – 4:00pm

Hours of operation for Adam Benjamin Jr. VA CBOC:

Monday - Thursday: 8:30am – 4:30pm

Holidays include:

New Years’ Day Labor Day

Martin Luther King Day Columbus Day

Presidents’ Day Veterans’ Day

Memorial Day Thanksgiving Day

Independence Day Christmas Day

And any other day specifically designated as a national holiday by the President of the

United States.

5. Place of Performance.

Jesse Brown VA Medical Center Adam Benjamin Jr. Outpatient Clinic

Room 1410A and Room 204

820 S. Damen Ave 9310 Madison Street

Chicago, IL 60612 Crown Point, IN 46307

6. Period of Performance.

Base Year: February 1, 2020 through January 31, 2021

Option Year One: February 1, 2021 through January 31, 2022

Option Year Two: February 1, 2022 through January 31, 2023

Option Year Three: February 1, 2023 through January 31, 2024

Option Year Four: February 1, 2024 through January 31, 2024

7. Reporting. The contractor shall submit a monthly report to the Jesse Brown VAMC Chief of

Optometry, with the following information:

7.1 Patients’ complete name, last 4 digits for their social security number, exam date, and the number of eyeglasses dispenses for the month. The items required on this report can be changed at the Government’s discretion. This information will be recorded and kept in a secure server / file cabinet, and made available upon request.

7.2 Eyeglasses that are sent to the on-site dispensing optician shall be verified. This will include all prescriptions fabricated either at the VA lab or (if patient pay) private lab(s). The optician(s) shall report the percentage that deviates from standard industry tolerances to the Chief of Optometry. The report shall separate VA vs.

private lab errors. The percentage of prescriptions that require remakes will be reported and sorted by VA lab vs. private lab vs. doctor errors.

7.3 The Contractor shall track delivery times for those eyeglasses sent to the on-site contracted dispensing optician for delivery. Those sent directly to the patients will be monitored by the VA lab or prosthetics service. The percentage that deviates from industry standard(s) will be reported by the on-site contracted dispensing optician to the Chief of Optometry.

7.4 The Contractor shall be responsible for maintaining prescription accuracy and delivery times from privately contracted fabricating labs consistent with industry standards. Deviations are to be reported to the Chief of Optometry.

8. Special Contract Requirements.

8.1 Qualifications. Personnel assigned by the Contractor to perform the services covered by this contract shall:

8.1.1 Be proficient in spoken and written English language (38 USC 7402).

8.1.2 Must be computer literate as patient documentation is directly inputted in the patient’s electronic medical record.

8.1.3 At least one of the opticians at each facility shall be board certified.

8.1.4 Adhere to the educational requirements of the VA through TMS or equivalent online programs.

8.2 Personnel Policy. The contractor shall be responsible for protecting the personnel providing services under this contract. To carry out this responsibility, the contractor shall provide the following for these personnel:

8.2.1 Workers compensation

8.2.2 Professional liability insurance

8.2.3 Health examinations

8.2.4 Income tax withholdings, and

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

8.3 Record Keeping. The VA shall establish and maintain a record keeping system that will record the hours worked by the contractor's employee(s). Contractor's employee(s) shall report to the Surgical Service upon arrival at and departure from the VA. Monitoring of contractor’s employee’s time shall be demonstrated through sign-in/sign-out sheets. After contract award, any incidents of contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

8.3.1 The payments for any leave, including sick leave, holiday, or vacation time, are the responsibility of the contractor.

8.3.2 Payments are to be made monthly in arrears upon receipt of a properly prepared invoice.

8.4 Designation of Contract Representative. A VA representative of the Contracting

Officer will be designated to represent the Contracting Officer in furnishing technical guidance and advice regarding the work being performed under this contract. The foregoing is not to be construed as authorization to interpret or furnish advice and information to the Contractor relative to the financial or legal aspects of the contract.

Enforcement of these segments is vested in and is the responsibility of the

Contracting Officer.

8.5 Key Personnel and Temporary Emergency Substitutions. The Contractor shall assign to this contract the following key personnel: Optician

8.5.1 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.

8.5.2 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 15 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.

8.5.3 For temporary substitutions where the key person will not be reporting to work for three (3) consecutive work days or more, the Contractor will provide a qualified replacement for the key person. This substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure stated in paragraph (b) above.

9. Contract Performance Monitoring.

9.1 VA Surgical Service Administrative Officer 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.

9.2 Documentation of services performed will be reviewed prior to certifying payment.

The COR will perform periodic spot checks to ensure contract is being monitored.

The VA will pay only for procedures actually performed at the VA, and in strict accordance with the schedule of prices/costs. Contract monitoring and record keeping procedures will be sufficient to ensure proper payment and allow audit verification that services were provided.

9.3 The using service, through the COR, will provide a written statement annually to the

Contracting Officer to include a summary of Contractor actions and a statement that all requirements of the contract have been fulfilled as agreed. This summary evaluation will be submitted 60 days prior to expiration of the contract.

9.4 A Contractor’s employee may not certify bills for payment.

9.5 VA may survey patients seen to determine patient satisfaction.

10. Quality Assurance Monitor. The results of all Quality Improvement activities performed by the Contractor involving VA patients will be shared with quality Management Service at the

VA. This will include, but not be limited to, quality improvement plans, minutes of staff meetings where quality improvement has been discussed and which include practitioner-specific findings, conclusions, recommendations, written plans for actions taken in response to such conclusions and recommendations, and evaluation of those actions taken. It will also include the annual evaluation required by JCAHO. The monitors should reflect, at a minimum, issues related to quality of care and appropriateness of referral.

11. Health and Human Services/Office of Inspector General (HHS/OIG). To ensure that the individuals providing services under the contract have not engaged in fraud or abuse regarding Sections 1128 and 1128A of the Social Security Act regarding federal health care programs, the contractor is required to check the HHS/OIG, List of Excluded

Individuals/Entities on the OIG Website (www.hhs.gov/oig) for each person providing services under this contract. Further the Contractor is required to certify in its proposal that all persons listed in the contractor’s proposal have been compared against the OIG list and are NOT listed. During the performance of this contract the Contractor is prohibited from using any individual or business listed on the List of Excluded Individuals/Entities.

12. Contractor Personnel Security Requirements. Failure to comply with the contractor personnel security requirements may result in termination of the contract for cause.

12.1 All contractor employees who require access to the Department of Veterans Affairs'

Contractors computer systems or have access to sensitive information shall be the subject of a background investigation. The contractor is encouraged to have its employee immediately download the background investigation packet from http://www.va.gov/vabackground_investigations upon notification of contract award.

A contractor’s employee shall not commence working at VA under contract until the

Contracting Officer receives notification from the VA Office of Security and Law

Enforcement that the contract employee’s application was received complete. A favorable adjudication from the VA Office of Security and Law Enforcement must be received in order for a contractor employee to continue contract performance.

This requirement is applicable to all subcontractor personnel.

12.2 Position Sensitivity - The position sensitivity has been designated as Low Risk.

12.3 Background Investigation - The level of background investigation commensurate with the required level of access is National Agency Check with Written Inquiries.

12.4 Contractor Responsibilities

12.4.1 The contractor shall bear the expense of obtaining background investigations.

If the Office of Personnel Management (OPM) conducts the investigation, the contractor shall reimburse VA within 30 days. If timely payment is not made within 30 days from date of bill for collection, then VA shall deduct the cost incurred from the contractors 1st month’s invoice(s) for services rendered.

12.4.2 It is imperative for the contractor to provide, at the request of VA, a listing of contractor personnel performing services under the contract in order for the background investigation process to commence. This list will include name

(first, middle, last) social security number; date of birth; city, state, and country of birth.

http://www.va.gov/vabackground_investigations http://www.va.gov/vabackground_investigations

12.4.3 The contractor or their employees shall submit a complete background investigation packet. Additional guidance and information in completing the required forms, and examples of the forms, can be found at http://www1.va.gov/VABackground_Investigations/page.cfm?pg=2. The following required forms must be submitted to the VA Office of Security and

Law Enforcement before contract performance begins:

12.4.3.1 Standard Form 85, Questionnaire for Non-Sensitive Positions

12.4.3.2 Optional Form 306, Declaration for Federal Employment

12.4.3.3 Standard Form 86A (EG), Continuation Sheet for Questionnaire

12.4.3.4 Electronic Fingerprint Form. Fingerprinting is required with the background investigation. Fingerprinting can be done at the local

VA Facility. The Electronic Fingerprint Verification Form must be submitted with the above required forms.

12.4.3.5 The Contractor shall inform the contract employee that when filling out Standard Form 85, that there should be no gaps in employment history. Any gaps in employment history on Standard Form 85 may result in OPM rejecting the documentation for investigation and delay contract performance.

12.4.3.6 The contractor, when notified of an unfavorable determination by the

Government, shall withdraw the employee from consideration from working under the contract, and at the request of the VA, submit another employee for consideration.

12.4.3.7 The contractor may utilize a private investigating agency if such agency possesses an OPM and Defense Security Service certification. A Cage Code number must be provided to the VA

Office of Security and Law Enforcement. VA Office of Security and

Law Enforcement will verify the information and advise the contracting officer whether contractor’s access to the computer systems can be authorized.

12.4.3.8 All contractor employees and subcontractors are required to complete VA’s Privacy training annually. All Contractor employees and subcontractors requiring access to VA computer network are http://www1.va.gov/VABackground_Investigations/page.cfm?pg=2 http://www1.va.gov/VABackground_Investigations/page.cfm?pg=2 required to complete Cyber Security training courses annually either on-line or hard copy. Documented proof must be provided to the

Contracting Officer.

12.4.3.9 The contractor will notify the COR immediately when their employee(s) no longer require access to VA computer systems.

12.4.4 Contractor shall submit the following with their quote:

12.4.4.1 Copy of all current licenses (Upon award these will be posted in the optical area).

12.4.4.2 Copy of Board Certifications for Opticians that will be located at each facility (Upon award these will be posted in the optical area).

12.4.4.3 A list of the experience of the proposed service providers.

12.4.4.4 A brief description of the vendors experience including 3 references regarding related work with points of contact.

12.4.4.5 Copy of current Malpractice Insurance and/or liability insurance certificate.

12.5 Government Responsibilities

12.5.1 The contracting officer will request the contractor employee’s background investigation by the Office of Security and Law Enforcement.

12.5.2 The Office of Security and Law Enforcement will notify the contractor with instructions for the contractor's employees, coordinate the background investigations, and notify the contracting officer and contractor of the results of the investigations.

12.5.3 The VA facility will pay for requested investigations in advance. A bill for collection will be sent to the contractor to reimburse the VA facility. The contractor will reimburse the VA facility within 30 days. If timely payment is not made within

30 days from date of bill for collection, then VA shall deduct the cost incurred from the contractors 1st month’s invoice(s) for services rendered.

12.5.4 The most recent fees associated with background investigations are $122.00 each for low level investigation, $855.00 each for medium level investigation, and $3,045.00 each for high level investigation.

13. Special Security Requirements. Due to the increased emphasis on privacy and information security, the following special contract requirements are established and hereby made part of the contract entered into with the Department of Veterans Affairs.

13.1 Privacy Training: Contractor and their sub-contractors assigned work under the contract are required to receive annual training on patient privacy as established by

HIPAA statues. Training must meet VHA’s and the Department of Health and

Human Services Standards for Privacy of Individually-identifiable health information. Contractor shall provide documented proof to the contracting officer that all employees assigned work and/or having access to Protected Health

Information have received annual training. Proof of training is to be forwarded to the COR. Training can be obtained through http://www.tms.va.gov/SecureAuth35/.

An account must be set up in order to access the training site by visiting the contacting the local VA Talent Management System (TMS) Administrator, contacting the Enterprise Service Desk by phone at 1-866-673-4357.

13.2 For contractors and sub-contractors who do not have access to VHA computer systems, this requirement is met by receiving VHA National Privacy Training, other

VHA approved privacy training or contractor furnished training that meets the requirements of the HHS standards.

13.3 Rules of Behavior for Automated Information Systems: Contractor personnel having access to VA Information Systems are required to read and sign a Rules of Behavior statement which outlines rules of behavior related to VA Automated Information

Systems. The COR will provide, through the facility ISO, the Rules of Behavior to the Contractor for the respective facility.

13.4 VA Cyber Security Awareness Training: Each contractor assigned work under the contract is required to receive and document completion of VA training on Cyber

Security. Training can be obtained through http://www.tms.va.gov/SecureAuth35/.

An account must be set up in order to access the training site by contacting the local

VA Talent Management System (TMS) Administrator, contacting the Enterprise

Service Desk by phone at 1-866-673-4357. Contractor shall provide documented proof to the COR that all contractor employees servicing a VA contract have received annual training.

14. Confidentiality of Patient Records.

14.1 The Contractor, as a VA provider, will assist in the provision of health care to patients seeking such care from or through VA. As such, the Contractor is considered as being part of the Department health care activity. Contractor is http://www.tms.va.gov/ http://www.tms.va.gov/ http://www.tms.va.gov/ http://www.tms.va.gov/ considered to be a VA provider for purposes of the Privacy Act, Title 5 U.S.C. 552a.

Further, for the purpose of VA records access and patient confidentiality, Contractor is considered to be a VA contractor for the following provisions: Title 38 U.S.C.

5701, 5705, and 7362. Therefore, Contractor may have access, as would other appropriate components of VA, to patient medical records including patient treatment records pertaining to drug and alcohol abuse, HIV, and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. However, like other components of the Department, and not withstanding any other provisions of the contract, the Contractor is restricted from making disclosures of VA records, or information contained in such records, to which it may have access, except to the extent that explicit disclosure authority from VA has been received. The Contractor is subject to the same penalties and liabilities for unauthorized disclosures of such records as VA.

14.2 The records referred to above shall be and remain the property of VA and shall not be removed or transferred from VA except in accordance with 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) and federal laws, rules and regulations. 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.

15. Joint Commission on Accreditation of Health Care Organizations (JCAHO) and Other

Special Requirements. (JCAHO standards are separate from clinical standards; therefore, this language does not apply to Physicians who are Credentialed and Privileged)

15.1 The Contractor will be responsible to ensure that Contractor employees providing work on this contract are fully trained and completely competent to perform the required work. The contractor will be in compliance with all JCAHO personnel requirements.

15.2 The Contractor is required to maintain records that document competence/performance level of Contractor employees working on this contract in accordance with JCAHO and other regulatory body requirements. The Contractor will provide a current copy of the competence assessment checklist and annual performance evaluation to the Contracting Officer’s Technical Representative (COR) for each Contractor employee working on this contract.

15.3 Contractor will provide and document a general VA orientation for all Contractor employees who are providing work on this contract before the commencement of work on site. VA will provide the content of the orientation to the Contractor at the time of contract award. Documentation of the orientation will be provided to the VA

COR. This orientation will include the following topics:

15.3.1 Fire and safety policy and procedure

15.3.2 Infection control policy and procedure

15.3.3 Emergency Preparedness/Disaster policy and procedure

15.4 Contractor employees will attend an area/program/unit-specific orientation meeting before the commencement of work on site. The VA will schedule, conduct and document this meeting, which will include discussion of the following area-specific topics:

15.4.1 Fire and safety policy and procedure

15.4.2 Infection control policy and procedure

15.4.3 Emergency preparedness/disaster policy and procedure

15.4.4 Initial competence assessment

15.4.5 Area/program/unit specific orientation

15.5 The VA will monitor the Contractor employees’ work to ensure contract compliance.

15.6 Notwithstanding other contract requirements, upon request of the Contracting

Officer, the Contractor will remove from the work site, any Contractor employee who does not comply with orientation requirements or meet competency requirements for the work being performed.

15.7 When changes in Contractor personnel are approved in accordance with the “Key

Personnel” clause of the contract, the Contractor must provide evidence of orientation, the current competence assessment, and current performance evaluation that supports the above.

15.8 Where the contract does not require JCAHO accreditation or other regulatory body requirements, the Contractor must perform the required work in accordance with

JCAHO standards. A copy of these standards may be obtained from the Joint

Commission on Accreditation of Healthcare Organizations, One Renaissance Blvd., Oakbrook Terrace, IL 60181.

15.9 Where the contract does not require JCAHO accreditation or other regulatory requirements regarding worker competency, the Contractor must perform the required work in accordance with JCAHO standards. The contractor is required to develop and maintain the following documents for each Contractor employee working on the contract: credentials and qualifications for the job; a current competence assessment checklist (an assessment of knowledge, skills, abilities and behaviors required to perform a job correctly and skillfully; includes knowledge and skills required to provide care for certain patient populations, as appropriate.); a current performance evaluation supporting ability of the Contractor employee to successfully perform the work required in this solicitation; and listing of relevant continuing education for the last two years. The Contractor will provide current copies of these records at the time of contract award and annually on the anniversary date of contract award to the VA COR, or upon request, for each Contractor employee working on the contract.

16. Required Registration with Contractor Performance System (CPS).

16.1 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 $100,000, 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, the

Contractor Performance System (CPS), which is maintained by the National

Institutes of Health (NIH). The CPS database information is shared with the Past

Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies.

16.2 Each contractor whose contract award is estimated to exceed $100,000 is required to register with the NIH CPS database at the following web address:

https://cpscontractor.nih.gov. Help in registering can be obtained by contacting CPS

Support via email at cps-support-l@list.nih.gov or by calling (301) 451-2771.

Registration should occur no later than thirty days after contract award, and must be kept current should there be any change to the contractor’s registered representative.

16.3 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 CPS to the contractor’s designated representative for comment. The contractor representative will have thirty days to submit any comments and re-assign the report to the VA contracting officer.

16.4 Failure to have a current registration with the NIH CPS database, or to re-assign the report to the VA contracting officer within those thirty days, will result in the

Government’s evaluation being placed on file in the database with a statement that the contractor failed to respond.

17. Health Insurance Portability and Accountability Act (HIPAA) Compliance. Contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and

Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and https://cpscontractor.nih.gov/ https://cpscontractor.nih.gov/

Security of Protected Health Information (PHI). As required by HIPAA, the Department of

Health and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of

Veterans Affairs (VA). In accordance with HIPAA, the Contractor may be required to enter into a Business Associate Agreement (BAA) with VA. Optical Dispensing Services qualifies as a medical service – therefore, no BAA is required.

18. Payment. The VA agrees to reimburse the Contractor monthly in arrears for resources furnished at the price(s) listed in the Schedule of Items for services rendered and accepted, less any deductions provided in this contract. Amounts due the Contractor will be paid monthly upon receipt of a properly prepared invoice submitted by the Contractor. All invoices shall reference the current contract number and purchase order number. Monthly invoices shall be submitted to the VA no later than 10 days past the last day of each month.