Performance Work Statement-OKC VAMC Neuromonitoring Services_watermarked.pdf

Performance Work Statement (PWS) Onsite Neuromonitoring Services

1. GENERAL:

Services Provided: Contractor shall provide a Certified Surgical Neuromonitorist to provide services necessary to perform onsite Neuromonitoring Services in the OR of Oklahoma City Veterans Affairs Medical Center (OKC VAMC) located in Oklahoma City, Oklahoma 73104. The Contractor’s provider(s)’ care shall cover the range of Neurosurgery Monitoring Services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by the Certification for Neurophysiological Intraoperative Monitoring (CNIM).

Neurophysiologic monitoring is the use of electrophysiological methods such as electroencephalography (EEG), electromyography (EMG), and Somatosensory evoked potentials (SSEP) to monitor the functional integrity of certain neural structures (e.g., nerves, spinal cord, and parts of the brain) during surgery. The purpose of intraoperative neurophysiologic monitoring is to reduce the risk to the patient of iatrogenic damage to the nervous system, and/or to provide functional guidance to the surgeon and anesthesiologist.

Contractor’s provider(s) shall be available and present in clinic during normal Oklahoma City VAMC OR hours, which will be established, and may be revised, as deemed appropriate for patient care by the COS. Currently, normal OR hours are 0700-1530. The OKC VAMC is estimating 135 cases per year for these services.

1.1. Surgical Neuromonitorists Services onsite in accordance with the specifications contained herein to beneficiaries of the VA and the Oklahoma City VAMC.

1.2. Place of Performance: Contractor shall furnish services at the Oklahoma City VAMC, 921 NE 13th Street, Oklahoma City, OK 73104.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR)

1.4. Policy/Directives/Handbooks. The contractor shall be subject to the following policies, including any subsequent updates during the period of performance. The policies listed below can be accessed electronically at the following: VA Publications VHA Publications

1.4.1. VA Directive 1663: Health Care Resources (HCR) Contracting – Buying Title 38 U.S.C. 8153

1.4.3. VHA Directive 1100.18: Reporting and Responding to State Licensing Boards

1.4.4. VHA Directive 1100.20: Credentialing of Health Care Providers

1.4.5. VHA Directive 1100.21: Privileging

1.4.6. VHA Directive 1605.01: Privacy and Release of Information

1.5. Acronyms/Definitions: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1. ABS: American Board of Surgery http://www.absurgery.org/

1.5.2. ACGME: Accreditation Council for Graduate Medical Education

1.5.3. ACLS: Advanced Cardiac Life Support

1.5.4. AJIC: American Journal for Infection Control

1.5.5. AQL: Acceptable Quality Level

https://www.va.gov/vapubs/ https://www.va.gov/vhapublications/index.cfm http://www.absurgery.org/

1.5.6. BAA: Business Associate Agreement

1.5.7. BBA: Balanced Budget Act

1.5.8. BLS: Basic Life Support

1.5.9. CDC: Centers for Disease Control and Prevention

1.5.10. CDR: Contract Deficiency Report

1.5.11. CEU: Certified Education Unit

1.5.12. Clinical Privileging: Clinical Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific, and within available resources.

1.5.13. CME: Continuing Medical Education

1.5.14. CMP: Civil Monetary Penalty

1.5.15. CMS: Centers for Medicare and Medicaid Services

1.5.16. CO: Contracting Officer: 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.

1.5.17. COI: Conflict of Interest

1.5.18. COR: Contracting Officer’s Representative: 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.

1.5.19. COS: Chief of Staff

1.5.20. CPARS: Contractor Performance Assessment Reporting System

1.5.21. Credentialing: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health care provider to provide care or services in or for the VA health care system. Credentials are documented evidence of licensure, education, training, experience or other qualifications.

1.5.22. DEA: Drug Enforcement Agency

1.5.23. EHR: Electronic Health Record - electronic health record system used by the VA

1.5.24. EPA: Environmental Protection Agency

1.5.25. FAPIIS: Federal Awardee Performance and Integrity Information System

1.5.26. FAR: Federal Acquisition Regulation

1.5.27. FOIA: Freedom of Information Act

1.5.28. FPPE: Focused Provider Practice Evaluation

1.5.29. FSMB: Federation of State Medical Boards

1.5.30. FTE: Full Time Equivalent: VA’s standard definition is for full time working the equivalent of 80 hours every two weeks, 2080 hours per year. However, providers may propose using their standard FTE definition.

1.5.31. HHS: Department of Health and Human Services

1.5.32. HICPAC: Hospital Infection Practices Advisory Committee

1.5.33. HIPAA: Health Insurance Portability and Accountability Act

1.5.34. IGRA: Interferon-gamma Release Assays

1.5.35. ISO: Information Security Officer

1.5.36. Key Personnel: The individuals specified in this contract who are essential to work performance.

1.5.37. MRI: Magnetic Resonance Imaging

1.5.38. MST: Military Sexual Trauma

1.5.39. NPI: National Provider Identifier. NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The VHA must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.40. NPPES: National Plan and Provider Enumeration System

1.5.41. NSO: National Surgery Office

1.5.42. OGC: Office of General Counsel

1.5.43. OIG: Office of Inspector General

1.5.44. OPPE: Ongoing Provider Practice Evaluation

1.5.45. OR: Operating Room

1.5.46. POP: Period of Performance

1.5.47. PPD: Purified Protein Derivative

1.5.48. PPIRS: Past Performance Information Retrieval System

1.5.49. PWS: Performance Work Statement

1.5.50. QA/QI: Quality Assurance/Quality Improvement

1.5.51. QM/PI: Quality Management/Performance Improvement

1.5.52. QASP: Quality Assurance Surveillance Plan

1.5.53. RFP: Request for Proposal

1.5.54. SCS: Specialty Care Services

1.5.55. SSAC: Sole Source Affiliate Contract

1.5.56. TJC: the Joint Commission

1.5.57. TST: Tuberculosis Skin Test

1.5.58. USC: United States Code

1.5.59. VA: Department of Veterans Affairs

1.5.60. VA-FSC: VA Financial Services Center

1.5.61. VAAR: VA Acquisition Regulation

1.5.62. VETPro: is VHA’s mandatory credentialing software platform to document the credentialing of VHA health care Providers. This system facilitates completion of a uniform, accurate and complete credentials file.

1.5.63. VHA: Veterans Health Administration

1.5.64. VistA: Veterans Integrated Systems Technology Architecture

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: The Contractor’s provider(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property.

All licenses held by the key personnel working on this contract shall be full and unrestricted licenses. Contractor’s provider(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification: All Contractor’s provider(s) shall be Certified for Neurophysiological Intraoperative Monitoring (CNIM), and be currently certified in electrophysiological monitoring of patients to access the functional integrity of the peripheral or central nervous system in the operating room or other acute care setting. Services shall be performed by surgical neuromonitorist. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.2.1. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive

1100.21 referenced above. The Contractor is responsible to ensure that proposed provider(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Contractor’s provider(s) prior to obtaining approval by the Facility Medical Executive Board (PENTAD) and Medical Center Director.

2.1.2.2. If a Contractor’s provider(s) and/or other contract provider(s) are not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.3. Technical Proficiency: Contractor’s provider(s) 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 shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all Contractor’s provider(s) and Contractor’s provider(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.4. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the facility. Contractor’s provider(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re-privileging.

Failure to provide shall result in loss of privileges for Contractor’s provider(s).

2.1.5. Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s provider(s) as required by the VA.

Other training may become required. VA will communicate any changes to the training requirement to the contractor.

Training Frequency Annual Hours

ACLS/BLS NA

Active Threat Training NA

Blood Administration:

Complications

NA

EHR NA

Government Ethics NA

Hospice and Palliative Care for VA Clinicians

NA

Military Sexual Trauma (MST) for Medical Providers

NA

Moderate Sedation In- Service Training

NA

PACT Act 2022 Toxic Exposure Screening (TES)

NA

Patient Abuse NA

Patient Rights NA

Patient Safety NA

Prevention/Management of Disruptive Behavior/Violence Prevention Level I

NA

Prevention of Workplace Harassment/No Fear Act

NA

Suicide Prevention: Suicide Risk Management Training for Clinicians

NA

SUX Infection Control and Blood Borne Pathogens

NA

VA Core Values Training (ICARE Recommitment)

NA

VA Privacy and Information Security Awareness and Rules of Behavior

Annually Less than one hour

VHA MRI Safety Training Level 1 Training (all who enter MRI suites)

NA

VHA Privacy and HIPAA Focused Training

VistA Imaging NA

2.1.6. STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.):

Contractor shall provide proof of the following for providers within five (5) calendar days after contract award and prior to the first duty shift to the COR and CO. Tests shall be current within the past year.

2.1.6.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s provider(s) upon hire in accordance with CDC guidance. (This is applicable to all health care workers). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results.

2.1.6.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor providers {This is applicable to all health care workers}.

2.1.6.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor providers {This is applicable to all health care workers}.

2.1.6.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor providers {This is applicable to all health care workers}.

2.1.6.5. INFLUENZA: Contractors shall provide proof that all Contractor providers have received the annual Influenza vaccine unless it is contraindicated. If the Contractor provider has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.1.6.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s provider(s) {This is applicable to all health care workers};

provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.6.7. The facility shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control - AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control.

http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.7. NPI: NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The VHA must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the CMS NPPES be provided to the CO with the proposal.

2.1.8. Conflict of Interest (COI): The Contractor and all Contractor’s provider(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided.

The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.9. Citizenship related Requirements:

2.1.9.1. 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 VA patient referrals.

2.1.9.2. While performing services for the VA, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant 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 FAR.

2.1.9.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the VA 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 VA patient referrals; or other place where the Contractor provides services to veterans who have been referred by the VA; and shall form the basis for termination of this contract for breach.

2.1.9.4. 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.

2.1.9.5. 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.

2.1.10. Annual OIG Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the HHS 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.

2.1.10.1. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed Contractor’s provider(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.10.2. By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by facility COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Directive 1100.20 and VHA Directive

1100.21. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the facility COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non Personal Healthcare Services: The parties agree that the Contractor and all Contractor’s provider(s) shall not be considered VA employees for any purpose.

2.4. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.

2.5. Prohibition against Self-Referral: Contractor’s provider are prohibited from referring VA patients to contractor’s or their own practice(s).

2.6. Inherent Government Functions: Contractor and Contractor’s provider(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, http://oig.hhs.gov/exclusions/index.asp approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No Employee status: The Contractor shall be responsible for protecting Contractor’s provider(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover Contractor or Contractor’s provider(s). When a Contractor or Contractor’s provider(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or Contractor’s provider(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The minimum number of Neurophysiological Intraoperative Monitoring required to be onsite per requested/scheduled case(s).

2.9.2. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled provider is unable to complete an assigned shift, the Contractor shall provide replacement provider coverage within 2 hours and notify the COR immediately of the schedule change.

2.9.3. Personnel Substitutions: During the first ninety (90) calendar 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 COR, in writing, within 15 calendar day(s) after the occurrence of any of these events and provide the information required below.

After 90 days, the Contractor shall submit the information required below to the COR at least 15 calendar days prior to making any permanent substitutions.

2.9.3.1. 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 CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO 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.

2.9.3.2. For temporary substitutions where the key person shall not be reporting to work for 15 consecutive workdays or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.9.3.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives.

Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s provider(s), s/he may request, without cause, immediate replacement of said Contractor’s provider(s). The CO and COR shall deal with issues raised concerning Contractor’s provider(s) conduct. The final arbiter on questions of acceptability is the CO.

2.9.3.4. Contingency Plan: Because continuity of care is an essential part of Facility’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor’s provider(s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: Monday through Friday, 0800 - 1630

3.2. OR Schedule: General Block time is Monday through Thursdays from 0800-1630, providers should be available as requested per scheduled cases.

3.2.1. Patients must be seen by a Contractor’s provider(s) onsite at the Oklahoma City VAMC in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.2.2. Contractor’s provider(s) shall be available and present in clinic during normal Oklahoma City VAMC OR hours, which will be established, and may be revised, as deemed appropriate for patient care by the COS. Currently, normal OR hours are 0700-1530.

3.2.3. Off-hours Coverage: Contractor must make the Contractor’s provider(s) available on-call during all hours when the Oklahoma City VMC OR is closed, including evenings, weekends and holidays.

3.2.3.1. On-call providers must be available within 15 minutes by phone and onsite within 60 minutes.

3.3. Federal Holidays: The following holidays are observed by the VA:

• New Year’s Day

• President’s Day

• Martin Luther King’s Birthday

• Memorial Day

• Juneteenth

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any day specifically declared to be a national holiday.

3.4. Cancellations: No additional charge for late/weekend cases or day of cancellations.

In cases of contracted provider cancellation, the contractor will make avalable a VA credentialed and privledged provider.

4. CONTRACTOR RESPONSIBILITIES:

4.1. OR Personnel Required: The Contractor shall provide Contractor’s provider(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contractor’s provider(s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

4.2. Standards of Care: The Contractor’s provider(s)’ care shall cover the range of services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized the Joint Commission (TJC), VA and national standards as established by:

4.2.1. CNIM (Certification in Neurophysiologic Intraoperative Monitoring) through ABRET: American Board of Registration of Electroencephalographic and Evoked Potential Technologists. Neurodiagnostic Credentialing and Accreditation -

4.2.2. The professional standards of TJC:

http://www.jointcommission.org/standards_information/standards.aspx

4.2.3. The standards of the American Hospital Association (AHA):

http://www.hpoe.org/resources?show=100&type=8

4.2.4. The requirements contained in this PWS

4.3. Medical Records:

4.3.1. Authorities: Contractor’s provider(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 5 U.S.C.552a (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), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164

(HIPAA).

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment of VA patients. Based on this exception, a BAA is not required for this contract.

Health records generated by this contract or provided to the Contractors by the VA are covered by the VA Privacy Act system of records entitled ‘Patient Medical Records-VA’ (24VA10A7). Contractor generated VA Patient records https://asnm.org/ https://asnm.org/ https://asnm.org/ http://www.jointcommission.org/standards_information/standards.aspx http://www.hpoe.org/resources?show=100&type=8 http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www.rms.oit.va.gov/SOR_Records/24VA19.asp are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations.

Contractor shall ensure that all records pertaining to medical care and services provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 4.4.4.

4.3.3. Disclosure: Contractor’s provider(s) may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under the contract; however, Contractor shall obtain permission from the VA before disclosing any patient information outside VA.

VA authorizes the Contractor to discuss patient health information for coordination of care within community health care providers in compliance with VA regulations, HIPAA and VHA Directive 1605.1, Privacy and Release of Information. The VA will provide the Contractor with a copy of VHA Directive 1907.01, Health Information Management and Health Records and VHA Directive1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.3.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Directive 1907.01 Health Information Management and Health Records:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 and all guidelines provided by the facility.

4.3.5. Release of Information: The VA shall maintain control of releasing any copies of patient health information or health records and will follow policies and standards as defined, but not limited to Privacy Act requirements. The Contractor will not release or disclose copies of records and will refer all such requests to the Release of Information Department at the VA facility where assigned.

4.3.6. Management for Medical Records: National Archives and Records Administration record disposition requirements are found in RCS 10-1 Chapter 6, 6000 series.

4.4. Direct Patient Care: Estimated 100% of the time involved in direct patient care.

Contractor shall be responsible for neuromonitoring.

4.4.1. Scope of Care: Contractor’s provider(s) shall be responsible for providing Surgical Neuromonitorists, including, but not limited to:

4.4.1.1. OR Responsibilities: Contractor provider(s) shall be present on time for any scheduled OR surgeries start times as documented by physical presence in the OR at the scheduled start time.

4.4.2. ADMINISTRATIVE: Estimated 0.00% of time not involved in direct patient care

4.4.2.1. Quality Improvement Meetings: The Contractor’s provider(s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the facility Chief of Service, COS, or designee.

List all meetings, associated time and frequency.

Meeting Frequency (once a year, etc.)

Annual Hours http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235

4.4.2.2. Staff Meetings: The Contractor’s provide(s) shall attend staff meetings as required by the facility Chief of Service, COS, or designee.

Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.

List all meetings, associated time and frequency.

Meeting Frequency (once a year, etc.)

Annual Hours

NA

4.4.2.3. Patient Safety Compliance and Reporting: Contractor’s provider(s) shall follow all established patient safety and infection control standards of care. Contractor’s provider(s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be documented in the medical record of those impacted and disclosed to the patient or surrogate. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and the COR will submit an entry in the VA Patient Safety Reporting System, following up with COR as required or requested.

4.5. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY

IMPROVEMENT(QI):

4.5.1. Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined in this PWS and methods of surveillance detailed in the QASP. The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.5.2. Patient Complaints: The COR in conjunction with the CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. If the Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

4.5.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives.

Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

4.5.4. Performance Standards:

4.5.4.1. Measure: Qualifications of Key Personnel

Performance Requirement: All Contractor’s provider(s) shall be certified for Neurophysiologic Intraoperative Monitoring (CNIM) in accordance with Surgical Neuromonitorists.

Standard: All (100%) Contractor’s provider(s) are Certified

AQL: 100%

Surveillance Method: Periodic Inspection or Random Sampling of qualification documents.

Frequency: Annually

4.5.4.2. Measure: Scope of Practice/Privileging

Performance Requirement: Contractor’s provider(s) perform within their individual scopes of practice/privileging

Standard: All (100%) Contractor’s provide(s) perform within their scope of practice/privileges 100% of the time

AQL: 100% Contractor’s provide(s) perform within their scope of practice/privileges 100% of the time

Surveillance Method: Random Sampling of records

Frequency: Annually

4.5.4.3. Measure: Patient Access

Performance Requirement: The Contractor shall provide Contractor’s provider(s) in accordance with the operating hours and VA OR schedule outlined in this PWS

Standard: All (100%) Contractor’s provide(s) are on time and available to perform services

AQL: Contractor’s provide(s) is on-time and available to perform services 100% of the time

Surveillance Method: Periodic Inspection of Time and Attendance Sheets

Frequency: Annually

4.5.4.4. Measure: Patient Safety

Performance Requirement: Patient safety incidents shall be reported using VA Patient Safety Reporting System. All incidents reported immediately (within 24 hours.) to the COR.

Standard: All (100%) of patient safety incidents are reported using VA Patient Safety Reporting System within 24 hours of incident

AQL: 100% of patient safety incidents are reported using VA Patient Safety Reporting System within 24 hours of incident by the COR.

Surveillance Method: Periodic Inspection or Random Sampling

Frequency: If incident arises, as needed.

4.5.4.5. Measure: Maintains licensing, registration, and certification

Performance Requirement: Updated licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current

Standard: All (100%) licensing, registration(s) and certification(s) for Contractor’s provider(s) shall be provided as they are renewed. Licensing and registration information kept current

AQL: 100% licensing, registration(s) and certification(s) for Contractor’s provider(s) shall be provided as they are renewed. Licensing and registration information kept current. No acceptable deviation.

Surveillance Method: Periodic Inspection or Random Sampling

Frequency: Annually

4.5.4.6. Measure: Mandatory Training

Performance Requirement: Contractor shall complete all required training on time per facility policy

Standard: All (100%) of required training is complete on time by Contractor’s provider(s)

AQL: 100% completions

Surveillance Method: Periodic Inspection or Random Sampling

Frequency: As required by the Oklahoma City VAMC

4.5.4.7. Measure: Privacy, Confidentiality and HIPAA

Performance Requirement: Contractor is aware of all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA and complies with all standards Zero breaches of privacy or confidentiality

Standard: All (100%) Contractor’s provider(s) comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and

HIPAA

AQL: 100% compliance

Surveillance Method: Periodic Inspection; Contractor shall provide evidence of annual training required by the facility, reports violations per VA Handbook 6500.6

Frequency: Annually

4.5.5. Registration with Contractor Performance Assessment Reporting System

4.5.5.1. As prescribed in FAR Part 42.15, the VA evaluates Contractor past performance on all contracts that exceed the Simplified Acquisition Threshold 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, CPARS, which is maintained by the Naval Sea Logistics Center in Portsmouth, New Hampshire. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the Federal

Awardee Performance and Integrity Information System (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information.

4.5.5.2. Each Contractor whose contract award is estimated to exceed the Simplified Acquisition Threshold requires a CPARS evaluation. A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations). Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk @ DSN:

684-1690 or COMM: 207-438-1690.

4.5.5.3. For contracts with a period of one year or less, the CO will perform a single evaluation when the contract is complete. For contracts exceeding one year, the CO 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 CPARS to the Contractor’s designated representative for comment. The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO.

4.5.5.4. Failure for the Contractor’s representative to respond to the evaluation within those sixty (60) days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor’s representative will be “locked out” of the evaluation and may no longer send comments.

5. GOVERNMENT RESPONSIBILITIES:

5.1. VA Support Personnel, Services or Equipment: Oversight of Service/Performance Monitoring in accordance with the QASP.

5.2. Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to: (enter contract administration if not already listed in another area- list the title (not name) and contact information for COR, Clinical point of contact, and any other relevant personnel involved).

5.2.1. CO Responsibilities:

CO: Patricia Toliver,Rocky Mountain Acquisiton Center/303-712- 5801/patricia.toliver@va.gov

5.2.1.1. The CO is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the CO on all matters pertaining to contract administration. Only the CO 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.

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

http://www.cpars.gov/

5.2.1.3. 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.

5.2.2. COR Responsibilities:

The COR for this contract is: Dallas Norton, COR/Program Specialist, 921 NE 13th St., Oklahoma City, OK 73104, 405-456-1095, dallas.norton@va.gov

5.2.2.1. 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 CO.

5.2.2.2. 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.

5.2.2.3. The COR will maintain a record-keeping system of services by Excel Spreadsheet. 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 CO.

5.2.2.4. 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.

5.2.2.5. All contract administration functions will be retained by the VA.

6. SPECIAL CONTRACT REQUIREMENTS:

6.1. Reports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each. Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required.

6.1.1. The following are brief descriptions of required documents that must be submitted by Contractor: upon award; weekly; monthly; quarterly’; annually, etc.

identified throughout the PWS and is provided here as a guide for Contractor convenience. If an item is within the PWS and not listed here, the Contractor remains responsible for the delivery of the service.

Proof of Indemnification and Medical Liability Insurance

Upon proposal and upon renewals

CO

Certificates of Patient Privacy Training Courses

Before receiving an account on VA Network and annual training and new hires.

CO

Contingency plan for replacing key personnel to maintain services as required under the terms of the contract

Upon proposal and as updated

COR

6.2. Billing:

6.2.1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 10th workday of the month.

Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:

6.2.1.1. Name and Address of Contractor

6.2.1.2. Invoice Date and Invoice Number

6.2.1.3. Contract Number and Purchase/Task Order Number

6.2.1.4. Date of Service

6.2.1.5. Contractor’s provider(s) – See attached list

6.2.1.6. Hourly Rate

6.2.1.7. Quantity of hours worked

6.2.1.8. Total price

6.3. Vendor Electronic Invoice Submission Methods:

Invoices will be electronically submitted to the Tungsten website at https://www.tungstenautomation.com/. Tungsten Automation direct vendor support number is 877-489-6135 for VA contracts. The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten Automation will confirm your Taxpayer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. To successfully submit an invoice to VA-FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten Automation to the VA-FSC should mirror the current submission of Invoice. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). Payment will only be made for actual services rendered. Payments shall be made monthly in arrears. The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. The contractor shall be reimbursed upon receipt of a proper invoice. For additional information, please contact:

Tungsten Support Phone: 1-877-489-6135 Website: https://www.tungstenautomation.com/

Department of Veterans Affairs Financial Service Center https://www.fsc.va.gov/einvoice.asp

6.4. Reduction in Services: This is a…