PWS - Cardiac Sonographers_SOW_01.pdf

B.2 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Contractor shall provide THREE 1.0 FTEs Cardiac Sonographer to provide echocardiography services on site in accordance with specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) located at the San Francisco VA Health Care System.

1.2. Place of Performance - Contractor shall furnish services at the SFVAHCS San Francisco, located at 4501 Clement Street, San Francisco, VA 94121. Services for other SFVAHCS Community Based Outpatient Clinics (CBOC) may be requested, depending on need.

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

1.4. Policy/Handbooks the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.4.1. VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.4.2. - VHA Handbook 1907.01 Health Information Management and Health Records:

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

1.4.3. - Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5. Definitions/Acronyms- 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. ARDMS: American Registry for Diagnostic Medical Sonography

1.5.2. CCI: Cardiovascular Credentialing International

1.5.3. CEU: Certified Education Unit

1.5.4. CME: Continuing Medical Education

1.5.5. CBOC: Community Based Outpatient Clinic

1.5.6. Contracting Officer (CO) – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

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

1.5.8. COS: Chief of Staff

1.5.9. CPARS: Contractor Performance Assessment Reporting System

1.5.10. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.11. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.5.12. HIPAA: Health Insurance Portability and Accountability Act

1.5.13. ISO: Information Security Officer

1.5.14. POP: Period of Performance

1.5.15. PWS: Performance Work Statement

1.5.16. Privileging (Clinical Privileging): 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 https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm determined by peer references, professional experience, health status, education, training and licensure.

Clinical privileges must be facility-specific and provider-specific.

1.5.17. QA/QI: Quality Assurance/Quality Improvement

1.5.18. QM/PI: Quality Management/Performance Improvement

1.5.19. QASP: Quality Assurance Surveillance Plan

1.5.20. RCS: Registered Cardiac Sonographer

1.5.21. RCCS: Registered Congenital Cardiac Sonographer

1.5.22. RDCS: Registered Diagnostic Cardiac Sonographer

1.5.23. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.5.24. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in

California and Hawaii.

1.5.25. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

1.5.26. VETPro: a federal web-based credentialing program for healthcare providers.

1.5.27. VA Palo Alto Health Care System (SFVAHCS): Unless identified with the name of a different VA medical

Center, for purposes of this contract, this term shall mean the VA Palo Alto Health Care System.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. Certification - All cardiac sonographers have completed an accredited training course in cardiac ultrasound and shall be certified as Registered Diagnostic Cardiac Sonographers (RDCS) by the American Registry for Diagnostic Medical Sonography (ARDMS) or as Registered Cardiac Sonographer (RCS) or Registered Congenital Cardiac Sonographer (RCCS) by the Cardiovascular Credentialing International (CCI), and be currently certified in Basic Life Support (BLS), though Advanced Cardiac Life Support (ACLS) is preferred.

All continuing education courses required for maintaining certification must be kept up to date at all times.

The Contractor shall provide documentation verifying current certification to the VA COR upon request.

2.1.2. Echocardiography Experience: All cardiac sonographers shall have a minimum of 2 years of echocardiography experience.

2.1.3. Technical Proficiency - Contract personnel 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.

2.1.4. Training (ACLS, BLS and VA MANDATORY): Contract personnel shall meet all VA educational requirements and mandatory course requirements defined herein; all trainings must be completed by the contract personnel as required by the VA. VA trainings include: Annual Government Ethics Training;

Compliance and Business Integrity; Emergency Preparedness; GEMS; Infection Control; Hazardous Material; Medical Equipment Management; Prevention of Workplace Harassment/NO FEAR; Privacy and HIPAA Training; Safety; Security; Staff and Patient Boundaries; Utilities Management; VA Privacy and Information Security Awareness; and Visitation.

Basic Life Support (BLS) is required and Advanced Cardiac Life Support is preferred.

2.1.5. Citizenship related Requirements:

2.1.5.1. 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 Department of Veterans Affairs patient referrals;

2.1.5.2. While performing services for the Department of Veterans Affairs, 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 Federal Acquisition Regulations.

2.1.5.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.5.4. 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.

2.1.5.5. 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.

2.1.6. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs.

Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.6.1. 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 contract personnel 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.

2.1.6.2. 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 Direction: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional direction of all clinical personnel covered by this contract for quality purposes will be provided by the SFVAHCS 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 contract personnel shall not be considered VA employees for any purpose.

2.4. Inherent Government Functions: Contractor and Contract personnel shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.5. No Employee status: The Contractor shall be responsible for protecting Contract personnel 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:

2.5.1. Workers’ compensation

2.5.2. Professional liability insurance

2.5.3. Health examinations

2.5.4. Income tax withholding, and

http://oig.hhs.gov/exclusions/index.asp

2.5.5. Social security payments.

2.6. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract personnel. When a Contractor or contract personnel 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 contract personnel) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.7. Key Personnel:

2.7.1. The VA Full Time Equivalency (FTE) for the echocardiography services required is THREE 1.0 FTE, to provide a total of 2080 hours of service coverage during the period of performance.

2.7.2. The number of cardiac sonographers to provide service on a daily basis (be on site) is a minimum of Two and a miximun of three as defined in paragraph Hours of Operation in this section.

2.7.3. The Contractor shall be responsible for providing coverage to the VA during extended periods of vacancies of the Contractor’s personnel due to sick leave and personal leave. For other requested time off, the contract personnel shall discuss with and obtain approval from the San Francisco VA Echocardiography Director.

2.8. Emergency 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 CO, in writing, within 15 calendar days 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 CO at least 15 calendar days prior to making any permanent substitutions.

2.8.1. 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.

2.8.2. 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 contract physician(s), s/he may request, without cause, immediate replacement of said contract physician(s).

2.8.3. The CO and COR shall deal with issues raised concerning Contract personnel conduct. The final arbiter on questions of acceptability is the CO.

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

3. HOURS OF OPERATION

3.1. VA Business Hours: Monday – Friday 8:00 AM – 4:30 PM

3.1.1. Contract personnel shall be available and present during normal SFVAHCS hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff or designee.

Currently, normal hours are Monday – Friday 8:00 AM – 4:30 PM.

3.1.2. Off-hours Coverage: Not Applicable. Off-hour onsite coverage is not required.

3.2. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

2023 Holiday Schedule

Date Holiday

Monday, January 02 * New Year’s Day

Monday, January 16 Birthday of Martin Luther King, Jr.

Monday, February 20 ** Washington’s Birthday

Monday, May 29 Memorial Day

Monday, June 19 Juneteenth National Independence Day

Tuesday, July 04 Independence Day

Monday, September 04 Labor Day

Monday, October 09 Columbus Day

Friday, November 10 * Veterans Day

Thursday, November 23 Thanksgiving Day

Monday, December 25 Christmas Day

• Any day specifically declared by the President of the United States to be a national holiday.

3.3. Cancellations: Unless a state of emergency has been declared by the SFVAHCS, the Contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES

4.1. Clinical Personnel Required: The Contractor shall provide contract personnel who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contract personnel 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.

4.1.2. The Contractor and/or contract personnel shall return required Background Investigation paperwork within 10 calendar days of receipt from the COR.

4.2. Standards of Care: The contract personnel’s care shall cover the range of echocardiography 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 current national standards recognized by the American Registry for Diagnostic Medical Sonography (ARDMS) or Cardiovascular Credentialing International (CCI).

4.3. MEDICAL RECORDS:

4.3.1. Authorities: Contract personnel providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 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), 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. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records 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 are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense.

Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one

(21) calendar days after the contract expiration date.

4.3.3. Disclosure: Contract personnel may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. 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. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.1, 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 Handbook 1907.01 Health Information Management and Health Records:

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the

SFVAHCS.

4.3.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address:

Nancy Ungson Privacy Officer Office of the Director San Francisco VA Health Care System 4501 Clement Street San Francisco, CA 94121 Tel: 415-221-4801 ext. 22135

4.3.6 Direct Patient Care: 90% of the time involved in direct patient care. The contract personnel shall perform the following and remain within their scope of practice/privilege at all times:

4.3.6.1 Identify and record anomalies indicative of disease, injury, or other medically significant condition from ultrasound imaging and simultaneous records of the Doppler.

4.3.6.2. Change and develop sounding techniques to accommodate such variables as limited patient mobility, variation in physical condition or dimensions of the patient, presence of prosthesis or foreign objects, and ultrasonic response to different body parts.

4.3.6.3. Produce diagnostic quality images and Doppler frequency recordings using M-mode, two-dimensional, and continuous and pulse wave Doppler and color flow exam.

4.3.6.4. Assist physicians in performing transesophageal echocardiograms.

4.3.6.5. Assist Cardiology fellows in performing and interpreting echo exams and present information to the interpreting physicians.

http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf

4.3.6.6. Perform stress echocardiograms with and without pharmaceuticals.

4.3.6.7. Perform bubble studies

4.3.6.8. Use problem-solving skills to optimize the evaluation and adjust the exams to ensure that they are comprehensive and accurate.

4.3.6.9. Use independent judgment in applying knowledge of clinical cardiology and ultrasound, and Doppler principles.

4.3.6.10. Independently set, calibrate, and operate all echocardiography machinery/equipment.

4.3.6.11. Have intimate knowledge of thoracic anatomy and physiology as related to cardiovascular function.

4.3.6.12. Receive patients and explain procedures to patient and family members.

4.3.7. ADMINISTRATIVE: 10% of time not involved in direct patient care

4.3.7.1. Quality Improvement Meetings: If applicable, the contract personnel shall participate in continuous quality improvement activities and meetings with committee participation as required by the SFVAHCS Chief of Service, Chief of Staff, or designee. Meetings will be on an as-needed basis and will occur during regular working hours.

4.3.7.2. Staff Meetings/Rounds: The contract personnel shall attend staff meetings as required by the SFVAHCS Chief of Service, Chief of Staff, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.

4.3.7.3. QA/QI documentation: The contract personnel shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations as needed.

4.3.7.4. Patient Safety Compliance and Reporting: The contract personnel shall follow all established patient safety and infection control standards of care. Contract personnel 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 reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.

4.3.7.5. Medical Records: The contract personnel shall complete all required clinical and medical record documentation for echocardiography services within the required timeframe. The contract personnel shall utilize VA’s electronic medical record system for all patient care documentation, where applicable, including the Computerized Patient Record System (CPRS).

4.3.7.6. Invoicing/Billing: In order to adequately document services provided under this contract, a record keeping system of Contractor work hours shall be established and implemented by the COR. Payment for services will not be made until all required documentation related to the services has been submitted. Contractor shall submit monthly invoices within 30 days.

4.4. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT (QI)

4.4.1. 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 Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.4.2. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that 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.

4.4.3. The Government reserves the right to refuse acceptance of any contract 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.

4.4.4. Performance Standards:

4.4.4.1. Measure: Provider Quality Performance

Performance Requirement: All contract personnel shall perform in accordance with clinical standards of care.

Standard: All services performed within clinical standards of care.

Acceptable Quality Level: 100% No deviations accepted.

Surveillance Method: Random Inspection Frequency: Annually or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation.

4.4.4.2. Measure: Qualifications of Key Personnel

Performance Requirement: All contract personnel shall be certified in accordance with ARDMS or CCI Standards.

Standard: All contract personnel are certified.

Acceptable Quality Level: 100% No deviations accepted.

Surveillance Method: Direct Observation of qualification documents Frequency: Annually or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation. Removal from contract until such time the contract personnel meet qualification standard.

4.4.4.3. Measure: Scope of Practice

Performance Requirement: All contract personnel shall provide services within their scope of practice.

Standard: All contract personnel perform within their scope of practice/privileges 100% of the time.

Acceptable Quality Level: All contract personnel perform within their scope of practice/privileges 100% of the time. No deviations accepted.

Surveillance Method: Random Inspection of records.

Frequency: Annually or as needed

4.4.4.4. Measure: Patient Access

Performance Requirement: The Contractor shall provide contract personnel in accordance with the operating hours and VA clinical schedule outlined in this PWS.

Standard: All contract personnel are on time and available to perform services.

Acceptable Quality Level: Contract personnel is on time and available to perform and provide services 90% of the time Surveillance Method: Periodic Sampling of Time and Attendance Sheets Frequency: Monthly or when itemized invoices are submitted Incentive: Favorable contactor performance evaluation.

Deduction: No monetary incentive for work not performed. Contractor will be paid for actual hours worked.

4.4.4.5. Measure: Patient Safety

Performance Requirement: Patient safety incidents shall be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)

Standard: All patient safety incidents are reported using Patient Safety Report within 24 hours of incident.

Acceptable Quality Level: All patient safety incidents are reported using Patient Safety Report within 24 hours of incident. No acceptable deviation.

Surveillance Method: Direct Observation, Validated Patient Complaints Frequency: Annual, per incident, or as needed.

Disincentive: Unfavorable contractor performance evaluation

4.4.4.6. 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 contract personnel shall be provided as they are renewed. Licensing and registration information kept current.

Acceptable Quality Level: All (100%) licensing, registration(s) and certification(s) for contract personnel shall be provided as they are renewed. Licensing and registration information kept current. No acceptable deviation.

Surveillance Method: Periodic Sampling and Random inspection of records Frequency: Annually or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation. Removal from contract until such time the contract personnel meet qualification standard.

4.4.4.7. Measure: Mandatory Training

Performance Requirement: Contract personnel shall complete all required training on time per SFVAHCS policy Standard: All (100%) of required training is complete on time by contract personnel.

Acceptable Quality Level: 100% completions, no deviations.

Surveillance Method: Periodic Sampling and Random inspection of records Frequency: Annually or as needed Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation, Suspension or termination of all physical and/or electronic access privileges and removal from contract until such time as the training is complete.

4.4.4.8. Measure: Timely Invoice

Performance Requirement: Monthly invoices shall be submitted within 30 days.

Standard: Monthly invoices shall be submitted within 30 days.

Acceptable Quality Level: 75% compliance Surveillance Method: Periodic Sampling Frequency: Monthly or as needed

Disincentive: Unfavorable contactor performance evaluation.

4.4.4.9. Measure: Privacy, Confidentiality and HIPAA

Performance Requirement:

Standard: All (100%) contractor personnel comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA Acceptable Quality Level: 100% compliance; no deviations.

Surveillance Method: Periodic Sampling; Contractor shall provide evidence of annual training required by SFVAHCS, reports violations per VA Directive 6500.6.

Frequency: Annually or as needed

Disincentive: Unfavorable contactor performance evaluation. Immediate removal from contract.

4.4.5. Registration with Contractor Performance Assessment Reporting System

4.4.5.1. 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 $150,000, 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, CPARS, which is maintained by the Naval Seal 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 $150,000 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 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 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. Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to:

5.1.1. CO RESPONSIBILITIES:

CO – To be determined

5.1.1.1. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract.

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

5.1.1.3. 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.

5.1.2. COR Responsibilities:

COR - Andrew M. Harris 4501 Clement Street Mail Code (111C) San Francisco, CA 94121 415-221-4810 ext. 23308 Andrew.Harris8@va.gov

5.1.2.1. 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 Contracting Officer.

http://www.cpars.gov/ mailto:Andrew.Harris8@va.gov

5.1.2.2. 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.

5.1.2.3. The COR will maintain a record-keeping system of services by reviewing the QASP, CPRS, and invoices submitted by the Contractor. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the Contractor’s non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

5.1.2.4. 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.

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

6. SPECIAL CONTRACT REQUIREMENTS

6.1. Billing:

6.1.1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th 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:

6.1.1.1. Name and Address of Contractor

6.1.1.2. Invoice Date and Invoice Number

6.1.1.3. Contract Number and Purchase/Task Order Number

6.1.1.4. Date of Service

6.1.1.5. Name of contract physician(s)

6.1.1.6. Hourly Rate

6.1.1.7. Quantity of hours worked

6.1.1.8. Total price

6.2. Vendor Electronic Invoice Submission Methods

Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests.

Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below:

6.2.1. Invoices will be electronically submitted to the Tungsten website at http://www.tungstennetwork.com/uk/en/ Tungsten 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 will confirm your Tax Payer 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. In order 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 to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact:

Tungsten Support Phone: 1-877-489-6135 Website: http://www.tungsten-network.com/uk/en/

6.3. Payment Adjustments/Performance Related Payment Deductions:

6.3.1. Invoices will be prorated for partial days/hours worked. The contractor shall be paid only for actual work performed onsite. Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed. In the event that the Contract providers work a portion of an hour, the government may adjust payments by 15-minute increments.

http://www.tungstennetwork.com/uk/en/ http://www.tungsten-network.com/uk/en/

6.4. Payments in full/no billing VA beneficiaries: The Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Contractor, even if VA does not pay for those services. This provision shall survive the termination or ending of the contract.

6.4.1. To the extent that the Veteran desires services which are not a VA benefit or covered under the terms of this contract, the Contractor must notify the Veteran that there will be a charge for such service and that the VA will not be responsible for payment.

6.4.2. The Contractor shall not bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against, any person or entity other than VA for services provided pursuant to this contract. It shall be considered fraudulent for the Contractor to bill other third party insurance sources (including Medicare) for services rendered to Veteran enrollees under this contract.

6.5. Contractor Security Requirements:

6.5.1. General

6.5.1.1. Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.

6.5.2. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS

6.5.2.1. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order.

6.5.2.2. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures.

6.5.2.3. Contract personnel who require access to national security programs must have a valid security clearance. National Industrial Security Program (NISP) was established by Executive Order 12829 to ensure that cleared U.S. defense industry contract personnel safeguard the classified information in their possession while performing work on contracts, programs, bids, or research and development efforts. The Department of Veterans Affairs does not have a Memorandum of Agreement with Defense Security Service (DSS). Verification of a Security Clearance must be processed through the Special Security Officer located in the Planning and National Security Service within the Office of Operations, Security, and Preparedness.

6.5.2.4. Custom software development and outsourced operations must be located in the U.S. to the maximum extent practical. If such services are proposed to be performed abroad and are not disallowed by other VA policy or mandates, the contractor/subcontractor must state where all non-U.S. services are provided and detail a security plan, deemed to be acceptable by VA, specifically to address mitigation of the resulting problems of communication, control, data protection, and so forth. Location within the U.S. may be an evaluation factor.

6.5.2.5. The contractor or subcontractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor or subcontractor’s employ. The Contracting Officer must also be notified immediately by the contractor or subcontractor prior to an unfriendly termination.

6.5.3. VA INFORMATION CUSTODIAL LANGUAGE

6.5.3.1. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227- 14(d) (1).

6.5.3.2. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor’s information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA’s information is returned to the VA or destroyed in accordance with VA’s sanitization requirements. VA reserves the right to conduct on-site inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements.

6.5.3.3. Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.

6.5.3.4. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract.

6.5.3.5. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of…