PWS Neuromonitoring Technicians.doc
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- Q523--San Francisco - Neuromonitoring
- Solicitation number
- 36C26122Q0508
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GENERAL:
Services Provided: The Contractor shall provide an Intraoperative Monitoring Specialist (IOM) under Surgical Service to perform Intraoperative Neurophysiologic Monitoring and Evoked Potential services in the Operating Room at 4150 Clement Street, San Francisco, California 94121 (SFVAMC) on an as needed basis. The Contractor (IOM) shall provide a range of services in accordance with the terms and conditions contained herein.
CPT
Code
Description
95940
Intraoperative Neuromonitoring 92585 Auditory evoked potentials (Auditor evoke potent compre) 95860 EMG, one extremity (muscle test 1 limb) 95861 EMG, two extremities (muscle test 2 limbs) 95863 EMG, three extremities (muscle test 3 limbs) 95864 EMG four extremities (muscle test 4 limbs) 95867 EMG, Cranial nerve supplied muscles, unilateral (muscle test cran nerv unilat) 95868 EMG, Cranial nerve supplied muscles, bilateral (muscle test cran nerv bilat) 95870 EMG, one extremity (limited study) (muscle test nonparaspinal) 95904 Nerve Conduction Study- Sensory 95900 Nerve Conduction Study- Motor 95830 Visual evoked potentials (insert electrodees for eeg) 95933 Orbicularis oculi blink reflex (blink reflex test) 95925 Somatosensory evoke potentials, upper 95926 Somatosensory evoke potentials, lower 95938 Somatosensory evoke potentials, upper and lower (somatosensory testing) 95939 Transcranial elicited motor evoked potentials, upper and lower (C motor evloked upr&lwr limbs) 95955 Electroencephalography (EEG during surgery) 95961 Funtional cortical/subcortical mapping (electrode stimulation brain) 95829 Electrocorticogram during surgery
Place of Performance - Primary: San Francisco VA, 4150 Clement Street, CA 94121;
Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority.
Policy/Handbooks:
| VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347 |
| 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
| VHA Handbook 1100.17: National Practitioner Data Bank Reports - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 | |
| VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards – http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 | |
| VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 | |
| VHA Handbook 1907.01 Health Information Management and Health Records: http://www.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=3025 | |
| Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm | |
| 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. | |
| CDC: Centers for Disease Control and Prevention |
CDR: Contract Discrepancy Report
CEU: Certified Education Unit
CMS: Centers for Medicare and Medicaid Services
| Contracting Officer (CO) – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings. |
| Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken. |
| COS: Chief of Staff |
CPARS: Contractor Performance Assessment Reporting System
| CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA. |
| 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. |
| DEA: Drug Enforcement Agency |
ED: Emergency Department
| Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included. |
| HHS: Department of Health and Human Services |
HIPAA: Health Insurance Portability and Accountability Act
HR: Human Resources
ISO: Information Security Officer
| Medical Emergency: a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part. |
| National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). |
| Non-Contract Provider: any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors |
| NPPES: National Plan and Provider Enumeration System |
POP: Period of Performance
PWS: Performance Work Statement
| 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 determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility- specific and provider-specific. |
| QASP: Quality Assurance Surveillance Plan |
| 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. |
| Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers. |
| 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. |
| VetPro: A federal web-based credentialing program for healthcare providers. |
| Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA Medical Center, for purposes of this contract, this term shall mean the San Francisco VA Medical Center, 4150 Clement Street, SF, CA 94121 |
| VANCHCS: Veterans Affairs Northern California Health Care System. |
QUALIFICATIONS:
Staff
| - The IOM contractor must possess one or more attributes from each of the following areas: |
| Education: |
| Doctorate degree (Ph.D.) in a relevant life science or biological field (including but not limited to fields such as physiology, biology, zoology, anatomy, neuroscience) |
| Master’s degree in Audiology from a college accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology (CCA-ASHA) |
| Doctorate degree in Audiology (Au. D.) from a college accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology (CCA-ASHA) |
| Doctorate degree in Medicine (M.D.) from an accredited college approved by the Liaison Committee on Medical Education and Hospitals of the American Medical Association |
| Doctorate degree in Osteopathy (D.O.) from a college accredited by the American Osteopathic Association |
Certification (Specialty/Subspecialty):
| Certified in Neurophysiological Intraoperative Monitoring (CNIM) |
| Diplomate of the American Board of Neurophysiologic Monitoring (DABNM). |
| Subspecialty in Clinical Neurophysiology, American Board of Psychiatry and Neurology (ABPN) |
| Special Competency in Intraoperative Neuromonitoring, American Board of Clinical Neurophysiology (ABCN) |
| Diplomate in Neurophysiology, EMG and evoked potentials, American Board of Electrodiagnostic Medicine (ABEM) |
| Certificate of Clinical Competence in Audiology,American Speech-Language-Hearing Association (CCC-A ASHA) |
Licensure
| If M.D. or D.O., must have current, valid, unrestricted License to practice Medicine, State of California |
| If Au.D., must have current, valid, unrestricted license to practice Audiology, State of California |
IOM contractors 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.
| Credentialing and Privileging – Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed IOM Technicians possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract IOM Technicians prior to obtaining approval by the San Francisco VA Medical Center Chief, Neurosurgery. | |
| If a contract IOM Technician is 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. | |
| Technical Proficiency - Contract IOM Technicians 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 contract IOM Technicians and shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior. | |
| Training: Complete annual mandatory VA Privacy and Information Security Awareness training online via the Talent Management System (TMS). | |
| Remedial Training: When notified, contract employees must complete remedial training and education to address any detected compliance exceptions. | |
| Proof of Training: Contract employees are responsible for submitting proof of awareness and remedial training completed to the Contracting Officer’s Technical Representative (COR) for this contract. The COR will retain proof of training in accordance with applicable Records Control Schedule. | |
| Information Security and Privacy Training. |
| All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems: | |
| Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E of VA Handbook 6500.6 relating to access to VA information and information systems; | |
| Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training; | |
| Successfully complete the appropriate VA privacy training and annually complete required privacy training; and | |
| The contractor shall provide to the contracting officer and/or the COR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required. | |
| Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, are grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete. | |
| Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for IOM Technicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year. | |
| TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract IOM Technicians. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually. | |
| RUBELLA TESTING: Contractor shall provide proof of immunization for all contract IOM Technicians for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR. | |
| National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration 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 Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the quote. | |
| Conflict of Interest: The Contractor and all contract IOM Technicians are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of quote and during the entirety of contract performance. At the time of quote, 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 (Jan 2008) and fully outlined in response to the subject attachment in solicitation document. | |
| Citizenship related Requirements: |
| The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals; | |
| While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national 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. | |
| If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach. | |
| This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001. | |
| The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFQ using the subject attachment in the solicitation document. | |
| 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. | |
| 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 IOM Technicians 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.
| By submitting their quote, 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 was signed. |
| Contracted IOM Technicians shall provide a copy of current DEA certificate to the COR/CO if requested. |
| 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 will be provided by the VAMC 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. |
| Non Personnel Healthcare Services: The parties agree that the Contractor and all contract IOM Technicians shall not be considered VA employees for any purpose. |
| Inherent Government Functions: Contractor and Contract IOM Technicians 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. |
| No Employee status: The Contractor shall be responsible for protecting Contract IOM Technicians 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: |
| Workers’ compensation |
Professional liability insurance
Health examinations
Income tax withholding, and
| Social security payments. |
| Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract IOM Technicians. When a Contractor or contract IOM Technicians 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 IOM Technicians action or non-action shall be the responsibility of the Contractor and/or insurance carrier. |
| Personnel: |
| Contract personnel shall be available Monday through Friday, excluding national holidays, to provide scheduled procedures. Hours of daily operations are normally 7 am to 7:30 pm however additional hours may be required to complete a case. |
| The number of IOM Technicians required to be on site on a daily basis is variable depending on the cases performed. |
| Emergency Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of 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. |
| 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 personnel. |
| For temporary substitutions where the person shall not be reporting to work for three (3) consecutive work days or more, the Contractor shall provide a qualified replacement for the person. The substitute shall have comparable qualifications to the person. Any period exceeding two weeks will require the procedure as stated above. |
| 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 IOM Technicians s/he may request, without cause, immediate replacement of said contract IOM Technicians. |
| The CO and COR shall deal with issues raised concerning Contract IOM Technicians conduct. The final arbiter on questions of acceptability is the CO. |
| Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the contract IOM Technicians leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract. |
VA Hours of Operation/SCHEDULING:
VA Business Hours: Hours of daily operations in the VA OR are normally 7 am to 7:30 pm, excluding national holidays.
Work Schedule: Contract personnel shall be available as needed Monday through Friday, excluding national holidays, to provide scheduled procedures. Hours of daily operations are normally 7 am to 7:30 pm however additional hours may be required to complete a case.
Patients must be seen by a contract IOM technician on-site at San Francisco VA, 4150 Clement Street, CA 94121 at the beginning of a scheduled case (7:45AM every day except Wed which is 9:15AM). Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.
Federal Holidays: The following holidays are observed by the Department of Veterans Affairs: New Year’s Day
President’s Day
Martin Luther King’s Birthday Memorial Day Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Christmas Any day specifically declared by the President of the United States to be a national holiday.
Unless a state of emergency has been declared, the Contractor shall be responsible for providing services.
CONTRACTOR RESPONSIBILITIES
Clinical Personnel Required: The Contractor shall provide contract IOM Technicians who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.
| Contract IOM Technicians 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. |
| Standards of Care: The contract IOM Technicians’ 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 TJC, VA and national standards as established by: |
| VA Standards: 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 |
| The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx |
| The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and; |
| The requirements contained in this PWS |
Patient Safety- Patient safety incidents occurring while contractor is on service will be reported to SFVA Chief Surgery within 24 hours, along with a completed complication form as indicated.
Medical Records
Authorities: Contract IOM Technicians 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).
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.
Disclosure: Contract IOM Technicians 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.
| 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 VAMC. |
| 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: Shannon Caston, 103 Bodin Circle, Travis AFB, CA 94535, (707) 437-1823, Shannon.Caston@va.gov |
| Direct Patient Care: |
Knowledge required by the IOM:
| Knowledge of scientific rationale in coordination of the patient care. |
| Promotes quality patient care by coordinating and evaluating the care of selected patients in collaboration with multidisciplinary and interdepartmental personnel. |
| Knowledge of Universal Precautions. |
| Knowledge of safety and environment of care procedures. |
Knowledge and expertise in the following areas of service:
| Auditory Brainstem Response (ABR) |
| Visual Evoked Response (VER) |
| Somatosensory Evoked Potential (SEP or SSEP) |
| Electroencephalography (EEG) |
Electromyography (EMG)
| Nerve Conduction Studies |
| Knowledge of the Axon bio-med computer, Eclypse Model (or similar type of machine), that will be used to provide services. |
| IOM must maintain up-to-date knowledge of developments in the field Intraoperative Neurophysiologic Monitoring and Evoked Potentials. |
Complies with the following VA Operating Room regulations:
Surgical Conscience
Complies and sets up equipment and supplies utilizing recommended practices and aseptic technique.
Maintains integrity of all sterile areas.
| Arrives in a timely manner when scheduled for a case (OR Start Time: 7:45AM every day except Wed which is 9:15AM) so as not to delay the surgical process. |
| Documents completed procedures and places in the patient’s chart prior to leaving the hospital. |
| The IOM specialist independently sets up and provides Intraoperative Neurophysiologic Monitoring and Evoked Potentials services for patients. |
| Effective member of patient care team, e.g., participates in patient care activities, telephone usage, communicates effectively with surgical staff. |
PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI)
| Quality Management/Quality Assurance Surveillance: Contractor IOM Technicians 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. |
| The contractor’s IOM Technicians are expected to actively participate in the facility’s performance improvement activities as part of the contracted service time. Performance Improvement Activities may include the following: |
GOVERNMENT RESPONSIBILITIES
VA Support Personnel, Services or Equipment
Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to:
Contracting Officer – TBD after contract award
Contracting Officer Responsibilities:
The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract.
| The Contracting Officer shall resolve complaints concerning Contractor relations with the Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof. |
| In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for Contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract. |
COR Responsibilities:
The COR for this contract is: TBD after contract award
| The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer. |
| The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected. |
| The COR will maintain a record-keeping system of services by keeping and maintaining monthly a Running Balance Excel spreadsheet of services rendered and invoices paid. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the Contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer. |
| The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference. |
| All contract administration functions will be retained by the VA. |
SPECIAL CONTRACT REQUIREMENTS
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.
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 item.
What Submit as noted Submit To Quality Control Plan: Description and reporting reflecting the contractor’s plan for meeting of contract requirements and performance standards Upon quote and as frequently as indicated in the performance standards.
Contracting Officer Copies of any and all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff Upon quote and upon renewal of licenses or change of personnel.
Contracting Officer Certification that staff list have been compared to OIG list Upon quote and upon new hires.
Contracting Officer Proof of Identification and Medical Liability Insurance Upon quote and upon renewals.
Contracting Officer Certificates of Completion for Cyber Security and Patient Privacy Training Courses Before receiving an account on VA Network and annual training and new hires.
COR
ACLS/BLS Certification Upon award
COR
Contingency plan Upon quote and as updated
COR
ORG Chart Upon quote and upon new hires.
Contracting Officer Remote Management Plan: Description reflecting the contractor’s plan for meeting of contract requirements if management/staff is located more than 30 miles away from the San Francisco VA Medical Center.
Upon quote Contracting Officer Coverage Plan: Description reflecting the contractor’s plan for meeting of coverage requirements if monitoring staff is located more than 30 miles away from the San Francisco VA Medical Center.
Upon quote
Emergency or After Hours Coverage Plan: Description reflecting the contractor’s plan for meeting of emergency or after hours coverage requirements if monitoring staff is located more than 30 miles away from the San Francisco VA Medical Center.
Upon quote
Billing:
| 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: |
| Name and Address of Contractor |
Invoice Date and Invoice Number
Contract Number and Purchase/Task Order Number
Date of Service
Contract IOM Technicians (Name of Contractor’s employees)
Rate
Quantity of hours/cases worked
Total price
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:
| VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, OB10, to transition vendors from paper to electronic invoice submission. Please go to this website: http://ob10.com/us/en/veterans-affairs-us/ to begin submitting electronic invoices, free of charge. |
| A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI). |
The X12 EDI Web site (http://www.x12.org).
| The Contract may contact FSC at the phone number or email address listed below with any questions about the e-invoicing program or OB10: |
| OB10 e-Invoice Setup Information: 1-877-489-6135 |
OB10 e-Invoice email: VA.Registration@ob10.com
FSC e-Invoice Contact Information: 1-877-353-9791
FSC e-invoice email: vafsccshd@va.gov
Payment Adjustments/Performance Related Payment Deductions:
| Invoices will be prorated for partial days/hours worked. The contractor shall be paid only for actual work performed onsite. In the event that the Contract employee works a portion of an hour, the government may adjust payments by 15 minute increments. Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed. | |
| The contract shall be adjusted at the end of the period of performance (base or option year) in accordance with actual performance. | |
| Performance Deductions: If the contractor fails to meet the Acceptable Quality Level on any performance measure that references a deduction as a disincentive, the following method for calculating and applying the deduction shall be employed: | |
| The COR will prepare a contract discrepancy report and will notify the CO in the event the contractor failed to meet the AQL established for any performance measure. The CO will provide the contractor with the CDR and documentation (as appropriate) supporting the performance level of the contractor and the government’s intent to apply the deduction in the following manner: 25% reduction of monthly invoice in accordance with section (reference contract page and paragraph) under the Performance Measures. The 25% reduction shall be applied to the next invoice billed. The contractor has thirty (30) days to respond if the contractor wishes to provide evidence that the AQL was met or to assert that the government’s action or inaction prevented the Contractor from reaching performance at the AQL. The Contracting Officer shall make the final determination regarding the deduction after reviewing the contractor’s response. | |
| 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. | |
| 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. | |
| 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.
Per 6500.6 Appendix C.
General
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.
Access to VA Information and VA Information Systems
| 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. |
| 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. |
| 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. |
| VA Information Custodial Language |
| 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). |
| 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. |
| 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. |
| Security Incident Investigation |
| The term “security incident” means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor/subcontractor shall immediately notify the COTR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor/subcontractor has access. |
| To the extent known by the contractor/subcontractor, the contractor/subcontractor’s notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the contractor/subcontractor considers relevant. |
| With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement. |
| In instances of theft or break-in or other criminal activity, the contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor, its employees, and its subcontractors and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident |
.5. Liquidated Damages for Data Breach
| Consistent with the requirements of 38 U.S.C. §5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any SPI the contractor/ subcontractor processes or maintains under this contract. However, it is the policy of the VA to forgo collection of liquidated damages in the event the contractor provides payment of actual damages in the amount determined to be adequate by the agency. |
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