PWS_Physical Therapist FY24-DRAFT.pdf

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified Physical Therapy Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Northern California Health Care System, CA.

1.2. Place(s) of Performance – Services will initially be provided at the following locations within VA Northern California Health Care System:

Full-time (1.0) Physical Therapist: Fairfield VA OPC

Full-time (1.0) Physical Therapist: McClellan VA OPC

Full-time (1.0) Physical Therapist: Martinez VA OPC

1.2.1. Location of services required will vary as positions become vacant or are filled with permanent employees. The Contractor may be required to provide services at any of the following locations within VA Northern California Health Care System:

Auburn VA OPC, 11985 Heritage Oak Pl, Auburn, CA 95603 Chico VA OPC, 1601 Concord Avenue, Chico, CA 95928 Fairfield VA OPC, 103 Bodin Circle, Fairfield, CA 94535 Martinez VA OPC, 150 Muir Road, Martinez, CA 94553 McClellan VA OPC, 5342 Dudley Boulevard, McClellan Park, CA 95652 Mare Island VA OPC, 201 Walnut Avenue, Mare Island, CA 94592 Modesto VA OPC, 1225 Oakdale Road, Modesto, CA 95355 Napa County VA, 650 Imperial Way, Napa, CA 94559 Redding VA OPC, 3455 Knighton Road, Redding, CA 96002 Sacramento VA Medical Center, 10535 Hospital Way, Sacramento, CA 95655 Sonora VA OPC, 13663 Mono Way, Sonora, CA 95370 Stockton VA OPC, 7777 Freedom Road, French Camp, CA 95231 Yreka VA OPC, 101 E. Oberlin Road, Yreka, CA 96907 Yuba City VA OPC, 425 Plumas Street, Yuba City, CA 95991

1.2.2. The CO shall notify the Contractor in writing, no less than 60 calendar days prior to the date services are required at the new location. The contract will be modified to reflect approved changes. The Contractor shall provide Board Certified Physical Therapy Services at the new site by the date required.

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

1.4. Policy/Handbooks:

1.4.1. VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

1.4.2. 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

1.4.3. VHA Handbook 1100.17: National Practitioner Data Bank Reports -http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.4. VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards -http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347 https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.5. VHA Handbook 1100.19 Credentialing and Privileging -

http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.4.6. VHA Handbook 1907.01 Health Information Management and Health Records:

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

1.4.7. 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. APTA: American Physical Therapy Association, http://www.apta.org/

1.5.2. ACLS: Advanced Cardiac Life Support

1.5.3. BLS: Basic Life Support

1.5.4. CDC: Centers for Disease Control and Prevention

1.5.5. CDR: Contract Discrepancy Report

1.5.6. CEU: Certified Education Unit

1.5.7. CME: Continuing Medical Education

1.5.8. CMS: Centers for Medicare and Medicaid Services

1.5.9. 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.

1.5.10. 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.

1.5.11. CPARS: Contractor Performance Assessment Reporting System

1.5.12. CPRS: Computerized Patient Record System- electronic health record system used by the VA.

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

1.5.14. DEA: Drug Enforcement Agency

1.5.15. ED: Emergency Department

1.5.16. FSMB: Federation of State Medical Boards

1.5.17. Full Time Equivalent (FTE): VA’s definition for full time employees 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.

1.5.18. HHS: Department of Health and Human Services

1.5.19. HIPAA: Health Insurance Portability and Accountability Act

1.5.20. HR: Human Resources

1.5.21. ISO: Information Security Officer

1.5.22. 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.

1.5.23. MOD: Medical Officer of the Day

1.5.24. 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 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.apta.org/ transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.25. Non-Contract Provider: Any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.5.26. POP: Period of Performance

1.5.27. PPD: Purified Protein Derivative

1.5.28. PWS: Performance Work Statement

1.5.29. 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.

1.5.30. QASP: Quality Assurance Surveillance Plan

1.5.31. 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.

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

1.5.33. 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.

1.5.34. VetPro: A federal web-based credentialing program for healthcare providers.

1.5.35. VA: Unless identified with the name of a different VA medical facility, for purposes of this contract, this term shall mean the Northern California Health Care System Outpatient Clinic in Martinez.

2. QUALIFICATIONS:

2.1. Staff/Facility:

2.1.1. License: Contract Physical Therapist(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contract Physical Therapist(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification: All contract Physical Therapist(s) shall be board certified by the National Board of Physical Therapy Specialties, http://www.abpts.org/ , and be currently certified in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification must be kept up to date at all times.

Documentation verifying current certification shall be provided by the Contractor to the VA COR.

2.1.3. 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 http://www.abpts.org/ ensure that proposed Physical Therapist(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract Physical Therapist(s) prior to obtaining approval by the Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.3.1. If a contract Physical Therapist(s) is not credentialed and privileged or has their credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.4. Technical Proficiency: Contract Physical Therapist(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documentation, 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 experience, including any gaps in educational history for all contract Physical Therapist(s). Contract Physical Therapist(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.1. EXPERIENCE: The Physical Therapist must have a minimum of one year of inpatient rehabilitation experience for inpatient rehabilitation. The Physical Therapist must have a minimum of one year of experience in outpatient PT setting.

2.1.2. Continuing Medical Education (CME)/Certified Education Unit (CEU) Requirements:

Contractor shall provide the COR copies of current CMEs as required or requested by the VA.

Contract Physical Therapist(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide this information shall result in loss of privileges for contract Physical Therapist(s).

2.1.3. Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contract Physical Therapist(s) as required by the VA.

(1) VA Privacy & Information Security Awareness & Rules of Behavior (TMS) – 1.5 hrs.

(2) Privacy & HIPAA Focused Training (TMS) – 1.5 hrs.

(3) CPRS (TMS) – 2.0 hrs.

2.1.4. Standard Personnel Testing (PPD, etc.): Contractor shall provide the CO and COR with proof of the following tests for all Physical Therapist(s) who will be performing services under the contract. Such information shall be provided within five (5) calendar days after contract award and prior to the first duty shift. Tests shall be current within the past year.

2.1.4.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract Physical Therapist(s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

2.1.4.2. RUBELLA TESTING: Contractor shall provide proof of immunization for all contract Physical Therapist(s) 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.

2.1.4.3. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contract Physical Therapist(s); provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan;

maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VA shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guidelines for Infection Control in health care personnel (as published in the American Journal for Infection Control (AJIC) 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.4.4. INFLUENZA VACCINATION TBD

2.1.4.5. COVID VACCINATION TBD

2.1.5. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The VHA must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.1.6. DEA (as required): Contractor shall provide copy of current DEA certificate in California where services will be provided under this contract.

2.1.7. Conflict of Interest: The Contractor and all contract Physical Therapist(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of 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 Section D of the solicitation document.

2.1.8. Citizenship related Requirements:

2.1.8.1. 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 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.

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

2.1.8.3. 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.

2.1.8.4. 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.

2.1.8.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFQ using the subject attachment of the solicitation document.

2.1.9. 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.

2.1.9.1. 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 Physical Therapist(s) is 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.

2.1.9.2. 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.

2.1.10. Clinical/Professional Direction: The qualifications of Contractor personnel are subject to review by the VA Chief, Physical Therapy or his/her clinical designee. Clinical/Professional direction of all clinical personnel covered by this contract will be provided by the VA Chief, Physical Therapy and/or his/her 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.

2.1.11. Non Personal Healthcare Services: The parties agree that the Contractor and all contract Physical Therapist(s) shall not be considered VA employees for any purpose.

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

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

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

Workers’ compensation Professional liability insurance Health examinations Income tax withholding, and Social security payments.

2.3. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract Physical Therapist(s).

When a Contractor or contract Physical Therapist(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract Physical Therapist(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.4. Key Personnel:

2.4.1. The VA Full Time Equivalency (FTE) for the services required is 2080 hours = 1.0 VA FTE. FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.4.2. The number of Board Certified Physical Therapists required to be on site on a daily basis is 3.0

FTE as defined in paragraph 3, Hours of Operation in this section.

2.5. 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.

2.5.1. 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.

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

2.5.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the COR; VA Chief, Physical Therapy or designee show documented clinical problems or continual unprofessional behavior/actions with any contract Physical Therapist(s), s/he may request, without cause, immediate replacement of said contract Physical Therapist(s).

2.5.4. The CO and COR shall deal with issues raised concerning Contract Physical Therapist(s)’ conduct.

The final arbiter on questions of acceptability is the CO.

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

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: Physical Therapy Clinic operates from 8:00am – 4:30pm, Monday through

Friday, excluding federal holidays.

3.2. Work Schedule: The Contract Physical Therapist(s) shall perform services Monday through Friday, from 8:00 am to 4:30 pm for a total of 40 hours per week. A 30-minute lunch break will be provided.

3.2.1. Contractor shall notify the COR about any obstacles to meeting this performance measure.

3.2.2. Contract Physical Therapist shall be available and present in clinic during normal clinic hours as indicated above. The VA NCHCS Physical Therapy Clinic will be established, and may be revised, as deemed appropriate for patient care by the Chief, Physical Therapy.

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

New Year’s Day Presidents Day Martin Luther King Junior Day Memorial Day Juneteenth 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.

3.4. Cancellations:

3.4.1. Unless a state of emergency has been declared and the VA Physical Therapy Clinic is closed, the Contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES:

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

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

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

4.3.1. American Physical Therapy Association, INC.: http://www.apta.org/policies/practice.aspx

4.3.2. 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

4.3.3. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

4.3.4. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

4.3.5. The requirements contained in this PWS.

4.4. Medical Records

4.4.1. Authorities: Contract Physical Therapist(s) 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).

4.4.2. 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.

4.4.3. Disclosure: Contract Physical Therapist(s) 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 http://www.aaos.org/research/guidelines/guide.asp https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.jointcommission.org/standards_information/standards.aspx http://www.hpoe.org/resources?show=100&type=8 http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www.rms.oit.va.gov/SOR_Records/24VA19.asp 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.

4.4.4. 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 VAMC.

4.4.5. 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:

PRIVACY OFFICER

103 BODIN CIRCLE

TRAVIS AFB, CA 94535

(707) 437-1823

4.5. Performance Standards, Quality Assurance (QA) and Quality Improvement (QI)

4.5.1. Performance Standards: Contract Physical Therapist(s) shall be responsible for providing care, including, but not limited to:

4.5.1.1. Direct Patient Care: 80% of the time involved in direct patient care.

4.5.1.1.1. Review patient medical records to assess for appropriateness of PT intervention, noting any potential risks or contraindications to treatment and to assist in guiding the evaluation process.

4.5.1.1.2. Perform comprehensive evaluations with using standard and nonstandard methods for evaluating complex patients with an emphasis on assessing a patient’s medical status.

Document independent evaluations and results according to departmental and medical center standards.

4.5.1.1.3. Evaluate to address rehabilitation potential, behavior, motor skills and psychosocial at an age-appropriate level. Identify barriers to learning. Develop and implement strategies to overcome them to ensure accurate patient evaluation.

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=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 http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf

4.5.1.1.4. Independently develop appropriate treatment plans and goals with emphasis on subacute and long term medical rehabilitation; performs a full range of PT treatment procedures, modifying the treatment according to the patient’s response to PT intervention.

4.5.1.1.5. Recognize adverse reactions to treatment and initiates effective action immediately.

4.5.1.1.6. Modify treatment plan according to patient response to best meet established goals.

Documents progression and/or modifications according to Departmental and Medical Center Standards.

4.5.1.1.7. Discuss patient performance in PT, current status, and continuing goals regularly with physicians and other team members. Work effectively with treatment team members and other health care providers in coordinating the patient’s total care.

4.5.1.1.8. Ensure appropriate patient referrals and discharge planning in concert with the Physical Therapy and Medical Center staff.

4.5.1.1.9. Measure, fit and instruct patients for the use of complex adaptive equipment and assistive devices. Justify medical need for all adaptive equipment and assistive device requests.

4.5.1.1.10. Practice all infection control and safety standards.

4.5.1.2. Administrative: 20% of time not involved in direct patient care.

4.5.1.2.1. Maintain and submit productivity and other required reports in a timely manner.

4.5.1.2.2. Assumes responsibility (under the direction of the Chief of Physical Therapy) for program development and refinements within specialty area of subacute-care and long term rehabilitation. This is to include the development of subacute-care and long term-care guidelines and protocols.

4.5.1.2.3. Interdisciplinary Team Meetings: The contract Physical Therapist(s) shall participate in continuous interdisciplinary team activities and meetings with committee participation as required by the VA Chief, Physical Therapy, or designee.

4.5.1.2.4. Staff Meetings: The contract Physical Therapist(s) shall attend staff meetings as required by the VA Chief, Physical Therapy, or designee. Physical Medicine & Rehabilitation Service All Staff Conference Call: Meets every month on the 2nd Tuesday of the month for 30 minutes.

4.5.1.2.5. QA/QI documentation: The contract Physical Therapist(s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations. Completion of required clinical and medical record documentation, including the use of computerized patient record system, where applicable. Document all evaluations and recommendations in electronic patient record; writing notes and/or orders. Note types may include pre-op notes, progress notes (detailing urgent management), admission history & physical, transfer notes, death notes, restraint notes, and procedure notes.

4.5.1.2.6. Patient Safety Compliance and Reporting: Contract Physical Therapist(s) shall follow all established patient safety and infection control standards of care. Contract Physical Therapist(s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breaches of patient safety shall be reported immediately using the ePER (Electronic Patient Event Reporting) system as required under VANCHCS Policy 00Q-20. At the time of submission of the ePER, the contract Physical Therapist(s) shall forward a copy to the VA Chief, Physical Therapy or designee. The contract Physical Therapist shall follow-up with VA as required or requested.

4.6. Quality Management/Quality Assurance Surveillance: Contract Physical Therapist(s) shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. 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.

4.7. The contract Physical Therapist(s) 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:

Infection Control Hospital Safety Outpatient Qualitative and Quantitative Review Medical Record Review Drug Usage Internal Peer Review Patient Incident Utilization

4.7.1. 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.

4.7.2. 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. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

5. GOVERNMENT RESPONSIBILITIES:

5.1. VA Support Personnel, Services or Equipment

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

5.1.2. CO Responsibilities:

5.1.2.1. 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.

5.1.2.2. 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.

5.1.2.3. 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.

5.1.3. COR Responsibilities:

5.1.3.1. 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.

5.1.3.2. The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled.

5.1.3.3. The COR will maintain a record-keeping system of services by electronic and paper systems.

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.

5.1.3.4. 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.

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

6. SPECIAL CONTRACT REQUIREMENTS:

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

6.2. 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 proposal 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 proposal and upon renewal of licenses and upon renewal of option periods or change of key personnel.

Contracting Officer

Certification that staff list have been compared to OIG list

Upon proposal and upon new hires. Contracting Officer

Proof of Indemnification and Medical Liability Insurance

Upon proposal 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.

Contracting Officer

ACLS/BLS Certification Upon award and every two years after award.

COR

Contingency plan Upon proposal and as updated COR

7. BILLING:

7.1. Invoice requirements: Invoices must be submitted no later than the 20th workday of the month following the month where services were performed. 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(s) of Service Contract Physical Therapist(s) (Name of Contractor’s employee) Hourly Rate Quantity of Hours Worked Daily Per Diem Total Price Copy of signed timecard

7.2. 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:

7.2.1. VA’s Electronic Invoice Presentment and Payment System – The Financial Services Center (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.

7.2.2. 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).

7.2.3. The Contractor 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

7.3. Payment Adjustments/Performance Related Payment Deductions:

7.3.1. Invoices will be prorated for partial days/hours worked. The contractor shall be paid only for actual work performed onsite. Contractor personnel shall be responsible for reporting time worked accurately. The Contractor shall be paid only for actual hours performed. The Government may adjust payments by 15 minute increments for non-full hours worked.

7.3.2. The contract shall be adjusted at the end of the period of performance (base or option year) in accordance with actual performance.

7.3.3. Acceptable Quality Level: Failure of Contract Physical Therapist(s) to meet the Acceptable Quality Level on any performance measure will be cause for removal from contract until such time the contract Physical Therapist(s) meets qualification standard. If unable to meet qualification standard, the contract will be terminated.

7.3.4. 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.

7.3.5. 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.

7.3.6. 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.

8. INFORMATION SECURITY AND MANDATORY TRAINING:

http://ob10.com/us/en/veterans-affairs-us/ http://www.x12.org/

8.1 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

8.2 Access to VA Information and VA Information Systems:

8.2.1 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.

8.2.2 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.

8.2.3 The contractor or subcontractor must notify the CO immediately when an…