RFQ 36C24822Q1676 - Accreditation 8-19-22.pdf

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R410--FY22: Accreditation Readiness Survey VISN 8
Solicitation number
36C24822Q1676
Issued by

About this file

This is a solicitation for accreditation readiness consulting services to support facilities within Veteran Integrated Service Network 8. The solicitation requires the contractor to provide labor, materials, and equipment to conduct mock surveys at each of the eight VISN 8 facilities located in Florida and the Caribbean. The mock surveys will focus on Joint Commission standards and Long Term Care Institute reviews, covering areas such as patient safety goals, life safety, and infection control. The contractor must have experienced surveyors and follow the most recent Joint Commission survey guidelines. Each facility will receive up to four days of on-site consultation. The contractor must submit written reports following each site visit. The base period of performance is one year with four optional one-year extensions. Questions regarding the solicitation are due by August 26, 2022 and quotes are due by September 6, 2022. The contracting officer is located in Tampa, Florida.

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PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TBD

36C24822Q1676 08-19-2022

Kim Tucker (813)816-8275 09-06-2022

3:00 PM EDT

36C248 Department of Veterans Affairs Network Contracting Office 8 (NCO 8)

8875 Hidden River Pkwy Suite 525 Tampa FL 33637

X 100

X

Y

541611

$16.5 Million

N/A

X

Department of Veterans Affairs James A. Haley Veterans Hospital (90C) 13000 Bruce B. Downs Blvd

Tampa FL 33612

36C248

Department of Veterans Affairs Network Contracting Office 8 (NCO 8)

8875 Hidden River Pkwy Tampa FL 33637

Department of Veterans Affairs Financial Services Center

P.O. Box 149971 Austin TX 78714-9971

See CONTINUATION Page

Provide all labor, materials, travel, equipment, etc. to provide Accreditation Readiness Consulting Services for all identified locations in accordance with the Performance of Work Statement (PWS), dated 08/17/2022 and the Pricing Schedule in Section B.2.

Enter pricing in Section B.2 Price Schedule.

Please submit all questions by email to Kim.Tucker1@va.gov no later than Friday, August 26, 2022, at 3:00 PM EST.

Please submit written proposals by email to Kim.Tucker1@va.gov no Later than Tuesday September 6th, 2022, at 3:00 PM EST.

See CONTINUATION Page

TO BE PROVIDED

X X

X 1

Kim Tucker

36C24822Q1676

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 PERFORMANCE WORK STATEMENT (PWS)

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2021)

C.2 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAY 2022) (JUL 2020) (DEVIATION)

C.3 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.4 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ... 54

C.5 52.247-5 FAMILIARIZATION WITH CONDITIONS (APR 1984)

C.6 52.247-21 CONTRACTOR LIABILITY FOR PERSONAL INJURY AND/OR

PROPERTY DAMAGE (APR 1984)

C.7 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.8 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.9 52.219-14 LIMITATIONS ON SUBCONTRACTING (SEP 2021)

C.10 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.11 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.12 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) . 60

C.13 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.14 MANDATORY WRITTEN DISCLOSURES

C.15 WAGE DETERMINATION

C.16 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.2 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2021)

E.3 PROPOSAL PREPARATION

E.4 ADDENDUM to FAR 52.212-2, EVALUATION—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2021)

E.5 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2022) (JUL 2020)

(DEVIATION)

E.6 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (OCT 2019)

E.7 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019)

E.8 52.216-1 TYPE OF CONTRACT (APR 1984)

E.9 52.217-5 EVALUATION OF OPTIONS (JUL 1990)

E.10 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.11 52.247-6 FINANCIAL STATEMENT (APR 1984)

E.12 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C248 Kim Tucker Department of Veterans Affairs Network Contracting Office 8 (NCO 8)

8875 Hidden River Pkwy Suite 525 Tampa FL 33637

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award

Management, or [X] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] MONTHLY

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

1.00 EA __________________ __________________

An Accreditation Readiness (AR) review for Joint Commission (TJC) survey and Long Term Care Institute (LTCI) Review will be conducted at each VISN facility to assist in the continuous readiness for unannounced TJC surveys and LTCI reviews. These visits can occur any time after the previous survey. The AR review process will focus on the National Patient Safety Goals, challenging standards, frequently cited requirements for improvement, survey process, human resource readiness, Life Safety, and system and individual tracer methodology. The LTCI Readiness consultation will be based on transformation of the culture of care and will be based on federal tags (F tags) for determination of severity and scope. Bay Pines VAHCS Accreditation Readiness Consultation.

Contract Period: Base POP Begin: 09-28-2022 - POP End: 09-27-2023 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services PRODUCT/SERVICE CODE: R410 - Support Professional: Program Evaluation/Review/Development

Miami VAHCS Accreditation Readiness Consultation

Contract Period: Base POP Begin: 09-28-2022 - POP End: 09-27-2023 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

West Palm Beach VAMC Accreditation Readiness Consultation -

BASE YEAR

Contract Period: Base POP Begin: 09-28-2022 - POP End: 09-27-2023 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Gainesville VAHCS Accreditation Readiness Consultation

Contract Period: Base POP Begin: 09-28-2022 - POP End: 09-27-2023 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services PRODUCT/SERVICE CODE: R410 - Support - Professional:

Program Evaluation/Review/Development

Lake City VAMC Accreditation Readiness Consultation - BASE

YEAR

Contract Period: Base

POP Begin: 09-28-2022 - POP End: 09-27-2023 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services PRODUCT/SERVICE CODE: R410 - Support Professional: Program

San Juan VAHCS Accreditation Readiness Consultation

Contract Period: Base POP Begin: 09-28-2022 - POP End: 09-27-2023 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Tampa VAMC Accreditation Readiness Consultation

Contract Period: Base POP Begin: 09-28-2022 - POP End: 09-27-2023 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Orlando VAMC Accreditation Readiness Consultation

Contract Period: Base POP Begin: 09-28-2022 - POP End: 09-27-2023 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

An Accreditation Readiness (AR) re-view for Joint Commission (TJC) sur-vey and Long Term Care Institute (LTCI) Review will be conducted at each VISN facility to assist in the continuous readiness for unannounced TJC surveys and LTCI reviews. These visits can occur any time after the previous survey. The AR review process will focus on the National Patient Safety Goals, challenging standards, frequently cited requirements for improvement, survey process, human re-source readiness, Life Safety, and system and individual tracer methodology. The LTCI Readiness consultation will be based on transformation of the culture of care and will be based on federal tags (F tags) for determination of severity and scope. Bay Pines VAHCS Accreditation Readiness Consultation.

Contract Period: Option 1 POP Begin: 09-28-2023 - POP End: 09-27-2024 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 1 POP Begin: 09-28-2023 - POP End: 09-27-2024 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services PRODUCT/SERVICE CODE: R410 - Support Professional: Program

West Palm Beach VAMC Accreditation Readiness Consultation

Contract Period: Option 1 POP Begin: 09-28-2023 - POP End: 09-27-2024 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 1 POP Begin: 09-28-2023 -POP End: 09-27-2024 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Lake City VAMC Accreditation Readiness Consultation

Contract Period: Option 1 POP Begin: 09-28-2023 - POP End: 09-27-2024 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 1 POP Begin: 09-28-2023 - POP End: 09-27-2024 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 1 POP Begin: 09-28-2023 - POP End: 09-27-2024 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 1 POP Begin: 09-28-2023 - POP End: 09-27-2024 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

An Accreditation Readiness (AR) re-view for Joint Commission (TJC) sur-vey and Long Term Care Institute (LTCI) Review will be conducted at each VISN facility to assist in the continuous readiness for unannounced TJC surveys and LTCI reviews. These visits can occur any time after the previous survey. The AR review process will focus on the National Patient Safety Goals, challenging standards, frequently cited requirements for improvement, survey process, human re-source readiness, Life Safety, and system and individual tracer methodology. The LTCI Readiness consultation will be based on transformation of the culture of care and will be based on federal tags (F tags) for determination of severity and scope. Bay Pines VAHCS Accreditation Readiness Consultation.

Contract Period: Option 2 POP Begin: 09-28-2024 - POP End: 09-27-2025 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 2 POP Begin: 09-28-2024 - POP End: 09-27-2025 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 2 POP Begin: 09-28-2024 - POP End: 09-27-2025 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 2 POP Begin: 09-28-2024 - POP End: 09-27-2025 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 2 POP Begin: 09-28-2024 - POP End: 09-27-2025 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 2 POP Begin: 09-28-2024 - POP End: 09-27-2025 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 2 POP Begin: 09-28-2024 - POP End: 09-27-2025 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 2 POP Begin: 09-28-2024 - POP End: 09-27-2025 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services survey and Long Term Care Institute (LTCI) Review will be conducted at each VISN facility to assist in the continuous readiness for unannounced TJC surveys and LTCI reviews. These visits can occur any time after the previous survey. The AR review process will focus on the National Patient Safety Goals, challenging standards, frequently cited requirements for improvement, survey process, human resource readiness, Life Safety, and system and individual tracer methodology. The LTCI Readiness consultation will be based on transformation of the culture of care and will be based on federal tags (F tags) for determination of severity and scope. Bay Pines VAHCS Accreditation Readiness Consultation.

Contract Period: Option 3 POP Begin: 09-28-2025 - POP End: 09-27-2026 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 3 POP Begin: 09-28-2025 - POP End: 09-27-2026 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 3 POP Begin: 09-28-2025 - POP End: 09-27-2026 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 3 POP Begin: 09-28-2025 - POP End: 09-27-2026 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 3 POP Begin: 09-28-2025 - POP End: 09-27-2026 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 3 POP Begin: 09-28-2025 - POP End: 09-27-2026 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 3 POP Begin: 09-28-2025 - POP End: 09-27-2026 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 3 POP Begin: 09-28-2025 - POP End: 09-27-2026 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services sur-vey and Long Term Care Institute (LTCI) Review will be conducted at each VISN facility to assist in the continuous readiness for unannounced

TJC surveys and LTCI reviews. These visits can occur any time after the previous survey. The AR review process will focus on the National Patient Safety Goals, challenging standards, frequently cited requirements for improvement, survey process, human resource readiness, Life Safety, and system and individual tracer method-ology. The LTCI Readiness consultation will be based on transformation of the culture of care and will be based on federal tags (F tags) for de-termination of severity and scope. Bay Pines VAHCS Accreditation Readiness Consultation.

Contract Period: Option 4 POP Begin: 09-28-2026 - POP End: 09-27-2027 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services PRODUCT/SERVICE CODE: R410 - Support Professional: Program

Contract Period: Option 4 POP Begin: 09-28-2026 - POP End: 09-27-2027 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 4 POP Begin: 09-28-2026 - POP End: 09-27-2027 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 4 POP Begin: 09-28-2026 - POP End: 09-27-2027 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 4 POP Begin: 09-28-2026 - POP End: 09-27-2027 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 4 POP Begin: 09-28-2026 - POP End: 09-27-2027 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

PRODUCT/SERVICE CODE: R410 - Support Professional: Program

Contract Period: Option 4 POP Begin: 09-28-2026 - POP End: 09-27-2027 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

Contract Period: Option 4 POP Begin: 09-28-2026 - POP End: 09-27-2027 PRINCIPAL NAICS CODE: 541611 - Administrative Management and General Management Consulting Services

GRAND TOTAL __________________

GRAND TOTAL SUMMARY

OPT YR FY LINS TOTAL AMOUNT

BASE 2022 0001 - 0008

OPT 1 2023 1001 - 1008

OPT 2 2024 2001 -2008

OPT 3 2025 3001 -3008

OPT 4 2026 4001 - 4008

GRAND TOTAL

B.3 PERFORMANCE WORK STATEMENT (PWS)

PERFORMANCE WORK STATEMENT (PWS)

ACCREDITATION READINESS JOINT COMMISSION SURVEY – VISN 8

DATED: 08/17/2022

I. GENERAL

The following terms discuss the requirements of Contractor delivery of Mock Survey Services. A Mock TJC survey and/or Long-Term Care Institute (LTCI) shall be conducted at each VISN 8 facility to assist in the continuous process improvement and readiness efforts. The Mock Survey process shall be conducted in accordance with “The Joint Commission, Survey Activity Guide for Health Care Organizations All Accreditation Programs,” dated January 2021 or most current version. These surveys shall focus on frequently cited standards, problematic standards, the high-risk areas of, but not limited to, sterile compounding, sterile processing, suicide, hemodialysis, environment of care, life safety and any topics pertinent and chosen by the facility. The survey process shall identify important organizational, and systems issues related to safety, quality of care, treatment and services and interfaces between such processes.

Each survey shall be a multi-day survey. Each facility will be allowed 1 consultative visit (up to 4 consecutive days) that will not exceed 12 consultant days per site. Each consultant team for the multi-day surveys shall have 4 consultant surveyors. The combination and expertise of the team will be at the discretion of the facility. Each facility can choose the desired combination of team members to consist of Nurse, physician, and LS/EOC. Each consultant shall have a minimum of three years of surveying experience. Each of the consultants shall have experience, education, and knowledge of infection control processes.

Consultants shall use the most recently published TJC Standards and other appropriate standards for Long Term Care, Ambulatory Care, Behavioral Health, and Home Care.

Each facility shall supply the surveyor with accurate information describing the scope of services provided. The facility shall provide access to those staff members who shall normally be involved in the survey process to allow adequate assessment of standards compliance.

II. OBJECTIVES

a. TJC Standards Compliance including Environment of Care and Life Safety standards.

b. Enhance Continuous Readiness (CR) state.

c. Support concepts of continuous process improvement and High Reliability

d. Enhance staff accreditation survey process knowledge.

e. Increase patient safety.

III. SCOPE

The purpose of this procurement action is to acquire CR services also known as Continuous Readiness standards compliance. The Department of Veterans Affairs (VA) health care facilities have been accredited by TJC for over 35 years. The accreditation process is a complex system of related and interdependent activities which enable the

VA to maintain a constant state of regulatory readiness and maintain a safe health care environment. These services shall support VISN 8 (See Attachment A) facilities to enable a CR program to achieve and continue compliance with TJC standards including but not limited to compliance with TJC Program, Environment of Care, Life Safety, and/or Emergency Management standards.

IV. PERFORMANCE PERIOD

Period of Performance is 1 Base Year plus 4 Option Years

V. LOCATIONS: See Attachment A

VI. DEFINITIONS:

• Contractor: A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

• Contracting Officer: A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government.

Note: The only individual who can legally bind the government.

• Contracting Officer's Representative (COR): An employee of the U.S. Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications.

This individual does NOT have authority to change the terms and conditions of the contract.

• Defective Service: A service output that does not meet the standard of performance associated with the Performance Work Statement.

• Deliverable: Anything that can be physically delivered but may include non-manufactured things such as meeting minutes or reports.

• Physical Security: Actions that prevent the loss or damage of Government property.

• Quality Assurance: The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

• Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

• Quality Control: All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

VII. ACRONYMS:

• CO - Contracting Officer

• COR - Contracting Officer Representative

• FAR - Federal Acquisition Regulation

• HIPAA - Health Insurance Portability and Accountability Act of 1996

• LTCI – Long Term Care Institute

• POC - Point of Contact

• PWS - Performance Work Statement

• QA - Quality Assurance

• QAP - Quality Assurance Plan

• QASP - Quality Assurance Surveillance Plan

• QC - Quality Control

• QCP - Quality Control Program

• TJC - The Joint Commission

• VA - Department Of Veterans Affairs

• VHA - Veterans Health Administration

• VISN - Veteran Integrated Service Network

VIII. CONSULTANT QUALIFICATIONS

a. The Contractor and their Consultants shall possess knowledge of TJC standards and VHA regulations which apply to accreditation bodies.

b. Each Consultant team shall have four consultant surveyors for each Mock Survey.

c. Each Consultant shall have experience, education, and knowledge of infection control processes.

d. Each Consultant shall have a minimum of three years of surveying experience.

e. Consultants shall use the most recently published TJC standards and other appropriate standards for Long Term g. Care, Ambulatory Care, Behavioral Health, and Home Care.

f. Each consulting team shall consist of comparable team credentials as a TJC team to include a combination at the discretion of the facility that can include physician consultant(s), a nurse consultant(s) and/or an administrative/life safety consultant(s).

g. The consultants shall possess the appropriate qualifications of surveyor and consultant experience to include RN, MD, or Admin/life Safety Specialist with previous experience serving as TJC surveyors/consultants and credentials for conducting the surveys. They shall have surveyor/consultant experience and be knowledgeable of the unique challenges faced by VA Medical Centers. Consultant expertise in LTCI, Hospital, Behavioral Health, Home Care, Life Safety and Ambulatory Care is required. Previous VA experience is preferred. The expectation is that the same contractor shall survey all VISN facilities. No substitution in surveyors will be permitted without first consulting with the VA contracting officer. If contractor performance is less than satisfactory, the VA reserves the right to request a substitute contractor at no additional cost to the VA.

IX. SPECIFIC MANDATORY TASKS AND ASSOCIATED DELIVERABLES

a. Surveys shall be conducted in accordance with “The Joint Commission, Survey

Activity Guide for Health Care Organizations All Accreditation Programs,” dated January 2021, or the most current version.

b. Each Mock Survey shall consist of a multi-day survey as specified by each ordering facility.

c. Each facility can choose the desired combination of team members to consist of nurse, physician, and LS.

d. Dates of the surveys shall be as directed by each facility.

e. The facility surveys shall be coordinated with the designated point of contact at each site.

f. The survey schedule for each facility and changes shall be provided to the COR in advance.

g. Each facility shall supply the surveyor with accurate information describing the scope of services provided by the facility.

h. The surveyor shall inform facility’s designated point of contact of the activity they will be conducting each day.

i. The facility shall provide access to those staff members who shall normally be involved in the survey process to allow adequate assessment of standards compliance.

j. Each survey shall include an opening conference, patient tracer and/or system tracer activities, leadership conference, and exit briefing.

k. For multi-day surveys, 30 minutes shall be scheduled towards the end of each day (except the last) for surveyors to conduct either Special Issue Resolution or engage in surveyor planning or team meeting activity.

l. For multi-day surveys, the surveyor will schedule a daily kick-off meeting with organization participants which shall be scheduled for a 30-minute period, where the surveyor shall summarize the events of the previous day and communicate observations according to the standards or areas that may or may not lead to findings.

m. After each facility survey is completed, the surveyor shall schedule an exit conference with the Facility Director and other leadership staff to discuss findings and trends.

n. Each survey shall include a survey report preparation session lasting 60-120 minutes in a conference room supplied by the facility, which will include a conference table, power outlets, telephone, and internet access.

o. Each survey shall include an Exit Brief lasting 10-15 minutes to discuss the survey findings report.

p. The Government will provide Joint Commission Standards policies and results of previous survey reports.

q. The Contractor shall submit a written report by TJC standard and/or LTCI within fifteen (15) working days after each site visit. The report shall cite the specific standard of noncompliance, a narrative assessment of noncompliance and specific recommendations for compliance. Any findings that may result in a finding of noncompliance must be clearly identified in the report, along with a recommendation on how best to resolve it. Findings of noncompliance and partial compliance shall be identified in the report. The report shall be submitted in an electronic format in Microsoft Word simultaneously to the Medical Center Director, and the surveyed VISN Quality Management Officer team.

r. The contractor shall provide an aggregated VISN wide written report for VISN Leadership at the time of the VISN summation session. The summary report shall include facility findings, recommendations by facility, general strengths and weaknesses by facility, trends across the VISN and general and site-specific recommendations.

s. The Contractor shall conduct survey business at each facility between the hours of 7:00AM and 5:00PM Monday thru Friday, except federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government-directed facility closings.

All employees of the Contractor shall not be considered VA employees. Survey Team members working on VA property shall be subject to the same rules and regulations as all contracted employees.

The Contractor must maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the above reasons. Prior to reporting to work, the Survey Team Lead shall contact the facility’s designated point of contact to arrange an escort to the on-site badging department. VA Staff will issue a temporary ID badge to the contracted Survey Team, who will properly display the badge while working onsite. Upon completion of the assignment, the designated Survey Team employees will return the badges. The VA reserves the right to refuse any Survey Team member access to the VA property for any or no reason.

The Contractor shall not release, publish, or disclose sensitive information to unauthorized personnel, and shall protect such information in accordance with provisions of 18 U.S.C. 641 (Criminal Code; Public Money, Property or Records) and any other pertinent laws and regulations governing the confidentiality of sensitive information.

X. CONFLICT OF INTEREST

A conflict of interest is defined as the existence of financial or other relationship between the Contractor, (including any of the employees, agents, subcontractors, or representatives) and a party involved under this contract. The Contractor shall promptly notify the presiding official whenever there is a potential or actual conflict of interest between the Contractor and such party. If a potential or actual conflict of interest is reported by the Contractor, the CO reserves the right to have the have the Contractor supply another qualified candidate from their agency to serve as a backup or fill-in replacement surveyor and the Contractor shall bear the full cost of replacing the contracted representative.

XI. QUALITY ASSURANCE SURVEILLANCE PLAN

Determining Performance

Government shall use the monitoring methods cited below to determine whether the performance standards/service levels/AQLs have been met. If the contractor has not met the minimum requirements, it may be asked to develop a corrective action plan to show how and by what date it intends to bring performance up to the required levels.

Reporting

At the end of the survey the Designated Point of Contact will prepare a written report for the VISN COR and CO summarizing the overall results of the quality assurance surveillance of the contractor’s performance. This written report, which includes the contractor’s final exit brief and will become part of the QA documentation. This will enable the VA to demonstrate whether the contractor is meeting the stated objectives and/or performance standards including cost/technical/scheduling objectives.

Reviews and Resolution

The VISN COR may require the contractor’s project manager, or a designated alternate, to meet with the VISN COR and Designated Point of Contact to discuss performance evaluation for the Contractor, due to the length of each survey. The Contractor performance evaluation will then be provided to the Contracting Officer for inclusion in the CO file.

Contract Oversight

The VISN COR (subject to CO approval), will be responsible for verifying contract compliance. The VISN COR will designate appropriate VA personnel to assist in monitoring services rendered through one or a combination of the following mechanisms:

a. Facilities Designated Point of Contacts will monitor Contractor Performance to ensure that services ordered have been rendered in a timely manner. Any incidents of Contractor noncompliance as evidenced by the monitoring procedures will be forwarded to the VISN COR and administering CO for performance evaluation consideration.

b. Facility Designated Point of Contacts shall provide a written statement at the completion of each survey to the VISN COR to include a summary of contractor actions and a statement that all requirements of the contract have been fulfilled as agreed. This summary evaluation will be submitted within 10 days of the completion of a facility survey.

c. Documentation of services performed will be reviewed prior to certifying payment. VISN COR contract monitoring, and recordkeeping procedures will be sufficient to ensure proper payment and allow audit verification that services were provided.

XII. Performance Standards

The chart below outlines performance objective, standards, quality levels, and surveillance methods that serve as a basic rubric for Contractor Performance evaluation under this contract. Confirmation of these delinquent performances will be made known to the Contractor immediately upon discovery.

Required Services

(Tasks) Performance Standards Acceptable

Quality Levels Method of Surveillance

Surveyor Arrival

Receive correspondence from Surveyor about arrival time

100%

Conducted by the VISN COR or Facility Designated Point of Contact

Surveyor survey Requested from Surveyor about the survey requested

Point of Contact

Surveyor Agenda about the Surveyors intended agenda for the survey

Point of Contact

Basic needs assessment

Review of hospital policies/procedures, staff training, performance improvement activities/goals, discussion with department heads, building maintenance program, or any area of weakness identified

Observed by Facility Designated Point of Contact

Conduct a building tour

Tour will include visits to patient care settings and other areas likely to be visited by the TJC

Conducted by Facility

Informal on-site educational sessions as needed during scheduled survey dates

Address shortcomings identified during the document review or building tour

As needed

Visual inspection of Surveyor conducting survey with intended service, department, or organization

Observance

Required Services (Tasks)

Performance Standards Acceptable Quality Levels

Method of Surveillance

Conducting of Opening Conference

Attendance of Opening Conference

Attendance by the Facility Designated Point of Contact

Contractor receipt of VA visitor access badge

Visit HR to receive Survey Team visitor access badges

Conducted by the COR or Facility Designated Point of Contact

Daily Briefing Daily brief will be conducted with designated attendees and the brief will last 15- 30 minutes

100% Facility Designated Point of Contact will be in attendance of all Daily Briefs

Sessions held with Program specific leadership

Conduct briefs/findings briefs with Program specific leadership

100% Attended by Facility Designated Point of Contact

Leadership Exit Brief

Conduct Leadership Exit Brief, attended by designated attendees and the brief will last 15- 30 minutes

Attended by Facility Designated Point of Contact and Appointed attendees

Organization Exit Conference

Conduct Organization Exit Conference, brief will last 60 minutes and allow time for question, comments, or concerns

Attendance required by Facility Leadership, Facility Designated Point of Contact and Appointed attendees

Receive final report

Upon completion of the Organization Exit Brief, the surveyor will provide the Facility Leadership, Designated Point of Contact and all attendees a copy of the Exit Brief

VISN COR will receive copy of final report/s to place in COR contract file and provide file/s to the Contracting Officer for inclusion in the CO file.

XIII. SECURITY REQUIREMENTS

a. The contractor, their personnel, and their subcontractors shall be subject to the Federal laws, regulations, standards, and VA Directives and Handbooks regarding information and information system security as delineated in this contract. The position sensitivity for this effort has been designated as LOW.

b. A National Business Associate Agreement (BAA) is required for this contract when awarded.

Attachment A

VA Sunshine Healthcare Network Facility Locations

North Florida / South Georgia VA Healthcare System Lake City VAMC 619 S Marion Ave Lake City, FL 32025

(386) 755-3016

(800) 308-8387

Malcom Randall VAMC 1601 SW Archer Rd Gainesville, FL 32608

(352) 376-1611

(800) 324-8387

The Villages OPC 8900 SE 165th Mulberry Ln The Villages, FL 32162

(352) 674-5000

Jacksonville OPC 1536 N Jefferson St Jacksonville, FL 32209

(904) 475-5800

(877) 870-5048

Ocala CBOC 1515 E Silver Springs Blvd Ocala, FL 34470

(352) 369-3320

Jacksonville 2 VA Clinic 3901 University Blvd S Jacksonville, FL 32216

(904) 732-6300

Ocala West (Specialty) 3307 SW 26th Ave Ocala, FL 34471

(352) 861-3940

Jacksonville Southpoint VA Clinic 6900 Southpoint Dr N.

Jacksonville, FL 32216

(904) 470-6900

Sergeant Ernest I. “Boots” Thomas Clinic 2181 E Orange Ave Tallahassee, FL 32311

(850) 878-0191

(800) 541-8387

Leo C. Chase Jr. CBOC 100 Deerfield Preserve Blvd St Augustine, FL 32086

(904) 829-0814

(866) 401-8387

Marianna CBOC 4970 Highway 90 Marianna, FL 32446

(850) 718-5620

Palatka CBOC 400 N State Rd 19 Palatka, FL 32177

(386) 329-8800

Valdosta CBOC 348 Enterprise Dr, Ste B Valdosta, GA 31601

(229) 293-0132

(877) 303-838

Perry VA Clinic 1224 N Peacock Ave Perry, FL 32347

(850) 223-8387

Waycross CBOC 515B City Blvd Waycross, GA 31501

(912) 279-4400

Middleburg CBOC 400 College Dr.

Middleburg, FL 32068

(904) 213-2700

St. Marys CBOC 2603 Osbourne Rd Ste E St. Marys, GA 31558

(912) 510-3420

Jacksonville Navy VAMC 280 Child Street, Bldg 200H Jacksonville, FL 32214

(904) 542-7300

Tampa VA Healthcare System West Palm Beach VA Healthcare System

Tampa VAMC 13000 Bruce B Downs Blvd Tampa, FL 33612

(813) 972-2000

West Palm Beach VAMC 7305 N Military Trail West Palm, FL 33410

(561) 422-8262

(800) 972-8262

Brooksville CBOC 14540 Cortez Blvd, Ste 108 Brooksville, FL 34613

(352) 597-8287

Vero Beach CBOC 372 17th St Vero Beach, FL 32960

(772) 299-4623

Zephyrhills CBOC 6937 Medical View Lane Zephyrhills, Florida 33542

(813) 780-2550

Fort Pierce CBOC 1901 S 25th St, Ste 103 Fort Pierce, FL 34947

(772) 595-5150

New Port Richey OPC 9912 Little Road New Port Richey, FL 34654

(727) 869-4100

Port St. Lucie VA Specialty Clinic 126 SW Chamber Court Port St. Lucie, FL 34986

PTSD (772) 878-7876

Expanding (722) 344-9288

Lakeland CBOC 4237 South Pipkin Rd Lakeland, FL 33811

(863) 701-2470

Stuart CBOC 3501 SE Willoughby Blvd Stuart, FL 34997

(772) 288-0304

Primary Care Annex 1315 Lake Terrace Lane Tampa, FL 33637

(813) 998-8000

Okeechobee CBOC 1201 N Parrot Ave Okeechobee, FL 34972

(863) 824-3232

Lecanto CBOC 2804 W. Marc Knighton Court, Ste A Lecanto, FL 34461

(352) 746-8000

Delray Beach CBOC 800 Linton Blvd, Ste 300 Delray Beach, FL 33445

(561) 495-1973

South Hillsborough CBOC 12920 Summerfield Crossing Blvd Riverview, FL 33579

(813) 998-8600

Boca Raton CBOC 901 Meadows Rd Boca Raton, FL 33433

(561) 416-8995

Bay Pines Healthcare System Miami Healthcare System

C.W. Bill Young VAMC 10000 Bay Pines Blvd Bay Pines, FL 33744

(727) 398-6661

(888) 820-0230

Bruce W Carter VAMC 1201 NW 16th St Miami, FL 33125

(305) 575-7000;

(888) 276-1785

Palm Harbor CBOC 35209 US Hwy 19 N Palm Harbor, FL 34684

(727) 734-5276

Deerfield Beach CBOC 2100 SW 10th St Deerfield Beach, FL 33442

(954) 570-5572

St Petersburg CBOC 840 Dr MLK Jr St N St. Petersburg, FL 33705

(727) 502-1700

William ‘Bill’ Kling VA Clinic 9800 W Commercial Blvd Sunrise City, FL 33351

(954) 475-5500

Bradenton CBOC Pembroke Pines CBOC

5520 State Rd 64, #101 Bradenton, FL 34208

(941) 721-0649

7369 Sheridan St, Ste 102 Hollywood, FL 33024

(954) 894-1668

Sarasota CBOC 5682 Bee Ridge Rd, #100 Sarasota, FL 34233

(941) 371-3349

Hollywood CBOC 3702 Washington St, Ste 201 Hollywood, FL 33021

(954) 986-1811

Sebring CBOC 5901 US Highway 27 S Sebring, FL 33870

(863) 471-6227

Healthcare for Homeless Veterans 1492 W Flagler St, Ste 102 Miami, FL 33135

(305) 541-5864

Port Charlotte CBOC 4161 Tamiami Trail, Unit 4 Port Charlotte, FL 33952

(941) 235-2710

Homestead CBOC 950 Krome Ave, Ste 401 Homestead, FL 33030

(305) 248-0874

Lee County HCS 2489 Diplomat Pkwy E Cape Coral, FL 33909

(239) 652-1800

Key Largo CBOC 105662 Overseas Highway Key Largo, FL 33037

(305) 451-0164

Naples CBOC 800 Goodlette Rd N, #120 Naples, FL 34101

(239) 659-9188

Key West OPC 1300 Douglas Circle Bldg L-15 Key West, FL 33040

(305) 293-4863

VA Caribbean Healthcare System San Juan VAMC 10 Casia Street San Juan, PR 00921

(787) 641-7582;

(800) 449-8729

Ceiba CBOC PR-3, Km. 54.9 Lot #3 Pueblo Ward, Ceiba, PR 00735

(800) 449-6303 Ext 2901

Mayaguez VA Clinic 175 Algarrobo Ave Mayaguez, PR 00682

(787) 834-6900

Comerio VA Rural Clinic 15 De Diego Street Comerio, PR 00782

(787) 522-2660

Arecibo CBOC Road PR-1Q, Puerto Rico Arecibo, PR 00612

(787) 816-1818

Guayama CBOC FISA Bldg Paseo Del Pueblo St.

Guayama, PR 00784

(787) 866-8755

St. Thomas CBOC Medical Foundation Bldg, Ste 101 St Thomas, VI 00802

(340) 774-6674

Ponce OPC Paseo Del Veterano #1010 Ponce, PR 00716-2001

(787) 787-812-3030

St. Croix CBOC Box 12, RR-02 The Village Mall #113 Kings Hill, VI 00850-4701

(340) 778-5553

Utuado Rural Clinic Isaac Gonzalez St Esquina Ledesma Utuado, PR 00641

(787) 522-2650

Vieques Rural Clinic Centro Salud Familiar, Susana Centen Co. Destino Carretera #997 Vieques, PR 00766

(340) 693-8900

Orlando VA Healthcare System Orlando VAMC 13800 Veterans Way Orlando, FL 32827

(407) 631-1000

Lake Baldwin VAMC 5201 Raymond St Orlando, FL 32803

(407) 646-5500

Tavares CBOC 1390 E Burleigh Blvd Tavares, FL 32778

(352) 253-2900

Viera CBOC 2900 Veterans Way Viera, FL 32940

(321) 637-3788

Daytona Beach MSCBOC 551 National Health Care Dr Daytona Beach, FL 32114

(386) 323-7500

Kissimmee CBOC 701 Union St Kissimmee, FL 34741

(407) 518-5004

Deltona CBOC 1200 Deltona Blvd, Ste 41-47 Deltona, FL 32725

(386) 575-5000

Palm Bay CBOC 5200 Babcock St NE Ste 101 Palm Bay, FL 32905

(321) 728-8300

Clermont CBOC 805 Oakley Seaver Dr Clermont, FL 34711

(352) 536-8200

PRIVACY – CLAUSE WITH SENSITIVE DATA

VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY LANGUAGE

ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEM

a. 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.

b. 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.

c. 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.

d. 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.

Contractor Personnel Security Requirements:

All contractor employees who require access to the Department of Veterans Affairs’ computer systems shall be the subject of a background investigation and must receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to contract performance. This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed prior to the start date of the contract the contractor will be responsible for the actions of those individuals that provide or perform work for the VA.

1. Position Sensitivity – The position sensitivity has been designated as ( low ) risk.

2. Background Investigation – The level of background investigation commensurate with the required level of access is National Agency Check (NACI) with written inquiries.

3. Contractor Responsibilities

a. The contractor shall bear the expense of obtaining background investigations. If the investigation is conducted by the Office of Personnel Management (OPM), the contractor shall reimburse the VA within 30 days.

The web site which provides information on the cost of the security investigation is:

www.opm.gov\extra\investigate – Select Federal Investigations Notices (FIN 01-01)

b. The contractor shall prescreen all personnel requiring access to the computer systems to ensure they maintain a U.S. citizenship and are able to read, write, speak, and http://www.opm.gov/extra/investigate understand the English language.

c. The contractor will provide to the Contracting Officer prior to award the following: (1) List of names of contract personnel. (2) Social security numbers of contractor personnel. (3) Home address of contractor personnel or the contractor address.

The Contracting Officer will submit the above information to the Office of Security and Law Enforcement, Washington, D.C. The Office of Security and Law Enforcement will provide the necessary investigative forms (these forms are indicated in paragraph 3.d. below) to the contractor’s personnel, coordinate the background investigations with OPM and notify the Contracting Officer and contractor of the results of the investigation.

d. The contractor shall submit or have their employees submit the following required forms to the VA Office of Security and Law Enforcement within 30 days of receipt:

(i) Standard From 85P, Questionnaire for Public Trust Positions

(ii) Standard Form 85P-S, Supplemental Questionnaire for Selected Positions

(iii) FD 258, U.S. Department of Justice Fingerprint Applicant Chart

(iv) VA Form 0710, Authority for Release of Information Form

(v) Optional Form 306, Declaration for Federal Employment

(vi) Optional Form 612, Optional Application for Federal Employment

e. The contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract.

f. Failure to comply with the contractor personnel security requirements may result in termination of the contract for default.

VA INFORMATION CUSTODIAL LANGUAGE

a. 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).

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

c. 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.

d. The…

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