S02 - 36C246-21-Q-0544 - Medical Transitional Homeless Veterans Housing.pdf

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

RFQ

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

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

TELEPHONE NO. DUNS: DUNS+4:

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. 2/2012)

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

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 117

36C24621Q0544 05/27/2021

Warren O'Bryant, Administrative C.O. 757-728-7083 06/11/2021 4:00pm EDST

36C246

Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

X

623110

$30.0 Million

N/A

14. METHOD OF SOLICITATIONX

RFP IFB

Department of Veterans Affairs Salisbury VA Medical Center 1601 Brenner Ave

Salisbury NC 28144

Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

727-507-3649 046070827

Shall Be Submitted Electronically To:

Department of Veterans Affairs Financial Services Center

PO BOX 149971

Austin TX 78714-9971

See CONTINUATION Page

Contractor to provide Off-Site Medical Transitional Homeless Veterans Housing (Respite Convalescent Care) service in two (2) separate facility locations in the Salisbury area in accordance with the Performance Work Statement (PWS).

See B.2: For the Schedule of Services Information

Base Period of Performance: 10/01/2021 through 09/30/2022

See CONTINUATION Page

X X x 1

Mario L. Santiago Contracting Officer

X

36C246-21-Q-0544

Table of Contents

SECTION A

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

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SERVICES

B.3 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.252-2 CLAUSES INCORPORATED BY REFENCE (FEB 1998)

C.2 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR

INFORMATION SYSTEM (JUN 2016)

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDERING LIMITATIONS (OCT 1995)

C.5 52.216-21 REQUIRMENTS (OCT 1995)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.8 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.9 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.10 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING

AND COMPLIANCE (JUL 2018)

C.11 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY

INSURANCE (OCT 2019)

C.12 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO

IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS

(JAN 2021)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 QUALITY ASSURANCE SURVIELLANCE PLAN (QASP)

D.2 CONTRACTOR CERTIFICATION: Immigration and Nationality Act of 1952, As Amended

D.3 CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT .. 86

D.4 WAGE DETERMINATION

D.5 PAST PEFORMANCE SURVEY

SECTION E - SOLICITATION PROVISIONS

E.1 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

E.2 SPECIFIC INSTRUCTIONS TO OFFERORS REGARDING REQUEST FOR

QUOTE (RFQ) PREPARATIONS AND SUBMISSION

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT

2018)

E.4 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003) 96

E.5 52.216-1 TYPE OF CONTRACT (APR 1984)

E.6 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.7 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (FEB 2021)

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: Name: __________________________ / Title: __________________ email: __________________________ / Phone: ___________________

b. GOVERNMENT: Mario L Santiago Warren O’Bryant Contracting Officer Administrative Contracting Officer 757-251-4254 757-728-70836 mario.santiago@va.gov warren.o’bryant@va.gov Department of Veterans Affairs Department of Veterans Affairs 100 Emancipation Drive 100 Emancipation Drive Hampton VA 23667 Hampton, VA 23667

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

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly in Arrears

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. Shall be submitted Electronically To:

Department of Veterans Affairs Financial Services Center

PO BOX 149971

Austin TX 78714-9971

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

AMENDMENT NO DATE

mailto:mario.santiago@va.gov mailto:warren.obryant@va.gov

B.2 SCHEDULE OF SERVICES

The Government intends to make multiple awards under a firm fixed price (FFP) requirements contract for services specified effective for the periods stated in the Schedule of Services. All quantities are estimates only. The guaranteed minimum quantity of bed services the Government will acquire under this contract for the Base and Option Periods is four (4) one-year periods for each contract year.

Contractor shall provide at two (2) separate locations: Off-Site Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and care for medically fragile Veterans from the community and contractors staff to include: Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to beneficiaries of W.G. ‘Bill’ Hefner Salisbury VAMC, Salisbury, NC.

Note: The Salisbury VAMC will not be responsible for paying for beds not occupied by a Veteran.

NOTE: All vendors responding to this solicitation know this solicitation is for two (2) separate locations identified by Line Item: 0001, 0002, 1001, 1002, 2001, 2002, 3001, 3002, 4001 and 4002 in providing the service being requested.

Period of Performance: BASE PERIOD: 10/01/2021 through 09/30/2022

LINE

ITEM

Description Est. Qty. Unit of

Issu e

Unit Cost Total Annual Cost

0001 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within the Salisbury community or within a 50 miles radius of the Salisbury VA.

(365 days

* 6 beds)

EA /

Per Day

0002 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within a 25-miles radius of the Community Based Outpatient Clinics (CBOC) and/or Health Care Centers

(HCC)

(365 days

* 6 beds)

EA /

TOTAL COST FOR BASE YEAR

TOTAL COST FOR BASE YEAR: $___________________

Option Year 1: Period of Performance: 10/01/2022 through 09/30/2023

Description Qty. Unit Unit Cost Total Annual Cost

1001 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within the Salisbury

* 6 beds)

EA /

1002 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within a 25-miles radius of the Community Based Outpatient Clinics (CBOC) and/or Health Care Centers

(HCC)

(365 days

* 6 beds)

EA /

TOTAL COST FOR OPTION YEAR 1

TOTAL COST FOR OPTION YEAR 1: $___________________

Option Year 2: Period of Performance: 10/01/2023 through 09/30/2024

Description Est. Qty. Unit of

Issue

Unit Cost Total Annual Cost

2001 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within the Salisbury community or within a 50 miles radius of the Salisbury VA.

(365 days

* 6 beds)

EA /

2002 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within a 25-miles radius of the Community Based Outpatient Clinics (CBOC) and/or Health Care Centers

(HCC)

(365 days

* 6 beds)

EA /

TOTAL COST FOR OPTION YEAR 2

TOTAL COST FOR OPTION YEAR 2: $___________________

Option Year 3: Period of Performance: 10/01/2024 through 09/30/2025

Description Est. Qty. Unit of

Issu e

Unit Cost Total Annual Cost

3001 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within the Salisbury

* 6 beds)

EA /

3002 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within a 25-miles radius of the Community Based Outpatient Clinics (CBOC) and/or Health Care Centers

(HCC)

(365 days

* 6 beds)

EA /

TOTAL COST FOR OPTION YEAR 3

TOTAL COST FOR OPTION YEAR 3: $___________________

Option Year-4: Period of Performance: 10/01/2025 through 09/30/2026

Description Est. Qty. Unit of

Issu e

Unit Cost Total Annual Cost

4001 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within the Salisbury

* 6 beds)

EA /

4002 Off-Site: Medical Transitional Homeless Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, Peer Support Specialist) to include housing, meals, transportation, medical monitoring, Activities of Daily Living and Case Management Assistance).

Located within a 25-miles radius of the Community Based Outpatient Clinics (CBOC) and/or Health Care Centers

(HCC)

(365 days

* 6 beds)

EA /

TOTAL COST FOR OPTION YEAR 4

TOTAL COST FOR OPTION YEAR 4: $___________________

TOTAL COST FOR BASE YEAR AND ALL OPTION YEARS: $ _______________________

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Contractor shall furnish Off-Site: Medical Transitional Homeless

Veterans Housing (Respite Convalescent Program Assistance) and medically fragile care for Veterans from the community to include: Nurse Practitioner, Registered Nurses (RN’s, CNA, LPN’s, LCSW’s, LCSWA’s, LCMHC, Peer Support Specialist) to beneficiaries of W.G. “Bill” Hefner Salisbury VAMC, Salisbury, NC, in accordance with the terms and conditions stated herein. The Contractor shall provide these services in accordance with all applicable Federal, state, and local regulations, laws and ordinances and in accordance with their performance work statement. The contract facility will be located within the Salisbury community or within a 50 miles radius of the Salisbury VA and/or a 25-mile radius of the Community Based Outpatient Clinics (CBOC) and/or Health Care Centers (HCC). The contract facility must have a current occupancy permit or license required by the authority having jurisdiction.

1.2. The Contractor shall provide Temporary Residential Shelter to include but not limited to beds, restroom, bath, kitchen facilities, and related furnishings. Adequate security measures in accordance with VA standards and in conformance with state and local safety and health codes as outlined in 38 CFR, Section 17.53. Contractors shall provide food for three (3) nutritionally adequate meals daily and snacks daily to each shelter resident, as well as personal hygiene items, first aid supplies and storage, as needed.

The Contract facility must have a current occupancy permit or license required by the State of North Carolina having jurisdiction.

1.3. Authority: Title 38 USC 8153 Sharing of Health-Care Resources and VAAR Part 873 in combination with FAR Parts 15.

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

1.4.1. VA Directive 1663: Health Care Resources Contracting - Buying https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.4.2. VHA Directive 1003 “VHA Customer Service Programs and Veterans’ Health Care

Service Standards” https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=7475.5

1.4.3. VHA Directive 1192 “Seasonal Influenza Prevention Program” https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep

1.4.4. VHA Handbook 1100.17: National Practitioner Data Bank Reports – https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.5. VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards – https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.6. VHA Handbook 1100.19 Credentialing and Privileging –

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

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

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088 https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID= https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

1.4.8. VHA Directive 2012-030 Credentialing of Health Care Professionals – https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2815

1.4.9. 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. Acceptable Quality Level (AQL): he AQL is the maximum percent defective that, for purposes of sampling inspections can be considered satisfactory.

1.5.2. Activities of Daily Living (ADL’s): Activities of daily living are routine activities people do every day without assistance. There are six basic ADLs: eating, bathing, getting dressed, toileting, transferring and continence.

1.5.3. ACLS: Advanced Cardiac Life Support

1.5.4. BLS: Basic Life Support

1.5.5. Contracting Officer (CO): The person executing this contract on behalf of the

Government with the authority to enter and administer contracts and make related determinations and findings.

1.5.6. 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 for appropriate action to be taken.

1.5.7. COS: Chief of Staff

1.5.8. CPARS: Contractor Performance Assessment Reporting System

1.5.9. Customer Complaint: A means of documenting certain kinds of contract service problems. A government program that is explained to every organization that receives service under this contract, which is used to evaluate contractor’s performance

1.5.10. Defective Service: A service output that does not meet the standard of performance associated with it in the Performance Requirements Summary (PRS).

1.5.11. HHS: Department of Health and Human Services

1.5.12. HIPAA: Health Insurance Portability and Accountability Act

1.5.13. ISO: Information Security Officer

1.5.14. Instrumental Activities of Daily Living (IADL’s): Instrumental ADLs (IADLs) are things involved in independent daily life at home and in the community including activities such as: housework, money management, meal preparation, shopping, and employment.

1.5.15. The Joint Commission (TJC): An independent, not-for-profit organization. The Joint Commission accredits and certifies more than 18,000 health care organizations and programs in the United States. The Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.

https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2815 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5.16. McKinney-Vento Act Definition of Homelessness: It is the responsibility of the VA HCHV program to determine homeless status of program applicants. The HCHV Program follows the definition of “homeless” as authorized in 38 U.S.C.

2002(1) and The McKinney-Vento Homeless Assistance Act, as amended by S.

896 The Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009. Note: See http://www.hudhre.info/hearth/

1.5.17. MD: Medical Director.

1.5.18. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (Health Care Practitioners) and organizational entities (Medical Centers).

1.5.19. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org.

1.5.20. Non-personal services contract: a contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees.

1.5.21. PWS: Performance Work Statement.

1.5.22. QA/QI: Quality Assurance/Quality Improvement

1.5.23. QASP: Quality Assurance Surveillance Plan

1.5.24. QM/PI: Quality Management/Performance Improvement.

1.5.25. Quality Control – Those actions taken by a contractor to control the performance of services so that they meet the requirements of the PWS

1.5.26. Quality Improvement (QI) – The ongoing process of responding to data gathered through quality monitoring efforts, to improve the quality of health care delivered to individuals. This process involves follow-up studies of the measures taken to effect change in order to demonstrate that the desired change has occurred.

The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (Health Care Practitioners) and organizational entities (Medical Centers).

1.5.27. RN: Registered Nurse

1.5.28. 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.

1.5.29. Veterans Integrated Services Network (VISN): The regional oversight for the VA Medical Centers.

1.5.30. 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.

1.5.31. VA Video Connect (VVC): Allows Veterans and their caregivers to easily meet with VA Health Care providers through live video on any computer, tablet or mobile device with an internet connection.

1.5.32. VetPro: a Federal web-based credentialing program for healthcare providers.

1.5.33. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA Medical Center, for purposes of this contract, this term shall mean the Salisbury VAMC.

http://www.nlnac.org/

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: The Registered Nurses (RN’s, CNA, LPN) assigned by the Contractor to perform the services covered by this contract shall be licensed as a Registered Nurse (RN) in the State of North Carolina. The license must be active, current and unrestricted by the North Carolina Board of Nursing.

2.1.2. Board Certification: All Contractor’s Registered Nurses (RN’s, CNA’s and LPN’s) shall be Certified in accordance with the National League for Nursing Accrediting Commission. www.nlnac.org. LCSW, LCSWA, LCMHC, LCMHCA shall be certified in accordance with the North Carolina Social Work Licensure Board and North Carolina Board of Licensed Clinical Mental Health Counselors. MSW shall have a degree from school that is accredited by the Council on Social Work Education. LCHMC and LCHMCA must have received a master’s degree from a regionally accredited institution of higher education in accordance with the North Carolina Board of Licensed Clinical Mental Health Counselors.

2.1.3. Technical Proficiency - Contractor’s Registered Nurses (RN’s) shall be technically proficient in the skills necessary to fulfill the government’s requirements including:

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

2.1.4. Continuing Medical Education (CME)/ Certified Education Unit (CEU)

Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractor’s Registered Nurses (RN’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 credentialing office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for the Contractor’s Registered Nurses (RN’s, LPN’s, CNA’s, LCSW, LCMHC and non-licensed staff).

Training (The following training is mandatory per VHACO for Contract staff)

Frequency (once a year, etc.) Annual Hours

Active Threat Training Every 1 Year 1 Hour Government Ethics Every 1 Year 1 Hour Prevention of Workplace Harassment/No Fear Act

Every 1 Year 1 Hour

VA Core Values Training (ICARE Recommitment)

Every 1 Year 1 Hour

VA Privacy and Information Security Awareness and Rules of Behavior

Every 1 Year 1 Hour

Privacy and HIPAA Training Every 1 Year 1 Hour AHA ACLS/BLS Every 2 Years 3 to 8 Hours Cultural Competency Suicide Prevention: Suicide Risk Management Training for Clinicians

Every 1 Year 1 Hour

Infections Control Policy and Procedures

Every 1 year 30 Minutes

Contractor Rules of Behavior Every 1 year 30 Minutes OPIOID Training Initial Onboarding 30 Minutes Fire and Safety Training Every 1 year 1 Hour

CBI (VA Compliance Business and Integrity Training)

Every 1 Year 1 Hour

Emergency Preparedness/Disaster Policy and Procedures

Every 1 year 30 Minutes

List other Training per local facility

Courses to be assigned in TMS as required.

Various

Contractor shall provide to the COR a copy of the training certificates for each applicable employee within one (1) week of the initiation of the contract and annually thereafter, as required. The online courses listed above are located at the following website:

https://www.tms.va.gov/plateau/user/login.jsp.

Detail instructions on account setup will be provided to the successful offeror upon contract award. Failure to complete the mandatory trainings listed above within the timeframe required shall be grounds for suspension or termination of all physical and/or electronic access privileges and removal from work on the contract until such time as the training is completed.

2.1.5. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for all contractor personnel within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer.

Tests shall be current within the past year.

2.1.5.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all health care workers. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

2.1.5.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor Health Care staff.

https://www.tms.va.gov/plateau/user/login.jsp

2.1.5.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor Health Care staff

2.1.5.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of the Tdap vaccination for all Contractor Health Care staff.

2.1.5.5. INFLUENZA: Contractors shall provide proof that all Contractor Health Care staff have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine, they (all health care workers) shall be required to wear a mask during the Influenza season.

2.1.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s Registered Nurses (RN’s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.6.1. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998;

26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.7. Conflict of Interest: The Contractor and all Contractor’s professional staff are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of Quotes and during the entirety of contract performance. At the time of Quotes, 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.

2.1.7.1. The Contractor must also provide relevant facts that show how the 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.

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

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 that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals.

2.1.8.2. 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 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 RFP using the subject attachment in Section D 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.

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

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

2.1.11. Non-Personal Healthcare Services: The parties agree that the Contractor and all

Contractor’s Registered Nurses (RN’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, MSW’s, LCMHC, LCMHCA) shall not be considered VA employees for any purpose.

2.1.12. Indemnification: As per VAAR 852-228-71, (a) The contractor expressly agrees to indemnify and save the Government, its officers, agents, servants, and employees harmless from and against any and all claims, loss, damage, injury, and liability, however caused, resulting from, arising out of, or in any way connected with the performance of work under this contract. Further, it is agreed that any negligence or alleged negligence of the Government, its officers, agents, servants, and employees, shall not be a bar to a claim for indemnification unless the act or omission of the Government, its officers, agents, servants, and employees is the sole, competent, and producing cause of such claims, loss, damage, injury, and liability. At the option of the contractor, and subject to the approval by the contracting officer, insurance coverage may be employed as guaranty of indemnification.

2.1.13. Prohibition Against Self-Referral: Contractor’s Nurse Practitioner’s, Registered Nurse’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, LCMHC and LCMHCA’s are prohibited from referring VA patients to contractor’s or their own practice(s).

2.1.14. Inherent Government Functions: Contractor and Contractor’s Registered Nurses

(RN’s, Nurse Practitioner’s, Registered Nurse’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, LCMHC’s and LCMHCA’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.

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

2.1.15. No Employee Status: The Contractor shall be responsible for protecting Contractor’s Nurse Practitioner’s, Registered Nurse’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, LCMHC’s, and LCMHCA’s who are furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.1.15.1. Workers’ compensation

2.1.15.2. Professional liability insurance

2.1.15.3. Health examinations

2.1.15.4 Income tax withholding, and

2.1.15.5. Social security payments.

2.1.16. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract

Contractor’s Nurse Practitioner’s, Registered Nurse’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, LCMHC’s and LCMHCA’s. When a Contractor or Contractor’s Nurse Practitioner’s, Registered Nurse’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, LCMHC’s and LCMHCA’s have 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 Nurse Practitioner’s, Registered Nurse’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, LCMHC’s and LCMHCA’s action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.1.17. Key Personnel: In the residential treatment facility there must be, at a minimum a licensed Nursing staff (NP, RN, LPN, CNA) ‘on call’ for consult 24 hours a day, 7 days a week. A licensed RN staff member should be employed by the facility to provide oversight and monitoring of the Nursing care provided by the facility. All medical staff at the facility should have at least one (1) year of experience in their medical field.

To provide a continuity of patient care to VA beneficiaries the Contractor shall provide designated personnel to perform the requirements of this contract.

Name: _________________________ Name: _________________________

Name: _________________________ Name: _________________________

Name: _________________________ Name: _________________________

Name: _________________________ Name: _________________________

In the event the scheduled medical professional is unable to begin or complete an assigned shift, the contractor shall provide replacement medical professional coverage within 2 hours and notify the Contracting Office Representative (COR) at the (Salisbury VAMC) immediately of the schedule change.

2.1.18. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The Contractor shall notify the CO, in writing, within five (5) calendar day (s) after the occurrence of any of these events and provide the information required below. After ninety (90) days, the Contractor shall submit the information required below to the CO at least sixty

(60) calendar days prior to making any permanent substitutions.

2.1.18.1. 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 seven

(7) 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.

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

2.1.19. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility.

Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction, or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s Physician(s) and Technologist(s), s/he may request, without cause, immediate replacement of said Contractor’s Registered Nurses (RN’s). The CO and COR shall deal with issues raised concerning Contractor’s Registered Nurses (RN’s) conduct. The final arbiter on questions of acceptability is the CO.

2.1.20. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor’s Registered Nurses (RN’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: Seven (7) days per week, twenty-four (24) hours per day on call

3.1.1. The W.G. Bill Hefner Salisbury VA Medical Center will only pay for qualified services received by the Transitional Homeless Veterans Housing medical fragile Service, pay will be per actual beds occupied.

3.1.2. Telemedicine or Teleconsultation: VA Video Connect

3.1.3. Federal Holidays: The ten (10) holidays are observed by the Department of

Veterans Affairs:

• New Year’s Day

• President’s Day

• Martin Luther King’s Birthday

• Memorial Day

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

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

When one of the holidays falls on Sunday, the following Monday shall be observed as a Federal Holiday. When a holiday falls on a Saturday, the proceeding Friday shall be observed as a Federal Holiday.

3.2. Off-Duty Hours Coverage: Not Required.

4. CONTRACTOR RESPONSIBILITIES

4.1. Standards of Care: The contractor’s Registered Nurse (RN, CNA, LPN) shall cover the rage of services as would be provided in medical treatment facility.

4.2. The contractors shall be responsible for meeting or exceeding VA standards in providing

Nurse Practitioner’s, Registered Nurse’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, LCMHC’s and LCMHCA’s in providing the standards of care shall be of quality, meeting or exceed currently recognized national standards as established by:

4.2.1. The professional standards of The Joint Commission (TJC) http://www.jointcommission.org/emergency_department/.

4.2.2. The North Carolina Social Work Certification and Licensure Board (NCSWCLB).

http://ncswboard.org.

4.2.3. North Carolina Licensed Professional Counseling Board (NCBLCMHC) http://ncblcmhc.org

4.2.4. North Carolina Board of Nursing. http://ncbon.com.

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

4.2.6. National League for Nursing Accrediting Commission www.nlnac.org.

4.2.7. The requirements contained in this PWS

http://www.jointcommission.org/emergency_department/ http://ncswboard.org/ http://ncblcmhc.org/ http://ncbon.com/ http://www.hpoe.org/resources?show=100&type=8

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contractor’s Nurse Practitioner’s, Registered Nurse’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, LCMHC’s and LCMHCA’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).

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled “Patient Medical Records-VA” (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations.

Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

4.3.3. Disclosure: Contractor’s Nurse Practitioner’s, Registered Nurse’s, CNA’s, LPN’s, LCSW’s, LCSWA’s, LCMHC’s and LCMHCA’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 representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

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

http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www.rms.oit.va.gov/SOR_Records/24VA19.asp http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1469 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/viewpublication.asp?pub_id=1423 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAMC.

4.3.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address: Terrall Hughley, 1601 Brenner Ave, Salisbury, NC 28144.

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

4.4.1. Contractor shall be responsible for each of the following areas stated in the PWS and the section below.

4.4.2. Patient Safety:…