S02-36C25720Q1314.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

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. 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 154

549-21-1-4093-000

36C25720Q1314 10-02-2020

Susan Flores 1-210-694-6307 10-15-2020

10AM

Department of Veterans Affairs VISN17 Network Contracting Activity 7400 Merton Minter Blvd. (10N17/90C) San Antonio TX 78229

X 100

X

541611

$16.5 Million

N/A

X

VISN17 Quality Service Department

San Antonio TX 78229-4401

VISN17 Network Contracting Activity

San Antonio TX 78229

This is accomplished through the Tungsten Network located at:

http://www.fsc.va.gov/einvoice.asp This is mandatory and the sole method for submitting invoices.

(877) 353-9791 (512) 460-5540

See CONTINUATION Page

The purpose to this solicitation is for VISN 17 Accreditation Readiness Services for Mock Surveys contained in SOW.

See CONTINUATION Page

X X

Michael J. Tusinger Contracting Officer

36C25720Q1314

Table of Contents

SECTION A

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

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 INSTRUCTIONS TO OFFERORS

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

B.4 DELIVERY SCHEDULE

SECTION C - CONTRACT CLAUSES

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

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

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JUN 2020)

C.3 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)... 29

C.4 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.5 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.6 SUPPLEMENTAL INSURANCE REQUIREMENTS

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (DEC 2019)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.4 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.5 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (JUN 2020)

E.6 52.216-1 TYPE OF CONTRACT (APR 1984)

E.7 52.233-2 SERVICE OF PROTEST (SEP 2006)

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 36C257 Michael J. Tusinger

VISN17 Network Contracting Activity 7400 Merton Minter Blvd. (10N17/90C) San Antonio TX 78229

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

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Reciept of Services

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.

This is accomplished through the Tungsten Network located at:

http://www.fsc.va.gov/einvoice.asp This is mandatory and the sole method for submitting invoices.

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

AMENDMENT NO DATE

B.2 INSTRUCTIONS TO OFFERORS

Evaluation Factors for Award http://www.fsc.va.gov/einvoice.asp

Solicitation issued as a total SDVOSB set-aside. All SDVSOB contractors participating in the Veterans First Contracting Program must be listed as verified in the VIP database at https://www.vip.vetbiz.gov to receive contract awards under the Veterans First Contracting Program.

The vendor must be registered for NAICS 541611 in SAM to be eligible for award at the time of the response to this solicitation.

Quotations due 10/15/20 at 11:00 p.m. ET (10:00 a.m. CT).

Email quotes to susan.flores2@va.gov

Point of Contact:

Susan Flores Contract Administrator Regional Procurement Office West (RPO West) Network Contracting Office 17 (NCO 17) 7400 Merton Minter Blvd. (10N17/90C) San Antonio, TX 78229 Phone: 210-694-6307 Susan.flores2@va.gov

Late quotes or documentation will not be accepted. All questions, comments, or inquiries are to be submitted in writing to the Point of Contact, referenced above, prior to the closing of the solicitation.

I. Basis of Award

The Government intends to make award without discussions. The quotes will be evaluated based on the evaluation factors listed below. However, it may be determined necessary to conduct discussions if award cannot be made on initial proposals submitted.

Contract will be made based on both price and technical considerations most advantageous to the Government IAW FAR Part 13.

Factor 1: Technical Capability – The contractor shall provide a written statement addressing each of the following items. The written statement must describe each point and must provide enough detail to determine minimum qualifications.

Provide a written plan detailing your firm’s experience and capability of performing work similar to what is being required in the Statement of Work. Written plan should address 1-5. Your firm shall address the minimum requirement as follows:

1. Each consultant shall have a minimum of three years of surveying experience. Each of the consultants shall have experience, education, and knowledge of Joint Commission Hospital, Behavioral Health, Home Care, Life Safety and Ambulatory Care AND LTCI standards and Hospital Safety with Infection Control practices.

2. The consultants shall possess the appropriate qualifications and credentials for conducting the surveys.

https://www.vip.vetbiz.gov/ mailto:susan.flores mailto:Susan.flores2@va.gov

They shall have surveyor and consultant experience and be knowledgeable of the unique challenges faced by VA Medical Centers.

3. The surveyors shall have knowledge of VA’s Electronic documentation system and history of data security compliance with VA medical records. Must guarantee consistent team membership unless for an approved emergency.

3. Members must possess previous experience as or with Joint Commission certified surveyors.

4. The surveyors shall have expertise in Infection Control and Hospital Safety Practices.

5. Each consulting team must 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).

FACTOR 2 PAST PERFORMANCE

a. This factor considers the quality of the Offeror’s past performance in carrying out relevant work. Emphasis will be on recent, relevant past performance. Recent is defined as work performed within the last 3 years. Relevant is defined as work similar in size and scope of the work described in the Statement of Work.

b. Provide (3) references of work, similar in scope with contact information, brief description of the work completed, and contract # (if relevant). References will be checked by the Contracting Officer or Contracting Officers Representative to ensure your company can perform the Statement of Work.

c. Provide a list of all agencies/companies/firms with whom the offeror is performing or has performed relevant work within the last 3 years.

d. The following information should be included. (a) Agency/Company name. (b) Contract Dollar Value. (c) Period of Performance. (d) Name, Address, e-mail address, telephone & fax number of the reference.

Past performance information shall also be obtained from other sources available to the Government to include, but not limited to, CPARS (contractor performance retrieval system) or other databases; interviews with Program Managers, and other Contracting Officer

Factor 3: Price – Contractor shall complete B.4 Price/Cost Schedule. The schedule may be altered, or an alternate schedule used where appropriate in order to express quote detail. Price will be evaluated for completeness and fairness by comparing the price with the Independent Government Estimate and comparison to prices on previous contracts.

Base Year price, each Option Year Price, and Total price will be evaluated by the Government. In evaluating the offeror’s proposed price for this project. The techniques and procedures described under FAR 12.209, Determination of Price reasonableness, will be the primary means of assessing proposal reasonableness.

Provide prices on all line items listed on the Price/Cost Schedule.

STATEMENT OF WORK (SOW)

1.0 GENERAL INFORMATION: This is a non-personnel services contract to provide Survey Readiness to all facilities within the VISN 17 Heart of Texas HealthCare System. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.1 Description of Services/Introduction: Perform Survey Readiness Service as defined in this Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.

A Mock Joint Commission Survey and/or Long Term Care Institute (LTCI) shall be conducted at each Veterans Integrated Service Network (VISN) 17 facility to assist in the continuous readiness efforts. The Mock Survey process shall focus on frequently cited standards, problematic standards, the high risk areas of, but not limited to, Sterile compounding, Suicide, Sterile processing, Hemodialysis, Environment of care, and Life Safety. The Contractor shall possess knowledge of The Joint Commission (TJC) standards and VHA regulations which apply to accreditation bodies. 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 last three days per facility with the exception of two days for Valley Coastal Bend and Big Spring. Each consultant team for the three day surveys shall have four consultant surveyors for three days. 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 team for the two day surveys shall have four consultant surveyors for two days. 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(s), physician(s), 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.

At the South Texas VA Health Care System facility, the review will be a three-day review consisting of four consultants with a focus and determination of team members at the discretion of the facility point of contact.

At the North Texas VA Health Care System facility, the review will be a three-day review consisting of four consultants with a focus and determination of team members at the discretion of the facility point of contact.

At the Central Texas VA Health Care System facility, the review will be a three-day review consisting of four consultants with a focus and determination of team members at the discretion of the facility point of contact.

At the Amarillo Texas VA Health Care System facility, the review will be a three-day review consisting of four consultants with a focus and determination of team members at the discretion of the facility point of contact.

At the El Paso Texas VA Health Care System facility, the review will be a three-day review consisting of four consultants with a focus and determination of team members at the discretion of the facility point of contact.

At the West Texas VA Health Care System facility, the review will be a two-day review consisting of three consultants with a focus and determination of team members at the discretion of the facility point of contact.

At the Valley Coastal Bend VA Health Care System facility, the review will be a two-day review consisting of three consultants with a focus and determination of team members at the discretion of the facility point of contact.

Dates of the surveys to be negotiated with each facility. However, all onsite surveys shall be completed no later than June 30, 2021. 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.

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.

The hospital surveys shall be coordinated with the designated point of contact at each site. Each survey shall include an opening conference; patient tracer activities, leadership conference, and exit briefing.

The consultants shall possess the appropriate qualifications and credentials for conducting the surveys.

They shall have surveyor and consultant experience and be knowledgeable of the unique challenges faced by VA Medical Centers. The surveyors shall have knowledge of VA’s Electronic documentation system and history of data security compliance with VA medical records. Must guarantee consistent team membership unless for an approved emergency.

Four-member and three-member team will be comprised of a combination of medical doctor, registered nurse, and a registered nurse with combined experience in Hospital (HAP), Home Care (HC), Ambulatory, Behavioral Health (BH), and LTCI, TJC standards, and a Life Safety Specialist. Members must possess previous experience as or with Joint Commission certified surveyors. The surveyors shall have expertise in Infection Control Practices.

1.2 Background: A Continuous Readiness (CR) review for TJC survey will be conducted at each VISN facility to assist in the facility’s efforts for unannounced TJC surveys. These visits can occur any time after the previous survey.

1.3 Objectives:

• TJC Standards Compliance including Environment of Care and Life Safety standards

• Enhance CR state

• Enhance staff accreditation survey process knowledge

• Increase patient safety

1.4 Scope: The purpose of this procurement action is to acquire CR services also known as continuous 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 17 and its 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.

1.5 Period of Performance: The period of performance will be for one (1) Base Year of 12 months with 4 additional option years.

1.7 Quality Assurance: The government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.8 Recognized Federal Holidays: The contractor shall not be required to perform services on national holidays.

New Year’s Day Labor Day

Martin Luther King Jr.’s Birthday Columbus Day

President’s Day Veteran’s Day

Memorial Day Thanksgiving Day

Independence Day Christmas Day

Any other day deemed to be a national holiday by the President of the United States.

1.9 Hours of Operation: The contractor shall be responsible for conducting business, 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. For other than firm fixed price contracts, the contractor will not be reimbursed when the government facility is closed for the above reasons.

The Contractor must maintain an adequate workforce for the uninterrupted performance of all tasks defined within this SOW when the Government facility is not closed for the above reasons.

When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.10 Place of Performance: The work to be performed under this contract shall be performed at Veterans Health Administration sites of care within the VA Heart of Texas Healthcare Network

(VISN 17).

Locations:

Amarillo VA Health Care System 6010 Amarillo Blvd West Amarillo, TX 79106

West Texas VA Health Care System 300 Veterans Blvd Big Spring, TX 79720

North Texas VA Health Care System 4500 S. Lancaster Rd.

Dallas, TX 75216

South Texas VA Health Care System 7400 Merton Minter San Antonio, TX 78229

Central Texas VA Health Care System 1901 Veterans Memorial Drive Temple, TX 76504

Valley Coastal Bend VA Health Care System 2601 Veterans Drive Harlingen, TX 78550

El Paso VA Health Care System 5001 N. Piedras El Paso, TX 79930

1.11 Type of Contract: The government will award a firm fixed price definite delivery contract.

1.12 Security Requirements: 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.

1.13 Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor’s use.

1.14 Operating Constraints: The contractor shall have a Business Associate Agreement (BAA) and safeguard Personal Health Information (PHI) agreements. The Contractor staff shall complete VA privacy training annually. The Contractor shall have no access to the VA computer network.

1.15 Confidentiality of Data and Privacy Act: Any information systems involved with this contract are classified as systems of records subject to the Privacy Act of 1974 (Public Law 93-

579) and all applicable Health Insurance Portability and Accountability Act (HIPAA) regulations.

The contractor may, during performance, observe or handle information subject to the Privacy Act or other Federal regulations. Duplication or disclosure of data and other information to which the contractor will or may have access because of this contract is prohibited by law. It is understood that throughout the performance of the contract, the contractor may have access to confidential data that is either the sole property of VA or is the sole property of other than the contracting parties. The contractor hereby agrees to maintain the confidentiality of all such data to which access may be gained throughout contract performance, whether title thereto vests in VA or otherwise. The contractor hereby agrees not to disclose said data, any interpretation thereof, or data derivative thereto unauthorized parties in contravention of the provisions, without the written approval of the CO, or the party in which the title is wholly vested. Also, FAR 52.224-1 Privacy Act Notification and FAR 52.224-2, Privacy Act, as stated in Section I, Contract Clauses, apply to this contract. All contract personnel performing on this contract shall be required to sign a Certificate of Confidentiality and Non-Disclosure prior to commencing work. The Certificate will be provided and maintained by the COR and added to the contract file.

1.16 Post Award Conference/Periodic Progress Meetings: The Contractor shall agree to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor's performance and the contractor shall apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.17 Contracting Officer Representative (COR): The (COR) will be identified by separate letter of delegation provided by the Contracting Officer (CO). The COR will monitor all technical aspects of the contract and assist in contract administration. The COR is not authorized to change any of the terms and conditions of the resulting contract.

1.18 Data Rights: The Government has unlimited rights to all documents/material produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government.

These documents and materials may not be used or sold by the contractor without written permission from the Contracting Officer. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

2.0 DEFINITIONS AND ACRONYMS

2.1. Definitions:

2.1.1. 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.

2.1.2. 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.

2.1.3. 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.

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

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

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

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

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

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

2.2. Acronyms:

CO Contracting Officer

COR Contracting Officer Representative

FAR Federal Acquisition Regulation

HIPAA Health Insurance Portability and Accountability Act of 1996

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

3.0 GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Materials: The Government will provide Joint Commission Standards policies and results of previous survey reports.

4.0 CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS.

5.0 SPECIFIC TASKS:

1. Conduct an Accreditation Readiness (AR) TJC and LTCI Review at each of the seven (7) VISN facilities.

a. Each facility will be allowed 1 consultative visit (up to 5 consecutive days) for their accreditation readiness review. The contractor shall provide Contractor for 76 days of onsite consultation time (see below for facility division) for the mock TJC surveys. (Actual dates to be mutually determined by contractor and each facility’s point of contact.

Parent Facility Total Days

Amarillo VA Health Care System 12 West Texas VA Health Care System 6 North Texas VA Health Care System 12 South Texas VA Health Care System 12 Central Texas VA Health Care System 12 Texas Valley Coastal Bend VA Health Care System 6 El Paso VA Health Care System 12

b. Each consulting team must 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).

c. The consultants will address Hospital, LTCI, Behavioral Health, Home Care, and applicable Ambulatory Care Standards and the programs under which these standards are surveyed.

3. Dates of the reviews are negotiated with the facility point of contact in consultation with the VISN Deputy QMO. After all reviews are completed, the consultants will schedule an exit conference with the VISN Network Director, VISN QMO, VISN CMO and Deputy QMO as well as other leadership staff to discuss findings and trends.

5. 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.

6. Each facility will supply the consultants with accurate information describing the scope of services provided. The facility will provide access to those staff members who would normally be involved in a TJC Survey to allow adequate assessment of standards compliance.

5.4. Deliverables/Reporting Requirements

The contractor shall submit reports to the COR or the Contracting Officer as requested for use in monitoring contractor performance. The complete lists of deliverables are provided below and shall be submitted in accordance with requirement. As a result of submissions additional information and/or clarification may be required and shall be provided upon request. All Tasks and Deliverables will be prioritized by the COR. Deliverable dates may be adjusted by mutual agreement.

As part of the contract the contractor shall provide:

a. Mock TJC surveys shall be conducted at each of the VISN 17 facilities during the contract period. The surveys shall include the development of a survey agenda that focuses on frequently cited standards, problematic standards, the high risk areas of, but not limited to, Sterile compounding, Suicide, Sterile processing, Hemodialysis, Environment of care, and Life Safety as well as LTCI program. The contractor shall coordinate the survey schedule with the Contracting Officer Representative (COR). The contractor shall assess the documentation covering items including, but not limited to, care delivery, fire safety, medical equipment, and utility systems. A review of related Environment of Care documentation from each facility’s Community Based Outpatient Clinic (CBOC) shall also be required.

(1) A brief needs assessment shall be conducted with each facility prior to the surveys to determine focus areas to include. This may include a review of hospital policies/procedures, staff training, performance improvement activities and goals, discussions with department heads, the building maintenance program, or any other area of weakness identified by the facility.

(2) The Contractor shall conduct a building tour, which will include visits to patient care settings and other areas likely to be visited by TJC. The Contractor shall provide consultation on the best methods to achieve the standards, and propose solutions to identified problems or issues.

(3) The Contractor shall conduct one or more informal on-site educational session(s) as needed, during scheduled survey dates, addressing shortcomings identified during the document review or building tour, or a general overview session for interested staff. These sessions shall be tailored to address the specific needs at each facility, and the background of those attending.

(4) 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 VISN 17 Quality Management team.

(5) The contractor shall provide an aggregated VISN wide written report for VISN 17 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.

(6) The Contractor shall conduct a two-hour summation conference with VISN 17 Leadership at the VISN 17 Network Office, Arlington, Texas at the conclusion of all surveys to discuss findings and trends.

3. The contractor shall provide deliverables as follows:

a. Mock TJC surveys at each of the seven (7) VISN 17 facilities and any CBOCs selected by the parent facility.

b. An electronic and hardcopy in a bound format (3-ring binder is acceptable), written report of findings provided to the facility within fifteen (15) working days of the survey citing the specific standard of noncompliance. Report shall be in Microsoft Word format submitted simultaneously to the Medical Center Director and VISN 17 Quality Management team.

c. An electronic and hardcopy in a bound format (3-ring binder is acceptable), aggregated VISN wide written report of findings provided to VISN prior to summation conference to include facility findings, recommendations by facility, general strengths and weaknesses by facility, trends across the VISN and general and site- specific recommendations.

Reports shall be in Microsoft Work format submitted simultaneously to the VISN 17 Network Director and VISN 17 Quality Management team.

d. A two (2) hour summation presentation with VISN leadership at the VISN Office in Arlington, Texas upon completion of surveys

4. All surveys shall be coordinated with the VISN 17 Quality Management team who will be designated as the Contracting Officer’s Representative (COR) for this contract.

a. Schedules for all contract services will be approved/finalized as soon as possible after contract award with a minimum of a two-week lead time from approval to scheduled task.

b. All contract services shall be completed within 180 days from award.

c. Each facility survey shall be completed on consecutive days in one week and not be continued over a weekend. No contract services shall be provided on weekends or federal holidays.

6.0 APPLICABLE PUBLICATIONS:

6.1. In the performance of the tasks associated with this SOW, the Contractor shall comply with:

• All applicable Health Insurance Portability and Accountability Act (HIPAA) Regulations

• FAR 52.224-1 Privacy Act Notification and FAR 52.224-2, Privacy Act

7.0 BACKGROUND INVESTIGATION: The contractor will be required to complete a background investigation through Human Resources Management Service.

The “Notice of Award” letter shall instruct the successful offeror how to obtain the VHA Service Center (VSC) Security Request Packet, which contains all the forms that the contractor must fill out. The VSC enters the request in the VA Security and Investigation Center (SIC) database. Once the VA SIC processes the request, the contractor POC, contract employee, CO, COR and VSC receive an e-mail with instructions for completing the

Electronic Questionnaire for Investigations Processing (e-QIP). The contract employee must complete the e-QIP within five (5) business days of receiving the e-mail from the VA SIC. If the e-QIP is not completed within the required timeframe, the CO shall notify the contractor that the individual is prohibited from working on the contract (or delivery/task order) until the e-QIP is completed. Each contract employee working on this contract must also be fingerprinted as part of the BI. Once a contract employee has submitted the required paperwork and has been fingerprinted, the VSC conducts the background screening. The VSC may request an applicant to complete and send an OPM Optional Form 306, Declaration of Federal Employment, if issues are identified. Upon completion of a background screening, the VSC will forward a “Fingerprint Check - National Criminal History Check Completion Notice” (NCHC) to the Contracting Officer, which will indicate a favorable or unfavorable screening decision for each contract employee listed on the form.

Notice to Proceed Letter: Upon receipt of the NCHC notice from the VSC, and verification of a fully executed local or National Business Associate Agreement if required, the Contracting Officer shall send the contractor a “Notice to Proceed” letter with a copy of the NCHC notice, which will instruct those contract employees who have favorable screening decisions to begin working and fulfill remaining security requirements. Failure to pass the Background Investigation and obtain Security Clearances shall be deemed a contractor performance issue, and if performance cannot start due to failed and/or unacceptable BI’s, it shall further be deemed a contractor delay, and may result in termination for default of the contract if the contractor cannot perform services in a timely manner after award. No costs will be paid to the contractor for contractor delays or for time the government takes to process Background Investigations. For more information on this process see VA Directive and Handbook 0710, Personnel Suitability and Security Program.

8.0 CONTRACTOR TRAINING/INFORMATION SYSTEM

8.1 All VA training will be provided to the contractor at no cost and the contractor will not be able to charge the government for training time or travel/per diem associated with training.

8.2 Prior to being able to gain access to the VA information, the contractor must successfully complete TMS courses: VA Privacy and Information Security Awareness and Rules of Behavior, Annual Government Ethics Training and Privacy and HIPPA training.

8.3 Training must be successfully completed, and copies of the training certificates provided to the CO or COR.

8.4 Other training may be required as determined by VA information officers.

This is a non-personal service contract under which the Contractor is an independent

Contractor. Contractor employees shall not be considered VA employees for any purpose.

9.0 SECURITY STATEMENT: Sensitive VA information is contained within the systems covered by this contract.

The contractor will not transfer any VA information to a location outside the VA. No removable media devices can be used by the contractor and removable media devices will not be provided to the contractor. The contractor will not have remote access to the VA network.

Following onsite service and before leaving the VA site, the contractor will enter notes from the session. A separate access code, UserID/Password, will be issued to the contractor’s representatives who have completed the required background check and information security training: 1) privacy/security training, 2) information security and 3) HIPPA.

10.0 VA RECORDS POLICY

All records (administrative and specific) created during the period of the contract belong to VISN 17 and must be returned to VISN 17 at the end of the contract or destroyed in accordance to the VHA Record Control Schedule (RCS)10-1.

No electronic memory devices (hard drives, etc.) shall leave the VA.

11.0 RECORDS MANAGEMENT STATEMENT

11.1.1 Citations to pertinent laws, codes and regulations such as 44 U.S.C

Chapter 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C.

552); Privacy Act (5 U.S.C. 552a); 36 CFR Part 1222 and Part 1228.

11.1.2 Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

11.1.3 Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government ‘IT’ equipment and/or Government records.

11.1.4 Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

11.1.5 Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract or identified in the RCS 10-1.

11.1.6 The Government Agency owns the rights to all data/records produced as part of this contract.

11.1.7 The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract.

Contractor must deliver sufficient technical documentation with all data deliverables to permit the agency to use the data.

11.1.8 Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.].

11.1.9 No disposition of documents will be allowed without the prior written consent of the Contracting Officer. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules.

11.1.10Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under or relating to this contract. The Contractor (and any sub-contractor) is required to abide by Government and Agency guidance for protecting sensitive and proprietary information.

12.0 SAFETY REQUIREMENTS: In the performance of this contract, the Contractor shall take such safety precautions as the Contracting Officer may determine to be reasonably necessary to protect the lives and health of occupants of the building. The Contracting Officer shall notify the Contractor of any safety issues and the action necessary to correct these issues. Such notice, when served to the Contractor or his representative at the work site shall be deemed sufficient for the corrective actions to be taken. If the Contractor fails or refuses to comply promptly, the Contracting Officer may issue an order stopping all or part of the work, and hold the Contractor in default.

13.0 INVOICING: Payment to be made monthly in arrears by certified invoices and must contain the contract number in addition to the requirements detailed in FAR 52.212- 4 (G) to be considered valid. All invoices shall be submitted to the VA Financial Service Center and faxed to the COR. All invoices will reference the purchase order number assigned to the contract.

Billing address:

VA FSC

PO Box 149971 Austin, TX 78714

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

528.00 Hr __________________ __________________

Readiness Mock Survey Contract for VISN 17 Services Consulting

See SOW for details Contract Period: Base POP Begin: 11-01-2020 POP End: 10-31-2021

528.00 HR __________________ __________________

See SOW for details Contract Period: Option 1 POP Begin: 11-01-2021 POP End: 10-31-2022

528.00 HR __________________ __________________

See SOW for details Contract Period: Option 2 POP Begin: 11-01-2022 POP End: 10-31-2023

528.00 EA __________________ __________________

Readiness Mock Survey Contract for VISN 17 Services

See SOW for details Contract Period: Option 3 POP Begin: 11-01-2023 POP End: 10-31-2024

528.00 Hr __________________ __________________

Readiness Mock Survey Contract for VISN 17 Services

See SOW for details Contract Period: Option 4 POP Begin: 11-01-2024 POP End: 10-31-2025

GRAND TOTAL __________________

B.4 DELIVERY SCHEDULE

ITEM NUMBER QUANTITY

DELIVERY

DATE

0001-

SHIP TO: Warehouse Bldg 44 VA Medical Center VA NTX Healthcare System 4500 S Lancaster Rd

ALL 11-01-2020-10-

31-2025

Dallas, TX 75216

USA

MARK

FOR:

Denise.Elliott 817.385.3734 Denise.Elliott@va.gov

SECTION C - CONTRACT CLAUSES

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

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

http://www.acquisition.gov/far/index.html http://www.va.gov/oal/library/vaar/

(End of Clause)

FAR

Number

Title Date

52.203-16 PREVENTING PERSONAL CONFLICTS OF INTEREST JUN 2020

52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS

AND REQUIREMENT TO INFORM EMPLOYEES OF

WHISTLEBLOWER RIGHTS

JUN 2020

52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON

POSTCONSUMER FIBER CONTENT PAPER

MAY 2011

52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE OCT 2018

52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE

MAINTENANCE

JUL 2016

52.228-5 INSURANCE—WORK ON A GOVERNMENT

INSTALLATION

JAN 1997

52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL

BUSINESS SUBCONTRACTORS

DEC 2013

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

IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS

(JUN 2020)

(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

(1) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (JAN 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(2) 52.204–23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 2018) (Section 1634 of Pub. L.

115–91).

(3) 52.204–25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment. (AUG 2019) (Section 889(a)(1)(A) of Pub. L. 115–232).

(4) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (NOV 2015).

http://www.va.gov/oal/library/vaar/

(5) 52.233-3, Protest After Award (Aug 1996) (31 U.S.C. 3553).

(6) 52.233-4, Applicable Law for Breach of Contract Claim (Oct 2004) (Public Laws 108-77 and 108-78 (19 U.S.C. 3805 note)).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

[] (1) 52.203–6, Restrictions on Subcontractor Sales to the Government (JUN 2020), with Alternate I (OCT 1995) (41 U.S.C. 4704 and 10 U.S.C. 2402).

[] (2) 52.203–13, Contractor Code of Business Ethics and Conduct (JUN 2020) (41 U.S.C.

3509).

[] (3) 52.203–15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (JUN 2010) (Section 1553 of Pub. L. 111-5). (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009.)

[] (4) 52.204–10, Reporting Executive Compensation and First-Tier Subcontract Awards (JUN 2020) (Pub. L. 109–282) (31 U.S.C. 6101 note).

[] (5) [Reserved]

[] (6) 52.204–14, Service Contract Reporting Requirements (OCT 2016) (Pub. L. 111–117, section 743 of Div. C).

[] (7) 52.204–15, Service Contract Reporting Requirements for Indefinite-Delivery Contracts (OCT 2016) (Pub. L. 111–117, section 743 of Div. C).

[] (8) 52.209–6, Protecting the Government’s Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment. (JUN 2020) (31 U.S.C. 6101 note).

[] (9) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018) (41 U.S.C. 2313).

[] (10) [Reserved]

[] (11)(i) 52.219-3, Notice of HUBZone Set-Aside or Sole-Source Award (MAR 2020) (15 U.S.C. 657a).

[] (ii) Alternate I (MAR 2020) of 52.219-3.

[] (12)(i) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (MAR 2020) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 U.S.C. 657a).

[] (ii) Alternate I (MAR 2020) of 52.219-4.

[] (13) [Reserved]

[] (14)(i) 52.219-6, Notice of Total Small Business Set-Aside (MAR 2020) (15 U.S.C. 644).

[] (ii) Alternate I (MAR 2020).

[] (15)(i) 52.219-7, Notice of Partial Small Business Set-Aside (MAR 2020) (15 U.S.C. 644).

[] (ii) Alternate I (MAR 2020) of 52.219-7.

[] (16) 52.219-8, Utilization of Small Business Concerns (Oct 2018) (15 U.S.C. 637(d)(2) and (3)).

[] (17)(i) 52.219–9, Small Business Subcontracting Plan (JUN 2020) (15 U.S.C. 637(d)(4)).

[] (ii) Alternate I…