S02 - 36C26019R0032.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 139

36C26019R0032 04-01-2021

Scott Reed scott.reed2@va.gov 509-321-1909 04-30-2021

5:00 PM PST

Department of Veterans Affairs Network Contracting Office 20 8524 N Wall St Spokane WA 99208

(509) 321-1909 scott.reed2@va.gov NCO20HCRGroup@va.gov

X

621498

$22 Million

N/A

Department of Veterans Affairs General Warehouse, Bldg 14 4815 N Assembly ST Spokane WA 99205

Network Contracting Office 20 8524 N Wall St Spokane WA 99208 Scott.reed2@va.gov

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971

This solicitation will result in a single VA Indefinite Delivery-Indefinite Quantity (IDIQ) contract for:

Bonner County, ID, Community Based Outpatient Clinic (CBOC) Primary Care Services.

The Schedule begins on page 5.

The PWS begins on page 8

Contracting POC for this action is Scott Reed at

(509) 321-1909 or scott.reed2@va.gov and NCO20HCRGroup@va.gov.

X 1

LAURA M. PARK

Contracting Officer mailto:scott.reed2@va.gov mailto:NCO20HCRGroup@va.gov mailto:Scott.reed2@va.gov mailto:NCO20HCRGroup@va.gov

36C26019D0032 Bonner County CBOC

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 SECURE FAX

B.3 POST AWARD ORIENTATION

B.4 SCHEDULE OF SERVICES

B.5 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

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

C.3 52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL

CONFIDENTIALITY AGREEMENTS OR STATEMENTS (JAN 2017)

C.4 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL

(JAN 2011)

C.5 52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND

CERTIFICATIONS (DEC 2014)

C.6 52.211-11 LIQUIDATED DAMAGES—SUPPLIES, SERVICES, OR RESEARCH AND

DEVELOPMENT (SEPT 2000)

C.7 52.216-18 ORDERING (AUG 2020)

C.8 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.9 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.10 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.11 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.12 52.227-2 NOTICE AND ASSISTANCE REGARDING PATENT AND COPYRIGHT

INFRINGEMENT (JUN 2020)

C.13 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)

C.14 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.15 VAAR 852.219-9 VA SMALL BUSINESS SUBCONTRACTING PLAN MINIMUM

REQUIREMENTS (DEC 2009)

C.16 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.17 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.18 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019) 106

C.19 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (NOV 2020)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JUN 2020)

E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.3 52.203-2 CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APR 1985)

E.4 52.203-18 PROHIBITION ON CONTRACTING WITH ENTITIES THAT REQUIRE

CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS OR STATEMENTS—

REPRESENTATION (JAN 2017)

E.5 52.204-20 PREDECESSOR OF OFFEROR (AUG 2020)

E.6 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018) .. 122

E.7 52.216-1 TYPE OF CONTRACT (APR 1984)

E.8 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999)

E.9 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.10 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.11 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (NOV 2020)

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 36C260 Laura Park

(360) 852-9898 laura.park@va.gov

Department of Veterans Affairs Network Contracting Office 20 5115 NE 82d Ave Ste 101 Vancouver WA 98662

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] 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.

FMS-VA-2(101)

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:laura.park@va.gov

B.2 SECURE FAX

Please review VA Handbook 6500 that requires the following statement on all fax cover sheets be included: “This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.

B.3 POST AWARD ORIENTATION

The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by Procurement Policy Memorandum (PPM) 2019-01. https://www.va.gov/oal/docs/business/pps/ppm201901.pdf.

B.4 SCHEDULE OF SERVICES

The guaranteed minimum contract amount is $500,000.00 and the maximum contract amount shall not exceed $20,000,000.00.

Ordering Procedures: VA has the sole authority to assign Veterans treated by the contractor into the Primary Care Management Manual (PCMM) software program used to track primary care clinic veteran rosters. Specific billable processes for issuing task orders under the resultant contract includes: determining veteran eligibility, enrollment eligibility, and qualifying encounters is further defined in 6.2.1 (beginning on page 78). Please review in detail section 6.2.1 to ensure compliance for issuance of subsequent task orders and payment processing.

Orders will be placed annually via SF1449, following shortly after the next option being exercised but not later than 30 calendar days prior to expiration of the current period of performance.

*PMPM includes cost of unassigned patient visits; contractor shall not bill separately or propose an additional CLIN or bill separately for these costs.

Total Estimated Cost shall be calculated by multiplying the Estimated Quantity X the Price Per Unit X 12 (Estimated Quantity X Price Per Unit = Monthly Amount X 12 = Total Estimated Amount).

Please reference Attachment 32, Workload History

PERIOD OF PERFORMANCE INCLUDING BASE AND ALL OPTIONS: 04/01/2022 – 03/31/2032 (MAY

CHANGE AT AWARD)

Line Item No.

Services Unit Estimated Quantity

Price Per Unit

Total Estimated Cost

Primary Care Services at Capitation rates per member per month (PMPM) Services shall be provided in Bonner County, Idaho

Base Year:

POP: 04/01/2022 – 03/31/2023

PMPM

https://www.va.gov/oal/docs/business/pps/ppm201901.pdf

Item No.

Services Unit Estimated Quantity

Price Per per month (PMPM) Services shall be provided in Bonner County, Idaho

Option Year One:

POP: 04/01/2023 – 03/31/2024

per month (PMPM) Services shall be provided in Bonner County, Idaho

Option Year Two:

POP: 04/01/2024 – 03/31/2025

per month (PMPM) Services shall be provided in Bonner County, Idaho

Option Year Three:

POP: 04/01/2025 – 03/31/2026

per month (PMPM) Services shall be provided in Bonner County, Idaho

Option Year Four:

POP: 04/01/2026 – 03/31/2027

per month (PMPM) Services shall be provided in Bonner County, Idaho

Option Year Five:

POP: 04/01/2027 – 03/31/2028

Item No.

Services Unit Estimated Quantity

Price Per per month (PMPM) Services shall be provided in Bonner County, Idaho

Option Year Six:

POP: 04/01/2028 – 03/31/2029

per month (PMPM) Services shall be provided in Bonner County, Idaho

Option Year Seven:

POP: 04/01/2029 – 03/31/2030

per month (PMPM) Services shall be provided in Bonner County, Idaho

Option Year Eight:

POP: 04/01/2030 – 03/31/2031

per month (PMPM) Services shall be provided in Bonner County, Idaho

Option Year Nine:

POP: 04/01/2031 – 03/31/2032

Contract Total: $_____________________________

B.5 PERFORMANCE WORK STATEMENT

Community Based Outpatient Clinic

Bonner County Idaho

Outpatient Site of Care per VHA Handbook 1006.02, VHA Site Classifications and Definitions

1. GENERAL

1.1. SERVICES REQUIRED: The Mann-Grandstaff VA Medical Center (MGVAMC) requires the following services to be provided in a private hospital, office or clinic environment to Veterans, primarily residing in Bonner County, Idaho:

1.1.1. [ ] Primary Care CBOC: offers both medical and mental health care (physically on site and by telehealth) and may offer support services such as pharmacy, laboratory and x-ray. Primary Care CBOCs are required to provide both primary care and mental health services. Mental health services will be provided ________.

[ ] Multi-Specialty CBOC: offers both primary and mental health care and two or more specialty services physically on site. Access to additional specialty services may be offered by referral or telehealth.

[ ] HCC Ambulatory Surgery Clinic (ASC) must meet the requirements of the assigned surgical complexity level and provide all associated support infrastructure, such as pharmacy, laboratory and x-ray, to perform these health care services safely and effectively. ASC programs are evaluated against clinical criteria established by VHA’s National Surgery Office (see VHA Directive 1220, Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures in Any Clinical Setting, https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8365).

[ ] HCC NOT designated as ASC but performing invasive procedures under moderate sedation (must meet criteria established by VHA Directive 1073, Moderate Sedation by Non-Anesthesia Providers, www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3073.

[X] Other Outpatient Clinical Services Site of Care (less than 500 encounters registered in primary care and mental health stop class within any given fiscal year or does not include MH Services). Clinical services are provided to remote areas through a telehealth clinic or other arrangement. If any other services are provided in this venue (external to a VA clinic or facility), they must be associated, attached to, and coordinated by a health care delivery site located in a clinic or facility.

1.2. PLACE OF PERFORMANCE: It is requested that this contract clinic be located in Bonner County, Idaho, which is 163 miles from the MGVAMC.

1.3. AUTHORITY: In accordance with Title 38 United States Code (USC) 8153, and Federal Acquisition Regulation Parts 12 and 15, to be furnished by the Contractor on behalf of MGVAMC, 4815 N Assembly St, Spokane, WA 99205.

1.4. POLICY AND REGULATIONS: The Contractor is required to meet VHA performance and quality criteria and standards including, but not limited to, access, customer satisfaction, prevention index, chronic disease index and clinical guidelines. Performance and quality standards may change during the contract.

New or revised quality/performance criteria or standards will be provided to the Contractor before implementation date and throughout the life of the contract through unilateral or bilateral modifications, as applicable. Copies of current VA and VHA publications can be located at http://www.va.gov/vhapublications/ or at http://www.va.gov/vapubs/. Compliance with mandated performance is required as a condition of this contract. Contractor shall comply with all relevant VA policies and procedures, including those related to quality, access, patient safety and performance including, but not limited to, the policies listed on the Contracted Clinic Policy Document located at https://www.patientcare.va.gov/primarycare/Resources.asp.

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8365 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3073 http://www.va.gov/vhapublications/ http://www.va.gov/vapubs/ https://www.patientcare.va.gov/primarycare/Resources.asp

1.5. DEFINITIONS/ACRONYMS:

1.5.1. ABMS: American Board of Medical Specialties

1.5.2. ACLS: Advanced Cardiac Life Support

1.5.3. ACGME: Accreditation Council for Graduate Medical Education

1.5.4. ACPE: American Council on Pharmaceutical Education

1.5.5. ACO: Administrative Contracting Officer

1.5.6. ADE: Adverse Drug Events

1.5.7. AED: Automatic External Defibrillator

1.5.8. AIS: Automated Information Security

1.5.9. ANA: American Nurses Association

1.5.10. AOA: American Osteopathic Association

1.5.11. ARRT: American Registry of Radiologic Technology

1.5.12. ASC: Ambulatory Surgery Clinic

1.5.13. Assigned: A Veteran is “assigned” to an outpatient clinic via PCMM (i.e. CBOC) where the patient receives their primary care after the patient’s eligibility is determined through registration and enrollment.

1.5.14. BAA: Business Associate Agreement

1.5.15. BI-RADS: Breast Imaging-Reporting and Data System; a quality assurance tool designed to standardize mammography reporting.

1.5.16. BLS: Basic Life Support

1.5.17. BOS: Bureau of Osteopathic Specialists

1.5.18. CAHEA: Committee on Allied Health Education and Accreditation

1.5.19. CAP: College of American Pathologists

1.5.20. CARF: Commission of Accreditation of Rehabilitation Facilities

1.5.21. CBO: VA Central Billing Office

1.5.22. CDC: Centers for Disease Control and Prevention

1.5.23. CEU: Certified Education Unit

1.5.24. CLIA: Clinical Laboratory Improvement Amendments

1.5.25. CME: Continuing Medical Education

1.5.26. CMS: Center for Medicare and Medicaid Services

1.5.27. CO: Contracting Officer

1.5.28. COPD: Chronic Obstructive Pulmonary Disease

1.5.29. COR: Contracting Officer’s Representative

1.5.30. COS: Chief of Staff

1.5.31. CPA: Collaborative Practice Agreement

1.5.32. CPS: Clinical Pharmacy Specialist

1.5.33. CPT: Current Procedural Terminology

1.5.34. CRNP: Certified Registered Nurse Practitioners

1.5.35. CSWE: The Council on Social Work Education. The CSWE website is http://www.cswe.org/.

1.5.36. CPARS: Contractor Performance Assessment Reporting System

1.5.37. CVT: Clinical Video Telehealth

1.5.38. DICOM: Digital Image and Communication in Medicine

1.5.39. DIGMA: Drop-in Group Medical Appointment

1.5.40. DRG: Diagnostic Related Group

1.5.41. DSS: Decision Support System

1.5.42. ECC: Extended Care Center

1.5.43. Enrollment: The process of establishing eligibility for VA’s “Medical Benefits Package.” Most veterans are required to “enroll’ into the VA Health Care System to be eligible for VA health care and to be assigned to an outpatient clinic like a CBOC, however some can still receive care without enrolling. Applicants are only required to “enroll” once for VA health care unless they are determined ineligible for care at time of application or they have disenrolled.

1.5.44. EPRP: External Peer Review Program

1.5.45. FDA: Food and Drug Administration

1.5.46. FSMB: Federation of State Medical Boards

1.5.47. HCC: Health Care Center. An HCC is a VA-owned, VA-leased, contract or shared clinic operated at least five days per week that provides primary care, mental health care and on-site specialty services, and performs ambulatory surgery and/or invasive procedures which may require moderate sedation or general anesthesia.

1.5.48. HHS: Department of Health and Human Services

1.5.49. HCFA: Health Care Financing Administration

1.5.50. HICPAC: Healthcare Infection Control Practices Advisory Committee: a federal advisory committee made up of 14 external infection control experts who provide advice and guidance to the CDC and the Secretary of HHS regarding the practice of health care infection control, strategies for surveillance and prevention and control of health care associated infections in United States health care facilities.

1.5.51. HT: Home Telehealth

1.5.52. ICAVL: Intersocietal Commission for the Accreditation of Vascular Laboratories http://www.cswe.org/

1.5.53. ICD-10: International Classification of Diseased, 10th edition

1.5.54. iMED: software used by VA for informed consent

1.5.55. INR: International Normalized Ratio

1.5.56. ISO: Information Security Officer

1.5.57. LIP: Licensed Independent Practitioner

1.5.58. MCCR: Medical Care Cost Recovery

1.5.59. Mental Health Services: per VHA Handbook 1160.01 is meant to include services for the evaluation, diagnosis, treatment and rehabilitation of both substance use disorders and other mental disorders.

General mental health services include:

a. Diagnostic and treatment planning evaluations for the full range of mental health problems;

b. treatment services using evidence-based pharmacotherapy or primary evidence-based psychotherapy for patients with mental health conditions and substance use disorders;

c. patient education;

d. family education when it is associated with benefits to the veterans;

e. referrals, as needed, to inpatient and residential care programs; and

f. consultation about special emphasis problems including Post Traumatic Stress Disorder

(PTSD) and Military Sexual Trauma (MST).

Specialty mental health services include:

a. Consultation and treatment services for the full range of mental health conditions;

b. evidence-based psychotherapy;

c. Mental Health Intensive Case Management (MHICM);

d. Psychosocial Rehabilitation Services, including: PRRCs, family psycho-education, family education, skills training, peer support and Compensated Work Therapy (CWT) and supported employment;

e. PTSD teams or specialists;

f. MST special clinics;

g. homeless programs; and

h. specialty substance abuse treatment services.

1.5.60. MQSA: Mammography Quality Standards Act

1.5.61. MSN: Master of Science in Nursing

1.5.62. NCCPA: National Commission on Certification of Physician Assistants

1.5.63. NLN: National League of Nursing

1.5.64. NSQIP/CICSP: National Surgical Quality Improvement Program/Continuing Improvement in Cardiac Surgical Program

1.5.65. OTC: Over the Counter

1.5.66. PA: Physician Assistant

1.5.67. PACS: Picture Archiving and Communications System

1.5.68. PACT: Patient Aligned Care Team. Background & Introduction: VA has implemented a PCMH model at all VA Primary Care sites which is referred to as PACT. This initiative supports VHA’s Universal Health Care Services Plan to redesign VHA healthcare delivery through increasing access, coordination, communication and continuity of care. PACT provides accessible, coordinated, comprehensive, patient-centered care in team-based environment including the active involvement of other clinical and non-clinical staff. PACT allows patients to have a more active role in their health care and is associated with increased quality improvement, patient satisfaction and a decrease in hospital costs due to fewer hospital visits and readmissions.

1.5.69. Parent Facility: VAMC responsible for performance monitoring and payment for contracted Outpatient

Site of Care services.

1.5.70. PCMH: Patient-Centered Medical Home

1.5.71. PCMM: Primary Care Management Module: a software program used to track Primary Care Clinic Veteran rosters.

1.5.72. PCP: Primary Care Provider

1.5.73. Phar.D.: Doctor of Pharmacy

1.5.74. POC: Point of Care testing

1.5.75. Primary Care Visit: an episode of care furnished in a clinic that provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients and practicing in the context of family and community. Primary care includes, but is not limited to, diagnosis and management of acute and chronic biopsychosocial conditions, health promotion, disease prevention, overall care management, and patient and caregiver education. The VHA site classification defines primary care as those encounters that occur within the primary care class of encounters.

1.5.76. PCMHI: Primary Care-Mental Health Integration

1.5.77. PWS: Performance Work Statement

1.5.78. QAPI: Quality Assessment and Performance Improvement

1.5.79. QASP: Quality Assurance Surveillance Plan

1.5.80. RME: Reusable Medical Equipment

1.5.81. SOP (Clinical): Scope of Practice

1.5.82. Self-referral: Referring patients to Contractor’s facility for follow-up care. Self-referral for outpatient services at the Contractor’s facility is prohibited.

1.5.83. SFT: Store and Forward Telehealth

1.5.84. SMA: Shared Medical Appointments

1.5.85. SPD: Sterile Processing Division

1.5.86. SPE: Senior Procurement Executive

1.5.87. Specialty Care Visit: a specialty care outpatient visit is an episode of care furnished in a clinic that does not provide primary care and is only provided through a referral. These services are generally divided into two sub-categories: medicine specialties and surgery specialties. The VHA site classification defines specialty care as those encounters that occur within the geriatric medicine;

allergy; cardiology; dermatology; emergency; employee health; endocrinology; gastroenterology;

general medicine; hematology or oncology; infectious disease; nephrology; neurology; outreach;

pulmonary or respiratory disease; rheumatology; amputation follow-up; amputation; anesthesia;

cardio-thoracic; ear, nose and throat (ENT); eye; general surgery; gynecology (GYN); neurosurgery;

orthopedics; plastic surgery; urology; or vascular clinic stops.

1.5.88. Support Staff: staff present in the clinic area assisting providers in the actual delivery of care to patients. It consists of RNs, LPNs, Medical Assistants, Health Technicians and Medical Clerks in the clinic.

1.5.89. TJC: The Joint Commission

1.5.90. TIU: Text Integration Utility

1.5.91. TCT: Telehealth Clinical Technicians

1.5.92. VA: Veterans Affairs

1.5.93. VA EHR: VA Electronic Health Record

1.5.94. VAMC: Veterans Affairs Medical Center

1.5.95. VetPro: a federal web-based credentialing program for healthcare providers

1.5.96. VHA: Veterans Health Administration

1.5.97. VVC: VA Video Connect

1.5.98. WHEN: Weekend- Holiday- Every Night

2. STAFFING AND QUALIFICATIONS

2.1. MINIMUM PATIENT ALIGNED CARE TEAM (PACT) STAFFING REQUIREMENTS:

PACTs comprise the patients, the patients’ personal support persons, teamlets (Primary Care Providers (PCPs), Registered Nurse Care Managers (RNCMs), Clinical Associates, Administrative Associates) and discipline specific team members (Clinical Pharmacy Specialists (CPSs), Licensed Clinical Social Workers (LCSWs), Registered Dietician/Nutritionists and Primary Care-Mental Health Integration (PCMHI) staff).

The Contractor shall provide PACT staffing in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The Contractor shall provide a sufficient number of primary care providers so that each primary care provider has a caseload ratio to meet VA standards. Current standards are 1200 active patients per full time physician and 900 active patients per full time mid-level provider. Actual panel sizes can be determined by the VA in accordance with VHA Directive 1406, Patient Centered Management Module (PCMM) for Primary Care. The staffing standard for support staff shall be in ratios to Primary Care Providers of at least three full time equivalent (FTE) support staff (1 FTE RNCM, 1 FTE Clinical Associate, 1 FTE Administrative Associate) for each FTE Primary Care Provider. The Clinical Pharmacy Specialist (CPS) shall be provided the same support staffing given to other providers on the team when they are working in the capacity of a mid-level provider. The Contractor shall provide personnel in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The Contractor must establish and implement contingency plans for ensuring patients receive continuity of, and access to, appropriate primary care during periods of inadequate resources, extended staff absences, staff turnover, understaffing and nature-related events (e.g., extreme weather conditions, natural disasters). If the number of patients reaches 90% of maximum panel size assigned by the facility the Contractor shall communicate to the VA the Contractor’s future staffing plan to ensure staffing ratio standards remain in accordance with PCMM staffing standards. Total Estimated Patients enrolled/assigned to site: 1500.

2.2. PHYSICIAN DIRECTOR (MANDATORY FOR ALL SITES): FTE Ration Performance Standard:

0.05 FTE per PACT. Responsible Party: Shall be provided by Contractor. Qualifications: Contractor’s Physicians (including subcontractors) providing physician director services under the resultant contract shall demonstrate evidence of education, training and experience in Internal Medicine or Family Practice.

Contractor’s Physicians performing under this contract shall be board certified by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. If proposed staff do not meet VA credentialing requirements, the Contractor shall propose substitute acceptable personal within five calendar days. May also be credentialed and privileged as a PCP (if so, authorization for prescriptive authority is required). Physicians shall be licensed in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise, qualifications as per VA Handbook 5005, Appendix G2, located at https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities:

Serves as medical director to oversee and be responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site.

2.3. PRIMARY CARE TEAMLET STAFFING (MANDATORY FOR ALL SITES): All primary care teamlet staffing shall be provided by Contractor.

2.3.1. TEAMLET MEMBER 1: Primary Care Provider (PCP): FTE Ratio Performance Standard: Current standards are 1200 active patients per full time physician and 900 active patients per full time mid-level provider. Contractor shall propose quantity of FTE to meet Standard FTE ratio to panel size. Contractor to propose mix of PCP from the options below. One of the PCPs shall be a physician.

OPTION 1: Physician (MD): Qualifications: Physicians shall demonstrate evidence of education, training and experience in Internal Medicine or Family Practice. Physicians performing under this contract shall be board certified by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. Authorization for prescriptive authority is required. If proposed staff do not meet VA credentialing requirements, the Contractor shall propose substitute acceptable personnel within five calendar days. Physicians shall be licensed in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise, qualifications as per VA Handbook 5005, Appendix G2, located at https://www.va.gov/vapubs/viewPublication.asp?Pub_ID-1006&FType=2.

Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face, telehealth and telephone care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs.

OPTION 2: Certified Registered Nurse Practitioner (CRNP): Qualifications: CRNPs (including subcontractors) must have an MSN from an NLN accredited nursing program and have ANA Certification as a Nurse Practitioner in either Adult Health or Family Practice. Authorization for prescriptive authority is required. Three years of clinical nursing experience is required. A minimum of one year clinical experience as a CRNP is required (three years preferred). Experience in outpatient care in a Family Medicine or Internal Medicine environment is preferred. CRNP shall have current, full, active and unrestricted license and registration as a graduate professional nurse in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise, qualifications as per VA Handbook 5005, Appendix G6, located at https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2.

Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2 https://www.va.gov/vapubs/viewPublication.asp?Pub_ID-1006&FType=2 https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2 clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face, telehealth and telephone care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs.

OPTION 3: Physician Assistant (PA): Qualifications: PAs (including subcontractors) must meet one of the three following educational criteria: a) a bachelor’s degree from a PA training program which is certified by the CAHEA; or b) graduation from a PA training program of at least 12 months duration, which is certified by the CAHEA and a bachelor’s degree in a health care occupation or health-related science; or c) graduation from a PA training program of at least 12 months duration which is certified by the CAHEA and a period or progressively responsible health care experience such as independent duty medical corpsman, license practical nurse, registered nurse, medical technologist or medical technician.

The duration of approved academic training and health care experience must total at least five years.

Authorization for prescriptive authority is required. PAs must be certified by the NCCPA. PA shall have current, full, active and unrestricted license and registration in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise, qualifications as per VA Handbook 5005, Appendix G8, located at https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities:

Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face, telehealth and telephone care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans the incorporate care management and care coordination appropriate to the patient’s needs.

2.3.2. TEAMLET MEMBER 2: Registered Nurse (RN) Care Manager: FTE Ratio Performance Standard:

Current standard is 1.0 FTE RNCM per 1.0 FTE PCP. Qualifications: Graduate of a school of professional nursing approved by the appropriate state-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). Current, full, active and unrestricted registration as a graduate professional nurse in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise, qualifications as per VA Handbook 5005, Appendix G6, located at https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities:

Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing all aspects of professional nursing services consistent with licensure, certification, nursing professional standards of practice and the clinician’s Functional Statement with elements of practice, enhancing patient safety and quality of care by collaborating with PACT staff to develop, oversee and manage care management plans and care coordination for patients assigned to PACTs, participating in mods of communication and care delivery including, but not limited to, secure messaging, telephone care, view alerts management, shared medical appointments, clinical video telehealth visits, face-to-face visits, etc., as part of care management, identifying patient needs for involvement of discipline-specific team members and discussing nursing recommendations with the PCP, engaging relevant PACT staff to support nursing care according to locally established informal and formal communication processes, including entering consultation requests to discipline-specific PACT members if required for formal communications, assuming full accountability for the appropriateness of assignments made by the RNCM to clinical associates or administrative associates related to care management, care coordination, nursing services and outcomes of care, entering orders in the VA EHR for tests per approved standardized RN care management protocols or PCP orders, ensuring the RNCM has same-day access for face-to-face and telephone care visits, using nursing expertise, evidence-based guidelines, standardized nursing protocols and professionally accepted practice standards to promote patient engagement, self-care and wellness, and provide care to patients and determine care management requirements for individual patients or cohorts of patients. The RN collaborates for the improvement of patient care outcomes in the PACT. Promotes systems to improve access and continuity of care, uses advanced clinical knowledge and critical thinking skills to mentor staff in planning, implementing and evaluating interventions that improve patient outcomes, designs and provides age and population specific health promotion and risk reduction strategies, translated evidence-based research into practice to ensure that patients benefit from the latest innovations in nursing science, manages patients in transition between levels of care, serves as an expert resource to implement and teach skills, including motivational interviewing to promote patient self-management toward patient-driven holistic care plan for life.

2.3.3. TEAMLET MEMBER 3: Clinical Associate: FTE Ratio Performance Standard: Current standard is

1.0 FTE Clinical Associate per 1.0 FTE PCP. Contractor to propose the mix of Clinical Associates from the options below.

OPTION 1: Licensed Practical Nurse (LPN): Qualifications: Current, full, active and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise, qualifications as per VA Handbook 5005, Appendix G13, located at https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities:

Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification and functional statement with elements of practice, to patients assigned to PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner and providing direction to patients as they move through the clinic environment. Duties include, but are not limited to, the ability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. This position shall receive training to provide back-up telehealth services.

OPTION 2: Licensed Vocational Nurse (LVN): Qualifications: Current, full, active and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise, qualifications as per VA Handbook 5005, Appendix G13, located at https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities:

Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification and functional statement with elements of practice to patients assigned to PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner and providing direction to patients as they move through the clinic environment. Duties include, but are not limited to, the ability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control, and knowledge of patient confidentiality, policies and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. This position shall receive training to provide back-up telehealth services.

OPTION 3: Medical Assistant (MA): Qualifications: Completion of an approved medical assistant training program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES), or by any accrediting agency recognized by the United States Department of Education or a current and active Certified Medical Assistant (CMA) or Registered Medical Assistant (RMA) from The American Association of Medical Assistants (AAMA) or the American Medical Technologists (AMT). Other credentials, such as completion of a medical services training program of the Armed Forces of the United States, may be accepted based on Chief of Staff determination. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification and functional statement with elements of practice to patients assigned to PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner and providing direction to patients as they move through the clinic environment. Duties include, but are not limited to, the ability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control, and knowledge of patient confidentiality, policies and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. This position shall receive training to provide back-up telehealth services.

OPTION 4: Health Care Technician (HCT) (as part of PACT teamlet, not primary telehealth technician): Qualifications: Completion of an approved medical assistant training program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES), or by any accrediting agency recognized by the United States Department of Education or a current and active Certified Medical Assistant (CMA) or Registered Medical Assistant (RMA) from The American Association of Medical Assistants (AAMA) or the American Medical Technologists (AMT). Other credentials, such as completion of a medical services training program of the Armed Forces of the United States, may be accepted based on Chief of Staff determination. Position Responsibilities: Responsible for the provision of covered services to enrolled an unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification and functional statement with elements of practice to patients assigned to PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner and providing direction to patients as they move through the clinic environment. Duties include, but are not limited to, the ability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control, and knowledge of patient confidentiality, policies and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. This position shall receive training to provide back-up telehealth services.

2.3.4. TEAMLET MEMBER 4: Administrative Associate: FTE Ratio Performance Standard: Current standard is 1.0 FTE Administrative Associate per 1.0 FTE PCP. Qualifications: Required education and experience demonstrating skills and abilities to perform duties ensuring smooth site operations. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing clerical support and administrative functions to PACT staff, collaborating with PACT staff to incorporate the logistical elements of care coordination into comprehensive care management plans, providing guidance and direction to patients and personal support persons for navigating the VA health care system and administrative functions in VA, and coordinating care for patients assigned to the PACT.

2.4. DISCIPLINE SPECIFIC PACT TEAM MEMBERS (REQUIRED FOR ALL SITES): Discipline-specific team members are designated in PCMM for one or more PACT(s). Discipline-specific team members provide continuity of direct discipline-specific care to all patients assigned to PACT(s) for which the team member is designated.

2.4.1. DISCIPLINE SPECIFIC 1: Clinical Pharmacy Specialist (CPS): Services shall be provided by VA staff via telehealth and/or telephone to enrolled and unassigned patients presenting for care.

2.4.2. DISCIPLINE SPECIFIC 2: Clinical Pharmacy Specialist (CPS) Anticoagulation: Services shall be provided by VA staff via telehealth and/or telephone to enrolled and unassigned patients presenting for care.

2.4.3. DISCIPLINE SPECIFIC 3: Licensed Clinical Social Worker (this position provides general/medical social work services): Services shall be provided by VA staff via telehealth and/or telephone to enrolled and unassigned patients presenting for care.

2.4.4. DISCIPLINE SPECIFIC 4: Registered Dietitian/Nutritionist: Services shall be provided by VA staff via telehealth and/or telephone to enrolled and unassigned patients presenting for care.

2.4.5. DISCIPLINE SPECIFIC 5: Primary Care Mental Health Integration (PC-MHI): Services shall be provided by VA staff via telehealth and/or telephone to enrolled and unassigned patients presenting for care.

2.5. SPECIALTY CARE STAFFING:

2.5.1. PODIATRIST: Contractor shall obtain Podiatry Services through referral to the VA for enrolled and unassigned patients presenting for care.

2.6. ANCILLARY SUPPORT SERVICES STAFFING: The following ancillary support staffing shall be provided by the Contractor:

2.6.1. DIAGNOSTIC RADIOLOGIC TECHNOLOGIST: CT, MRI and Ultrasound will be provided at the

VA.

[X] X-Ray Machine staffing standard: Requires one Technologist per machine per 8-hour shift.

Qualifications: Must be certified in general radiologic technology by the ARRT and possess an active, current certification. For CT and MRI, must also possess an Advanced ARRT certification specific to the respective modality. Must meet radiological technologist requirements of the state in which the services are provided; otherwise, qualifications as per VA Handbook 5005 Part 2, Appendix G25, located at https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities:

Responsible for the provision of covered services to enrolled and unassigned patients presenting for care.

2.6.2. PHLEBOTOMIST/LABORATORY TECHNICIAN: Medical Laboratory Technician.

Qualifications: Successful completion of: a) an associate degree course of study of which the second year of the two year program included successful completion of a training course of approximately one year’s duration in a certified laboratory assistant school approved by a nationally recognized accrediting agency; b) one year of study that included six semester hours in chemistry and/or the biological sciences, plus successful completion of: (a) a full time training course of approximately one year’s duration in a medical or clinical laboratory assistant (or technician) school that included instruction in chemistry, hematology, blood banking and microbiology (including serology) and that, in addition, included supervised laboratory practice incident to the diagnostic process and the treatment of patients; or (b) one year of study that included at least six semester hours in chemistry and/or biological science; or (c) two years of study that included at…