S02 36C26125Q0593.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. UEI: EFT:

PHONE: FAX:

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

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

SEE ADDENDUM

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

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

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

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

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

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

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

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

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

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

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C26125Q0593 08-27-2025

Maricela Berrones-Gauger 559-225-6100 6792 09-15-2025

10:00AM PDT

Department of Veterans Affairs

Network Contracting Office (NCO) 21

X

621498

$25.5 Million

N/A

See Performance Work Statement

FMS-VA-2(101) Financial Services Center

PO BOX 149971

Austin TX 78714-9971

See CONTINUATION Page

Contractor shall provide medical office space services for the VA Pacific Island Health Care System

(VAPIHCS) in accordance with the performance work statement.

Period of Performance: 11/01/2025 - 10/31/2035

Point of Contact is Maricela Berrones-Gauger

Email: Maricela.Berrones-Gauger@va.gov

See CONTINUATION Page

X 1

Maricela Berrones-Gauger

Contracting Officer

36C26125Q0593

Table of Contents

SECTION A

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

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

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

AND COMMERCIAL SERVICES (NOV 2023)

C.2 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR

INFORMATION SYSTEMS (NOV 2021)

C.3 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.4 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (JAN 2023) (DEVIATION)

C.5 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019)

C.6 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)

C.7 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.8 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ... 66

C.9 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.10 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.11 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY

(FEB 2023)

C.12 VAAR 852.211-76 LIQUIDATED DAMAGES - REIMBURSEMENT FOR DATA

BREACH COSTS (FEB 2023)

C.13 VAAR 852.216-71 ECONOMIC PRICE ADJUSTMENT OF CONTRACT PRICE(S)

BASED ON A PRICE INDEX (MAR 2018)

C.14 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.15 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.16 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) . 82

C.17 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (JAN 2025) (DEVIATION FEB 2025)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

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

COMMERCIAL SERVICES (SEP 2023)

E.2 ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

ITEMS

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.216-1 TYPE OF CONTRACT (APR 1984)

E.5 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.6 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.7 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024) (DEVIATION

FEB 2025)

E.8 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT

ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)

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 36C261

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

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

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

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

12.00 MO __________________ __________________

Provide use of (2) exam rooms for use by VA Primary Care Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Base POP Begin: 11-01-2025 POP End: 10-31-2026 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers PRODUCT/SERVICE CODE: Q201 - Medical - Managed Healthcare

MANUFACTURER PART NUMBER (MPN): N/A

Clerical Support Administration Contract Period: Base POP Begin: 11-01-2025 POP End: 10-31-2026 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Other Patient Support Services: Space, Furniture, Office/Medical Supplies and Equipment as needed Contract Period: Base POP Begin: 11-01-2025 POP End: 10-31-2026 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Option 1 POP Begin: 11-01-2026 POP End: 10-31-2027

PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 1 POP Begin: 11-01-2026 POP End: 10-31-2027 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Supplies and Equipment as needed Contract Period: Option 1 POP Begin: 11-01-2026 POP End: 10-31-2027 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Option 2 POP Begin: 11-01-2027 POP End: 10-31-2028 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 2 POP Begin: 11-01-2027 POP End: 10-31-2028 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Supplies and Equipment as needed Contract Period: Option 2 POP Begin: 11-01-2027 POP End: 10-31-2028 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Option 3 POP Begin: 11-01-2028 POP End: 10-31-2029 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 3 POP Begin: 11-01-2028 POP End: 10-31-2029 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Supplies and Equipment as needed Contract Period: Option 3 POP Begin: 11-01-2028 POP End: 10-31-2029 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Option 4 POP Begin: 11-01-2029 POP End: 10-31-2030 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 4 POP Begin: 11-01-2029 POP End: 10-31-2030 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Supplies and Equipment as needed Contract Period: Option 4 POP Begin: 11-01-2029 POP End: 10-31-2030 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Option 5 POP Begin: 11-01-2030 POP End: 10-31-2031 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 5 POP Begin: 11-01-2030 POP End: 10-31-2031 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Supplies and Equipment as needed Contract Period: Option 5 POP Begin: 11-01-2030 POP End: 10-31-2031 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Option 6 POP Begin: 11-01-2031 POP End: 10-31-2032 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 6 POP Begin: 11-01-2031 POP End: 10-31-2032 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Other Patient Support Services: Space, Furniture, Office/Medical Supplies and Equipment as needed Contract Period: Option 6 POP Begin: 11-01-2031 POP End: 10-31-2032 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Option 7 POP Begin: 11-01-2032 POP End: 10-31-2033 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 7 POP Begin: 11-01-2032 POP End: 10-31-2033 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Supplies and Equipment as needed Contract Period: Option 7 POP Begin: 11-01-2032 POP End: 10-31-2033 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Option 8 POP Begin: 11-01-2033 POP End: 10-31-2034 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 8 POP Begin: 11-01-2033 POP End: 10-31-2034 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Supplies and Equipment as needed Contract Period: Option 8 POP Begin: 11-01-2033 POP End: 10-31-2034 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Physicians and Mental Health Physicians including applicable equipment and instruments. All procedures shall be performed by VA Physician on eligible VA patients.

Contract Period: Option 9 POP Begin: 11-01-2034 POP End: 10-31-2035 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 9

POP Begin: 11-01-2034 POP End: 10-31-2035 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Supplies and Equipment as needed Contract Period: Option 9 POP Begin: 11-01-2034 POP End: 10-31-2035 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

GRAND TOTAL __________________

B.3 PERFORMANCE WORK STATEMENT

Offsite Contracted Medical Space

1. GENERAL:

1.1 Services Provided: The VA Pacific Islands Health Care System (VAPIHCS) requires the following services to be provided to Veterans primarily residing in Lanai, Hawaii, in a private hospital, office or clinic environment.

1.2 Place of Performance: Contractor shall furnish services on the Island of Lanai, Hawaii

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

1.4 Policy/Directives/Handbooks. Contractor shall comply with all relevant VA policies and procedures related to quality, access, patient safety, and performance, including but not limited to, the policies listed below. The policies listed below can be accessed electronically at the following: VA Publications and VHA Publications

1.4.1 VA Directive 1663: Health Care Resources (HCR) Contracting – Buying Title 38

U.S.C. 8153

1.4.2 VHA Directive 1003.04: VHA Patient Advocacy

1.4.3 VHA Directive 1088: Communicating Test Results to Providers and Patients

1.4.4 VHA Directive 1100.16: Health Care Accreditation of VHA Facilities and

Programs

1.4.4 VHA Directive 1100.18: Reporting and Responding to State Licensing Boards

1.4.5 VHA Directive 1400.01: Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents.

1.4.6 VHA Directive 1605.01: Privacy and Release of Information

1.4.7 VHA Directive 1900: VA National Standards of Practice

1.4.8 VHA Directive 1907.01: VHA Health Information Management and Health

Records

1.4.9 VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports

1.4.9 Privacy Act of 1974 (5 U.S.C. 552a) as amended:

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5 Acronyms/Definitions: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict https://www.va.gov/vapubs/ https://www.va.gov/vhapublications/ http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1 AAAHC: Accreditation Association for Ambulatory Health Care

1.5.2 ABA: American Board of Anesthesiology http://www.theaba.org/

1.5.3 AORN: Association of Operating Room Nurses

1.5.4 ASC: Ambulatory Surgery Center

1.5.5 AST: Association of Surgical Technicians

1.5.6 BAA: Business Associate Agreement

1.5.7 CDC: Centers for Disease Control and Prevention

1.5.8 CDR: Contract Discrepancy Report

1.5.9 CEU: Certified Education Unit

1.5.10 CMS: Centers for Medicare and Medicaid Services

1.5.11 CO: Contracting Officer – The person executing this contract on behalf of the VA with the authority to enter and administer contracts and make related determinations and findings.

1.5.12 COR: Contracting Officer’s Representative – A person appointed by the CO to take necessary action to ensure the contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the VA.

The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.5.13 COS: Chief of Staff

1.5.14 CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.15 CPARS: Contractor Performance Assessment Reporting System

1.5.16 CPT: Current Procedural Terminology

1.5.17 CRNA: Certified Registered Nurse Anesthetist

1.5.18 ED: Emergency Department

1.5.19 EHR: Electronic Health Records. Electronic health record system used by the VA.

1.5.20 EMR: Electronic Medical Record

1.5.21 FSMB: Federation of State Medical Boards

1.5.22 FTE: Full Time Equivalent: VA’s standard definition is for full time-working the equivalent of 80 hours every two weeks, 2080 hours per year. However, providers may propose using their standard FTE definition.

1.5.23 HHS: Department of Health and Human Services

1.5.24 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.

1.5.25 HIPAA: Health Insurance Portability and Accountability Act

1.5.26 HR: Human Resources

1.5.27 Implants: Implants are defined as any active medical device which is intended to be totally or partially introduced, surgically or medically, into the human body or by medical intervention into a natural orifice, and which is intended to remain after the procedure.

1.5.28 ISO: Information Security Officer

http://www.theaba.org/

1.5.29 Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.5.30 MOD: Medical Officer of the Day

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

1.5.32 NPI: National Provider Identifier: NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration shall use NPIs in all

HIPAA- standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.33 NP: Nurse Practitioner

1.5.34 NPPES: National Plan and Provider Enumeration System

1.5.35 Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the contractor or any of its subcontractors.

1.5.36 PA: Physician Assistant

1.5.37 POP: Period of Performance

1.5.38 PPD: Purified Protein Derivative

1.5.39 PWS: Performance Work Statement

1.5.40 QA/QI: Quality Assurance/Quality Improvement

1.5.41 QASP: Quality Assurance Surveillance Plan

1.5.42 QAPI: Quality Assessment and Performance Improvement

1.5.43 QM/PI: Quality Management/Performance Improvement

1.5.44 TJC: The Joint Commission

1.5.45 VA: Veterans Affairs

1.5.46 VHA: Veterans Health Administration

1.5.47 VISN: Veterans Integrated Services Network

1.5.48 VISTA: Veterans Integrated Systems Technology Architecture

2. QUALIFICATIONS: Contractor shall be duly licensed by the Department of Health and the

State of Hawaii to operate and provide a medical office space and shall be a qualified provider under the Medicare Program.

2.1 Facility:

2.1.1 The contracted facility shall meet or exceed health care accreditation requirements of VHA Directive 1100.16 or Accreditation Requirements for

Ambulatory Health Care. Documentation verifying accreditation requirements shall be provided by the contractor on an annual basis.

2.1.2 The contractor’s facility shall meet all federal, state, and local fire and life safety codes and shall be accessible and convenient for wheelchair patients and other handicapped or disabled Veterans.

2.2 Staff:

2.2.1 Contractor staff shall meet state licensure requirements and all licenses held by contractor’s staff working on this contract shall be full and unrestricted licenses. Contractor staff who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending http://www.nlnac.org/ action, or denied upon application shall not provide services under this contract.

2.2.2 Contractor shall have written policies and procedures regarding staff credentials and privileges. All contractor staff shall be appropriately credentialed and privileged according to those policies and procedures and practice within the scope of their privileges.

2.2.3 Contractor staff shall be technically proficient in the skills necessary to fulfill the VA’s requirements, including the ability to speak, understand, read, and write English fluently.

2.2.4 Contractor staff qualifications, licenses, and certifications shall be maintained in good standing throughout the contract period of performance.

Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. In the event that contractor staff is not directly employed by the treating facility, documentation shall be provided to the COR to ensure adequate certification.

2.2.5 Contractor shall provide statement that all required infectious disease testing for personnel is current and that the contractor is compliant with all applicable laws to include OSHA regulations concerning occupational exposure to blood borne pathogens. The contractor shall also notify the VA of any significant communicable disease exposures and the VA shall also notify the contractor of the same, as appropriate. Contractor shall adhere to current

CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control- AJIC 1998; 26:289-354 https://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. If personnel are absent from work secondary to infectious disease, then contractor shall provide follow up documentation of clearance prior to return to the workplace.

2.3 Conflict of Interest: The contractor and all contractor’s personnel are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The contractor shall also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest and fully outlined in response to the subject attachment in Section D.

2.4 Citizenship Related Requirements:

2.4.1 The contractor certifies that the contractor shall comply with all legal provisions contained in the Immigration and Nationality Act of 1952 (as https://www.cdc.gov/hicpac/pdf/InfectControl98.pdf amended); its related laws and regulations that are enforced by the

Department of Homeland Security and the Department of Labor as these may relate to undocumented noncitizens and/or non-immigrant foreign nationals working under contract or subcontract for the contractor while providing services to Department of Veterans Affairs.

2.4.2 While performing services for the Department of Veterans Affairs, the contractor shall not knowingly employ, contract, or subcontract with an undocumented noncitizen or foreign national non-immigrant who is in violation their status, because of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the contractor is required to comply with all E-Verify requirements consistent with

Executive Order 12989 and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations (including FAR Subpart 22.18).

2.4.3 If the contractor fails to comply with any requirements outlined in the preceding paragraphs or above referenced laws and regulations, the

Department of Veterans Affairs may, at its discretion, require that the undocumented noncitizen or foreign national who has failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by the Department of Homeland

Security and/or the Department of Labor, shall be prohibited from working at the contractor’s place of business that services Department of Veterans

Affairs patient referrals; or other place where the contractor provides services to Veterans who have been referred by the Department of Veterans Affairs;

and may form the basis for termination of this contract for breach.

2.4.4 The contractor acknowledges that this certification concerns a matter within the jurisdiction of an agency of the United States. The contractor further acknowledges that this certification is subject to Title 18, United States Code, Section 1001, and, as such, a false, fictitious, or fraudulent certification may render the offeror subject to criminal, civil, or administrative penalties, including prosecution.

2.4.5 The contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D.

2.5 Annual Office of Inspector General (OIG) Statement: In accordance with The Health

Insurance Portability and Accountability Act (HIPAA) and the Balanced Budget Act

(BBA) of 1977, the VA OIG has established a list of parties and entities excluded from

Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the

Medicare and Medicaid programs.

2.5.1 Therefore, all contractors shall review the OIG List of Excluded

Individuals/Entities (LEIE) on the OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed Contract http://oig.hhs.gov/exclusions/index.asp staff and/or firm(s) are not listed. Contractors should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a civil monetary penalty (CMP) for each item or service furnished during a period that the person or entity was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contract staff and entities that employ or enter contracts with excluded individuals or entities to provide items or services to

Federal program beneficiaries.

2.5.2 By submitting their proposal, the contractor certifies that the OIG LEIE has been reviewed and that the contractor and its subcontractors are not listed as of the date the proposal was signed. In addition, the contractor will review the

OIG LEIE annually to verify compliance.

2.6 Non-Personal Services: The parties agree that the contractor, contract staff, agents and sub-contractors shall not be considered VA employees for any purpose. All individuals that provide services under this resultant contract and are not staff of the contractor shall be regarded as subcontractors. The contractor shall be responsible and accountable for the quality of care delivered by all its subcontractors. The contractor shall be responsible for strict compliance of all contract terms and conditions without regard to who provides the service.

2.7 Indemnification: The contractor shall be liable for, and shall indemnify and hold harmless the VA against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the contractor, its agents, or employees.

2.8 Prohibition Against Self-Referral: Contractor’s personnel are prohibited from referring

VA patients to contractor’s or their own practice(s).

2.9 Inherently Governmental Functions Prohibited: This includes, but is not limited to, determination of agency policy, determination of federal program priorities for budget requests, direction and control of VA employees, selection or non-selection of individuals for federal VA employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for federal employees, approving any contractual documents, approval of federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.10 Contract Personnel: The contractor shall be responsible for protecting contractor’s personnel furnishing services. To carry out this responsibility, the contractor shall provide or certify that the following is provided for all contract staff providing services under the resultant contract:

2.10.1 Workers’ compensation

2.10.2 Professional liability insurance

2.10.3 Health examinations

2.10.4 Income tax withholding, and

2.10.5 Social security payments.

2.11 Tort Liability: The Federal Tort Claims Act does not cover contractor personnel.

When a contracted provider has been identified as a provider in a tort claim, The contractor’s provider shall notify the contractor’s legal counsel and/or insurance carrier. Any settlement or judgment arising from a contractor’s personnel action or non-action is the responsibility of the contractor and/or insurance carrier.

3. HOURS OF OPERATION/SCHEDULING:

3.1 BUSINESS HOURS: Monday through Friday. Hours Operations: 0800-1630 (0800am-

430pm). Evenings Hours: None. Weekend Hours: None

3.2 FEDERAL HOLIDAYS: The following holidays are observed by the Department of

Veterans Affairs:

• New Year’s Day

• President’s Day

• Martin Luther King’s Birthday

• Memorial Day

• Juneteenth

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any day specifically declared to be a national holiday.

4. CONTRACTOR RESPONSIBILITIES:

4.1 Contractor performing services under this contract shall provide administrative support services. The contractor shall provide services solely dedicated to Veterans regardless of gender or age. Those patients needing specialty care shall be referred to

VA.

4.2 The contractor shall be responsible for supervising the daily services provided under this contract by the contractor’s support staff.

4.3 Contractor shall be responsible for providing on Other Patient Support Services:

Space, Furniture, Equipment to include Medical Supplies and Office Supplies.

4.4 If the VA requires any equipment not supplied by the contractor, VA shall be responsible for bringing/providing the equipment. This does not include disposable items; the contractor shall supply all disposable items.

4.5 The contractor shall provide necessary and dedicated and shared areas to accommodate VA workstations for VA to perform administrative and clinical documentation tasks in support of procedures conducted at the contractor’s site.

These areas shall be identified mutually by the contractor and the VA.

4.6 Standards of Practice: Contractor shall meet or exceed VA and AAAHC (or equivalent) standards.

4.7 SPACE REQUIREMENTS: PACT space standards are found in the PACT Space

Module Design Guide at http://www.cfm.va.gov/til/dGuide/dgPACT.pdf. Accessibility design standards are defined in the VA Barrier Free Design Standard at:

http://www.cfm.va.gov/til/etc/dsBarrFree.pdf These documents are to be used by VA as a reference in defining space requirements for this solicitation. Contractor’s design of space will be evaluated on how it best supports accessibility and the PACT model of care.

1. Contractors shall provide space that meets the standards outlined in the

PACT Space Module Design Guide (see link above) and for the purposes of this solicitation the following minimum space requirements are:

1. Clinic Space:

1. One office for Primary Care (PC) provider

2. One clinical exam/treatment room

3. One office for Mental Health (MH) and/or Specialty

Care (SC) providers

4. One office for Home Based Primary Care (HBPC) provider

5. One telemedicine room

2. The codes, standards, and references listed below indicate minimum performance requirements. Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and on-going maintenance of the contracted facility. Design and documentation of the medical facility shall be in compliance with the requirements of the codes, standards, and references listed below. This also covers construction materials and standards not fully addressed by the codes, standards, and references below.

3. Codes: All contracted medical facilities are to conform to all applicable codes, which includes but is not limited to following:

1. National Fire Protection Association (NFPA) 101 Life

Safety Code, NFPA 99

2. Health Care Facilities Code and all standard references therein, current edition.

3. Occupancy classification to be Chapter 38 New Business

Occupancy.

http://www.cfm.va.gov/til/dGuide/dgPACT.pdf http://www.cfm.va.gov/til/etc/dsBarrFree.pdf

4. NFPA 75 Standard for the Fire Protection of Information

Technology, current edition, applicable where the CBOC contains a Data Center.

5. Architectural Barriers Act Accessibility Standards (ABAAS), current edition.

6. International Building Codes (IBC)

7. International Energy Code

8. International Mechanical Code

9. International Plumbing Code

10. State and local International Building Codes (IBC) amendments as required by the local Authority Having Jurisdiction

(AHJ).

11. United States Pharamcopeial Convention (USP) Chapters

<795>, <797>, and <800>

4. Standards: All contracted CBOC facilities are to conform to the following standards:

1. FGI Guidelines for the Design and Construction of

Outpatient Facilities, current edition (referred to as FGI Guidelines herein).

2. The Joint Commission (TJC) accreditation standards for outpatient clinics in a Business occupancy. TJC requirements apply to the facility under the affiliated VA medical center license.

Building construction and on-going maintenance procedures shall meet TJC Environment of Care and Life Safety standards.

Contractor shall provide and submit all documentation that is required for TJC requirements.

3. GSA Facility Security Level (FSL) shall be FSL II.

4. Sustainability standards.

5. American Society of Heating, Refrigerating and Air-

Conditioning Engineers (ASHRAE) Standard 170, Ventilation of

Health Care Facilities, current edition (referred to as ASHRAE 170 herein)

6. ASHRAE Standard 188, Legionellosis: Risk Management for Building Water Systems, current edition.

7. ASHRAE Standard 62.1, Ventilation for Acceptable Indoor

Air Quality, current edition (referred to as ASHRAE 62.1 herein)

8. Sheet Metal and Air Conditioning Contractors National

Association (SMACNA) Standard, HVAC Duct Construction

Standards - Metal and Flexible.

9. USP General Chapter 797 Pharmaceutical Compounding –

Sterile Preparations

10. USP General Chapter 800 Hazardous Drugs - Handling in

Healthcare Settings

5. References: Following are guides, manuals, and other references developed by VA applicable to contracted CBOC facilities:

1. VA Signage Design Manual PG 18-12

2. VA Enterprise Facility IT Support Infrastructure Standard, V2.1

1. Building Prototypes, Community Based Outpatient

Clinic https://www.cfm.va.gov/til/prototypes.asp#CBOC

2. PACT Space Module Design Guide https://www.cfm.va.gov/til/dGuide/dgPACT.pdf

3. Space Planning Criteria PG 18-9 https://www.cfm.va.gov/til/space/spChapter265.pdf

4. Room Templates, Leased Community Based

Outpatient Clinics https://www.cfm.va.gov/til/leasing.asp

6. The Contractor shall provide a floor plan of their proposed space as part of their proposal and indicate how it meets the design standards in the PACT

Space Module Design Guide.

7. The Contractor's facility must be in compliance with National Fire

Protection Association (NFPA) Life/Safety requirements and the Americans with

Disabilities Act. VA shall inspect the Contractor's facility before contract start date and retains a rite of inspection throughout the period of performance during normal business hours of 8:00 AM – 4:30 PM, Monday through Friday.

Contractor must be in compliance with these requirements prior to contract start date. A list of any deficiencies identified during an inspection will be provided to the Contractor along with a required date for correction of the deficiencies. Any planned changes in the physical environment at the Outpatient Site of Care must be reviewed and approved by the VA to ensure that all life safety codes are met. Parking should be adequate to accommodate Veteran patients, and shall include at least two (2) handicapped parking spaces.

8. Automatic Fire Sprinkler System – The VAPIHCS will either install automatic fire sprinkler system or seek a waiver for this requirement.

1. In VA occupied buildings, fire sprinkler protection shall be required to protect patients, visitors, and staff; also for maintaining the continuity of important clinical and administrative activities;

and protecting VA property. This is for compliance with the

Federal Fire Safety Act PL-102-522. This applies to all categories of VA construction and renovation projects, station level projects, and acquisition of all VA property (including contracted outpatient clinics).

2. The entire Building shall be protected throughout by an automatic fire sprinkler system. Automatic fire sprinkler system(s) shall be installed in accordance with the requirements of NFPA 13, Standard for the Installation of Sprinkler Systems that was in effect on the actual date of installation.

3. Automatic fire sprinkler system(s) shall be maintained in accordance with the requirements of NFPA 25, Standard for the

Inspection, Testing, and Maintenance of Water-based Fire

Protection Systems (current as of Contract Award Date).

https://www.cfm.va.gov/til/leasing.asp

4. "Equivalent level of safety" means an alternative design or system (which may include automatic fire sprinkler systems), based upon fire protection engineering analysis, which achieves a level of safety equal to or greater than that provided by automatic fire sprinkler systems.

5. VA requires a fire alarm system regardless of floor.

1. Fire Alarm System:

1. A Building-wide fire alarm system shall be installed in the entire building.

2. The fire alarm system shall be installed in accordance with the requirements of NFPA 72, National Fire Alarm and Signaling Code, that was in effect on the actual date of installation.

3. The fire alarm system shall be maintained in accordance with the requirements of NFPA 72, National Fire Alarm and Signaling Code (current as of the Contract Award Date).

4. The fire alarm system shall transmit all fire alarm signals to the local fire department via any of the following means: directly to the local fire department, to the (911) public communications center, to a central station, to a remote supervising station, or to a proprietary supervising station.

5. If the Building’s fire alarm control unit is over

25 years old as of the date of award of this contract, Contractor shall install a new fire alarm system in accordance with the requirements of

NFPA 72, National Fire Alarm and Signaling Code

(current as of the Contract Award Date), prior to

Government acceptance and occupancy of the

Space.

9. Access by the government: The Government shall have the right to access any space within the Building during construction or build out for the purposes of performing inspections or installing Government furnished equipment. The Government shall coordinate the activity of Government contractors with the Contractor to minimize conflicts with and disruption to other contractors on site. Access shall not be unreasonably denied to authorized

Government officials including, but not limited to, Government contractors, subcontractors, or consultants acting on behalf of the Government on this project.

10. Maintenance and Testing of Systems: The Contractor is responsible for the total maintenance and repair of the contracted premises. Such maintenance and repairs include the site and private access roads. All equipment and systems shall be maintained to provide reliable, energy efficient service without unusual interruption, disturbing noises, exposure to fire or safety hazards, uncomfortable drafts, excessive air velocities, or unusual emissions of dirt. The

Contractor's maintenance responsibility includes initial supply and replacement of all supplies, materials, and equipment necessary for such maintenance.

Maintenance, testing, and inspection of appropriate equipment and systems shall be done in accordance with current applicable codes, and inspection certificates shall be displayed as appropriate. Copies of all records in this regard shall be forwarded to the Government’s designated representative.

11. At the Contractor’s expense, the Government reserves the right to require documentation of proper operations, inspection, testing, and maintenance of fire protection systems, such as, but not limited to, fire alarm, fire sprinkler, standpipes, fire pump, emergency lighting, illuminated exit signs, emergency generator, prior to occupancy to ensure proper operation. These tests shall be witnessed by the Government’s designated representative.

12. Acceptance of Space and Certificate of Occupancy. The Contractor shall issue written notice to the Government to schedule inspection of the space for acceptance. The Government shall only accept the space if the construction or build-out is conforming to the requirements of the solicitation. The space shall be considered complete only if the space may be used for its intended purpose and completion of any remaining work will not interfere unreasonably with the intended use of the space as defined under the contract. Acceptance is final with the exception of items identified on a punch list generated as a result of the inspection, concealed conditions, latent defects or fraud but shall not relieve the

Contractor of any other contract requirements.

13. VA shall inspect the Contractor's facility before contract start date and retains a rite of inspection throughout the period of performance during normal business hours of 8:00 AM – 4:30 PM, Monday through Friday. Contractor must be in compliance with these requirements prior to contract start date. A list of any deficiencies identified during an inspection will be provided to the Contractor along with a required date for correction of the deficiencies. Any planned changes in the physical environment at the Outpatient Site of Care must be reviewed and approved by the VA to ensure that all life safety codes are met.

14. The Contractor shall provide a valid Certificate of Occupancy, issued by the local jurisdiction, for the intended use as outlined in the contract. If the local jurisdiction does not issue C of O’s or if the C of O is not available, the Contractor may satisfy this condition by providing a report prepared by a licensed fire protection engineer that indicates the Space and Building are compliant with all applicable local codes and ordinances and all fire protection and life safety-related requirements of this contract.

15. Other equipment required by Occupational Safety and Health

Administration (OSHA) and TJC List most current version.

16. Privacy Standards: Veterans must be provided adequate visual and auditory privacy at check-in. Patient names are not posted or called out loudly in hallways or clinic areas. Veterans must be provided adequate visual and auditory privacy in the interview area. Patient-identified information must not be visible in the hall including charts where names are visible. Every effort should be made to restrict unnecessary access to hallways by patients and staff who do not work in that clinic area. Patient dignity and privacy must be maintained at all times during the course of a physical examination. Examination rooms must be located in a space where they do not open into a public waiting room or a public corridor.

Appropriate locks which allow staff members to have emergency key or code access are required for all examination room doors. Locks must be installed in all examination rooms in all clinics and outpatient testing or procedure areas, not only those clinical areas primarily serving women. All locks must be designed to always allow a safe exit from locked rooms without a key or code. Privacy curtains/screens must be present and functional in examination rooms.

Curtains/screens are to ensure privacy from incidental door openings, or from view of others in the room that are not taking part in the examination.

Curtains/screens must fully shield the patient while dressing/undressing, during examination, and offer sufficient work space for the provider to perform the examination. Rooms where a patient would not be expected to disrobe within a private room are exempted from this requirement. All examination tables must be placed in such a way that the genital area is not visible from the doorway. Toilet rooms should be located in close proximity to the examination room. Patients who are undressed or wearing examination gowns must have access without going through public hallways or waiting rooms. Personal hygiene products shall be available in public female, unisex, and family toilet rooms at no charge.

Diaper changing tables shall be available in designated public male, female, unisex, and family toilet rooms. Diaper changing tables shall be placed at least one per floor in male, female, and unisex toilet rooms, and no more than 300 feet from areas accessible to a patient. Rooms with changing table must be identified, and toilet rooms without changing tables should include signage directing users to the nearest changing table. Cameras (telehealth, computer, teaching) must be shielded/ covered/in locked cabinet/room when not in use.

17. “VETERANS ONLY” CLINIC REQUIREMENTS FOR CO-LOCATED

FACILITIES: To meet VA’s requirements for a “Veterans Only” clinic in a co-located facility, the Contractor’s site must have separate signage and dedicated staff for the site. The clerical/administrative personnel who check patients into and out of the clinic, respond to questions, and resolve issues for Veterans must be working with Veterans only. Contractor employees must be working with one computer system only (the VA EHR). The system used by the Contractor for tracking Veteran patients for billing purposes must be separate from the system used to track and bill non-Veterans treated in the co-located clinic. The exam room/treatment area must be separate. Clinical staff providing care to Veteran patients must be dedicated solely to the task of serving the Veteran patients associated with this clinic. There must be a separate telephone number associated with the Veterans’ clinic.

18. Physical Security: The contract clinic site for the VA clinic shall comply with VA Physical Security requirements which may be found in the Physical

Design Manual for Life-Safety Protected Facilities located at the following link:

https://www.cfm.va.gov/til/PhysicalSecurity/dmPhySecLS.pdf and with Appendix

B of VA Handbook 0730 which defines specifications for physical barrier security, lock set hardware, alarms, and storage containers for high value items and https://www.cfm.va.gov/til/PhysicalSecurity/dmPhySecLS.pdf dangerous drugs. In order to comply with Executive Orders, Federal laws, and

VA policy, space contracted by VA must meet certain physical security requirements. VA has adopted the protection of the Interagency Security

Committee (ISC) Security Design Criteria for all facilities as the minimum requirement.

1. The Contractor shall provide a written certification from a licensed professional engineer that the Building conforms to a minimum of:

1. Window glazing and façade protection level, with a performance condition as prescribed by WINGARD 4.1 or later or WINLAC 4.3 software.

2. Setback distance from the face of the Building's exterior to the protected/defended perimeter (i.e., any potential point of explosion). This means the distance from the Building to the curb or other boundary protected by bollards, planters or other street furniture. Such potential points of explosion may be, but are not limited to, such areas that could be accessible by any motorized vehicle

(i.e., street, alley, sidewalk, driveway, parking lot).

3. Lobbies, mailrooms, and loading docks shall not share a return-air system with the remaining areas of the

Building. The Contractor shall provide lobby, mailroom, and loading dock ventilation systems' outside air intakes and exhausts with low leakage, fast acting, isolation dampers that can be closed to isolate their systems.

Dedicated HVAC shall be required for mailrooms only when the Government specifically requires a centrally operated mailroom. On Buildings of more than four stories, air intakes shall be located on the fourth floor or higher. On Buildings of three stories or less, air intakes shall be located on the roof or as high as practical.

Locating intakes high on a wall is preferred over a roof location.

2. Panic Alarms: The VA shall provide or seek a waiver for a panic alarm system per VA Handbook 0730/4, “Security and

Law Enforcement”. This system must provide coverage of entire facility to protect staff in all rooms.