S02 - 36C26323R0032.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

36C26323R0032 05-30-2023

Daniel Vagts 651-293-3040 06-21-2023

12:00 PM CDT

36C263

Department of Veterans Affairs

Network 23 Contracting Office

Attention: Daniel Vagts

316 Robert Street N. STE. 506

St Paul MN 55101

X

621111

$14 Million

N/A

Department of Veterans Affairs

NCO 23 - St. Cloud

4801 Veterans Drive

St. Cloud MN 56303

Network 23 Contracting Office

316 Robert Street N. STE. 506

St. Paul MN 55415

Y

Financial Services Center

PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

Medical Officer of the Day (MOD) Services to be performed by three (3) full-time equivalent Physician Assistants (PA), Nurse Practitioners (NP), Medical Doctors (MD), or Doctors of Osteopathy (DO), or any combination, on-site at

St. Cloud VA Health Care System (SCVAHCS), St. Cloud, MN.

See Section B.4 Schedule of Services (pg.7)

See Section B.5 Performance Work Statement (pg.12)

See CONTINUATION Page

X ONE

Daniel Vagts VA-VHA-SAOC-2019-161D3612

Contract Officer

36C26323R0032

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 SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011)

B.3 SUPPLEMENTAL INSURANCE REQUIREMENTS

B.4 SCHEDULE OF SERVICES

B.5 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

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

COMMERCIAL SERVICES (DEC 2022)

C.2 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL (JAN 2011)

C.3 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS

(NOV 2021)

C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.6 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.7 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.8 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.9 VAAR 852.219-10 VA NOTICE OF TOTAL SERVICE-DISABLED VETERAN-OWNED SMALL

BUSINESS SET-ASIDE (JUL 2019) (DEVIATION)

C.10 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018)

C.11 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (OCT 2019)

C.12 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE (OCT 2019)

C.13 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.14 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (NOV 2021)

C.15 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR

EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAR 2023)

ALTERNATE II (MAR 2023)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 LIST OF ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (OCT 2018)

E.2 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JAN 2017)

E.3 PROPOSAL SUBMITTAL INSTRUCTIONS

E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

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

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

E.7 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

E.8 VAAR 852.252-70 SOLICITATION PROVISIONS OR CLAUSES INCORPORATED BY REFERENCE

(JAN 2008)

E.9 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION (OCT 2018)

E.10 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.11 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.12 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (DEC 2022)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer

Contracting Officer is Daniel Vagts at daniel.vagts@va.gov

Department of Veterans Affairs

NCO 23 – St. Paul

316 Robert Street N.

St. Paul MN 55101

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

See Billing Instructions, PWS 6.2. Billing:

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.

5. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the

Solicitation numbered and dated as follows:

AMENDMENT NO DATE

mailto:daniel.vagts@va.gov

6. TYPE OF CONTRACT: Resultant contracts shall be a Firm Fixed Price (FFP) contract effective for the period stated in the Schedule of Services.

7. TERM OF CONTRACT: The contract period is effective July 23, 2023 through July 22, 2024 with four

(4) available option periods.

8. POINT OF CONTACT: The Contractor shall provide a point of contact (POC) who shall be responsible for the performance of the work under this contract. The POC shall have full authority to act for the

Contractor on all matters relating to the daily operation of this contract. The POC may be a contract health care provider performing under this contract. An alternate may be designated, but the

Contractor shall identify, in writing, those times when the alternate shall act as the POC. The Contractor shall identify the POC and alternate in writing to the Contracting Officer’s Representative (COR) and

Contracting Officer (CO). The Contractor shall give written notification to the COR and CO of the time when the alternate will act as the POC. The POC shall be available by telephone Monday through Friday, 8:00 AM through 4:30 PM, excluding Federal holidays.

9. SECURE FAX: VA Handbook 6500 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, distribute on, 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.”

10. 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.

B.2 SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-9, Small Business Subcontracting Plan, and VAAR 852.219-9, VA Small Business Subcontracting Plan Minimum Requirement. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing the contractor's compliance with the plan, including reviewing the contractor's accomplishments in achieving the subcontracting goals in the plan. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting plan.

B.3 SUPPLEMENTAL INSURANCE REQUIREMENTS

In accordance with FAR 28.307-2 and FAR 52.228-5, the following minimum coverage shall apply to this contract:

(a) Workers' compensation and employers’ liability: Contractors are required to comply with applicable Federal and State workers' compensation and occupational disease statutes. If occupational diseases are not compensable under those statutes, they shall be covered under the employer's liability section of the insurance policy, except when contract operations are so commingled with a Contractor's commercial operations that it would not be practical to require this coverage. Employer's liability coverage of at least $100,000 is required, except in States with exclusive or monopolistic funds that do not permit workers' compensation to be written by private carriers.

(b) General Liability: $500,000.00 per occurrences.

(c) Automobile liability: $200,000.00 per person; $500,000.00 per occurrence and $20,000.00 property damage.

(d) The successful bidder must present to the Contracting Officer, prior to award, evidence of general liability insurance without any exclusionary clauses for asbestos that would void the general liability coverage.

B.4 SCHEDULE OF SERVICES

The Contractor shall furnish all personnel necessary to perform onsite Medical Officer of the Day

Services to eligible beneficiaries of the Department of Veterans Health Administration (VHA) at the St.

Cloud Veterans Affairs (VA) Health Care System (HCS), St. Cloud, Minnesota.

The VAHCS Services are accredited by The Joint Commission (TJC) and follow the standards & guidelines set forth by The American College of Physicians (encompassing all of internal medicine) and the Society of Hospital Medicine (http://www.hospitalmedicine.org). A contractor providing onsite Medical Officer of the Day services shall provide services that meet or exceed those guidelines.

The St. Cloud VA Health Care System (SCVAHCS) is a 388-bed facility providing psychiatric, primary care, specialty care, and long-term care to male and female veterans. The mental health department includes a 148-bed residential chemical dependency, and mental health treatment program and domiciliary, outpatient clinics, and a 15-bed inpatient psychiatric unit. The Rehabilitation & Extended Care (REC) community living center (CLC) consists of 225 nursing home beds which includes long-term care, rehabilitation (short stay), dementia care, hospice care, behavioral recovery unit and a specialized nine-bed, ventilator-dependent patient unit located in the CLC.

The SCVAHCS provides 24-hour evaluation and care for onsite bedded patients. During regular clinic workday tours psychiatric and medical walk-ins are evaluated in the respective clinics. Urgent Care (UC) is available daily from 8:00a.m. to 6:00p.m. and includes weekends and Federal Holidays for medical and psychiatric evaluation.

Place of Performance: Services shall be provided on site, St. Cloud VA Health Care System, 4801

Veterans Drive, St. Cloud, MN 56303.

Pricing Instructions:

The offeror is instructed to edit the number of sub-Line-Item Numbers (SLIN) to correspond with the number of key personnel submitted for the line-item number (LIN). Affiliate Offerors shall include the

“title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SUB-LINs if adding or removing Key

Personnel.

The Contractor shall propose a minimum of three (3) full-time equivalent (FTE) Physician’s Assistants (PA), Nurse Practitioners (NP), Physicians (MD), or Doctors of Osteopathy (DO), or any combination of these providers to be credentialed and be available for scheduling to meet the requirements of the contract.

Period of Performance: BASE YEAR: July 23, 2023 to July 22, 2024

OPTION YEAR 1: July 23, 2024 to July 22, 2025

LIN

No.

SUB-

Description Qty. Unit Unit Cost Total

Annual Cost

1001 None Medical Officer of the Day (MOD)

Services 7660 Hours DO NOT

PRICE

DO NOT PRICE

LIN

No.

Annual Cost

0001 None Medical Officer of the Day (MOD)

Services

7660 Hours DO NOT

PRICE

DO NOT PRICE

KEY PERSONNEL

None 0001a

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2670 Hours $__/hr $__

None 0001b

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2495 Hours $__/hr $__

None 0001c

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2495 Hours $__/hr $__

TOTAL FOR BASE YEAR

Hours

None 1001a

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2670 Hours $__/hr $__

None 1001b

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2495 Hours $__/hr $__

None 1001c

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

TOTAL FOR OPTION YEAR 1

OPTION YEAR 2: July 23, 2025 to July 22, 2026

No.

Annual Cost

2001 None Medical Officer of the Day (MOD)

Services 7660 Hours DO NOT

None 2001a

NAME:____________

TITLE/LEVEL OF

2670 Hours $__/hr $__

None 2001b

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2495 Hours $__/hr $__

None 2001c

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

TOTAL FOR OPTION YEAR 2

OPTION YEAR 3: July 23, 2026 to July 22, 2027

No.

Annual Cost

3001 None Medical Officer of the Day (MOD)

Services 7660 Hours DO NOT

None 3001a

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2670 Hours $__/hr $__

None 3001b

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2495 Hours $__/hr $__

None 3001c

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

TOTAL FOR OPTION YEAR 3

OPTION YEAR 4: July 23, 2027 to July 22, 2028

No.

Annual Cost

4001 None Medical Officer of the Day (MOD)

Services 7660 Hours DO NOT

None 4001a

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2670 Hours $__/hr $__

None 4001b

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

EXPERIENCE:____________

2495 Hours $__/hr $__

None 4001c

Medical Officer of the Day Provider

NAME:____________

TITLE/LEVEL OF

TOTAL FOR OPTION YEAR 4

Total for base performance period and all option years: $_________________________

B.5 PERFORMANCE WORK STATEMENT

Onsite Medical Officer of the Day Services

1. GENERAL:

1.1. Services Provided: The Contractor shall provide National Certified/Board Certified Provider

Services on site in accordance with the specifications contained herein to beneficiaries of the

Department of Veterans Affairs (VA) and the St. Cloud VA Health Care System.

1.2. Place of Performance: Contractor shall furnish services at the St. Cloud VA Health Care System, 4801 Veterans Drive, St. Cloud, MN 56303.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) Sharing Authority. FAR 12 in combination with 15.

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

1.4.1. VA Directive 1663: Health Care Resources (HCR) Contracting – Buying Title 38 U.S.C. 8153:

https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.4.2. VHA Directive 1003.04: VHA Patient Advocacy:

https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=5970

1.4.3. VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider Group

Practice: https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=9130

1.4.4. VHA Directive 1088(1): Communicating Test Results to Providers and Patients:

https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=3148

1.4.5. VHA Directive 1100.18: Reporting And Responding To State Licensing Boards:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9174

1.4.6. VHA Directive 1100.20 Credentialing of Health Care Providers:

https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=9444

1.4.7. VHA Directive 1192.01: Seasonal Influenza Vaccination Program For VHA Health Care

Personnel: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8948

1.4.8. VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements To

Perform Invasive Procedures In Any Clinical Setting:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8365 https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=5970 https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=9130 https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=3148 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9174 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fvaww.va.gov%2Fvhapublications%2FViewPublication.asp%3Fpub_ID%3D9444&data=04%7C01%7C%7C5a2fc81d5c9e4c31696308d9ca3b3c47%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637763178024295633%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=g4iIWP0fMWV1ITn9%2F0vT4lpul7nFJAe%2FDMHlz4MTfT8%3D&reserved=0 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8948 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8365

1.4.9. VHA Directive 1400.01: Supervision of Physician, Dental, Optometry, Chiropractic, and

Podiatry Residents:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8579

1.4.10. VHA Directive 1605.01: Privacy and Release of Information:

https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=3233

1.4.11. VHA Directive 1907.01: VHA Health Information Management and Health Records:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235

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

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.13. VHA Handbook 1100.19: Credentialing and Privileging:

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

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

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

1.5. Definitions/Acronyms: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1. ABIM: American Board of Internal Medicine http://www.abim.org/

1.5.2. ACGME: Accreditation Council for Graduate Medical Education

1.5.3. ACLS: Advanced Cardiac Life Support

1.5.4. ATLS: Advanced Trauma Life Support

1.5.5. AOD: Admitting Officer of the Day

1.5.6. BLS: Basic Life Support

1.5.7. CCNE:Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

1.5.8. CDC: Centers for Disease Control and Prevention

1.5.9. CDR: Contract Discrepancy Report

1.5.10. CEU: Certified Education Unit

1.5.11. CME: Continuing Medical Education

1.5.12. CMS: Centers for Medicare and Medicaid Services

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8579 https://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=3233 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.abim.org/ http://www.aacn.nche.edu/accreditation

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

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

1.5.14. Contracting Officer’s Representative (COR): A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specification contained in the contract and to protect the interest of the Government. The

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

1.5.15. COS: Chief of Staff

1.5.16. CPARS: Contractor Performance Assessment Reporting System

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

1.5.18. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.5.19. DEA: Drug Enforcement Agency

1.5.20. FSMB: Federation of State Medical Boards

1.5.21. HHS: Department of Health and Human Services

1.5.22. HIPAA: Health Insurance Portability and Accountability Act

1.5.23. Hospital Medicine: A medical specialty dealing with the care of hospitalized patients.

1.5.24. HR: Human Resources

1.5.25. ISO: Information Security Officer

1.5.26. 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.

1.5.27. MOD: Medical Officer of the Day

1.5.28. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

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

1.5.30. Non-Contract Provider: Any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors.

1.5.31. NP: Nurse Practitioner

1.5.32. NPPES: National Plan and Provider Enumeration System

1.5.33. PA: Physician Assistant

1.5.34. PALS: Pediatric Advanced Life Support

1.5.35. POP: Period of Performance

1.5.36. PPD: Purified Protein Derivative

1.5.37. Provider: a person who provides medical care or treatment; Physician’s Assistant (PA), Nurse Practitioner (NP), Physician (MD), or Doctor of Osteopathy (DO)

1.5.38. PWS: Performance Work Statement

1.5.39. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.5.40. QA/QI: Quality Assurance/Quality Improvement

1.5.41. QM/PI: Quality Management/Performance Improvement

1.5.42. QASP: Quality Assurance Surveillance Plan

1.5.43. Veterans’ Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.5.44. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.

1.5.45. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

http://www.nlnac.org/

1.5.46. VetPro: A federal web-based credentialing program for healthcare providers.

1.5.47. Veteran Affairs Health Care System (VAHCS): Unless identified with the name of a different VA Medical Center, for purposes of this contract, this term shall mean the St.

Cloud VA Health Care System (STCVAHCS).

2. QUALIFICATIONS:

2.1. Staff/Facility:

2.1.1. License: The Contractor’s provider(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property.

All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor’s provider(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification and Experience: All contractor’s provider(s) shall be nationally certified in one of the following specialties: Adult Health, Geriatric, Family or Primary Care.

Advanced Practice Professional (APRN/PA-C) employee contractors shall maintain National Certification for the duration of the contract. Physicians will be board certified in Internal Medicine or Family Practice. The provider will be Basic Life Support (BLS) certified prior to arrival to the worksite. The provider is responsible to hold the certification the length of the contract and is responsible to provide the Chief of Staff office a copy of the certification cards prior to the expiration date. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 and VHA Directive 1100.20 referenced above. The Contractor is responsible to ensure that proposed provider(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contractor’s provider(s) prior to obtaining approval by the St. Cloud VA Medical Staff Executive Council and Medical Center Director.

2.1.3.1. If a contractor’s provider(s) is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.4. Technical Proficiency: Contractor’s provider(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed.

Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s provider(s) and contractor’s provider(s) shall meet all requirements for appointment to the Medical Staff at the

SCVAHCS as outlined by the Bylaws, Rules and Regulations of the Medical and Clinical Staff

(referenced herein), which will include prescriptive authority.

2.1.5. Continuing Medical Education (CME)/Certified Education Unit (CEU) Requirements:

Contractor shall provide the COR copies of current CMEs as required or requested by the

VAMC. Contractor’s provider(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credential’s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract provider(s).

2.1.6. Training (BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements; all training must be completed by the contractor’s provider(s) as required by the VA.

2.1.6.1. An orientation process will be required for all contractor personnel. Orientation will consist of both didactic and mentoring time. These hours will be flexible;

approximately 40 hours of training will need to be completed prior to the first clinical

MOD shift by the contract employee. This may include short shifts during the day or evening hours. New contract employees will need to allow flexibility prior to the first day of work in order to obtain an active PIV badge, SCVAHCS Service Line or

Integrated Clinical Community (ICC) orientations, Computerized Patient Record

System (CPRS) training and other trainings as required. The Contractor must ensure that there is MOD coverage at all times during contract employee orientations, PIV badge renewals (this process begins 60-90 days prior to expiration), and, during mandatory or annual training. Payment for training time will be based on the type of training and determined by the SCVAHCS.

2.1.7. Standard Personnel Testing (PPD, etc.) and Physical: Contractor shall provide proof of current provider physical and the following tests for provider(s) within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting

Officer. Tests shall be current within the past year.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative

Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all

Contractor’s provider(s) upon hire in accordance with CDC guidance. (This is applicable to all health care workers). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results.

2.1.7.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor provider(s) {This is applicable to all health care workers}.

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor provider(s) {This is applicable to all health care workers}.

2.1.7.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor provider(s) {This is applicable to all health care workers}.

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor provider(s) have received the annual Influenza vaccine unless it is contraindicated. If the Contractor provider has a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.1.7.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE

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

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

Infection Control- AJIC 1998; 26:289-354

(https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/index.html) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.8. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate

NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for

Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System

(NPPES) be provided to the Contracting Officer with the proposal.

2.1.9. DEA (required): Contractor shall provide copy of current DEA certificate and responsible for maintaining for the duration of the contract.

2.1.10. Conflict of Interest: The Contractor and all contractor’s provider(s) 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 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Finfectioncontrol%2Fguidelines%2Fhealthcare-personnel%2Findex.html&data=05%7C01%7C%7Cd7680a2a6e804141d0cb08da3dc81d55%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637890226930302569%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=tVJJoWuHL1TL2cTHqFwOw%2F4DalpjL2163AL8MHWeiMQ%3D&reserved=0 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 must 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 (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.11. Citizenship related Requirements:

2.1.11.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the

Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.11.2. While performing services for the Department of Veterans Affairs, the

Contractor shall not knowingly employ, contract or subcontract with an illegal alien;

foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-

Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.11.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs

Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.11.4. This certification concerns a matter within the jurisdiction of an agency of the

United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.11.5. The Contractor agrees to obtain a similar certification from its subcontractors.

The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.12. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the

Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS)

Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.12.1. Therefore, Contractor shall review the HHS OIG List of Excluded

Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor’s provider(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty

(CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.12.2. By submitting their proposal, the Contractor certifies that the HHS OIG List of

Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical

Center Director as provided in VHA Handbook 1100.19 and VHA Directive 1100.20.

Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the

Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non-Personal Healthcare Services: The parties agree that the Contractor and all contractor’s provider(s) shall not be considered VA employees for any purpose.

2.4. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the

Government 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.

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

2.5. Prohibition Against Self-Referral: Contractor’s provider(s) are prohibited from referring VA patients to contractor’s or their own practice(s).

2.6. Inherent Government Functions: Contractor and Contractor’s provider(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No Employee status: The Contractor shall be responsible for protecting Contractor’s provider(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract provider(s).

2.8.1. When a Contractor or contractor’s provider(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract provider(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The Full Time Equivalency (FTE) for the services required is three (3).

2.9.2. The minimum number of Board Certified /National Certified Medical Officer of the Day provider(s) required to be on site on a daily basis is one (1) as defined in paragraph Hours of Operation in this section.

2.9.3. The contractor is responsible to submit three (3) months of contract employee schedules, to the Contracting Officer Representative (COR), three (3) months in advance (ex. submit January, February, and March’s schedules in October).

2.9.3.1. It is essential that continuity of services is maintained to the maximum degree possible, hence, substitution of Provider(s) shall be limited to urgent/emergent absences of approved, fully credentialed MD, NP, or PA. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled provider is unable to begin or complete an assigned shift, the contractor shall provide replacement provider coverage to be on station within 24-48 hours, within 24 hours is highly encouraged, and notify the Contracting Office Representative (COR) at the St. Cloud VA Health Care System immediately of the schedule change.

2.9.4. Personnel Substitutions: During the first ninety (90) calendar days of performance, the

Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 30 calendar day(s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 30 calendar day (s) prior to making any permanent substitutions.

2.9.4.1. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 30 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.9.4.2. For temporary substitutions where the key person shall not be reporting to work for 24 hours, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.9.4.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s provider(s), s/he may request, without cause, immediate replacement of said Contractor’s provider(s) .The CO and COR shall deal with issues raised concerning Contractor’s provider(s) conduct. The final arbiter on questions of acceptability is the CO.

2.9.4.4. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor’s provider(s) leaves Contractor’s employment or is unable to continue performance in accordance the terms and conditions of the resulting contract.

2.9.4.4.1. If any contract employee resigns or is terminated in less than three (3) consecutive months, the VA will not pay for any time associated with the orientation at the VA for a different contract employee. If a contract employee is dismissed by the VA for reasons due to negligence, inappropriate behavior, tardiness, poor performance, or an inability to complete the required tasks associated with the position during the orientation process, the VA will not pay for that individual’s orientation period. If a contract employee is dismissed by the VA for reasons due to negligence, inappropriate behavior, tardiness, poor performance, or an inability to complete the required tasks associated with the position after the orientation period, the VA reserves the right to negotiate with the contractor to adjust payment accordingly during the pay period in which the contractor employee was dismissed.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: Contractor shall provide a PA, NP, or MD to cover from 4:00p.m. – 8:00a.m., Monday through Friday, including Federal Holidays (24 hours), 24-hour or 48-hour weekend coverage, and any other mutually agreed upon hours. This could include day shifts on holidays, day or evening shifts on weekends, and coverage in UC.

3.1.1. Care coverage will be provided at 80 to 136 hours per week (depending on weekend coverage) plus up to five (5) hours weekly beyond normal tour of duty for approved activity (i.e. trainings, patient care activities and administrative duties).

3.1.2. Patient care appointments are not scheduled. Average workload is two patient transfers and three program admissions per tour. Assessment of in-house patients varies in workload but is the primary responsibility of the MOD on duty. MOD tours on evenings, weekends, and holidays to include patient care rounding in the CLC, as necessary, are included in this coverage. On occasion, the heavy workload in the UC area may necessitate the MOD to assist the UC provider when such assistance does not affect MOD in-house patient care duties.

3.2. Patients must be seen by a contractor’s provider(s) on-site at St. Cloud VA Health Care System in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.2.1. Contractor’s Provider(s) shall be available to be scheduled as required by the facility Chief of Staff or designee. The St.