Solicitation No. 36C24924R0063.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

36C24924R0063 02-11-2025

Angela Tucker, Contract Specialist No Phone Calls Accepted 03-25-2025

10:00AM CDT

Department of Veterans Affairs Network Contracting Office 9 (90C)

NCO 9

1639 Medical Center Parkway, Suite 204 Murfreesboro TN 37129

X

621498

$25.5 Million

N/A

X

Department of Veterans Affairs Lt. Col. Luke Weathers, Jr.

VA Medical Center 1030 Jefferson Avenue Memphis TN 38104

90C

Network Contracting Office 9 Department of Veterans Affairs Network Contracting Office (90C) 1639 Medical Center Parkway Suite 204 Murfreesboro TN 37129

90C

FSC e-Invoicing Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information 1-877-489-6135 Invoice must be submitted electronically

Setup 1-877-489-6135

See CONTINUATION Page

Contractor shall provide Community Based Outpatient Clinic (CBOC) Services located in Holly Springs, MS in accordance with the terms and conditions contained herein.

Instructions for Proposal Preparation: Page 179 Proposal Evaluation Criteria: Page 189

X

X X 1

Carol Franklin Contracting Officer

36C24924R0063

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF PRICE AND SERVICES

B.2.1 PRICE SCHEDULE

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.1.1 ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

C.1.2 52.2-4-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL (JAN 2011)

C.1.3 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR

INFORMATION SYSTEMS (NOV 2021)

C.1.2 52.216-18 ORDERING (AUG 2020)

C.1.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.1.4 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.1.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.1.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.1.7 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.1.8 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.1.9 VAAR 852.201-70 CONTRACTING OFFICER’S REPRESENTATIVE (DEC 2022)

C.1.10 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEM SECURITY

(FEB 2023)

C.1.11 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.1.12 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT FOR DATA

BREACH COSTS (FEB 2023)

C.1.13 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.1.14 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

C.1.15 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

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

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAY 2024)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

Attachment D.1 – Quality Assurance Surveillance Plan Attachment D.2 – Contractor Organizational Conflict of Interest Attachment D.3 – Contractor Certification of Immigration

Attachment D.4 – Contractor Rules of Behavior Attachment D.5 – IB10-441 Enrollment Priority Groups Attachment D.6 – Reserved Attachment D.7 – BI Security Package Instructions and Documents Attachment D.8 – CFM-CBOC Prototype Design Attachment D.8a – OIT-Infrastructure Standard Telecom Spaces Attachment D.8b – OIT Design Guide Attachment D.9 – Wage Determinations Attachment D.10 – Reserved Attachment D.11 – SB Goals Attachment D.12 – VA National Formulary Attachment D.13 – PACT Space Module Design Guide

SECTION E - SOLICITATION PROVISIONS

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

COMMERCIAL SERVICES (SEP 2023)

E.1.1 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

INSTRUCTIONS FOR THE PREPARATION OF PROPOSAL

E.1.2 52.204-24 REPRESENTATION REGARDING CERTAIN

TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT

(NOV 2021)

E.1.3 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT

ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)

E.1.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT

2018)

E.1.5 52.216-1 TYPE OF CONTRACT (APR 1984)

E.1.6 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.1.7 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.1.8 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

E.1.X ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

E.1.9 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.2 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024)

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:

Company Name:

Contact Person:

Title:

Address:

City/State/Zip:

Phone No.:

E-Mail:

Tax ID No.:

UEID No.:

b. GOVERNMENT:

Angela Tucker, Contract Specialist U.S. Department of Veterans Affairs Network Contract Office (NCO) 9 1639 Medical Center Parkway, Suite 204 Murfreesboro TN 37129 Overnight Mailing Address: Same as above E-Mail: angela.tucker2@va.gov

2. Contractor Remittance Address: All payments by the Government to the Contractor will be made in accordance with FAR 52.232-33, Payment by Electronic Funds Transfer-System for Award Management

3. Invoices: Refer to the Performance Work Statement Section 20 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. Invoicing shall be in accordance with the requirements of the Department of Veterans Affairs (VA) Financial Services Center (VAFSC). The latest information shall be used for invoicing and payments and may change during the Period of Performance of this acquisition. Current Invoicing information is located at http://www.fsc.va.gov/einvoice.asp.

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

AMENDMENT NO. DATE

6. Place of Performance: Services shall be provided on-site at Contractor’s clinic facility to be located in Holly Springs, Mississippi.

7. Post Award Orientation: The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by FAR 42.

8. 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, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.”

9. Mandatory Written Disclosures: Mandatory written disclosures required by FAR clause

52.203-13 to the Department of Veterans Affairs, Office of Inspector General (OIG) must be made electronically through the VA OIG Hotline at http://www.va.gov/oig/contacts/hotline.asp and clicking on "FAR clause 52.203-13 Reporting." If you experience difficulty accessing the website, call the Hotline at 1-800-488- 8244 for further instructions.

B.2 SCHEDULE OF PRICE AND SERVICES

Holly Springs Community Based Outpatient Clinic (CBOC) Services

Contract Guaranteed Minimum and Contract Maximum

The fixed-price indefinite-delivery indefinite-quantity (IDIQ) contract will have a one (1) year base period with nine (9) option periods. All PMPM quantities are estimated. The total guaranteed minimum quantity of services that the Government will acquire under this indefinite delivery, indefinite quantity (IDIQ) contract is $500,000.00, which also represents a bona fide need of the current fiscal year. The guaranteed minimum award amount is for the entire contract duration. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum contract award amount. The ceiling amount for the entire contract effort is $40,000,000.00. The maximum amount under this contract is not guaranteed.

Ordering Procedures

The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount of $500,000.00. Firm‐fixed-price task orders (TO) will be placed under this contract via email by the COR prior to the start of each month with the fixed quantity of members for the upcoming month. See FAR clause 52.216-19, Order Limitations, for minimum and maximum values of each TO. Task Orders are contingent upon availability of funds per FAR clause 52.232-18. See Monthly Billable Roster and Invoice Reconciliation section in the PWS below regarding the invoicing instructions for reconciliation of task orders once the monthly billable roster is finalized. The aggregate value of orders placed under this contract shall not exceed the IDIQ contract maximum.

Billing/Payment Procedures

The contractor will be provided a list of all patients on the billable roster at the time when the contractor begins performing clinical services and will be able to bill for those patients on the billable roster in the following month’s invoice. In order to remain on the monthly billable roster, patients shall have at least one qualifying encounter during the previous 12 months. Qualifying encounters are further defined in PWS Section 6.2.1. Please review in detail to ensure compliance for issuance of subsequent task orders and payment processing.

For Veterans newly assigned in PCMM the contractor may bill for patients newly assigned in PCMM the month following a qualifying encounter.

For unassigned/unenrolled patient visits/encounters - PMPM includes cost of unassigned/unenrolled patient visits. Contractor shall not bill separately or propose an additional LIN for these costs.

See Section E instructions to offerors for further information regarding pricing proposals related to clinic buildout.

B.2.1 PRICE SCHEDULE

ITEM

NUMBER

DESCRIPTION OF

SERVICES QUANTITY UNIT UNIT PRICE ESTIMATED AMOUNT

12.00 MO __________________ __________________

Primary Health Care Services $______ x 1515 PMPM

Contract Period: Base POP Begin: 10-01-2025 POP End: 09-30-2026 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers PRODUCT/SERVICE CODE: Q201 - Medical - General Health Care

Mental Health Care Services $______ x 455 PMPM

Contract Period: Base POP Begin: 10-01-2025 POP End: 09-30-2026 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Primary Health Care Services $______ x 1512 PMPM

Contract Period: Option 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Mental Health Care Services $______ x 454 PMPM

Contract Period: Option 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Primary Health Care Services $______ x 1509 PMPM

Contract Period: Option 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Mental Health Care Services $______ x 453 PMPM

Contract Period: Option 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Primary Health Care Services $______ x 1506 PMPM

Contract Period: Option 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Mental Health Care Services $______ x 452 PMPM

Contract Period: Option 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Primary Health Care Services $______ x 1504 PMPM

Contract Period: Option 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Mental Health Care Services $______ x 451 PMPM

Contract Period: Option 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Primary Health Care Services $______ x 1501 PMPM

Contract Period: Option 5

POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Mental Health Care Services $______ x 450 PMPM

Contract Period: Option 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Primary Health Care Services $______ x 1498 PMPM

Contract Period: Option 6 POP Begin: 10-01-2031 POP End: 09-30-2032 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Mental Health Care Services $______ x 449 PMPM

Contract Period: Option 6 POP Begin: 10-01-2031 POP End: 09-30-2032 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Primary Health Care Services $______ x 1495 PMPM

Contract Period: Option 7 POP Begin: 10-01-2032 POP End: 09-30-2033 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Mental Health Care Services $______ x 448 PMPM

Contract Period: Option 7 POP Begin: 10-01-2032 POP End: 09-30-2033 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient

Care Centers

Primary Health Care Services $______ x 1490 PMPM

Contract Period: Option 8 POP Begin: 10-01-2033 POP End: 09-30-2034 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Mental Health Care Services $______ x 446 PMPM

Contract Period: Option 8 POP Begin: 10-01-2033 POP End: 09-30-2034 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Primary Health Care Services $______ x 1485 PMPM

Contract Period: Option 9 POP Begin: 10-01-2034 POP End: 09-30-2035 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Mental Health Care Services $______ x 445 PMPM

Contract Period: Option 9 POP Begin: 10-01-2034 POP End: 09-30-2035 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

GRAND TOTAL

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

SERVICES REQUIRED: The Department of Veterans Affairs, Lt. Col. Luke Weathers, Jr. VA Medical Center, Memphis, TN requires the following services to be provided in a private hospital, office or clinic environment to Veterans, primarily residing in Marshall County, Mississippi. Proposed Contractor facility for Holly Springs CBOC must be physically located in Holly Springs, Mississippi. Veterans to be serviced under this contract reside primarily in the cities surrounding and/or in Holly Springs, Mississippi; however, residency is not restricted to this county. The Parent Facility is the Lt. Col. Luke Weathers, Jr. VA Medical Center. Payment for Primary Care and Mental Health services shall be based on a monthly capitated rate, as further explained within this solicitation.

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

SITE CLASSIFICATION: This site is classified as a Primary Care CBOC.

PLACE OF PERFORMANCE: Services shall be performed by Contractor in Holly Springs, MS and within 10 miles of a local hospital providing emergency room services, on behalf of the Lt.

Col. Luke Weathers, Jr. VA Medical Center.

AUTHORITY: Title 38 United States Code (USC) 8153 and FAR Part 12 in combination with FAR Part 15.

POLICY AND REGULATIONS: The contractor is required to meet VHA performance and quality criteria, policy and standards including, but not limited to, access, quality of care, Veteran satisfaction, coordination of care, and clinical guidelines. Performance and quality standards may change during the contract. New or revised quality/performance criteria or standards will be provided to the contractor before implementation date and throughout the life of the contract through unilateral or bi-lateral modifications, as applicable. Copies of current VA and VHA publications can be located at http://www.va.gov/vapubs/ or at http://www.va.gov/vhapublications/. Some VA policy documents include Standard Operating Procedures (SOPs) located on internal VA websites that are not available to the public. SOPs relevant to this requirement are provided as attachments under Section D. Compliance with mandated performance is required as a condition of this contract. Contractor shall comply with all relevant VA policies and procedures, including those related to quality, access, patient safety and performance, including, but not limited to the policies listed on the Contracted Clinic Policy Document located at https://www.patientcare.va.gov/primarycare/Resources.asp. A link to the VA Qualifications Standards is also included in this document.

1.1. DEFINITIONS/ACRONYMS:

1.1.1. ABMS: American Board of Medical Specialties

1.1.2. ACIP: Advisory Committee on Immunization Practices

1.1.3. ACLS: Advanced Cardiac Life Support

1.1.4. ACGME: Accreditation Council for Graduate Medical Education

1.1.5. ACPE: American Council on Pharmaceutical Education

1.1.6. ACO: Administrative Contracting Officer

1.1.7. ADE: adverse drug events

1.1.8. AED: Automatic External Defibrillator

1.1.9. AIS: Automated Information Security

1.1.10. ANA: American Nurses Association

1.1.11. AOA: American Osteopathic Association

1.1.12. ARRT: American Registry of Radiologic Technology

1.1.13. ASC: Ambulatory Surgery Clinic

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

1.1.15. ASYNCHRONOUS CARE: Care provided outside of bookable time and includes but is not limited to the following activities: refilling prescriptions, reviewing outside records, huddles and case management, team meetings, processing view alerts, secure messaging and training.

1.1.16. BAA: Business Associate Agreement

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

1.1.18. BLS: Basic Life Support

1.1.19. BOS: Bureau of Osteopathic Specialists

1.1.20. CAHEA: Committee on Allied Health Education and Accreditation

1.1.21. CAP: College of American Pathologists

1.1.22. CARF: Commission on Accreditation of Rehabilitation Facilities

1.1.23. CBO: VA Central Billing Office.

1.1.24. CDC: Centers for Disease Control and Prevention

1.1.25. CEU: Certified Education Unit

1.1.26. CLIA: Clinical Laboratory Improvement Amendments

1.1.27. CME: Continuing Medical Education

1.1.28. CMS: Center for Medicare and Medicaid Services

1.1.29. CO: Contracting Officer

1.1.30. COPD: chronic obstructive pulmonary disease

1.1.31. COR: Contracting Officer’s Representative

1.1.32. COS: Chief of Staff

1.1.33. CPA: Collaborative Practice Agreement

1.1.34. CPS: Clinical Pharmacy Specialist

1.1.35. CPT: Current Procedural Terminology

1.1.36. CRNP: Certified Registered Nurse Practitioners

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

1.1.38. CPARS: Contractor Performance Assessment Reporting System

1.1.39. CVT: Clinical Video Telehealth

1.1.40. DICOM: Digital Image and Communication in Medicine

1.1.41. DIGMA: Drop in Group Medical Appointment

1.1.42. DRG: Diagnostic Related Group

1.1.43. DSS: Decision Support System

1.1.44. ECC Extended Care Center

1.1.45. Enrollment: The process of establishing eligibility for VA’s “Medical Benefits

Package.” Most Veterans are required to “enroll” into the VA Health Care System to be eligible for VA health care and to be assigned to an outpatient clinic like a CBOC, however some can still receive care without enrolling. Applicants are only required to “enroll” once for VA health care unless they are determined ineligible for care at time of application or they have disenrolled.

1.1.46. EPRP: External Peer Review Program

1.1.47. FDA: Food and Drug Administration

1.1.48. FSMB: Federation of State Medical Boards

1.1.49. FTE: Full Time Equivalent

1.1.50. HCC: Health Care Center A HCC is a VA-owned, VA-leased, contract, or shared clinic operated at least 5 days per week that provides primary care, mental health care, on site specialty services, and performs ambulatory surgery and/or invasive procedures which may require moderate sedation or general anesthesia.

1.1.51. HCFA: HealthCare Financing Administration

1.1.52. HHS: Department of Health and Human Services

1.1.53. 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.

1.1.54. HT: Home Telehealth

1.1.55. ICAVL: Intersocietal Commission for the Accreditation of Vascular Laboratories

1.1.56. ICD: International Classification of Diseases

1.1.57. iMED: software used by VA for informed consent

1.1.58. INR: International Normalized Ratio

1.1.59. ISO: Information Security Officer

1.1.60. LIP: Licensed Independent Practitioner

1.1.61. MCCR: Medical Care Cost Recovery

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

General mental health services include:

(a) Diagnostic and treatment planning evaluations for the full range of mental health problems, including SUD

(b) Treatment services using evidence-based pharmacotherapy, somatic treatments, or primary evidence-based Psychotherapy (EBP) for patients with mental health conditions and substance use disorders

(c) Patient education

(d) Family education, family consultation, family psychoeducation and couples/marriage and family counseling when it is associated with benefits to the Veterans

(e) Referrals as needed to inpatient and residential care programs; and

(f) Consultation about special emphasis problems including Post Traumatic Stress Disorder (PTSD) and Military Sexual Trauma (MST)

(g) Suicide Prevention

(h) Referrals and coordination of care between other levels of care and community treatment programs.

Specialty mental health services include:

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

(b) Evidence-based psychotherapy;

(c) Mental Health Intensive Case Management (MHICM);

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

(e) PTSD teams or specialists;

(f) MST special clinics;

(g) Homeless programs; and

(h) Specialty substance abuse treatment services.

1.1.63. MQSA: Mammography Quality Standards Act

1.1.64. MSN: Master of Science in Nursing

1.1.65. NCCPA: National Commission on Certification of Physician Assistants

1.1.66. NLN: National League for Nursing

1.1.67. NLNAC: National League for Nursing Accreditation Commission

1.1.68. NP: Nurse Practitioner

1.1.69. NSQIP/CICSP: National Surgical Quality Improvement Program/Continuing

Improvement in Cardiac Surgical Program

1.1.70. OTC: Over the Counter

1.1.71. PA: Physician Assistant

1.1.72. PACS: Picture Archiving and Communications System

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

1.1.74. Parent Facility: VAMC responsible for performance monitoring and payment for contracted Outpatient Site of Care services.

1.1.75. PCMH: Patient-Centered Medical Home

1.1.76. PCMM: Primary Care Management Module – an enterprise application that enables users to (1) set up and define health care teams, (2) assign staff and their associated full-time equivalent (FTE) staff to positions within each team, (3) assign patients to the team, and (4) assign patients to specific team members.

1.1.77. PCP: Primary Care Provider

1.1.78. Phar.D.: Doctor of Pharmacy

1.1.79. POC: Point of Care Testing

1.1.80. PMPM: Per Member Per Month – reimbursement methodology for services provided under the PC and MH LINs based on all-inclusive monthly rate per Veteran that meets qualifying encounter criteria in the previous twelve (12) months of the contract period. This methodology also accounts for costs of unassigned/unenrolled visits based on estimates provided to contractors and it supports the PACT model in increasing coordination, quality, and continuity of care of Veterans receiving services at the Outpatient Site of Care.

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

1.1.82. PCMHI: Primary Care-Mental Health Integration

1.1.83. PWS: Performance Work Statement

1.1.84. QAPI: Quality Assessment and Performance Improvement

1.1.85. QASP: Quality Assurance Surveillance Plan

1.1.86. REACH VET: Recovery Engagement and Coordination for Health Veterans

Enhanced Treatment – REACH VET summarizes information from the Veterans Health Record and uses predictive modeling to identify Veterans at statistical risk for suicide and other negative outcomes. This tool supplements clinical strategies used to identify at-risk Veterans and may help providers intervene prior to these negative outcomes occurring.

1.1.87. RME: Reusable Medical Equipment

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

1.1.89. SFT: Store and Forward Telehealth

1.1.90. SMA: Shared Medical Appointments

1.1.91. SOP (Clinical): Scope of Practice

1.1.92. SPD: Sterile Processing Division

1.1.93. SPE: Senior Procurement Executive

1.1.94. SPECIALTY CARE VISIT: A specialty care outpatient visit is an episode of care furnished in a clinic that does not provide primary care, and is only provided through a referral.” These services are generally divided into two sub-categories:

medicine specialties and surgery specialties. The VHA site classification defines specialty care as those encounters that occur within the geriatric medicine;

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

gastroenterology; general medicine; hematology or oncology; infectious disease;

nephrology; neurology; outreach; pulmonary or respiratory disease;

rheumatology; amputation follow-up; amputation; anesthesia; cardio-thoracic;

ear, nose, and throat (ENT); eye; general surgery; gynecology (GYN);

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

1.1.95. STORM: Stratification Tool for Opioid Risk Monitoring

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

1.1.97. SYNCHRONOUS CARE: Bookable, real-time care provided in person or virtually (VA Video Connect, CVT, telephone) with a Veteran and involves clinical decision-making in a two way conversation.

1.1.98. TCT: Telehealth Clinical Technicians

1.1.99. TIU: Text Integration Utility

1.1.100. TJC: The Joint Commission

1.1.101. TMS: Talent Management System

1.1.102. VA: Veterans Affairs

1.1.103. VA ECHO: VA Extension for Community Health Outcomes

1.1.104. VA EHR: VA electronic health record

1.1.105. VAMC: Veterans Affairs Medical Center

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

1.1.107. VHA: Veterans Health Administration

1.1.108. VSSC: VHA Support Service Center

1.1.109. VVC: VA Video Connect

1.1.110. WHEN: Weekend- Holiday- Every Night

2. STAFFING AND QUALIFICATIONS:

2.1. MINIMUM PATIENT ALIGNED CARE TEAM (PACT) STAFFING

REQUIREMENTS:

PACTs comprise the patients, the patients’ personal support persons, teamlets (Primary Care Providers (PCPs), Registered Nurse Care Managers (RNCMs), Clinical Associates, Administrative Associates), and discipline specific team members (Clinical Pharmacy Specialists (CPSs), Licensed Clinical Social Workers (LCSWs), Registered Dietician/Nutritionists, and Primary Care-Mental Health Integration (PCMHI) staff). The Contractor shall provide PACT staffing in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The Contractor shall provide a sufficient number of primary care providers so that each primary care provider has a caseload ratio to meet VA standards. Current standards are 1200 active patients per full time physician and 900 active patients per full time midlevel provider. Actual panel sizes can be determined by the VA in accordance with VHA Directive 1406 Patient Centered Management Module (PCMM) for Primary Care. The staffing standard for support staff shall be in ratios to Primary Care Providers of at least three full time equivalent (FTE) support staff (1 FTE RNCM, 1 FTE Clinical Associate, 1 FTE Administrative Associate) for each FTE Primary Care Provider. The Clinical Pharmacy Specialist (CPS) shall be provided the same support staffing given to other providers on the team when they are working in the capacity of a mid-level provider. The Contractor shall provide personnel in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The Contractor must establish and implement contingency plans for ensuring patients receive continuity of and access to appropriate primary care during periods of inadequate resources, extended staff absences, staff turnover, understaffing, and nature-related events (e.g., extreme weather conditions, natural disasters). If the number of patients reaches 90% of maximum panel size assigned by the facility the Contractor shall communicate to the VA the Contractor’s future staffing plan to ensure staffing ratio standards remain in accordance with PCMM staffing standards. Contractor shall provide as least one (1) MD in every PACT team of four (4) teamlets (one (1) physician for every three (3) mid-level providers). Total Estimated Patients enrolled/assigned to site: 1,515.

PHYSICIAN DIRECTOR (MANDATORY FOR ALL SITES): FTE Ratio Performance Standard: 0.05* FTE per PACT Responsible Party: Shall be provided by Contractor.

Qualifications: Contractor’s Physicians (including subcontractors) providing physician director services under the resultant contract shall demonstrate evidence of education, training, and experience in Internal Medicine or Family Practice. Contactor’s Physicians performing under this contract shall be board certified by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. If proposed staff do not meet VA credentialing requirements, the Contractor shall propose substitute acceptable personnel within five (5) calendar days. May also be credentialed and privileged as a PCP. (If so, authorization for prescriptive authority is required).

Physicians shall be licensed in the state in which the Outpatient Site of Care (i.e.

CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G2.

*NOTE: How much time provider is in person at CBOC is FTE number.

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

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

2.2.1. TEAMLET MEMBER 1: Primary Care Provider (PCP): FTE Ratio Performance

Standard: Current standards are 1,200 active patients per full time physician and 900 active patients per full time midlevel provider. Contractor shall propose quantity of FTE to meet Standard FTE ratio to panel size. Contractor to propose mix of PCP from the options below. At least one of the PCPs is to be a physician.

2.2.1.1. FTE Ratio Performance Standard: 1 FTE per PACT Responsible Party:

Shall be provided by Contractor.

2.2.1.2. Physician (MD/DO): Qualifications: Physicians shall demonstrate evidence of education, training, and experience in Internal Medicine or

Family Practice. Physicians performing under this contract shall be board certified by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. Authorization for prescriptive authority is required. If proposed staff do not meet VA credentialing requirements, the Contractor shall propose substitute acceptable personnel within five (5) calendar days. Physicians shall be licensed in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA qualification standards for Physician located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information.

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

OPTION 2: Advanced Practice Registered Nurse (APRN): Qualifications:

APRN’s (including subcontractors) shall possess a master’s degree from a program accredited by the National League for Nursing Accreditation Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE) and maintain full and current certification as a Certified Nurse Practitioner (CNP) from the American Nurses Association or another nationally recognized certifying body in either Adult Health or Family Practice. Authorization for prescriptive authority is required. CNPs shall prescribe controlled substances in accordance with limitations imposed by the Controlled Substances Act and the CNP’s State licensure on the authority to prescribe or administer controlled substances. Three years of clinical nursing experience is required. A minimum of one (1) year clinical experience as a CNP is required (three (3) years preferred). Experience in outpatient care in a Family Medicine or Internal Medicine environment is preferred. CNP shall have current, full, active, and unrestricted license and registration as a graduate professional nurse in the state in which the outpatient site of care (i.e., CBOC) is located; otherwise, qualifications as per VA qualification standards for Advanced Practice Nurse located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information.

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

OPTION 3: Physician Assistant (PA):Qualifications: PAs (including subcontractors) shall be a graduate of a training program which is accredited by the Accreditation Review Commission on Education of PA (ARC-PA) or one of its predecessor organizations. Additionally, PAs shall have a master’s degree in any discipline or a bachelor’s degree in any discipline with one year of experience as a PA. PAs shall have successfully passed the PA National Certifying Exam (PANCE). Authorization for prescriptive authority is required. PA shall have current, full, active, and unrestricted license and registration in the state in which the outpatient site of care (i.e., CBOC) is located; otherwise, qualifications as per VA qualification standards for Physician Assistant located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face and virtual care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs.

2.2.2. TEAMLET MEMBER 2: Registered Nurse (RN) Care Manager: FTE Ratio Performance Standard: Current standard is 1.0 FTE RNCM per 1.0 FTE PCP Qualifications: Graduate of a school of professional nursing accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The accreditation Commission for Education in Nursing (ACEN) or the commission on Collegiate Nursing Education (CCNE). Current, full, active, and unrestricted registration as a graduate professional nurse in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA qualification standards for Nurse located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing all aspects of professional nursing services consistent with licensure, certification, nursing professional standards of practice, and the clinician’s Functional Statement with elements of practice, enhancing patient safety and quality of care by collaborating with PACT staff to develop, oversee, and manage care management plans and care coordination for patients assigned to PACTs, participating in modes of communication and care delivery including, but not limited to, secure messaging, telephone care, view alerts management, shared medical appointments, clinical video telehealth visits, face to face visits, etc., as part of care management, identifying patient needs for involvement of discipline-specific team members and discussing nursing recommendations with the PCP, engaging relevant PACT staff to support nursing care, according to locally established informal and formal communication processes, including entering consultation requests to discipline-specific PACT members, if required for formal communications, assuming full accountability for the appropriateness of assignments made by the RNCM to clinical associates or administrative associates related to care management, care coordination, nursing services, and outcomes of care, entering orders in the VA EHR for tests per approved standardized RN care management protocols or PCP orders, ensuring the RNCM has same-day access for face-to-face and virtual care visits, using nursing expertise, evidence-based guidelines, standardized nursing protocols, and professionally accepted practice standards to promote patient engagement, self-care and wellness, and provide care to patients and determine care management requirements for individual patients or cohorts of patients. The RN collaborates for the improvement of patient care outcomes in the Patient Aligned Care Team. Promotes systems to improve access and continuity of care, uses advanced clinical knowledge and critical thinking skills to mentor staff in planning, implementing and evaluating interventions that improve patient outcomes, designs and provides age and population specific health promotion and risk reduction strategies, translates evidence-based research into practice to ensure that patients benefit from the latest innovations in nursing science, manages patients in transition between levels of care, serves as an expert resource to implement and teach skills, including motivational interviewing to promote patient self-management toward patient-driven holistic care plan for life. CARE STAFFI

NG – CLINICAL

2.2.3. TEAMLET MEMBER 3: CLINICAL ASSOCIATE FTE Ratio Performance Standard: Current standard is 1.0 FTE clinical associate per 1.0 FTE PCP.

Contractor to propose the mix of Clinical Associates from the options below.

Option 1: Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN): Qualifications: Current, full, active, and unrestricted license in the state in which the outpatient site of care (i.e., CBOC) is located; otherwise, qualifications as per VA qualification standards for Licensed Practical or Vocation nurse located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities:

Responsible for the provision of covered services to assigned and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification, and functional statement with elements of practice, to patients assigned PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner, and providing direction to patients as they move through the clinic environment. Duties include but are not limited to the ability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies and procedures.

Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. This staff member will be required to receive training as back-up for telehealth services.

OPTION 2: Unlicensed Assistive Personnel (Health Technician, Nursing Assistant). This staffing is part of the PACT Teamlet, not the primary telehealth clinical technician (TCT): Qualifications: Nursing Assistant qualifications per VA qualification standards for Nursing Assistant located in the VA Qualification Standards. See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Health Technician qualifications per Health Aid and Technician Series 0640 located at: Health Aid and Technician Series 0640 (opm.gov). Position Responsibilities: Responsible for the provision of covered services to assigned and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification, and functional statement with elements of practice, to patients assigned PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner, and providing direction to patients as they move through the clinic environment.

Duties include but are not limited to the ability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies, and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. This staff member will be required to receive training as back-up for telehealth services.for all

2.2.4. TEAMLET MEMBER 4: ADMINISTRATIVE ASSOCIATE: FTE Ratio

Performance Standard: Current standard is 1.0 FTE administrative associate per 1.0 FTE PCP. Qualifications: Required education and experience demonstrating skills and abilities to provide clerical support and administrative functions to support site operations. Completion of scheduling training per VA policies and guidance. See VA qualification standards for Medical Support Assistant located in the VA Qualification Standards for additional qualifications.

See the Policy and Regulations section of this PWS for VA Qualification Standards access information. Position Responsibilities: Responsible for the provision of covered services to assigned and unassigned patients presenting for care. Provide clerical support and administrative functions to PACT staff and collaborate with PACT staff to incorporate the logistical elements of care coordination into comprehensive care management plans.