Statement of Work RRT and RRT Polysomn.docx

STATEMENT OF WORK

1. BACKGROUND

Medical Service-Respiratory Section, part of VA Greater Los Angeles Healthcare System (VAGLAHS) located at 11301 Wilshire Blvd, Los Angeles, CA 90073, has a need to establish a temporary staffing contract to support existing staff, i.e. Respiratory Therapists with Polysomnographer capability on an as needed basis.

2. NEED

Medical Service-Respiratory Section is seeking a contractor who can provide up to two (2) full time experienced and qualified Registered Respiratory Therapists (RRT) AND two (2) full time experienced and qualified Registered Respiratory Therapist ALSO WITH the qualifications of a Polysomnographer (RRT Polysomnographer) as specified in Section 4 below., Contracted staff shall work 8-hour shifts from either 8:00am to 4:30pm or 8pm to 4:30am.

WORK HOURS

Contract Registered Respiratory Therapists and RRT Polysomnographers shall be available for any shift and shall work in areas designated by the Contracting Officer’s Representative (COR).

Lunch or dinner meal periods: each contractor employee that works an 8-hour shift shall be entitled to two (2) 15-minute breaks and one (1) 30-minute break.

Overtime: Tours of duty are not to exceed 40 hours per week. Contract Registered Respiratory Therapists / RRTs WITH Polysomnographer qualifications, will not be required to work overtime or holidays and shall not be billed to, nor reimbursed by the Government.

3. DUTIES AND RESPONSIBILITIES

3.1. General Duties: The Contractor shall maintain an adequate record system for recording services, listing servicing providers, charges, patient identification, service dates, and all other commonly accepted information elements for services rendered to patients pursuant to the resulting awarded contract including, but not limited to, such records as are necessary for the evaluation of the quality, appropriateness, and timeliness of services performed under the contract.

3.2. Definition of Respiratory Therapists/RRT Polysomnographer A Respiratory Therapist/RRT Polysomnographer, who has graduated from a college or a university, passed the National board for Respiratory Care, and is a specialized healthcare practitioner that performs testing that measures sleep cycles and stages of sleep, monitors, and records the following elements:

3.2.1 Sleep patterns and stages

3.2.2 Blood oxygen levels

3.2.3 Body position

3.2.4 Brain waves (EEG)

3.2.5 Breathing rate

3.2.6 Electrical activity of muscles

3.2.7 Eye movements

3.2.8 Leg movements

3.2.9 Heart rate

Respiratory Therapists educate and treat people who are suffering from heart and lung problems. They often collaborate with specialists in Pulmonary, Emergency Room (ER), and Intensive Care Units (ICU) in various aspects of clinical care of patients. Respiratory Therapists are specialists in airway management and mechanical ventilation. They are often in charge of initiating and managing life support for people in ICUs and emergency departments; stabilizing and monitoring high risk patients being moved from hospital to hospital by ambulance; and administering inhaled drugs and medical gases such as mucolytics, bronchodilators, oxygen, and nitric oxide.

3.3 Contract Respiratory Therapists/RRT Polysomnographers shall be competent in the following tasks:

3.3.1 Therapeutic and diagnostic procedures with the use of medical gases and administration devices including oxygen and nitric oxide.

3.3.2 All forms of humidification use with the appropriate devices, including aerosols and high flow systems.

3.3.3 Administration of inhaled medications, with use of appropriate devices, to the cardiopulmonary system.

3.3.4 Assist with intubation.

3.3.5 Use of all ventilators in VAGLAHS and all modes of mechanical ventilation.

3.3.6 Chest Physiotherapy (CPT), both manual and with the Vest System, and postural drainage.

3.3.7 Cardiopulmonary Resuscitation (CPR); the Respiratory Therapist must also have a current CPR card.

3.3.8 Respond to Rapid Response Calls.

3.3.9 Set up Continuous Positive Airway Pressure (CPAP), Automatic Positive Airway Pressure (APAP), and Bilevel Positive Airway Pressure (BIPAP) systems.

3.3.10 Provide Patient/family education.

3.3.11 Arterial puncture.

3.3.12 Recognize the need for medical intervention if patient safety is at risk.

3.3.13 The use of “split-night” diagnostic/therapeutics studies as described: perform polysomnogram during the first part of the night and then CPAP titration study during the 2nd half of the night if initial part of the study is consistent with obstructive sleep apnea.

3.3.14 Perform full night polysomnogram.

3.3.15 Sleep staging, defined as continuous recording of at least one (1) channel of Electroencephalogram (EEG), two (2) channels of Electrooculography (EOG) and one (1) channel of Electromyography (EMG) recording, following the rules of staging systematized by A. Rechstcahffen and A. Kales.

3.3.16 Continuous recording of four (4) or more additional parameters of sleep, including at least airflow, oximetry, Electrocardiogram (EKG), and EMG.

3.3.17 Continuous attendance as a technologist, working under the direction of the Chief of Pulmonary and Critical Care Medicine and Chief of Respiratory Therapy, who reports to Chief of Pulmonary and Critical Care.

3.3.18 Maintain a technical log, manually and electronically of patient information including nocturnal patient activity, position and events.

3.3.19 Perform electronic and manual scoring.

3.3.20 Follow written policies, procedures and guidelines defining the response to findings disclosed during testing requiring medical evaluation and treatment, including the use of oxygen, and “spilt-night” protocols.

4. QUALIFICATIONS

Competency requirements are to perform full night of polysomnogram plus all tasks defined in Section 3 above in Duties and Responsibilities and summarized table below. Only personnel approved by VAGLAHS shall be allowed to perform under this contract.

All contractor personnel shall be Advanced Cardiac Life Support certified.

Specific qualification requirements for each specialty are as depicted in the table below:

Accredited Sleep Program

(PSG) experience

Therapist (RRT) Credential Issued by National Board of Respiratory Care (NBRC) Registered Polysmonographic Technologist (RPSGT) Credential with the Board of Registered Polysmonographic Technologists (BRPT), OR Registered Sleep Technologist (RST) Credential with the American Association of Sleep Medicine (AASM), OR Sleep Disorders Specialist (SDS) credentialed with the National Board for Respiratory Care

California Medical Board of California (only)

5. NON-ACCEPTANCE OF CONTRACTOR PERSONNEL

The Contractor shall ensure that all Contractor personnel have met the qualifying criteria, including health requirements and possess valid licenses/certifications. Ultimately, the decision to accept or reject Contractor personnel rests with the VA.

6. STANDARD OF CONDUCT

6.1. The Government reserves the right to refuse acceptance of Contractor personnel whose 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 abuse, or other conduct resulting in formal complaints by patients or other staff members to designated Government Representatives. Standards for conduct shall mirror those prescribed by current Federal Personnel Regulations.

6.2. Complaints concerning Contractor personnel’s conduct with Government employees or patients will be reported to the COR. The Contracting Officer is the final authority on validating complaints. In the event that Contractor personnel are involved and named in a validated complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse. The final arbiter on questions of acceptability is the Contracting Officer.

7. CONFLICT OF INTEREST

The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of the Department of Veterans Affairs unless such person seeks and receives approval in accordance with Department of Veterans Affairs Regulations. Nor shall the Contractor employ any person who, as a member, would create a conflict of interest or the appearance of a conflict of interest, particularly with regard to influencing contract negotiations. In any such case, Department of Veterans Affairs must review the matter and give its approval in accordance with agency ethics rules.

8. EMERGENCIES OR COMPLICATIONS

All accidents, malfunctions, injuries and deaths related to the delivery of services shall be immediately reported verbally to the COR. The Contractor may be required to provide evidence of follow-up through a written report of the incident, describing the event, analysis of cause and effect, and corrective action taken. If such a report is requested by the COR, this will be done within three (3) working days of the verbal report.

9. ARRANGEMENT FOR REPLACEMENT STAFF

The Contractor shall provide scheduled services throughout the performance period of the contract. In the event of the absence of Contractor’s personnel for any reason, the Contractor shall coordinate an alternate.

10. IDENTIFICATION BADGE

An identification (ID) badge will be issued by the VA to Contractor personnel providing services under the awarded contract. The appropriate ID badge shall be worn at all times while on Government facility grounds, clearly displayed on the outermost garment (i.e. coat, jacket, sweater, shirt, blouse, lab coat etc.).

11. GOVERNMENT TRAINING AND ORIENTATION

11.1. The VA will provide a briefing to familiarize Contractor personnel with the policies and procedures on the first scheduled duty day or within a period acceptable to the VA.

11.2. The Contractor shall ensure that all Contractor personnel attend and participate in VA or any other mandatory training to include but not limited to VA Privacy, VA Cyber Security, Diversity, Total Quality Improvement, Annual Fire Safety, and Infection Control.

12. PERSONAL HYGIENE AND CLOTHING

In accordance with VAGLAHS Policy 00-10A-10A2-23, dated August 2010, subject: Personal Appearance and Hygiene, all personnel, including Contractors, shall be neat, clean, well-groomed and shall otherwise exercise good personal hygiene. Appropriate and professional attire shall be worn at all times. This policy memorandum will be provided to each contract provider during in-processing.

13. HEALTH REQUIREMENTS

13.1. Contractor personnel shall not perform services under the resulting BPA unless a pre-assignment medical examination has been performed within 30 calendar days of their first scheduled shift. Pre-assignment medical examinations shall be the responsibility of the Contractor at no cost to the Government.

13.2. As a condition of employment, Occupational Safety and Health Administration (OSHA) requires that all contract staff who will have occupational exposure to blood, other body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination or have documented proof of immunity to Hepatitis B infection. The immunization shall be the responsibility of the Contractor at no cost to the Government.

13.3. Contractor personnel having patient contact or exposure to biological or pathological specimens shall be immunized against, be granted an immunization waiver, or have documented proof of immunity to rubella, mumps, polio, and Hepatitis B. In addition, Contractor personnel shall be free of infectious diseases (including but not limited to active Tuberculosis and Viral Hepatitis) that might reasonably be expected to place other workers, patients, or the public at risk.

13.4. The Contractor shall provide the Government with all the information necessary to ensure that Government records are maintained correctly and in compliance with The Joint Commission, OSHA, and the Center for Disease Control health records requirements, for each individual Contractor employee, if applicable.

13.5. The Contractor shall provide the COR with certification that Contractor personnel have completed the medical evaluation required above, a minimum of five (5) working days prior to performance of contract services. This certification shall state the date that the examination was completed, the doctor’s name that performed the examination, a statement concerning the physical health of the individual, and the following statement:

[Name of contract health care provider] is suffering from no contagious diseases to include, Tuberculosis, Hepatitis, and Venereal Disease.

13.6. The Government may take nose and throat cultures from Contractor personnel when required by Government Infection Control Committees (ICC).

13.7. When a Contractor employee has been found medically unfit for providing services required under the resulting contract, they shall be required to discontinue working immediately. Contractor personnel shall not return to work until the Contractor is given clearance for that provider to return by the COR.

13.8. The Government will provide emergency health care for injuries sustained while on duty for Contractor personnel. These services will be billed to the Contractor at the current full reimbursement rate.

14. IMMUNIZATION WAIVER/EXEMPTIONS

Waivers and exemptions may be granted in accordance with VA regulations and Medical Staff Bylaws.

15. DRUG SCREENING

Contractor personnel are subject to random drug testing. They are also subject to drug testing when there is a reasonable suspicion that they use or are impaired by illegal drugs while on duty. Reasonable suspicion of drug use or impairment includes, but is not limited, to the following:

16.1 Observable phenomena, such as direct observation of drug use, possession, or the physical symptoms of being under the influence of a drug.

16.2 A pattern of abnormal conduct or erratic behavior.

16.3 Arrest or conviction for a drug-related offense or the identification of a contract healthcare provider as the focus of a criminal investigation into illegal drug possession, use or trafficking.

16.4 Information provided either by reliable and credible sources or independently corroborated.

16.5 Newly discovered evidence that the contract health care provider has tampered with a previous drug test.

16. CONTRACT PERFORMANCE MONITORING

Monitoring of Contractor’s time shall be demonstrated through clinical and administrative record reviews and through patient satisfaction surveys. The COR will be responsible for verifying contract compliance. After contract is awarded, any incidents of Contractor noncompliance as evidenced by the monitoring procedures or by failure to supply required documentation shall be forwarded immediately to the Contracting Officer.

17. MEDICAL RECORDS

Clinical or other medical records of VA beneficiaries treated by Contractor personnel under the resulting contract are VA records. Contractor personnel who obtain access to hardware or media that may manipulate or store drug or alcohol abuse data, sickle cell anemia treatment records, records or tests or treatment for infection with HIV, medical quality assurance records, or any other sensitive information as defined by the Department of Veterans Affairs, shall not have access to the records unless absolutely necessary to perform their contractual duties. Any individual who has access to these data will disclose them to no one, including other employees of the Contractor not involved in the performance of the particular contractual duty for which access was obtained.

18. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA)

18.1. Contractor shall take reasonable measures to ensure patient privacy and confidentiality. The Contractor personnel assigned to provide services under the resulting BPA agree to take all reasonable precautions to safeguard patient information from unauthorized access or modification, in both electronic and hard-copy formats. This includes not only electronic security measures such as “strong” user passwords on computer systems, but also physical barriers to prevent unauthorized use of computer workstations; that hard copy patient files are in secured lockable areas, that files are in lockable cabinets, that the cabinets can, in fact, be locked, i.e., keys are available, and the locking mechanisms work properly. This precaution also includes the proper transfer of patient information via electronic means, such as faxing or system-to-system transmission.

18.2. Contractor personnel shall make sure no patient information of any type is given to outside parties, agencies, or organizations of any type without the expressed written consent of the patient and the VA and only in capacities directly related to the provision of the services contracted in this instrument. Only the minimum necessary patient information shall be used to provide appropriate service to the correct patient. The Contractor is subject to the same penalties and liabilities for unauthorized disclosures of such records as VA personnel.

18.3. The undersigned understands that all parties are bound by the requirements of the “Health Insurance Portability and Accountability Act of 1996” which provide guidance on the protection of patient privacy and confidentiality. This Act mandates that all government agencies and those bodies with whom they contract must be in compliance with the directives of the Act. Details of the Act are still under development by the Congress of the United States.

19. PERFORMANCE IMPROVEMENT (PI)/RISK MANAGEMENT

Contractor personnel shall participate in PI/Risk Management activities to the extent required by VAGLAHS. Contractor personnel’s specific data must be submitted by the Contractor to the COR upon request. The Government shall evaluate Contractor personnel’s performance under the resulting contract using quality assurance standards specified in VA Regulations, The Joint Commission (TJC), and VAGLAHS policies.

20. THE JOINT COMMISSION

20.1. Contractor’s personnel shall be subject to the same quality assurance standards in meeting or exceeding current recognized National Standards as established by The Joint Commission. Copies of the quality assurance standards are on file in the VA Medical Healthcare Group and will be available to the Contractor. The Contractor shall perform services in accordance with the ethical, professional, and technical standards of the healthcare industry as consistent with VA policy, regulations, and procedures.

20.2. The personnel provided by the Contractor 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 personnel shall be responsible for compliance with all procedures in accordance with applicable VAGLAHS written policies, procedures, Bylaws of the Medical Staff, and protocols. Copies of the Bylaws will be available to all Contractor personnel and are located within the Healthcare Group. They shall not introduce new procedures or services without prior recommendation to and approval of the Chief of Staff (COS) or authorized representative(s) and through the Contracting Officer.

20.3. The Contractor is required to maintain records that document the competence/ performance level of Contractor employees working on the resulting contract in accordance with The Joint Commission Accreditation and other regulatory body requirements. The Contractor shall provide a current copy of the competence assessment checklist and annual performance evaluation to the COR at the time of the contract award or upon request for each Contractor employee working on the resulting awarded contract.

20.4. Where the contract does not require The Joint Commission Accreditation or other regulatory body requirements, Contractor personnel must perform the required work in accordance with the Joint Commission Accreditation standards. A copy of these standards may be obtained from The Joint Commission, One Renaissance Blvd., Oakbrook Terrace, IL 60181.

21. HHS/OIG REQUIREMENTS

To ensure that the individuals providing services under the resulting awarded contract have not engaged in fraud or abuse regarding Sections 1128 and 1128A of the Social Security Act regarding federal health care programs, the Contractor is required to check the Health and Human Services - Office of Inspector General (HHS/OIG), List of Excluded Individuals/Entities on the OIG Website (www.hhs.gov/oig) for each person providing services under the resulting awarded contract. Further, the Contractor is required to certify in its proposal that all persons listed in the Contractor’s proposal have been compared against the OIG list and are NOT listed. During the performance of the resulting awarded contract, the Contractor is prohibited from using any individual or business listed on the List of Excluded Individuals/Entities.

22. CONTINUING MEDICAL EDUCATION (CME) REQUIREMENTS

Contractor personnel registered by national associations shall continue to meet the minimum standards for CME and VAGLAHS Bylaws and Rules to remain current as prescribed by legal requirements. CME is the sole responsibility of the Contractor, shall be obtained at no additional cost to the Government, and shall be reported to the COR annually on the first normal duty day in January for the previous calendar year. Periodic CME may be conducted at the VA and may be available, at no cost, to Contractor personnel.

23. EVIDENCE OF INSURANCE COVERAGE

Per VAAR 852.237-7, Indemnification and Medical Liability Insurance, before commencing work under this contract, the Contractor shall furnish certification to the Contracting Officer that the $1,000,000.00 coverage required (General & Professional Liability as well as Workers Comp) has been obtained and such policy shall state, “This policy may not be changed or canceled without written notice to the VA Contracting Officer, VA Network Contracting Office 22, 4800 Airport Plaza Drive, Suite 600, Long Beach, CA 90815. Said policy must bear an appropriate “loss payable clause’’ to the United States as its interest may appear. Such evidence of insurance shall not be waived.

24. CONTRACTOR PERSONNEL POLICY

24.1. The Contractor shall assume full responsibility for the protection of its personnel furnishing services under the resulting awarded contract. To carry out this responsibility, the Contractor shall provide the following to the personnel:

24.1.1. Worker’s compensation

24.1.2. Professional liability insurance

24.1.3. Health examinations

24.1.4. Income tax withholdings

24.1.5. Social Security withholdings

24.2. Payment for any leave, including sick leave or vacation time is considered the sole responsibility of the Contractor. The Contractor shall comply with all existing local, state, federal, and/or union laws, regulations relevant to fringe benefits, and premium pay for their employees. Such personnel shall not be considered VAGLAHS employees for any purpose and shall be considered employees of the Contractor. There is no employer-employee relationship between the VA and the Contractor or the Contractor’s employee(s).

25. NATIONAL HOLIDAYS

Listed below are the eleven (11) national holidays:

When one of the holidays falls on a Sunday, the following Monday will be observed as a national holiday. When a holiday falls on a Saturday, the preceding Friday is observed as a national holiday by U.S. Government Agencies. Also included would be any day specifically declared by the President of the United States of America as a national holiday.