VA247-17-R-0885-006.docx

VA247-17-R-0885

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

544-18-1-041-0002

VA247-17-R-0885

12-13-2017 Valeria Murray 334-725-2624 1/8/2018

4:30 PM EST

36C247 Department of Veterans Affairs Central Alabama Veterans Health Care East Campus 2400 Hospital Road Tuskegee AL 36083-5001 X X 561320 $27.5 Million X N/A X Department of Veterans Affairs Dorn VAMC 6439 Garners Ferry Road Columbia SC 30912 Department of Veterans Affairs Central Alabama Health Care System East Campus 2400 Hospital Road Tuskegee AL 36083-5001

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971 Under the Authority of Title 38 USC Section 8153, and IAW FAR Parts, 12, 13 and 15:

Contractor shall provide Emergency Department Physician services in accordance with enclosed Price/Cost Schedule (pg 6) and Performance Work Statement (pg 10).

X X X Valeria Murray Table of Contents

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 (90C) Valeria Murray (valeria.murray@va.gov) Department of Veterans Affairs Central Alabama Veterans Health Care System 2400 Hospital Road

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address:

3. INVOICES: Invoices shall be submitted in arrears:

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

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

5. SECURE FAX: Contractor shall add the following language when faxing information: 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.

6. HHS/OIG: To ensure that the individuals providing services under the 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 Service – Office of Inspector General, List of excluded individuals/entities on the OIG Website (www.hhs.gov/oig) for each person providing services under this 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 this contract the Contractor is prohibited from using any individual or business listed on the List of Excluded Individuals/Entities.

7. HIPAA COMPLIANCE: - Contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). A business associate agreement is not required in this case.

8. POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation conference for contract orientation purposes.

VA247-17-R-0885

B.2 PRICE/COST SCHEDULE

SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform onsite Emergency Department Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Dorn VA Medical Center (hereinafter referred to as Dorn VAMC).

The Dorn VAMC Emergency Services are accredited by The Joint Commission (TJC)and follow the standards & guidelines set forth by American College of Emergency Physicians (ACEP). A contractor providing onsite emergency department physician services shall provide services that meet or exceed the ACEP Guidelines http://www.ACEP.org/

Place of Performance: Services shall be provided on site at Dorn VAMC, 6439 Garners Ferry Road, Columbia, SC 29209.

Pricing Instructions:

The offeror is instructed to edit the number of sub-clins to correspond with the number of key personnel submitted for the contract line item number (CLIN). Also, renumber SUB-CLINs if adding or removing Key Personnel.

The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments.

The Contractor shall propose 2.3 FTEE key personnel to be credentialed and be available for scheduling to meet the requirements of the contract. For approximately 2 FTEE, the contractor shall provide a minimum of 4 appropriately qualified physicians to be credentialed and privileged.

One FTE is defined by VA as a minimum of 80 hours every two week per year and does not include holidays.

Base Period of Performance: March 26, 2018 thru September 25, 2018

Annual Cost

(includes non-clinical work)

2,496

KEY PERSONNEL

NAME:____________________

NAME:____________________

Hours

Hours

Hours

TOTAL

Hours

Option Period 1: September 26, 2018 thru March 25, 2019

Annual Cost

(includes non-clinical work)

KEY PERSONNEL

NAME:____________________

Hours

Hours

Hours

TOTAL

Hours

BASE PLUS OPTION PERIOD TOTAL $ ______________________

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified/Board Eligible Emergency Medicine Physician Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and Dorn VAMC in Columbia, South Carolina. Dorn VAMC treats approximately 33,500 patients per year or approximately 2,791 patients per month. This facility is not a trauma center and is operative with 11 ER beds and 8 fast track beds.

1.2. Place of Performance - Contractor shall furnish services at the VA in Columbia, South Carolina 6439 Garners Ferry Road, Columbia, SC 29209.

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

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 Contracting – Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

1.4.2. - VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.4.3. - VHA Handbook 1100.17: National Practitioner Data Bank Reports – http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.4. - VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364.

1.4.5. - VHA Handbook 1100.19 Credentialing and Privileging – http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.4.6. - VHA Handbook 1101.05 Emergency Medicine Handbook – http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2231

1.4.7. - VHA Handbook 1907.01 Health Information Management and Health Records:

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

1.4.8. - Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.4.9. - VHA Handbook 2010-018 Facility Infrastructure Requirements to Perform Standard, Intermediate, or Complex Surgical Procedures https://www1.va.gov/vhapublications/publications.cfm?pub=1

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. ACEP: American College of Emergency Physicians.

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. CDC: Centers for Disease Control and Prevention.

1.5.8. CDR: Contract Discrepancy Report.

1.5.9. CEU: Certified Education Unit.

1.5.10. CME: Continuing Medical Education.

1.5.11. CMS: Centers for Medicare and Medicaid Services.

1.5.12. 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.

1.5.13. 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 specifications 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.

1.5.14. COS: Chief of Staff.

1.5.15. CPARS: Contractor Performance Assessment Reporting System.

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

1.5.17. 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.

1.5.18. DEA: Drug Enforcement Agency.

1.5.19. ED: Emergency Department.

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. HR: Human Resources.

1.5.24. ISO: Information Security Officer.

1.5.25. 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.

1.5.26. MOD: Medical Officer of the Day.

1.5.27. 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).

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

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

1.5.30. NP: Nurse Practitioner.

1.5.31. NPPES: National Plan and Provider Enumeration System.

1.5.32. PA: Physician Assistant.

1.5.33. PALS: Pediatric Advanced Life Support.

1.5.34. POP: Period of Performance.

1.5.35. PPD: Purified Protein Derivative.

1.5.36. PWS: Performance Work Statement.

1.5.37. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for an 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.

1.5.38. QA/QI: Quality Assurance/Quality Improvement.

1.5.39. QM/PI: Quality Management/Performance Improvement.

1.5.40. QASP: Quality Assurance Surveillance Plan.

1.5.41. 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.

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

1.5.43. 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.

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

1.5.45. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA Medical Center, for purposes of this contract, this term shall mean the Dorn VA Medical Center, Columbia, SC.

2. QUALIFICATIONS:

2.1 Staff/Facility

2.1.1. License – The Contract physicians 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. Contract physicians 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 - All contractors’ physician (s) shall be Board Certified/Board Eligible in Emergency Medicine and be currently certified in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS) and 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 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Contract physicians prior to obtaining approval by the Dorn VAMC Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.3.1. If a Contract physicians 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 within 24 hours.

2.1.4. Technical Proficiency - Contract physicians shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read, write, and type 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 Contract physicians and Contract physicians shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

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. Contract physicians 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 credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

2.1.6. Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the Contract physicians as required by the VA.

Additional TMS requirements (Ex. OOORAM, Active Threat, Govt Ethics, VA Core Values, Prevention of Workplace Harassment)

Contractor shall provide to the COR a copy of the training certificates for each applicable employee within one (1) week of the initiation of the contract and annually thereafter, as required. These online courses listed above are located at the following web site: https://www.tms.va.gov/plateau/user/login.jsp. Detail instructions on account setup will be provided to the successful offeror upon contract award. Failure to complete this mandatory training listed above within the timeframe required shall be grounds for suspension or termination of all physical and/or electronic access privileges and removal from work on the contract until such time as the training is completed.

2.1.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for physicians 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 physician (s) {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. The TST or IGRA testing shall be repeated annually.

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

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

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician 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 physician (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 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) 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 is required - Contractor shall provide copy of current DEA certificate.

2.1.10. Conflict of Interest: The Contractor and all contractors’ physician (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 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 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 Contract physiciansare 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. 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 Contract physicians 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.

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

2.6. Inherent Government Functions: Contractor and Contract physicians 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 Contract physicians 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 physician(s). When a Contractor or Contract physicians 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 physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The VA Full Time Equivalency (FTE) for the services required is 2.3 FTE. FTE is defined by VA as a minimum of 80 hours every two weeks and does include holidays.

2.9.2. The number of Board Certified /Board Eligible Emergency Department physicians required to be on site on a daily basis is four (4) as defined in paragraph Hours of Operation in this section. It is essential that continuity of services is maintained to the maximum degree possible, hence, substitution of contractor provided Physicians shall be limited to urgent/emergent absences of approved, assigned providers. 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 physician is unable to begin or complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours before the scheduled time and notify the Contracting Office Representative (COR) at the Dorn VAMC immediately of the schedule change. The contract provider cannot leave the Emergency Department until physician coverage arrives.

2.9.3. 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 two (2) 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 fifteen (15) calendar days prior to making any permanent substitutions.

2.9.3.1. 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 seven (7) 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.

2.9.3.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive work days or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. To ensure continuity of care, the Contractor shall provide and ensure that additional contracted physicians are fully credentialed and have completed the minimum required TMS courses in the event back up is needed for any contracted physicians. The contractor must provide back up to see patients within 24 hours of notification.

2.9.3.3. 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 Chief of the Emergency Department or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s physician (s), s/he may request, without cause, immediate replacement of said Contractor’s physician(s). The CO and COR shall deal with issues raised concerning Contract physicians conduct. The final arbiter on questions of acceptability is the Chief of the Emergency Department.

2.9.3.4. 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 Contract physicians leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract. For this reason, the Contractor shall make preparations and ensure a minimum of 4 or more physicians at all times are fully credentialed at Dorn VAMC and ready to treat patients within 24 hours notification.

3. HOURS OF OPERATION

3.1. VA Business Hours: 24 hours a day, seven days a week.

3.1.1. Work Schedule: 24/7 coverage.

The services covered by this contract shall be furnished by the Contractor as defined herein. When able to provide coverage, the Contractor will be required to furnish such services 24 hours a day. The contracted provider shall work in accordance with an established work schedule. A 15-day notice to the COR is required for any shift schedule changes needed by the contracted physician(s). No provider is to work longer than one 12-hour shift/every 24 hours unless relief has not come in to replace the physician on duty. The contractor has the responsibility to maintain coverage in the ED at all times until the on-duty ED physician is relieved by his/her replacement physician. Services shall be required twelve hours (12) hours per day for shifts to include 7:00 a.m. - 7:00 p.m.; 9:00 a.m. – 9:00 p.m.; 12:00 p.m. – 12:00 a.m.; and the night shift from 8:00 p.m. – 8:00 a.m., Sunday through Saturday.

3.1.2. Patients must be seen by a Contract physician on-site at Dorn VAMC in a timely manner in accordance with VA Rules and Regulations. The Contract Physicians should meet performance metrics set forth by VHA Emergency Medicine Guidelines and metrics in accordance with ACEP. The Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.1.3. Contract Physicians shall be available and present in clinic during operative Hours at Dorn VAMC, and may be revised, as deemed appropriate for patient care by the Chief of the Emergency Department or designee. Currently, normal clinic hours are 24/7 coverage.

3.1.4. Off-hours Coverage: No on-call or off-hours coverage, and no overtime hours to be worked or paid.

4. CONTRACTOR RESPONSIBILITIES

4.1. Clinical Personnel Required: The Contractor shall provide Contract physicians who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contract physicians shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided to support and verify the contractor’s invoices.

4.2. Standards of Care: The contractor’s physician (s)’ care shall cover the range of Emergency services as would be provided in a state-of-the-art health care treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1. The American Board of Emergency Medicine

4.2.2. American Board of Osteopathic Emergency Medicine

4.2.3. Relevant professional societies including ACEP. SAEM, AAEM American College of Emergency Physicians: http://www.acep.org

4.2.4. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

4.2.5. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/emergency_department/

4.2.6. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

4.2.7. The requirements contained in this PWS

4.3. Medical Records:

4.3.1. Authorities: Contract physicians providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

4.3.3. Disclosure: Contract physiciansmay have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of the VHA Handbook 1605.1, Privacy and Release of Information, http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1423. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.3.4. Professional Standards for Documenting Care: Care shall be appropriately documented in

4.3.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer or designee at Dorn VAMC.

4.4. Direct Patient Care: 90% of the time involved in direct patient care.

4.4.1. Per the qualification section of this PWS, the Contractor shall provide the following staff: Board Certified /Board Eligible in Emergency Medicine.

4.4.2. Scope of Care: Contract physicians (as appropriate and within scope of practice/privileging) shall be responsible for providing Emergency Department care, including, but not limited to:

4.4.2.1. Evaluation, Emergent Treatment and Management: Employment of the principles of emergency care for life/limb threats, resuscitation and stabilization, triage, diagnosis and disposition.

4.4.2.1.1. Initial evaluation, emergent treatment and management of minor wound care, respiratory illness, gastrointestinal illness, burns, musculoskeletal trauma, dermatological illness, ENT, eye and urological problems.

4.4.2.1.2. Initial evaluation, emergent treatment and management of minor procedures such as local infiltration anesthesia, incision and drainage, simple laceration repair, nail trephination, electro-coagulation, nasal cautery, gastric lavage, bladder catheterization, peripheral venous line insertion, and spinal immobilization.

4.4.2.1.3. Initial evaluation, emergent treatment and management of abdominal and gastrointestinal disorders (including trauma) of the esophagus, stomach, small bowel and colon rectum and anus, liver and biliary tree and pancreas.

4.4.2.1.4. Initial evaluation, emergent treatment and management of cardiovascular disorders (including trauma) involving cardiac failure, differential diagnosis of chest pain, cardiac structural disorders, cardiac rhythm and conduction defects, pericardial disorders, disease of peripheral arteries and veins, shock, and cutaneous disorders.

4.4.2.1.5. Initial evaluation, emergent treatment and management of emergent disorders caused by antigens, organisms and other foreign substances such as reactions of hypersensitivity; reactions from venoms, bites and stings; reactions caused by infectious agents; disorders due to chemical, drug and physical agents; and disorders associated with the environment to include barotraumas, near drowning, electrical injury, hypothermia and radiation injury.

4.4.2.1.6. Initial evaluation, emergent treatment and management of emergent disorders of the hematopoietic system such as anemia, coagulopathy and management of acute neoplastic disease complication.

4.4.2.1.7. Initial evaluation, emergent treatment and management of emergent disorders of endocrine, metabolic and nutritional natures relating to acid-base disturbance, adrenal, parathyroid and thyroid disturbances.

4.4.2.1.8. Initial evaluation, emergent treatment and management of emergent disorders of the head and neck (including trauma) involving the ears, nose, oral cavity,…