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TC "SECTION A" \l 1TC "A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS" \l 2PAGE 1 OF1. REQUISITION NO. 2. CONTRACT NO.3. AWARD/EFFECTIVE DATE4. ORDER NO.5. SOLICITATION NUMBER6. SOLICITATION ISSUE DATEa. NAMEb. TELEPHONE NO. (No Collect Calls)8. OFFER DUE DATE/LOCALTIME9. ISSUED BYCODE10. THIS ACQUISITION IS UNRESTRICTED ORSET ASIDE: % FOR:SMALL BUSINESSHUBZONE SMALLBUSINESSSERVICE-DISABLEDVETERAN-OWNEDSMALL BUSINESSWOMEN-OWNED SMALL BUSINESS(WOSB) ELIGIBLE UNDER THE WOMEN-OWNEDSMALL BUSINESS PROGRAMEDWOSB8(A)NAICS:SIZE STANDARD:11. DELIVERY FOR FOB DESTINA-TION UNLESS BLOCK ISMARKEDSEE SCHEDULE12. DISCOUNT TERMS 13a. THIS CONTRACT IS A RATED ORDER UNDERDPAS (15 CFR 700)13b. RATING14. METHOD OF SOLICITATIONRFQIFBRFP15. DELIVER TO CODE16. ADMINISTERED BYCODE17a. CONTRACTOR/OFFERORCODEFACILITY CODE18a. PAYMENT WILL BE MADE BYCODETELEPHONE NO.DUNS:DUNS+4:PHONE:FAX:17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKEDSEE ADDENDUM19.20.21.22.23.24.ITEM NO.SCHEDULE OF SUPPLIES/SERVICESQUANTITYUNITUNIT PRICEAMOUNT(Use Reverse and/or Attach Additional Sheets as Necessary)25. ACCOUNTING AND APPROPRIATION DATA26. 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. ADDENDAAREARE NOT ATTACHED.27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDAAREARE NOT ATTACHED28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFERCOPIES 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 SPECIFIEDSET FORTH HEREIN IS ACCEPTED AS TO ITEMS:30a. SIGNATURE OF OFFEROR/CONTRACTOR31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)30c. DATE SIGNED31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT)31c. DATE SIGNEDAUTHORIZED FOR LOCAL REPRODUCTION(REV. 2/2012)PREVIOUS EDITION IS NOT USABLEPrescribed by GSA - FAR (48 CFR) 53.2127. FOR SOLICITATIONINFORMATION CALL:STANDARD FORM 1449OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS151VA244-15-R-009707-07-2015Shawn Smith814-860-29047-20-20152 PM00244Department of Veterans AffairsNetwork Contracting Office 41010 DELAFIELD ROADASPINWALL, PA 15215 XX621111$11 MillionXN/AXSee attached schedule file 00244Department of Veterans AffairsNetwork Contracting Office 4 Austin Payment CenterDepartment of Veterans AffairsPO Box 149971Austin TX TX(877) 353-9791(512) 460-5545LONG TERMINDEFINITE DELIVERY/INDEFINITE QUANTITY CONTRACT FORPERIOD OF PERFORMANCE:8/1/2015 THROUGH 7/31/20QUESTIONS CAN BE DIRECTED TO AMANDA MEIGHAN 412-822-3771 ORSHAWN SMITH 412-822-3785XXXX1SHAWN SMITHCONTRACTING OFFICER19.20.21.22.23.24.ITEM NO.SCHEDULE OF SUPPLIES/SERVICESQUANTITYUNITUNIT PRICEAMOUNT32a. QUANTITY IN COLUMN 21 HAS BEENRECEIVEDINSPECTEDACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: _______________________________________________________32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE32c. DATE32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE33. SHIP NUMBER34. VOUCHER NUMBER35. AMOUNT VERIFIED CORRECT36. PAYMENT37. CHECK NUMBERFORPARTIALFINALCOMPLETEPARTIALFINAL38. S/R ACCOUNT NUMBER39. S/R VOUCHER NUMBER40. PAID BY41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT42a. RECEIVED BY (Print)41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER41c. DATE42b. RECEIVED AT (Location)42c. DATE REC'D (YY/MM/DD)42d. TOTAL CONTAINERSSTANDARD FORM 1449 (REV. 2/2012) BACK Table of Contents TOC \o "1-4" \f \h \z \u \x SECTION A PAGEREF _Toc422747938 \h 1A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS PAGEREF _Toc422747939 \h 1SECTION B - CONTINUATION OF SF 1449 BLOCKS PAGEREF _Toc422747940 \h 5B.1 CONTRACT ADMINISTRATION DATA PAGEREF _Toc422747941 \h 5B.2 SPECIAL CONTRACT REQUIREMENTS PAGEREF _Toc422747942 \h 6B.3 IT CONTRACT SECURITY PAGEREF _Toc422747943 \h 8B.4 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011) PAGEREF _Toc422747944 \h 18B.5 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011) PAGEREF _Toc422747945 \h 19B.6 Price/Cost Schedule PAGEREF _Toc422747947 \h 47Item Information PAGEREF _Toc422747948 \h 47SECTION C - CONTRACT CLAUSES PAGEREF _Toc422747949 \h 48C.1 52.203-7 ANTI-KICKBACK PROCEDURES (MAY 2014) PAGEREF _Toc422747950 \h 48C.2 52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON POSTCONSUMER FIBER CONTENT PAPER (MAY 2011) PAGEREF _Toc422747951 \h 49C.3 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL (JAN 2011) PAGEREF _Toc422747952 \h 50C.4 52.204-7 SYSTEM FOR AWARD MANAGEMENT (JUL 2013) PAGEREF _Toc422747953 \h 50C.5 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (DEC 2014) PAGEREF _Toc422747954 \h 52C.6 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (APR 2015) PAGEREF _Toc422747955 \h 58C.7 52.216-1 TYPE OF CONTRACT (APR 1984) PAGEREF _Toc422747956 \h 64C.8 52.216-18 ORDERING (OCT 1995) PAGEREF _Toc422747957 \h 64C.9 52.216-19 ORDER LIMITATIONS (OCT 1995) PAGEREF _Toc422747958 \h 65C.10 52.216-22 INDEFINITE QUANTITY (OCT 1995) PAGEREF _Toc422747959 \h 65C.11 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) PAGEREF _Toc422747960 \h 66C.12 52.224-1 PRIVACY ACT NOTIFICATION (APR 1984) PAGEREF _Toc422747961 \h 66C.13 52.224-2 PRIVACY ACT (APR 1984) PAGEREF _Toc422747962 \h 66C.14 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997) PAGEREF _Toc422747963 \h 67C.15 52.237-3 CONTINUITY OF SERVICES (JAN 1991) PAGEREF _Toc422747964 \h 67C.16 SUPPLEMENTAL INSURANCE REQUIREMENTS PAGEREF _Toc422747965 \h 68C.17 52.245-2 GOVERNMENT PROPERTY INSTALLATION OPERATION SERVICES (APR 2012) PAGEREF _Toc422747966 \h 68C.18 VAAR 852.203-70 COMMERCIAL ADVERTISING (JAN 2008) PAGEREF _Toc422747967 \h 69C.19 VAAR 852.203-71 DISPLAY OF DEPARTMENT OF VETERAN AFFAIRS HOTLINE POSTER (DEC 1992) PAGEREF _Toc422747968 \h 69C.20 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2012) PAGEREF _Toc422747969 \h 69C.21 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (JAN 2008) PAGEREF _Toc422747970 \h 71C.22 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984) PAGEREF _Toc422747971 \h 72C.23 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) PAGEREF _Toc422747972 \h 72C.24 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO BENEFICIARIES (JAN 2008) PAGEREF _Toc422747973 \h 72SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS PAGEREF _Toc422747974 \h 73SECTION E - SOLICITATION PROVISIONS PAGEREF _Toc422747987 \h 126E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (APR 2014) PAGEREF _Toc422747988 \h 126E.2 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL ITEMS (MAR 2015) PAGEREF _Toc422747989 \h 136E.3 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003) PAGEREF _Toc422747990 \h 151SECTION B - CONTINUATION OF SF 1449 BLOCKSB.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) SHAWN SMITH 412-822-3785Department of Veterans AffairsNetwork Contracting Office 41010 DELAFIELD ROADASPINWALL, PA 15215 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: a. Quarterly[] b. Semi-Annually[] c. Other[X] MONTHLY 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.Austin Payment CenterDepartment of Veterans AffairsPO Box 149971Austin TX TX ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:AMENDMENT NODATEB.2 SPECIAL CONTRACT REQUIREMENTS Under the authority of Public Law 104-262 and 38 USC 8153, the contractor agrees to provide Health Care Resources in accordance with the terms and conditions stated herein, to furnish to and at the Department of Veterans Affairs Medical Center, VA PITTSBURGH HEALTHCARE SYSTEM, UNIVERSITY DRIVE C PGH PA, the services and prices specified in the Section entitled Schedule of Supplies/Services of this contract. 1. SERVICES: a. The services specified in the Sections entitled Schedule of Supplies/Services and Special Contract Requirements may be changed by written modification to this contract. b. Other necessary personnel for the operation of the services contracted for at the VA will be provided by the VA at levels mutually agreed upon which are compatible with the safety of the patient and personnel and with quality medical care programming. c. The services to be performed by the contractor will be performed in accordance with VA policies and procedures and the regulations of the medical staff by laws of the VA facility. 2. TERM OF CONTRACT: This contract is effective one year from date of award. The period of performance for this contract is 8-1-2015 through 7-31-2020. The contract is subject to the availability of funds. The contractor shall perform no services after September 30 of any year until the Contracting Officer authorizes such services in writing. 3. QUALIFICATIONS: Personnel assigned by the Contractor to perform the services covered by this contract shall be licensed in a State, Territory, or Commonwealth of the United States or the District of Columbia. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. The qualifications of such personnel shall also be subject to review by the VA Chief of Staff and approval by the VA Facility Director. Each person assigned to work under this contract shall be licensed by any of one or more state in the United States or Districtof Columbia. 4. WORK HOURS: a. The services covered by this contract shall be furnished by the contractor as defined herein. The contractor will not be required, except in case of emergency, to furnish such services during off-duty hours as described below. b. The following terms have the following meanings: (1) Work hours: Monday through Friday, 8:00 a.m. - 4:30 p.m. (2) National Holidays: The 10 holidays observed by the Federal Government are: New Years Day Martin Luther King’s Birthday Presidents Day Memorial Day Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Christmas ANDany other day specifically declared by the President of the United States to be a national holiday. (3) Off-Duty hours: Friday through Monday, 4:30 p.m. - 8:00 a.m. 5. PERSONNEL POLICY: The contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the contractor shall provide the following for these personnel: - general liability - workers compensation - professional liability insurance - health examinations - income tax withholding, and - social security payments. The parties agree that the contractor, its employees, agents and subcontractors shall not be considered VA employees for any purpose. 6. RECORD KEEPING: The VA Medical Center, VA PITTSBURGH HEALTHCARE SYSTEM, UNIVERSITY DRIVE C PGH PA shall establish and maintain a record keeping system that will record the hours worked by the contractor employee(s). Contractor's employee(s) shall report to the Surgeon of Record or Administrative Officer, or designee upon arrival at the VA PITTSBURGH HEALTHCARE SYSTEM, UNIVERSITY DRIVE, PGH PA. 7. CONTRACT PERFORMANCE MONITORING: Monitoring of contractors time shall be demonstrated through sign-in/ sign-out sheets. The contractor shall be required to sign an attendance log upon reporting to work and departing from work. SALLIE D. GRAY, MANAGEMENT ANALYST, shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer. 8. KEY PERSONNEL AND TEMPORARY EMERGENCY SUBSTITUTIONS: The Contractor shall assign to this contract the following key personnel: a. During the first ninety (90) 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 Contracting Officer, in writing, within 15 calendar days after the occurrence of any of these events and provide the information required by paragraph (c) below. After the initial 90-day period of the contract, the Contractor shall submit the information required by paragraph (c) to the Contracting Officer at least 15 days prior to making any permanent substitutions. b. 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 Contracting Officer. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The Contracting Officer will notify the Contractor within 15 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. c. For temporary substitutions where the key person will not be reporting to work for three (3) consecutive work days or more, the Contractor will provide a qualified replacement for the key person. This substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.B.3 IT CONTRACT SECURITY VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY 1. GENERAL Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security. 2. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS a. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order. b. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures. c. Contract personnel who require access to national security programs must have a valid security clearance. National Industrial Security Program (NISP) was established by Executive Order 12829 to ensure that cleared U.S. defense industry contract personnel safeguard the classified information in their possession while performing work on contracts, programs, bids, or research and development efforts. The Department of Veterans Affairs does not have a Memorandum of Agreement with Defense Security Service (DSS). Verification of a Security Clearance must be processed through the Special Security Officer located in the Planning and National Security Service within the Office of Operations, Security, and Preparedness. d. Custom software development and outsourced operations must be located in the U.S. to the maximum extent practical. If such services are proposed to be performed abroad and are not disallowed by other VA policy or mandates, the contractor/subcontractor must state where all non-U.S. services are provided and detail a security plan, deemed to be acceptable by VA, specifically to address mitigation of the resulting problems of communication, control, data protection, and so forth. Location within the U.S. may be an evaluation factor. e. The contractor or subcontractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor or subcontractor's employ. The Contracting Officer must also be notified immediately by the contractor or subcontractor prior to an unfriendly termination. 3. VA INFORMATION CUSTODIAL LANGUAGE a. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1). b. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor's information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA's information is returned to the VA or destroyed in accordance with VA's sanitization requirements. VA reserves the right to conduct on-site inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements. c. Prior to termination or completion of this contract, contractor/ subcontractor must not destroy information received from VA, or gathered/ created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract. d. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract. e. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed. f. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12. g. If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. Absent an agreement to use or disclose protected health information, there is no business associate relationship. h. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated. i. The contractor/subcontractor's firewall and Web services security controls, if applicable, shall meet or exceed VA's minimum requirements. VA Configuration Guidelines are available upon request. j. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA's prior written approval. The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response. k. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor/subcontractor is in receipt of a court order or other requests for the above mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA contracting officer for response. l. For service that involves the storage, generating, transmitting, or exchanging of VA sensitive information but does not require C&A or an MOU-ISA for system interconnection, the contractor/subcontractor must complete a Contractor Security Control Assessment (CSCA) on a yearly basis and provide it to the COR. 4. INFORMATION SYSTEM DESIGN AND DEVELOPMENT a. Information systems that are designed or developed for or on behalf of VA at non-VA facilities shall comply with all VA directives developed in accordance with FISMA, HIPAA, NIST, and related VA security and privacy control requirements for Federal information systems. This includes standards for the protection of electronic PHI, outlined in 45 C.F.R. Part 164, Subpart C, information and system security categorization level designations in accordance with FIPS 199 and FIPS 200 with implementation of all baseline security controls commensurate with the FIPS 199 system security categorization (reference Appendix D of VA Handbook 6500, VA Information Security Program). During the development cycle a Privacy Impact Assessment (PIA) must be completed, provided to the COR, and approved by the VA Privacy Service in accordance with Directive 6507, VA Privacy Impact Assessment. b. The contractor/subcontractor shall certify to the COR that applications are fully functional and operate correctly as intended on systems using the VA Federal Desktop Core Configuration (FDCC), and the common security configuration guidelines provided by NIST or the VA. This includes Internet Explorer 7 configured to operate on Windows XP and Vista (in Protected Mode on Vista) and future versions, as required. c. The standard installation, operation, maintenance, updating, and patching of software shall not alter the configuration settings from the VA approved and FDCC configuration. Information technology staff must also use the Windows Installer Service for installation to the default "program files" directory and silently install and uninstall. d. Applications designed for normal end users shall run in the standard user context without elevated system administration privileges. e. The security controls must be designed, developed, approved by VA, and implemented in accordance with the provisions of VA security system development life cycle as outlined in NIST Special Publication 800-37, Guide for Applying the Risk Management Framework to Federal Information Systems, VA Handbook 6500, Information Security Program and VA Handbook 6500.5, Incorporating Security and Privacy in System Development Lifecycle. f. The contractor/subcontractor is required to design, develop, or operate a System of Records Notice (SOR) on individuals to accomplish an agency function subject to the Privacy Act of 1974, (as amended), Public Law 93-579, December 31, 1974 (5 U.S.C. 552a) and applicable agency regulations. Violation of the Privacy Act may involve the imposition of criminal and civil penalties. g. The contractor/subcontractor agrees to: (1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and regulations issued under the Act in the design, development, or operation of any system of records on individuals to accomplish an agency function when the contract specifically identifies: (a) The Systems of Records (SOR); and (b) The design, development, or operation work that the contractor/ subcontractor is to perform; (1) Include the Privacy Act notification contained in this contract in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract requires the redesign, development, or operation of a SOR on individuals that is subject to the Privacy Act; and (2) Include this Privacy Act clause, including this subparagraph (3), in all subcontracts awarded under this contract which requires the design, development, or operation of such a SOR. h. In the event of violations of the Act, a civil action may be brought against the agency involved when the violation concerns the design, development, or operation of a SOR on individuals to accomplish an agency function, and criminal penalties may be imposed upon the officers or employees of the agency when the violation concerns the operation of a SOR on individuals to accomplish an agency function. For purposes of the Act, when the contract is for the operation of a SOR on individuals to accomplish an agency function, the contractor/subcontractor is considered to be an employee of the agency. (1) "Operation of a System of Records" means performance of any of the activities associated with maintaining the SOR, including the collection, use, maintenance, and dissemination of records. (2) "Record" means any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and contains the person's name, or identifying number, symbol, or any other identifying particular assigned to the individual, such as a fingerprint or voiceprint, or a photograph. (3) "System of Records" means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual. i. The vendor shall ensure the security of all procured or developed systems and technologies, including their subcomponents (hereinafter referred to as "Systems"), throughout the life of this contract and any extension, warranty, or maintenance periods. This includes, but is not limited to workarounds, patches, hotfixes, upgrades, and any physical components (hereafter referred to as Security Fixes) which may be necessary to fix all security vulnerabilities published or known to the vendor anywhere in the Systems, including Operating Systems and firmware. The vendor shall ensure that Security Fixes shall not negatively impact the Systems. j. The vendor shall notify VA within 24 hours of the discovery or disclosure of successful exploits of the vulnerability which can compromise the security of the Systems (including the confidentiality or integrity of its data and operations, or the availability of the system). Such issues shall be remediated as quickly as is practical, but in no event longer than 7 days. k. When the Security Fixes involve installing third party patches (such as Microsoft OS patches or Adobe Acrobat), the vendor will provide written notice to the VA that the patch has been validated as not affecting the Systems within 10 working days. When the vendor is responsible for operations or maintenance of the Systems, they shall apply the Security Fixes within 7 days. l. All other vulnerabilities shall be remediated as specified in this paragraph in a timely manner based on risk, but within 60 days of discovery or disclosure. Exceptions to this paragraph (e.g. for the convenience of VA) shall only be granted with approval of the contracting officer and the VA Assistant Secretary for Office of Information and Technology. 5. INFORMATION SYSTEM HOSTING, OPERATION, MAINTENANCE, OR USE a. For information systems that are hosted, operated, maintained, or used on behalf of VA at non-VA facilities, contractors/subcontractors are fully responsible and accountable for ensuring compliance with all HIPAA, Privacy Act, FISMA, NIST, FIPS, and VA security and privacy directives and handbooks. This includes conducting compliant risk assessments, routine vulnerablity scanning, system patching and change management procedures, and the completion of an acceptable contingency plan for each system. The contractor's security control procedures must be equivalent, to those procedures used to secure VA systems. A Privacy Impact Assessment (PIA) must also be provided to the COR and approved by VA Privacy Service prior to operational approval. All external Internet connections to VA's network involving VA information must be reviewed and approved by VA prior to implementation. b. Adequate security controls for collecting, processing, transmitting, and storing of Personally Identifiable Information (PII), as determined by the VA Privacy Service, must be in place, tested, and approved by VA prior to hosting, operation, maintenance, or use of the information system, or systems by or on behalf of VA. These security controls are to be assessed and stated within the PIA and if these controls are determined not to be in place, or inadequate, a Plan of Action and Milestones (POA&M) must be submitted and approved prior to the collection of PII. c. Outsourcing (contractor facility, contractor equipment or contractor staff) of systems or network operations, telecommunications services, or other managed services requires certification and accreditation (authorization) (C&A) of the contractor's systems in accordance with VA Handbook 6500.3, Certification and Accreditation and/or the VA OCS Certification Program Office. Government- owned (government facility or government equipment) contractor-operated systems, third party or business partner networks require memorandums of understanding and interconnection agreements (MOU-ISA) which detail what data types are shared, who has access, and the appropriate level of security controls for all systems connected to VA networks. d. The contractor/subcontractor's system must adhere to all FISMA, FIPS, and NIST standards related to the annual FISMA security controls assessment and review and update the PIA. Any deficiencies noted during this assessment must be provided to the VA contracting officer and the ISO for entry into VA's POA&M management process. The contractor/subcontractor must use VA's POA&M process to document planned remedial actions to address any deficiencies in information security policies, procedures, and practices, and the completion of those activities. Security deficiencies must be corrected within the timeframes approved by the government. Contractor/subcontractor procedures are subject to periodic, unannounced assessments by VA officials, including the VA Office of Inspector General. The physical security aspects associated with contractor/ subcontractor activities must also be subject to such assessments. If major changes to the system occur that may affect the privacy or security of the data or the system, the C&A of the system may need to be reviewed, retested and re- authorized per VA Handbook 6500.3. This may require reviewing and updating all of the documentation (PIA, System Security Plan, Contingency Plan). The Certification Program Office can provide guidance on whether a new C&A would be necessary. e. The contractor/subcontractor must conduct an annual self-assessment on all systems and outsourced services as required. Both hard copy and electronic copies of the assessment must be provided to the COR. The government reserves the right to conduct such an assessment using government personnel or another contractor/subcontractor. The contractor/subcontractor must take appropriate and timely action (this can be specified in the contract) to correct or mitigate any weaknesses discovered during such testing, generally at no additional cost. f. VA prohibits the installation and use of personally-owned or contractor/ subcontractor-owned equipment or software on VA's network. If non-VA owned equipment must be used to fulfill the requirements of a contract, it must be stated in the service agreement, SOW or contract. All of the security controls required for government furnished equipment (GFE) must be utilized in approved other equipment (OE) and must be funded by the owner of the equipment. All remote systems must be equipped with, and use, a VA-approved antivirus (AV) software and a personal (host-based or enclave based) firewall that is configured with a VA-approved configuration. Software must be kept current, including all critical updates and patches. Owners of approved OE are responsible for providing and maintaining the anti-viral software and the firewall on the non-VA owned OE. g. All electronic storage media used on non-VA leased or non-VA owned IT equipment that is used to store, process, or access VA information must be handled in adherence with VA Handbook 6500.1, Electronic Media Sanitization upon: (i) completion or termination of the contract or (ii) disposal or return of the IT equipment by the contractor/subcontractor or any person acting on behalf of the contractor/subcontractor, whichever is earlier. Media (hard drives, optical disks, CDs, back-up tapes, etc.) used by the contractors/ subcontractors that contain VA information must be returned to the VA for sanitization or destruction or the contractor/subcontractor must self-certify that the media has been disposed of per 6500.1 requirements. This must be completed within 30 days of termination of the contract. h. Bio-Medical devices and other equipment or systems containing media (hard drives, optical disks, etc.) with VA sensitive information must not be returned to the vendor at the end of lease, for trade-in, or other purposes. The options are: (1) Vendor must accept the system without the drive; (2) VA's initial medical device purchase includes a spare drive which must be installed in place of the original drive at time of turn-in; or (3) VA must reimburse the company for media at a reasonable open market replacement cost at time of purchase. (4) Due to the highly specialized and sometimes proprietary hardware and software associated with medical equipment/systems, if it is not possible for the VA to retain the hard drive, then; (a) The equipment vendor must have an existing BAA if the device being traded in has sensitive information stored on it and hard drive(s) from the system are being returned physically intact; and (b) Any fixed hard drive on the device must be non-destructively sanitized to the greatest extent possible without negatively impacting system operation. Selective clearing down to patient data folder level is recommended using VA approved and validated overwriting technologies/methods/tools. Applicable media sanitization specifications need to be pre-approved and described in the purchase order or contract. (c) A statement needs to be signed by the Director (System Owner) that states that the drive could not be removed and that (a) and (b) controls above are in place and completed. The ISO needs to maintain the documentation. 6. SECURITY INCIDENT INVESTIGATION a. The term "security incident" means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor/ subcontractor shall immediately notify the COR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor/ subcontractor has access. b. To the extent known by the contractor/subcontractor, the contractor/ subcontractor's notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the contractor/subcontractor considers relevant. c. With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement. d. In instances of theft or break-in or other criminal activity, the contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor, its employees, and its subcontractors and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident. 7. LIQUIDATED DAMAGES FOR DATA BREACH a. Consistent with the requirements of 38 U.S.C. 5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any SPI the contractor/subcontractor processes or maintains under this contract. b. The contractor/subcontractor shall provide notice to VA of a "security incident" as set forth in the Security Incident Investigation section above. Upon such notification, VA must secure from a non-Department entity or the VA Office of Inspector General an independent risk analysis of the data breach to determine the level of risk associated with the data breach for the potential misuse of any sensitive personal information involved in the data breach. The term 'data breach' means the loss, theft, or other unauthorized access, or any access other than that incidental to the scope of employment, to data containing sensitive personal information, in electronic or printed form, that results in the potential compromise of the confidentiality or integrity of the data. Contractor shall fully cooperate with the entity performing the risk analysis. Failure to cooperate may be deemed a material breach and grounds for contract termination. c. Each risk analysis shall address all relevant information concerning the data breach, including the following: (1) Nature of the event (loss, theft, unauthorized access); (2) Description of the event, including: (a) date of occurrence; (b) data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code; (3) Number of individuals affected or potentially affected; (4) Names of individuals or groups affected or potentially affected; (5) Ease of logical data access to the lost, stolen or improperly accessed data in light of the degree of protection for the data, e.g., unencrypted, plain text; (6) Amount of time the data has been out of VA control; (7) The likelihood that the sensitive personal information will or has been compromised (made accessible to and usable by unauthorized persons); (8) Known misuses of data containing sensitive personal information, if any; (9) Assessment of the potential harm to the affected individuals; (10) Data breach analysis as outlined in 6500.2 Handbook, Management of Security and Privacy Incidents, as appropriate; and (11) Whether credit protection services may assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that may have been compromised. d. Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages in the amount of $37.50 per affected individual to cover the cost of providing credit protection services to affected individuals consisting of the following: (1) Notification; (2) One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports; (3) Data breach analysis; (4) Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution; (5) One year of identity theft insurance with $20,000.00 coverage at $0 deductible; and (6) Necessary legal expenses the subjects may incur to repair falsified or damaged credit records, histories, or financial affairs. 8. SECURITY CONTROLS COMPLIANCE TESTING On a periodic basis, VA, including the Office of Inspector General, reserves the right to evaluate any or all of the security controls and privacy practices implemented by the contractor under the clauses contained within the contract. With 10 working-days’ notice, at the request of the government, the contractor must fully cooperate and assist in a government-sponsored security controls assessment at each location wherein VA information is processed or stored, or information systems are developed, operated, maintained, or used on behalf of VA, including those initiated by the Office of Inspector General. The government may conduct a security control assessment on shorter notice (to include unannounced assessments) as determined by VA in the event of a security incident or at any other time. 9. TRAINING a. All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems: (1) Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to VA information and information systems; (2) Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training; (3) Successfully complete the appropriate VA privacy training and annually complete required privacy training; and (4) Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access [to be defined by the VA program official and provided to the contracting officer for inclusion in the solicitation document - e.g., any role-based information security training required in accordance with NIST Special Publication 800-16, Information Technology Security Training Requirements.] b. The contractor shall provide to the contracting officer and/or the COR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required. c. Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete.(End of Clause)IT CONTRACT SECURITYContractor will be required to comply with physical security guidelines by obtaining a VA Contractor PIV card in accordance with VAPHS Policy. The PIV card will service as a VA ID badge and must be worn at all times. Contractor must meet all VA requirements to obtain/maintain computer access. Contractor must complete “VA Privacy and Information Security Awareness and Rules of Behavior” and “Privacy and HIPAA Focused Training” courses prior to the performance of the contract and annually thereafter. Training must be completed in VA’s TMS system (). Contractors must use the TMS Managed Self Enrollment method to complete the training in TMS. The COR must ensure that all contractors are validated in the PIH domain. Proof of training completion must be verified and tracked by the COR. Contractor employee(s) must sign Appendix D Contractor Rules of Behavior which is an attachment to this solicitation.Records Management Language for ContractsCitations to pertinent laws, codes and regulations such as 44 U.S.C chapters 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C. 552a); 36 CFR Part 1222 and Part 1228.Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government IT equipment and/or Government records. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract. The Government Agency owns the rights to all data/records produced as part of this contract. The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract. Contractor must deliver sufficient technical documentation with all data deliverables to permit the agency to use the data. Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.]. No disposition of documents will be allowed without the prior written consent of the Contracting Officer. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules. Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, this contract. The Contractor (and any sub-contractor) is required to abide by Government and Agency guidance for protecting sensitive and proprietary information. B.4 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011) This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.(End of Clause)B.5 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011) This solicitation includes FAR 52.219-4 Notice of Price Evaluation Preference for HubZone Small Business Concerns. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.(End of Clause)PERFORMANCE WORK STATEMEMENTThe Contractor shall furnish all personnel to provide services necessary to perform onsite SURGICAL NEUROPHYSIOLOGIST Physician Services and NEURODIAGNOSTIC TECHNOLOGIST to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Pittsburgh, Healthcare System, University Drive, Pittsburgh, Pennsylvania 15240 (hereinafter referred to as VAMC). The contract Surgical Neurophysiologist physician (s)’ care shall cover the range of NEUROPHYSIOLOGY services to support the operative surgeries for the medical specialties NEUROSURGERY, VASCULAR SURGERY, ORTHOPEDIC SURGERY, and CARDIAC SURGERY services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards American Board of Neurophysiologic Monitoring/American Clinical Neurophysiology Society. of Performance: Services shall be provided on site, VAMC Pittsburgh Healthcare System, University Drive, Pittsburgh, Pennsylvania 15240Pricing Instructions: The offeror is instructed to edit the number of sub-clins to correspond with the number of key personnel submitted for the CLIN. Affiliate Offerors shall include the “title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SUB-CLINs if adding or removing Key Personnel.The Contractor shall propose __4.25_ key personnel to be credentialed and be available for scheduling to meet the requirements of the contract.8/1/2015 to 7/31/2016:CLINPrice Schedule SourceDRG (IF APPLICABLE) orCPT CodeEst. QtyProfessional Medicare Price per CodeTechnical Medicare Price per CodePercent of MedicareTotal Extended Cost All Cells000195812- Electroencephalogram (EEG) extended monitoring; 41-60 minutes1$____$_______%$_______000295813- Greater than 1 hour1$_____$_______%$________0003 95955- Electroencephalogram (EEG) during nonintracranial surgery (eg. carotid surgery) 55$_____$______%$_______0004 95925- Short-latency somatosensory evoked potential study52$_____$______%$________000595926- In lower limbs4$______$_______%$_______000695938- In upper and lower limbs71$_____$_______%$_______000795927- In the trunk or head25$ $ _%$ 000895930- Visual evoked potential (VEP) testing central nervous system, checkerboard or flash25$_____$______%$______000995933- Orbicularis oculi(blink) reflex, by electrodiagnostic testing25$ $ _%$ 001095937- Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method25$_____$_______%$______001192585- Auditory evoked potentials for evoked response audiometry and/ or testing of the central nervous system; comprehensive 25$________$________ ___% $________001292586- Limited 1 $______ $_______ _____% $_______001395961-Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional 4 $_______ $_______ ______% $________001495962- Each additional hour of attendance by a physician or other qualified health care professional (List separately in addition to code for primary procedure) 25 $_____ $______ ______% $______0015 95829-Electrocorticogram at surgery 25 $______ $______ _______% $_________001695867- Cranial nerve supplied muscle(s), unilateral 1.00 $_______ $______ ______% $___________001795868- Cranial nerve supplied muscles, bilateral 25 $_____ $_______ _______% $_______001895865- Larynx 25 $______ $______ _______% $________001995869- Thoracic paraspinal muscles (excluding T1 or T12) 25 $______ $_______ ______% $________0020 95860- Needle electromyography; 1 extremity with or without related paraspinal areas 1.00 $_______ $_______ _______% $________002195861- 2 extremities with or without related paraspinal areas 6.00 $______ $________ ________% $_________002295864- 4 extremities with or without related paraspinal areas 25 $_____ $_______ ________% $________002351785- Needle electromyography studies (EMG) of anal or urethral sphincter, any technique 1.00 $_____ $______ ______% $______002495928- Central motor evoked potential study (transcranial motor stimulation); upper limbs 1.00 $______ $______ ______% $_______002595929- Lower limbs 25.00 $______ $_______ ______% $_______002695939- In upper and lower limbs 25.00 $_____ $______ _______% $_______002793888- Limited study 25.00 $______ $_______ _______% $_______002895940- Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (List separately in addition to code for primary procedure) 25 $______ $_______ _______% $________002995822- Recording in coma or sleep only 25.00 $______ $______ ________% $________003095863- 3 extremities with or without related paraspinal areas 25.00 $______ $_______ ________% $________003195870- Limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters 25.00 $______ $______ ________% $_______0032 95866- Hemidiaphragm 25.00 $______ $_______ _______% $_______003395907- Nerve conduction studies; 1-2 studies 25.00 $______ $_______ _______% $_______003495908- 3-4 studies 25.00 $______ $_______ _______% $________003595909- 5-6 studies 25.00 $______ $________ _______% $________003695910- 7-8 studies 25.00 $______ $________ _______% $________003795911- 9- 10 studies 25.00 $______ $________ _______% $________003895912- 11-12 studies 25.00 $______ $________ _______% $________003995913- 13 or more studies 25.00 $______ $________ _______% $________0040 G0453 25.00 $______ $________ _______% $________Note: The Government shall order the below specified minimum contract value of services and may order up to and including the below specified maximum contract value of services through task orders under this basic IDIQ contract throughout the duration of the contract to include all option periods (if applicable). The maximum amount under this contract is not guaranteed.IDIQ contract Minimum $100.00___IDIQ contract Maximum $770,000.00Performance Work Statement for Onsite Surgical Neurophysiologist Physician Services and Neurodiagnostic TechnologistGENERAL:Services Provided: The Contractor shall provide Board Certified Surgical NEUROPHYSIOLOGIST Physician Services and Board Certified NEURODIAGNOSTIC TECHNOLOGIST on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the VA Pittsburgh Healthcare System. Place of Performance - Pittsburgh, Healthcare System, University Drive, Pittsburgh, Pennsylvania 15240.Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority.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.ABNM: American Board of Neurophysiologic Monitoring. : American Board of Neurological Surgery : American Board of Psychiatry and Neurology – Intraoperative neurophysiological monitoringSSEPs - Somatosensory evoked potentials (SSEPs)TcMEPs – Transcranial motor evoked potentialsEMGs - ElectromyographyEEG - ElectroencephalographyACGME: Accreditation Council for Graduate Medical EducationACLS: Advanced Cardiac Life SupportAOD: Admitting Officer of the DayBLS: Basic Life SupportCCNE: Commission on Collegiate Nursing Education: aacn.nche.edu/accreditationCDC: Centers for Disease Control and PreventionCDR: Contract Discrepancy ReportCEU: Certified Education Unit CME: Continuing Medical EducationCMS: Centers for Medicare and Medicaid ServicesContracting 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. 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. COS: Chief of StaffCPARS: Contractor Performance Assessment Reporting SystemCPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.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. DEA: Drug Enforcement AgencyED: Emergency DepartmentFSMB: Federation of State Medical Boards Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.HHS: Department of Health and Human ServicesHIPAA: Health Insurance Portability and Accountability ActHR: Human ResourcesISO: Information Security OfficerMedical 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.MOD: Medical Officer of the DayNational 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).NLNAC: National League for Nursing Accrediting Commission. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractorsNP: Nurse PractitionerNPPES: National Plan and Provider Enumeration SystemPA: Physician AssistantPALS: Pediatric Advanced Life SupportPOP: Period of PerformancePPD: Purified Protein DerivativePWS: Performance Work StatementPrivileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for 8independent 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. QASP: Quality Assurance Surveillance PlanVeterans 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.Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in Michigan and Indiana.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.VetPro: a federal web-based credentialing program for healthcare providers.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 VA Pittsburgh Healthcare System Medical Center.QUALIFICATIONS:Staff/FacilityLicense - Contract physician(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contract physician(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract. Board Certification - All contract Surgical Neurophysiologist physician(s) shall be board certified by Certification in American Board of Psychiatry and Neurology , Neurophysiologic Intraoperative Monitoring (CNIM) from the American Board of Registered Electroneurodiagnostic Technologist (). This technical certification intended for technologists who work under supervision by a neurophysiologist or neurologist. American Board of Neurophysiologic Monitoring (ABNM) certification (). This is a professional level certification intended for neurophysiologist working independently, and be currently certified in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS) or equivalency. Neurodiagnostic Technologist must be American Board of Registered Electroneurodiagnositc Technologist (). This technical certification intended for technologists who work under supervision by a neurophysiologist or neurologist. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.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 physician(s) prior to obtaining approval by the (VA Pittsburgh Healthcare System) Professional Standards Board, Medical Executive Board and Medical Center Director. If a contract physician(s) is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.Technical Proficiency - Contract physician(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract physician(s) and contract physician (s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.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 physician (s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the 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).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 physician (s) and Neurodiagnostic Technologist as required by the VA on an annual basis. VA Privacy and Information Security Awareness and Rules of Behavior and HIPAA and Privacy training courses taken on an annual basis.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.TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract physician (s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.RUBELLA TESTING: Contractor shall provide proof of immunization for all contract physician (s) for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contract physician (s); provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. 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 ) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.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. DEA (as required) - Contractor shall provide copy of current DEA certificate. Conflict of Interest: The Contractor and all contract 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.Citizenship related Requirements: 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;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.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.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.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. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at to ensure that the proposed contract physicians (s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.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.Clinical/Professional Direction: 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 direction of all clinical personnel covered by this contract 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.Non Personal Healthcare Services: The parties agree that the Contractor and all contract physician (s) shall not be considered VA employees for any purpose.Inherent Government Functions: Contractor and Contract physician (s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.No Employee status: The Contractor shall be responsible for protecting Contract physician (s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:Workers’ compensationProfessional liability insuranceHealth examinationsIncome tax withholding, andSocial security payments.Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s). When a Contractor or contract physician(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.Key Personnel:The number of Board Certified Surgical Neurophysiologist physicians and Neurodiagnostic Technologist required to be on site on a daily basis is based upon the surgical case workload for the day and 2.00 (1.00 Surgical Neurophysiologist and 1.00 Neurodiagnostic Technologist as defined in paragraph Hours of Operation in this section. Emergency 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 15 calendar days 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 15 calendar days prior to making any permanent substitutions.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 15 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.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. Any period exceeding two weeks will require the procedure as stated above.The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contract physician (s), s/he may request, without cause, immediate replacement of said contract physician (s). The CO and COR shall deal with issues raised concerning Contract physician (s) conduct. The final arbiter on questions of acceptability is the CO.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 physician (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract. VA Hours of Operation/SCHEDULING:VA Business Hours: 6:30 am – 7:00 pm Monday - Friday Work Schedule: 6:30 am – 7:00 pm Monday – FridayServices Required: Neurophysiologist and Neurotechnologist Per-ProcedurePatients must be seen by a contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) on-site at (VA Pittsburgh Healthcare System) in a timely manner in accordance with VA Rules and Regulations on surgical operation times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.Contract Surgical Neurophysiologist Physician(s) and Neurodiagnostic Technologist(s) shall be available and present in the operating room working simultaneous on patients with 1:1 ratio. The Intraoperative Neurophysiological Monitoring (IONM) data interpretation shall be performed by a board certified neurophysiologist both in the operating room (in-house), as well as remotely at the contractor’s location during normal established VA Pittsburgh Healthcare System (VAPHS) operating room hours. The contractor will be required to utilize their own secure internet connection e.g. (USB 4G device) with wireless and encryption capabilities. Data from the neurophysiology monitoring is transmitted via contractor’s VPN (Virtual Private Network). Non- identifying patient information is transferred through the VPN system. Contractor must be compliant with ALL HIPAA rules. The neurophysiologist interprets the neurophysiology patient waves in “real time” and conveys these findings to the neurotechnologist in the operating room or bedside who in turn will relay this information to the surgeon. The operating hours may be revised, as deemed appropriate for patient care by the Chief of Staff (COS). Currently, normal operating room hours are 6:30 am – 7:00 pm. The contractor shall provide comprehensive neurophysiology services for operative procedures listed in the Schedule of Services and Prices/Costs (the Schedule) at the VAPHS, University Drive, Pittsburgh, PA 15240. Services shall be performed in accordance with the requirements specified in this contract, and in accordance with the technical/logistical approach presented by the contractor and agreed to by VAPHS. The contractor’s group performing services will be responsible for a full spectrum of direct intraoperative monitoring, analysis, and reporting of findings to surgical staff as well as documentation in the patient medical record. The VAPHS prefers that intraoperative feedback be provided during the actual performance of the procedure being monitored; such ‘real time’ feedback, if included, will be delineated in the contractor’s technical/logistical approach. The services to be performed by the contractor will be monitored for quality of patient care by the VA Pittsburgh Healthcare System’s Chief of Staff and Vice President, Surgery Service Line.The VAPHS Operating Room Program Support Clerk will contact the contractor between the hours of 12:00 Noon and 3:00 p.m. Monday through Friday (or the contractor may contact the VAPHS Operating Room Program Support Clerk at (412) 360-6360), the day before scheduled procedure(s), to determine the need for neurophysiology services for scheduled cases. The VAPHS will make every effort to provide at least a 2-day notice for scheduled cases. The contractor group must be available for emergency coverage 24 hours per day, 7 days per week. The VAPHS will not pay for on-call or standby time, and will only pay for actual services performed. For emergent or unscheduled cases during weekday nights, weekends, or holidays, the VAPHS Operating Room staff will contact the designated contractor staff person via an on-call pager. The contractor group must be available “on-call” to provide monitoring services within one hour of actual contact by VA Pittsburgh Healthcare System, except where inclement weather, natural disaster, or other force major prevents responding in such a time period. Anticipated volume of emergency cases is one (1) per month.PHYSICIAN SERVICES: All services provided by the group must be overseen in real time by a VA credentialed physician. NEUROPHYSIOLOGIST SERVICES: The neurophysiologist will directly supervise the work of all neurotechnologist staff and will provide monitoring services intraoperatively. The neurophysiologist will provide diagnostic evaluation, intraoperative and intensive care neurophysiological monitoring, and transcranial doppler evaluations. The neurophysiologist will prospectively determine monitoring modalities for each case and communicate this to the neurotechnologist, and will determine when specific cases require additional on-site staffing. The neurophysiologist providing coverage during a case will make judgments regarding intraoperative readings during that case and will remain in communication with the assigned neurotechnologist intraoperatively regarding his/her clinical findings. He/she will provide all necessary direction to the neurotechnologist during the entirety of each surgical procedure and will complete and insert a formal intraoperative case report in the patient’s electronic patient record within 2 weeks of the procedure. The neurophysiologist will also be required to participate in any VAPHS quality improvement activities as requested.NEUROTECHNOLOGIST SERVICES: Under supervision, neruotechnologist staff will perform multiple modality evoked potentials on patients in the operating room at the VAPHS. The neurotechnologist will be responsible for setting up all necessary OR equipment and supplies necessary for neurophysiological intraoperative monitoring and the placement of suitable electrodes on predetermined measured positions on the patient’s body. The neurotechnologist will be sufficiently knowledgeable to test equipment prior to use and to make any adjustments in the equipment settings that are required. The neurotechnologist will select predetermined electrode combinations as well as non-standard assortments as necessary. The neurotechnologist will obtain standard recordings and report on-going status of patient’s nervous system to the surgeon. The neurotechnologist will also maintain constant communication with a supervisory neurophysiologist during each operative procedure and will accept direction from the neurophysiologist. Under the direction of the neurophysiologist supervisor the neurotechnologist will relay information to the surgeon. The Neurotechnologist will recognize artifacts in the data differentiate them from evoked potential patterns and take appropriate steps to eliminate them. They will obtain patient medical information when requested and will translate test results from computer files to a hard copy report for physician interpretation. The Neurotechnologist staff will also be responsible for removing electrodes post procedure and returning equipment if VAPHS to specified locations or remove the contractor’ supplied equipment from the operating room upon completion of each procedure. At all times during procedures in the operating room, the ratio of neurotechnologist to patient will be 1 to 1. EQUIPMENT: VAPHS will not procure, or provide separate compensation for contractor’s use of, any equipment required to perform services under this contract. Contractor may utilize *existing VAPHS monitoring equipment and software, or may provide and utilize its own equipment and software if preferred, so long as its efficacy and reliability can be evidenced. VAPHS will provide hardware and expendable supplies used in the VAPHS operating room for the VAPHS equipment owned (*Neuro 5 – Cube). Off-hours Coverage: Contractor must make the contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) available on-call during all hours when the (VA Pittsburgh Healthcare System) operating room is closed, including evenings, weekends and holidays. The Contractor must ensure it is not providing concurrent on-call duty to both VA and other community health care facilities for the same period of time.On-call contract Surgical Neurophysiologist physicians must?be available at all times for phone consultations with VA residents and physicians. ?Patients must be seen within _1.00_hours of the page when medically indicated.Federal Holidays: The following holidays are observed by the Department of Veterans Affairs: New Year’s DayPresident’s DayMartin Luther King’s BirthdayMemorial DayIndependence DayLabor DayColumbus DayVeterans DayThanksgivingChristmasAny day specifically declared by the President of the United States to be a national holiday. Cancellations: Unless a state of emergency has been declared or surgeries are otherwise cancelled by the VA Pittsburgh Healthcare System, the Contractor shall be responsible for providing services.Absences – The payment for any leave, including sick leave, holiday, or vacation time is the responsibility of the Contractor and is not reimbursable under this contract. Appropriate coverage as per contract terms and conditions must be supplied by the Contractor. The Contractor’s neurophysiologist and neurotechnologist must be present at the VAPHS and must be actually performing the required services or performing administrative duties associated with this contract. CONTRACTOR RESPONSIBILITIESClinical Personnel Required: The Contractor shall provide contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties. Standards of Care: The contract Surgical Neurophysiologist physician (s)’ care shall cover the range of NEUROSURGERY, Orthopedic, Cardiac Surgery, and Vascular Surgery services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as established by:Certification in American Board of Psychiatry and Neurology Intraoperative Monitoring (CNIM) from the American Board of Registered Electroneurodiagnostic Technologist ().This technical certification intended for technologists who work under supervision by a neurophysiologist or neurologist. American Board of Neurophysiologic Monitoring (ABNM) certification ().VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) The professional standards of the Joint Commission (TJC) The standards of the American Hospital Association (AHA) and;The requirements contained in this PWS Medical Records Authorities: Contract physician (s) 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) 38 U.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). 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. Disclosure: Contract physician(s) may 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 VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: and all guidelines provided by the VAMC. 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 Pittsburgh Healthcare System Release of Information Department 136H4-A at the following address: 1010 Delafield RoadPittsburgh, PA 15215Phone number: (412) 822-1143Fax number: (412) 822-1161Direct Patient Care: 99% of the time involved in direct patient care. Per the qualification section of this PWS, the Contractor shall provide the following staff:Board Certified Surgical Neurophysiologist and Board Certified Neurodiagnostic TechnologistScope of Care: Contract physician(s) (as appropriate and within scope of practice/privileging) shall be responsible for providing NEUROPHYSIOLOGY care, including, but not limited to :Clinic and Surgical Care: Contractor Surgical Neurophysiologist physician(s) and Neuordiagnostic Technologist (s) shall provide clinical Neurophysiology services. Contractor Surgical Neurophysiologist physician(s) and Neurodiagnostic Technologist (s) shall be present on time for any scheduled surgeries as documented by physical presence in the operating room at the scheduled start time. Approximate case load is as follows: # of procedures per surgical session: 6.00Operative Services: Contractor Surgical Neurophysiologist physician(s) shall provide comprehensive clinical Neurophysiology services, including but not limited to the following:95812EEG (Electroencephalography) Intraop 41 – 60 min95813EEG Intraop 60 min +95955EEG Extra cranial Procedure95925SEP(Somatosensory Evoked Potential) Upper Extremity95926SEP Lower Extremity95938SEP 4 Extremities95927SEP-Pudendal/Trigeminal95930VEP (Visual Evoked Potential)92586BAEP(Brainstem Auditory Evoked Potentials) (Limited) 95961Cortical Mapping (1st Hour)95962Cortical Mapping (2nd Hour)95829Electrocorticogram95867EMG(Electromyography) Cranial – Left/Right95868EMG Cranial - Bilateral95865EMG Larynx95869EMG Thoracic95860EMG 1Extremity-Left/Right95861EMG 2 Extremities95864EMG 4 Extremities51785EMG Sphincter95928TcMEP (Transcranial Motor Evoked Potential) Upper Extremity95929TcMEP Lower Extremity95939TcMEP 4 Extremities93888Doppler Intraoperative (Ltd)95941Intraop Neurophysiology TestIntraoperative Follow-up: the Contractor Surgical Neurophysiologist physician(s) and Neurodiagnostic Technologist shall be present in the operating suite for all NEUROSURGERY, CARDIAC SURGERY, VASCULAR SURGERY, and, ORTHOPEDIC procedures.ADMINISTRATIVE: 1% of time not involved in direct patient care. Quality Improvement Meetings: The contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the VAMC Chief of Service, Chief of Staff, or designee. Staff Meetings: The contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) shall attend staff meetings as required by the VAMC Chief of Service, Chief of Staff, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement. QA/QI documentation: The contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations.Patient Safety Compliance and Reporting: Contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) shall follow all established patient safety and infection control standards of care. Contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI)Quality Management/Quality Assurance Surveillance: Contractor Surgical Neurophysiologist physician(s) shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted. The contractor’s Surgical Neurophysiologist physician(s) are expected to actively participate in the facility’s performance improvement activities as part of the contracted service time. Performance Improvement Activities may include the following:Surgical Case ReviewSurgical Risk Assessment ProgramExternal Peer/case Review Program ReportingInfection ControlBlood Usage ReviewHospital SafetyOutpatient Qualitative and Quantitative ReviewMedical Record ReviewDrug UsageInternal Peer ReviewPatient IncidentUtilizationThe Contractor shall furnish the Chief of Staff, on an annual basis, provider-specific information on all contractor Surgical Neurophysiologist physician(s) providing services at the facility. This information shall be furnished using Proficiency Report Form 10-2623a, which will be provided to the contractor by the VA. This confidential, provider-specific information shall be used to identify opportunities for improvement and provide the appropriate data to support the decision of re-appointment/re-privileging. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that The Contractor is involved and named in a validated patient 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 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. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.Performance Standards: The Contractor is responsible for performance of ALL terms and conditions of the contract. CORS will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in the QASP shall be used to determine the level of contractor performance in the elements defined.Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.The Performance Requirements are listed below in section 4.5.4.1. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assigns a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the Contractor on the contract.Measure: Qualifications of Key PersonnelPerformance Requirement: All contract physician (s) shall be board certified in accordance with American Board of Psychiatry and Neurology Standards. Neurophysiologic Intraoperative Monitoring (CNIM) from the American Board of Registered Electroneurodiagnostic Technologist. This technical certification intended for technologists who work under supervision by a neurophysiologist or neurologist. American Board of Neurophysiologic Monitoring (ABNM) certification.All contract Neurodiagnostic Technologist shall be American Board of Registered Electroneurodiagnostic Technologist (). This technical certification intended for technologists who work under supervision by a neurophysiologist or neurologist.Standard: All (100%) contract Surgical Neurophysiologist physicians and Neurodiagnostic Technologist are board certified.Acceptable Quality Level: 100% No deviations accepted.Surveillance Method: Random Inspection of qualification documentsIncentive: Favorable contactor performance evaluation.Disincentive: Unfavorable contractor performance evaluation. Removal from contract until such time the contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) meet qualification standard.Measure: Scope of Practice/Privileging Performance Requirement: Contract Surgical Neurophysiologist physician (s) performs within their individual scopes of practice/privileging.Standard: All (100%) contract Surgical Neurophysiologist physician (s) perform within their scope of practice/privileges 100% of the time.Acceptable Quality Level: All (100%) contract Surgical Neurophysiologist physician (s) performs within their scope of practice/privileges 100% of the time. No deviations accepted.Surveillance Method: Random Inspection of records.Incentive: Favorable contactor performance evaluation.Disincentive: Unfavorable contractor performance evaluation. Removal from contract until such time the contract Surgical Neurophysiologist physician (s) meet qualification standard.Measure: Patient AccessPerformance Requirement: The Contractor shall provide contract Surgical Neurophysiologist physician(s) and Neurodiagnostic Technologist (s) in accordance with the operating hours and VA clinical schedule outlined in this PWS.Standard: All (100%) contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist(s) are on time and available to perform services.Acceptable Quality Level: Contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist is on-time and available to perform services 97% of the timeSurveillance Method: Periodic Sampling of Time and Attendance SheetsIncentive: Favorable contactor performance evaluation.Disincentive: Unfavorable contractor performance evaluation.Measure: Patient SafetyPerformance Requirement: Patient safety incidents shall be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)Standard: All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident.Acceptable Quality Level: All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident. No acceptable deviation.Surveillance Method: Direct Observation- This observation will need to be accomplished via the Chief of Service Line as this requires clinical expertise regarding the patient safety measure.Incentive: Favorable contactor performance evaluation.Disincentive: Unfavorable contractor performance evaluation.Measure: Maintains licensing, registration, and certificationPerformance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current.Standard: All (100%) licensing, registration(s) and certification(s) for contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) shall be provided as they are renewed. Licensing and registration information kept current.Acceptable Quality Level: All (100%) licensing, registration(s) and certification(s) for contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) shall be provided as they are renewed. Licensing and registration information kept current. No acceptable deviation.Surveillance Method: Periodic Sampling and Random SamplingIncentive: Favorable contactor performance evaluation.Disincentive: Unfavorable contractor performance evaluation, Suspension or termination of all physical and/or electronic access privileges and removal from contract until such licensing, registration, and certification is current.Measure: Mandatory TrainingPerformance Requirement: Contractor shall complete all required training on time per VA Pittsburgh Healthcare System policyStandard: All (100%) of required training is complete on time by contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s).Acceptable Quality Level: 100% completions, no deviations.Surveillance Method: Contractor to provide documented evidence.Incentive: Favorable contactor performance evaluation.Disincentive: Unfavorable contractor performance evaluation, Suspension or termination of all physical and/or electronic access privileges and removal from contract until such time as the training is complete.Measure: Privacy, Confidentiality and HIPPAPerformance Requirement: Contractor shall comply with all laws, regulations, and policiesStandard: All (100%) contractor Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPPA. Zero breaches of privacy or confidentiality.Acceptable Quality Level: 100% compliance; no deviations.Surveillance Method: Periodic Sampling; Contractor shall provide evidence of annual training required by VA Pittsburgh Healthcare System, reports violations per VA Directive 6500.6.Incentive: Favorable contactor performance evaluation.Disincentive: Unfavorable contactor performance evaluation. Immediate removal from contract.Registration with Contractor Performance Assessment Reporting System As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials.? The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing.? To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire.? CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS.? CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS).? FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information.Each Contractor whose contract award is estimated to exceed $150,000 requires a CPARS evaluation.??? A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations).?? Additional information regarding the evaluation process can be found at or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690 or COMM: 207-438-1690. Registration should occur no later than thirty days after contract award, and must be kept current should there be any change to the Contractor’s registered representative.For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete.? For contracts exceeding one year, the contracting officer will evaluate the Contractor’s performance annually.? Interim reports will be filed each year until the last year of the contract, when the final report will be completed.? The report shall be assigned in CPARS to the Contractor’s designated representative for comment.? The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO.Failure for the Contractor’s representative to respond to the evaluation within those sixty (60) days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor’s representative will be “locked out” of the evaluation and may no longer send comments.? GOVERNMENT RESPONSIBILITIESVA Support Personnel, Services or Equipment: Other necessary personnel for the operation of the services contracted for at the VA Pittsburgh Healthcare System at levels mutually agreed upon which are compatible with safety of the patient and personnel and with quality medical care programming.Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to: CO (Contracting Officer), Management Analyst contact information for COR, Clinical point of contact Business Manager Surgery Service Line.CO RESPONSIBILITIES: The CO for this contract is: Shawn Smith/1010 Delafield Road Pittsburgh, PA 15215/ (412) 822-3785/Shawn.Smith@The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract. The Contracting Officer shall resolve complaints concerning Contractor relations with the Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof. In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for Contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract.COR Responsibilities:The COR for this contract is: Sallie Gray/1010 Delafield Road Pittsburgh, PA 15215 (412) 822-1228/Sallie.Gray2@.The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected.The COR will maintain a record-keeping system of services by tabulating hours worked utilizing sign-in/sign-out log book, operating room records, clinic productivity reports, medical center committee meeting attendance rosters, physician VPN activity and other methods of documentation deemed appropriate for this purpose. Failure of Contractor staff (physicians and neurodiagnostic technologist) to utilize the sign-in/sign-out log book to properly document attendance may result in nonpayment for on-site hours which cannot be verified. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the Contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference.All contract administration functions will be retained by the VA. SPECIAL CONTRACT REQUIREMENTSReports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each. Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required. The following are brief descriptions of required documents that must be submitted by Contractor: upon award; weekly; monthly; quarterly’; annually, etc. identified throughout the PWS and is provided here as a guide for Contractor convenience. If an item is within the PWS and not listed here, the Contractor remains responsible for the delivery of the item. WhatSubmit as noted Submit ToQuality Control Plan: Description and reporting reflecting the contractor’s plan for meeting of contract requirements and performance standardsUpon proposal and as frequently as indicated in the performance standards.Contracting OfficerCopies of any and all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff Upon proposal and upon renewal of licenses and upon each year’s new task order or change of key personnel.Contracting OfficerCertification that staff list have been compared to OIG listUpon proposal and upon new hires.Contracting OfficerProof of Indemnification and Medical Liability Insurance Upon proposal and upon each year’s new task order.Contracting OfficerCertificates of Completion for Cyber Security and Patient Privacy Training Courses Before receiving an account on VA Network and annual training and new hires.Contracting OfficerACLS/BLS CertificationUpon award and every two years after award.CORContingency plan Upon proposal and as updatedCORBilling: Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th workday of the month. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:Name and Address of ContractorInvoice Date and Invoice NumberContract Number and Purchase/Task Order NumberDate of ServiceContract physician (s), Contract Technologist(s) NameCPT Codes with applicable Unit CostTotal priceVendor Electronic Invoice Submission MethodsFacsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below:VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, OB10, to transition vendors from paper to electronic invoice submission. Please go to this website: to begin submitting electronic invoices, free of charge. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI).The X12 EDI Web site ().The Contract may contact FSC at the phone number or email address listed below with any questions about the e-invoicing program or OB10: OB10 e-Invoice Setup Information: 1-877-489-6135OB10 e-Invoice email: VA.Registration@FSC e-Invoice Contact Information: 1-877-353-9791FSC e-invoice email: vafsccshd@Payments in full/no billing VA beneficiaries: The Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Contractor, even if VA does not pay for those services. This provision shall survive the termination or ending of the contract. To the extent that the Veteran desires services which are not a VA benefit or covered under the terms of this contract, the Contractor must notify the Veteran that there will be a charge for such service and that the VA will not be responsible for payment. The Contractor shall not bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against, any person or entity other than VA for services provided pursuant to this contract. It shall be considered fraudulent for the Contractor to bill other third party insurance sources (including Medicare) for services rendered to Veteran enrollees under this contract. Contractor Security Requirements (Handbook 6500.6) - All personnel associated with the contract working in support of this contract are required to complete VA mandated training on an annual basis. The following TMS courses are mandated: 1) Privacy & HIPPA Training –DVA-002, 2) VA Privacy and Information Security Awareness and Rules of Behavior – DVA-003. The training requirements are mandated throughout the VA and are completed on an annual basis. Once the user completes the training in the Talent Management System (TMS); annual reminders pertaining to the training courses are automatically generated by TMS and sent to user based on his/her anniversary date (date last completed). Ex. 30 days out reminder based off the date the training is due. A physician working in support of this contract shall not provide support on contract in the event the annual training requirement lapses. B.6 Price/Cost ScheduleItem InformationITEM NUMBERDESCRIPTION OF SUPPLIES/SERVICESQUANTITYUNITUNIT PRICEAMOUNT1PROVIDE NEUROPHYSIOLOGY SERVICES FOR THE TIME PERIOD 8/1/2015 to 7/31/2016.1.00LT____________________________________GRAND TOTAL__________________SECTION C - CONTRACT CLAUSESC.1 52.203-7 ANTI-KICKBACK PROCEDURES (MAY 2014) (a) Definitions. "Kickback," as used in this clause, means any money, fee, commission, credit, gift, gratuity, thing of value, or compensation of any kind which is provided to any prime Contractor, prime Contractor employee, subcontractor, or subcontractor employee for the purpose of improperly obtaining or rewarding favorable treatment in connection with a prime contract or in connection with a subcontract relating to a prime contract. "Person," as used in this clause, means a corporation, partnership, business association of any kind, trust, joint-stock company, or individual. "Prime contract," as used in this clause, means a contract or contractual action entered into by the United States for the purpose of obtaining supplies, materials, equipment, or services of any kind. "Prime Contractor" as used in this clause, means a person who has entered into a prime contract with the United States. "Prime Contractor employee," as used in this clause, means any officer, partner, employee, or agent of a prime Contractor. "Subcontract," as used in this clause, means a contract or contractual action entered into by a prime Contractor or subcontractor for the purpose of obtaining supplies, materials, equipment, or services of any kind under a prime contract. "Subcontractor," as used in this clause, (1) means any person, other than the prime contractor, who offers to furnish or furnishes any supplies, materials, equipment, or services of any kind under a prime contract or a subcontract entered into in connection with such prime contract, and (2) includes any person who offers to furnish or furnishes general supplies to the prime Contractor or a higher tier subcontractor. "Subcontractor employee," as used in this clause, means any officer, partner, employee, or agent of a subcontractor. (b) 41 U.S.C. chapter 87, Kickbacks, prohibits any person from— (1) Providing or attempting to provide or offering to provide any kickback; (2) Soliciting, accepting, or attempting to accept any kickback; or (3) Including, directly or indirectly, the amount of any kickback in the contract price charged by a prime Contractor to the United States or in the contract price charged by a subcontractor to a prime Contractor or higher tier subcontractor. (c) (1) The Contractor shall have in place and follow reasonable procedures designed to prevent and detect possible violations described in paragraph (b) of this clause in its own operations and direct business relationships. (2) When the Contractor has reasonable grounds to believe that a violation described in paragraph (b) of this clause may have occurred, the Contractor shall promptly report in writing the possible violation. Such reports shall be made to the inspector general of the contracting agency, the head of the contracting agency if the agency does not have an inspector general, or the Attorney General. (3) The Contractor shall cooperate fully with any Federal agency investigating a possible violation described in paragraph (b) of this clause. (4) The Contracting Officer may (i) offset the amount of the kickback against any monies owed by the United States under the prime contract and/or (ii) direct that the Prime Contractor withhold from sums owed a subcontractor under the prime contract, monies withheld, the amount of the kickback. The Contracting Officer may order that monies withheld under subdivision (c)(4)(ii) of this clause be paid over to the Government unless the Government has already offset those monies under subdivision (c)(4)(i) of this clause. In either case, the Prime Contractor shall notify the Contracting Officer when the monies are withheld. (5) The Contractor agrees to incorporate the substance of this clause, including subparagraph (c)(5) but excepting subparagraph (c)(1), in all subcontracts under this contract which exceed $150,000.(End of Clause)C.2 52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON POSTCONSUMER FIBER CONTENT PAPER (MAY 2011) (a) Definitions. As used in this clause— "Postconsumer fiber" means— (1) Paper, paperboard, and fibrous materials from retail stores, office buildings, homes, and so forth, after they have passed through their end-usage as a consumer item, including: used corrugated boxes; old newspapers; old magazines; mixed waste paper; tabulating cards; and used cordage; or (2) All paper, paperboard, and fibrous materials that enter and are collected from municipal solid waste; but not (3) Fiber derived from printers' over-runs, converters' scrap, and over-issue publications. (b) The Contractor is required to submit paper documents, such as offers, letters, or reports that are printed or copied double-sided on paper containing at least 30 percent postconsumer fiber, whenever practicable, when not using electronic commerce methods to submit information or data to the Government.(End of Clause)C.3 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL (JAN 2011) (a) The Contractor shall comply with agency personal identity verification procedures identified in the contract that implement Homeland Security Presidential Directive-12 (HSPD-12), Office of Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201. (b) The Contractor shall account for all forms of Government-provided identification issued to the Contractor employees in connection with performance under this contract. The Contractor shall return such identification to the issuing agency at the earliest of any of the following, unless otherwise determined by the Government: (1) When no longer needed for contract performance. (2) Upon completion of the Contractor employee's employment. (3) Upon contract completion or termination. (c) The Contracting Officer may delay final payment under a contract if the Contractor fails to comply with these requirements. (d) The Contractor shall insert the substance of this clause, including this paragraph (d), in all subcontracts when the subcontractor's employees are required to have routine physical access to a Federally-controlled facility and/or routine access to a Federally-controlled information system. It shall be the responsibility of the prime Contractor to return such identification to the issuing agency in accordance with the terms set forth in paragraph (b) of this section, unless otherwise approved in writing by the Contracting Officer.(End of Clause)C.4 52.204-7 SYSTEM FOR AWARD MANAGEMENT (JUL 2013) (a) Definitions. As used in this provision— Data Universal Numbering System (DUNS) number means the 9-digit number assigned by Dun and Bradstreet, Inc. (D&B) to identify unique business entities. Data Universal Numbering System +4 (DUNS+4) number means the DUNS number assigned by D&B plus a 4-character suffix that may be assigned by a business concern. (D&B has no affiliation with this 4-character suffix.) This 4-character suffix may be assigned at the discretion of the business concern to establish additional System for Award Management records for identifying alternative Electronic Funds Transfer (EFT) accounts (see the FAR at Subpart 32.11) for the same concern. Registered in the System for Award Management (SAM) database means that— (1) The offeror has entered all mandatory information, including the DUNS number or the DUNS+4 number, the Contractor and Government Entity (CAGE) code, as well as data required by the Federal Funding Accountability and Transparency Act of 2006 (see Subpart 4.14) into the SAM database; (2) The offeror has completed the Core, Assertions, and Representations and Certifications, and Points of Contact sections of the registration in the SAM database; (3) The Government has validated all mandatory data fields, to include validation of the Taxpayer Identification Number (TIN) with the Internal Revenue Service (IRS). The offeror will be required to provide consent for TIN validation to the Government as a part of the SAM registration process; and (4) The Government has marked the record “Active”. (b)(1) By submission of an offer, the offeror acknowledges the requirement that a prospective awardee shall be registered in the SAM database prior to award, during performance, and through final payment of any contract, basic agreement, basic ordering agreement, or blanket purchasing agreement resulting from this solicitation. (2) The offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation "DUNS" or "DUNS +4" followed by the DUNS or DUNS +4 number that identifies the offeror's name and address exactly as stated in the offer. The DUNS number will be used by the Contracting Officer to verify that the offeror is registered in the SAM database. (c) If the offeror does not have a DUNS number, it should contact Dun and Bradstreet directly to obtain one. (1) An offeror may obtain a DUNS number— (i) Via the Internet at or if the offeror does not have internet access, it may call Dun and Bradstreet at 1-866-705-5711 if located within the United States; or (ii) If located outside the United States, by contacting the local Dun and Bradstreet office. The offeror should indicate that it is an offeror for a U.S. Government contract when contacting the local Dun and Bradstreet office. (2) The offeror should be prepared to provide the following information: (i) Company legal business. (ii) Tradestyle, doing business, or other name by which your entity is commonly recognized. (iii) Company Physical Street Address, City, State, and Zip Code. (iv) Company Mailing Address, City, State and Zip Code (if separate from physical). (v) Company Telephone Number. (vi) Date the company was started. (vii) Number of employees at your location. (viii) Chief executive officer/key manager. (ix) Line of business (industry). (x) Company Headquarters name and address (reporting relationship within your entity). (d) If the Offeror does not become registered in the SAM database in the time prescribed by the Contracting Officer, the Contracting Officer will proceed to award to the next otherwise successful registered Offeror. (e) Processing time, which normally takes 48 hours, should be taken into consideration when registering. Offerors who are not registered should consider applying for registration immediately upon receipt of this solicitation. (f) Offerors may obtain information on registration at .(End of Provision)C.5 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (DEC 2014) (a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or re-performance of nonconforming services at no increase in contract price. If repair/replacement or re-performance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights— (1) Within a reasonable time after the defect was discovered or should have been discovered; and (2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item. (b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Government-wide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract. (c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties. (d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract. (e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference. (f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence. (g) Invoice. (1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include— (i) Name and address of the Contractor; (ii) Invoice date and number; (iii) Contract number, contract line item number and, if applicable, the order number; (iv) Description, quantity, unit of measure, unit price and extended price of the items delivered; (v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading; (vi) Terms of any discount for prompt payment offered; (vii) Name and address of official to whom payment is to be sent; (viii) Name, title, and phone number of person to notify in event of defective invoice; and (ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract. (x) Electronic funds transfer (EFT) banking information. (A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract. (B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures. (C) EFT banking information is not required if the Government waived the requirement to pay by EFT. (2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315. (h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings. (i) Payment.— (1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract. (2) Prompt payment. The Government will make payment in accordance with the Prompt Payment Act (31 U.S.C. 3903) and prompt payment regulations at 5 CFR part 1315. (3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause. (4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made. (5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the Contractor shall— (i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the— (A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment); (B) Affected contract number and delivery order number, if applicable; (C) Affected contract line item or subline item, if applicable; and (D) Contractor point of contact. (ii) Provide a copy of the remittance and supporting documentation to the Contracting Officer. (6) Interest. (i) All amounts that become payable by the Contractor to the Government under this contract shall bear simple interest from the date due until paid unless paid within 30 days of becoming due. The interest rate shall be the interest rate established by the Secretary of the Treasury as provided in 41 U.S.C. 7109, which is applicable to the period in which the amount becomes due, as provided in (i)(6)(v) of this clause, and then at the rate applicable for each six-month period as fixed by the Secretary until the amount is paid. (ii) The Government may issue a demand for payment to the Contractor upon finding a debt is due under the contract. (iii) Final decisions. The Contracting Officer will issue a final decision as required by 33.211 if— (A) The Contracting Officer and the Contractor are unable to reach agreement on the existence or amount of a debt within 30 days; (B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the Contractor has requested an installment payment agreement; or (C) The Contractor requests a deferment of collection on a debt previously demanded by the Contracting Officer (see 32.607-2). (iv) If a demand for payment was previously issued for the debt, the demand for payment included in the final decision shall identify the same due date as the original demand for payment. (v) Amounts shall be due at the earliest of the following dates: (A) The date fixed under this contract. (B) The date of the first written demand for payment, including any demand for payment resulting from a default termination. (vi) The interest charge shall be computed for the actual number of calendar days involved beginning on the due date and ending on— (A) The date on which the designated office receives payment from the Contractor; (B) The date of issuance of a Government check to the Contractor from which an amount otherwise payable has been withheld as a credit against the contract debt; or (C) The date on which an amount withheld and applied to the contract debt would otherwise have become payable to the Contractor. (vii) The interest charge made under this clause may be reduced under the procedures prescribed in 32.608-2 of the Federal Acquisition Regulation in effect on the date of this contract. (j) Risk of loss. Unless the contract specifically provides otherwise, risk of loss or damage to the supplies provided under this contract shall remain with the Contractor until, and shall pass to the Government upon: (1) Delivery of the supplies to a carrier, if transportation is f.o.b. origin; or (2) Delivery of the supplies to the Government at the destination specified in the contract, if transportation is f.o.b. destination. (k) Taxes. The contract price includes all applicable Federal, State, and local taxes and duties. (l) Termination for the Government's convenience. The Government reserves the right to terminate this contract, or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work. Subject to the terms of this contract, the Contractor shall be paid a percentage of the contract price reflecting the percentage of the work performed prior to the notice of termination, plus reasonable charges the Contractor can demonstrate to the satisfaction of the Government using its standard record keeping system, have resulted from the termination. The Contractor shall not be required to comply with the cost accounting standards or contract cost principles for this purpose. This paragraph does not give the Government any right to audit the Contractor's records. The Contractor shall not be paid for any work performed or costs incurred which reasonably could have been avoided. (m) Termination for cause. The Government may terminate this contract, or any part hereof, for cause in the event of any default by the Contractor, or if the Contractor fails to comply with any contract terms and conditions, or fails to provide the Government, upon request, with adequate assurances of future performance. In the event of termination for cause, the Government shall not be liable to the Contractor for any amount for supplies or services not accepted, and the Contractor shall be liable to the Government for any and all rights and remedies provided by law. If it is determined that the Government improperly terminated this contract for default, such termination shall be deemed a termination for convenience. (n) Title. Unless specified elsewhere in this contract, title to items furnished under this contract shall pass to the Government upon acceptance, regardless of when or where the Government takes physical possession. (o) Warranty. The Contractor warrants and implies that the items delivered hereunder are merchantable and fit for use for the particular purpose described in this contract. (p) Limitation of liability. Except as otherwise provided by an express warranty, the Contractor will not be liable to the Government for consequential damages resulting from any defect or deficiencies in accepted items. (q) Other compliances. The Contractor shall comply with all applicable Federal, State and local laws, executive orders, rules and regulations applicable to its performance under this contract. (r) Compliance with laws unique to Government contracts. The Contractor agrees to comply with 31 U.S.C. 1352 relating to limitations on the use of appropriated funds to influence certain Federal contracts; 18 U.S.C. 431 relating to officials not to benefit; 40 U.S.C. chapter 37, Contract Work Hours and Safety Standards; 41 U.S.C. chapter 87, Kickbacks; 41 U.S.C. 4712 and 10 U.S.C. 2409 relating to whistleblower protections; 49 U.S.C. 40118, Fly American; and 41 U.S.C. chapter 21 relating to procurement integrity. (s) Order of precedence. Any inconsistencies in this solicitation or contract shall be resolved by giving precedence in the following order: (1) The schedule of supplies/services. (2) The Assignments, Disputes, Payments, Invoice, Other Compliances, Compliance with Laws Unique to Government Contracts, and Unauthorized Obligations paragraphs of this clause; (3) The clause at 52.212-5. (4) Addenda to this solicitation or contract, including any license agreements for computer software. (5) Solicitation provisions if this is a solicitation. (6) Other paragraphs of this clause. (7) The Standard Form 1449. (8) Other documents, exhibits, and attachments (9) The specification. (t) System for Award Management (SAM). (1) Unless exempted by an addendum to this contract, the Contractor is responsible during performance and through final payment of any contract for the accuracy and completeness of the data within the SAM database, and for any liability resulting from the Government's reliance on inaccurate or incomplete data. To remain registered in the SAM database after the initial registration, the Contractor is required to review and update on an annual basis from the date of initial registration or subsequent updates its information in the SAM database to ensure it is current, accurate and complete. Updating information in the SAM does not alter the terms and conditions of this contract and is not a substitute for a properly executed contractual document. (2)(i) If a Contractor has legally changed its business name, "doing business as" name, or division name (whichever is shown on the contract), or has transferred the assets used in performing the contract, but has not completed the necessary requirements regarding novation and change-of-name agreements in FAR subpart 42.12, the Contractor shall provide the responsible Contracting Officer a minimum of one business day's written notification of its intention to (A) change the name in the SAM database; (B) comply with the requirements of subpart 42.12; and (C) agree in writing to the timeline and procedures specified by the responsible Contracting Officer. The Contractor must provide with the notification sufficient documentation to support the legally changed name. (ii) If the Contractor fails to comply with the requirements of paragraph (t)(2)(i) of this clause, or fails to perform the agreement at paragraph (t)(2)(i)(C) of this clause, and, in the absence of a properly executed novation or change-of-name agreement, the SAM information that shows the Contractor to be other than the Contractor indicated in the contract will be considered to be incorrect information within the meaning of the "Suspension of Payment" paragraph of the electronic funds transfer (EFT) clause of this contract. (3) The Contractor shall not change the name or address for EFT payments or manual payments, as appropriate, in the SAM record to reflect an assignee for the purpose of assignment of claims (see Subpart 32.8, Assignment of Claims). Assignees shall be separately registered in the SAM database. Information provided to the Contractor's SAM record that indicates payments, including those made by EFT, to an ultimate recipient other than that Contractor will be considered to be incorrect information within the meaning of the "Suspension of payment" paragraph of the EFT clause of this contract. (4) Offerors and Contractors may obtain information on registration and annual confirmation requirements via SAM accessed through . (u) Unauthorized Obligations. (1) Except as stated in paragraph (u)(2) of this clause, when any supply or service acquired under this contract is subject to any End User License Agreement (EULA), Terms of Service (TOS), or similar legal instrument or agreement, that includes any clause requiring the Government to indemnify the Contractor or any person or entity for damages, costs, fees, or any other loss or liability that would create an Anti-Deficiency Act violation (31 U.S.C. 1341), the following shall govern: (i) Any such clause is unenforceable against the Government. (ii) Neither the Government nor any Government authorized end user shall be deemed to have agreed to such clause by virtue of it appearing in the EULA, TOS, or similar legal instrument or agreement. If the EULA, TOS, or similar legal instrument or agreement is invoked through an “I agree” click box or other comparable mechanism (e.g., “click-wrap” or “browse-wrap” agreements), execution does not bind the Government or any Government authorized end user to such clause. (iii) Any such clause is deemed to be stricken from the EULA, TOS, or similar legal instrument or agreement. (2) Paragraph (u)(1) of this clause does not apply to indemnification by the Government that is expressly authorized by statute and specifically authorized under applicable agency regulations and procedures. (v) Incorporation by reference. The Contractor's representations and certifications, including those completed electronically via the System for Award Management (SAM), are incorporated by reference into the contract.(End of Clause)ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The following clauses are incorporated into 52.212-4 as an addendum to this contract:C.6 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (APR 2015) (a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items: (1) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (Dec 2014) (2) 52.233-3, Protest After Award (Aug 1996) (31 U.S.C. 3553). (3) 52.233-4, Applicable Law for Breach of Contract Claim (Oct 2004) (Public Laws 108-77 and 108-78 (19 U.S.C. 3805 note)). (b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items: [X] (1) 52.203-6, Restrictions on Subcontractor Sales to the Government (Sept 2006), with Alternate I (Oct 1995) (41 U.S.C. 4704 and 10 U.S.C. 2402). [] (2) 52.203-13, Contractor Code of Business Ethics and Conduct (APR 2010)(41 U.S.C. 3509). [] (3) 52.203-15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (JUN 2010) (Section 1553 of Pub. L. 111-5). (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009.) [] (4) 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (Jul 2013) (Pub. L. 109-282) (31 U.S.C. 6101 note). [] (5) [Reserved] [] (6) 52.204-14, Service Contract Reporting Requirements (JAN 2014) (Pub. L. 111-117, section 743 of Div. C). [] (7) 52.204-15, Service Contract Reporting Requirements for Indefinite-Delivery Contracts (JAN 2014) (Pub. L. 111-117, section 743 of Div. C). [X] (8) 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment. (Aug 2013) (31 U.S.C. 6101 note). [] (9) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Jul 2013) (41 U.S.C. 2313). [] (10) [Reserved] [] (11)(i) 52.219-3, Notice of HUBZone Set-Aside or Sole-Source Award (NOV 2011) (15 U.S.C. 657a). [] (ii) Alternate I (NOV 2011) of 52.219-3. [X] (12)(i) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (OCT 2014) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 U.S.C. 657a). [] (ii) Alternate I (JAN 2011) of 52.219-4. [] (13) [Reserved] [] (14)(i) 52.219-6, Notice of Total Small Business Set-Aside (NOV 2011) (15 U.S.C. 644). [] (ii) Alternate I (NOV 2011). [] (iii) Alternate II (NOV 2011). [] (15)(i) 52.219-7, Notice of Partial Small Business Set-Aside (June 2003) (15 U.S.C. 644). [] (ii) Alternate I (Oct 1995) of 52.219-7. [] (iii) Alternate II (Mar 2004) of 52.219-7. [X] (16) 52.219-8, Utilization of Small Business Concerns (OCT 2014) (15 U.S.C. 637(d)(2) and (3). [] (17)(i) 52.219-9, Small Business Subcontracting Plan (OCT 2014) (15 U.S.C. 637(d)(4)). [] (ii) Alternate I (Oct 2001) of 52.219-9. [] (iii) Alternate II (Oct 2001) of 52.219-9. [] (iv) Alternate III (OCT 2014) of 52.219-9. [] (18) 52.219-13, Notice of Set-Aside of Orders (NOV 2011) (15 U.S.C. 644(r)). [] (19) 52.219-14, Limitations on Subcontracting (NOV 2011) (15 U.S.C. 637(a)(14)). [] (20) 52.219-16, Liquidated Damages—Subcontracting Plan (Jan 1999) (15 U.S.C. 637(d)(4)(F)(i)). [] (21) 52.219-27, Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (NOV 2011) (15 U.S.C. 657f). [X] (22) 52.219-28, Post Award Small Business Program Rerepresentation (Jul 2013) (15 U.S.C 632(a)(2)). [] (23) 52.219-29, Notice of Set-Aside for Economically Disadvantaged Women-Owned Small Business (EDWOSB) Concerns (Jul 2013) (15 U.S.C. 637(m)). [] (24) 52.219-30, Notice of Set-Aside for Women-Owned Small Business (WOSB) Concerns Eligible Under the WOSB Program (Jul 2013) (15 U.S.C. 637(m)). [X] (25) 52.222-3, Convict Labor (June 2003) (E.O. 11755). [] (26) 52.222-19, Child Labor—Cooperation with Authorities and Remedies (JAN 2014) (E.O. 13126). [X] (27) 52.222-21, Prohibition of Segregated Facilities (APR 2015). [X] (28) 52.222-26, Equal Opportunity (APR 2015) (E.O. 11246). [X] (29) 52.222-35, Equal Opportunity for Veterans (JUL 2014) (38 U.S.C. 4212). [X] (30) 52.222-36, Equal Opportunity for Workers with Disabilities (JUL 2014) (29 U.S.C. 793). [X] (31) 52.222-37, Employment Reports on Veterans (JUL 2014) (38 U.S.C. 4212). [X] (32) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496). [X] (33)(i) 52.222-50, Combating Trafficking in Persons (MAR 2015) (22 U.S.C. chapter 78 and E.O. 13627). [] (ii) Alternate I (MAR 2015) of 52.222-50 (22 U.S.C. chapter 78 and E.O. 13627). [X] (34) 52.222-54, Employment Eligibility Verification (AUG 2013). (Executive Order 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803.) [] (35)(i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008) (42 U.S.C.6962(c)(3)(A)(ii)). (Not applicable to the acquisition of commercially available off-the-shelf items.) [] (ii) Alternate I (MAY 2008) of 52.223-9 (42 U.S.C. 6962(i)(2)(C)). (Not applicable to the acquisition of commercially available off-the-shelf items.) [] (36)(i) 52.223-13, Acquisition of EPEAT?-Registered Imaging Equipment (JUN 2014) (E.O.s 13423 and 13514). [] (ii) Alternate I (JUN 2014) of 52.223-13. [] (37)(i) 52.223-14, Acquisition of EPEAT?-Registered Televisions (JUN 2014) (E.O.s 13423 and 13514). [] (ii) Alternate I (JUN 2014) of 52.223-14. [] (38) 52.223-15, Energy Efficiency in Energy-Consuming Products (DEC 2007)(42 U.S.C. 8259b). [] (39)(i) 52.223-16, Acquisition of EPEAT?-Registered Personal Computer Products (JUN 2014) (E.O.s 13423 and 13514). [] (ii) Alternate I (JUN 2014) of 52.223-16. [X] (40) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging While Driving (AUG 2011) [] (41) 52.225-1, Buy American—Supplies (MAY 2014) (41 U.S.C. chapter 83). [] (42)(i) 52.225-3, Buy American—Free Trade Agreements—Israeli Trade Act (MAY 2014) (41 U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103-182, 108-77, 108-78, 108-286, 108-302, 109-53, 109-169, 109-283, 110-138, 112-41, 112-42, and 112-43. [] (ii) Alternate I (MAY 2014) of 52.225-3. [] (iii) Alternate II (MAY 2014) of 52.225-3. [] (iv) Alternate III (MAY 2014) of 52.225-3. [X] (43) 52.225-5, Trade Agreements (NOV 2013) (19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note). [X] (44) 52.225-13, Restrictions on Certain Foreign Purchases (JUN 2008) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury). [] (45) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Jul 2013) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note). [] (46) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007) (42 U.S.C. 5150). [] (47) 52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov 2007) (42 U.S.C. 5150). [] (48) 52.232-29, Terms for Financing of Purchases of Commercial Items (Feb 2002) (41 U.S.C. 4505, 10 U.S.C. 2307(f)). [] (49) 52.232-30, Installment Payments for Commercial Items (Oct 1995) (41 U.S.C. 4505, 10 U.S.C. 2307(f)). [] (50) 52.232-33, Payment by Electronic Funds Transfer—System for Award Management (Jul 2013) (31 U.S.C. 3332). [X] (51) 52.232-34, Payment by Electronic Funds Transfer—Other than System for Award Management (Jul 2013) (31 U.S.C. 3332). [] (52) 52.232-36, Payment by Third Party (MAY 2014) (31 U.S.C. 3332). [] (53) 52.239-1, Privacy or Security Safeguards (Aug 1996) (5 U.S.C. 552a). [] (54)(i) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx. 1241(b) and 10 U.S.C. 2631). [] (ii) Alternate I (Apr 2003) of 52.247-64. (c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items: [X] (1) 52.222-17, Nondisplacement of Qualified Workers (MAY 2014) (E.O. 13495). [] (2) 52.222-41, Service Contract Labor Standards (MAY 2014) (41 U.S.C. chapter 67). [] (3) 52.222-42, Statement of Equivalent Rates for Federal Hires (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). [] (4) 52.222-43, Fair Labor Standards Act and Service Contract Labor Standards—Price Adjustment (Multiple Year and Option Contracts) (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). [] (5) 52.222-44, Fair Labor Standards Act and Service Contract Labor Standards—Price Adjustment (MAY 2014) (29 U.S.C 206 and 41 U.S.C. chapter 67). [] (6) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment—Requirements (MAY 2014) (41 U.S.C. chapter 67). [] (7) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services—Requirements (MAY 2014) (41 U.S.C. chapter 67). [] (8) 52.222-55, Minimum Wages Under Executive Order 13658 (DEC 2014) (Executive Order 13658). [] (9) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (MAY 2014) (42 U.S.C. 1792). [] (10) 52.237-11, Accepting and Dispensing of $1 Coin (SEP 2008) (31 U.S.C. 5112(p)(1)). (d) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records—Negotiation. (1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract. (2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved. (3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law. (e)(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c), and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (e)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause— (i) 52.203-13, Contractor Code of Business Ethics and Conduct (APR 2010) (41 U.S.C. 3509). (ii) 52.219-8, Utilization of Small Business Concerns (OCT 2014) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds $650,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities. (iii) 52.222-17, Nondisplacement of Qualified Workers (MAY 2014) (E.O. 13495). Flow down required in accordance with paragraph (l) of FAR clause 52.222-17. (iv) 52.222-21, Prohibition of Segregated Facilities (APR 2015). (v) 52.222-26, Equal Opportunity (Mar 2007) (E.O. 11246). (vi) 52.222-35, Equal Opportunity for Veterans (JUL 2014) (38 U.S.C. 4212). (vii) 52.222-36, Equal Opportunity for Workers with Disabilities (JUL 2014) (29 U.S.C. 793). (viii) 52.222-37, Employment Reports on Veterans (JUL 2014) (38 U.S.C. 4212). (ix) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496). Flow down required in accordance with paragraph (f) of FAR clause 52.222-40. (x) 52.222-41, Service Contract Labor Standards (MAY 2014) (41 U.S.C. chapter 67). (xi)(A) 52.222-50, Combating Trafficking in Persons (MAR 2015) (22 U.S.C. chapter 78 and E.O. 13627). (B) Alternate I (MAR 2015) of 52.222-50 (22 U.S.C. chapter 78 and E.O. 13627). (xii) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment—Requirements (MAY 2014) (41 U.S.C. chapter 67). (xiii) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services—Requirements (MAY 2014) (41 U.S.C. chapter 67). (xiv) 52.222-54, Employment Eligibility Verification (AUG 2013). (xv) 52.222-55, Minimum Wages Under Executive Order 13658 (DEC 2014) (E.O. 13658). (xvi) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Jul 2013) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note). (xvii) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (MAY 2014) (42 U.S.C. 1792). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6. (xviii) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx. 1241(b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64. (2) While not required, the contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations.(End of Clause)C.7 52.216-1 TYPE OF CONTRACT (APR 1984) The Government contemplates award of an IDIQ contract containing Fixed-priced line items with economic price adjustment resulting from this solicitation.(End of Provision)C.8 52.216-18 ORDERING (OCT 1995) (a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued from the effective date of the contract through the end of the effective period. (b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control. (c) If mailed, a delivery order or task order is considered "issued" when the Government deposits the order in the mail. Orders may be issued orally, by facsimile, or by electronic commerce methods only if authorized in the Schedule.(End of Clause)C.9 52.216-19 ORDER LIMITATIONS (OCT 1995) (a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than $100, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract. (b) Maximum order. The Contractor is not obligated to honor— (1) Any order for a single item in excess of $10,000; (2) Any order for a combination of items in excess of $140,000; or (3) A series of orders from the same ordering office within two days that together call for quantities exceeding the limitation in paragraph (b) (1) or (2) of this section. (c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section. (d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within two days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.(End of Clause)C.10 52.216-22 INDEFINITE QUANTITY (OCT 1995) (a) This is an indefinite-quantity contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies and services specified in the Schedule are estimates only and are not purchased by this contract. (b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. The Contractor shall furnish to the Government, when and if ordered, the supplies or services specified in the Schedule up to and including the quantity designated in the Schedule as the "maximum." The Government shall order at least the quantity of supplies or services designated in the Schedule as the "minimum." (c) Except for any limitations on quantities in the Order Limitations clause or in the Schedule, there is no limit on the number of orders that may be issued. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations. (d) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor's and Government's rights and obligations with respect to that order to the same extent as if the order were completed during the contract's effective period; provided, that the Contractor shall not be required to make any deliveries under this contract after .(End of Clause)C.11 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 30 days.(End of Clause)C.12 52.224-1 PRIVACY ACT NOTIFICATION (APR 1984) The Contractor will be required to design, develop, or operate a system of records on individuals, to accomplish an agency function subject to the Privacy Act of 1974, Public Law 93-579, December 31, 1974 (5 U.S.C. 552a) and applicable agency regulations. Violation of the Act may involve the imposition of criminal penalties.(End of Clause)C.13 52.224-2 PRIVACY ACT (APR 1984) (a) The Contractor agrees to— (1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and regulations issued under the Act in the design, development, or operation of any system of records on individuals to accomplish an agency function when the contract specifically identifies— (i) The systems of records; and (ii) The design, development, or operation work that the contractor is to perform; (2) Include the Privacy Act notification contained in this contract in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract requires the design, development, or operation of a system of records on individuals that is subject to the Act; and (3) Include this clause, including this subparagraph (3), in all subcontracts awarded under this contract which requires the design, development, or operation of such a system of records. (b) In the event of violations of the Act, a civil action may be brought against the agency involved when the violation concerns the design, development, or operation of a system of records on individuals to accomplish an agency function, and criminal penalties may be imposed upon the officers or employees of the agency when the violation concerns the operation of a system of records on individuals to accomplish an agency function. For purposes of the Act, when the contract is for the operation of a system of records on individuals to accomplish an agency function, the Contractor and any employee of the Contractor is considered to be an employee of the agency. (c) (1) "Operation of a system of records," as used in this clause, means performance of any of the activities associated with maintaining the system of records, including the collection, use, and dissemination of records. (2) "Record," as used in this clause, means any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and that contains the person's name, or the identifying number, symbol, or other identifying particular assigned to the individual, such as a fingerprint or voiceprint or a photograph. (3) "System of records on individuals," as used in this clause, means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual.(End of Clause)C.14 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997) (a) The Contractor shall, at its own expense, provide and maintain during the entire performance of this contract, at least the kinds and minimum amounts of insurance required in the Schedule or elsewhere in the contract. (b) Before commencing work under this contract, the Contractor shall notify the Contracting Officer in writing that the required insurance has been obtained. The policies evidencing required insurance shall contain an endorsement to the effect that any cancellation or any material change adversely affecting the Government's interest shall not be effective— (1) For such period as the laws of the State in which this contract is to be performed prescribe; or (2) Until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer, whichever period is longer. (c) The Contractor shall insert the substance of this clause, including this paragraph (c), in subcontracts under this contract that require work on a Government installation and shall require subcontractors to provide and maintain the insurance required in the Schedule or elsewhere in the contract. The Contractor shall maintain a copy of all subcontractors' proofs of required insurance, and shall make copies available to the Contracting Officer upon request.(End of Clause)C.15 52.237-3 CONTINUITY OF SERVICES (JAN 1991) (a) The Contractor recognizes that the services under this contract are vital to the Government and must be continued without interruption and that, upon contract expiration, a successor, either the Government or another contractor, may continue them. The Contractor agrees to (1) furnish phase-in training and (2) exercise its best efforts and cooperation to effect an orderly and efficient transition to a successor. (b) The Contractor shall, upon the Contracting Officer's written notice, (1) furnish phase-in, phase-out services for up to 90 days after this contract expires and (2) negotiate in good faith a plan with a successor to determine the nature and extent of phase-in, phase-out services required. The plan shall specify a training program and a date for transferring responsibilities for each division of work described in the plan, and shall be subject to the Contracting Officer's approval. The Contractor shall provide sufficient experienced personnel during the phase-in, phase-out period to ensure that the services called for by this contract are maintained at the required level of proficiency. (c) The Contractor shall allow as many personnel as practicable to remain on the job to help the successor maintain the continuity and consistency of the services required by this contract. The Contractor also shall disclose necessary personnel records and allow the successor to conduct on-site interviews with these employees. If selected employees are agreeable to the change, the Contractor shall release them at a mutually agreeable date and negotiate transfer of their earned fringe benefits to the successor. (d) The Contractor shall be reimbursed for all reasonable phase-in, phase-out costs (i.e., costs incurred within the agreed period after contract expiration that result from phase-in, phase-out operations) and a fee (profit) not to exceed a pro rata portion of the fee (profit) under this contract.(End of Clause)C.16 SUPPLEMENTAL INSURANCE REQUIREMENTS In accordance with FAR 28.307-2 and FAR 52.228-5, the following minimum coverage shall apply to this contract: (a) Workers' compensation and employers liability: Contractors are required to comply with applicable Federal and State workers' compensation and occupational disease statutes. If occupational diseases are not compensable under those statutes, they shall be covered under the employer's liability section of the insurance policy, except when contract operations are so commingled with a Contractor's commercial operations that it would not be practical to require this coverage. Employer's liability coverage of at least $100,000 is required, except in States with exclusive or monopolistic funds that do not permit workers' compensation to be written by private carriers. (b) General Liability: $500,000.00 per occurrences. (c) Automobile liability: $200,000.00 per person; $500,000.00 per occurrence and $20,000.00 property damage. (d) The successful bidder must present to the Contracting Officer, prior to award, evidence of general liability insurance without any exclusionary clauses for asbestos that would void the general liability coverage.(End of Clause)C.17 52.245-2 GOVERNMENT PROPERTY INSTALLATION OPERATION SERVICES (APR 2012) (a) This Government Property listed in paragraph (e) of this clause is furnished to the Contractor in an "as-is, where is" condition. The Government makes no warranty regarding the suitability for use of the Government property specified in this contract. The Contractor shall be afforded the opportunity to inspect the Government property as specified in the solicitation. (b) The Government bears no responsibility for repair or replacement of any lost Government property. If any or all of the Government property is lost or becomes no longer usable, the Contractor shall be responsible for replacement of the property at Contractor expense. The Contractor shall have title to all replacement property and shall continue to be responsible for contract performance. (c) Unless the Contracting Officer determines otherwise, the Government abandons all rights and title to unserviceable and scrap property resulting from contract performance. Upon notification to the Contracting Officer, the Contractor shall remove such property from the Government premises and dispose of it at Contractor expense. (d) Except as provided in this clause, Government property furnished under this contract shall be governed by the Government Property clause of this contract. (e) Government property provided under this clause: (End of Clause)C.18 VAAR 852.203-70 COMMERCIAL ADVERTISING (JAN 2008) The bidder or offeror agrees that if a contract is awarded to him/her, as a result of this solicitation, he/she will not advertise the award of the contract in his/her commercial advertising in such a manner as to state or imply that the Department of Veterans Affairs endorses a product, project or commercial line of endeavor.(End of Clause)C.19 VAAR 852.203-71 DISPLAY OF DEPARTMENT OF VETERAN AFFAIRS HOTLINE POSTER (DEC 1992) (a) Except as provided in paragraph (c) below, the Contractor shall display prominently, in common work areas within business segments performing work under VA contracts, Department of Veterans Affairs Hotline posters prepared by the VA Office of Inspector General. (b) Department of Veterans Affairs Hotline posters may be obtained from the VA Office of Inspector General (53E), P.O. Box 34647, Washington, DC 20043-4647. (c) The Contractor need not comply with paragraph (a) above if the Contractor has established a mechanism, such as a hotline, by which employees may report suspected instances of improper conduct, and instructions that encourage employees to make such reports.(End of Clause)C.20 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2012) (a) Definitions. As used in this clause— (1) Contract financing payment has the meaning given in FAR 32.001. (2) Designated agency office has the meaning given in 5 CFR 1315.2(m). (3) Electronic form means an automated system transmitting information electronically according to the Accepted electronic data transmission methods and formats identified in paragraph (c) of this clause. Facsimile, email, and scanned documents are not acceptable electronic forms for submission of payment requests. (4) Invoice payment has the meaning given in FAR 32.001. (5) Payment request means any request for contract financing payment or invoice payment submitted by the contractor under this contract. (b) Electronic payment requests. Except as provided in paragraph (e) of this clause, the contractor shall submit payment requests in electronic form. Purchases paid with a Government-wide commercial purchase card are considered to be an electronic transaction for purposes of this rule, and therefore no additional electronic invoice submission is required. (c) Data transmission. A contractor must ensure that the data transmission method and format are through one of the following: (1) VA’s Electronic Invoice Presentment and Payment System. (See Web site at .) (2) Any system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) and chartered by the American National Standards Institute (ANSI). The X12 EDI Web site () includes additional information on EDI 810 and 811 formats. (d) Invoice requirements. Invoices shall comply with FAR 32.905. (e) Exceptions. If, based on one of the circumstances below, the contracting officer directs that payment requests be made by mail, the contractor shall submit payment requests by mail through the United States Postal Service to the designated agency office. Submission of payment requests by mail may be required for: (1) Awards made to foreign vendors for work performed outside the United States; (2) Classified contracts or purchases when electronic submission and processing of payment requests could compromise the safeguarding of classified or privacy information; (3) Contracts awarded by contracting officers in the conduct of emergency operations, such as responses to national emergencies; (4) Solicitations or contracts in which the designated agency office is a VA entity other than the VA Financial Services Center in Austin, Texas; or (5) Solicitations or contracts in which the VA designated agency office does not have electronic invoicing capability as described above.(End of Clause)C.21 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (JAN 2008) (a) It is expressly agreed and understood that this is a non- personal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor or its health-care providers are rendered in its capacity as an independent contractor. The Government may evaluate the quality of professional and administrative services provided but retains no control over professional aspects of the services rendered, including by example, the Contractor's or its health-care providers' professional medical judgment, diagnosis, or specific medical treatments. The Contractor and its health-care providers shall be liable for their liability-producing acts or omissions. The Contractor shall maintain or require all health-care providers performing under this contract to maintain, during the term of this contract, professional liability insurance issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrence: *__________________. However, if the Contractor is an entity or a subdivision of a State that either provides for self-insurance or limits the liability or the amount of insurance purchased by State entities, then the insurance requirement of this contract shall be fulfilled by incorporating the provisions of the applicable State law.* Amounts are listed below: (b) An apparently successful offeror, upon request of the Contracting Officer, shall, prior to contract award, furnish evidence of the insurability of the offeror and/or of all health- care providers who will perform under this contract. The submission shall provide evidence of insurability concerning the medical liability insurance required by paragraph (a) of this clause or the provisions of State law as to self-insurance, or limitations on liability or insurance. (c) The Contractor shall, prior to commencement of services under the contract, provide to the Contracting Officer Certificates of Insurance or insurance policies evidencing the required insurance coverage and an endorsement stating that any cancellation or material change adversely affecting the Government's interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer. Certificates or policies shall be provided for the Contractor and/or each health- care provider who will perform under this contract. (d) The Contractor shall notify the Contracting Officer if it, or any of the health-care providers performing under this contract, change insurance providers during the performance period of this contract. The notification shall provide evidence that the Contractor and/or health-care providers will meet all the requirements of this clause, including those concerning liability insurance and endorsements. These requirements may be met either under the new policy, or a combination of old and new policies, if applicable. (e) The Contractor shall insert the substance of this clause, including this paragraph (e), in all subcontracts for health-care services under this contract. The Contractor shall be responsible for compliance by any subcontractor or lower-tier subcontractor with the provisions set forth in paragraph (a) of this clause.* Amounts from paragraph (a) above:Currently, the total required amounts of medical profesional liability coverage, including primary and MCare coverage for health care providers excluding hospitals, are $1 million per occurrence and $3 million per annual policy aggregate. PA Act 13 of 2002 requires participating health care providers to obtain primary coverage in the amount of $500,000 per occurrence and $1.5 million per annual aggregate in excess of primary coverage. (End of Clause) C.22 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984) The contractor shall obtain all necessary licenses and/or permits required to perform this work. He/she shall take all reasonable precautions necessary to protect persons and property from injury or damage during the performance of this contract. He/she shall be responsible for any injury to himself/herself, his/her employees, as well as for any damage to personal or public property that occurs during the performance of this contract that is caused by his/her employees fault or negligence, and shall maintain personal liability and property damage insurance having coverage for a limit as required by the laws of the State of . Further, it is agreed that any negligence of the Government, its officers, agents, servants and employees, shall not be the responsibility of the contractor hereunder with the regard to any claims, loss, damage, injury, and liability resulting there from.(End of Clause)C.23 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) The contracting officer reserves the right to designate representatives to act for him/her in furnishing technical guidance and advice or generally monitor the work to be performed under this contract. Such designation will be in writing and will define the scope and limitation of the designee's authority. A copy of the designation shall be furnished to the contractor.(End of Provision)C.24 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO BENEFICIARIES (JAN 2008) The contractor agrees to provide all services specified in this contract for any person determined eligible by the Department of Veterans Affairs, regardless of the race, color, religion, sex, or national origin of the person for whom such services are ordered. The contractor further warrants that he/she will not resort to subcontracting as a means of circumventing this provision.(End of Provision)SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTSATTACHMENT 1 MS-001CREDENTIALING AND PRIVILEGING OF THE MEDICAL STAFF(Includes Physicians, Dentists, Podiatrists, Optometrists, Social Workers, Psychologists, Audiologists, Speech Pathologists) AND ADVANCED PRACTICE PROVIDERS (Includes Clinical Nurse Specialists, Nurse Practitioners, Nurse Anesthetists, Physician Assistants) PURPOSEIPOLICYIIDEFINITIONSIIIPROCEDURESIVRESPONSIBILITYVREFERENCESVIRESCISSIONVIICONCURRENCES VIIIEXPIRATIONIXI.PURPOSE To provide guidance on the credentialing and privileging process for the Medical Staff and Advanced Practice Providers and to ensure that patient care is provided by well-qualified, competent health care practitioners.II.POLICY The Medical Staff includes all fully licensed physicians, dentists, podiatrists, optometrists, psychologists, social workers, audiologists and speech pathologists. Medical Staff who provide patient care services independently at the VAPHS and are appointed on a full-time (FT), part-time (PT), intermittent, consulting/attending, without compensation (WOC), or on station fee basis, contract, or sharing agreement basis will have proper credentials and specifically delineated clinical privileges. This policy includes residents who function outside the scope of their training program (Medical Officer of the Day). The Advanced Practice Providers include all fully licensed Clinical Nurse Specialists, Nurse Practitioners, Nurse Anesthetists and Physician Assistants who provide patient care services under the direction of a Supervising Physician at the VAPHS and are appointed on a full time (FT), part-time (PT), intermittent, consulting, without compensation (WOC), or on station fee basis, contract or sharing agreement basis will have proper credentials and a specifically delineated scope of practice.Reappraisal and re-privileging is done every two years, with privileges or scopes of practice renewed or amended, and review of current licensure, health status, professional performance and judgment, and any actions involving license restrictions, disciplinary actions or privilege limitations. Reappraisal of professional performance, judgment, and clinical and/or technical skills is based in part on results of performance improvement activities. Exception: Please note that credentialing and privileging of contracted providers will occur every year. Privileges of contracted providers will automatically expire after one year if the contract has not been renewed. The Director has delegated assessment and evaluation of medical staff to the Medical Executive Board and for Advanced Practice Providers to the Discipline-Specific Professional Standards Board, but retains ultimate responsibility for credentialing and granting, modification, and denial of clinical privileges or scopes of practice.Service Line Vice Presidents must document their own review of all licensed healthcare practitioners in Vet Pro and may not delegate other staff to enter the approval unless they are acting in the absence of the Service Line Vice President. One standard of care must be provided for any given treatment or procedure, regardless of the practitioner, service or location in the facility. For credentialing and privileging/scopes of practice, the standard for granting privileges or scopes of practice to perform any given procedure will be the same for all services or locations.G.A minimum of 40 hours of continuing medical education (CME) in the field of practice over a two-year period (to be prorated if the cycle is less than two years) will be required for medical staff for reappointment to the VAPHS. Please note that of the 40 hours CME, 20 hours Category I CME are required for physicians.H.Advanced Cardiac Life Support (ACLS) certification is required by the VAPHS for the Cardiopulmonary Resuscitation Physician Team Leaders, physicians in the Emergency Department, Critical Care, Telemetry, Medical Officers of the Day (MOD) at University Drive, and physicians with moderate sedation and airway management privileges (Interventional Cardiologists, Interventional Gastroenterologists, Interventional Pulmonologists, Anesthesiologists). I.Each provider of services for patients with Acute Coronary Syndrome/Acute MI is required to complete a minimum of two Continuing Medical Education (CME) Credits per year.J.VAPHS physicians who prescribe, diagnose, or treat patients via telemedicine are to obtain clinical privileges from the facility receiving the telemedicine services.III.DEFINITIONS A.Credentialing is the systematic process of reviewing the health status and qualifications of practitioners to ensure that patients receive care, treatment and services from qualified providers. An evaluation of licensure, education, training, experience, competence and ability to perform the privileges requested is conducted. Documentation of credentialing will be maintained in a paper or electronic file, as required by VHA regulations. Verification of information is sought to minimize the possibility of granting privilege(s) based on the review of fraudulent documents. B.Clinical privileging is the process by which a licensed independent practitioner is permitted by law and the facility to provide medical or other patient care services within the scope of the individual's license, based on the individual's clinical competence as determined by peer references, professional experiences, health status, education, training and licensure. Clinical privileges will be provider- specific, will be granted only for site-specific procedures that the practitioner will perform in the facility and will be in effect for no more than two years. C.Reappraisal/recredentialing is the process of evaluating the professional credentials and clinical competence of licensed independent practitioners who have been granted clinical privileges at least every two years.D.Reprivileging is the renewal of clinical privileges at least every two years.petencies are general areas used to evaluate a provider’s performance. The areas of general competencies include patient care, medical / clinical knowledge, practice-based learning, and improvement, interpersonal and communication skills, professionalism and system-based practice.F.Focused Professional Practice Evaluation is a review of a specific aspect of a practitioner’s performance. This process is used when a practitioner has the credentials to suggest competence, but additional information or a period of evaluation is needed to confirm competence in the organization’s setting; or when questions arise regarding a practitioner’s professional practice during the course of the ongoing professional practice evaluation.G.Ongoing Professional Practice Evaluation is a process designed to continuously evaluate a practitioner’s performance. The process requires the Medical Staff to conduct an ongoing evaluation of each practitioner’s professional performance. This process not only allows any potential problems with a practitioner’s performance to be identified and resolved as soon as possible, but also fosters a more efficient, evidence-based privilege renewal process. H.The National Practitioner Data Bank (NPDB) is a secondary source of information that will report only those malpractice reports made in behalf of the practitioner and reportable formal disciplinary actions taken by medical licensing and disciplinary boards, professional societies, and health care facilities. I.Vet Pro is an internet enabled system for the credentialing of VHA health care providers that facilitate completion of a uniform, accurate, and complete credentials file and has sharing capabilities throughout the national VA healthcare system.IV.RESPONSIBILITIES A.The Director is responsible for ensuring that all independent practitioners are properly credentialed and privileged. Procedures for credentialing and privileging will be strictly adhered to and documented, and the process will meet VA requirements. The credentialing and privileging process for all licensed independent practitioners will adhere to the same requirements. B.The Chief of Staff, through the Credentialing Office, is responsible for maintenance of a credentialing and privileging file for each licensed independent practitioner. These files will contain all documents relevant to the credentialing and privileging process and will be in compliance with VHA regulations and Joint Commission standards or equal accrediting body that meets or exceeds the standards of The Joint Commission. C.The Service Line Vice Presidents are responsible for recommending members of the medical staff and for assuring that each individual requesting clinical privileges has demonstrated competency and that the quality of the individuals’ performance is evaluated on an ongoing basis. Each clinical service will propose to the Medical Executive Board criteria for granting clinical privileges within designated clinical areas for all categories of medical staff based on available resources. D.The Executive Assistant to the Chief of Staff is the technical advisor for the medical center for credentialing and privileging and supervisor of the Credentialing Staff. E.The Credentialing Staff are responsible for verifying that all information submitted for credentialing and privileging is valid and that all required information is available. The Credentialing Staff are responsible for advising each physician and other health care professionals that failure to fulfill this obligation and/or falsification of documents may lead to medical center liability and/or individual prosecution. The Credentialing Staff will ensure that all medical staff and advanced practice providers are provided with a copy of the medical staff bylaws and agree to accept the professional obligations reflected therein. The Credentialing Staff will maintain records of all documents relevant to the credentialing and privileging process including enrollment and maintenance of VetPro and internal credentialing and privileging databases. The Credentialing Staff will present cases for review to the Medical Executive Board or Discipline Specific Professional Standards Boards and will ensure timely completion of documentation, verification of state license, education, board certification, etc., as required. F.Human Resource Management Service is responsible for assuring legal and administrative requirements are met and provide a technical review of all board actions to ensure compliance with VA policies. G.The Medical Executive Board and Discipline Specific Professional Standards Boards will make recommendations for initial appointment and for delineation of clinical privileges/scopes of practices based on established criteria mutually agreed upon by the medical staff. The Medical Executive Board will make recommendations to the Director on requested privileges to initiate, alter, or terminate privilege requests. H.Each Health Care Provider will respond to requests for information in a timely manner and must provide evidence of licensure registration, certification, and for relevant credentials for verification prior to appointment and throughout the employment process, as requested. They must agree to accept the professional obligations delineated in the Medical Staff Bylaws, rules and regulations provided to them. They are responsible for keeping the VA apprised of anything that would adversely affect or otherwise limit their clinical privileges. Failure to keep VA informed on these matters may result in administrative or disciplinary action.V.PROCEDURES A.The credentialing and privileging process involves a series of activities designed to collect, verify and evaluate data relevant to a practitioner’s professional performance. These activities serve as the foundation for objective, evidence-based decisions regarding appointments to membership on the Medical Staff, and recommendations to grant or deny initial and renewed privileges. In the course of the credentialing and privileging process, an overview of each applicant’s licensure, education, training, current competence, and physical ability to discharge patients care responsibilities is established. B.All licensed healthcare providers who provide patient care services independently will be credentialed and privileged by the VAPHS: physicians, dentists, podiatrists, optometrists, psychologists, social workers, audiologists and speech pathologists. Physician residents, who function outside of the scope of their training program as independent practitioners, e.g., paid Medical Officers of the Day or fee-basis physicians, must meet all requirements for credentialing and privileging. All Advanced Practice Providers will be credentialed and function under the direction of a Supervising Physician according to an approved scope of practice. Advanced Practice Providers include all fully licensed Clinical Nurse Specialists, Nurse Practitioners, Nurse Anesthetists, and Physician Assistants. Each credentialed practitioner will have a credentialing and privileging file established and maintained according to VHA requirements. All research staff who do not hold, but may be or are eligible for, licensure, registration, or certification that would be required for clinical practice in the health care profession and who are not covered by VHA Handbook 1100.19 or VHA Directive 2006-067 must be credentialed by VAPHS.1.Initial Appointmenta.Practitioners must be fully credentialed and privileged prior to initial appointment, reappointment, or after a break in service. The credentialing process includes verification, through the appropriate primary sources, the individual's professional education, training, licensure, certifications, review of health status, previous experience (including any gaps in employment or training greater than 30 days), clinical privileges, professional references, malpractice history, adverse actions or criminal violations as appropriate. Employment commitments will not be made until applicants have been properly screened through the state licensing boards and National Practitioner Data Bank (NPDB). All information obtained through the credentialing process will be carefully considered before employment and privileging decision actions are made. The applicable service line will review the credentialing folder and requested privileges and make recommendations regarding appointment. The VetPro database information and recommendations will be reviewed by the Service Line and Medical Executive Board and recommendations will be forwarded to the Director. All applicants applying for clinical privileges will be provided a copy of the Medical Staff Bylaws, rules and regulations and must agree in writing to accept the professional obligations reflected therein. 2.Licensure a.Except as described in VHA Handbook 5005.2, Chapter 2, every VA physician, dentist, podiatrist, optometrist, psychologist, social worker, audiologist and speech pathologist must have a current, full active, and unrestricted license to practice their specialty in any state, territory or Commonwealth of the United States, or the District of Columbia. If required by the state of licensure, current registration must also be maintained. Physicians and dentists who have a current unrestricted license in one or more states, but who have, or have had, a license restricted, suspended or revoked, will be hired in accordance with VHA Handbook 1100.19, Credentialing and Privileging. The Chief of Staff will document on VA Form 10-2850,"Application for Physicians, Dentists, Podiatrist and Optometrists", and on VA Form 10-2850c, "Application for Associated Health Occupations", that the status of all licensure/registration has been verified with the appropriate state licensing board for all states in which the applicant lists licensure.b.The National Practitioner Data Bank (NPDB) and Federation of State Medical Boards (FSMB) are secondary information sources; any reported information must be validated with the primary source (i.e., State Licensing Board, healthcare entity, malpractice payer). Screening applicants and appointees with the NPDB or FSMB does not abrogate the Chief of Staff's responsibility for verifying all information prior to appointment, privileging/re-privileging or proposed personnel action. This requirement does not apply to individuals functioning within the scope of a training program.3.Pre-employment References a.To assess experience, ability and current competence, documented contact must be made with at least three professional references that are from the same professional discipline as the applicant, including one from the current or most recent employer or institution where the applicant practiced or had privileges. rmation must be obtained relative to the scope and level of professional and clinical competence in the areas in which privileges are sought, health status, and fulfillment of responsibility as a member of the medical staff. Documentation of adequate information to fully assess the applicant's educational background and/or prior professional experiences must be present in the credentialing and privileging file.c.Supplemental information may be required to fully evaluate the educational background and/or prior professional experiences of an applicant. These reference checks may be obtained orally, but must be documented and filed with other references. d.For an applicant with prior VA or other Federal government service, the official personnel folder should be obtained as well as the credentialing and privileging folder before the individual is appointed. If an applicant has prior VA service, an effort should be made to obtain a reference from officials at the facility where the applicant was previously employed.e.All licensed independent practitioners must have their National Provider Identifier (NPI) and Taxonomy Code to complete the VetPro process. If the practitioner does not have this number, he/she must complete the online form and provide the tracking number. Once a ten digit number is assigned, this must be given to the Service Line ADPAC for entry into Vista. Assistance with obtaining an NPI number is provided by the service line.f.All providers listed below, must be enrolled with the Centers for Medicare & Medicaid Services (CMS) under the Provider Enrollment Chain of Ownership System (PECOS). If the provider is not enrolled, he/she must complete the online form and submit evidence of application. Assistance with enrolling in PECOS is provided by the service line. Anesthesiology AssistantAudiologistCertified Registered Nurse AnesthetistClinical Nurse SpecialistClinical Social WorkerDentistNurse PractitionerPhysician AssistantPhysicianPsychiatristPsychologist, ClinicalSpeech and Language Pathologist4.Health Statusa.The VAPHS complies with the Americans with Disabilities Act, which bars discrimination both on physical or mental impairments. Each applicant's health status, and physical and mental capability, must be consistent with their ability to satisfactorily perform the duties of their medical staff assignment and the clinical privileges being sought. Determination of the applicant's health status includes a declaration of appropriate health status by the applicant with a confirmation by a physician designated by or acceptable to the facility, such as the employee health physician or physician service/section chief. When doubt has been raised about an applicant’s ability to meet the requested clinical privileges, the MEB may request further evaluation. 5.Board Certification a.Board Certification is an excellent benchmark and is considered when delineating clinical privileges. Physician and/or dentist service chiefs should be certified by an appropriate specialty board. For candidates not board certified, or board certified in a specialty (ies) not appropriate for the assignment, the Medical Executive Board affirmatively establishes and documents through the privilege delineation process, that the person possesses comparable competence. The Credentialing Staff have been delegated the responsibility to document, prior to appointment, evidence of certification by an American Specialty Board(s), if claimed by a physician, or a Dental Specialty Board for dentists. Physicians' board certification may be confirmed by the listings in the Compendium of Certified Medical Specialists, or the Directory of Medical Specialists, or by direct communication with the Specialty Board; dentists' certification must be confirmed by the listing in the American Dental Directory published annually by the American Dental Association or by contacting the appropriate Dental Specialty Board. Other healthcare practitioners may be confirmed by direct communication with officials of the certification in question or approved website verification.6.Malpracticea. VA application forms require written details be provided on any administrative, professional or judicial proceedings in which professional malpractice on the applicant's part is, or was alleged. A full evaluation of any such claim will take place by officials participating in the credentialing, selection and approval processes prior to making recommendations or decisions on the applicant's suitability for VA employment. The evaluating officials will consider the VA's obligation as a health care provider to exercise reasonable care in determining that applicants are properly qualified, recognizing that many allegations of malpractice are proven groundless. Providers who have 3 or more medical malpractice payments in their payment history, or a single medical malpractice payment of $550,000 or more, or 2 medical malpractice payments totaling $1,000,000 or more will have their VetPro file reviewed by the VISN Chief Officer prior to presentation to the VA Pittsburgh Healthcare System Medical Executive Board. The VISN Chief Medical Officer will provide a recommendation whether to continue the appointment and privileging process. 7.Educationa.Educational and training credentials inform the organization of the applicant’s clinical knowledge and skill set and will be verified from the primary source whenever possible. Verification of all privileged healthcare practitioners will be conducted by the Credentialing Staff and will include medical/dental/graduate school as well as residency/fellowship training. b.Primary source verification of other advanced education/clinical practice program is required if the applicant offers this credential(s) as a primary support for requested specialized clinical privileges. All efforts to verify educational credentials, particularly credentials from foreign countries, will be fully documented by the Credentialing Staff. For graduates of foreign medical schools who possess ECFMG (Educational Council of Foreign Medical Graduates) certificate, primary source verification will be obtained by the Credentialing Office. A certified ECFMG verification will suffice for medical school training verification if written requests for verification are unavailable. Applicants are required to provide information on all educational and training experience including all gaps greater than 30 days in educational history. 8.Drug Enforcement Administration (DEA) a. DEA certification is not a requirement for employment in a Department of Veterans Affairs Medical Center. Physicians and dentists may apply for and be granted renewable certification by the DEA to prescribe controlled substances. Each applicant will be required to indicate on the application form information about the most recent or current DEA certificate. In addition, any applicant with a DEA certification revoked, suspended, limited, restricted in any way, or voluntarily relinquished, will be required to provide a written explanation at the time of application. A copy of the current DEA certification will be obtained. 9.Bylaws a.All practitioners being considered for appointment will be forwarded a copy of the Medical Staff Bylaws, Rules and Regulations for review and must agree in writing to abide by them. 10.Medical Executive Board a. The Medical Executive Board will review credentialing and privileging documentation and will make recommendations to the Director for actions on medical staff appointments/re-appointments and initial privileging and re-privileging of licensed independent practitioners. 11.Deans Committee a.The Deans Committee may nominate for consideration by the Director, full and part-time physicians and dentists, including service chiefs, and consultant and attending staff.12.Verification of IdentityHuman Resources will complete the following clearance processes to ensure that an individual requesting clinical privileges is the same individual identified in the credentialing documents: verification of identity; verification of employment eligibility; background check; fingerprinting; and screening the OIG Exclusionary List.B.Temporary Appointment for Urgent Patient Care Need 1.Temporary appointments for urgent patient care needs may require appointment before full credentialing information has been received. Since credentialing is a key component in any patient safety program, the appointment of providers with less than complete credentials packages warrants serious consideration and thorough review of the available information. 2.When there is an emergent or urgent patient care need, a temporary appointment may be made by the Director prior to receipt of references or verification of other information and action by the Medical Executive Board. Minimum required evidence includes:a.verification of at least one, active, current, unrestricted license with no previous or pending actions;b.confirmation of current comparable clinical privileges;c.response from NPDB-HIPDB with no matchd.response from FSMB with no reports;e.receipt of at least one peer reference who is knowledgeable of and confirms the provider’s competence, and has reason to know the individual’s professional qualifications; and,f.documentation by the Director of the specific patient care situation that warranted such an appointment.3.Temporary appointments must be completed in VetPro including the NPDB query and response, and the FSMB query and response. These appointments may not be renewed or repeated.4.An application through VetPro will be completed within three calendar days of the date the appointment is effective. This will include Supplemental Questions, a Declaration of Health and a Release of Information. This additional information will facilitate the required completion of the practitioner credentialing for these practitioners used in urgent patient care needs situations as well as provide additional information for evaluation of the current Temporary Appointment and reduce any potential risk to patients.5.If the Temporary Appointment is not converted to another form of medical staff appointment, complete credentialing will be completed even if completion occurs after the practitioner’s temporary appointment is terminated or expires. At a minimum, the licensed independent practitioner will submit a VetPro application, and all credentials will be verified. If unfavorable information was discovered during the course of the credentialing, a review of the care provided may be warranted to ensure that patient care standards have been met. NOTE: Temporary appointments are for emergent patient care only and NOT to be used for administrative convenience.C.Expedited Appointment 1.The credentialing process for an Expedited Appointment to the Medical Staff cannot begin until the licensed independent provider completes the entire credentials package, including VetPro. 2.Credentialing requirements for this process include confirmation of:a.The physician’s education and training; b.One active, current unrestricted license verified by the primary source, State, Territory, or Commonwealth of the United States and in the District of Columbia;c.Confirmation of the declaration of health, by a physician designated by or acceptable to the VAPHS, of the applicant’s physical and mental capability to fulfill the requirement of the clinical privileges being sought;d.Query of licensure history through the Federation of State Medical Boards Action Data Center with no report documented;e.Confirmation from two peer references who are knowledgeable of and confirm the physician’s competence, including at least one from the current or most recent employer(s) or institution(s) where the applicant holds or held privileges or who would have reason to know the individual’s professional qualifications;f.Current comparable privileges held in another institution; and,g. National Practitioner Data Bank query with documentation of no match.3.If all credentialing elements are reviewed and no current or previously successful challenges to any of the credentials are noted; and there is no history of malpractice payment, a delegated Subcommittee of the Medical Executive Board, consisting of at least two members of the full Board, may recommend appointment to the medical staff. Full credentialing will be completed within 30 workdays and presented to the Medical Executive Board for ratification.4.The expedited appointment process may only be used for what are considered “clean” applications. The expedited appointment process cannot be used if the application is not complete (including answers to Supplemental Questions, Declaration of Health, and Bylaws Attestation); or if there are current or previously successful challenges to licensure; ANY history of involuntary termination of medical staff membership at another organization, involuntary limitation, reduction, denial, or loss of clinical privileges; or there has been a final judgment adverse to the applicant in a professional liability action.5.For those providers where there is evidence of current or previously successful challenge to any credential or any current or previous administrative or judicial action, the expedited process cannot be used and complete credentialing must be accomplished though routine processes by the Medical Executive Board documentation should include the numbers, types and outcomes of related cases.D.Clinical Privileging - Clinical privileging is the process by which a practitioner is granted permission by the facility to independently provide medical or other patient care services within the scope of the practitioner's license and on an individual's clinical competence as determined by peer references, professional experience, health status (as it relates to the individual's ability to perform the requested clinical privileges), education, training, and licensure and registration. Prior to granting of a privilege, the resources necessary to support the requested privileges are determined to be currently available or available within a specified time frame. 1.Only practitioners who are licensed and permitted by law and the facility to practice independently may be granted clinical privileges and the privileges are not to be extended beyond a two-year period. Clinical privileges of contract providers will automatically expire after one year if the contract will not be renewed. Privileges should be requested for only those procedures, which the medical staff member will perform within the facility. Admitting privileges are granted to physicians, oral surgeons and dentists. The medical staff bylaws specify that any medical staff member is permitted to provide emergency care to an individual whose life is in immediate danger and where delay would place the individual at risk. 2.General criteria for privileging will be uniformly applied to all applicants. Such criteria will include:a.Current licensure and / or certification, as appropriate, verified with the primary source.b.The applicants specific relevant training, verified with the primary source.c.Evidence of physical ability to perform the requested privilege.d.Data from professional practice review by an organization that currently privileges the applicant (if available).e.Peer and / or faculty recommendation.f.When renewing privileges review of the practitioner’s performance within the organization.g.Each Service Line Vice President will establish additional criteria for granting clinical privileges within the service consistent with the needs of the service and the facility. Clinical privileges must be based on evidence of an individual's current competence. When privilege delineation is based primarily on experience, the individual's credentials record should reflect that experience and the documentation should include the numbers, types and outcomes of related cases. 3.Privileges granted to an applicant must be facility specific and based on the procedures and types of services that are provided with the facility. The requirements and standards for granting privileges to perform any given procedure, if performed by more than one service, must be the same. One standard of care must be guaranteed regardless of practitioner, service or location within the facility. Each practitioner will be assigned to and have clinical privileges in one clinical service and may be granted privileges in other clinical services. The exercise of clinical privileges within any service will be subject to the policies and procedures of that service and the authority of that Service Line Vice President. a.Initial Privileges (1)Clinical privilege requests must be initiated by the practitioner and reviewed and recommended by the Service Line Vice President responsible for the particular specialty area in which the privileges are requested. Clinical privileges held by the applicant practitioner at other hospitals may also be reviewed as part of the granting of privileges. The Service Line Vice President will verify clinical experience and determine the appropriate level of initial privileging based on an applicant's health status, past experience, training, and clinical competence and other appropriate information. The Service Line Vice President will recommend approval, disapproval or modification of the requested clinical privileges. This may include a limited period of direct supervision by an appropriately credentialed practitioner for privileges that are high risk. (2)Residents who elect to work as fee basis, and/or MOD physicians must be licensed, credentialed and privileged for the duties they are expected to perform. In this capacity they are not working under the auspices of a training program, and must meet the same requirements as all medical staff appointed at the facility. (3)Clinical privileges by provider are available to hospital staff on a need-to-know basis in order to ensure providers are operating within the scope of their clinical privileges. Employees performing procedures outside the scope of their privileges may be subject to disciplinary or administrative action. b.Temporary Privileges(1)The Director/Acting Director may grant temporary clinical privileges for emergent or urgent patient care needs for a period not to exceed 60 calendar days. Such privileges will be based on evidence of current licensure; relevant training or experience; current competence; ability to perform the privileges requested; a query and evaluation of NPDB information; a complete application; no current or previously successful challenge to licensure or registration; no subjection to involuntary termination of medical staff membership at another organization; and no subjection to involuntary limitation, reduction, denial, or loss of clinical privilege. The recommendation for temporary privileges will be made by the Chief of Staff and approved by the Director. Special requirements of supervision and reporting may be imposed on any practitioner granted temporary privileges by the responsible Service Line Vice President. The Director may at any time, upon recommendation of the Chief of Staff, terminate a practitioner's temporary privileges. Such individuals are not entitled to a hearing or appeal. c.Disaster Privileges(1)In circumstances of disaster (s), in which the emergency management plan has been activated and the Medical Center is unable to handle the immediate patient needs, the Director/Chief of Staff/or Designee may grant disaster privileges to licensed independent practitioners from another Joint Commission accredited healthcare facility on a case by case basis at his/her discretion. The practitioner must present a current photo ID from the healthcare facility where he/she is employed and a valid photo ID used by a federal, state or regulatory agency (e.g. driver’s license), present evidence of current professional licensure, and must be queried whether his/her professional license is in good standing. The individual may also present identification as being a member of a disaster medical assistance team to render patient care, treatment and services in disaster circumstances with such authority granted by federal, state, or municipal entity. Verification of the practitioner’s identity may also be made by a current member of the hospital or medical staff with personal knowledge regarding the provider’s identity.(2)Primary source verification of licensure and queries to the National Practitioner Data Bank and Federation of State Medical Boards, etc. will be completed within 72 hours or as soon as communication is available. The standards credentials verification process will be used. The practitioner will be granted disaster privileges to provide patient care at the VAPHS within the scope of his/her professional licensure and will be mentored by a currently credentialed and privileged medical staff member for guidance and direction. The practitioner will be identified as a volunteer by a medical manpower armband. The practitioner will be granted disaster privileges limited to one-week duration. If the disaster is of a critical nature, the situation will be reassessed within 72 hours and an extension of the disaster responsibilities may be authorized if warranted. d.Provisional Privileges(1)Provisional Privileges are time-limited privileges that may be requested by a provider when the provider has not fully met all criteria. Provisional privileges may be considered when:(a)a provider has received initial training to perform a new procedure but has not fully developed the required technical skills;(b)a provider has not met the required number of cases to be granted full privileges;(c)a provider is new to the facility and the provider’s skill level is not known particularly for high risk / low volume procedures.(2)Provisional privileges may be performed without direct supervision, however during this time the provider will practice under the direction of another provider with full privileges for those privileges granted as provisional. The fully privileged provider will monitor the performance of the provider with provisional privileges throughout the designated provisional period. The provider with provisional privileges will be expected to meet the competency requirements for full privileges before the completion of the provisional period.In some situations, especially related to advances in technology of new procedures in the facility (e.g. robotic-assisted surgery), a fully privileged practitioner may not be available on site to provide direction to a provider with provisional privileges. In such cases, the Medical Executive Board will review a proposal from the requesting practitioner and/or Service Line to determine whether the Institutional Review Board and Human Studies Committee should regulate the procedure as research. Such proposals should include a summary of the procedure or technology, an assessment of its risks and benefits compared to other treatment options, and a justification for performance of the procedure. (3)Upon recommendation from the sponsoring Service Line, the Medical Executive Board will review and determine whether the requirements for provisional privileges for each specific procedure have been met. In general, these requirements will include:(a)The provider is fully privileged to perform standard procedures for the disease being treated; if applicable (e.g. a surgeon should be fully privileged to perform an open operation that corresponds to a minimally invasive surgical procedure). (b)The provider received formalized training at another institution, if available.(c) The Medical Executive Board will designate who should be assigned to monitor and report outcomes to assure patient safety.(d) The Medical Executive Board will determine the number of cases to be performed by the provider to be eligible for full privileges that will be based upon the complexity of the procedure, experience of the provider with related procedures, and procedural risk profile.(e) A contingency plan for management of complications will be presented. (4)The Medical Executive Board may grant provisional privileges for a specified period of time that may range from 3 months but not to exceed 12 months. Provisional privileges up to 12 months may be needed in specialized areas when the caseload may be low to achieve competency within a shorter period of time.e.Supervised Privileges(1) Supervised Privileges are time-limited privileges that may not be performed independently by a provider and require the participation of another provider with full privileges during the delivery of care.(2) Supervised privileges may be granted for a specified period of time from 6 months but not to exceed 26 months while a provider is learning how to perform a new procedure and/or developing a new skill. The level of supervision provided for supervised privileges will vary and will be determined on an individual’s case-by-case basis. The level of supervision may include one or more of the following: direct hands-on training;offering guidance or direction during performance of the procedure;review of medical record documentation; or,monitoring procedure outcomes.(3)Focused Professional Practice Evaluation will be conducted to assess competency for full privileges. Focused professional practice evaluation is a time limited process whereby the organization evaluates the privilege-specific competence of the practitioner who does not have documented evidence of competently performing the requested privileged at the organization. Information for focused professional practice evaluation may include chart review, monitoring clinical practice patterns, simulation, proctoring, peer review, and discussion with other individuals involved in the care of the patient (eg. consulting physician, surgical assistant, etc).(a)The competency of the provider to practice independently will be assessed before the completion of the period of provisional or supervised privileges. The provider may voluntarily withdraw his or her request for privileges at any time during the provisional or supervised process without adverse action.(b)Ninety days before the provider’s provisional or supervised privileges are due to expire, a formal reappointment review process will be initiated by the Credentialing Office. The Credentialing Office will send the provider documentation to apply for full privileges, initiate all of the requirements for reappointment (e.g. VetPro; hard copy documents), and complete the verification of credentials for reappointment as required by VA regulations.(c)The provider with provisional or supervised privileges will summarize the details of cases performed to include outcomes and complications and a competency assessment will be conducted by the Service Line.(d)The Service Line Vice President will review the provider’s summary and will provide a recommendation to the Medical Executive Board.(e)The Medical Executive Board will provide a final determination of whether the practitioner is competent to be granted full privileges.(4)If the focused professional practice evaluation identifies that the provider is unable to perform the procedure(s) independently, the provider may elect to withdraw the request for full privileges without incurring an adverse action.(5)If the provider was unable to complete the number of required cases during the initial provisional or supervised period, an extension may be requested by the provider. An extension will be considered only if the provider concurs with provisional or supervised privileges during the extension period. The Service Line must concur with the extension and submit the request to the Medical Executive Board for approval.(6)At the request of the practitioner, and with concurrence of the Service Line Vice President, the Medical Executive Board may increase the number of cases to be performed during the period of provisional or supervised privileges to provide additional educational opportunities for the practitioner.(7)If the provider disagrees with the findings of the focused professional practice evaluation, an appeal may be filed for adjudication by the Chief of Staff of Designee.(8)If concern for patient safety is raised at any time during the period of time that the provider has provisional or supervised privileges or following the appeal process, the provider’s full privileges will be denied and the action will be reported as a reduction or revocation of the privileges to the National Practitioner Data Bank.(9)Noncompliance with any element of the provisional or supervised privileging process will be cause for review by the Medical Executive board and may result in suspension of provisional or supervised privileges. Suspension of provisional or supervised privileges is considered an adverse action and is reportable to the National Practitioner Data Bank.E.Reappraisal / Re-privileging 1.Reappraisala.Reappraisal is the process of evaluating the professional credentials, clinical competence and health status (as it relates to the ability to perform the requested privileges) of practitioners who hold clinical privileges within the facility. Reappraisal for the granting of clinical privileges must be conducted for each practitioner at least every 2 years. b.The reappraisal process will include the practitioner's statements regarding successful or pending challenges to any licensure or registration; voluntary or involuntary relinquishment of licensure or registration; voluntary or involuntary limitation, reduction or loss of privileges at another hospital; voluntary or involuntary loss of medical/affiliate staff membership; any evidence of an unusual pattern or an excessive number of professional liability actions resulting in a final judgment against the applicant’s mental and physical status (as it relates to the ability to perform the requested clinical privileges) and any other reasonable indicators of continuing qualifications. Additional information regarding licensure/certification status; NPDB; FSMB; query peer recommendations; continuing education accomplishments and copies of clinical privileges held at other institutions will be secured for review.c.General competencies include the following: patient care, medical / clinical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practices. Evaluation of professional performance, judgment, clinical and/or technical competence and skills are to be based on peer recommendations, data and ongoing professional practice evaluation. Peer recommendation will include information regarding the provider’s current medical / clinical knowledge, technical and clinical skills, clinical judgment, interpersonal skills, communication skills, and professionalism. Ongoing professional practice evaluation by the Service line may include, when applicable, information from surgical case review, infection control reviews, drug usage evaluations, medical record review, blood usage review, pharmacy and therapeutic review, morbidity and mortality data, monitoring and evaluation of quality, utilization, risk and appropriateness of care. The reappraisal process should include consideration of such factors as the number of procedures performed or major diagnoses treated, rates of complications compared with those of others doing similar procedures and adverse results indicating patterns or trends in a practitioner's clinical practice. The information used in the ongoing professional practice evaluation may be acquired through periodic chart review, direct observation, monitoring of diagnostic and treatment techniques and discussion with other individuals involved in the care. Relevant information obtained from ongoing professional practice evaluation is integrated into performance improvement activities. Ongoing professional practice evaluation information is factored into the decision to maintain existing privilege(s), to review existing privilege(s), or to revoke an existing privilege prior to or at the time of renewal. d. If a provider voluntarily allows clinical privileges to expire, the provider must submit a complete credentialing and privileging package to request clinical privileges.2.Re-privileging a.Requests for renewal of clinical privileges will be processed in the same manner as initial privileges. Individual participation in continuing medical education is required at the time of reprivileging. The medical center requirement for continuing education is 40 hours during a two-year reprivileging cycle or will be pro-rated if the cycle is less than two years. Please note that of the 40 hours CME, 20 hours Category I CME are required for physicians. b.A recommendation from peers (appropriate practitioners in the same professional discipline as the applicant who have pursued knowledge of the applicant) reflects a basis for recommending the granting of privileges. A minimum of two peer recommendations will be obtained. At least one of the two peer recommendations should be obtained from a provider in the same subspecialty (when feasible), who had recent contact (within the past two years) and knowledge of the person who is being recommended. The following competencies will be assessed: patient care, medical/clinical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and clinical judgment, and systems-based practices. The Service Line Vice President will assess the results of performance improvement activities that have been considered in recommending individual privileges and complete the Assessment by Service Line Vice President for Renewal of Clinical Privileges. c.The Service should review with the practitioner the specific procedures and/or treatments that are being requested. Issues such as documented changes in the facility mission, failure to perform a sufficient number of procedures to maintain proficiency, or failure to use privileges previously granted will affect the Service Line Vice President's recommendation for renewal of privileges. These actions will be considered changes and shall not be construed as a reduction, restriction, loss or revocation of clinical privileges. Such changes should be discussed with the individual requesting renewal of privileges. d.The requested privileges and the Service Line's recommendation will be presented, with the supporting credentialing, health status and clinical competence information, to the Medical Executive Board for review and recommendation. The recommendation will be submitted to the facility Director, as the approving authority, for final action.e.Administrative disapproval of clinical privileges may be based on one or more of the following reasons:the privilege is not a requirement for the provider’s position;the provider lacks sufficient training certification;the provider lacks a proficient case number to maintain competency;the procedure is not performed at the VAPHS;supportive resources are not available at the VAPHS for the privilege.f.Practitioners may submit a request for modification of clinical privileges at any time. Requests to increase privileges will be accompanied by the appropriate documentation, which supports the practitioner's assertion of competence, i.e. advanced education or clinical practice program, clinical practice information from other institution(s), reference, etc. Licensure, NPDB and any additional education credentials will be verified before any new clinical privileges are granted. Requests for other changes should be accompanied by an explanatory statement(s). g.The process of reappraisal and granting privileges for the Chief of Staff (COS) will be the same as outlined above. The COS requests for privileges will be reviewed and a recommendation made by the relevant Service Line responsible for the specialty area in which the privileges are requested. When the COS is considered for privileging, the COS will be absent from the deliberation of the Medical Executive Board and an appropriate practitioner will serve as chairperson.3.Changes in Clinical Privilegesa.The decision to grant or deny a privilege(s) and / or review an existing privilege(s) is an objective, evidence-based process. b.Deployment Privilege Status: In those instances when a provider is called to active duty, the provider’s privileges will be placed in a Deployment Status. The credential files continue to remain active with the privileges in this new status. If at all possible this process for returning privileges to an active status will be communicated to providers before deployment.(1)Providers returning from active duty will be asked to communicate with the medical center staff as soon as possible upon returning to the area. This will hopefully occur with as much lead-time as possible.(2)The provider will update the electronic Credentials File after the file has been reopened for credentialing updating licensure information, health status, and professional activities while on active duty.(3)The credentials file will be brought to a verified status. If the provider performed clinical work while on active duty, an attempt will be made to confirm the type of duties, the provider’s physical and mental ability to perform these duties, and the quality of the work and this information will be documented.(4)The verified credentials, the practitioner’s request for returning the privileges to an active status, and the Service Chief’s recommendation will be presented to the Medical Executive Board for review and recommendation. The decision of the Medical Executive Board will be documented (minutes will reflect the documents reviewed and the rationale for the stated conclusion) and forwarded to the Director for recommendation and approval of restoring the provider’s privileges to Active Status from Deployment Status.(5)The date of the original clinical privileges will continue to be the date of the restored clinical privileges if they did not expire during the deployment.(6)In those instances where the privileges lapsed during the call to active duty, the provider would need to provide additional references for verification and the medical center staff will need to perform all verifications required for reappointment.(7)In those instances where the provider was not providing clinical care while on active duty, the provider in cooperation with the Service Line Vice President, Medical Executive Board must consider the privileges held prior to the call to active duty and whether a request for modification of these privileges should be initiated, on a short term basis.(8)If the file cannot be brought to a verified status and the practitioner’s privileges restored by the Director, the practitioner can be granted a Temporary Appointment not to exceed 60 calendar days during which time the credentialing and privileging process will be completed. In order to qualify for this temporary appointment when returning from active duty the following must be documented in Vet Pro:(a)Verification of all licenses that were current at the time of deployment as current and unrestricted with no previous or pending adverse actions on the Temporary Enrollment Screen;(b)A response from the NPDB with no match;(c)A response from the FSMB with no match;(d)Marking of the Temporary enrollment Screen as reinstatement form Deployment;(e)Documentation of the Temporary Appointment on the Appointment Screen not to exceed 60 calendar days.c.Inactivation of PrivilegesThe inactivation of privileges occurs when a practitioner leaves the medical staff for an extended period of time and will not be an active member of the medical staff. Although it is difficult to quantify “extended period of time” but it is defined as periods of no clinical practice or continued medical knowledge skills and learning or when there is no formal clinical relationship between the facility and the practitioner for an extended period of time. Conditions that would be considered reasons for inactivation of privileges may include extended sick leave, sabbatical with or without clinical practice while on sabbatical, and the end of a provider’s contract that is not renewed or the period of performance extended. When a provider returns to the medical center under these circumstances, credentialing and privileging activities will be similar to the initial credentialing process with the exception that non-time limited information, e.g. education and training, does not need to be re-verified. 4.Reduction and Revocation of Privileges a.Reduction and/or revocation of clinical privileges may be initiated based on deficiencies in professional performance. Management officials are prohibited from taking or recommending personnel actions (resignation, retirement, or reassignment) in return for an agreement not to initiate procedures to reduce or revoke clinical privileges where such action is indicated. b.Data gathered in conjunction with the medical center's performance improvement activities is an important tool for identifying potential deficiencies. However, material that is obtained as part of a protected Title 38 U.S.C. 3305 performance improvement program may not be disclosed in the course of any action to reduce or revoke privileges, nor may any reduction or revocation of privileges be based directly on such performance improvement data. If such information is necessary to support a change in privileges, it must be developed through mechanisms independent of the performance improvement program, such as administrative reviews and boards of investigation. In these instances, the performance improvement may have triggered the review; however, the performance improvement information is confidential and privileged in accordance with 38 U.S.C. 3305. c.Any professional review action that adversely affects the clinical privileges of a practitioner for a period longer than 30 days; or any acceptance of the surrender of clinical privileges or any restriction of such privileges by a practitioner either while the practitioner is under investigation by the institution relating to possible incompetence or improper professional conduct, or in return for not conducting such an investigation or proceeding; will be reported to the National Practitioner Data Bank. d.Reduction of privileges may include, but not be limited to, restricting or prohibiting performance of specific procedures, or prescribing and/or dispensing controlled substances. Reduction of privileges may be time limited and/or have restoration contingent upon some condition, such as demonstration of recovery from a medically disabling condition or further training in a particular area. Revocation of privileges refers to the permanent loss of clinical privileges. e. If it becomes necessary to formally reduce or revoke the clinical privileges of a medical staff member, based on deficiencies in professional performance, the following process must be followed. 5.Reduction of Privileges a.Prior to any action or decision by the facility Director, the practitioner will receive written notice of the proposed changes in privileges from the Chief of Staff. The notice will include a discussion of the reason(s) for the change. The notice should also indicate that if a reduction or revocation is affected based on the outcome of the proceedings, a report will be filed with the NPDB with a copy to the appropriate SLB in all states in which the practitioner holds a license and in the state in which the facility is located. The notice will also include a statement of the practitioner's right to be represented by counsel or a representative of the practitioner's choice, throughout the proceedings. b.The practitioner will be allowed to review all evidence not restricted by regulation or statute upon which proposed changes are based. Following the review, the practitioner may respond in writing to the Chief of Staff's written notice of intent. The practitioner must submit a response within 10 workdays. If requested by the practitioner, the Chief of Staff may grant an extension for a brief period, normally not to exceed 10 workdays except in extraordinary circumstances. c.All information will be forwarded to the facility Director for decision. The Director will make a decision on the basis of the record. If the practitioner disagrees with the Director's decision, a hearing may be requested. The practitioner must submit the request for a hearing within 5 workdays after receipt of the decision. d.The facility Director will appoint a review panel of three professionals within 5 workdays to conduct a review and hearing. At least two members of the panel will be members of the same profession. e.During such a hearing, the practitioner has the right to be present throughout the evidentiary proceedings, represented by counsel or a representative of the practitioner's choice, to cross-examine witnesses and to purchase a copy of the transcript or tape of the hearing. f.The panel will complete its review and submit its report within 15 workdays. Additional time may be allowed by the facility Director for extraordinary circumstances or cause. The panel's report, including findings and recommendations, will be forwarded to the facility Director who has the authority to accept, reject, accept in part or modify the review panel's recommendations. g.The facility Director will issue a written decision within 10 workdays of the date of receipt of the panel's report. If the practitioner's privileges are reduced, the written decision will indicate the reason(s) for change. The signature of the facility Director constitutes a final action and the reduction is reportable to the NPDB. h.The practitioner may submit a written appeal to the Veterans Integrated Service Network (VISN) Director within 5 workdays of receipt of the facility Director's decision. This appeal option will not delay the submission of the NPDB report. i.The VISN Director will provide a written decision based on the record within 20 days. The decision of the VISN Director is not subject to further appeal. 6.Revocation of Privileges a.Recommendations to revoke a practitioner's privileges will be made by the Medical Executive Board, based upon review and deliberation of clinical performance and professional conduct information. When revocation of privileges is proposed and combined with a proposed demotion or dismissal, the due process rights of the practitioner will be accommodated by the hearing provided under the dismissal process. Dismissal constitutes a revocation of privileges, whether or not there was a separate and distinct privileging action, and will be reported without further review or due process to the NPDB. When revocation of privileges is proposed and not combined with a proposed demotion or dismissal, the due process procedures under reduction of privileges will pertain. b.Practitioners, whose privileges are revoked, for professional competence or professional conduct, will be reported to the NPDB in accordance with the VHA policy on NPDB reporting. In addition, the practitioner's practice must be reviewed for reporting to SLB(s) consistent with VHA policy on SLB reporting. c.Nothing in these procedures restricts the authority of management to temporarily detail or reassign a practitioner to non-patient care areas or activities, thus suspending privileges, during the tendency of any proposed reduction of privileges or discharge proceedings. Further, the Director, on the recommendation of the Chief of Staff, may summarily suspend privileges, on a temporary basis, when there is sufficient concern regarding patient safety or specific practice patterns. Individuals appointed under authority of 38 U.S.C. 7405 may be terminated when this is determined to be in the best interests of VA, in accordance with provisions of MP-5, Part I, Chapter 9 and without regard to the procedural requirements indicated. VI.REFERENCES Joint Commission Accreditation Manual & UpdatesVHA Handbook 1100.19 "Credentialing & Privileging"VHA Directive 2001-002, Implementation of Vet Pro, VHA's National Credentials DatabankVHA Directive 2002-07 “Expedited Medical Staff Appointment Process”VHA Directive 2009-054 “Credentialing of Unlicensed Research Staff”VII.RESCISSION NONEVIII.CONCURRENCES001, 11, 11D, 002, 00B, 00S, 05, all Service Line VPs, AFGE Local 2028 and AFGE Local 3344IX.EXPIRATION This memorandum automatically expires May 5, 2014//Signed//TERRY GERIGK WOLF, FACHEDirector ATTACHMENT 2 – NEW EMPLOYEE ORIENTATION DATESNEO Day 2 - DatesTuesday, November 18, 2014 Tuesday, December 2, 2014 Tuesday, December 16, 2014 Tuesday, December 30, 2014 Tuesday, January 13, 2015 Tuesday, January 27, 2015 Tuesday, February 10, 2015 Tuesday, February, 24, 2015Tuesday, March 10, 2015Tuesday, March 24, 2015Tuesday, April 7, 2015Tuesday, April 21, 2015 Tuesday, May 5, 2015Tuesday, May 19, 2015Tuesday, June 2, 2015Tuesday, June 16, 2015Tuesday, June 30, 2015Tuesday, July 14, 2015Tuesday, July 28, 2015Tuesday, August 11, 2015Tuesday, August 25, 2015Tuesday, September 8, 2015Tuesday, September 22, 2015Tuesday, October 6, 2015Tuesday, October 20, 2015 Tuesday, November 3, 2015Tuesday, November 17, 2015Tuesday, December 1, 2015Tuesday, December 15, 2015 Tuesday, December 29, 2015 ATTACHMENT 3Memorandum PI-003 February 21, 2013QUALITY MANAGEMENT SYSTEMPURPOSEIPOLICYIIDEFINITIONSIIIPROCEDURESIVRESPONSIBILITYVREFERENCESVIRESCISSIONVIICONCURRENCES VIIIEXPIRATIONIX I. PURPOSE VA Pittsburgh Healthcare System (VAPHS) utilizes a comprehensive structure which supports a culture of quality and patient safety.II.POLICY VA Pittsburgh Healthcare System is committed to providing quality health care to eligible Veterans through a Quality Management System that optimizes health care and patient safety processes and outcomes. The System supports VA core mission; recognizes current and emerging veteran needs; and is aligned with VHA strategic guidance, resource allocation, and associated VHA policy. III. DEFINITIONSPerformance measures – patient outcome measures used to evaluate the provision of care for specific diagnoses and/or settings.ORYX data – performance measures evaluated by The Joint Commission.PDCA – performance improvement model used at VAPHS. The Plan-Do-Check-Act (PDCA) Cycle is a checklist of the four stages one must go through to get from “problem-faced” to problem solved.1. Plan – Identify the Problem – select the problem to be analyzed; clearly define the problem and define a precise problem statement; set a measurable goal for the problem solving effort; and establish a process for coordinating with and gaining approval of leadership.Analyze the Problem – identify the process that impact the problem and select one; list the steps in the process as it currently exists; identify the potential cause of the problem; collect and analyze data related to the problem.2. Do – Develop Solutions – establish criteria for selecting a solution; generate potential solutions that will address the root causes of the problem; select a solution; plan the solution.Implement a Solution – implement the chosen solution on a trial or pilot basis.3. Check – Evaluate the Results – gather data on the solution; analyze the data on the solution.4. Act – Standardize the Solution and Capitalize on New Opportunities – identify systemic changes and training needs for full implementation; adopt the solution; plan ongoing monitoring of the solution; and continue to look for incremental improvements to refine the solution.Data management and analyses – critical factor in any Quality Management Program. It includes, but is not limited to: gathering and critically analyzing data relevant to quality and patient safety, ensuring data is valid and reliable, comparing the data analysis results with established goals or internal or external benchmarks, identifying specific opportunities for improvement, and implementing and evaluating actions until problems are resolved or improvements are achieved.Confidentiality – The requirements for a Quality Management document to be confidential are described in Title 38 United States Code (U.S.C.) Section 5705 and it’s implementing regulations; and Title 38 Code of Federal Regulations (CFR) Sections 17.501 (a), (b), (c), and (g); and is fully outlined in current VHA policy. Quality and patient safety data must be protected and used only as consistent with 38 U.S.C. 5705 and appropriate Department of Veterans Affairs (VA) policies and directives governing confidential data.IV.PROCEDUREThe annual performance measures plan for VA Headquarters along with VISN specific measures represents the key driver in defining the priorities for Healthcare System improvements and will be coordinated with the Strategic Planning process with an emphasis on quality outcomes, improved efficiency and integration. Target performance is established at benchmark levels and is monitored on a regular basis.Data analysis identifies trends, patterns and performance levels which suggest opportunities for improvement. Once a change has been made the change is monitored to make sure the desired improvement is achieved and sustained. When an improvement does not meet expectations, additional changes are made and/or the PDCA cycle starts over.Interdisciplinary committees and continuous readiness teams are established around key medical center functions, Joint Commission accredited programs, performance measures, and other required review body activities.1. The membership of these committees is based upon identification of the stakeholders in the process(s) that is/are under the committees’ charge. The committees’ responsibilities include:Assure compliance with all regulatory and accrediting bodies for this process(s). Define, review, and monitor for stability and adequacy all processes included in the span of the committee responsibility.b. Evaluate performance of the processes, included in the committee responsibility, to comparative databases of other healthcare entities, reference information, and community and/or national standards of practice. Processes selected for in-depth evaluation will be prioritized based on high volume, problem prone, high risk, and high impact on patient outcomes.All Service Lines and/or Programs are encouraged to identify opportunities for improvement within their operations and are empowered to re-design or improve within their scope, utilizing the Plan-Do-Check-Act process. Extensive changes in policy or exceptional resource requirements will be brought to the appropriate board. The domains of cost, access, utilization, quality and satisfaction are to be considered in choosing improvement opportunity. Successful improvement efforts will be prepared in a concise and clear manner and posted for staff and visitors to view in the applicable work area. Bulletin boards for this purpose will be maintained in each patient care and administrative work area.All Performance Improvement Activities which reflect medical center performance are reviewed by the Executive Leadership Board. These include but are not limited to:1. Operative or other procedures that place patients at risk of disability or death.2. All significant discrepancies between preoperative and postoperative diagnoses, including pathologic diagnoses.3. Adverse events relating to using moderate or deep sedation or anesthesia.4. Use of blood and blood components.5. All reported and confirmed transfusion reactions.6. Results of resuscitation.7. Behavior management and treatment (restraint and seclusion usage).8. Significant medication errors.9. Significant adverse drug reactions.10. Patient perception of the safety and quality of care, treatment and services.11. All performance measures which include ORYX data.12. Analysis of organ procurement conversion rate data as provided by the organ procurement organization (OPO).13. Staffing effectiveness.Adverse trends, significant outliers, and strong practices are communicated to the VISN Director at the discretion of the Medical Center Director.1. The reporting, of significant adverse trends and significant adverse outliers, needs to occur in a timely manner, and contain an analysis of the issue and clear mechanisms and timeliness for follow-up for quality concerns.2. VHA Issue Brief format is to be used for VISN reports.3. Identified issues communicated to the VISN will be documented inthe minutes of the Executive Leadership Board.An annual evaluation completed by the Quality Improvement staff will focus on achievements and accomplishments throughout the medical center within the key components of the Quality Management System which include but are not limited to: performance measures, resident supervision, occurrence screens, peer review, patient safety, internal and external reviews, internal and external customer satisfaction, controlled substance inspection program, and initiatives driven through the utilization of the data warehouse.RESPONSIBILITIES Medical Center Director is responsible for: 1. Providing oversight to ensure that quality management components are implemented and integrated.2. Communicating quality management priorities.3. Promoting a culture conducive to patient safety and continuous quality improvement.4. Ensuring adequate resources for planning and implementing the facility’s Quality Management System.5. Convening teams as warranted.6. Reviewing the outcomes of the Quality Management System at the facility level.7. Ensuring there is a medical center Quality Management policy and plan that is inclusive of the requirements of an effective Quality Management System as delineated in the VHA directive 2009-043.8. Identifying a leadership committee to review and analyze quality data, and to take appropriate actions and track improvements to completion utilizing the principles of System Redesign, as appropriate.9. Ensuring use of valid quality improvement tools for analysis of quality data by leadership within the facility. Identification of opportunities for improvement needs to be evaluated and prioritized based on the feasibility of implementation.10. Ensuring a documented process for communication of quality data within the facility.11. Tracking organizational priorities.12. Ensuring adverse trends, significant outliers, and strong practices are communicated to the VISN Director.13. Meeting requirements for external accreditation of the medical center.14. Ensuring the facility Vice Presidents integrate all components of the quality management plan.15. Encouraging employees to report issues affecting the quality and safety of health care provided to Veterans through the appropriate medical center channels.16. Ensuring the Quality Management Director has unrestricted access to data and information that is relevant to key quality management components that are collected, consolidated, or analyzed within the medical center.Chief of Staff is responsible for:1. Ensuring that components of the Quality Management System are integrated.2. Monitoring the quality and safety of clinical medical practice within the medical center.3. Contributing to effective quality management through clinical leadership.4. Participating in medical center quality management activities.5. Ensuring a data driven process for granting and renewing clinical privileges based on appropriate initial and ongoing evaluations of training, competency, and performance is present at the medical center.6. Chairing the Adverse Events and Procedure Committee (Peer Review Committee).7. Ensuring medical staff participation on Peer Review activities.Associate Director for Patient Care Services is responsible for:Ensuring that components of the quality management plan are integrated.2. Monitoring the quality and safety of clinical nursing practice within the facility.3. Contributing to effective quality management through clinical leadership.4.Participating in medical center quality management activities.5. Serving as a member of the Peer Review Committee. Quality Management Director is responsible for:1. Ensuring that components of the quality management system are integrated.2.Ensuring a systematic process is in place for monitoring the facility quality data.3. Serving as the quality consultant to the medical center leadership, Quality Improvement teams and employees.4. Serving on executive committees and workgroups where quality data and information is reviewed, analyzed, and acted upon.E.Lead Patient Safety Manager is responsible for:Ensuring that components of the Quality Management System and Patient Safety Program are integrated. 2. Implementing a coordinated patient safety program within the medical center that is based on guidance and tools from NCPS, and which meets the needs and priorities identified by the Medical Center Director. These include but are not limited to addressing important standards, requirements, and recommendations, promulgated by The Joint Commission and other organizations working to improve patient safety.F.Service Line Vice Presidents are responsible for:1. Integrating all components of the quality management plan.2. Promote effective quality management activities by working collaboratively with medical center leadership, quality and patient safety staff, to ensure that services under their supervision support quality care expectations and those applicable accrediting body standards and VA policies.3. Develop, in collaboration with the Chief of Staff, Associate Director for Patient Care, and Quality Management Director the collection, analysis, evaluation, and follow-up of quality management activities. All of which must be approved by the Medical Center Director.4. Ensure their staff participates in Peer Review activities.G.Executive Leadership Board is responsible for:1. Serving as the Quality Management Committee.2. Ensuring that components of the Quality Management System are integrated.3. Overseeing the quality and safety of care delivered by its members, who need to be actively involved in the collection, analysis, evaluation, and follow-up of quality management activities.4. Ensuring that a data driven process is in place for granting privileges.5. Meeting at a minimum 10 months of the year.6. Membership includes the Director, Chief of Staff, Associate Director for Patient Care Services, Quality Management Director, Patient Safety Manager, and clinical Senior Leadership.7. Meeting minutes track issues to completion and record attendance.8. Data collected for key quality management components are trended. Aggregate data are examined for change and reviewed by the board. Use of comparison data and triggering thresholds are used as available. 9. Prioritize all identified improvement opportunities. All employees are responsible for patient safety. Each is encouraged to participate in continuous quality improvement activities. This is accomplished through identifying areas for improvement, sustaining improvement, maintaining and supporting the organization’s mission, vision and strategic goals.VI.REFERENCESVHA Directive 2009-043 Quality Management System September 11, 2009Current Joint Commission Standards Manual VII.RESCISSIONS Memorandum PI-003 dated March 22, 2010. VIII.CONCURRENCES 11, 00S, 001, 002, 05, all Service Line VP’s, AFGE Local 2028 and AFGE Local 3344 IX.EXPIRATION This memorandum will automatically expire February 21, 2016. //Signed//TERRY GERIGK WOLF, FACHEDirector and CEOATTACHMENT #4VA PITTSBURGH HEALTHCARE SYSTEMCONTRACT PHYSICIAN HEALTH REQUIREMENTSDate: __________________________________________________Contract Employee’s Name: ________________________________ DOB: ________________Contract Physician: University of Pittsburgh Physicians Contract: ___________________Contract Physician Contact Person: _____________________ Phone: ______________ COR: Sallie Gray Phone: 412-954-4034ImmunizationsREQUIRED PRIOR TO START DATEDATEOCCURRENCE/IMMUNIZATIONChickenpoxRequiredStrong verbal history of recollection of having Chickenpox is acceptable. If unsure or unknown, blood work to determine Varicella titer should be done. If not immune, 2 doses of Varicella vaccine are required. Document the following: Strong verbal history? Yes or NoIf no, unknown or unsure, date of Varicella titer and results:Vaccine dates if administered:Rubella/RUBEOLARequiredIF BORN ON OR AFTER 1/1/57 PHYSICIAN DOCUMENTATION OF DISEASE, DOCUMENTATION OF RECEIVING 2 DOSES OF VACCINE, OR BLOOD TITERS SHOWING IMMUNITY IS REQUIRED. If not immune, 2 doses of MMR vaccine are required. Document the following:Date of Rubella titer and resultsDATE of Rubeola titer and resultsVaccine dates if administeredTB ScreeningRequiredTB Screening is to be done by Mantoux method (PPD) no longer than one year prior to starting an assignment at VAPHS and yearly thereafter. If HE/SHE HAS A HISTORY OF A POSTIVE PPD, THE INDIVIDUAL SHOULD HAVE DOCUMENTATION OF AN EVALUATION RULING OUT ACTIVE TB FROM THE ALLEGHENY COUNTY HEALTH DEPARTMENT OR THEIR PRIMARY CARE PHYSICIAN. If there is a past history of positive results, a questionnaire should be completed. This can be obtained by calling VAPHS Employee Health at 412-688-6000, X-815556.Document The date of testing and results orAttach a copy of completed questionnaire.IMMUNIZATIONREQUIREDDATETetanus/DiphtheriaAdvisedImmunization within the last 10 years is recommended. This is advised and not a requirement. Document the date of last booster.Workers’ CompensationEach Contract Physician should have a work injury report process in place to be reviewed with the worker before beginning an assignment at VAPHS. Document in this table the date the worker signed the Worker’s Compensation Acknowledgment. Each company will notify and will update when any information changes occur. Your company will notify the VAPHS Safety Manager, Joanne Faas, at 412-688-6000, X-815703 when a worker from your company is injured on the premises.If a contract employee is injured while on duty, he should follow Contract Physician’s policy for injuries. If immediate treatment is needed, the VAPHS emergency room will provide humanitarian treatment. The individual will be referred to the Contract Physician’s worker compensation provider.REQUIRED FOR PARTICULAR DEPARTMENTSHepatitis B VaccineClinical Areas (Contract Physician must have documentation that vaccine was offered, however employee has the right to decline.)A minimum of the initial Hepatitis B injection has been administered, if required.If an assigned position puts the individual at risk for exposure to blood and body fluids, VAPHS will comply with OSHA’s Bloodborne Pathogens Standard regarding training and Hepatitis B Vaccine. If you have any questions on assignments putting individuals into this risk category, please contact Employee Health at 412-688-6000, X6035556.Signature of Contract Physician Contact ____________________________________Date_________Reviewed by VA Employee Health NurseApprove/Disapprove (circle one)Comments: ______________________________________________________________________________________________________________________________________________________________________Signature VA Employee Nurse: _________________________________________Date:____________ATTACHMENT #5CONTRACT PHYSICIAN CERTIFICATION: Immigration and Nationality Act of 1952, As AmendedThe Contract Physician must certify that the Contract Physician 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 Contract Physician while providing services to Department of Veterans Affairs patient referrals;Citizenship-related requirements. Each affected Contract Physician employee as described in paragraph shall be: A United States (U.S.) citizen; orA national of the United States (see 8 U.S.C. 1408); orAn alien lawfully admitted into the United States for permanent residence as evidenced by an Alien Registration Receipt Card Form I–151.While performing services for the Department of Veterans Affairs, the Contract Physician 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.If the Contract Physician 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 Contract Physician’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contract Physician 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.The Contract Physician must obtain a similar certification from its sub Contract Physicians.Signature:____________________________________________Date:____________________________________________Typed Name and Title: __________________________________________Company Name:___________________________________________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.ATTACHMENT #6QUALITY ASSURANCE SURVEILLANCE PLANContractor Description: Contractor shall provide Surgical Neurophysiologist and Neurodiagnostic Technologist to eligible beneficiaries of the Department of Veterans Affairs. All services are to be performed at the VA Pittsburgh Healthcare System facility. Contractor’s Name: TBDThe contractor will be evaluated in accordance with the following:1.PURPOSEThis Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:What will be monitored?How monitoring will take place.Who will conduct the monitoring?How monitoring efforts and results will be documented.This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor through contract modification. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.ernment Roles and ResponsibilitiesThe following personnel shall oversee and coordinate surveillance activities.a.Contracting Officer (CO) – The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.Assigned CO: Shawn SmithOrganization or Agency: Department of Veterans Affairs, Network Contracting Office (NCO) 4b.Contracting Officer’s Representative (COR) – The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.Assigned COR: Sallie D. Gray, COR, FAC-P/PMOrganization or Agency: VA Pittsburgh Healthcare System3.Contractor RepresentativesThe following employee(s) of the contractor serve as the contractor’s program manager(s) for this contract.Primary: ______________________Alternate: _____________________4.Performance StandardsThe contractor is responsible for performance of ALL terms and conditions of the contract. CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined. Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.The Performance Requirements are listed below in Section 6. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.5. Incentives/DEDUCTSThe Government shall use past performance as incentives. Incentives shall be based on ratings received on the performance standards. 6. Methods of QA Surveillance Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP. a. DIRECT OBSERVATION. This observation will need to be accomplished via the Chief of the Service Line as this requires clinical expertise regarding the patient safety measure.b. RANDOM SAMPLING. For example, ten (10) randomly selected patient files will be reviewed per quarter. All reviews and reports will be conducted in compliance with VA Privacy and Information security standards. PERFORMANCE MEASURES MeasuresPWSReferencePerformanceRequirementStandardAcceptable Quality LevelSurveillanceMethodIncentiveDisincentive/DeductQualifications of Key Personnel 2.7;4.5.4.1.All contract Surgical Neurophysiologist physician(s) and Neurodiagnostic Technologist shall have current board certified in accordance with PWS requirements.All (100%) contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist are board certified.100% No deviations accepted.Random Inspection of qualification documents Favorable contactor performance evaluation.Unfavorable contractor performance evaluation. Removal from contract until such time the contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist meet qualification standard. Scope of Practice/Privileging2.1;4.5.4.2.Contract Surgical Neurophysiologist physician(s) perform within their individual scopes of practice/privilegingAll (100%) contract Surgical Neurophysiologist physician (s) perform within their scope of practice/privileges 100% of the time.All (100%) contract Surgical Neurophysiologist physician (s) perform within their scope of practice/privileges 100% of the time. No deviations accepted.Random Inspection of records.Favorable contactor performance evaluation.Unfavorable contractor performance evaluation. Removal from contract until such time the contract Surgical Neurophysiologist physician (s) meet qualification standard.Patient Access 3.1; 3.2;4.5.4.3.Contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) shall be available and in location as needed to properly perform tasks as specified.All (100%) contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) are on time and available to perform services.Contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist are on-time and available to perform services 97% of the timePeriodic Sampling of Time and Attendance SheetsFavorable contactor performance evaluation.Unfavorable contractor performance evaluation.Patient Safety4.4.3.4.;4.5.4.4.Patient safety incidents shall to be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident.All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident. No acceptable deviation.Direct Observation – This observation will need to be accomplished via the Chief of Service Line as this requires clinical expertise regarding the patient safety measure. Favorable contactor performance evaluation.Unfavorable contractor performance evaluation.Licensing, registration, and certification2.1.5.;4.5.4.5.Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current.All (100%) licensing, registration(s) and certification(s) for contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) shall be provided as they are renewed. Licensing and registration information kept current.All (100%) licensing, registration(s) and certification(s) for contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist shall be provided as they are renewed. Licensing and registration information kept current. No acceptable deviation.Periodic Sampling and Random Sampling Favorable contactor performance evaluation.Unfavorable contractor performance evaluation, Suspension or termination of all physical and/or electronic access privileges and removal from contract until such time licensing, registration, and certification is current.Mandatory Training2.1.6.;4.5.4.6.Contractor shall complete all required training per VA Pittsburgh Healthcare System policyAll (100%) of required training is complete on time by contract Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist.100% completions, no deviations.Contractor to provide documented evidence.Favorable contactor performance evaluation.Unfavorable contractor performance, Suspension or termination of all physical and/or electronic access privileges and removal from contract until such time as the training is complete.Privacy, Confidentiality and HIPPA4.3.2.;4.5.4.7.Contractor shall comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPPA and complies with all standards Zero breaches of privacy or confidentialityAll (100%) contractor Surgical Neurophysiologist physician (s) and Neurodiagnostic Technologist (s) comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPPA100% compliance; no deviations.Contractor shall provide evidence of annual training required by VAMC, reports violations per VA Directive 6500.6.Favorable contactor performance evaluation.Unfavorable contractor performance evaluation. Immediate removal from contractThe table below is a sample that can be tailored – note that the table must identify where in the PWS the standards are found for monitoring performance. Check the MSO Customer Resource Center for approved mandatory QASPs.7.RatingsMetrics and methods are designed to determine rating for a given standard and acceptable quality level. The following ratings shall be used:Exceptional:Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.Note: To justify an Exceptional rating, you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT. However a singular event could be of such magnitude that it alone constitutes an Exceptional rating. Also there should have been NO significant weaknesses identified. VERY GOOD:Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.Note: To justify a Very Good rating, you should identify a significant event in each category and state how it was a benefit to the GOVERNMENT. Also there should have been NO significant weaknesses identified.Satisfactory:Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. Also there should have been NO significant weaknesses identified.MARGINAL:Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.Note: To justify Marginal performance, you should identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g. Management, Quality, Safety or Environmental Deficiency Report or letter).Unsatisfactory:Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.Note: To justify an Unsatisfactory rating, you should identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. However, a singular problem could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g. Management, Quality, Safety or Environmental Deficiency Reports, or letters).8. DOCUMENTING PERFORMANCEa.The Government shall document positive and/or negative performance. Any report may become a part of the supporting documentation for any contractual action and preparing annual past performance using CONTRACTOR PERFORMANCE ASSESSMENT REPORT (CPAR).b. If contractor performance does not meet the Acceptable Quality level, the CO shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the CO shall document the discussion and place it in the contract file. When the COR and the CO determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to CO. The CO will in turn review and will present to the contractor's program manager for corrective action.The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has to present this corrective action plan to the CO. The Government shall review the contractor's corrective action plan to determine acceptability. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance and the acceptability of the Contractor’s corrective action plan.Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO. See Sample CDR below.CONTRACT DISCREPANCY REPORT1. CONTRACT NUMBER2. Report Number for this Discrepancy3. TO: (Contracting Officer)4. FROM: (Name of COR)5. DATES a. CDR PREPAREDb. Returned by Contractor:c. Action Complete6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.) 7. SIGNATURE OF CORDate:8. SIGNATURE OF CONTRACTING OFFICERSHAWN E. SMITH, CODate:9a. TO (Contracting Officer)9a. FROM (Contractor)10. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable quality control program procedures or new procedures. Attach continuation sheet(s) if necessary.)11. SIGNATURE OF CONTRACTOR REPRESENTATIVEDate:12. GOVERNMENT EVALUATION. (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)13. GOVERNMENT ACTIONS (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)14. CLOSE OUTNAMETITLESIGNATUREDATEContractor notifiedCORContracting Officer9. Frequency of Measurementa.Frequency of Measurement. The frequency of measurement is defined in the contract or otherwise in this document. The government (COR or CO) will periodically analyze whether the frequency of surveillance is appropriate for the work being performed. b.Frequency of Performance Reporting. The COR shall communicate with the Contractor and will provide written reports to the Contracting Officer quarterly (or as outlined in the contract or COR delegation) to review Contractor performance. 10. COR AND CONTRACTOR ACKNOWLEDGEMENT OF QASPSIGNED:_______________________________________Sallie Gray, Management AnalystCOR NAME/TITLEDATESIGNED:________________________________________CONTRACTOR NAME/TITLEDATEATTACHMENT 7SAMPLE QUESTIONNAIRE COVER LETTERCORPORATE LETTERHEAD(Date)FOR OFFICIAL USE ONLYThe VA Pittsburgh Healthcare System (VAPHS) is in the process of selecting a contractor to provide Neurophysiology Services to the VAPHS. The solicitation requires the Contractor to furnish all personnel to provide services necessary to perform onsite Surgical Neurophysiologist Physician Services and Neurodiagnostic Technologist to eligible beneficiaries of the Department of Veterans Affairs Medical Center, University Drive, Pittsburgh, PA 15240.One of the considerations in the proposal evaluation is the verification of our past/present performance on contracts that are similar in size and scope to the VAPHS procurement. The VAPHS is depending on information received from agencies/businesses such as yours, which have had first- hand experience with our efforts.The areas of interest are summarized in the enclosed questionnaire. The VAPHS appreciates your response no later than **fill in due date**. This schedule will allow the evaluation team time to analyze the data.To assist you in preparing your response and expediting your reply, the questionnaire may be filled out and emailed to the Contracting Officer, Shawn Smith, at Shawn.Smith@. Your completed questionnaire will become a part of the official Source Selection records.Your help is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection._________________________Signature1 Attachment: QuestionnaireATTACHMENT 8PAST PERFORMANCE QUESTIONNAIRESOLICITATION NUMBER – VA244-15-R-0097NEUROPHYSIOLOGY SERVICESI. Please complete this questionnaire. For assistance with this form, please notify the contract specialist listed at the address below. If you need more space than provided, please attach additional pages. Please include only relevant information. Responses will be treated as source selection sensitive information. Please submit this information on or before the proposal due date. Return the completed questionnaire either by email, mail, or fax to the following address:VA Pittsburgh Healthcare System1010 Delafield RoadE-mail: Shawn.Smith@Telephone: (412)822-3785II. Explanation of codes:CODEPERFORMANCE LEVELOOUTSTANDING– Performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.EEXCELLENT – Performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.AACCEPTABLE – Performance meets contractual requirements. The contractual performance of the element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.MMARGINAL – Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.UUNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.NNOT APPLICABLE – Unable to provide a score. Performance in this area not applicable to the effort assessed.Please complete the following identifying information and past performance assessment:III. CONTRACTOR IDENTIFICATION: Contractor:Contract Number:Period of Performance:Negotiated price or cost at award:Current estimated contract dollar amount:Describe product/service acquired:IV. EVALUATOR INFORMATION: Name:Organization:Phone Number:Relation to Program:(i.e., Contracting Officer, Program Manager, Contract Specialist/Administrator, Contracting Officer's Technical Representative, etc.)Time On Contract:ASSESSMENT ELEMENTS: Place an “X” in the appropriate box next to the letter for each item on the questionnaire. Narrative statements are vital. Please provide a supporting narrative for each area. Attach additional pages if there is insufficient space in the comment space.A. QUAlity of Product/Service (e.g., Does the contractor provide qualified personnel, necessary equipment, and quality control for performance of your contract?) O FORMCHECKBOX E FORMCHECKBOX A FORMCHECKBOX M FORMCHECKBOX U FORMCHECKBOX N FORMCHECKBOX __________________________________________________________________________________________________________________________________________________________________________________________________________________1. Did the personnel provided meet or exceed your requirement?Yes FORMCHECKBOX No FORMCHECKBOX 2. Were any of the contract personnel released and/or replaced due to qualifications, performance, or behavior?Yes FORMCHECKBOX No FORMCHECKBOX 3. Were all positions required by the contract filled by the date required?Yes FORMCHECKBOX No FORMCHECKBOX B. Schedule (i.e., Is the work performed in a timely manner and in accordance with the requirement?)O FORMCHECKBOX E FORMCHECKBOX A FORMCHECKBOX M FORMCHECKBOX U FORMCHECKBOX N FORMCHECKBOX __________________________________________________________________________________________________________________________________________________________________________________________________________________1. Did personnel arrive for duty on time, remain on duty as required, and report off appropriately before leaving duty?Yes FORMCHECKBOX No FORMCHECKBOX 2. Did personnel submit accurate and timely records of their time worked?Yes FORMCHECKBOX No FORMCHECKBOX 3. Were leave issues, and vacation handled appropriately and did contractor provide for absences as required?Yes FORMCHECKBOX No FORMCHECKBOX C.Business Relations (e.g., Are contractor personnel promoting a strong working relationship with the Government? Does the contractor adequately address and make efforts to resolve issues/problems concerning site employees? Does the contractor show initiative? Were contractor personnel courteous and responsive? Does the contractor interface effectively with your staff, etc.?) O FORMCHECKBOX E FORMCHECKBOX A FORMCHECKBOX M FORMCHECKBOX U FORMCHECKBOX N FORMCHECKBOX __________________________________________________________________________________________________________________________________________________________________________________________________________________1. Were accurate and clear invoices submitted in a timely fashion?Yes FORMCHECKBOX No FORMCHECKBOX 2. Did personnel resolve work-related problems in a satisfactory manner?Yes FORMCHECKBOX No FORMCHECKBOX 3. Were contract personnel proactive in their approach to problem identification and prevention?Yes FORMCHECKBOX No FORMCHECKBOX D. Did the contractor adhere to their technical and management approach?Yes FORMCHECKBOX No FORMCHECKBOX If no, explain what was different.__________________________________________________________________________________________________________________________________________________________________________________________________________________E. Please comment on any other contractor information you consider relevant to this evaluation.__________________________________________________________________________________________________________________________________________________________________________________________________________________F. Identify the contractor’s overall strengths and weaknesses. __________________________________________________________________________________________________________________________________________________________________________________________________________________G. Given the choice, would you award to this contractor again? Yes FORMCHECKBOX No FORMCHECKBOX SECTION E - SOLICITATION PROVISIONSE.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (APR 2014) (a) North American Industry Classification System (NAICS) code and small business size standard. The NAICS code and small business size standard for this acquisition appear in Block 10 of the solicitation cover sheet (SF 1449). However, the small business size standard for a concern which submits an offer in its own name, but which proposes to furnish an item which it did not itself manufacture, is 500 employees. (b) Submission of offers. Submit signed and dated offers to the office specified in this solicitation at or before the exact time specified in this solicitation. Offers may be submitted on the SF 1449, letterhead stationery, or as otherwise specified in the solicitation. As a minimum, offers must show— (1) The solicitation number; (2) The time specified in the solicitation for receipt of offers; (3) The name, address, and telephone number of the offeror; (4) A technical description of the items being offered in sufficient detail to evaluate compliance with the requirements in the solicitation. This may include product literature, or other documents, if necessary; (5) Terms of any express warranty; (6) Price and any discount terms; (7) "Remit to" address, if different than mailing address; (8) A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically); (9) Acknowledgment of Solicitation Amendments; (10) Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information); and (11) If the offer is not submitted on the SF 1449, include a statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offers that fail to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration. (c) Period for acceptance of offers. The offeror agrees to hold the prices in its offer firm for 30 calendar days from the date specified for receipt of offers, unless another time period is specified in an addendum to the solicitation. (d) Product samples. When required by the solicitation, product samples shall be submitted at or prior to the time specified for receipt of offers. Unless otherwise specified in this solicitation, these samples shall be submitted at no expense to the Government, and returned at the sender's request and expense, unless they are destroyed during preaward testing. (e) Multiple offers. Offerors are encouraged to submit multiple offers presenting alternative terms and conditions or commercial items for satisfying the requirements of this solicitation. Each offer submitted will be evaluated separately. (f) Late submissions, modifications, revisions, and withdrawals of offers. (1) Offerors are responsible for submitting offers, and any modifications, revisions, or withdrawals, so as to reach the Government office designated in the solicitation by the time specified in the solicitation. If no time is specified in the solicitation, the time for receipt is 4:30 p.m., local time, for the designated Government office on the date that offers or revisions are due. (2)(i) Any offer, modification, revision, or withdrawal of an offer received at the Government office designated in the solicitation after the exact time specified for receipt of offers is "late" and will not be considered unless it is received before award is made, the Contracting Officer determines that accepting the late offer would not unduly delay the acquisition; and— (A) If it was transmitted through an electronic commerce method authorized by the solicitation, it was received at the initial point of entry to the Government infrastructure not later than 5:00 p.m. one working day prior to the date specified for receipt of offers; or (B) There is acceptable evidence to establish that it was received at the Government installation designated for receipt of offers and was under the Government's control prior to the time set for receipt of offers; or (C) If this solicitation is a request for proposals, it was the only proposal received. (ii) However, a late modification of an otherwise successful offer, that makes its terms more favorable to the Government, will be considered at any time it is received and may be accepted. (3) Acceptable evidence to establish the time of receipt at the Government installation includes the time/date stamp of that installation on the offer wrapper, other documentary evidence of receipt maintained by the installation, or oral testimony or statements of Government personnel. (4) If an emergency or unanticipated event interrupts normal Government processes so that offers cannot be received at the Government office designated for receipt of offers by the exact time specified in the solicitation, and urgent Government requirements preclude amendment of the solicitation or other notice of an extension of the closing date, the time specified for receipt of offers will be deemed to be extended to the same time of day specified in the solicitation on the first work day on which normal Government processes resume. (5) Offers may be withdrawn by written notice received at any time before the exact time set for receipt of offers. Oral offers in response to oral solicitations may be withdrawn orally. If the solicitation authorizes facsimile offers, offers may be withdrawn via facsimile received at any time before the exact time set for receipt of offers, subject to the conditions specified in the solicitation concerning facsimile offers. An offer may be withdrawn in person by an offeror or its authorized representative if, before the exact time set for receipt of offers, the identity of the person requesting withdrawal is established and the person signs a receipt for the offer. (g) Contract award (not applicable to Invitation for Bids). The Government intends to evaluate offers and award a contract without discussions with offerors. Therefore, the offeror's initial offer should contain the offeror's best terms from a price and technical standpoint. However, the Government reserves the right to conduct discussions if later determined by the Contracting Officer to be necessary. The Government may reject any or all offers if such action is in the public interest; accept other than the lowest offer; and waive informalities and minor irregularities in offers received. (h) Multiple awards. The Government may accept any item or group of items of an offer, unless the offeror qualifies the offer by specific limitations. Unless otherwise provided in the Schedule, offers may not be submitted for quantities less than those specified. The Government reserves the right to make an award on any item for a quantity less than the quantity offered, at the unit prices offered, unless the offeror specifies otherwise in the offer. (i) Availability of requirements documents cited in the solicitation. (1)(i) The GSA Index of Federal Specifications, Standards and Commercial Item Descriptions, FPMR Part 101-29, and copies of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained for a fee by submitting a request to—GSA Federal Supply Service Specifications Section Suite 8100 470 East L'Enfant Plaza, SWWashington, DC 20407Telephone (202) 619-8925 Facsimile (202) 619-8978. (ii) If the General Services Administration, Department of Agriculture, or Department of Veterans Affairs issued this solicitation, a single copy of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained free of charge by submitting a request to the addressee in paragraph (i)(1)(i) of this provision. Additional copies will be issued for a fee. (2) Most unclassified Defense specifications and standards may be downloaded from the following ASSIST websites: (i) ASSIST (); (ii) Quick Search (); (iii) (). (3) Documents not available from ASSIST may be ordered from the Department of Defense Single Stock Point (DoDSSP) by? (i) Using the ASSIST Shopping Wizard (); (ii) Phoning the DoDSSP Customer Service Desk (215) 697-2179, Mon-Fri, 0730 to 1600 EST; or (iii) Ordering from DoDSSP, Building 4, Section D, 700 Robbins Avenue, Philadelphia, PA 19111-5094, Telephone (215) 697-2667/2179, Facsimile (215) 697-1462. (4) Nongovernment (voluntary) standards must be obtained from the organization responsible for their preparation, publication, or maintenance. (j) Data Universal Numbering System (DUNS) Number. (Applies to all offers exceeding $3,000, and offers of $3,000 or less if the solicitation requires the Contractor to be registered in the System for Award Management (SAM) database. The offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation "DUNS" or "DUNS +4" followed by the DUNS or DUNS +4 number that identifies the offeror's name and address. The DUNS +4 is the DUNS number plus a 4-character suffix that may be assigned at the discretion of the offeror to establish additional SAM records for identifying alternative Electronic Funds Transfer (EFT) accounts (see FAR Subpart 32.11) for the same concern. If the offeror does not have a DUNS number, it should contact Dun and Bradstreet directly to obtain one. An offeror within the United States may contact Dun and Bradstreet by calling 1-866-705-5711 or via the internet at . An offeror located outside the United States must contact the local Dun and Bradstreet office for a DUNS number. The offeror should indicate that it is an offeror for a Government contract when contacting the local Dun and Bradstreet office. (k) System for Award Management. Unless exempted by an addendum to this solicitation, by submission of an offer, the offeror acknowledges the requirement that a prospective awardee shall be registered in the SAM database prior to award, during performance and through final payment of any contract resulting from this solicitation. If the Offeror does not become registered in the SAM database in the time prescribed by the Contracting Officer, the Contracting Officer will proceed to award to the next otherwise successful registered Offeror. Offerors may obtain information on registration and annual confirmation requirements via the SAM database accessed through . (l) Debriefing. If a post-award debriefing is given to requesting offerors, the Government shall disclose the following information, if applicable: (1) The agency's evaluation of the significant weak or deficient factors in the debriefed offeror's offer. (2) The overall evaluated cost or price and technical rating of the successful and the debriefed offeror and past performance information on the debriefed offeror. (3) The overall ranking of all offerors, when any ranking was developed by the agency during source selection. (4) A summary of the rationale for award; (5) For acquisitions of commercial items, the make and model of the item to be delivered by the successful offeror. (6) Reasonable responses to relevant questions posed by the debriefed offeror as to whether source-selection procedures set forth in the solicitation, applicable regulations, and other applicable authorities were followed by the agency.INSTRUCTIONS TO OFFEROR FOR PREPARING AND SUBMITTING A PROPOSALThe VA will evaluate offers in accordance with the clause FAR 52.212-2 Evaluation – Commercial Items. In addition to completing the required forms for submission of an offer in response to this RFP (See Required Forms for Submission of Offer below), Offeror must demonstrate its capabilities with regard to the evaluation factors specified within the clause. In its submission Offeror should address each factor in the order listed, and clearly identify which factor is being addressed. The evaluation factors for award are as follows: a. FACTOR 1 – TECHNICAL CAPABILITY This factor will be used to determine each offeror’s ability to provide qualified staff and management capability that possess the expertise described in this solicitation. (Sub-factors (A), (B), and (C), are listed in descending order of importance. Offerors will be evaluated on the quality of their described technical capability to provide Neurophysiology Services to the VAPHS in accordance with the requirements of the Solicitation as demonstrated by their responses to Sub-factors 1A -1C below. Proposals will be evaluated on their completeness (the extent to which requirements have been considered, defined, and satisfied), understanding of requirements (the extent to which the proposal demonstrates a clear understanding of the Solicitation requirements and any problems involved in meeting or exceeding the standards for various tasks necessary to support the VAPHS and the extent to which uncertainties are identified and resolutions proposed), and proposal risk (the extent to which Offeror’s proposed approach represents a risk of successful Contract performance.) Offeror must outline in narrative fashion its Technical Capabilities approach to satisfying the VA’s requirements for performing the services listed in the Schedule of Services. Describe in detail the procedure(s) for performing services, the equipment to be used, the type of personnel involved and their physical location(s), methods of communication, whether or not feedback will be provided “real time” during the procedure(s). Describe procedures in place for quality control and methods for handling problems which may occur. Describe method for storing and maintaining data electronically for system reliability and HIPAA compliance. Describe capability and plan with regard to meeting VA performance requirements for both scheduled cases and emergencies. Generally, Offeror’s narrative should define and explain its complete process such that the Government evaluators can objectively determine the offeror’s capability to effectively meet or exceed VAPHS requirements as outlined.Sub-factor 1A – Contract Staffing The Offeror shall provide adequate information to demonstrate the ability to perform and manage the work to ensure quality performance. Sufficient evidence will include, at a minimum:The Offeror will describe in narrative format its plan for completing all Neurophysiological Services identified in the Performance Work Statement of the Request for Proposal. If the Offeror’s proposal to adjust workload as necessary to accommodate a fluctuating schedule includes a subcontracting plan, this will need to be addressed in the narrative format. Contracting Staffing/ Key PersonnelThe Offeror shall submit a list that clearly identifies by title each key employee involved in the performance of the contract and the responsibilities held by each. Provide a resume (limited to two pages) of the person(s) currently holding each of the listed “key personnel” positions. Resumes shall identify educational background, experience, training certifications, licenses, etc. (2) Sub-factor 1B – ExperienceThe Offeror shall describe the length and type of experience the Offeror possesses in providing Neurophysiology Services to veterans or civilian patients. This can be services provided under other than formal contract arrangements to clients not affiliated with the Offeror. This factor will be used to determine the offeror’s ability to provide qualified staff that possesses the credentials and experience described in the solicitation (reference “Qualifications and Performance of Services”). The curriculum vitae (CV) of each individual proposed for contract work should be furnished so that qualifications and experience can be determined. Provide the CV of the physician who provides oversight to the group, whether or not this person is expected to be on site at the VAPHS on a regular basis. Evaluation preference will be given to Offerors who are able to demonstrate clinical experience in a setting that offers surgical programs similar to those offered at VAPHS.(3) Sub-factor 1C - ManagementThis factor refers to the merit of the Offeror’s plan for managing and contract administration. It may be pertinent to evaluate the degree to which the Offeror’s management plan has established well-defined lines of authority, responsibility and communication. The Offeror will describe in narrative format its plan for successfully fulfilling the requirements of the Performance Work Statement. Offeror shall provide adequate information to demonstrate the ability to perform and manage the work to ensure quality performance. The Offeror shall define and describe the processes, tools, and approaches to be utilized in the management of providing Neurophysiologist Services. This should include:The program management philosophies, tools, techniques, etc., that will be used for planning, controlling (to include cost), reporting and directing the accomplishment of the Neurophysiological Service requirements. Discuss the tools that will provide timely information, risk management with mitigation actions to provide uninterrupted support, and quality assurance. The approach for identifying, measuring and documenting performance must be included.The methodology that will be utilized for recruiting, retaining, and replacing employees with appropriate qualifications/skill sets (labor skill set) throughout the life of the contract. Explain how uninterrupted support will be provided during emergencies.The proposal will be evaluated based upon the extent to which the proposed management approach is capable of satisfying requirements and is realistically achievable. b.FACTOR 2 – PAST PERFORMANCE. (1) Offeror should submit past performance information on up to five (5) previous or on-going contracts for Intraoperative Monitoring Services (including Federal, State, local government, and private) for Neurophysiology Services as called for in this Solicitation that are of similar size and scope. Past performance information shall be submitted utilizing the Past/Present Performance Information Sheet (Attachment #8 in solicitation)--one sheet must be submitted for each previous contract and should include: Type of services provided:Name and address of contracting activity:Name and phone number or email address of Contracting Officer:Name and phone number or email address of Clinical Program Manager:Dates of Performance:Total Contract Value:The Offeror shall ensure that references complete the Past/Present Performance Questionnaires (Attachment # 8) in solicitation and return them directly by email to Shawn.Smith@. These must be received no later than the proposed due date and time listed in block 8 of the SF 1449.The Government is most interested in information that demonstrates quality of performance relative to the requirements of this solicitation. The VAPHS will only consider relevant work performed within the past five (5) years. Past performance information is required on the prime Contractor, as well as any subcontractors, teaming partners, or joint ventures that will be performing at least 20% of the proposed work. Offerors may also provide information on problems encountered on these identified contracts and the Offeror’s corrective actions. In addition, provide evidence of any past adverse actions by state, local or federal regulatory agencies (such as citations, notice of violations, etc.). (2) Failure to provide any information may result in the Offeror being removed from consideration for award. (NOTE: An Offeror with no past/present performance experience should still submit the Past/Present Performance document with an explanation that it has no recent or relevant experience). Past performance information regarding predecessor companies, key personnel who have relevant experience, or subcontractors that perform major or critical aspects of the requirement may be used, as appropriate, as part or all of the past performance evaluation. In the case of an Offeror without a record of relevant past performance or for whom information on past performance is not available, the Offeror may be evaluated as neutral for past performance. The VAPHS will evaluate the Offeror’s demonstrated record of contract compliance in supplying Neurophysiology Services that meet user’s needs in regards to Quality of Services, Business Relations, and Customer Satisfaction as identified in the Past/Present Performance Questionnaire (Attachment # 8). VAPHS may contact the references listed on the Questionnaire and interview them. In evaluating the Offeror’s past/present performance record, information may also be obtained through the Past Performance Information Retrieval System (PPIRS) or other Government databases and other sources known to the VAPHS, including commercial sources. The Government’s assessment will focus on contracts that meet the following conditions:Recency – Only contracts that were performed or awarded within the last five (5) calendar years will be considered.Relevancy – Only contracts which were/are relevant in size and scope to the current requirement will be considered.The objective of past performance information is to determine the Offeror’s Quality of service, compliance with contract requirements, timely performance, accuracy, technical excellence, customer satisfaction, business relations, effective management, cooperative approach, and effective problem-solving.Relevancy – Only contracts which were/are relevant in size and scope to the current requirement will be considered.(3) Offerors are responsible for providing Past/Present Performance Questionnaires to each of the companies they have previously had contracts with who are listed on the Past/Present Performance Information Sheets. (4) The VAPHS will evaluate Past Performance based on the extent the Contractor demonstrates recent and relevant performance for same or similar work from current and previous customers. The Contracting Officer will also assess the relative risks associated with the Offeror’s likelihood of success in performing the solicitation’s requirements, as indicated by that Offeror’s record of Past Performance. When assessing performance risk, the Contracting Officer will focus its inquiries on the Offeror’s record of performance as it relates to the performance of solicitation requirements. The VAPHS will conduct a performance risk assessment based on the quality, relevancy and recentness of the Offeror’s past performance, as well as that of its major or critical subcontractors, as it relates to the probability of successful accomplishment of the required effort. c. FACTOR 3 – PRICE Price Proposal: Price proposal indicates the Offeror’s total price to the VAPHS, if selected. The proposed prices shall be inclusive of all requirements in this Solicitation and shall contain the Offeror’s best terms from a price standpoint. The Contracting Officer will make a determination as to whether pricing is fair and reasonable. Contractor shall complete pricing for each Contract Line Item Number (CLIN) on the Price/Cost Schedule page and a total price of all CLIN’s. PROPOSAL SUBMISSIONIn order that each Offeror’s proposal can be properly evaluated, it is necessary that each Offeror respond to all items in the same order as presented in the Offeror Proposal Outline below. Offerors shall submit proposals organized with sections appropriately identified as stated below. The technical proposal will primarily determine the qualifications and capability of the Offeror to furnish the services as stated in this Solicitation. It should be specific and complete in every detail. The proposal should be concise and provide sufficient information to demonstrate the Offeror’s capacity to satisfactorily fulfill the VAPHS requirement; therefore, Offerors should assure that their ability to meet or exceed these requirements is adequately represented in their proposals. Failure to meet any one of these requirements or an incomplete proposal may result in rejection of the proposal. The VA will not pay any costs incurred for the preparation and submission of proposals. Price proposal will be a separate proposal from the technical proposal.Note: Offerors are advised that they are not restricted in what is presented in their proposals as long as sufficient materials are provided to allow evaluation of proposals based on evaluation factors as defined below in Evaluation Factors for Award. Preparation – Offeror Proposal Outline: Each section shall be specifically labeled and Identifiably separate from other sections of the proposal:Section 1 – Cover LetterSection 1 shall be a maximum two-page cover letter and introduction and shall include the name and address of the organization submitting the proposal, together with the name, address, and telephone number of the contact person who has the actual power to make an offer/negotiate and make representations relative to the proposal and any resultant contact for the organization.Section 2 – Table of ContentsSection 2 shall be a detailed Table of Contents and shall include an outline of the proposal, identified by a sequential page number and by section reference and section title.Section 3 – Technical ProposalSection 3 shall be the Offeror’s response to the Technical Evaluation Factor 1, addressing all Sub-factors in the order identified. Offeror’s proposal should represent an understanding of the sub-factors and the associated criteria and demonstrate the excellence of the work offered and the ability of the Offeror to actually accomplish what is offered. Section 4 – Past Performance Section 4 should consist of a completed Past/Present Performance Information Sheet (Attachment #8 in solicitation) up to five (5) past or ongoing contracts. Services must have been performed under the identified contracts within the past five (5) years from date of Offeror’s proposal. Offeror’s references shall complete the Past/Present Performance Questionnaires (Attachment in solicitation) and return them directly to Shawn.Smith@ by the proposal due date and time (Standard Form 1449; block 8). A sample cover letter (Attachment #7) is provided to assist Offerors with sending out the Past/Present Performance Questionnaires.Section 5 – PriceSection 6, Price Proposal, shall contain: 1) the signed SF 1449, Solicitation/Contract/Order for Commercial Items, on which the Offeror has completed blocks 12, 17a, 17b, 30a, 30b, and 30c; 2) completed Contractor information on Pages 5 of 155, and 7-8 of 145 in Section B.1, Contract Administration Data; 3) acknowledgement of any amendments on Page 6 of 155 and DUNS number on Page 9 of 145 in Section B.1; 4) completed Section B.6, Schedule of Supplies or Services and Prices/Costs, on Pages 43-48 of 145; 5) completed paragraph (b) of FAR 52.212-3, Offeror Representations and Certifications of Commerical Items on must be completed in the System for Award Management (SAM) All prospective awardees must be registered in the SAM database prior to award, during the performance of the contract, and through final payment of any contract which results from this solicitation in order to be considered for award of this contract. If the Offeror is not registered in the SAM database in the time prescribed by the Contracting Officer, the Contracting Officer will then advance to award to the next otherwise successful registered Offeror. Offerors may acquire information on registration and annual confirmation requirements via the SAM database accessed through 6) completed pararagraph (b) of FAR 52.209-7, Information Regarding Responsibility Matters (FEB 2012).E.2 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL ITEMS (MAR 2015) The offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically via . If an offeror has not completed the annual representations and certifications electronically at the System for Award Management (SAM) website, the offeror shall complete only paragraphs (c) through (p) of this provision. (a) Definitions. As used in this provision— “Economically disadvantaged women-owned small business (EDWOSB) concern” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program. “Forced or indentured child labor” means all work or service— (1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or (2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties. “Highest-level owner” means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner. “Immediate owner” means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: Ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees. “Inverted domestic corporation” means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c). “Manufactured end product” means any end product in product and service codes (PSCs) 1000-9999, except— (1) PSC 5510, Lumber and Related Basic Wood Materials; (2) Product or Service Group (PSG) 87, Agricultural Supplies; (3) PSG 88, Live Animals; (4) PSG 89, Subsistence; (5) PSC 9410, Crude Grades of Plant Materials; (6) PSC 9430, Miscellaneous Crude Animal Products, Inedible; (7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products; (8) PSC 9610, Ores; (9) PSC 9620, Minerals, Natural and Synthetic; and (10) PSC 9630, Additive Metal Materials. “Place of manufacture” means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture. “Restricted business operations” means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate— (1) Are conducted under contract directly and exclusively with the regional government of southern Sudan; (2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization; (3) Consist of providing goods or services to marginalized populations of Sudan; (4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization; (5) Consist of providing goods or services that are used only to promote health or education; or (6) Have been voluntarily suspended. “Sensitive technology”— (1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically— (i) To restrict the free flow of unbiased information in Iran; or (ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and (2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)). “Service-disabled veteran-owned small business concern”— (1) Means a small business concern— (i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and (ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran. (2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16). “Small business concern” means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation. “Small disadvantaged business concern”, consistent with 13 CFR 124.1002, means a small business concern under the size standard applicable to the acquisition, that— (1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by— (i) One or more socially disadvantaged (as defined at 13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and (ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and (2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition. “Subsidiary” means an entity in which more than 50 percent of the entity is owned— (1) Directly by a parent corporation; or (2) Through another subsidiary of a parent corporation. “Veteran-owned small business concern” means a small business concern— (1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and (2) The management and daily business operations of which are controlled by one or more veterans. “Women-owned business concern” means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women. “Women-owned small business concern” means a small business concern— (1) That is at least 51 percent owned by one or more women; or, in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and (2) Whose management and daily business operations are controlled by one or more women. “Women-owned small business (WOSB) concern eligible under the WOSB Program” (in accordance with 13 CFR part 127), means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States. (b)(1) Annual Representations and Certifications. Any changes provided by the offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications posted on the SAM website. (2) The offeror has completed the annual representations and certifications electronically via the SAM website access through . After reviewing the SAM database information, the offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications—Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs N/A. (c) Offerors must complete the following representations when the resulting contract will be performed in the United States or its outlying areas. Check all that apply. (1) Small business concern. The offeror represents as part of its offer that it [ ] is, [ ] is not a small business concern. (2) Veteran-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents as part of its offer that it [ ] is, [ ] is not a veteran-owned small business concern. (3) Service-disabled veteran-owned small business concern. [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.] The offeror represents as part of its offer that it [ ] is, [ ] is not a service-disabled veteran-owned small business concern. (4) Small disadvantaged business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it [ ] is, [ ] is not a small disadvantaged business concern as defined in 13 CFR 124.1002. (5) Women-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it [ ] is, [ ] is not a women-owned small business concern. (6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that— (i) It [ ] is, [ ] is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and (ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: ___________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation. (7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that— (i) It [ ] is, [ ] is not an EDWOSB concern, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and (ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: ___________.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.Note: Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold. (8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it [ ] is a women-owned business concern. (9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price: ___________________________________________ (10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that— (i) It [ ] is, [ ] is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material change in ownership and control, principal office, or HUBZone employee percentage has occurred since it was certified by the Small Business Administration in accordance with 13 CFR Part 126; and (ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for the HUBZone small business concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the HUBZone small business concern or concerns that are participating in the joint venture:____________.] Each HUBZone small business concern participating in the joint venture shall submit a separate signed copy of the HUBZone representation. (d) Representations required to implement provisions of Executive Order 11246— (1) Previous contracts and compliance. The offeror represents that— (i) It [ ] has, [ ] has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and (ii) It [ ] has, [ ] has not filed all required compliance reports. (2) Affirmative Action Compliance. The offeror represents that— (i) It [ ] has developed and has on file, [ ] has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts 60-1 and 60-2), or (ii) It [ ] has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor. (e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made. (f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American—Supplies, is included in this solicitation.) (1) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” The terms “commercially available off-the-shelf (COTS) item,” “component,” “domestic end product,” “end product,” “foreign end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American—Supplies.” (2) Foreign End Products: Line Item No Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (3) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. (g)(1) Buy American—Free Trade Agreements—Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American—Free Trade Agreements—Israeli Trade Act, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms “Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product,” “commercially available off-the-shelf (COTS) item,” “component,” “domestic end product,” “end product,” “foreign end product,” “Free Trade Agreement country,” “Free Trade Agreement country end product,” “Israeli end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act.” (ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”: Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act.” The offeror shall list as other foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” Other Foreign End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (iv) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. (2) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”: Canadian End Products: Line Item No. __________________________________________ __________________________________________ __________________________________________[List as necessary] (3) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate II. If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”: Canadian or Israeli End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (4) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”: Free Trade Agreement Country End Products (Other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product, as defined in the clause of this solicitation entitled “Trade Agreements”. (ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products. Other End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American statute. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation. (h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals— (1) [ ] Are, [ ] are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency; (2) [ ] Have, [ ] have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property; (3) [ ] Are, [ ] are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and (4) [ ] Have, [ ] have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied. (i) Taxes are considered delinquent if both of the following criteria apply: (A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted. (B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded. (ii) Examples. (A) The taxpayer has received a statutory notice of deficiency, under I.R.C. Sec. 6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights. (B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. Sec. 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights. (C) The taxpayer has entered into an installment agreement pursuant to I.R.C. Sec. 6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment. (D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. 362 (the Bankruptcy Code). (i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). (1) Listed end products.Listed End ProductListed Countries of Origin (2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.] [ ] (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. [ ] (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor. (j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly— (1) __ In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or (2) __ Outside the United States. (k) Certificates regarding exemptions from the application of the Service Contract Labor Standards. (Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) [ ] (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1). The offeror [ ] does [ ] does not certify that— (i) The items of equipment to be serviced under this contract are used regularly for other than Governmental purposes and are sold or traded by the offeror (or subcontractor in the case of an exempt subcontract) in substantial quantities to the general public in the course of normal business operations; (ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR 22.1003- 4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and (iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees servicing the same equipment of commercial customers. [ ] (2) Certain services as described in FAR 22.1003- 4(d)(1). The offeror [ ] does [ ] does not certify that— (i) The services under the contract are offered and sold regularly to non-Governmental customers, and are provided by the offeror (or subcontractor in the case of an exempt subcontract) to the general public in substantial quantities in the course of normal business operations; (ii) The contract services will be furnished at prices that are, or are based on, established catalog or market prices (see FAR 22.1003-4(d)(2)(iii)); (iii) Each service employee who will perform the services under the contract will spend only a small portion of his or her time (a monthly average of less than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the contract period if the contract period is less than a month) servicing the Government contract; and (iv) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract is the same as that used for these employees and equivalent employees servicing commercial customers. (3) If paragraph (k)(1) or (k)(2) of this clause applies— (i) If the offeror does not certify to the conditions in paragraph (k)(1) or (k)(2) and the Contracting Officer did not attach a Service Contract Labor Standards wage determination to the solicitation, the offeror shall notify the Contracting Officer as soon as possible; and (ii) The Contracting Officer may not make an award to the offeror if the offeror fails to execute the certification in paragraph (k)(1) or (k)(2) of this clause or to contact the Contracting Officer as required in paragraph (k)(3)(i) of this clause. (l) Taxpayer Identification Number (TIN) (26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if the offeror is required to provide this information to the SAM database to be eligible for award.) (1) All offerors must submit the information required in paragraphs (l)(3) through (l)(5) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the Internal Revenue Service (IRS). (2) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror's relationship with the Government (31 U.S.C. 7701(c)(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror's TIN. (3) Taxpayer Identification Number (TIN). [ ] TIN: _____________________. [ ] TIN has been applied for. [ ] TIN is not required because: [ ] Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States; [ ] Offeror is an agency or instrumentality of a foreign government; [ ] Offeror is an agency or instrumentality of the Federal Government. (4) Type of organization. [ ] Sole proprietorship; [ ] Partnership; [ ] Corporate entity (not tax-exempt); [ ] Corporate entity (tax-exempt); [ ] Government entity (Federal, State, or local); [ ] Foreign government; [ ] International organization per 26 CFR 1.6049-4; [ ] Other _________________________. (5) Common parent. [ ] Offeror is not owned or controlled by a common parent; [ ] Name and TIN of common parent: Name _____________________. TIN _____________________. (m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that the offeror does not conduct any restricted business operations in Sudan. (n) Prohibition on Contracting with Inverted Domestic Corporations. (1) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.108-2(b) applies or the requirement is waived in accordance with the procedures at 9.108-4. (2) Representation. By submission of its offer, the offeror represents that— (i) It is not an inverted domestic corporation; and (ii) It is not a subsidiary of an inverted domestic corporation. (o) Prohibition on contracting with entities engaging in certain activities or transactions relating to Iran. (1) The offeror shall email questions concerning sensitive technology to the Department of State at CISADA106@. (2) Representation and certifications. Unless a waiver is granted or an exception applies as provided in paragraph (o)(3) of this provision, by submission of its offer, the offeror— (i) Represents, to the best of its knowledge and belief, that the offeror does not export any sensitive technology to the government of Iran or any entities or individuals owned or controlled by, or acting on behalf or at the direction of, the government of Iran; (ii) Certifies that the offeror, or any person owned or controlled by the offeror, does not engage in any activities for which sanctions may be imposed under section 5 of the Iran Sanctions Act; and (iii) Certifies that the offeror, and any person owned or controlled by the offeror, does not knowingly engage in any transaction that exceeds $3,000 with Iran’s Revolutionary Guard Corps or any of its officials, agents, or affiliates, the property and interests in property of which are blocked pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701 et seq.) (see OFAC’s Specially Designated Nationals and Blocked Persons List at ). (3) The representation and certification requirements of paragraph (o)(2) of this provision do not apply if— (i) This solicitation includes a trade agreements certification (e.g., 52.212–3(g) or a comparable agency provision); and (ii) The offeror has certified that all the offered products to be supplied are designated country end products. (p) Ownership or Control of Offeror. (Applies in all solicitations when there is a requirement to be registered in SAM or a requirement to have a DUNS Number in the solicitation.) (1) The Offeror represents that it [ ] has or [ ] does not have an immediate owner. If the Offeror has more than one immediate owner (such as a joint venture), then the Offeror shall respond to paragraph (2) and if applicable, paragraph (3) of this provision for each participant in the joint venture. (2) If the Offeror indicates “has” in paragraph (p)(1) of this provision, enter the following information:Immediate owner CAGE code:________________________________________________________________Immediate owner legal name:________________________________________________________________(Do not use a “doing business as” name) Is the immediate owner owned or controlled by another entity: [ ] Yes or [ ] No. (3) If the Offeror indicates “yes” in paragraph (p)(2) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information:Highest-level owner CAGE code:________________________________________________________________Highest-level owner legal name:________________________________________________________________(Do not use a “doing business as” name)(End of Provision)E.3 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003) (a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer, conforming to the solicitation, will be most advantageous to the Government, price and other factors considered. The following information or factors shall be used to evaluate offers:FACTOR 1 –TECHNICAL CAPABILITY AND APPROACH SUBFACTOR 1A – CONTRACT STAFFINGSUBFACTOR 1B -- EXPERIENCESUBFACTOR 1C -- MANAGEMENTFACTOR 2 – PAST PERFORMANCE FACTOR 3 - PRICE (b) Except when it is determined not to be in the Government's best interest, the Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are materially unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). (c) If this solicitation is a request for proposals (RFP), a written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.(End of Provision)End of Document ................
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