SECTION B - CONTINUATION OF SF 1449 BLOCKS - Veterans …



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 ITEMS501-15-3-070-0009VA258-14-R-017506-26-2015FRANCIS LEE REYNOLDS505-767-608807-30-201513:00 HRS M.S.TYDepartment of Veterans AffairsContracting Office (501/90C)New Mexico VA Health Care System1501 San Pedro Drive SEAlbuquerque NM 87108X621498$19.0 MillionXN/AXDepartment of Veterans AffairsNew Mexico VA Health Care System1501 San Pedro Drive SEAlbuquerque NM 87108Department of Veterans AffairsContracting Office (501/90C)New Mexico VA Health Care System1501 San Pedro Drive SEAlbuquerque NM 87108 Department of Veterans AffairsFMS-VA-FSCPO Box 149971Austin TX 78714-9971See CONTINUATION PagePURCHASE OF CONTRACTED COMMUNITY BASED OUTPATIENTCLINIC (CCBOC) FOR THE TRUTH OR CONSEQUENCE (T or C),NEW MEXICO VETERAN ADMINISTRATION HEALTH CARE SYSTEM(NMVAHCS).This requirement is being solicited under the authority of38 U.S.C, Section 8153-Enhanced Sharing AuthoritySEE SCHEDULE FOR COMPLETE LISTING OF SERVICES PG 16& PERFORMANCE WORK STATEMENT (PWS) ON PAGE 22.$0.00See CONTINUATION Page501-363-0160070-820400-2560 010032400XX- 5 -Valeria GutierrezContracting OfficerTable of Contents TOC \o &quot;1-4&quot; \f \h \z \u \x SECTION A PAGEREF _Toc422474712 \h 1A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS PAGEREF _Toc422474713 \h 1SECTION B - CONTINUATION OF SF 1449 BLOCKS PAGEREF _Toc422474714 \h 4SECTION C - CONTRACT CLAUSES PAGEREF _Toc422475064 \h 145C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (MAY 2014) PAGEREF _Toc422475065 \h 145C.2 52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS (APR 2014) PAGEREF _Toc422475066 \h 151C.3 52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON POSTCONSUMER FIBER CONTENT PAPER (MAY 2011) PAGEREF _Toc422475067 \h 151C.4 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL (JAN 2011) PAGEREF _Toc422475068 \h 152C.5 52.216-18 ORDERING (OCT 1995) PAGEREF _Toc422475069 \h 152C.6 52.216-19 ORDER LIMITATIONS (OCT 1995) PAGEREF _Toc422475070 \h 153C.7 52.216-22 INDEFINITE QUANTITY (OCT 1995) PAGEREF _Toc422475071 \h 153C.8 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) PAGEREF _Toc422475072 \h 154C.9 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) PAGEREF _Toc422475073 \h 154C.10 52.222-17 NONDISPLACEMENT OF QUALIFIED WORKERS (MAY 2014) PAGEREF _Toc422475074 \h 154C.11 52.227-17 RIGHTS IN DATA—SPECIAL WORKS (DEC 2007) PAGEREF _Toc422475075 \h 158C.12 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997) PAGEREF _Toc422475076 \h 159C.13 SUPPLEMENTAL INSURANCE REQUIREMENTS PAGEREF _Toc422475077 \h 160C.14 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984) PAGEREF _Toc422475078 \h 160C.15 52.237-3 CONTINUITY OF SERVICES (JAN 1991) PAGEREF _Toc422475079 \h 161C.16 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (DEC 2009) PAGEREF _Toc422475080 \h 161C.17 VAAR 852.203-70 COMMERCIAL ADVERTISING (JAN 2008) PAGEREF _Toc422475081 \h 161C.18 VAAR 852.203-71 DISPLAY OF DEPARTMENT OF VETERAN AFFAIRS HOTLINE POSTER (DEC 1992) PAGEREF _Toc422475082 \h 162C.19 VAAR 852.219-9 VA SMALL BUSINESS SUBCONTRACTING PLAN MINIMUM REQUIREMENTS (DEC 2009) PAGEREF _Toc422475083 \h 162C.20 VAAR 852.219-71 VA MENTOR-PROT?G? PROGRAM (DEC 2009) PAGEREF _Toc422475084 \h 162C.21 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2012) PAGEREF _Toc422475085 \h 163C.22 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984) PAGEREF _Toc422475086 \h 164C.23 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011) PAGEREF _Toc422475087 \h 165C.24 SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011) PAGEREF _Toc422475088 \h 165C.25 MANDATORY WRITTEN DISCLOSURES PAGEREF _Toc422475089 \h 165C.26 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) PAGEREF _Toc422475090 \h 166C.27 52.224-1 PRIVACY ACT NOTIFICATION (APR 1984) PAGEREF _Toc422475091 \h 166C.28 52.224-2 PRIVACY ACT (APR 1984) PAGEREF _Toc422475092 \h 166C.29 52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS SUBCONTRACTORS (DEC 2013) PAGEREF _Toc422475093 \h 167C.30 52.245-1 GOVERNMENT PROPERTY (APR 2012) PAGEREF _Toc422475094 \h 167C.31 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JUL 2014) PAGEREF _Toc422475095 \h 179SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS186SECTION E - SOLICITATION PROVISIONS PAGEREF _Toc422475105 \h 2755E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (APR 2014) PAGEREF _Toc422475106 \h 275E.2 52.212-2 EVALUATION—COMMERCIAL ITEMS (JAN 1999) PAGEREF _Toc422475107 \h 279 HYPERLINK \l "_Toc422475108" E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013) PAGEREF _Toc422475108 \h 279 HYPERLINK \l "_Toc422475109" E.4 52.209-5 REPRESENTATION BY CORPORATIONS REGARDING AN UNPAID TAX LIABILITY OR A FELONY CONVICTION UNDER ANY FEDERAL LAW (DEVIATION)(MAR 2012) PAGEREF _Toc422475109 \h 288E.5 52.216-1 TYPE OF CONTRACT (APR 1984) PAGEREF _Toc422475110 \h 288E.6 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) PAGEREF _Toc422475111 \h 288E.7 52.233-2 SERVICE OF PROTEST (SEP 2006) PAGEREF _Toc422475112 \h 289E.8 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008) PAGEREF _Toc422475113 \h 289E.9 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-OWNED SMALL BUSINESS EVALUATION FACTORS (DEC 2009) PAGEREF _Toc422475114 \h 290E.10 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION (JAN 2008) PAGEREF _Toc422475115 \h 291E.11 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998) PAGEREF _Toc422475116 \h 291E.12 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) PAGEREF _Toc422475117 \h 292E.13 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO BENEFICIARIES (JAN 2008) PAGEREF _Toc422475118 \h 292E.14 VAAR 852.273-71 ALTERNATIVE NEGOTIATION TECHNIQUES (JAN 2003) PAGEREF _Toc422475119 \h 292E.15 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003) PAGEREF _Toc422475120 \h 292E.16 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL ITEMS (MAR 2015) PAGEREF _Toc422475121 \h 292E.17 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (JAN 2008) PAGEREF _Toc422475122 \h 306SECTION B - CONTINUATION OF SF 1449 BLOCKS 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 52.227-17. 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 day. 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 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, and 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 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-day's 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.B.4 PRICE SCHEDULE AND SERVICESUnder the authority of Public Law 104-262, Title 38 U.S.C. 8153, FAR Part 12 and 15 the Contractor shall provide continuous delivery of primary and preventive medical care services, for enrolled Veterans with the New Mexico Veterans Affairs Health Care System (hereinafter NMVAHCS) at the Contractor’s clinic facility in the city of Truth or Consequences, NM catchment area, for all assigned patients, in accordance with the terms and conditions stated herein, on behalf of the NMVAHCS, 1501 San Pedro Drive SE, Albuquerque, New Mexico, 87108. The Contractor’s clinic site shall be in the Truth or Consequences, NM, city limits.NMVAHCS shall be the primary Medical Center (Parent Facility) referring eligible Veteran beneficiaries to the Contract Community Based Outpatient Clinic (CBOC). Services shall be for a base year with four optional one year renewal periods, to be exercised at the Government’s discretion. Services shall be provided in accordance with all terms, conditions, and provisions of this solicitation.VA beneficiaries shall not, under any circumstances, be charged nor their insurance companies be charged for services rendered by the Contractor. This provision shall survive the termination or ending of the contract.T or C CBOC Base Year Date of Award 09/01/15 TO 08/31/16 CLINDescriptionEstimated Qty.Per Veteran Per MonthPrice Total by MonthTotal Amount per year0001Primary Health Care Services SEE NOTE 1 & 2Estimated 700 Monthly enrolled Veterans EachEstimated Base Year Total$BASE YEARNote: CLIN includes Licensed Social Worker. (See PWS paragraph B.3.13)NOTE: Ordering Procedures: VA has the sole authority to assign Veterans treated by the contractor into the Primary Care Management Manual (PCMM) software program used to track primary care clinic veteran rosters. Specific billable processes for issuing task orders under the resultant contract includes: determining veteran eligibility, enrollment eligibility, and patient vesting is further defined in B.3.41. Please review in detail section B.3.41 to ensure compliance for issuance of subsequent task orders and payment processing.OPTION YEAR 1 T or C CBOC Option #1 Date of Award 09/01/16 TO 08/31/17CLINDescriptionEstimated Qty.Per Member Per MonthPrice per VeteranTotal by MonthTotal Amount per year1001Primary Health Care Services Estimated Option Year 1 Total$Note: CLIN includes Licensed Social Worker. (See PWS paragraph B.3.13)NOTE: Ordering Procedures: VA has the sole authority to assign Veterans treated by the contractor into the Primary Care Management Manual (PCMM) software program used to track primary care clinic veteran rosters. Specific billable processes for issuing task orders under the resultant contract includes: determining veteran eligibility, enrollment eligibility, and patient vesting is further defined in B.3.41. Please review in detail section B.3.41 to ensure compliance for issuance of subsequent task orders and payment processing.OPTION YEAR 2T or C CBOC Option Year #2 Date of Award 09/01/17 TO 08/31/18 CLINDescriptionEstimated Qty.Per Member Per MonthPrice per VeteranTotal by MonthTotal Amount per year2001Primary Health Care Services Estimated Option Year 2 Total$Note: CLIN includes Licensed Social Worker. (See PWS paragraph B.3.13)NOTE: Ordering Procedures: VA has the sole authority to assign Veterans treated by the contractor into the Primary Care Management Manual (PCMM) software program used to track primary care clinic veteran rosters. Specific billable processes for issuing task orders under the resultant contract includes: determining veteran eligibility, enrollment eligibility, and patient vesting is further defined in B.3.41. Please review in detail section B.3.41 to ensure compliance for issuance of subsequent task orders and payment processing.T or C CBOC Option Year #3 Date of Award 09/01/18 TO 08/31/19 CLINDescriptionEstimated Qty.Per Member Per MonthPrice per VeteranTotal by MonthTotal Amount per year3001Primary Health Care Services Estimated Option Year 3 Total$Note: CLIN includes Licensed Social Worker. (See PWS paragraph B.3.13)NOTE: Ordering Procedures: VA has the sole authority to assign Veterans treated by the contractor into the Primary Care Management Manual (PCMM) software program used to track primary care clinic veteran rosters. Specific billable processes for issuing task orders under the resultant contract includes: determining veteran eligibility, enrollment eligibility, and patient vesting is further defined in B.3.41. Please review in detail section B.3.41 to ensure compliance for issuance of subsequent task orders and payment processing.T or C CBOC Option Year #4 Date of Award 09/01/19 TO 08/31/20 CLINDescriptionEstimated Qty.Per Member Per MonthPrice per VeteranTotal by MonthTotal Amount per year4001Primary Health Care Services Estimated Option Year 4 Total$Estimated Aggregate Total (Base + all option years) $1. Note: CLIN Note: CLIN includes Licensed Social Worker. (See PWS paragraph B.3.13)2. NOTE: Ordering Procedures: VA has the sole authority to assign Veterans treated by the contractor into the Primary Care Management Manual (PCMM) software program used to track primary care clinic veteran rosters. Specific billable processes for issuing task orders under the resultant contract includes: determining veteran eligibility, enrollment eligibility, and patient vesting is further defined in B.3.41. Please review in detail section B.3.41 to ensure compliance for issuance of subsequent task orders and payment processing.Contractual Minimum and Maximum: The guaranteed minimum contract amount, including the base year and any option years exercised, is 500 Veterans for CLINS 0001 thru 4001 and the maximum contract amount, including the base year and any option years exercised, shall not exceed 725 Veterans for CLINS 0001 thru 4001. Estimated Quantities - All quantities listed herein are estimated annual quantities. The Government is not obligated to purchase any specified amount of services under this contract, but will be obligated to make payment for all services requested and received in the quantities and of the quality requested. The Government does not guarantee or imply that any fixed number of orders/referrals for services will be placed under the resultant contract.CAPITATION RATES:Contractor shall receive a full monthly capitation rate for each enrolled patient beginning from the first month in which a provider has actually seen the patient for a visit which meets the requirements of “vesting” or qualified visit in the VA system (see below for current Evaluation and Management (E&M) codes). (Qualified Visit - The Veteran must have at least one (1) CBOC provider visit per year (12 month period) with comprehensive assessment by the CBOC primary care provider including a history, physical examination and electronic medical record documentation sufficient to meet the criteria for a Current Procedural Terminology (CPT) code 9921 series, level 3. The visit must be coded with at least one of the E&M codes listed below in order for the patient to be “vested”. Changes in vesting requirements shall be conveyed to the contractor and implemented within 30 days. The contractor shall be paid in arrears for the number of patients enrolled in any month. For dis-enrolled patients, the contractor shall receive payment for the full month in which the date of disenrollment occurred only if a provider treated the patient during that month. Note: Contractor shall ensure that all patients are “checked-in/out” for scheduled appointments in VISTA and that all check out elements is completed. This shall be monitored by NMVAHCS Health Administration Service (HAS) and shared with the CBOC designated COR. Additionally, the HAS through the COR shall run a monitoring report (Add/Edit Error Report) multiple times a week. All items that are missing or in error for checkouts each week are to be completed by close of business (COB) the following Monday. Contractor shall not receive payment for an enrolled patient who is a “No Show”. Contractor shall not receive payment for a patient under this contract until a provider has provided a face-to-face visit for meeting the requirements for vesting in the VA system and has entered an authenticated electronic progress note into Computerized Patient Record System-Graphical User Interface (CPRS-GUI) for each visit. The contractor shall receive payment for vested patients for 12 months from the month each patient is vested.Contractor shall be prohibited from charging enrolled patients for services covered under this contract. If a patient desires services that are not a NMVAHCS benefit, contractor shall notify patient that there shall be a charge for such service and that NMVAHCS shall not be responsible for payment. If a patient requires services not covered under the program but is eligible for these services, contractor shall refer patient to NMVAHCS.The number of current assigned patients is approximately 700 per month. (See QASP) Contractor and NMVAHCS shall comply with all reporting requirements established in this contract and ensure that all reports are accurate and complete and are submitted timely. VA will provide contractor with appropriate reporting format, submission timetables, and technical assistance. Contractor shall maintain a system for recording services, service providers, charges, appointment dates, and all other commonly accepted elements for services rendered to enrolled patients including such records necessary for the evaluation of the quality, appropriateness and timeliness of services performed. Contractor shall provide reports to the Contracting Officer Representative (COR) as listed and required in the Attachment Section.NMVAHCS reserves the right to audit any and all encounters for compliance with VA regulations and policies.NOTE: Refer to Quality Assurance Surveillance Plan (QASP) for all items being tracked/audited above. Refer to B.6.8 BILLIABLE ROSTER CONTROLS AND INVOICING ? 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: Name: ___________________________________________ Title: ___________________________________________ Name of Company: _________________________________ Address: _________________________________________ City: _________________ State: _____ Zip Code: _________ Email: ___________________________________________ Phone #: _____________ Toll Free#: __________________ Fax #: ________________ DUNS: _______________ GSA/FSS Contract Number: __________________________ b. GOVERNMENT: Name: Francis Lee ReynoldsTile: Contract SpecialistDepartment of Veteran Affairs (501/90C)1501 San Pedro Drive SEAlbuquerque, NM 87108-5154Francis.reynolds@Phone: 505-767-6088Fax: 505-767-6087 2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor shall be made in accordance with:(X) 52.232-34, Payment by Electronic Funds Transfer – Other than Central Contractor Registration, or() 52.232-36, Payment by Third Party Invoices: Invoices shall be submitted in arrears 3. INVOICES: Invoices shall be submitted in arrears: a. Quarterly[] b. Semi-Annually[] c. Other[]4. Contractor shall complete the Contractor Certification statement see Section D (Attachment U). 5. The Contracting Officer shall schedule a post award orientation conference for contract orientation purposes as required by IL 003A3-12-04. . 7. GOVERNMENT INVOICE ADDRESS: Method of payment for services ordered under this contract shall be by Electronic Funds Transfer (EFT). All invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 “Electronic Submission of Payment Requests.” This is now accomplished through the “OB10” website, located at . This is the mandatory and sole method for submission of vendor invoices, so please ensure you are properly registered to avoid any potential payment delays. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:AMENDMENT NODATE8. Subcontracting Plan - Monitoring and ComplianceThis solicitation includes FAR 52.219-9, Small Business Subcontracting Plan, and VAAR 852.219-9, VA Small Business Subcontracting Plan Minimum Requirement. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing the contractor's compliance with the plan, including reviewing the contractor's accomplishments in achieving the subcontracting goals in the plan. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting plan. SPECIAL CONTRACT REQUIREMENTS Under the authority of 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, , 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 plus one-year options that may be exercised by the VA. 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: All contract employees shall be United States citizens or permanent or foreign residents (requiring VISAs). Personnel assigned by the Contractor to perform the services covered by this contract shall be licensed in a State of New Mexico, 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 New Mexico Veterans Administration Health Care System Chief of Staff (NMVAHCS) and approval by the NMVAHCS Facility Director. Each physician or nurse assigned to work under this contract shall be credentialed by the NMVAHCS (see page 34 of PWS B.4.2 Qualifications & B.4.32 ADDITIONAL PERONNELL REQUIREMENTS page 84). 4. RECORD KEEPING: The Contractor shall establish and maintain a record keeping system that shall record the hours worked by the contractor employee(s). Contractor shall establish a position know as Administrative Officer to conduct the business of the CBOC. Contractor's employee(s) shall report to the CBOC Administrative Officer, or designee upon arrival at the CBOC in Truth or Consequences, NM. In addition, ending tour of duty must be addressed in an operating policy for the CBOC Truth or Consequences, NM, act as coordination point of contact for the CBOC to the COR. 5. CONTRACT PERFORMANCE MONITORING: Monitoring of contractor’s performance shall be demonstrated through quarterly performance sheets maintained by the COR. The contractor shall be required to sign this document or submit mitigating information concerning performance. Contracting Officer Representative (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. 6. 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 (This includes all 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.4 PERFORMANCE WORK STATEMENT (PWS) GENERAL: SERVICES REQUIRED: This solicitation is for a contracted Community Based Outpatient Clinics (CBOCs) for providing Primary Care Services.PLACE OF PERFORMANCE: Within city limits of Truth or Consequences, NM, Sierra CountyThe New Mexico Veterans Affairs Health Care System (NMVAHCS) located in Albuquerque, NM; also known as “the parent facility” requires CBOC services providing Primary Care services in a private hospital, office or clinic environment to veterans, primarily residing in the city limits of Truth or Consequences, NM, Sierra County and surrounding catchment area.AUTHORITY: In accordance with Title 38 United States Code (USC) 8153 to be furnished by the contractor on behalf of (NMVAHCS) POLICY AND REGULATIONS: The Contractor is required to meet VHA performance and quality criteria and standards including, but not limited to, customer satisfaction, prevention index, chronic disease index and clinical guidelines. Performance and quality standards may change during the course f the contract. New or revised quality/performance criteria or standards will be provided to the Contractor before implementation date. Compliance with mandated performance is required as a condition of this contract. Contractor shall comply with all relevant VA policies and procedures, including those related to quality, patient safety and performance, including, but not limited to, the following:The care provided by the Contractor should be patient centered, continuous, accessible, coordinated, and consistent with VA standards, including the thirteen service standards detailed in VHA Directive 2006-041, “Veterans Health Care Service Standards,” dated 6/27/06 (2006-041 expired on June 30, 2011 but will still be effective until a revision or rescission is published and/or subsequent revisions thereto. NMVHACS: NMVHACS MCM (Medical Center Memorandum) Information, Forms, Handbooks and Manuals: Care Performance Measures Title 21 C.F.R 900.12(c) Mammography Quality Standards Title 21 CFR “Food and Drugs” Section 1300-end. 38 USC. Section 7332, regarding a timely special consent for any medical treatment for drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus (HIV), or sickle cell anemia, to a Veteran with health insurance. A special consent from the Veteran is needed to allow VA to release bills and medical records associated with the treatment. 42 CFR Part 482 Conditions of Participation 42 CFR 493.15(b) Laboratories performing waived tests: Clinical Laboratory Improvement Amendments (CLIA): VA Forms, Publications and Record Management: VA Directive 1663: Health Care Resources Contracting - Buying VA Directive 6371, Destruction of Temporary Paper Records VHA Record Control Schedule 10-1 "Patient Medical Records-VA" (24VA19). 24VA19 Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) VHA Directive 2007-016 Coordinated Care Policy for Traveling Veterans. VHA Directive 2007-033 "Telephone Service for Clinical Care," Directive 2008-015 “Public Access to Automated External Defibrillators (AEDs): Deployment, Training, and Policies for use in VHA Facilities” VHA Directive 2009-019, “Ordering and Reporting Test Results,” vhapublications/ViewPublication.asp?pub_ID=1864 VHA Directive 2009-038 “VHA National Dual Care Policy” VHA Directive 2010-020 “Anticoagulation Management” VHA Directive 2010-027 "VHA Outpatient Scheduling Processes and Procedures” VHA Directive 2010-033 “Military Sexual Trauma (MST) Programming,” VHA Directive 2011-012 “Medication Reconciliation” VHA Handbook 1003.4, "VHA Patient Advocacy Program," Handbook 1100.17: National Practitioner Data Bank Reports - Handbook 1100.18 Reporting And Responding To State Licensing Boards - VHA Handbook 1100.19 Credentialing and Privileging - Handbook 1101.02 Primary Care Management Module. VHA Handbook 1105.03 “Mammography Program Procedures and Standards” VHA handbook 1106.1 “Pathology and Laboratory Medicine Service Procedures Handbook 1120.2, "Health Promotion and Disease Prevention Core Program Requirements" . Handbook 1330.1, "VHA Services for Women Veterans" dated 7/16/04, . Handbook 1160.01 “Uniform Mental Health Services” Handbook 5005, Part 2, Appendix G15, Licensed Pharmacist Qualification Standards. Act of 1974 (5 U.S.C. 552a) as amended The Contractor must be poised to respond quickly to VA policy and procedure changes. DEFINITIONS/ACRONYMS: The following terms when used in this contract, shall be defined as follows: unless the context expressly requires a different conclusion and/or interpretation. In the event of a conflict in language between the Definitions, Addendums, Attachments, and/or other sections of this Contract, the language in the specific applicable sections shall govern.ABMS: American Board of Medical SpecialtiesACO: Administrative Contracting Officer: Who monitors contract for the Contracting OfficerAQL: Acceptable AQL is defined as the minimum amount of work that is performed without defects in order to be considered satisfactory. AQL represents the level of quality required in a VA run operation. An AQL does not imply that the Contractor has knowingly performed in an unsatisfactory way. It implies that the Government recognizes that unsatisfactory performance sometimes happens unintentionally. As long as satisfactory performance does not fall below the AQL, the service shall not be subject to payment disincentive by the Government (refer to QASP Attachment A). The Contractor, however, shall correct unsatisfactory work unless excused by the Contracting Officer Representative (COR), or is unable to do so based upon clinical results. For example: Veteran refuses the flu vaccine.ACLS: Advanced Cardiac Life SupportACGME: Accreditation Council for Graduate Medical EducationACPE: American Council on Pharmaceutical EducationACO: Administrative Contracting Officer – who monitors contract for the Contracting OfficerADE: adverse drug eventsAED: Automatic External DefibrillatorAIS: Automated Information SecurityANA: American Nurses AssociationAOA: American Osteopathic AssociationARRT: American Registry of Radiologic TechnologyAP: Assigned patient- Any eligible veteran, as determined by NMVAHCS who is assigned in a Contractor’s plan in accordance with the terms and provisions of this contract, including a completed physical examination and assessment which satisfies the requirement for the capitation rateBAA : Business Associate AgreementBI-RADS: Breast Imaging-Reporting and Data System; a quality assurance tool designed to standardize mammography reportingBLS: Basic Life SupportBOS: Bureau of Osteopathic SpecialistsBD: Minimum of 8 hours per dayBusiness Manager, Rural Healthcare: The VA employee responsible for management of the clinical and administrative performance of the Contractor. Works with the Contracting Officer’s Technical Representative and Contracting Office on contract performance mattersCapitation Rate: A method of payment for healthcare services in which providers are paid a pre-determined, fixed amount of money per vested Veteran per time period, in return for providing contractually agreed upon services to a specifically defined population. An amount established by this Contract.CAHEA: Committee on Allied Health Education and Accreditation CAP: College of American PathologistsCARF: Commission on Accreditation of Rehabilitation FacilitiesCare/Case Manager: an organization or a provider responsible for supervising or coordinating the provision of initial and primary care to patients; for initiating and/or authorizing referrals for specialty care; and for monitoring the continuity of patient care services.CBO: VA Central Billing Office.CDC: Centers for Disease Control and PreventionCEU: Certified Education UnitClinical Practice Guidelines: VHA defines Clinical Practice Guidelines as recommendations for the performance or exclusion of specific procedures or services for specific disease entities. These recommendations are derived through a rigorous methodological approach that includes a systematic review of the evidence to outline recommended practice. Guidelines are frequently displayed in the form of an algorithm, which is a set of rules, in a flowchart format, for solving a problem in a finite number of steps. CLIA: Clinical Laboratory Improvement AmendmentsClinical Reminders: VA template prompts in the electronic medical designed to assist the providers and staff in assuring the patient receives the proper treatment at the right time to obtain maximal health care and to prevent disease or illness. When completed these prompts shall be turned off in the electronic record. CME: Continuing Medical Education CMS: Center for Medicare and Medicaid ServicesCO: Contracting OfficerCommercial Service: A service that is offered and sold competitively in the commercial marketplace, is performed under standard commercial terms and conditions, and is procured using firm-fixed price contracts. See also FAR 2.101 definitions of commercial services.COPD: chronic obstructive pulmonary diseaseCOR: Contracting Officer’s RepresentativeCOS: Chief of StaffCPA: collaborative practice agreementCPS : Clinical Pharmacy SpecialistCPT: Current Procedural Terminology CRNP: Certified Registered Nurse PractitionersCSA: Community Service Area - one or more counties in a defined geographical area in which Contractor is authorized to have assigned and serve NMVAHCS assigned patients in exchange for a monthly fee.CSWE: The Council on Social Work Education The CSWE website is : Contractor Performance Assessment Reporting SystemCPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.CPRS/GUI: Computerized Patient Record System/Graphical User InterfaceCVT: clinical video TeleHealthDICOM: Digital Image and Communication in Medicine DIGMA: Drop In Group Medical AppointmentDis-assignment: The discontinuance of a member’s entitlement to receive covered services under the terms of a Contract, and deletion from the approved list of assigned patients furnished by NMVAHCS to Contractor. ie no qualifying visit within the VA.Dis-enrolled: No longer eligible for VA services (example —death; Veteran moved out of NMVAHCS).DRG: Diagnostic Related GroupDSS: Decision Support SystemECC Extended Care CenterEHR: Electronic Health Record This is the electronic medical record maintained by the VA and accessed via the CPRS/GUI.Eligible Person: Any person certified by NMVAHCS as eligible to receive medical services.Emergency Needs: A sudden onset of a medical condition manifesting by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in:1) Immediate health in jeopardy of an assigned patient2) Causing other serious medical consequences3) Causing impairments to body functions or 4) Causing serious or permanent dysfunction of any body organ or part.Enrollment: Registration of the patient by the VA in the contractor’s primary care program. Paid enrollment shall occur when there is a documented initial vesting qualifying visit and maintained with a documented and qualifying annual visit.EPRP: External Peer Review ProgramFacility: Premises’ (a) owned, leased, used or operated directly or indirectly by or for a Contractor or its affiliates for purposes related to a contract; or (b) maintained by a subcontractor or provider to provide services on behalf of a Contractor.FDA: Food and Drug AdministrationFee-for-Service: A method of making payment for health services based on fees jointly set by NMVAHCS and a Contractor for services defined in a Contract.Fiscal Agent: An agent who processes claims for payment and performs other fiscally related functions.FSMB: Federation of State Medical BoardsFTE: Full time equivalent positionFTC: Facility Telehealth CoordinatorGrievance Procedure: An organized process by which assigned patients express dissatisfaction with services received under a Contractor’s plan and the subsequent resolution of these dissatisfactions. This procedure refers to the provisions of Contractor’s plan exclusively and does not affect the inherent right of assigned patients to grieve to NMVAHCS.HAS: Health Administration Service – The section responsible for enrollment.HHS: Department of Health and Human ServicesHCFA: HealthCare Financing AdministrationHCPC: Healthcare Common Procedure Coding System - Coding system developed by Medicare that standardizes the coding systems used to process Medicare claims on a national basis. The system is used to bill primarily for supplies, materials and injections. It is also used to bill for procedures and services that are not defined in CPT.HICPAC: Healthcare Infection Control Practices Advisory Committee- a federal advisory committee made up of 14 external infection control experts who provide advice and guidance to the CDC and the Secretary of HHS regarding the practice of health care infection control, strategies for surveillance and prevention and control of health care associated infections in United States health care facilities.HT: Home Telehealth ICAVL: Intersocietal Commission for the Accreditation of Vascular LaboratoriesINR: International Normalized RatioISO: Information Security OfficerJC: Joint Commission – Accreditation of medical facilitiesLIP: licensed independent practitionerMarketing: Any activity conducted by or on behalf of a Contractor where information regarding the services offered by a Contractor is disseminated in order to persuade eligible persons to be assigned or accept any application for assignment in Contractor’s plan operated pursuant to a contract.Market Area: One or more community service areas in which Contractor is authorized, by the terms of a contract, to market eligible persons for assignment to Contractor’s plan.MCCR: Medical Care Cost RecoveryMCO: Medical Care OfficeMedical Record: A single complete CPRS/GUI record kept at the assigned patient’s treatment location, which documents all treatment plans developed, medical services ordered for the patient and medical services received by the patient.Medically Necessary - Services or supplies provided by an institution, physician, or other provider that are required to identify or treat a NMVAHCS assigned patient’s illness or injury and which shall consist of, but are not limited to the following:1) Consistent with the symptoms or diagnosis and treatment of the assigned patient’s condition, disease, ailment or injury; anda) Appropriate with regard to standards of good medical practice; b) Not solely for the convenience of an assigned patient, physician, institution or other provider; c) The most appropriate supply or level of services which can safely be provided to the assigned patient. 2) When applied to the care of an inpatient, it further means that services for the assigned patient’s medical symptoms or condition require that the services cannot be safely provided to the assigned patient as an outpatient.MT: Means Test - The Veterans’ financial statement of assessing their household income and net worth. A Means Test is required to determine whether a Non-service connected or 0% non-compensable Service connected Veteran is eligible for free healthcare, or pharmacy co-payments. It also determines the Veteran's priority group for VA enrollment. The annual means test indicator is an income and asset disclosure statement completed by Veterans in groups Five, Seven, and Eight to determine their co-payment status. The Veterans in Priority Groups One, Two, Three, and Four are exempt from the annual means test. See the table of Enrollment Priorities Attachment V. MQSA: Mammography Quality Standards Act MSN: Master of Science in NursingNCCPA: National Commission on Certification of Physician AssistantsNLN: National League for NursingNon-Contract Provide: Any person, organization, agency, or entity that is not directly or indirectly employed by Contractor or any of its subcontractors.NMVAHCS: New Mexico Veterans Affairs Health Care System.NSQIP/CICSP: National Surgical Quality Improvement Program/Continuing Improvement in Cardiac Surgical ProgramOTC: Over the CounterOut-of-Plan Services: Services provided by a non-contract provider.PA: Physician Assistant PACS: Picture Archiving and Communications SystemPACT: Patient Aligned Care Team Background & Introduction: VA has implemented a PCMH model at all VA Primary Care sites which is referred to as PACT. This initiative supports VHA’s Universal Health Care Services Plan to redesign VHA healthcare delivery through increasing access, coordination, communication, and continuity of care. PACT provides accessible, coordinated, comprehensive, patient-centered care, in team based environment including the active involvement of other clinical and non-clinical staff. PACT allows patients to have a more active role in their health care and is associated with increased quality improvement, patient satisfaction, and a decrease in hospital costs due to fewer hospital visits and readmissions. Actions that will assist CBOC Contractor in implementing PACT model:Participation in PACT national teleconferences and educational forums.Teamlet staff should attend VA sponsored Transformational Learning Centers of Excellence.Parent Facility: VAMC responsible for performance monitoring and payment for contracted CBOC services. The New Mexico VA Health Care System Hospital, located at 1501 San Pedro SE, Albuquerque, New Mexico 87108.PCMH: patient-centered medical homePCMM : Primary Care Management Module- a software program used to track Primary Care Clinic Veteran rosters. PCP: Primary Care ProviderPerformance Measures: Quality indicators for patient care as identified by the VA Office of Quality and Performance. Each VA facility is scored on meeting Performance Measure targets.Pharm. D: Doctor of PharmacyPlan: The benefits and services provided through a primary care contract.POC: Point of Care Testing Preferred Facility: The VA facility in which the Veteran expresses preference for care in which the major portion of the Veteran’s primary care is provide.Primary Care Visit: The act of being seen by a physician/provider to determine medical need or status, including diagnosis, necessary treatment of medical and psychiatric conditions.Primary Source Verification: Physician documentation of original source verification of credentials verifying accuracy of a qualification. This shall be done by letter, telephone contact or electronic communication with the original source (not Fax). Verification occurs at the time of initial appointment and the expiration of the credential if not renewed to verify good standing.Prior Authorization: The act of authorizing specific services before they are rendered or activities before they occur.Provider: Individual licensed, certified, or authorized by law to render professional health services directly to members and credentialed by the New Mexico VA Health Care System (NMVAHCS). A provider shall include physicians, Physician Assistants, or Nurse Practitioners.PWS: Performance Work StatementQAP: Quality Assurance Plan - Provided by Contractor to list how Contractor plans on complying with the QASP.QAPI: Quality Assessment and Performance ImprovementQASP: Quality Assurance Surveillance PlanQM: Quality Monitoring - the ongoing process of assuring that the delivery of health care is appropriate, timely, accessible, available, medically necessary and in keeping with established guidelines and standards and reflective of the current state of medical knowledge.Qualifications: Established business who, in the judgment of the Contracting Officer, are financially responsible and can demonstrate responsibility, ability, experience, equipment, facilities, and personnel directly employed or supervised by them to render prompt and satisfactory service in the volume required for all items under this Contract. By signing this Contract the Contractor is certifying that all requirements of Federal, State, or local laws, codes, and/or regulations shall be met regarding the operation and provision of these types of services. Personnel assigned to perform the services covered by this Contract shall be licensed in accordance with PWS.Qualified Visit: The Veteran shall have at least one (1) CBOC provider visit per year (12 month period) with comprehensive assessment by the CBOC primary care provider including a history, physical examination and electronic medical record documentation to at least meet the criteria for a CPT level 3. Vesting visit is the first qualifying visit by the CBOC primary care provider.Refill: Filling of a prescription with the same prescribed contents which were originally prescribed.Renewal: A new prescription for a medication a patient is already receiving. Renewal prescriptions shall cancel any previous remaining refills.RME: reusable medical equipmentRoutine Need: Treatment needed within thirty (30) days due to conditions that are not considered urgent or life threatening. Included in this group are services such as immunizations, general physical, and wellness counseling.SOP (Clinical): Scope of PracticeSelf- Referral: Referring patients to Contractor’s facility for follow-up care. Self-referral for outpatient services at the Contractor’s facility is prohibited.Service Location: Any location at which an assigned patient obtains any health care service covered by a Contractor pursuant to the terms of a Contract.Service Site: The location designated by a Contractor at which assigned patients shall receive primary care provider and preventive services.SFT: Store and Forward TelehealthSMA: Shared Medical AppointmentsSPD: Sterile Processing DivisionSPE: Senior Procurement ExecutiveSubcontract: A contract entered into by a Contractor with another organization or person who agrees to perform any administrative function or service for that Contractor specifically related to securing or fulfilling a Contractor’s obligations to NMVAHCS under the terms of another Contract.Subcontractor: Any organization or person who provides any function or service for the Contractor specifically related to securing or fulfilling the Contractor’s obligations to NMVAHCS under the terms of this contract. Third Party: Any entity or funding source other than the assigned patient who assumes liability to pay for all or part of the cost of medical care provided on behalf of an assigned patient. TIU: Text Integration UtilityTCT: Telehealth Clinical TechniciansTraveling Veteran: Veteran who is registered at another VA facility other than the NMVAHCSUrgent Need: Treatment needed due to symptoms, illness or diseases that do not fall into emergency or routine categories. Appointment shall be as soon as possible but not beyond seven (7) days.VA: Veterans AffairsVA Co-Payment: A co-payment that is billed to the Veteran by the NMVAHCS Billing Department based on determination of the eligibility of the Veteran. This co-payment charge shall be assessed for inpatient, outpatient and pharmaceuticals.VAMC: Veterans Affairs Medical CenterVESTED/VESTING: A Veteran that has been treated within the prior twelve (12) month period criteria.VetPro: a federal web-based credentialing program for healthcare providers.VHA: Veterans Health AdministrationVISN: Veterans Integrated Service NetworkVISTA: Veterans Health Information Systems and Technology ArchitectureVisiting Veteran: A Veteran who is registered and properly enrolled at another NMVAHCS facility Services Provided:Primary Health Care services shall provide a continuum of care from prevention to diagnosis and treatment, to appropriate referral and follow-up and coordination of all care provided to the patient. Those patients needing specialty or follow-up care shall be referred to NMVHACS. The CBOC shall have the necessary professional medical staff, referral arrangements needed to ensure continuity of health care within the scope of the PWS. Primary Health Care services include longitudinal outpatient medical care for the purposes of prevention and detection of disease and subsequent management of medical conditions, for Veterans deemed eligible. The care shall be provided by primary care providers who shall be general practitioners, general internists, family practitioner or their authorized designees. Primary Mental Health Care services within the scope of practice of a Social Worker are provided by the CBOC Social Worker within the scope of the PWS. Primary health care management shall include the appropriate referral and scheduling assistance of assigned patients needing specialty health care services, including specialty mental health care such as psych pharmacotherapy or specific psychotherapies and those identified through the provision of preventive services to the assigned patient. The contractor’s primary care providers are responsible for reviewing the documentation from other providers, including dual care Veterans, and following up on all diagnostic abnormalities and monitoring of therapy. (per VHA Directive 2009-038 – VHA National Dual Care Policy ( ). Contractor’s preventive health care program shall follow the guidelines of the U.S. Preventive Services task force and adult immunization guidelines of the American College of Physicians, and/or the most current VHA Performance Measurement System: () & JC: ) care measures available. The proposed CBOC, at a minimum, shall provide one standard of care that shall be consistent, safe and of high quality. Additionally, the proposed CBOC is expected to comply with all relevant VA policies and procedures, including those related to quality, patient safety and performance. The CBOC shall be poised to respond quickly to VA and NMVAHCS policy and procedure changes. If requested or required by either the government or the Contractor, the Contractor shall work closely with the Contracting Officer (CO) and Contracting Officer Representative (COR) to modify the contract expeditiously, in order to limit the impact on the clinic’s Veterans and ensure consistency with the care provided by the NMVAHCS other Primary Care Clinics. The care provided by the CBOC is patient centered, continuous, accessible, coordinated, and consistent with NMVAHCS standards, including the thirteen service standards detailed in VHA Directive 2006-041, “Veterans Health Care Service Standards,” dated 6/27/06 (or subsequent revisions thereto) and PACT Handbook 1101.10, “Patient Alignment Care Team Handbook” shall complete Level I and Level II Traumatic Brain Injury (TBI) Screen. NMVAHCS shall provide initial training to PCP and other clinical staff involved in the screening. Ongoing training is the responsibility of the Contractor. Contractor is encouraged to request/enroll their staff in additional training.The contractor shall identify Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans, complete Post-deployment and TBI screenings and refer for additional evaluation and/or treatment as indicated.? The contractor shall ensure each OEF/OIF Veteran is provided a full range of post-deployment assessment to include medical, mental health and psychosocial assessments and refer for additional evaluation and/or treatment, to include case management follow-up by a licensed social worker or nurse as indicated.Instructions to Veterans and/or care giver on the safe and appropriate use of equipment being supplied shall be documented in the Veteran's medical record.Providers shall encourage and work to influence Veterans to receive all of their care through the NMVAHCS. (VHA Directive 2009-038, VHA National Dual Care Policy) HYPERLINK "" ). However, providers shall provide care to Veterans who are also receiving care with community health care providers under the following circumstances:Co-managed care with non-community health care providers shall occur only if the Veteran is receiving ongoing primary care from the NMVAHCS. The Veteran shall have at least one (1) CBOC visit per year with comprehensive assessment by the CBOC primary care provider including a complete history, physical examination and electronic medical record documentation to at least meet the criteria for a CPT level 3. Moreover, documentation and coding shall accurately reflect the medical necessity and services provided during that visit.Veterans who receive dual care shall be monitored with the same intensity by the CBOC as Veterans who receive only NMVAHCS outpatient care. CBOC providers have the same responsibilities for monitoring medications they prescribe for dual care patients as for patients who receive care only from the NMVAHCS. (Including all required laboratory tests, therapeutic drug levels and assessment of medication efficiency, side effects, adverse drug reactions, drug interactions, )The NMVAHCS and CBOC shall not simply be used as a pharmacy or as a dispenser of equipment and supplies. The Veteran shall be enrolled and assigned in the CBOC and followed/monitored at appropriate intervals consistent with optimal quality healthcare.It is the Veteran's responsibility to furnish their CBOC primary care provider with documented information about episodes of care occurring in the community.The name, address and telephone number of the community providers regularly seen by a Veteran shall be documented in a progress note in the Veteran's electronic medical record.This care shall include:Scheduled initial or follow-up visits to primary care providers at the CBOC site. A complete history and physical examination which includes cervical cancer screening for women as indicated by patient preference and clinical practice guidelines including one of the following (CPT) codes:(Current Evaluation and Management (E&M) codes)E&M CODEE&M CODE DESCRIPTION99203-99205Office/Outpatient Visit for New Patient99213-99215Office/Outpatient Visit for Established PatientThese codes shall be performed on the first visit for newly enrolled Veterans other than in exceptional circumstances. This is a Vesting CPT Code visit. Documentation of this visit includes the Veteran problems via the on-line Problem List option in the Veterans Health Information Systems and Technology Architecture (VISTA)/Computerized Patient Record System (CPRS/GUI) computer system, and be updated as needed on each subsequent visit. Outpatient visit for the evaluation and management of an established patient requires at least?2 of these 3 key components:An expanded problem focused history;An expanded problem focused examination;Medical decision?making of low complexity.Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs.Exceptional circumstances means the Veteran is seen for his first visit as an emergency for a shorter duration visit. In this case, a complete history and physical examination shall be completed within 72 hours. The complete history and physical examination shall be performed with documentation of Veteran problems via the on-line Problem List option in the VISTA CPRS/GUI computer system which shall be updated as needed on each subsequent visit. The Problem List is to be updated at all subsequent visits, and include all significant diagnoses, procedures, drug allergies, and medications. Every twelve (12) months the Veteran shall receive a visit, a vesting visit.PATIENT ASSESSMENT:All care provided shall be based on needs identified through the assessment process. Patient medical history and physical exams shall be performed in accordance with NMVAHCS Bylaws/Rules/Regulations , guiding Medical Center policies, and as clinically indicated by patient signs and symptoms. Findings from assessment and reassessment shall be clearly documented in the electronic medical record, which is used by all members of the interdisciplinary care team in care planning and treatment. The plan of care, all findings from patient assessment, treatment and clinical reminders provided shall be documented in the electronic medical record, and integrated with the overall plan of care in all care settings across the continuum. Electronic documentation (including completion of the encounter) of all Veteran visits and all medication orders shall be entered and signed by the provider, by the close of business the day of the appointment. Patient’s allergy information and changes in allergy information shall be entered into CPRS/GUI.Every patient is to receive a comprehensive physical and preventative medicine assessment CPT level 3 at least yearly. Specific assessment areas that need to be addressed include the following: History & Physical examination including pain, psychological, social, nutritional, and overall functional screening by the contractor physician or nurse as appropriate and within license. Contractor findings related to the above areas shall be recorded in the electronic medical record and addressed or referred as indicated, in accordance with Medical Center policies.Assessment for all procedures shall include all elements as explicitly outlined in NMVAHCS Bylaws and applicable policies. All required documentation shall be fully completed within NMVAHCS required time frames. The contractor shall fully complete all signed and informed consent documentation prior to the procedures within 24 hrs. as required. Planned procedures shall not be allowed if these requirements are not met.For patients that are assigned to the CBOC, but have ancillary services requested by specialty service providers at other VA sites, the contractor shall provide the services ordered. Requested services shall include phlebotomy, lab services, and data collection services (i.e., weight check, blood pressure readings, pulse oximetry readings, ). The requesting VA site shall identify these patients for the contractor by entering orders into CPRS/GUI. The contractor shall document the treatment provided to the patient by completing appropriate records in CPRS/GUI.For Veterans identified as homeless, the CBOC Social Worker shall provide a list of local shelter addresses/telephone numbers and additional services as appropriate. All homeless Veterans shall be referred for services to the VA Social Worker for homeless Veterans at the NMVAHCS for assistance/support for the CBOC Social Worker as needed. (Contact the NMVAHCS Behavioral Health Care Line at (505) 265-1711 x5922). The contractor shall develop local support and referral for homeless Veterans.PATIENT EDUCATION:The contractor shall develop and coordinate the interdisciplinary education plan for the patient based on a learning assessment of each enrolled/assigned Veteran. This assessment shall be documented in the electronic medical record in the progress notes per clinical practice guidelines. Education provided by the contractor shall be interactive with the patient, and shall be aimed at disease management/prevention and quality of life. Discharge instructions from hospitalizations shall be reviewed with the Veteran and family at the CBOC primary care follow up visit. All education given shall be documented in the electronic medical record using patient education templates in accordance with NMVAHCS policies and procedures.Point of Care Testing (POC): The CBOC shall provide POC Testing for the following conditions:Conditions requiring chronic anticoagulation with warfarin. All CBOCs shall perform POC INR (International Normalized Ratio) testing to allow for real-time adjustment of warfarin dosing. The Contractor shall provide Quarterly and annual anticoagulation quality assurance summaries as instructed by NMVAHCS. For questions, please contact, NMVAHCS Anticoagulation Coordinator through the Pharmacy office extension (505) 265-1711 x 4429.Optional POC testing: Urine dip stick, finger stick glucose. (Urine tests can be sent to the NMVAHCS laboratory for processing. Glucose tests can be sent to the NMVAHCS laboratory for processing)See Women Veterans section for POC Urine Pregnancy testing: Per VHA Handbook – Health Care Services For Women Veterans lab results from point of care testing done for the clinic shall be entered into CPRS/GUI within 24 hours of visit and shall include name and address of testing site, reference ranges, date of testing and person performing testing.Office visits to other health care providers including nurses, physician extenders, or others for the purposes of monitoring or preventing disease and providing patients with information and/or skills so they can participate in decision-making and self-care.Diagnostic tests ordered by primary care provider or his/her designee as indicated in table in area (7) b below.Phone contacts with patients and primary care providers or their designee.Traveling Veterans – Care shall be coordinated/conducted in accordance with VHA Directive 2007-016 Coordinated Care for Traveling Veterans () Enrollment Verification and Episodic Care for unassigned/unenrolled patientsContractor Reasonability: The Contractor shall confirm eligibility of all patients presenting for care at the Contractor’s site. Contractor shall provide at no additional cost the approximately 5 / month nurse-only visits and 5 / month provider visits to Veterans who are not enrolled (assigned) for care at the outpatient site of care. These visits occur when an unassigned Veteran, but who is an otherwise eligible Veteran, comes to the clinic seeking limited episodic care that cannot be provided by the Veterans assigned primary care provider/team at their preferred facility. The clinic shall ensure that the Veteran is triaged by a nurse and that any basic care that can be provided by the nurse and/or provider is provided. Telehealth support for Patients Not Assigned at the Outpatient Site of Care— At no additional cost the contractor shall provide approximately 5 / month specialty TeleHealth visits with the VAMC parent for Veterans who are not enrolled (assigned) for care at the Outpatient Site of Care. These visits occur when a Veteran (not assigned to the site), but who is an otherwise eligible Veteran, requires a specialty TeleHealth visit with the parent VAMC (vs. requiring the patient traveling to the parent VAMC). The Contractor shall support the scheduling and visit management as per requirements and normal routine as defined in the PWS.Procedure for first visit Traveling Veterans presenting at the CBOC not enrolled with NMVAHCS:The contract staff shall verify the Veteran’s VA status by checking the Veteran’s VA ID card if they have one available, for Episodic Visits for Patients not assigned to the CBOC. If no ID card is available, Contractor’s staff shall obtain the Veteran’s information and verify eligibility with the NMVAHCS Enrollment Section in Albuquerque (1-800-465-8262 extension 2741).If the care need is deemed emergent, the Veteran shall be referred to the nearest emergency facility. (See notification of NMVAHCS Assessment Section)The contract clinic staff shall complete Form Report NMVAHCS’ ‘FL04-202 (01/09), registration information on traveling and temporary Veterans (see Attachment D) and fax the information to the NMVAHCS Enrollment Unit (04E), FAX 505-256-5453.The contract clinic staff shall contact the Enrollment Unit at the NMVAHCS facility and provide the Veteran’s name, social security number, date of birth, and whether the Veteran is a “temporary” resident in the area or “traveling through” the area.The NMVAHCS Enrollment Unit shall determine the Veteran’s eligibility and register them in the NMVAHCS with the annotation of “Temporary” or “Traveling Through” under remarks.If a traveling Veteran presents for care and has never been registered with the VA, the Contractor shall contact the NMVAHCS Enrollment Unit to determine eligibility. If the Veteran is eligible the Contractor shall have him/her fill out a 1010EZ and fax that along with their DD214 or discharge papers to the Enrollment Unit, FAX: 505-256-5453, for processing.The contract clinic provider shall evaluate the Veteran’s needs using any available remote or local patient information in CPRS/GUI. Reimbursement to the Contractor for Traveling Veteran’s services shall be in accordance with Schedule of Services.The Veteran shall be directed to a local affiliated pharmacy for partial prescription(s) filled based upon need and travel. Where appropriate for longer term fills, follow process in the Pharmaceuticals section of this document.NOTE: For ALL Traveling Veterans: for Episodic Visits for Patients not assigned to the CBOC.The Contractor shall maintain a list to identify and track patients who are traveling Veterans. The Contractor shall notify the NMVAHCS COR when the Veteran is no longer being seen in the area and shall remove them from the traveling Veteran list. Lists of traveling Veterans shall be submitted with the monthly billing.The Contractor’s invoice shall identify/list traveling Veteran patients separately for invoicing each month for traveling patients seen and/or treated during that month.Traveling Veteran: Listed are the CPT codes that Traveling Veteran care encompasses. A Traveling Veteran may be seen for single or multiple codes; in accordance with their classification as a "Traveling Veteran," and invoiced per CLINs 0001, 1001, 2001, 3001, 4001. ?Traveling Veterans?CPT CodeDescription Estimated Quantity99201Office or outpatient visit336410Venipuncture for collection of specimens ??????????? ??????????????? ??????????????? 336415Collection of venous blood by venipuncture??????? ??????????????? ??????????????? 380061Lipid panel????????????????????????????????????????????????????????????????????????? ??????????????? ??????????????? 381002Urinalysis, by dip stick or tablet reagent???????????????? ??????????????? ??????????????? 381025Urine Pregnancy test, by visual color compare methods??????????????? 382272 Blood, occult, by peroxidase activity??????????????????????????????????????????????????????? 382075Alcohol breath????????????????????????????????????????????????????????????????????????????????????????????????? 382948Glucose; blood reagent strip?????????????????????????????????????????????????????????????????????? 383036Hemoglobin; glycosylated (A1C)??????????????????????????????????????????????????????????????? 385610Prothrombin time??????????????????????????????????????????????????????????????????????????????????????????? 384153Prostate specific antigen (PSA); total????????????????????????????????????????????????????? 382043Albumin; urine, micro albumin, quantitative??????????????????????????????????????? 390700Diphtheria, tetanus toxoids, and Accellular pertussis?Vaccine (DTaP)????????????????????? 390749Unlisted vaccine/toxoid??????????????? ??????????????????????????????????????????????????????????????? 31.8.4 Brief Clinic Visit1.8.4.1. Visiting NMVAHCS Veteran Brief Clinic Visit - visit by a Veteran assigned to another NMVAHCS primary care site who requires and has orders from their VA PCP for lab draw, flu shot or other approved minor care. The CBOC Primary Care Provider involvement is not required; clinic support staff can provide the needed services. (Not to be confused with Traveling Veteran (See Para 1.8.3.). Contractor shall provide lab services for Veterans assigned to other VA sites. The Veteran’s assigned PCP (not the Contractor’s PCP) shall provide the order for the services in CPRS/GUI. Such lab draws shall include labs drawn related to specialty care, results required for review by the PCP prior to or at the time of a visit. Contractor shall identify this service on the monthly billing statement.1.8.4.2. Visiting Veteran: Listed are the CPT codes that Visiting Veteran care encompasses. A Visiting Veteran may be seen for single or multiple codes; in accordance with their classification as a "Visiting Veteran," and invoiced per CLINs 0001, 1001, 2001, 3001, 4001?Visiting Veterans?CPT CodeDescriptionEstimated Monthly Quantity99201Office or outpatient visit336410Venipuncture for collection of specimens ??????????? ??????????????? ??????????????? 336415Collection of venous blood by venipuncture??????? ??????????????? ??????????????? 380061Lipid panel????????????????????????????????????????????????????????????????????????? ??????????????? ??????????????? 381002Urinalysis, by dip stick or tablet reagent???????????????? ??????????????? ??????????????? 381025Urine Pregnancy test, by visual color compare methods??????????????? 382272 Blood, occult, by peroxidase activity??????????????????????????????????????????????????????? 382075Alcohol breath????????????????????????????????????????????????????????????????????????????????????????????????? 382948Glucose; blood reagent strip?????????????????????????????????????????????????????????????????????? 383036Hemoglobin; glycosylated (A1C)??????????????????????????????????????????????????????????????? 385610Prothrombin time??????????????????????????????????????????????????????????????????????????????????????????? 384153Prostate specific antigen (PSA); total????????????????????????????????????????????????????? 382043Albumin; urine, micro albumin, quantitative??????????????????????????????????????? 390700Diphtheria, tetanus toxoids, and Accellular pertussis?Vaccine (DTaP)????????????????????? 390749Unlisted vaccine/toxoid??????????????? ??????????????????????????????????????????????????????????????? 31.8.4.3. Examples of primary care services include, but are not limited to, the following CPT codes: (The Contractor shall adhere to the most current CPT coding standards.) CPT CODES SERVICES 989669896798968T1016S9445S9446S0255S0257H003190791961509615196152961539615499420Telephone call 5-10 minTelephone call 11-20 minTelephone call 21-30 minIneligible non-veteran or veteran case managementIndividual Patient Education – Non-PhysicianGroup Patient Education – Non-PhysicianHospice Referral visit (advising patient and family of care options)Advance Directives – counseling and discussion. This should be the only code used for Advance DirectivesPsychosocial Assessment by non-LIP social workerPsychosocial Assessment/Psychiatric Diagnostic InterviewHealth and Behavioral Assessments 15 *initial assessmentHealth and Behavioral Assessments 15 * reassessmentHealth and Behavioral Interventions 15 minHealth and Behavioral Interventions 15 min – group 2 or moreHealth and Behavioral Interventions 15 min 0 family with patient presentAdministration and Interpretation of Health Risk Assessment Instrument99201-99215Office or Other Outpatient Services 99241-99245Consultations 99354-99355Prolonged Services Face to Face 99420High Risk Assessment99441-99443Telephone Calls to Patient or Other Health Care Professionals 99381-99397Preventive Medicine Service 99401-99429Counseling and or Risk Factor Reduction Intervention 99499Case Management36410, 36415Venipuncture for collection of specimens Included in CPT codes listed elsewhere in this table.Female: Women's health services, , pap smear pelvic/breast exams; contraception counseling and management; management of osteoporosis, menopause, pelvic pain, abnormal uterine bleeding, and sexually transmitted diseases; in addition to screening for breast and cervical cancer or, a history of sexual trauma. Referral for pregnancy, mammography and recognition of ectopic pregnancy. GYN abnormalities should be referred through a Gynecology consult to the Parent facility.65205Eye: Superficial removal of foreign bodies. 69000-6920069210Ear: Simple procedures (e.g., drainage ext. ear abscess, removal foreign body). 70010TC-76499TCDiagnostic Radiology and Diagnostic Imaging, Mammography, shall be performed with the exclusion of invasive procedures, MRI, CT, and ultra sound. Services include technical component and professional interpretation. 80061, 81002, 81025, 82272QW, 82075, 82948,83036QW, 85610QW 88270/G0328, 84153, 82043Laboratory Services as follows: Lipid Screen, Urinalysis (non-automated w/o microscopic), pregnancy testing (visual color comparison), fecal occult blood tests, whole blood glucose, glycated Hemoglobin (A1C), PSA Total, Micro albumin random, and prothrombin time/INR. Optional Provider Performed Tests are as follows: Gastro cult and crystals. Note: Waived laboratory tests can be typically done in physicians' offices. All other laboratory services should be referred to NMVAHCS. 90700-90749Immunization Injections as recommended by CDC, or other recognized medical groups/academies. 93000, 93005, 93010, 93040,93041, 93042Cardiography Services are limited to ECG performance and interpretation. Note: The Contractor shall utilize MUSE-compatible EKGs. 94010, 94060,94640, 94760Performance and interpretation of spirometry and pulse oximetry for oxygen saturation. Other pulmonary procedures are excluded. 10060, 10061, 10080, 10081, 10120, 11200, 11730, 11770, 12001, 12002, 12004, 12005, 12006Minor Surgery. Procedures are limited to minor surgeries that only require local anesthesia and does not include sedation. 11719, 11720, 11721TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBERDEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 6 OR MORECBOC PACT STAFFING AND QUALIFICATIONS:2.1 CBOC PACT STAFFING REQUIREMENTS: Background & Introduction:VHA is implementing a patient-centered medical home (PCMH) model at all VHA Primary Care sites which is referred to as Patient Aligned Care Teams (PACT). This initiative supports VHA’s Universal Health Care Services Plan to redesign VHA healthcare delivery through increasing access, coordination, communication, and continuity of care. PACT provides accessible, coordinated, comprehensive, patient-centered care, in team based environment including the active involvement of other clinical and non-clinical staff. PACT allows patients to have a more active role in their health care and is associated with increased quality improvement, patient satisfaction, and a decrease in hospital costs due to fewer hospital visits and readmissions. Actions that shall assist CBOC in implementing PACT model:Participation in PACT national teleconferences and educational forums.Teamlet staff shall attend NMVAHCS sponsored Transformational Learning Centers of Excellence. The training shall be provided by the NMVAHCS. Travel expenses shall be paid by the Contractor.The Contractor shall provide personnel, either through direct hire or through subcontracting, in numbers and qualifications capable of fulfilling the requirements of the resultant contract. The Contractor shall provide a sufficient number of primary care providers so that each primary care provider has a reasonable caseload. Current caseload ratios are based on the expectation that a fulltime physician will care for approximately (500-725) patients, and a midlevel provider will care for approximately (500-725) patients. These numbers may be adjusted, upon approval by the Government, based on the availability of exam rooms and support staff (refer to VHA Handbook 1101.02).PACT Pillars and Foundations: The PACT delivery model is predicated on a foundation of delivering care that is patient centered, team based and continuously striving for improvement. A systems redesign approach has been developed to help teams focus on important components of the model including Patient Centered Care, Access, Care Management and Coordination as well as Redesigning the Team & Work.Enhance Patient Centered Care: Establishing a patient centered practice environment and philosophy as a core principle of PACT requires a knowledgeable staff and an engaged, activated patient and family. Clinic staff shall be required to complete the following tasks in order to begin to implement Patient Centered Care:Engage the patient/family in self-management and personal goal settingProvide education pertinent to care needs and document the provision of that education.Provide support on site to enroll patients in MyHealtheVet & Secure MessagingEnsure staff are trained in self-management techniques, motivational interviewing, shared decision making as made available by VAMC.CBOC patients shall be notified of all test results within 14 days. Link to VHA Communication of Test Results toolkit Enhance Access to Care: PACT strives for superb access to care in all venues including face to face and virtual care. Achievement of the following list of requirements shall assist the CBOC in achieving superb access for Veterans.Face to Face Visit Access:Provide same day access for patientsIncrease (establish) group visits and shared medical appointmentsVirtual Access:Telephones:Phones shall be answered by a “live” person with a focus on achieving first call resolution. First call resolution is taking care of the Veteran’s issue/request during that call. This approach requires thoughtful planning and strategy.Increase telephone care delivered to Veterans by PACT members.MyHealtheVet (MHV):Provide support to enroll into MyHealtheVetIncrease enrolleesSecure Messaging (SM):Encourage & educate patients to use SM as a non-synchronous mode of communicationEstablish SM as a communication method in clinicIncrease Veteran participationTele-medicine & Tele-healthImprove access to scarce medical services via Tele-medicine capabilities as deemed appropriate by VAMCIncrease Veteran enrollment in Tele-health modalities available at VAMC.Enhance Care Management & Coordination of Care: Improving systems and processes associated with critical patient transitions, managing populations of patients and patients at high risk has proven to have a positive impact on quality, patient satisfaction and utilization of high cost services such as acute inpatient admissions, skilled nursing facility stays, and emergency department visits. CBOC staff shall focus on the following actions to achieve improvements.Improve Critical Transitions Processes:Inpatient to Outpatient:Develop systems to identify admitted primary care patients.Provide follow up care either by face to face visit or telephone visit within 2 days post discharge.Document the follow up care in CPRS/GUI delivered and communicate among the team.Enhance Primary Care to Specialty Care InterfaceParticipate in electronic virtual consults as availableDevelop resource listing of specialty care points of contact for nursing and medical careParticipate in VAMC sponsored medical educational activities to enhance networking with specialty staffEnhance VA & Community Interfaces in Caring for VeteransDevelop a list of community points of contactDevelop mutually agreeable interface systems with community facilities and providersImprove Systems for Managing the Care of Patient PopulationsEnhance Management of Patients with Chronic IllnessIdentify patients with suboptimal chronic disease indices from VHA databases (registries)Develop plans including staff roles and responsibilities in addressing care needs. Include all team members in delivering care as license allows. Use face to face and virtual care delivery methods such as pharmacy/nurse clinics, telephone clinicEnhance Health Promotion & Disease Prevention Focus in Care Delivery:Identify patients with preventive care needs from VHA databases (registries)Develop & implement plans including staff roles and responsibilities in addressing care needs. Include all team members in delivering care as license allows. Use face to face and virtual care delivery methods such as pharmacy/nurse clinics, telephone clinicEnhance Management of High Risk Veterans: frequent emergency department visits, frequent inpatient admissions for ambulatory sensitive conditions, and severely injured/disabled, frail elderly.Identify patients with preventive care needs from VHA databases (registries)Develop plans including staff roles and responsibilities in addressing care needs. Include all team members in delivering care as license allows. Use face to face and virtual care delivery methods such as pharmacy/nurse clinics, telephone clinicImprove Practice Design & Flow to Enhance Work Efficiency & Care Delivery:Maximize functioning of all team members through role and task clarification for work flow processes.Develop a plan to improve work flow process for visit or virtual care.Conduct daily Teamlet huddles to focus on operational needs for that dayConduct weekly team meeting to focus on systems and process improvements, review and use data to monitor processes,PACT Staffing Model: Provision of appropriate staffing resources is an essential component of the PACT model. Teams need to be staffed adequately to fully implement a robust PACT model. Staffing for the PACT model is divided into the Teamlet and expanded team. The Teamlet staff is responsible for managing the care for a panel of patient(s) equivalent to a full time provider (500-725). The expanded PACT staff is equally important for the roles they play in the overall care of the Veteran and deliver care to multiple Teamlets.Teamlet staffing: The recommended staffing for a “Teamlet” is 4.00 FTE for a full time provider panel (approximately (500-725)). Members of the Teamlet include a primary care provider (MD, NP, PA), a RN Care Manager, a Clinical Associate (LPN/LVN, MA, HCT) and a Clerical Associate. Discipline-specific team member: A discipline-specific team member is a health care professional designated to a PACT position in PCMM who provides direct discipline-specific patient care to more than one panel of patients, but not to all primary care patients at the facility. Examples of discipline-specific team members are: Clinical Pharmacy Specialists, Registered Dietitians, Social Workers, Primary Care-Mental Health Integration providers. Expanded Team staffing (optional: shall be provided by NMVAHCS): Other PACT members such as pharmacists, social workers, and dieticians are critical to effective and efficient PACT delivery. Expanded team members deliver care to multiple Teamlets. Recommended staffing for expanded team members per Teamlet includes 0.3 FTE clinical pharmacy specialist, 0.5 FTE and 0.2 FTE registered dietician and 0.5 FTE registered Social Worker. The following are recommendations for minimal staffing ratios of select discipline-specific team members:At least one CPS for every three patient panels. The PACT CPS will function in the capacity of a mid-level provider functioning with an advanced scope of practice as their primary duty is to assist Teamlets with comprehensive medication management. Staffing ratio may be adjusted upward locally to provide appropriate comprehensive medication management.At least one anticoagulation CPS for every five patient panels, in addition to the PACT CPS. Since the staffing for anticoagulation management depends on the facility demographics for chronic anticoagulation, this equates to one anticoagulation CPS to safely manage approximately (500-725) chronic warfarin patients. Staffing ratio may be adjusted upward locally to provide appropriate pharmacy-related care to patients.At least one dietitian for every five patient panels or approximately (500-725) patients per dietitian. Staffing ratio may be adjusted upward locally to provide appropriate medical nutrition therapy or education.At least one social worker for every two patient panels. Minimum staffing requirements:Sufficient support staff to conduct daily business in an orderly manner, including such functions as patient registration, financial assessments, and medical record documentation in VISTA. “Support staff” is defined as staff present in the clinic area assisting providers in the actual delivery of primary care to patients. It consists of RNs, LPNs, Medical Assistants, Health Technicians, and Medical Clerks in the clinic. Staff involved in Coumadin Anticoagulation Clinics. Anticoagulation clinic management and Telephone Care for the primary care patients are also considered support staff, even if located in a separate area. Staff time dedicated to Business Office functions (means testing, registrations or billing), phlebotomy, file room activities, or supporting non-primary care clinics (e.g., podiatry, social work, and dietary) are not considered support staff for the purposes of this definition. Support staff should be in ratios to Primary Care Providers of at least three support staff for each full time equivalent Primary Care Provider. Clinical Pharmacy Services (provided by contractor or VA) The CPS should be provided the same support staffing given to other providers on the team when they are working in the capacity of a mid-level provider. The support staffing mix should include a registered nurse care manager for every (500-725) patient served by the CBOC.A physician with current licensure in any state may be designated to serve as medical director to oversee and be responsible for the proper provision of covered services to enrolled patients. It is preferred that this physician be board certified in Internal Medicine or Family Practice (see qualifications). Other primary care staff: Provider staff including nurse practitioners, physician assistants, registered nurses, and support staff including licensed practical nurses, medical assistants, and health technicians as deemed necessary to support the PACT concept outlined and the caseload ratios described in the PWS.Licensed Social Worker – It is anticipated that an LSW will be required at CBOC 40 hours per week to handle the anticipated mental health workload effectively. All personnel qualifications listed in this PWS shall be met.CBOC STAFFING QUALIFICATIONS: Personnel provided by the contractor (including subcontractors) shall provide the education and credentials of each clinical employee by name (C.V. and/or resume acceptable). Offers shall be considered only from offerors who are regularly established in the business called for and who, in the judgment of the Contracting Officer, are financially responsible and able to show evidence of their responsibility, ability, experience, equipment, facilities, and personnel directly employed or supervised by them to render prompt and satisfactory service in the volume required for all items under this contract. By the signing of this offer, offeror is certifying that he/she shall meet all requirements of Federal, State, or local laws, codes, and/or regulations and all applicable standards in the most current version of The Joint Commission Accreditation Manual for Hospitals regarding the operation of this type of service. (Current standards can be found on the JC Website ), In addition, the contractor shall follow all applicable NMVAHCS Directives, and policies and procedures. The contractor shall comply with all applicable privacy and confidentiality statutes and regulations of the HIPPA: Health Insurance Portability and Accountability Act.NMVAHCS shall inspect and investigate the establishment, facilities, business reputation, and other qualifications of the offeror and reserves the right to reject any offer, irrespective of price, that shall be administratively determined by the Contracting Officer to be lacking in any of the essentials judged necessary to assure acceptable standards of performance.The contractor shall abide by the NMVAHCS Compliance and Business Integrity (CBI) Program Memorandum 0028 () which addresses marketing, admission process, transfer/discharge process, and billing issues. Eligible Veterans shall not be denied care for treatment which is not reimbursed by the third party insurance payer. Personnel assigned by the Contractor to perform the services covered by this contract shall be licensed in the State of New Mexico, 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 Chief of Staff NMVAHCS, per NMVAHCS Medical Staff Bylaws . Each physician or nurse assigned to work under this contract shall be credentialed by the New Mexico Veterans Administration Health Care System (NMVAHCS).Any subcontractor utilized by the Contractor for the provision of services required under this contract shall meet the same qualifications specified herein for the Contractor, as appropriate to the work being performed. The Contractor shall obtain approval from the CO for subcontractor(s) utilized. Shall be paid by the Contractor.Contractor’s Physician(s) (including subcontractors)Contractor’s Physicians providing primary care services under the resultant contract shall demonstrate evidence of education, training, and experience in Internal Medicine or Family Practice. Contractor’s Physicians shall have current DEA licensure. Contractor shall provide copies of DEA cards for staff providing services under the resultant contract.Contractor’s Physician(s) providing podiatry services under this resultant contract shall demonstrate education, training and experience in podiatry. Contactor’s Physicians performing under this contract shall be board certified (or board eligible) by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. If selected for contract award and physician(s) proposed by the Contractor are not board certified or not eligible for board certification to provide services under this contract, the NMVAHCS Chief of Staff and Director will make a determination that these physicians are well qualified and fully capable of providing high quality care for veteran patients based on the verification of their credentials related to education, training, professional experience and competency. If NMVAHCS rejects a proposed physician, the Contractor is required to propose substitute acceptable personnel within five (5) calendar days.Contractor’s Physicians and personnel providing services under this contract must speak and write English proficiently.Subcontracted Provided Services:All individuals that provide services under this Contract and are not employees of the Contractor shall be regarded as sub-contractors (including non-medical individuals). Contractor shall be responsible and accountable for the quality of care and services delivered by any and all of its sub-contractors. Contractor shall hold the sub-contractor accountable for the requirements for availability and accessibility of services as outlined in this contract.Contractor shall use a systematic approach to monitoring the availability and accessibility of services of the sub-contractor as they relate to the quality of care monitors listed in this contract. Subcontracted Provider Reports: The main Contractor shall furnish to the NMVAHCS COR, prior to commencement of services, a listing of all providers subcontracted for in the plan with documentation that they are credentialed and documentation that they meet current JC standards. If subcontracted providers change, a new report shall be provided, reflecting those changes. On the 15th calendar day after the beginning of each calendar quarter, Contractor shall submit a revised sub-contractor report to the Contracting Officer, NMVAHCS, of sub-contractors approved by NMVAHCS. The list of minimum required data sets shall be the same as those specified above.Contractor shall report to the COR, NMVAHCS, all cases of suspected provider, sub-contractor’s provider, patient abuse and/or fraud. Contractor shall immediately notify NMVAHCS of any professional liability actions brought against any of its sub-contractors, regardless of source or outcome.NMVAHCS reserves the right to refuse to allow any Contractor employee or sub-contractor employee, to perform work under this contract and/or to require dismissal from contract work any individual who, by reason of previous unsatisfactory performance at NMVAHCS or for any other reason, is considered by the CO to be objectionable; as long as thirty (30) days written notification of unsatisfactory performance has been provided to the Contractor and the problem has not been corrected within that 30 day period.Physicians and personnel providing services under this contract shall speak and write English proficiently.The offeror’s signature in Block 30a of the Standard Form 1449, Solicitation/Contract/Order for Commercial Items, is a certification that any individual providing clinical services under this contract: Shall have no physical/mental limitations or other conditions that shall adversely affect his/her ability to perform as required by this contract;Shall not have a loss, reduction, restriction, or revocation of his/her clinical privileges at any institution;Shall not, is not currently, and is not pending any litigation for medical malpractice;Shall be a member in good standing or has not had a loss of medical staff membership at or from any institution; andShall not, does not currently, and has no pending felony criminal charges against him/her.Contractor Dietitian services (including subcontractors): There are not Dietitian services required to be provided by the Contractor and are not to be a part of this contract.CONTRACTOR’S SOCIAL WORKER (S) (including subcontractors): Social Workers providing services under this contract shall have a degree in Social Work from a school accredited by Council on Social Work Education (CSWE) and be licensed in a State of New Mexico, Territory, or Commonwealth of the United States or the District of Columbia. Social worker shall have experience providing MH services. The CSWE website is . The social worker is required to meet the needs of the Veterans as outlined in the PWS. Contractor can provide additional support/resources to assure Veteran needs are met and or additional training to the social worker. The VA prefers that the social worker have experience providing social work services. CONTRACTOR’S Certified Registered Nurse Practitioners (CRNPs) (including subcontractors) shall have a MSN from a National League for Nursing (NLN) accredited nursing program and have American Nurses Association (ANA) Certification as a Nurse Practitioner in either Adult Health or Family Practice. Authorization for prescriptive authority is required. Three years of clinical nursing experience is required. A minimum of one (1) year clinical experience as a CRNP is required (three (3) years preferred). Experience in outpatient care in a Family Medicine or Internal Medicine environment is preferred.CONTRACTOR’S Physician Assistants(including subcontractors) must meet one of the three following educational criteria: a) A bachelor’s degree from a Physician Assistant (PA) training program which is certified by the Committee on Allied Health Education and Accreditation (CAHEA); or b) Graduation from a PA training program of at least twelve (12) months duration, which is certified by the CAHEA and a bachelor’s degree in a health care occupation or health related science; or c) graduation from a PA training program of at least twelve (12) months duration which is certified by the CAHEA and a period of progressively responsible health care experience such as independent duty medical corpsman, licensed practical nurse, registered nurse, medical technologist, or medical technician. The duration of approved academic training and health care experience must total at least five (5) years. Authorization for prescriptive authority is required. PAs must be certified by the National Commission on Certification of Physician Assistants (NCCPA).If Licensed Practical Nurses and Medical Assistants are used they shall be utilized for information gathering in the clinic setting but cannot perform assessments or triage of Veterans. They shall provide patient teaching only when delegated by a RN and instructed on the content of the instruction by the Registered Nurse or provider. Only staff licensed in the State of New Mexico and authorized by the State Board of Nursing to administer medications can administer medications. CONTRACTOR’S Radiologic Technologists X-rays shall not be performed by the Contractor on site at the CBOC. Radiology services shall be provided outside of the CBOC operations primarily through parent facility NMVAHCS. NOTE: paid by Contractor. (SEE 4.6.7. Radiology Services)CONTRACTOR’S Clinical Pharmacy Services (including subcontractors) should be provided by a CPS who is a licensed pharmacist who has completed an ACPE accredited Pharmacy D program or has at least 1 year of pharmacy equivalent experience at the next lower level. Clinical pharmacy services may be provided by the VA pharmacy or through the contractor depending on the location. The CPS has duties and responsibilities as defined in VHA Handbook 5005, Part 2, Appendix G15, Licensed Pharmacist Qualification Standards . In addition to the requirements listed above, the CPS. Pharmacists must meet licensed qualification standards to include 1) citizen of the United States 2) graduate of a degree program in pharmacy from an approved college or university. The degree program must have been approved by the ACPE and obtain full, current and unrestricted license to practice pharmacy in a state, territory, commonwealth of the United States or the District of Columbia.CONTRACTOR’S TELEHEALTH SERVICES (including subcontractors) All staff employed providing TeleHealth related services into the clinic must be appropriately credentialed and; where necessary, privileged. All contractor staff who support TeleHealth services must be working within permitted licensure and scope of practice. Where non-licensed staff is supporting TeleHealth services provided through the contractor they must do so under the appropriate clinical supervision. TCT’s will serve in a generalist role to support and manage tele-health clinical encounters from a patient and provider location as the Tele-presenter and imager for Tele-health store and forward applications. This position serves as the clinic manager for real time Tele-health events, including patient education activations, provision of equipment for the Home Tele-health program, technical and scheduling activities, training, developing and monitoring improvement process for all Tele-health activities as well as other program support duties as assigned. Licensed staff serving as TCTs will perform patient screening and determine the cognitive, physical, emotional and chronological development of adult and geriatric patients effecting appropriate inter/intra facility and outpatient transportation. Ensure proper operation of equipment and products by performing routine maintenance and maintaining proper records for quality reports and workload reporting.License and Accreditation: All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Technical Proficiency/Board Certification: The qualifications of such personnel shall also be subject to review and approval by the VA COS. Personnel 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.The Contractor must ensure that all individuals who provide services and/or supervise services at the CBOC, including individuals furnishing services under contract are qualified to provide or supervise such services.Contractor staff qualifications, licenses, certifications and facility accreditation must be maintained throughout the contract period of performance. In the event that Contractor’s staff is not directly employed by the treating facility, documentation must be provided to the COR to ensure adequate certification. All actions required for maintaining certification must be kept up to date at all times. Documentation verifying current licenses, certifications and facility accreditation must be provided by the Contractor on an annual basis.The Contractor is responsible for assuring that all persons, whether they be employees, agents, subcontractors, providers or anyone acting for or on behalf of the Contractor, are properly licensed at all times under the applicable state law and/or regulations of the provider’s license, and shall be subject to credentialing and privileging requirements by VA.The Contractor will not permit any employee to begin work at a CBOC prior to confirmation from the VA that the individual’s background investigation has been reviewed and released to the Office of Personnel Management (OPM), by the Security and Investigations Center (SIC), and that credentialing and privileging requirements have been met. A copy of licenses must be provided with offer and will be updated annually. Any changes related to the providers' licensing or credentials will be reported immediately to the VA Credentialing Office. Failure to adhere to this provision may result in one or more of the following sanctions, which shall remain in effect until such time as the deficiency is corrected:The VA will not pay the capitation rate due on behalf of an enrolled patient if service is provided or authorized by unlicensed personnel, without regard to whether such services were medically necessary and appropriate.The VA shall not approve of subcontracts with non-licensed individual or group providers. The VA will rescind subcontractor approval if the subcontractor should lose their license during the course of the contract.The VA may refer the matter to the appropriate licensing authority for action, as well as notify the patient that he/she was seen by a provider outside the scope of the contract and may pursue further action. The Government reserves the right to refuse acceptance of Contractor, 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 contract personnel’s conduct. The final arbiter on questions of acceptability is the CO.All patient complaints are reported immediately (within 24 hours.) The CO shall resolve complaints received from the COR concerning Contractor relations with the Government employees or patients. Providers and staff are familiarized with the process outlined in contractor’s grievance procedures as well as patient rights. 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.Credentialing and Privileging: Credentialing and privileging will be done in accordance with the provisions of VHA Handbook 1100.19. This VHA Handbook provides updated VHA procedures regarding credentialing and privileging, to include incorporating: VHA policy concerning VetPro; the Expedited Medical Staff Appointment Process; credentialing during activation of the facility Disaster Plan; requirements for querying the FSMB; credentialing and privileging requirements for Telemedicine and remote health care; clarifications for the Summary Suspension of Privileges process in order to ensure both patient safety and practitioner rights; and the credentialing requirements for other required providers.Contractor will ensure that all Physicians, Social Workers and any specialist that requires licensure or accreditation under this contract participate in the Credentialing and Privileging process through VHA’s electronic credentialing system, “VetPro” No services are to be provided by any contract provider requiring credentialing until the parent VA Medical Executive Board and Director have granted approval. The Contractor will be provided copies of current requirements and updates as they are published.Credentials and Privileges shall require renewal annually in accordance with VA and The JC requirements. Credentialed providers assigned by the Contractor to work at the CBOC shall be required to report specific patient outcome information, such as complications, to the VA. Quality improvement data provided by the Contractor and/or collected by the VA will be used to analyze individual practice patterns. The Service Chief, Primary Care Service Line will utilize the data to formulate recommendations to the Medical Executive Board when clinical privileges are being considered for renewal.Contractor will ensure that all Nurse Practitioners, Clinical Pharmacy Specialists, and Physician Assistants to be employed under this contract also participate in the Credentialing process through VA’s “VetPro,” as described above. Since Nurse Practitioners, Clinical Pharmacy Specialists, and Physician Assistants are not recognized by the VA as independent practitioners, they function under a Scope of Practice (not Clinical Privileges). The credentials and scope of practice for Nurse Practitioners, Clinical Pharmacy Specialists, and Physician Assistants are reviewed at the time of the initial appointment and at least every two years thereafter by an appropriate VA discipline-specific Professional Standards Board.CME/CEU: Contractor staff registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentials office for tracking. These documents are required for both privileging and re privileging. Failure to provide will result in loss of privileges.Training (ACLS/BLS/VA MANDATORY): Contractor staff shall complete VA mandatory training as requested and complete ACLS/BLS training and keep ACLS/BLS certifications current throughout the life of the contract. Copies of current certifications shall be provided to the COR.PATIENT INFORMATION: In performance of official duties, Contractor’s provider(s) have regular access to printed and electronic files containing sensitive data, which must be protected under the provisions of the Privacy Act of 1974 (5 U.S.C. 552a), and other applicable laws, Federal Regulations, Veterans Affairs statutes and policies. Contractor’s provider(s) are responsible for (1) protecting that data from unauthorized release or from loss, alteration, or unauthorized deletion and (2) following all applicable regulations and instructions regarding access to computerized files, release of access codes, etc., as set out in a computer access agreement which contract provider(s) signs.Contractor staff shall complete required security training and sign a VA Computer Access Agreement prior to having access to the VA computer system. Security Training will be accomplished annually. Contractor staff shall select training modules for Privacy Training and Information Security Training. Upon completion of the training, please scan and email to the COR.In addition, if providing medical services, Contractor staff will attend CPRS training prior to providing any patient care services. Contractor staff shall document patient care in CPRS to comply with all VA and equivalent JC standards.Rules of Behavior for Automated Information Systems: Contractor staff having access to VA Information Systems are required to read and sign a Rules of Behavior statement which outlines rules of behavior related to VA Automated Information Systems. The COR will provide, through the facility ISO, the Rules of Behavior to The Contractor for the respective facility. Standard Personnel Testing (PPD, etc): Contractor shall provide statement that all required infection control testing is current and that the contractor is compliant with OSHA regulations concerning occupational exposure to blood borne pathogens. The Contractor shall also notify the VA of any significant communicable disease exposures and the VA will also notify the contractor of the same, 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 Identification (NPI): All Contractors who provide billable healthcare services to VA; VHA, shall obtain a NPI as required by the Health Insurance Portability and Accountability Act (HIPPA) National Provider Identifier Final Rule, administered by the CMS. This rule establishes assignment of a 10-digit numeric identifier for Contractor staff, intended to replace the many identifiers currently assigned by various health plans. Contractor staff needs only one NPI, valid for all employers and health plans. Contractor staff must also designate their Specialties/Subspecialties by means of Taxonomy Codes on the NPI application. The NPI may be obtained via a secure website at: Conflict of Interest: the Contractor is 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 sub-Contractors 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.Citizenship related Requirements: 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. The Contractor shall return a signed certification at the time of proposal 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 the VA. 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 and is applicable to the entire period of performance.Annual Office of Inspector General (OIG) Statement: In accordance with The Health Insurance Portability and Accountability Act (HIPAA) and the Balanced Budget Act (BBA) of 1977, the VA 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, all Contractors shall review the OIG List of Excluded Individuals/Entities on the OIG web site at oig to ensure that the proposed Contract staff and/or firm(s) are not listed. Contractors 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 or entity 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 Contract staff and entities that employ or enter into contracts with excluded individuals or entities to provide items or services to Federal program beneficiaries.By submitting their proposal, the Contractor certifies that the OIG List of Excluded Individuals/Entities has been reviewed and that the Contractor and/or firm is/are not listed as of the date the offer/bid was signed.Non-Personal Services: The parties agree that The Contractor, contract staff, agents and sub-Contractors shall not be considered VA employees for any purpose. All individuals that provide services under this resultant contract and are not employees of the Contractor will be regarded as subcontractors. The Contractor shall be responsible and accountable for the quality of care delivered by any and all of its subcontractors. The Contractor shall be responsible for strict compliance of all contract terms and conditions without regard to who provides the service.CONTRACT PERSONNEL: The Contractor shall be responsible for protecting all Contractor personnel furnishing services. To carry out this responsibility, The Contractor shall provide or certify that the following is provided for all contract staff providing services under the resultant contract:Workers’ compensationProfessional liability insuranceHealth examinationsIncome tax withholding, andSocial security paymentsContractor and contract staff 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, 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.TORT: The Federal Tort Claims Act does not cover Contract staff. When a contract staff member has been identified as a provider in a tort claim, The Contractor’s staff member shall notify the Contractor’s legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s provider’s action or non-action is the responsibility of The Contractor and/or insurance carrier.Thirty (30) days prior to the contract expiration date of each year (Base or Option Year), the Contractor shall certify in writing to the CO that all licenses and registrations of personnel employed under this contract are valid and current and shall be renewed as necessary during the option period. Failure to provide this certification shall result in a determination not to exercise the NMVAHCS's renewal option. Updated copies of all licenses and registrations shall be provided to the CO annually based upon expiration dates of the licenses and registrations.NMVAHCS reserves the right to refuse to allow any Contractor employee or sub-contractor employee, to perform work under this contract and/or to require dismissal from contract work any individual who, by reason of previous unsatisfactory performance at NMVAHCS or for any other reason, is considered by the CO to be objectionable; as long as thirty (30) written notification of unsatisfactory performance has been provided to the Contractor and the problem had not been corrected within that 30 day period.Prior to extended absences and termination of employment PCP and Nurses shall establish a surrogate within VistA CPRS/GUI. Instructions shall be provided at award of contract.hours of Operation: Business Hours: Services shall be available from the contractor 8:00 am to 4:30 pm federal holidays are outlined in the next paragraph.Federal Holidays: The following holidays are observed by the Department of Veterans Affairs: New Year’s DayWashington’s BirthdayMartin Luther King’s BirthdayMemorial DayIndependence DayLabor DayColumbus DayVeterans DayThanksgivingChristmasAny day specifically declared by the President of the United States to be a national holiday.CONTRACTOR RESPONSIBILITIESGENERAL: Contractor performing Primary Care services shall provide a continuum of care from prevention to diagnosis and treatment, to appropriate referral and follow-up.The Contractor shall provide CBOC services solely dedicated to veterans regardless of gender or age.Those patients needing specialty or follow-up care shall be referred to VA. Contractor’s CBOC must have the necessary professional medical staff, diagnostic testing and treatment capability, and referral arrangements needed to ensure continuity of health care. If requested or required by either the Government or the Contractor, the Contractor will work closely with the CO and COR to modify the contract expeditiously, in order to limit the impact on the clinic’s veterans and ensure consistency with the care provided by the VA’s other Primary Care Clinics. Standards of practice: Contractor shall be responsible for meeting or exceeding NMVAHCS and TJC (or equivalent) standards. PACT Pillars and Foundations: The PACT delivery model is predicated on a foundation of delivering care that is patient centered, team based and continuously striving for improvement. A systems redesign approach has been developed to help teams focus on important components of the model including Patient Centered Care, Access, Care Management and Coordination as well as redesigning the team and work.Enhance Patient Centered Care: Establishing a patient centered practice environment and philosophy as a core principle of PACT requires a knowledgeable staff and an engaged, activated patient and family. Contractor CBOC Clinic staff shall be required to complete the following tasks in order to begin to implement Patient Centered Care:Engage the patient/family in self-management and personal goal settingProvide education pertinent to care needs and document the provision of that education.Provide support on site to enroll patients in MyHealtheVet & Secure Messaging Ensure staff is trained in self-management techniques, motivational interviewing, shared decision making as made available by VA. CBOC patients will be notified of all normal test results within 14 days. Enhance Access to Care: PACT strives for superb access to care in all venues including face to face and virtual care. Achievement of the following list of requirements will assist the Contractor’s CBOC in achieving superb access for Veterans.Face to Face Visit Access:Provide same day access for patientsIncrease (establish) group visits and shared medical appointmentsVirtual AccessTelephones: Phones should be answered by a “live” person with a focus on achieving first call resolution. First call resolution is taking care of the Veteran’s issue/request during that call. This approach requires thoughtful planning and strategy. Increase telephone care delivered to veterans by PACT members. MyHealtheVet (MHV):Provide support to enroll into MyHealtheVetIncrease enrollees in MHV and Secure MessagingSecure Messaging (SM):Encourage & educate patients to use SM as a non-synchronous mode of communicationEstablish SM as a communication method in clinicIncrease Veteran participationTelemedicine & Telehealth Improve access to scarce medical services via telemedicine capabilities as described in FY 14 T21 Implementation Guidance document. Increase Veteran enrollment in TeleHealth modalities available at VAMC.Enhance Care Management & Coordination of Care: Improving systems and processes associated with critical patient transitions, managing populations of patients and patients at high risk has proven to have a positive impact on quality, patient satisfaction and utilization of high cost services such as acute inpatient admissions, skilled nursing facility stays, and emergency department visits. CBOC staff shall focus on the following actions to achieve improvements. Improve Critical Transitions Processes: Inpatient to Outpatient:Develop systems to identify admitted primary care patients. Provide follow up care either by face to face visit or telephone visit within 2 days post discharge.Document the follow up care in CPRS delivered and communicate among the team. Enhance Primary Care to Specialty Care InterfaceParticipate in electronic virtual consults & SCAN ECHO as availableDevelop resource listing of specialty care points of contact for nursing and medical careParticipate in VAMC sponsored medical educational activities to enhance networking with specialty staffEnhance VA & Community Interfaces in Caring for VeteransDevelop a list of community points of contact Develop mutually agreeable interface systems with community facilities and providersImprove Systems for Managing the Care of Patient PopulationsEnhance Management of Patients with Chronic IllnessIdentify patients with suboptimal chronic disease indices from VHA databases (registries)Develop plans including staff roles and responsibilities in addressing care needs. Include all team members in delivering care as license allows. Use face to face and virtual care delivery methods such as pharmacy/nurse clinics, telephone clinic etc. Enhance Health Promotion & Disease Prevention Focus in Care DeliveryIdentify patients with preventive care needs from VHA databases (registries)Develop & implement plans including staff roles and responsibilities in addressing care needs. Include all team members in delivering care as license allows. Use face to face and virtual care delivery methods such as pharmacy/nurse clinics, telephone clinic etc. Enhance Management of High Risk Veterans: frequent emergency department visits, frequent inpatient admissions for ambulatory sensitive conditions, and severely injured/disabled, frail elderly. Identify patients with preventive care needs from VHA databases (registries)Develop plans including staff roles and responsibilities in addressing care needs. Include all team members in delivering care as license allows. Use face to face and virtual care delivery methods such as pharmacy/nurse clinics, telephone clinic etc. Improve Practice Design & Flow to Enhance Work Efficiency & Care Delivery:Maximize functioning of all team members through role and task clarification for work flow processes. Develop a plan to improve work flow process for visit or virtual care.Conduct daily Teamlet huddles to focus on operational needs for that dayConduct weekly team meeting to focus on systems and process improvements, review and use data to monitor processes, etc. DIRECT PATIENT CARE: Contractor’s CBOC shall provide Primary Care and MH services supporting a continuum of care from prevention to diagnosis and treatment, to appropriate referral and follow-up. Simple to Moderately Complex workload that can be appropriately managed in primary care and mental health are identified below:HypertensionDepressionIschemic Heart DiseaseAnxietyHypercholesterolemiaDegenerative ArthritisCongestive Heart FailureRespiratory InfectionCerebral Vascular DiseaseChronic Obstructive Pulmonary Disease (COPD)Peripheral Vascular DiseaseUrinary Tract InfectionDiabetes MellitusCommon Dermatological ConditionsChronic PainAcute Wound ManagementGastric DiseaseSkin Ulcers (Stasis and Dermal)AnemiaMale Genitourinary (GU) IssuesStable Chronic Hepatic InsufficiencyCervical Cancer screeningConstipationOsteoporosisCommon otic and optic conditionsBasic diagnostic evaluation and tests for infertilityPreventative Medicine Screening and ProceduresCervical Cancer ScreeningBreast Cancer ScreeningPharmacology in Pregnancy & LactationEvaluation & Treatment of VaginitisAmenorrhea/Menstrual DisordersEvaluation of Abnormal Uterine BleedingMenopause Symptom ManagementDiagnosis of pregnancy and initial screening testsEvaluation and management of Acute and Chronic Pelvic PainRecognition and management of Postpartum Depression and Postpartum BluesEvaluation and management of Breast Symptoms (Mass, Fibrocystic Breast Disease, Mastalgia, Nipple Discharge Mastitis, Galactorrhea, Mastodynia)Crisis Intervention; Evaluate psychosocial well being and risks including issues regarding abuseViolence in women & Intimate Partner Violence Screening -Personal and physical abuse -Verbal/Psychological abusePreconception CounselingAssessment of abnormal cervical pathologyContractor shall schedule initial or follow-up visits to primary care providers at the Contractor’s CBOC site. Contractor shall obtain a complete history and physical examination which must be performed on the first visit other than in exceptional circumstances. Cervical cancer screening is not required on first visit but must be accomplished within VA screening guidelines, documenting any?outside results and meeting guidelines for a new patient within the guideline time limits. This is a Vesting CPT Code visit. Exceptional circumstances means the Veteran is seen for his first visit as an emergency for a shorter duration visit. In this case, a complete history and physical examination must be completed within 72 hours. The complete history and physical examination shall be performed with documentation of Veteran problems via the on-line Problem List option in VISTA/CPRS computer system which shall be updated as needed on each subsequent visit. The Problem List shall be updated by the third visit and all subsequent visits, and include all significant diagnoses, procedures, drug allergies, and medications. Contractor shall ensure within twelve (12) months of the last visit, the Veteran receives a visit which justifies any of the Vesting CPT Codes.Contractor shall schedule office, telephone and TeleHealth visits with other health care providers including nurses, physician extenders, CPSs, or dietitians for the purposes of monitoring or preventing disease and providing patients with information and/or skills so they can participate in decision-making and self-care. Contractor shall ensure phone contacts with patients and primary care providers or their designee. INPATIENT CARE:Should elective inpatient care be deemed necessary by the Contractor, the Contractor shall contact the NMVAHCS Bed Control Pager at 505-530-4884 to coordinate an admission.Should emergency inpatient care be deemed necessary by the Contractor, the Contractor shall contact the Communications Center at NMVAHCS Managed Care Office 505-256-2825 during normal working hours and the AOD at 505-265-1711 after normal working hours for guidance. Under no circumstances should emergent medical intervention be delayed pending administrative guidance from the NMVAHCS. After notification, the NMVAHCS Eligibility Office shall make a determination of eligibility for payment purposes.CBOC/contractor providers shall not have a direct role in the patients’ care while patients are hospitalized. CBOC Patient Aligned Care Team (PACT) providers are expected to participate in the assigned patient’s post-discharge care. In all cases where the Contractor is aware of an assigned patient’s use of any emergency medical services, Contractor shall document emergency encounters in each assigned patient’s electronic medical record. Follow up with the Veteran is made within 24 hours of knowledge of the discharge. Documentation shall be made in CPRS/GUI.AMBULANCE SERVICES:If an ambulance is required to transport a patient to a local hospital for emergency care, the Contractor shall contact a local ambulance company. The ambulance company shall be instructed to bill the NMVAHCS Eligibility Office for these services at the following address:Raymond G. Murphy VA Medical CenterAttn: Beneficiary Travel (04E)1501 San Pedro SEAlbuquerque, NM 87108Contractor shall complete the Notice of Hospitalization (NOH) in CPRS/GUI and transmit to the Managed Care Office. Any questions regarding the billing for emergency transportation shall be referred to NMVAHCS-Beneficiary Travel.To qualify for emergency ambulance transportation, veterans must meet the following criteria: 1) he or she must be rated at least at the 50% service connected level; 2) a physician must deem the emergency ambulance transport as medically necessary and related to the service connected condition; and 3) before the transportation can take place, the veteran must receive prior approval. The CBOC can obtain such approval by contacting the Patient Transportation Office, Transportation Assistants at NMVAHCS. Once a decision has been made that the veteran meets the above criteria, the Contractor's physician shall complete automated VA Form 2105, Request for Special Transportation, a form provided by the NMVAHCS which serves as authorization for ambulance service payment. The automated VA Form 2105 must be signed by the physician and faxed to the Patient Transportation Office at NMVAHCS the same day the ambulance is requested. The Contractor shall also notify the Communications Center at NMVAHCS if a patient is transferred to a local hospital.In non-emergent situations when the Veteran needs to be transferred to the NMVAHCS, by the PCP or his/her designee shall contact the NMVAHCS-Bed Control pager at 505-530-4884 to discuss the case. In addition, a brief electronic Progress Note shall be entered by PCP immediately and electronically signed outlining the reason for the urgent referral to the NMVAHCS Medical Center. The Progress Note shall be completed in such time that the note is available for viewing by the NMVAHCS Medical Center staff when the patient arrives for care. NMVAHCS Bed Control coordinates transfer/transportation arrangements with the Beneficiary Travel Office. The Contractor's physician shall complete a form VA-10-0114J(R) Supplement to Progress Note for Specialized Discipline, and fax to 505-265-6025. Calls regarding non-emergent transfers occurring after normal business hours shall be made to the Administrative Officer of the Day (AOD) at 505-265-1711. LABORATORY SERVICES:The Contractor is responsible for entering orders for laboratory tests into VISTA utilizing the Computerized Patient Record System (CPRS). Information concerning the laboratory tests is available in CPRS under the Tools Menu. The Contractor will send laboratory tests to the NMVAHCS, except for those specified in this PWS. The Contractor is responsible for any costs associated with transportation of specimens to the VMVAHCS and for arranging such transportation in a proper secure method and ensuring that all courier service employees have completed VHA Privacy Awareness Training or equivalent.The specimens shall be sent to the NMVAHCS Core Laboratory twice daily, prior to the Contractor’s mid-day break period and after the close of business of the workday. The Contractor shall be responsible for the proper collection, collection supplies, and other preservation of specimens. The Contractor is responsible for providing appropriate specimen collection containers that are compatible with the instrumentation and methodology used by the VA laboratory.Specimens must arrive at the VA in a condition that allows for safe specimen handling and not compromise the analyzers used for testing or specimen integrity. In the event that specimens are received in a container that does not satisfy those requirements, the VA reserves the right to specify the collection container to be used. A listing of specimen collection containers and laboratory test panels/profiles utilized by VA is included as an attachment to this requirement. The Contractor may not purchase the specimen collection containers from the VA since Federal Acquisition Regulations prohibit the purchase of supplies for resale. Specimens with a shipping manifest shall be delivered to the VA laboratory receiving area, BD115, at the NMVAHCS. Instructions for specimen collection, specimen processing, shipping manifest, and packaging of specimens for transport as an attachment to this requirement. The VA will not be responsible for the quality of laboratory test results obtain from specimens improperly collected or labeled, processed (centrifuged and aliquoted) and/or transported by the Contractor. The CBOC will be contacted to resolve any discrepancies identified on the shipping manifest. The CBOC will be notified of any specimen or testing problems. All laboratory test results will be available through VISTA/CPRS upon completion. The Pathology and Laboratory Program Laboratory Information Manual is available through CPRS/Tools/Lab Information (Local). The Pathology and Laboratory Program Laboratory Information Manual is available electronically and or by hardcopy. Questions regarding VA laboratory services shall be addressed to the VA Chief Medical Technologist at 505-265-1711 ext. 2772.The cost of all lab work, with the exception of lab work sent to the VA or emergency lab work sent to another site which has been authorized by the VA Communications Center, shall be borne by the Contractor.If laboratory services to be provided under this resultant contract are not performed at Contractor's site, the Contractor shall be responsible for transporting laboratory samples in a manner to ensure the integrity of the specimens and proper safeguarding of protected health information. The Contractor shall supply any special preservatives required for specimen preservation. Frozen specimens shall be shipped on dry ice, if required. If laboratory services are performed at a site other than the VA, the Contractor is responsible for entering the laboratory results into VISTA. The results for laboratory tests performed at another site cannot be entered into VISTA using existing test files. The Contractor’s CBOC shall provide POC Testing for the following conditions:Mandated POC testing includes: (a) Conditions requiring chronic anticoagulation with warfarin. All CBOCs shall perform POC INR (International Normalized Ratio) testing to allow for real-time adjustment of warfarin dosing. The Contractor shall provide Quarterly and annual anticoagulation quality assurance summaries as instructed by NMVAHCS. For questions, please contact, NMVAHCS Anticoagulation Coordinator through the Pharmacy office extension (505) 265-1711 x 4429Non Mandated POC Testing: Urine dip stick, finger stick glucose. (Urine tests can be sent to the NMVAHCS laboratory for processing. Glucose tests can be sent to the NMVAHCS laboratory for processing.) See Women Veterans section for POC Urine Pregnancy testing: Per VHA Handbook – Health Care Services For Women Veterans All lab results from point of care testing done for the clinic shall be entered into CPRS/GUI within 24 hours of visit and shall include name and address of testing site, reference ranges, date of testing and person performing testing.The laboratory tests designated as waived under the Clinical Laboratory Improvement Amendments of 1988 and all amendments (CLIA’88, et al.), 42 CFR 493.15(b) and 493.15(c). In the CLIA regulations, waived tests were defined as simple laboratory examinations and procedures that are cleared by the FDA for home use; employ methodologies that are so simple and accurate as to render the likelihood of erroneous results negligible; or pose no reasonable risk of harm to the patient if the test is performed incorrectly. In order to perform these tests, The Contractor must apply for and maintain a current VA CLIA Certificate. The application for the VA CLIA Certificate, obtained from the Chief Medical Technologist, is sent to the National Enforcement Office who issues the CLIA Certificate. In addition, the Contractor must apply for and maintain a New Mexico Department of Health Level II Clinical Laboratory Permit. In the performance of these tests, the Contractor must comply with the terms and requirements of the Ancillary Testing Policy, MCM 113-14 vapubs/. The Ancillary Testing Policy is available electronically. All waived testing at the Contractor’s site will be under the oversight of the VA Ancillary Testing Program. The Contractor is required to use the same test systems/instruments; quality control and reagent lot numbers used for waived testing performed at the VA. A current list of Waived Testing Test Systems/Instruments and Reagents is available from the NMVAHCS Pathology & Laboratory Medicine Service on request. The VA will provide the test systems/instruments and reagents for CBOC waived testing with the exception of fecal occult blood testing cards and developer. The Contractor must contact the VA Ancillary Testing staff prior to purchasing fecal occult blood test kits to ensure consistency of methodology/ manufacturer. If the VA changes fecal occult blood testing methodology/ manufacturer, the Contractor must comply with the change to maintain the same standard of care. All of these test systems/instruments are from manufacturers that have received 510(K) clearance from the FDA. When the VA Ancillary Testing Program upgrades waived test systems/instruments, the VA will furnish the Contractor with the new test systems/instruments to maintain the same standard of care. It is the Contractor’s responsibility to maintain the test systems/instruments in proper working order. The Ancillary Testing staff will arrange for repair/maintenance in the event of system/instrument failure. If required, the Contractor will provide a courier to transport instruments and/or reagents to the CBOC or the VA Ancillary Testing staff for linearity/correlation studies and minor repairs. The VA will purchase proficiency testing materials for the Contractor, and the Contractor must comply with the Pathology and Laboratory Medicine, CAP and JC requirements/regulations for testing proficiency materials and submitting results. The Contractor must adhere to the VA (as detailed in VA handbook 1106.1) standards/requirements when performing waived laboratory tests. The results of all waived testing must be entered into the medical record through the laboratory software package in VISTA or CPRS template notes. The Contractor must take immediate action on any critical waived test result and immediately inform the VA, document the action taken through CPRS. The VA will provide test procedures and training materials, initial training, and annual competency assessment. The Ancillary Testing staff will make periodic visits to the Contractor’s site and monitor the quality control and test results to ensure accuracy and, consistency, and adherences to VA policies and requirements. When necessary, the Contractor must send quality control records and test results to the Ancillary Testing staff for the purpose of troubleshooting test system/instrument malfunction. The Contractor must address all questions concerning waived point of care testing to the Ancillary Testing staff at 505-265-1711 ext. 5163.RADIOLOGY SERVICES: The Contractor is responsible for entering requests for Radiology procedures into VISTA utilizing CPRS/GUI. X-rays shall not be performed by the Contractor on site at the CBOC. Radiology services shall only be provided by primary parent facility NMVAHCS or through a subcontractor that is not paid separately under this contract.All images shall be stored in VISTA Imaging and which is considered part of the patient’s electronic record. These images shall be a result of direct digital (DR) or computed radiography (CR) acquisition and cannot be from a DICOM film digitizer.These images shall be case edited in the Radiology VistA package by the technologists, and sent to VISTA Imaging and PACS as defined by the NMVAHCS local policy, within two (2) hours of completion. All images shall be stored within VISTA Imaging and become part of the patient’s electronic record. X-rays performed at NMVAHCS can be viewed by the Contractor through VISTA Imaging and the PACS. The NMVAHCS Radiology Program Service may be contacted at (505-265-1711)All imaging orders shall be clinically appropriate.Mammograms: All mammograms performed by Contractor or Contractor’s provider shall be performed by an entity accredited by the American College of Radiology. The Contractor, or the Contractor’s provider, shall maintain its mammography accreditations and Mammography Quality Standards Act (MQSA) certification, issued by either the Federal Drug Administration (FDA) or an FDA-approved State, in accordance with the MQSA. Any change in either the accreditation or certification status shall be communicated in writing to the COR within 5 working days of event. No patients shall be referred for, or provided a mammography that is not FDA or VA-certified. This is in accordance with VHA Handbook 1104.1, Mammography Standards. ) LAB AND X-RAY RESULTS:VHA Directive 2009-019, “Ordering and Reporting Test Results,” dated March 24, 2009, ) mandates that all test results, even normal results, be reported to the patient within 14 days of when the results become available. The NMVAHCS has developed a general process that shall be implemented in all clinics and shall provide support/instruction on the implementation. For after hours the Contractor shall provide the NMVAHCS with the name, pager and telephone numbers of a LIP (physician, nurse practitioner, or physician assistant) at the CBOC to accept critical laboratory results discovered on tests done by the NMVAHCS. For critical laboratory results, the LIP must respond back to the Core Laboratory within forty-five (45) minutes of the initial page or telephone call. The receiving LIP will document the results in the record and conduct a “read back” procedure to ensure accuracy of transmission and translation of all verbal results. NMVAHCS will not be responsible for the failure of the Contractor to receive critically abnormal test results. For critical laboratory and x-ray results that represent an imminent danger to the patient, the Contractor shall notify the patient immediately but NLT: four (4) hours. Critical results shall be reported to the clinician by the radiologist by telephone. Documentation of this notification, “who, when” must appear in the radiology report. For critical results that do not pose an imminent danger to the patient, the Contractor shall notify the patient within twenty-four (24) hours of receipt of the results and provide follow-up treatment within the scope of the contract. Documentation of actions taken regarding critical laboratory results and serious radiology results must be made by the Contractor in an electronic Progress Note.ELECTROCARDIOGRAM SERVICES: The contractor shall utilize MUSE-compatible EKG machine, which are interfaced with VistA Imaging. The GE5500 or other machines can be used if they are compatible with the NMVAHCS MUSE sever and have a modem. This will be supplied at the cost to the contractor and maintained by the Contractor. EKGs are done by the CBOC and documentation will be sent electronically from the GE 5500 EKG machine directly into VistA Imaging. When MUSE -compatible system is not available EKGs will be confirmed, interpreted and documented by the CBOC licensed provider. The report will be scanned directly into VistA Imaging by the CBOC. The EKGs will be confirmed and/or read by CBOC providers. When MUSE system is not available, clinic staff shall notify the NMVAHCS Heart Station to help trouble shoot the problem. If the system is unavailable and the provider has an EKG that is questionable, the provider shall call the NMVAHCS Heart Station and fax the EKG to be reviewed. When the system becomes available the EKGs shall be transmitted for reading, interpretation and documentation in the MUSE system.PHARMACY SERVICES: A signature card from each Contractor prescriber authorized to prescribe medications to be used under this contract, including the typed name, actual signature Drug Enforcement Agency (DEA) number and National Provider Identifier (NPI) Number shall be provided to NMVAHCS Pharmacy.Contactor shall provide or arrange for the provision for up to a fourteen day (14) supply of all medically necessary prescriptions to the assigned patient, except Schedule II medications, where Contractor shall provide or arrange for the provision of a lower day supply when sufficient for patient need. For all prescriptions, Contractor shall use NMVAHCS pharmaceutical formulary as configured in accordance with the VISTA Drug Listing at the initiation of each prescription and each time a prescription is renewed. For Schedule III-V controlled substances, and all other medications/supplies, Contractor’s PCP shall utilize the pharmacy package in the VISTA CPRS/GUI system, entering all newly prescribed prescriptions and pharmaceuticals within twenty-four (24) hours of the Veteran visit. This requirement applies to both new prescriptions and renewal of the patient’s existing prescriptions.Contractor shall be responsible for the medically necessary pharmaceutical renewal of prescriptions providing that the existing prescription is issued by a NMVAHCS facility physician or is issued by one of the Contractor PCP’s.Contractor shall be responsible for prescribing medications as needed. Prior to prescribing any medications, the Contractor shall review medication profiles in CPRS/GUI for duplicate therapy, drug-disease complications, drug-drug, drug-food, drug-lab interferences, appropriateness of dose, frequency and route of administration, drug allergy, clinical abuse/misuse, and documentation of medications obtained outside of the NMVAHCS in CPRS/GUI “Non-VA” medications list, including over-the-counter and herbal agents and known allergies. Routine prescriptions will be dispensed by at the NMVAHCS and mailed to the veteran. The NMVAHCS pharmacy mail out system shall mail the necessary quantity of the prescribed pharmaceutical directly to the assigned patient for the time beyond the initial fourteen day period. The Contractor is required to enter all prescription orders using the CPRS/GUI outpatient medication order entry option. The Contractor must include complete directions for the prescription (“PRN” alone is not acceptable), the indication for the medication use (whenever possible), and the appropriate quantity and subsequent refills for the medication. Medication orders for controlled substance (Schedule II) prescriptions must be entered into CPRS (as per local policy) as well as be written (on an authorized VA Form 10-2547F or other State or Federally approved controlled substance order form) and sent to the NMVAHCS Pharmacy at the end of each business day. The written and signed prescription shall be mailed via certified/overnight delivery to NMVAHCS Pharmacy on the same day the order is written at the Contractor’s expense. An Opioid Renewal note shall be required and notification of need for renewal 10 days before the expiration of the prescription or a progress note from a clinic visit. The VA will dispense controlled substances in accordance with Federal Law CFR Title 21 1300-end.The PCP shall furnish the following information on the order:Name and signature of ProviderAddress of Provider Telephone number of ProviderDrug Enforcement Administration (DEA) number of ProviderPatient name and last four of his/her Social Security NumberPatient addressDrug name, strength and quantityInstructions for drug’s use by patientThe Contractor is required to utilize the NMVAHCS’ drug formulary. The formulary is available electronically under Drug File Inquiry in the VISTA physician package. Non-formulary drugs are also marked “NF” in the CPRS drug file. Changes to the formulary effecting prescribing will be sent to the Contractor electronically. Non-formulary medications can be obtained with appropriate clinical justification by utilization of the electronic non-formulary medication order form in CPRS. The Contractor is required to follow national and local VA guidelines for the use of non-formulary or restricted medications, and to support evidence based pharmacy cost savings initiatives undertaken by the local VA. These guidelines can be accessed in CPRS through the Tools menu, Web links, Pharmacy Benefits Management website or directly through the PBM website at . The Contractor is required to adhere to the local VA Dual Care Policy.Prescriptions, with the exception of CII narcotics, shall be entered electronically in CPRS for transmission to the VA Pharmacy for processing and mailing. CII narcotic prescriptions shall be couriered to the VA at the end of each business day. The VA Pharmacy will work closely with the Contractor in prompt mailing of medications. Should the provider determine that it would be detrimental to the patient’s health to wait 7-10 days before initiating drug therapy, the provider may write a prescription (based on a limited formulary of emergent items attached) for a bridge supply of the drug to be filled at the local contracted pharmacy vendor until the prescription can be processed and mailed from VA Pharmacy. NOTE: The provider must enter an order for the drug in CPRS as with documentation that the medication was filled locally. Medications determined by the provider to be emergent but NOT on the emergent formulary list must be pre-approved by VA pharmacy service prior to being filled at the local contracted pharmacy vendor (Check with PBM website at ).. Authorization must occur BEFORE sending the patient to the local pharmacy to ensure the prescription will be filled. To gain said authorization, the Contractor must contact the CBOC Outpatient Pharmacy Staff at 505-265-1711 ext. 4245 or 4844, PRIOR to sending the patient to the local pharmacy. The VA CBOC EMERGENT DRUG FORMULARY should NOT be used to bridge refills for the patient (i.e. used to give partials until refills are processed).All medications and supplies that are stocked at the CBOC location must be approved and procured by NMVAHCS Pharmacy. All routine medications and supplies used in the treatment of outpatients on premises are required to be stored and secured to meet compliance with TJC standards, VHA policy, and OSHA guidelines. Efforts should be made to limit the number of ward stock medications and supplies stored at the CBOC. The Contractor is responsible to ensure all medications are subject to routine inspection, inventory as required by NMVAHCS Pharmacy, proper storage (in a secure and locked location), and meet all VA policy and TJC standards for medication management. The Pharmacy will provide the Contractor with a limited supply of routine vaccines for administration. An order for the vaccine must be entered into CPRS by the provider. The Contractor must keep all vaccines furnished by the VA separated from all other pharmaceuticals, in a secure and locked location, refrigerated and monitor temperatures of vaccines and other refrigerated drugs on a twice daily basis per TJC and CDC guidelines for vaccines. A record of refrigerator temperature monitoring must be maintained by the contractor. If a temperature variation is identified by the contractor, the contractor should contact the VA immediately to determine the appropriate disposition for the refrigerated medications. daily basis. Vaccines furnished to the Contractor by the VA are only to be used for VA patients. To monitor the use of VA provided vaccines, the Contractor must develop an electronic log for each VA-furnished vaccine. Upon dispensing or administration to a VA patient, the Contractor shall enter in the log the first initial of the patient’s last name, the patients first name (to avoid confusion between patients with the same SSN or last name), the last four digits of patient's SS #, date, vaccine name, and quantity. The electronic log book will reside on a VA shared drive or SharePoint site. No paper based log books are to be maintained for any reason. When nearing depletion, the supply of vaccines provided to the Contractor will be replenished by VA upon faxing a copy of the appropriate properly completed log to ATTN: COR/Infection Control Coordinator at 505-256-2888 Influenza, pneumococcal, tetanus/diphtheria toxoid, with and without pertussis (TD/TDaP), Herpes zoster, human papilloma virus, and PPD will be stocked at the CBOCs. The more expensive, less routine vaccines will not be stocked, but must be ordered by prescription for the specific patient.A patient's new allergy information shall be entered into the patient’s record via CPRS. The specifics of the patient’s allergy or adverse drug reaction, if known, must be included in the documentation. VA Pharmacy is not permitted to dispense any prescriptions without documentation of a patient’s allergies being listed in the chart (or documentation that no known allergies exist as appropriate).In accordance with TJC standards, the Contractor shall conduct nursing station inspections in collaboration with the local VA Pharmacy on a monthly basis (with oversight provided by VA Pharmacy and governing bodies). The medication storage sites and clinic nursing station will be inspected to ensure that medications are being stored properly (i.e.under refrigeration, if required; externals separated from internals; expiration dates checked, etc.), and VA Medication Inspection Form (VA Form 10-0053) will be completed and mailed to the VA Outpatient Pharmacy Supervisor and the COR by the tenth (10th) day of each month. This information will be used in conjunction with the COR’s quarterly evaluation of the Contractor’s performance. The VA will provide the Contractor with a supply of VA Form 10-0053. The mailing address is: CBOC Outpatient Pharmacy Staff The Contractor shall be responsible for providing all necessary information for each provider with prescriptive authority to VA Pharmacy to include a signature documentation that includes the prescribers name, state license information, DEA number (as applicable), address, phone number and the original prescribers “wet signature. A signature card with the prescribers “wet” signature must be provided to the VA Pharmacy prior to the prescribers start date. New drug orders: The contractor will ensure that at least 95% of all new drug order requests follow all NMVAHCS prescribing guidelines. This is including but not limited to ensuring all appropriate labs have been previously ordered and that the order is not a non-formulary drug.The Contractor shall provide counseling to patients, family or caregivers in accordance with State and Federal laws and VHA requirements, /family, including, but not limited to:Medication instructions regarding drug, dose, route, storage, what to do if dose is missed, self-monitoring drug therapy, precautions, common side effects, drug-food interactions, and medication reconciliation, and importance of maintaining an accurate and up-to-date list of all medications (including herbals and over-the-counter medications). (Verbal and/or written instruction). Confirmation and documentation of patient/caregiver instruction and the of patient's/caregiver patient's understanding of the instructions including telephone contacts must be documented in the Progress Notes or by using a template provided for this purpose.Instructions of VA refill process (VA patient handout).Instructions to veterans and/or care giver on the safe and appropriate use of equipment being supplied shall be documented in the veteran's medical record.Instructions on VHA Directive 2007-016 “Coordinated Care Policy for Traveling Veterans”.Instructions on VHA Directive 2009-038 “VHA National Dual Care Policy”. Reports of ADEs will be documented in the patients’ medical record (under the Allergy/Adverse Drug Reaction tracking option in CPRS) and the specifics of the event shall be forwarded to VA Pharmacy as they occur via E-mail to NMVAHCS.All medication errors and medication related incidents shall be reported immediately to the Chief, Pharmacy Service or designee. Additionally, the Contractor shall record and report these events to prescribers and the NMVAHCS Chief Pharmacy service on a routine basis (as determined by the NMVAHCS Chief, Pharmacy Service).Customer complaints regarding pharmacy services must be addressed by the VA pharmacy service. The Contractor cannot resolve a medication related issue; the Contractor shall contact the VA pharmacy service to assist in resolution. Reports of such complaints must be recorded and forwarded to the VA Chief, Pharmacy Service on a routine basis. The Contractor must work in collaboration with VA Pharmacy when there are identified medication management needs of the CBOC patients. Examples of this include notification and management of patients that are taking medications that pose a medication safety concern or patients that are taking medications that require therapeutic substitution based on formulary or medication safety concerns. Contractor requirements will be identified by VA governing bodies and VA Pharmacy. In accordance with TJC regulations, the Contractor shall provide the patient with an accurate, reconciled list of medication to include medications that the patient is receiving from the VA, medications that he takes from non-VA providers, and any OTC, herbal or alternative medications that the patient reports taking. The Contractor shall meet all requirements of VHA Directive 2011-012 “Medication Reconciliation” (or subsequent revisions thereto) as well as VA policy related to medication reconciliation. The Contractor shall also provide monthly monitors to NMVAHCS or compliance with Medication Reconciliation per Medical Center which can be obtained from the Chief, Pharmacy at 505-265-1711 ext. 4243 or ACOS, Ambulatory Care Service at 505-265-1711 ext. 2627.The Contractor shall meet all requirements for anticoagulation management outlined in VHA Directive 2010-020 “Anticoagulation Management” (or subsequent revisions thereto) as well as VA policy related to the management of patients on anticoagulation. The Contractor will provide Quarterly and annual anticoagulation quality assurance summaries as outlined by Drug Utilization Committee format. For questions, please contact, POC, VA Tele-Health Anticoagulation Coordinator at 505-265-1711 ext. 4243 Clinical Pharmacy Services The provision for clinical pharmacy services and expertise of a CPS should be available to all patients managed by the contractor. This service may be provided by the VA pharmacy or through the contractor depending on the location. If the services are provided by the NMVAHACS, the contractor shall provide ample space, support staffing, and ancillary support to allow for the provision of clinical pharmacy services. The support services should be consistent for each CBOC scheduled clinic to include but not limited to intake vitals by LVN/LPN, Unlicensed Assistive Personnel (health tech or nursing assistant), or similar, downloading of blood sugar from meters, POC INR testing and downloading, teaching patients how to use BP monitors at home, calling patients for lab reminders, scheduling patient visits and contacting patients who no-show for rescheduling. Clinical pharmacy. These services should be provided by a CPS with appropriate knowledge, skills, and abilities (KSAs) to perform comprehensive medication management as described previously. The CPS will function in the capacity of a mid-level provider (through a SOP) or CPA as their primary duty is to collaborate with providers to provide comprehensive medication management to patients. The PACT CPS and other CBOC providers will receive support from VA to handle routine outpatient medication activities such as prescription verification, refill, renewal, and extension of medication, therapeutic substitutions and conversions, and other general pharmacy issues. Core privileges should be established in the SOP or CPS to include medication prescriptive authority, assessments, laboratory and other test ordering privileges in the most common Primary Care disease states (chronic diseases including, but not limited to, diabetes, hypertension, hyperlipidemia, smoking cessation, pain management, hepatitis C, osteoporosis). Direct patient care activities are essential to the role of the CPS in impacting comprehensive medication management and optimal patient care outcomes in PACT. The CPS should have 30-35 hours of bookable appointment time per week. Direct patient care activities in PACT Pharmacy Clinics should contain the 160 stop code in the primary or secondary position to ensure workload capture for clinical pharmacy services. As appropriate, telephone clinic shall contain appropriate stop codes as well to ensure billing and workload for clinical pharmacy services (160 in the secondary position). Direct patient care refers to patient care functions which are carried out by a pharmacist in an advanced practice role and are above and beyond those functions considered to be routine part of a pharmacist’s duties. Some examples of direct patient care activities include:Face-to-face comprehensive medication management of complex patients and chronic diseases (such as anticoagulation, hypertension, diabetes, hyperlipidemia, COPD, heart failure, hepatitis C, pain management);Urgent or same day face-to-face patient visits including but not limited to patient medication review for polypharmacy, recent hospital discharges, co-managed care patients; Virtual Care modality visits such as veteran requests through secure messaging, telephone-based care, CVT,HT; SMA; andDIGMAsIn the event Telepharmacy services are provided by VA (for anticoagulation or PACT), space should provide privacy for patients to meet confidentially in an individual or group setting with providers at the VA via electronic transmissions. The space shall be large enough for a desk, chair, computer, and TV and videoconferencing equipment (provided by VA). The VA will maintain the VA-provided Telehealth equipment. VA will also provide the networking capability to support the TeleHealth equipment. The Contractor will facilitate use of the equipment for the veterans. PODIATRY SERVICES/REUSEABLE MEDICAL EQUIPMENT: Podiatry services shall be provided on site by the Primary Health Care Team and shall focus on wellness of the foot and ankle, prevention of podiatric disease, screening for disease precursors and timely interventions and the management of existing conditions. Management includes: The diagnosis, medical, and mechanical treatment of ailments and deformities of the human foot and ankle. Surgical and more specialized podiatric cases shall be referred to the NMVAHCS.MENTAL HEALTH: The Contractor shall provide the services of a Licensed Social Worker (LSW) Licensed independent provider (LIP) to provide Mental Health Assessment, psychosocial assessment, brief treatment, and referral management for support and supportive counseling to veterans on site at the Primary Care CBOC in T or C, NM. The services of the LSW shall be a part of the CBOC provided Primary Medical Care services in accordance with PWS. All Mental Health treatment shall be performed at the parent facility or through Tele-Health. If the Contractor employs Advanced Practice Registered Nurses or Physician Assistants to provide mental health services, documentation of mental health licensure or prior experience in mental health settings shall be required. All Mental Health treatment shall be performed at the parent facility or through Tele-Health.The provision of MH services shall comply with JC requirements pertaining to patient treatment, NMVAMC quality assurance requirements which include the Peer Review (Administrated by NMVAHCS SW Executive Office) analyses of care at CBOCs and credentialing and privileging of licensed independent and dependent providers. Non-compliance of with these requirements may result in the revocation of clinical privileges by the NMVAHCS.The LSW LIP shall provide consultative advice to the primary care team, provide direct clinical care when indicated and maintain an ongoing relationship with the enrolled patient for counseling and case management of veterans with psychiatric disorders and arrange and manage for referral to NMVAHCS if more specialized mental health services (such as PTSD evidence based psychotherapy, psychological testing, or treatment of more complex diagnoses) are indicated. The LSW LIP shall also establish contact with NMVAHCS AOD or MCO if inpatient care is needed and serve as liaison between the CBOC primary care staff to coordinate primary care and specialty Mental health treatment at NMVAHCS facility.The care provided by the LSW LIP is primarily meant to be assessment, case management and treatment that includes supportive care consistent with current VA practices regarding mental health services in primary care and includes assessment and brief treatment for common mental conditions that can be managed in primary care (examples include uncomplicated depression, anxiety and at-risk substance use). The maximum visit limit in the treatment plan is eight (8) counseling visits. Treatment beyond that must be authorized by the NMVAHCS. The LSW LIP will assist the Primary Care Provider or team when a need for supportive treatment, case management or referral to community or VA resources is indicated. Duties of the LIP include, but are not limited to, marshalling VA or local community resources to assist the veteran patient in meeting activities of daily living, arranging for temporary or long term residential care and/or inpatient skilled nursing care, referral to hospice services, performing in an assistive or advocacy role regarding accessing benefit programs for which the patient may be eligible, and completing assessments and providing appropriate intervention for patients suspected of being victims of neglect or abuse. The LSW shall also identify situations where supportive group therapy may be beneficial to veterans and their families. Groups should be time limited (10-12 sessions) and goal directed. Mental health treatments should be consistent with current evidence based practice of mental health in primary care in VA.If at any time a patient needs more intense services than those provided on site at the inpatient care, the LSW LIP shall take steps to arrange transfer to NMVAHCS; or if more urgent care is needed, to the nearest emergency room. BHCL Beacon Team — NMVAHCS Urgent Mental Health Care Services for Our Veterans Call the Beacon office at 505-265-1711, Extension 2184, Hours Monday through Friday 8:00 a.m. to 4:00 p.m. During normal business hours, transfer to NMVAHCS can be arranged by calling the Bed Control at (505-530-4884); and after normal business hours by calling 505-265-1711 asking for the Administrator of the Day which is answered twenty-four (24) hours per day. The nurses or Administrative Officer of the Day will assist in arranging transfer to VA. If immediate consultation with a psychiatrist is needed, the LSW can also call this number and request assistance. Patients with health-related questions may also be directed to call the Big Spring Nurse Helpline at 1-800-472-1365 x5678 and follow the menu options.VA Behavioral Health also maintains a walk-in service. Patients shall be given specific directions to the location, the contractor shall call the location on the VA Campus and alert the personnel to expect the walk-in. The patient shall be advised that they will be seen in the Initial Evaluation clinic the same day. The Contractor shall follow up to document that patient successfully arrived or did not arrive at the location and document the file accordingly. If the patient did not arrive, the Contractor shall make phone contact with the patient to determine if the patient requires further direction or assistance.Documentation will be complete, timely and reported in compliance with NMVAHCS policies. The Progress Note must reflect the time spent with the patient and the diagnosis. Staff will also comply with all NMVAHCS policies and performance measures. Estimated Veteran Workload: Based on historical data, it is estimated that 30% of enrolled veterans shall require Behavioral Health Services.NMVAHCS Mental Health Provider Work Space: The Contractor shall provide a private office, no smaller than 120 square feet, and appropriate office furniture for a NMVAHCS mental health provider who shall work out of the CBOC. The Contractor shall provide administrative support for scheduling and answering and forwarding calls. The Contractor shall provide a phone, basic administrative office supplies, and use of the CBOC’s shared office machines. The NMVAHCS shall provide a computer work station for this provider. Mental Health professionals shall require one group room that shall accommodate 2 therapists and 10 Veteran patients. Space shall be shared based upon priority for clinical services at established scheduled time.Documentation shall be complete, timely and reported in compliance with NMVAHCS policies. The Progress Note shall reflect the time spent with the patient and the diagnosis. Staff shall also comply with all NMVAHCS policies and performance measures.TELEHEALTH SERVICES: Supporting Documentation NMVAHCS Memorandum 115-13, “Telehealth Services”. Currently there are approximately 33 TeleHealth medical specialty initiatives (e.g., Teleretinal, Teledermatology, Telesurgery, Tele-anesthesia, Tele-pharmacy (anticoagulation), Tele-ENT, Tele-neurology, Tele-Mental Health etc.) are in service with planned expansion in the near future. The Contractor shall provide the following 120 square feet of space for Tele-Health equipment to be placed within the facility by the NMVAHCS. This space shall provide privacy for patients to meet confidentially in an individual or group setting with providers of the NMVAHCS/VISN 18 via electronic transmissions. . Clinical Video Equipment:Equipment/LocationData/Electrical Other Comments47” Teleconference Unit (conference room)1 LAN1 Electrical Receptacle This unit will be mounted on the WallGlobal Media Cart( Exam room with exam table)2- LAN connections same location1-Electrical OutletThis is a standalone unit on its own cart that rolls2-Ex90 ( 1- private room, 1- for staff break room to participate in VTEL conferences)1-LAN 1- Electrical Unit will sit on Desk/Table top not wall mountedTelehealth Service Line Agreements (TSA): The contractor shall read and sign all Service Line Agreements associated with Telehealth acknowledging distant providers requirements for delivery of care at the highest quality via Telehealth listed below:Polytrauma Support Co-Occurring DisordersProsthetics AmputeeNutritionPCMHI Mental HealthPhysical Medicine and Rehabilitation (PM&R) PhysicianAnesthesiology Pain MedicineDiabetes EducationRetinalEar Nose and Throat (ENT)NeurologyDermatologyPhysical Therapy TENSSpeech Language PathologyOrthopedicsUrologyHomePain MedicineClinical Pharmacy Anticoagulation ManagementSurgery Telehealth involves the delivery of clinical care in situations in which patient and provider are separated by geographic distance. It is the responsibility of the contractor to ensure that in the event of a patient emergency, e.g. acute medical event, violence or threat of self-harm that explicit processes are in place that ensures a distance provider can alert the clinic and institute the appropriate actions to protect patients and/or staff from harm. These processes must be regularly checked to ensure they are operational and meet specified response times.Links to VA TeleHealth resources that detail clinical, technology and business associated processes. These are provided for information and to guide the contractor in configuring the TeleHealth services that VA requires. The contractor cannot assume that all clinical, technology, business, regulatory and legal aspects of TeleHealth that apply to VA and VA practitioners will automatically apply to a third party contracting for TeleHealth-related services with VA. It is the responsibility of the contractor to ensure that all services provided by a third party to VA using TeleHealth meet all such requirements.Teleretinal: The Contractor shall provide tele-retinal imaging services for a target population of patients, to include those with Diabetes Mellitus who have not been evaluated for retinopathy within the past year, in accordance with NMVAHCS Memorandum 11-6, “Tele-retinal Imaging Program,” dated: 02/2014 (or subsequent revisions thereto). ) The Contractor’s Primary Care Providers (PCPs) will determine, based on CPRS eye clinic records or patient eye history documented in CPRS, which patients that need to be imaged. Staffing - The Contractor will be required to provide two (2) personnel for performance of these services; one primary and one back-petency - Teleretinal Imagers will be expected to provide clinical care in compliance with established clinical protocol. Additional guidelines governing operations will be utilized and provided to Contractor by VA. The Teleretinal Imager will be expected to successfully complete training programs required for certification as a Teleretinal Imager including NMVAHCS required training and any NMVAHCS training mandated for Teleretinal Imagers. Teleretinal Imagers will be responsible for maintaining imager certification. Teleretinal Imagers will be expected to demonstrate competency on the function and use of the digital retinal imaging system. NMVAHCS will provide training to Teleretinal Imager and document competency. Equipment - The NMVAHCS will provide the necessary Teleretinal imaging equipment and maintenance beyond the user level. The Contractor will provide routine user-level maintenance and cleaning (to include cleaning supplies) ensuring that preventive maintenance is performed on schedule, reporting of equipment failures per protocol, entry of service requests, routine minor maintenance, troubleshooting, and interfacing with vendor to resolve equipment issues. (See Government Supplied Equipment Listing Attachment P)Minimum square footage 120 square feetTeleretinal Video Equipment:EquipmentData/Electrical Other CommentsTopcon TRC-NW8 VA PC2-LAN Connections4 quad electrical receptacleLAN to support VA PCLAN to support Topcon A Desk will be needed to support 2 PC.4 quad will be needed on the wall near the Topcon Unit.Services - The Contractor’s Teleretinal service shall include but are not limited to: coordinating Teleretinal clinic set up, scheduling, coordination of consult loading into local CPRS account, consult management, provision of data on request, attendance on VA or Network Teleretinal Imaging Team calls, maintaining records required for quality control processes, and participating in performance improvement activities. The Contractor will be responsible for transmitting tele-retinal images and all other supporting data to the assigned VA reading center within time lines established by policy. The Contractor will notify patient of results within 14 days of procedure and is responsible for scheduling follow up evaluations based on clinical protocol. The Contractor will be responsible for satisfying the clinical reminder for eye care. Patient Education – The Contractor will provide basic education to patients including but not limited to: review of acquired images for anatomic and general findings, discussion with veteran regarding the association between glucose control and ocular health, review of the importance of receiving routine eye evaluations, review of photos, and provision of approved handouts.Telehealth Required Education for Telepresenter (staff assisting distant provider):Courses in My Telehealth:CBT Business-Clinic Based Telehealth OverviewClick here to enrollCVT: Technology OverviewClick here to enrollCVT Core CompetenciesClick here to enrollCVT Emergency ProceduresClick here to enrollMy Telehealth To take this course on My Telehealth:Click on the link for My Telehealth: My TelehealthThis will redirect you to TMSYou will need to login to TMS. After you login you will be redirected to MY Telehealth.Click the go to content buttonIf this if the first time accessing My Telehealth, you will see this message:You will need to wait 24 hours and then go back to My Telehealth. You will once again click the go to content button, but this time you will be launched to MY Telehealth: 73342555054500The courses open for you to choose from will be located in the column over on the left titled CVT Open Courses. Please find the training with the corresponding title that you wish to take. You will receive a certificate from MY Telehealth and your completion of the course will be noted in your TMS Learning History.Teledermatology: The Contractor shall be prepared to provide medical specialty consultative services in Dermatology. NMVAHCS will provide all necessary equipment and supplies, to include: specialized camera with associated memory cards, tripod, storage case, battery pack and cleaning equipment; transmission software; cleaning supplies with instructions; and rulers. The Contractor shall be required to:Contractor shall Identify a Licensed Nurse/Medical Assistant to complete online and Face to Face complete online Teledermatology training through the NMVAHCS and compile documents necessary to modify scope of practice and collaborative practice contracts. Staffing – The Contractor shall be required to provide two (2) personnel for performance of these services; one primary and one back-petency – Tele-Derm Imager shall be expected to provide clinical care in compliance with established clinical protocol. Additional guidelines governing operations shall be utilized and provided to Contractor by NMVAHCS. The Tele-Derm Imager shall be expected to successfully complete training programs required for certification as a Tele-Derm Imager including NMVAHCS required training and any NMVAHCS training mandated for Tele-Derm Imagers. Tele-Derm Imagers shall be responsible for maintaining imager certification. Tele-Derm Imagers shall be expected to demonstrate competency on the function and use of the digital imaging. NMVAHCS shall provide training to Tele-Derm Imager and document competency.As requested by a CBOC PCP, utilize the trained mid-level provider to measure and photograph (using VA provided rulers and a Teledermatology camera) potential dermatologic concernsUsing VA provided VistA Imaging software, utilize the trained Licensed Nurse/Medical Assistant or other staff member to measure and photograph (using NMVAHCS approved rulers and a Tele-Derm camera) potential dermatologic concerns. Transfer images from the Teledermatology camera to an existing computer workstation at the CBOC, then transmit the images to the NMVAHCS Dermatology Department for consultative analysisShall initiate treatment, as directed by the NMVAHCS Dermatology Department. Provide for storage of two Teledermatology camera (and associated supplies), dermatoscope and the ability to move the camera to various exam rooms to take photos of potential dermatologic concerns by way of a movable device/table.Shall clean camera, as needed, and request maintenance/repair, beyond user-level, from NMVAHCS Biomedical RepairMILITARY SEXUAL TRAUMA (MST) SCREENING:VHA Directive 2010-033 “Military Sexual Trauma (MST) Programming,” dated July 14, 2010 (or subsequent revisions thereto) ) requires the expansion of the focus on sexual trauma beyond counseling and treatment, mandates that counseling and appropriate care and services be provided, and mandates that a formal mechanism be implemented to report on outreach activities. The NMVAHCS shall mandate screening of every veteran, male and female, for sexual trauma while in the military. This includes asking the veteran whether they have experienced sexual harassment, sexual or physical assault, or domestic violence while on active duty. Screening must be conducted by the CBOC primary care physician or licensed staff member as the screener and documented in the electronic medical record and in the MST software package in VISTA. If a veteran screens positive for such trauma and would like to receive evaluation or counseling services, a consult can be initiated to Behavioral Health outpatient services. The veteran may decline such services, and this shall be documented as well. Immediate assistance can be obtained by calling the NMVAHCS Division at (505)265-1711 x5432 and asking for the Military Sexual Trauma Coordinator.SPECIALTY CONSULTATIONS, DIAGNOSTIC TESTING, AND CARE PROVIDED AT VA AND SITES OTHER THAN THE CONTRACTORSITECONTRACTORSITE: More specialized evaluations and treatments beyond the purview of a primary care provider can be provided at no cost to the Contractor through the NMVAHCS. Non-emergent specialty consultations and diagnostic tests not performed at the CBOC will be performed at the NMVAHCS. The charges incurred from non-emergent specialty evaluations, diagnostic testing, and care provided at sites other than the NMVAHCS will be the responsibility of the Contractor, unless prior authorization is obtained from Non-VA Medical Care (formerly known as Fee Basis) Section at 505-265-1711 X 2707. The Contractor shall not bill the Veteran for such services. A request for Authorization for Outpatient Non-VA Medical Care (formerly known as Fee Basis) Services is requested by the ordering Provider by completing the CPRS Generic Fee Consult with full vendor information including name, address, fax, phone and date of appointment, if the date of appointment is known. Subsequent approval may be granted upon review by the Outpatient Non-VA Medical Care (formerly known as Fee Basis) Services Approving Physician or Nurse. These authorizations, however, will be granted only in rare instances, as non-emergent referrals should be made to the VA. NOTE: Non-VA Medical Care (formerly Fee Basis) is outside of this contract i.e. if subsequent approval is granted by Non-VA Medical Care reimbursement shall be made outside the contract. Women Veterans Health Care.Reference: HEALTH CARE SERVICES FOR WOMEN VETERANS CBOC providers shall discuss the risk of breast cancer in females and the risks and benefits of screening for the disease in each age group. Starting at age 40, all women shall be offered a mammogram every year. Clinician discretion is advised for women age 70 and older in recognition of limited data availability regarding the efficacy of screening in this age group.The Contractor shall refer patients for mammograms to local accredited and certified mammography facilities in the CBOC’s applicable county after faxing the Non-VA Medical Care (formerly known as Fee Basis) Section at 505-265-1711 X 2707 Mammogram form provided by the NMVAHCS to Contractor and receiving the completed Non-VA Medical Care (formerly known as Fee Basis) Section at 505-265-1711 X 2707 authorization by return fax. The Contractor shall ensure, prior to services being rendered, that the mammography facility is certified by the FDA, or a State that has been approved by FDA under 21 C.F.R. 900.21 to certify mammography facilities. The mammography facility will invoice the NMVAHCS at the following address: Outpatient Non-VA Medical Care (formerly known as Fee Basis)A written Standard Operating Procedure (SOP) sufficient to meet the requirements of 21 CFR 900.12(g) is required to ascertain which patients have breast implants, and to provide proper care for patients with breast implants prior to mammography. The Contractor, or the Contractor’s provider, shall maintain its mammography accreditations and MQSA certification, issued by either the FDA or an FDA-approved State, in accordance with the Mammography Quality Standards Act. Any change in either the accreditation or certification status shall be communicated in writing to the COR within 5 working days. No patients can be referred for, or provided a mammography that is not FDA or VA-certified. This is in accordance with VHA Handbook 1104.1, Mammography Standards, dated September 8, 2005 () Any change in either the accreditation or certification status of a referral mammography facility will be communicated to Contracting Officer Representative (COR) within five (5) working business day after you become aware of such change. In addition, there must be a process established at each facility that ensures timely tracking and follow up of all abnormal mammogram results. [A process must be developed between contractor and VA facility on receipt of reports images etc to an established POC. All reports must include the appropriate BI-RADS code including the FDA mandatory final assessment wording category. The off-site contracted mammography facility’s interpreting physician must ensure the referring NMVAHCS/Contractor ordering practitioner or surrogate is contacted by telephone with all critical results. Practitioner must document in radiology report when and to whom they spoke. A process shall be established at the CBOC facility that ensures timely tracking and follow up of all abnormal mammogram results. The off-site contracted mammography facility’s interpreting physician shall ensure the referring practitioner or surrogate is contacted for results of “Suspicious” or, “Highly Suggestive of Malignancy,” this communication occurs as soon as possible but no later than 3 business days after the mammogram procedure. Responsibilities for NMVAHCS on-site provider notifications may be found in VHA Handbook 1105.03 Mammography Program Procedures ans Standards (dated April 28, 2011) Each certified VA Mammography Program and off-site non-VHA mammography provider is required to establish a documented procedure to provide a lay summary of the written mammography report to the patient within 30 days from the date of the procedure. The documentation of letters, reports, and/or verbal communication with the patient in the patient’s medical record must be in accordance with VA or Mammography Quality Standards Act (MQSA) PL 102-539, Mammography Quality Standards Act and Public Law 105-248 standards and guidelines, Mammography Quality Standards Re-authorization Act and have and maintain certification and accreditation according to the law. Any change in either accreditation or certification status shall be communicated to the COR within 5 working days. In accordance with VHA Directive 2009-019, Ordering and Reporting Test Results, the Ordering Practitioner, CBOC Provider, shall communicate and document the meaning of the findings, including any care plan, and/or follow up testing, within 14 days of receiving the mammogram result. (reference: 21 C.F.R 900.12(c), et. seq.). Comprehensive primary care for women veterans is defined as the availability of complete primary care from one primary care provider at one site. The primary care provider should, in the context of a longitudinal relationship, fulfill all primary care needs, including acute and chronic illness, gender-specific, preventative and mental health care. The full range of primary care needs for women veterans is described below: Care for acute and chronic illness includes routine detection and management of disease such as acute upper respiratory illness, cardiovascular disorders, cancer of the breast, cervix, colon, and lung, diabetes mellitus, osteoporosis, thyroid disease, Chronic Obstructive Pulmonary Disease (COPD), etc. Gender-specific primary care, delivered by the same provider, encompasses sexuality, contraception counseling, pharmacologic issues related to pregnancy and lactation, management of menopause-related concerns, and the initial evaluation and treatment of gender-specific conditions such as pelvic and abdominal pain, abnormal vaginal bleeding, vaginal infections, etc. Preventative care includes services such as age-appropriate cancer screening, weight management counseling, smoking cessation, immunizations, etc. The same PCP should screen and appropriately refer patients for military sexual trauma as well as evaluate and treat uncomplicated mental health disorders and substance use disorders. When specialty care is necessary, the primary care provider will coordinate this care and communicate with the specialty provider regarding the evaluation and treatment plan to ensure continuity of care.The CBOC shall develop a plan to assign women to an interested, proficient women veteran champion who has a sufficient number of women in their primary care panel to maintain competency in caring for those veterans. The CBOC shall provide ongoing education, and training to the primary care women veteran champion to assure competency, proficiency and expertise in providing care to women veterans. Staffing shall be adequate to provide gender-appropriate chaperones as well as clinical support with availability of same-gender providers on request.It is required that all NMVAHCS facilities (including CBOCs) have a mechanism in place whereby urgent and emergent care needs of female Veterans are met in an appropriate, timely manner with the highest quality of care during normal hours including evenings, weekends and holidays. All VHA facilities offering urgent care treatment for female Veterans during business and expanded business hours (i.e., same-day clinic appointments, urgent care appointments) are required to have the necessary equipment to treat female patients (tables, lights, Sexually Transmitted Infections (STI) kits, urine pregnancy tests, speculums, medications, etc.) and to have appropriate supplies to make accurate and efficient diagnosis of vaginal and sexually transmitted infections at the point of care. This includes microscopes, slides, Potassium Hydroxide (KOH) solution, litmus paper. Urine pregnancy tests be available for female veterans.VA is authorized to provide comprehensive pre-natal, intra-partum and post-partum care to eligible women Veterans. Maternity benefits begin with the confirmation of pregnancy, preferably in the first trimester, and continue through the final post-partum visit, usually at 6-8 weeks after the delivery, when the Veteran is medically released from obstetric care. Providers must initiate and Non-VA Medical Care (formerly known as Fee Basis) Section at 505-265-1711 X 2707 Consult and notify the Women Veterans Program Manager, at NMVAHCS.Medical Emergency/ Emergent Care, Urgent Medical, (services beyond the scope of the CBOC): If the NMVAHCS is informed at the time of medical emergency Medical emergency patients (those with life threatening emergent needs) shall be referred to the nearest medical facility capable of providing critical emergent services, via appropriate means of transportation. Contractor shall complete the Notice of Hospitalization (NOH) in Vista and transmit to Managed Care Office. (Phone 505-256-2825) If after 4:30 PM and on weekends and holidays notification shall be called to the NMVAHCS Administrative Officer of the Day (AOD) at (505) 265-1711 and ask for the AOD and subsequent approval is granted after review of medical records, emergency care charges shall be paid for by the NMVAHCS, generally only if the veteran is seen at the Contractor’s site and then sent for emergency medical care at the nearest facility.If the contractor becomes aware of the Veteran making a self-referral and receiving emergency care, the Contractor shall provide education to the Veteran regarding appropriate notice to the NMVAHCS Non-VA Medical Care (formerly known as Fee Basis) office (505-265-1711 X2707).If the Veterans presents at the CBOC for urgent medical care (services beyond the scope of the CBOC) the Veteran is directed to the appropriate level of medical care (hospital or ER). Contractor shall complete the Notice of Hospitalization (NOH) in Vista and transmit to Managed Care Office. However, the Veterans Millennium Health Care and Benefits Act (38 U.S.C. 1725) (effective 5/29/00) established provisions for the possible payment of non-VA emergency services provided for non-service connected conditions of certain veterans who have no medical insurance and no other recourse for payment. Refer to ‘Patient Scheduling’ regarding patients who self-refer or are directed by telephone contact with the CBOC to go to local emergency facilities. Under no circumstances should emergency care be delayed pending administrative guidance from the NMVAHCS.Hard copies of reports from sites other than the Contractor's must be scanned by the Contractor into the electronic medical record maintained at the CBOC. No hard copies of medical records will be maintained at the CBOCs.Available Consult Services: Consult services available at VA via electronic request: Medicine:Surgery:Other:AllergyAnesthesiaAnticoagAutopsy RequestBariatric SurgeryAudiology SpeechCardiologyCardiac SurgeryBehavioral HealthDermatologyColorectal Cancer Clinical PharmacyEmergency Dept. ReferralCareCommunity Based CareEndocrine/DiabetesENTCommunicationGeneral MedicineGeneral SurgeryDentalGastro Intestinal (GI)GynecologyLaboratoryHematology/OncologyNeurosurgeryGeriatricHospice (Palliative Care Ophth/OptometryMiscellaneous Team)OrthopedicNutrition & WeightInfectious DiseasePlasticPain ManagementNeurologyPodiatryPastoral CarePulmonaryPressurePrimary CareRenal Ulcer/WoundsProstheticsRheumatologyThoracic SurgeryRadiation TherapyTherapeutic PhlebotomyTransplantRecreation (Liver/Renal)Rehab MedicineUrologySocial WorkUrogynecologySpeech PathologyVascularReferral Process:Contractor shall request specialty consultations electronically through CPRS/GUI and include consult service requested, urgency, diagnosis (when required), and reason for request. Any and all additional information required by some Specialty Sections must be entered by the referring CBOC Primary Care Provider via the consult template.The Contractor is responsible for the coordination of the patient's primary care including referral to specialties as indicated. The NMVAHCS serves as the referral center for any care or service outside the scope of this contract unless pre-authorized by the NMVAHCS.The NMVAHCS is responsible for communicating with the Contractor results of any treatment provided by the NMVHACS for the patient. The primary communication link will be the computerized patient record system in CPRS/GUI. The CBOC PCP is responsible for follow up based upon the completed consult and communication with the Veteran as appropriate. SPACE REQUIREMENTS:Mental HealthVA Mental Health Provider Work Space: The Contractor shall provide a private office, no smaller than 80 square feet, and appropriate office furniture for a VA mental health provider who will work out of the CBOC. The Contractor shall provide administrative support for scheduling and answering and forwarding calls. The Contractor shall provide a phone, basic administrative office supplies, and use of the CBOC’s shared office machines. The VA will provide a computer work station for this provider. Telepsychiatry: The Contractor shall provide space for Telepsychiatry equipment to be placed within the facility by the VA. This space should provide privacy for patients to meet confidentially in an individual or group setting with providers at the VA via electronic transmissions. The space shall be large enough for a desk, chair, computer, and TV and videoconferencing equipment (provided by VA). The VA will maintain the VA-provided Telepsychiatry equipment. VA will also provide the networking capability to support the Telepsychiatry equipment. The Contractor’s LSW will facilitate use of the equipment for the veterans. Contractor will provide clerical support, including scheduling, for VA Telepsychiatry CRNP.ADMINISTRATIVE: 10 hours per week of time not involved in direct patient care. This includes telephone contact with Veterans.Contractor’s Personnel shall attend service staff meetings as required by the VA COS or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.PATIENT SCHEDULING:The Contractor clinic is not designated as an emergency or urgent care center, and as such is by “appointment only.” Nonetheless, the Contractor shall maintain a triage system for walk-in patients. Urgent walk-in patients are to be triaged by a qualified medical practitioner. During normal clinic hours, all walk-in patients shall be triaged within 20 minutes of presentation. A walk-in patient’s care needs shall be triaged by a registered nurse. All Veterans contacting the clinic by telephone with a medical problem shall be triaged by a Registered Nurse. Patients shall receive care based on their clinical level of urgency. If the Veteran is qualified for care, but not enrolled in the Contractor’s program, contractor personnel shall use clinic judgment for the need for immediate treatment, assist the patient in obtaining forms for enrollment into the Contractor’s program as appropriate, and contact the COR. Walk in triage and telephone triage calls shall be entered into Vista Schedule as unscheduled nurse visits. Services provided shall be documented in CPRS/GUI. Appropriate follow up care shall be scheduled. Open Access is an important concept for VHA primary care and is in part measured by the Same Day Access metric.The Contractor will schedule routine appointments as soon as possible for Primary Care patients and urgent appointments within two (2) business days of request or as medically indicated.. The CBOC shall meet the Veterans Health Administration's (VHA's) timeliness standards as outlined in VHA Directive 2010-027 "VHA Outpatient Scheduling Processes and Procedures,” dated June 9, 2010 (or subsequent revisions to VHA Performance Standards). )Contractor will not unnecessarily cancel patient appointments and will reschedule cancelled appointments in a timely manner Any appointment cancelled needs to be rescheduled within 2 weeks. This means the patients must be seen within 2 weeks of the original cancelled appointment date.Radiology appointments to be made within seven (7) days of order and completed within 30 days.Critical patients (those with true emergent needs) shall not be served by the Contractor, and shall be referred to the nearest “safe harbor” medical facility capable of providing critical emergent services. Immediate notification to NMVAHCS Integrated Care Office at (505)265-1711 x5739 is mandatory by CBOC Clinical personnel.In most instances, patients shall be seen within twenty (20) minutes of scheduled appointments in accordance with VHA Directive 2006-041 (expired on June 30, 2011 but will still be effective until a revision or rescission is published). who arrive at the clinic late for their appointment shall not be turned away, rather shall be given options for being seen by the clinic. Options include: 1) Brief visit by staff/provider based upon patient needs and time becoming available on the schedule. 2) Reschedule at the next available appointment. 3) Brief visit at the end of the clinic schedule. It is important that the Veteran understand that the clinic is unable to inconvenience another Veteran due to their late arrival, however the CBOC staff shall endeavor to meet the Veteran’s needs.All staff who schedule appointments SHALL complete VHA/NMVAHCS Scheduling Training and provide certificates of training to the COR and the MAS ADPAC in order to have the menu option to schedule (this is an annual requirement).Patients who self-refer to local emergency facilities and their associated charges for care are not the responsibility of the Contractor; and shall not be provided service under this contract, even if the designated PCP under this contract is performing “on call” duties at the local facility. If an enrolled patient who is not actually receiving care in Contractor's facility contacts the Contractor, and the Contractor believes that the Veteran needs emergency care that the Contractor cannot provide, the Contractor shall advise the patient to go to the nearest emergency care facility. The Contractor shall also advise the patient that NMVAHCS shall not be able to pay for emergency care at the non-VA facility and that the Veteran shall contact the NMVAHCS as soon as possible to determine if NMVAHCS shall pay. Documentation is entered in CPRS/GUI.My Healthe Vet: Veterans interested in the My HealtheVet initiative shall be directed to the web site myhealth. where they can register as a veteran seen at the VAHCS. Once registered, the veteran can present to the CBOC to be authenticated. My HealtheVet computer shall be provided by the NMVAHCS. Contractor shall assist Veterans as needed for access to the My HealtheVet site. The computer is available for official use only. (also see PACTs above regarding Contractor’s support for enrollment and increase enrollment.)Secure Messaging (SM): Provider teams shall participate in secure messaging (also see PACTs above). Contractor shall encourage and educate patients to use SM as a non-synchronous mode of communication, establish SM as a communication method in clinic, and increase Veteran participation.Records Retention: The Contractor shall retain records generated in the course of services provided under this contract for the time periods required by VHA Record Control Schedule 10-1 and VA regulations (24 VA 136, Patient Medical Records - VA, par. Retention and Disposal). No hard copies of medical records or logbooks of any type shall be maintained. (Logbooks required by regulation/policy are maintained electronically.) If this contract is terminated for any reason, the contractor shall promptly provide the NMVAHCS with any and all individually-identified VA patient treatment records or information in its possession, as well as the database created pursuant to this contract, within two (2) weeks of termination date. (Department of Veterans Affairs Records Control Schedule 10-1 .TELEPHONE ACCESS:The Contractor must make provisions for toll free telephone care, twenty-four (24) hours a day, seven (7) days a week, including evenings, weekends and holidays, for all enrolled patients, in accordance with VHA Directive 2007-033 "Telephone Service for Clinical Care," This directive further establishes benchmarks for telephone service, which will be used by VA to monitor CBOC performance (e.g., call volume, abandonment rate, and average speed to answer). Benchmarks include an average speed of answer by a live person within 30 seconds and a call abandonment rate of less than 5%.In all cases where the contractor is aware of an assigned patient’s use of emergency medical services outside of the NMVAHCS, the contract staff shall document these encounters in the assigned patient’s medical record in VISTA. Documentation of visit shall be scanned into electronic record. Documentation shall include appropriate medically indicated follow-up at the CBOC. (See QASP)For periods other than normal clinic hours, the contractor shall inform patients of NMVAHCS off-hours telephone triage service. NMVAHCS Advice Nurse Line: (866) 862-7863. Reference VHA Directive 2007-033, "Telephone Service for Clinical Care," dated 10/11/07 (or subsequent revisions thereto) located at , Patient Aligned Care Team Handbook located at . This directive further establishes benchmarks for telephone service, which though not currently mandated by the VHA, are being implemented. Benchmarks include an average speed of answer by a live person within 30 seconds and a call abandonment rate of less than 3%. Business Hours Telephone Care: CBOC’s shall strive for 1) answering all incoming calls by answering with a “live person” (vs. voice mail) and 2) resolving the patient’s reason for calling while on the phone with the Veteran (known as First Call Resolution). Strong practice for responding to incoming clinical calls is to provide a response to the patient within four business hours. All calls must receive a response within one business day. [Note: First Call Resolution: When the reason why the veteran is calling the NMVAHCS (veteran’s inquiry) is addressed or answered to the veteran’s satisfaction and no further follow-up on the phone is needed.] This requirement is met if the Contractor makes arrangements with the parent VA facility after hours call center to provide after hours telephone access. The Contractor must establish a mechanism to provide this coverage, and it is recommended that the CBOC telephone rolls over to the after-hours number.EMERGENCIES:The CBOCs shall have a local policy or standard operating procedure defining how emergencies are handled, including mental health. The CBOCs shall maintain appropriate emergency response capability.Work-Related Incident Treatment: When treating the Veteran for injuries sustained as a result of a work-related incident or an accident, the Contractor shall complete the appropriate forms to allow the NMVAHCS to assert a Federal Medical Care Recovery Act (FMCRA) or a Workers Compensation Claim. Patients who self-refer to local emergency facilities and their associated charges for care are not the responsibility of the Contractor; and shall not be provided service under this contract, even if the designated Primary Care Provider under this contract is performing “on call” duties at the local facility. If an enrolled patient who is not actually receiving care in Contractor's facility contacts the Contractor, and the Contractor believes that the veteran needs emergency care that the Contractor cannot provide, the Contractor shall advise the patient to go to the nearest emergency care facility. The Contractor shall also advise the patient that VA may not be able to pay for emergency care at the non-VA facility and that the veteran should contact the VA as soon as possible to determine if VA will pay.CBOCs without Advanced Cardiac Life Support (ACLS) teams are required to have an Automatic External Defibrillator (AED). The Contractor shall provide the CBOC with an AED and train the staff in its use and checks of the device. The Contractor is responsible for performing the device checks and supplying monthly reports to the COR verifying that the checks are being performed in accordance with the contract requirements. Records of monitoring of the device shall be maintained at the CBOC and available for review by the NMVAHCS upon request. Smaller sites that do not have the appropriate staff mix to manage a code need to dial 911 in addition to retrieving and using the AED. At these facilities, the Chief Medical Officer, in consultation with the code team at the NMVAHCS, must determine the best location for AEDs throughout the facility. VHA Directive 2008-015, "Automatic External Defibrillators (AEDs)," dated March 12, 2008 (or subsequent revisions thereto). VISTA: NMVAHCS will provide the Contractor access to VISTA, NMVAHCS's patient record computer system, Computerized Patient Record System (CPRS) that contains: patient medical records, medication profiles, laboratory and radiology data, and other diagnostic test results. Access will be for the purpose of:Obtaining patient specific information.Requesting specialty consults, laboratory, radiology, or other diagnostic municating with VA Staff about patient care issues.Checking formulary status of pletion of electronic medical records – Alcohol Use Screen, Positive Audit-C Needs Evaluation, PTSD screening, Depression screening, Tobacco Counseling, I&A Post Deployment, TBI, Flu/Pneumovax/Colorectal/FOBT/Diabetes Eye/Lab/Breast/Cervical/IDH LDL/HTN/Obesity &Wt. mgt., screening.Use of VISTA scheduling software.Use of VISTA reports including the ambulatory care reports package (ACPR) and others.MEDICAL RECORDS REQUIREMENTS:Authorities: Contractor 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 (Health Insurance Portability and Accountability Act).The resultant 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.The Contractor shall maintain up-to-date electronic medical records (No manual records are allowed to be maintained) at the site where medical services are provided for each Veteran enrolled under this contract. Records accessible by the Contractor in the course of performing this contract are the property of the NMVAHCS and shall not be accessed, released, transferred or destroyed except in accordance with applicable federal law and regulations. The treatment and administrative patient records created by, or provided to, the Contractor under this contract are covered by the NMVAHCS system of records entitled "Patient Medical Records-VA" (24VA19). 24VA19 can be viewed at (). The NMVAHCS shall have unrestricted access to these records.Medical documentation shall meet NMVAHCS content requirements and shall be compliant with Medicare regulations. NMVAHCS shall provide training in the Record Tracking Package with reference to the NMVAHCS Medical Record Handbook 1607.1, (). VA Manual, M-1, Part 1, Chapter 5 can be viewed or downloaded at . The contractor shall develop a policy to ensure that all notes and orders are signed within 24 hours of service and respond to any NMVAHCS report on unsigned documents with a plan of correction. Treatment and administrative patient records generated by this contract or provided to the Contractor 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’s provider 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.Professional standards for documenting care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by the VA.Clinical Reminders: Proper documentation and completion of all clinical reminders as they appear during a patient’s visit. Standard is 90% completion of all clinical reminders monthly. VISTA/CPRS will automatically remind providers to complete the following clinical reminders during patient’s visits:-Alcohol Use Screen-Positive AUDIT-C Needs Evaluation-Depression Screening-Evaluation of positive PTSD-Tobacco Counseling by provider -Tobacco Counseling -Iraq and Afghanistan Post- Deployment Screening-TBI Screening-Influenza Immunization-Pneumovax-Colorectal Ca Screening-FOBT Positive F/U-Diabetes Eye Exam-Diabetes Foot Exam-Mammogram Screening-Pap Smear ScreeningMedical record entries shall be understandable/legible and maintained in detail consistent with good medical and professional practices so as to facilitate internal and external peer reviews, medical audits and follow-up treatments. Copies of received medical information shall be authenticated (signed) copies.The quality of medical practice shall meet or exceed reasonable standards of professional practice for the required services in health care as determined by the same authority that governs VAMC medical professionals and will be audited by the Medical Center, Service Line or other processes established for that purpose.The Contractor shall maintain up-to-date electronic medical records at the site where medical services are provided for each member enrolled under this contract. Records accessible by the Contractor in the course of performing this agreement are the property of the NMVAHCS and shall not be accessed, released, transferred or destroyed except in accordance with applicable federal law and regulations. The treatment and administrative patient records created by, or provided to, the Contractor under this agreement are covered by the VA system of records entitled "Patient Medical Records-VA" (24VA19). 24VA19 can be viewed at . The VA shall have unrestricted access to these records.The contractor will maintain electronic medical records using the computerized patient record system, CPRS, and Vista Imaging making sure they are up-to-date and will include the enrolled patient’s medical records for all subcontractor providers. The electronic record shall include, at a minimum, medical information, prescription orders, diagnoses for which medications were administered or prescribed, documentation of orders for laboratory, radiological, EKG, hearing, vision, and other tests and the results of such tests and other documentation sufficient to disclose the quality, quantity, appropriateness, and timeliness of services performed or ordered under this contract. Each member's record shall be electronic, which includes scanned images, shall be maintained in detail consistent with good medical and professional practice, which permits electronic documentation that occurs in CPRS/GUI and Vista Imaging. No documents from the electronic medical record will printed and maintained manually and no shadow records are authorized. Effective internal and external peer review and/or medical audits facilitate an adequate system of follow-up treatment. Hard copies of external source documents may be scanned into the electronic medical record by the Contractor using a NMVAHCS approved scanner or a summary progress note written by an appropriate clinician after a review of the external source documents may be used in lieu of scanning any external source documents. After these documents have been scanned, the original hard copies will be mailed weekly via UPS Ground delivery to: NMVAHCS . The UPS delivery service will be at the expense of the Contractor. An audit of the scanned records must be conducted by the contractor to assure they are scanned properly after scanning, and then the original documents are to be sent via UPS or other tracking service to VA Medical Records file room to be stored for 9 months and then destroyed. Scanning and audit reports will be sent via PKI encrypted e-mail to the VA File Room/Scanning Supervisor and File Room/Scanning Lead by the end of the first week of every month. No paper record shall be maintained. If there are no errors found the CBOC will report via email that there were no errors to be reported for the previous month.Availability of Records: The Contractor shall make all records available at the Contractor's expense for review, audit, or evaluation by authorized federal, state, and Comptroller or VA personnel. Access will be during normal business hours and will be either through on-site review of records or through the mail. All records to be sent by mail will be sent via UPS Ground delivery at contractor's expense to the VA within one (1) business day of request at no expense to VA. External Peer Review Program: The Contractor shall document in the medical record preventive health case management measures and the chronic disease indicators of the enrolled patient. The medical treatment records generated by the contractor in the course of performing services under this contract shall be made available for audit by the VA's External Peer Review Program (EPRP). Medical record data must be available in CPRS and Vista Imaging and any additional records required for EPRP audit will be promptly forwarded to the VA upon request. This data will be sent via UPS/Federal Express or other means of ground delivery at contractor's expense if necessary to meet the due date requested by the NMVAHCS. EPRP is provided to the NMVAHCS by other contractors. Contract providers who are seeing VA patients are considered to be the VA providers and as such are provided access to confidential patient information as contained in the medical record.Release of Information: The NMVAHCS 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 NMVAHCS authorizing the Contractor to release patient information, the Contractor in compliance with NMVAHCS regulations, and at his/her own expense, shall use VA Form 5345a, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address: , Release of Information Office phone: 505-265-1711 x2449/2722Disclosure: Contractor and Contractor may have access to patient medical records: however, Contractor and Contractor must 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, Contractor and/or sub Contractors.The Contractor must provide copies of medical records, at no charge, when requested by the VA to support billing and/or VA mandated programs if these records are not available in CPRS or Vista Imaging. The Contractor will use VA Form 5345 (release of records to outside parties), and VA Form 5345a (release of records to veterans themselves), Request for and Consent to Release of Medical Records Protected by 38 U.S.C., for veterans wishing to have their CBOC records released. The Contractor will release information in accordance with the Privacy Act of 1974, and the Health Insurance Portability and Accountability Act. Release of Information software will be used to print and release record information thus accounting for any and all disclosures of record information. The contractor will use the provided software package DSS ROI Manager to record and account for all release of information request processed by the contractor. When releasing medical records to the veteran themselves, the 5345a form will clearly indicate: The veteran full name and full SSNThe information that was released as authorized by the veteranThe date the information was released (inferred that date signed is date released) Block will be checked that the information was released in person to the veteran.When releasing the information to an outside third party, the 5345a form will clearly indicate:Full name of veteran and full plete address of third party to who the records were released toThe exact information that was released as authorized by the veteranThe purpose for third party receiving the recordsThe expiration date for authorizationThe date the information was released, what was released, and by who shall be noted in the bottom right corner of the form in the area designated for such if software is unavailable for more than a 1 week period, the contractor will send via UPS the signed, completed release forms clearly noting packaged material is for entry into the release of information disclosure tracking system. Complex requests, those requiring a bill or those where all the information may not be available to the CBOC, will be forwarded via fax to the VA Release of Information The completed VA For 5345a shall be sent to NMVAHCS Release of Information Office (ROI).New Mexico VA Health Care SystemAttn: Release of Information Office1501 San Pedro SEAlbuquerque, NM 87108Fax: 505-256-5705Faxed information that is confirmed as received can be shredded.Patient Handbook: The Contractor shall provide each patient with a copy of a patient handbook. A sample patient handbook which the Contractor can edit to apply specifically to this CBOC will be provided by the parent VAMC. The handbook shall include:Address of CBOC, names of providers, telephone number(s), and office hours;Description of services provided;Procedures for obtaining services;Procedures for obtaining emergency services; andNotice to the patient that they have the right to grieve eligibility related decisions directly to the VA.Records Retention: The Contractor must retain records generated in the course of services provided under this contract for the time periods required by VHA Record Control Schedule 10-1 and VA regulations (24 VA 136, Patient Medical Records - VA, par. Retention and Disposal). No hard copies of medical records or logbooks of any type may be maintained. If this agreement is terminated for any reason, the contractor will promptly provide the VA with any individually-identified VA patient treatment records or information in its possession, as well as the database created pursuant to this agreement, within two (2) weeks of termination date. Work-Related Incident Treatment: When treating the veteran for injuries sustained as a result of a work-related incident or an accident, the Contractor must complete the appropriate forms to allow the VA to assert a Federal Medical Care Recovery Act (FMCRA) or a Workers Compensation Claim. In addition, must notify the COR prior to making the decision to receive approval of action.The VA utilizes both a scanned and electronic medical record (EMR). The primary electronic component is the Veterans Information System and Technology Architecture (VISTA) /CPRS (Computerized Patient Record System), which consists of hardware configurations and software developed by the VA. VISTA/ CPRS, is a collection of over one hundred (100) applications that make up a comprehensive hospital information system. It includes both medical records and clinical applications or packages such as order entry, Progress Note, laboratory, radiology, scheduling/admission-discharge-transfer and discharge summary. The present VISTA/CPRS packages combined comprise an estimated 80 percent of a total electronic medical record. The scanned component of the medical record will consist only of those items not already on-line in CPRS. CPRS requires that all medical entries be done electronically, including, but not limited to, prescriptions, labs, radiology requests, Progress Notes, vital signs, problem lists, and consults.Contractor personnel will utilize VA’ current VISTA/CPRS technology to compile a concise and relevant account of the patient’s health care with Contractor-owned workstation equipment and communication software.Training: VA will provide the necessary training to Contractor personnel on the proper use and operation of the CPRS system. VA will provide VISTA training and access appropriate to Contractor’s decision to utilize clinic staff or subcontracted vendor for data entry.Documentation and Clinical Records: Documentation and clinical records shall be complete, timely, and compliant with VA policies, and current Joint Commission Standards. The Contractor shall report workload (check-in, check-out) within two (2) working days and other important clinical data including entry into the Patient Care Encounter (PCE module) including ICD9-CM diagnostic codes as well as CPT as defined by the American Medical Association. The Contractor shall provide individual patient encounters (visits) workload in accordance with established VA reporting procedures. The Progress Notes for each enrolled patient visit, whether the patient visit was with the Contractor or a subcontractor, shall be entered electronically in the patient's record through the VA CPRS system. Documentation must be complete for all fields including whether or not the patient is service connected. The CPT and provider codes must match and codes must accurately reflect complexity of visit. Complete documentation must be completed before the 18th of each month.All Progress Notes, medication orders, and test results, applicable to services which the Contractor is responsible to provide and perform at its site or subcontractor's site, shall be entered into CPRS by the Contractor within two (2) calendar days of the patient’s visit, with the exception of radiology reports. VA Radiologist's professional interpretation of diagnostic radiology and diagnostic imaging performed by the Contractor will be entered into VISTA/CPRS by VA. Contractor shall be responsible for entering into VA’s CPRS all information and requests for laboratory and radiology test requests. Progress Notes will be entered into CPRS or the Progress Note portion of the TIU package. The results of laboratory tests performed at the CBOC must be included in the Progress Notes. Progress Notes must meet CMS guidelines for documentation which include the 3 key components to determine the level of evaluation and management (E/M). These key components include: (1) History; (2) Exam; and (3) Medical decision making. Progress Notes associated with each clinic visit will include pertinent medical treatment, a treatment plan, teaching that was provided to the patient and/or the patient’s family, the date of appointment, and the electronic signature of the treating clinician. All notes must be linked to the correct visit and location. A patient problem list must be present on the patient’s record by the third clinic visit and will be entered via CPRS on the Problem List tab. This list will include all diagnoses, medications and procedures and will be updated as the patient’s condition changes. Laboratory reports and results will be entered into the Laboratory Package. The process for entry of data may include manual entry or an automated procedure; however, it must adhere to applicable VA Automated Information Security (AIS) system regulations. Questions may be directed to the VA Information Security Officer at ABQISO@.Encounter Forms: The Contractor will electronically complete encounter form data in the VISTA/CPRS system within two (2) working days of visit. Completed Encounter Forms will include, but are not limited to, the Problem list, appropriate CPT code(s), a primary ICD-9 Diagnosis Code(s), designation of a primary provider, and whether the treatment or care rendered was for a service connected condition or as a result of exposure to agent orange, environmental contaminates, or ionizing radiation. Women’s Health Software Package: The Contractor must utilize the Women's Health Software package to track and document preventative care for women veterans (in addition to all other VISTA requirements of this contract). Mammograms, pap smears, bone density tests and HPV vaccine administration must be ordered via clinical reminders and the results of same must be documented via clinical reminders. In addition, every mammogram ordered must be tracked. In addition to the documentation of results in the clinical record, every mammogram report received must be faxed to the Women Veterans Program Manager, at 505-265-1711 ext. 2679.Forms: Any new or existing Templates used by the CBOC must be approved by the VA Forms Team of Clinical Informatics Team. Request for approval shall be submitted to the forms team via e-mail VHA FORMS.Access to VA Records: Subject to applicable federal confidentiality laws, the Contractor or its designated representatives may have access to VA records at VA's place of business on request during normal business hours where necessary to perform the duties under this resultant contract.Reports: The Contractor is responsible for complying with all related VA reporting requirements requested by the VA.Equipment and Technical Support:In accordance with VA and VHA directives, policies, and handbooks, all equipment attaching to a VA network will be owned by the VA and controlled by the VA. No other equipment will be connected to this network. The use of the equipment will be for the benefit of the Government in providing care to our veterans. The equipment shall only be used by those expressly authorized in support of the NMVAHCS and the TorC CBOC. All users shall comply with and adhere to VA Directives and VA Cyber Security policies.The NMVAHCS shall provide the PC workstations, software, primary telecommunications lines and networking equipment required to access the VISTA system. The NMVAHCS shall provide necessary antivirus software for PC workstations and ensure that data definition files are current. In addition the NMVAHCS shall ensure that all Microsoft critical updates and patches are current. The Contractor shall be responsible for installation and maintenance of the network infrastructure within the facility including, but not limited to, cabling located inside the walls of the structure and a secure communications closet space to house the patch panels and networking equipment (see para’s below). For backup, contingency and continuity of operations, the Contractor will provide connectivity to the Internet via cable modem, DSL or T1 circuits to the communications closet space. The VA will make and manage the connection from that connectivity to the VA owned networking equipment in the closet. Backup, contingency, COOP connectivity to the VA will be established through a VA provided Site-to-Site VPN connection utilizing Contractor provided Internet Service Provider (ISP). The VA will provide and manage the necessary VPN security router hardware. The Contractor shall be responsible for maintenance and on-going technical support for all data and voice wiring within the walls and ceilings from the data closet to the endpoints of the network. The Contractor is responsible for all charges related to the backup, contingency, and COOP connectivity. The Contractor shall be responsible for procurement, installation and maintenance of all printers, copiers, fax machines, shredders, or other peripheral office equipment required to operate the facility.Hardware/software Compatibility List: The following printers have passed compatibility testing with the VISTA Encounter Form:Lexmark T642n, Lexmark T644n and Lexmark E342n or compatible. The Contractor shall also provide one small desktop color printer for printing patient education information.The following scanner has passed compatibility testing with the VISTA Imaging System:Fujitsu fiI-4340C Sheet Feed Scanner (Any other model used will require approval and certification for Vista Imaging)4.25.4.3.1For a list Government furnished property (see Attachment O). The attached list is intended to identify equipment that shall be provided. Specific numbers of each type of equipment needed shall be discussed during the award process. A specific inventory list with ID numbers shall be completed upon commencement of the contract. Contractor shall be required to complete an annual inventory of government furnished equipment. Additions or removal of equipment shall be jointly documented by the contractor and NMVAHCS. Contractor shall notify NMVAHCS OI&T upon loss or destruction of, or damage to government provided property under this contract. Contractor shall be responsible for replacement and/or all repair costs at Contractor’s expense. The CO shall direct action in regard to damaged Government property as specified in FAR 52.245-1 (JUN 2007). The NMVAHCS will provide advisory technical support to the Contractor’s technical support person for the initial CBOC set-up relative to VISTA, CPRS and VPN connectivity. The NMVAHCS will provide on-going technical support for VISTA and CPRS software and any other VA software applications. Technical support will be through an escalation process. The Contractor’s employee technical representative will submit a “Help Desk” request by calling 505-265-1711 x6007. Initial technical support will be provided by the NMVAHCS via telephone, which will consist of a NMVAHCS technical representative speaking to a Contractor employed representative to identify the problem, trouble-shoot and attempt to resolve the problem with the Contractor’s end-user. If the problem cannot be resolved the NMVAHCS will provide on-site support for NMVAHCS owned equipment, VISTA, CPRS software and other VA software applications, if necessary within two business days or less depending on the nature and severity of the problem.The Contractor shall not allow its inability to access VISTA to prevent any patient from being seen by a provider. In the event, and for any reason, that the Contractor is not able to access the VISTA system, the Contractor will record all data manually including the completion of the Encounter Form. Upon recovery of the Contractor’s ability to access the VISTA system, the Contractor will input all data recorded manually into the VISTA system within forty-eight (48) hours of the system becoming operational. Upon entering all data into CPR/SUI delete created files.The Contractor shall have a contingency plan for computer downtime that defines the processes in order to ensure continuity of patient care and maintenance of the integrity of the patient’s medical record during periods of loss of computer functions. The contingency plan must be reviewed and approved by the Contracting Officer prior to award. In addition, a contingency plan template that designates criticality of application/system, estimate of impact, locations of equipment, and contact persons will be provided to the Contractor for completion after award. Contractor shall complete the "contingency report" outlining the 1) problem; 2) what they did; and 3) what action they did to complete the patient record(s). They are to keep a copy on file and send the report to the COR within 72 hours of the event. The Contractor shall provide a secure, double locked communications closet to house the computer networking equipment and network patch panel to service the clinic space. This space shall be at least 10’x10’ with air conditioning and fire suppression. The solid core door to the communications closet shall have no vents, windows, or other gaps. This door shall be keyed separately with a copy of the key only provided to the VA Office of Information & Technology department and the site manager. Access to this space shall be strictly controlled to ensure adequate information security.VA Handbook 6500 that requires the following statement on all fax cover sheets be included: This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. if you have received this fax in error, please notify this office immediately at the telephone number listed above.”Nothing?SHALL be added to the NMVAHCS provided network environment that is not approved by the NMVAHCS. If this is violated, the NMVAHCS provided equipment and data lines shall be disconnected and removed as a result of violation of the security of the VA network.Contractor Personnel Security Requirements:All Contractor employees who require access to the Department of Veterans Affairs’ computer systems shall be the subject of a background investigation and shall receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to contract performance.? This requirement is applicable to all subcontractor personnel requiring the same access.? If the investigation is not completed prior to the start date of the contract, the Contractor shall be responsible for the actions of those individuals they provide to perform work for VA.? The investigation shall be initiated prior to being granted access to VA computer systems. Also as a condition of employee, all Contractor employees will be required to come to Albuquerque to get process for their VA PIV badge which will allow them access to the VA system.? This will require more than one trip.? (COMPLETE ATTACHMENTs in Section D and turn in with proposal)(1) Position Sensitivity – The position sensitivity has been designated as Low Risk.Background Investigation - The level of background investigation commensurate with the required level of access is National Agency Check with Written Inquiries (NACI).? Non-citizen contract personnel appointed to Low Risk or Non-sensitive positions shall be subject to a National Agency Check with Law Enforcement and Credit Check (NACLC).Contractor Responsibilities:The Contractor shall bear the expense of obtaining background investigations.? If the investigation is conducted by the Office of Personnel Management (OPM), the Contractor shall reimburse VA within 30 days.? The estimated cost of the NACI or NACLC is $210.00 per person. The Contractor shall prescreen all personnel requiring access to the computer systems to ensure they are able to read, write, speak, and understand the English language.? The Contractor employees shall download, complete, and mail the documents required for a Low Risk Position found on the following website within fourteen (14) calendar days of the individual’s appointment to the position: Electronic fingerprinting can be performed free of charge at the University Drive Human Resources Office.? The Contractor employees shall also complete the Electronic Fingerprinting Memo which shall be provided at award.? All documents shall be mailed by the Contractor, along with a copy of the request worksheet completed by the CO and the Electronic Fingerprinting Memo, to:VA Law Enforcement Training Center/SIC2200 Fort Roots Dr., Bldg. 104North Little Rock, AR 72114The Contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract.Failure to comply with the Contractor personnel security requirements shall result in termination of the contract for ernment Responsibilities:Upon receipt, the VA Office of Security and Law Enforcement shall review the completed forms for accuracy and forward the forms to OPM to conduct the background investigation.The VA facility shall pay for investigations conducted by the Office of Personnel Management (OPM) in advance.? In these instances, the Contractor shall reimburse the VA facility within 30 days.The VA Office of Security and Law Enforcement shall notify the CO and Contractor after adjudicating the results of the background investigations received from OPM. The CO shall ensure that the Contractor provides evidence that investigations have been completed or are in the process of being requested.Contractor personnel performing work under this contract shall satisfy all requirements for appropriate security eligibility in dealing with access to sensitive information and information systems belonging to or being used on behalf of the Department of Veterans Affairs. The Contractor shall be responsible for the actions of those individuals they provide to perform work for the VA under this contract. In the event that damages arise from work performed by Contractor provided personnel, under the auspices of this contract, the Contractor shall be responsible for all resources necessary to remedy the incident. Printed output containing sensitive VA data shall be stored in a secured area and disposed of properly, per VA Directive 6371, Destruction of Temporary Paper Records. Under the provisions of the Privacy Act of 1974 as amended, personnel performing work under this contract have an obligation to protect VA information indefinitely. At cost to the contractor the chosen shredder device shall have a crosscutting capability which produces particles that are 1 X 5 millimeters in size or that shall pulverize/disintegrate paper material using disintegrator devices with a 3/32 inch security screen. (Reference NSA Disintegrator Evaluated Products List). Furthermore it is the contractor's responsibility to notify the service line ADPAC, Office of Information and Technology (OI&T) staff, or the Information Security Officer (ISO) when access to Automated Information Systems is no longer needed by personnel performing work under this contract. (Contractor shall complete one document per employee see ATTACHMENTS in Section D)Contractor employees shall be required to complete the online training classes entitled “VA Cyber Security Awareness” and “VHA Privacy Awareness Training” prior to receiving an account on the NMVAHCS network and annually thereafter.? The Education Coordinator shall create an account for each contractor employee in the NMVAHCS Talent Management System (TMS).? A TMS account request form shall be obtained by calling the Education Coordinator 505-265-1711 X4050.? The link to the training web site is . A Certificate of successful completion shall be generated and maintained by the COR. These certificates shall be made available upon request to the CO, Privacy Officer, Information Security Officer or NMVAHCS Primary Care CBOC Manager. In performing this contract, the Contractor shall be considered part of the Department of Veterans Affairs (VA) for purposes of 38 U.S.C. §§ 5701 and 7332.? Its employees shall have access to patient medical records to the extent necessary to perform this contract.? Notwithstanding any other provision of this contract, the Contractor and its employees shall disclose patient records and individually-identified patient information, including information and records generated by the Contractor in performance of this contract, only pursuant to explicit disclosure authority from NMVAHCS. The NMVAHCS shall provide Contractor and subcontractor employees with access to NMVAHCS automated patient records maintained on VA computer systems only to the extent and under the same conditions and requirements as VA provides access to these records to its own employees. All Contractor personnel and any subcontracted employees, if applicable, accessing the VISTA system shall be required to sign and abide by all VA security policies, and applicable VA confidentiality statutes, 38 U.S.C. §5701, 38 U.S.C. §7332, and the Privacy Act, 5 U.S.C. §552a.? The VA shall provide access applications and security contracts. All access request forms shall be submitted to the ISO with required signatures. Contractor shall ensure the confidentiality of all patient information and shall be held liable in the event of the breach of confidentiality. Due to the confidential nature of medical reports, all transcription shall be completed in areas that provide reasonable security and maintain the highest degree of auditory privacy. All documents are confidential and are protected under the Privacy Act of 1974, as amended.? All vendor personnel shall be required to observe the requirements imposed on sensitive data by law, federal regulations, VA/NMVHACS statutes and policy, DM&S policy and the associated requirements to insure appropriate screening of personnel. The database utilized by the Contractor under this contract, the adverse drug event reports provided to the Contractor by NMVAHCS, and documents created from analyzing this database, the adverse drug event reports, and patient medical records are medical quality assurance records protected by 38 U.S.C. § 5705, its implementing regulations at 38 U.S.C. §§ 17.500-.511 and VHA Directive 2008-077, Quality Management (QM) And Patient Safety Activities That Can Generate Confidential Documents (or subsequent revisions thereto). These records shall be disclosed only as authorized by § 5705 and the VA regulations.? Disclosure of these records in violation of § 5705 is a criminal offense under 38 U.S.C. § 5705(e). The treatment and administrative patient records created by, or provided to, the Contractor under this contract are covered by the VA system of records entitled "Patient Medical Records - VA (24VA136). Records created by the Contractor in the course of treating VA patients under this contract are the property of the VA and shall not be accessed, released, transferred or destroyed except in accordance with applicable federal law and regulations and VA policies. Upon expiration of this contract or termination of the contract, the Contractor shall promptly provide the VA with any individually identified VA patient treatment records.All portable media shall be approved in advance in writing from the ISO ( thumb-drives, CD-ROMs, ) utilized by the Contractor under this contract shall be encrypted in accordance with the security requirements identified in FIPS 140-2.? Only thumb drives and encryption software explicitly approved by the VA shall be used.? The use of floppy disks is not permitted without written approval.? Exemption requests shall be processed through the ISO office. No NMVAHCS data is permitted to be stored on a desktop or laptop computer hard drive.? Any portable computer used under this contract shall have the hard drive encrypted in accordance with FIPS 140-2.No records containing Individually Identifiable Information or Protected Health Information (PHI), as defined by Federal law and regulation, shall be sent, maintained, stored or accessed by the Contractor (or any Subcontractor(s)) outside of the United States.Privacy and Security incidents shall be report immediately to the NMVAHCS Privacy Officers for entry into the Privacy Violation and Tracking Software. Poster containing the names and contact information for the NMVAHCS Privacy and Security Officers shall be prominently display in an area where all Veterans can easily view. The VA’s Notice of Privacy Practices shall be prominently displayed and copies available upon request. Liquidated Damages for Data Breach:Consistent with the requirements of 38 U.S.C. §5725, a contract shall 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. The contractor/subcontractor shall provide notice to NMVAHCS within 1 hour of a “security incident” as set forth in the Security Incident Investigation section above. Upon such notification, VA shall 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 shall be deemed a material breach and grounds for contract termination.Each risk analysis shall address all relevant information concerning the data breach, including the following:Nature of the event (loss, theft, unauthorized access);Description of the event, including:Date of occurrence;data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code;Number of individuals affected or potentially affected;Names of individuals or groups affected or potentially affected;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;Amount of time the data has been out of VA control;The likelihood that the sensitive personal information shall or has been compromised (made accessible to and usable by unauthorized persons);Known misuses of data containing sensitive personal information, if any;Assessment of the potential harm to the affected individuals;Data breach analysis as outlined in 6500.2 Handbook, Management of Security and Privacy Incidents, as appropriate; and Whether credit protection services shall assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that shall have been compromised.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:Notification;One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports;Data breach analysis;Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution;One year of identity theft insurance with $20,000.00 coverage at $0 deductible; and Necessary legal expenses the subjects shall incur to repair falsified or damaged credit records, histories, or financial affairs.Patient Rights and Responsibilities: Contractor shall conform to all patients’ rights issues addressed in VA Medical Center Memorandum 003-34 Patient/Resident Rights and Responsibilities eligible veterans shall be provided primary medical and preventive health care, to include assessment, diagnosis, and treatment, which shall be based on assessed needs. Care provided shall respect and integrate the patient’s beliefs, values and cultural influences. The contractor shall involve the patient in care decisions by keeping him/her fully informed about the diagnosis, plan of care and treatment goals, risks and benefits of proposed treatment, and prognosis; shared-decision making shall be pursued. Reference Patient Rights and Responsibilities MCM 003-34. The levels of care provided shall be equal to the standards of care provided by NMVAHCS. Contractor’s preventive health care program shall follow the guidelines of the U.S. Preventive Services task force and adult immunization guidelines of the American College of Physicians, and/or the most current VHA Performance Measurement System () & JC () care measures available. Performance Measure Updates shall be reviewed monthly by Contractor in order to ensure knowledge and compliance with current standards (see Attachment A). The contractor shall query all patients regarding the development of Advance Directives, and participation in Organ Donation programs. Contract clinic staff shall provide the patient assistance as needed in the completion of an Advance Directive, which shall be documented in the electronic medical record in the Advanced Directive Progress note. Hard copy is sent to NMVAHCS for scanning or scanned using approved VA scanner. Contract staff shall provide Veteran with Advanced Directives document for completion. When the medical record contains information about current Advance Directives, the information shall be reviewed and honored by the contractor. Contract staff shall use current documentation instructions provided by NMVAHCS. Changes in documentation requirement or technology shall be communicated to the contractor from NMVAHCS in a timely manner. Protection of all patient rights is of highest priority. The contractor shall comply with all applicable privacy and confidentiality statutes and regulations of the HIPPA: Health Insurance Portability and Accountability Act. Contract clinic staff shall provide all patients a copy of the NMVAHCS Patient Rights handbook on entry to care. Current Patient Rights posters shall be prominently displayed in the clinic waiting room. All CBOC staff and providers shall review the Patient Rights, and follow the standards of care. Patient privacy and confidentiality shall be maintained at all times. All examination rooms shall have locking doors, (with ease of access in case of an emergency) privacy curtains and provide for auditory privacy. The CBOC staff person(s) designated as the Patient Satisfaction Advocate reviews all patient complaints. The Patient Satisfaction Advocate shall maintain an electronic record of all complaints, investigations, follow-ups and outcomes, using the VA Form 119 Report of Contact. Data shall be tracked and trended by the Contractor. Patient complaints shall be addressed and reported the COR. All patient complaints, which cannot be resolved by the contractor, shall be referred to the COR. The Contractors Patient Satisfaction Coordinator shall send a monthly summary, with Report of Contact forms attached to the summary report, of patient complaints to the COR, to be received on or before the 10th workday of each month. Reports of no complaints are required. (Reference VHA Handbook 1003.4, "VHA Patient Advocacy Program," dated 9/2/05 available at . Response to complaints by the Contractor shall occur as soon as possible, but no longer than seven (7) days after the complaint is made. Patient complaints shall be entered in the National Patient Complaint database by Service Level Advocates and/or the NMVAHCS Patient Advocates. Information concerning the Patient Advocacy Program shall be prominent and available to CBOC patients. The NMVHACS shall provide the Contractor with informational handouts describing the program and how to contact the NMVAHCS Patient Advocate. The contractor shall fully complete all required consent documentation within the electronic medical record utilizing the current NMVAHCS universal protocol for all invasive and any non-invasive procedure requiring patient consent. Planned procedures shall not be performed without appropriate pre-procedure consent documentation. Contractor shall be trained by NMVAHCS on consent documentation requirements and processes. Veteran Eligibility and Benefits:All veterans applying for care at the CBOC will have an application processed in VISTA by the Contractor to determine priority enrollment category for benefits. The Contractor will process all applications for veterans requesting to be followed at the CBOC. The Contractor will use a number of processes in making priority group determinations including discharge documentation, Hospital Inquiry (HINQ), and communications (written and telephonic) with the VA Regional Office and Records Management Center in St. Louis. The Contractor will contact the VA Supervisor, Patient Registration for any unusual or complicated enrollment issues/questions. The Contractor will adhere to the processes and guidelines established by the Supervisor, Patient Registration in regard to all issues concerning patient enrollment and registration. No veteran should receive clinical care by a CBOC without the Contractor confirming enrollment within the VA. Persons not verified eligible who present to a CBOC in need of urgent or emergent care will be treated on a Humanitarian basis until stable and discharged from CBOC, or referred to the proper level of care in the community. If the patient is determined to have no authorization for services, and has received care at the Contractor's CBOC, the patient will be billed directly by the VA and will be informed by staff at the CBOC that he is not eligible to continue receiving services at this site.Registration and Enrollment: All applications will be registered and enrolled into VISTA by the Contractor using the "Register a Patient" option in the VISTA Registration package. All registrations will then be "Dispositioned" in VISTA by using the "Disposition an Application" option before close of business each day. Any questions related to registrations, enrollment, and dispositions can be referred to the VA Supervisor, Patient Registration at 505-265-1711 ext. 4215.Financial Assessments (Means Tests and Copayment Exams): For some veterans, an annual assessment of household income (and sometimes assets) must be completed by the veteran prior to being seen by the Contractor's provider. The Contractor will provide a blank VA Form 10-10EZR (Renewal Application for Health Benefits) to the veteran; and the veteran will fill it out completely, including the financial information on side two of the form. The demographic and financial assessment information will be input into VISTA and maintained by the Contractor. For some veterans, a financial assessment is not required (VA pensioners, service-connected veterans receiving VA compensation, etc.). VA will provide the Contractor with guidelines regarding Financial Assessments, and questions can be addressed to the VA Means Test Clinic at 505-265-1711 ext. 4215Co-Payment: A co-payment may be assessed for in-patient and outpatient services, as well as pharmaceuticals, to veterans. This co-payment is determined by priority group status and the law. All VA co-payments shall be billed and collected by the VA and are not the responsibility of the Contractor. The Contractor shall notify the patient that, depending on the priority group determination, there may be a co-payment. All disputes for VA co-payments shall be referred to the Customer Service Representative for Billing at 866-802-6819. Patient Safety:Adverse events at the CBOC will be reported to the VA Quality & Patient Safety Office to the Patient Safety Manager or Patient Safety Coordinator and entered into the Patient Safety Reporting System, as outlined in the National Center for Patient Safety Handbook (). Adverse events will be scored utilizing the Safety Assessment Code for determination of the need for conducting a Root Cause Analysis (RCA). Report adverse events to Lead Patient Safety Manager at 505-265-1711 ext. 4790 or if unavailable, contact Patient Safety Coordinator 505-265-1711 ext. 4084.Adverse drug reactions, allergies, and adverse drug events should be appropriately and promptly entered into CPRS.Patient Complaints:The VA Patient Advocacy Program was established to ensure that all veterans and their families, who are served in VHA facilities and clinics, have their complaints addressed in a convenient and timely manner in accordance with VHA Handbook 1003.4, "VHA Patient Advocacy Program," dated 9/2/05 available at the following hyperlink: . Response to complaints will occur as soon as possible, but no longer than seven (7) days after the complaint is made. All patient complaints will be entered in the National Patient Complaint database. Information concerning the Patient Advocacy Program must be prominent and available to CBOC patients. The VA will provide the Contractor with informational handouts describing the program and how to contact the VA Patient Advocate.Grievance System Requirements:The enrolled patients have the right to grieve actions taken by the Contractor, including disenrollment recommendations, directly to the Contractor. The Contractor shall provide readable materials reviewed and approved by VA, informing enrolled patients of their grievance rights. The Contractor shall develop internal grievance procedures and obtain VA approval of the procedures prior to implementation. The grievance procedures shall be governed by the guidelines in VHA Handbook 1003.4 (dated September 2, 2005).Performance Standards, Quality Assurance and Quality Improvement: Services and documentation of care provided under the resultant contract shall be subject to quality management and safety standards as established by VA, consistent with the standards published by JC or equivalent. The contractor shall develop and maintain Quality Improvement/ Quality Assurance Programs and provision of care equal to or exceeding VA Standards. The results of all Quality Improvement activities performed by the contractor involving VA patients will be shared with VA Quality Management Office. Documentation by the Contractor provided to the VA includes, but is not be limited to the following:Quality improvement plans: Staff meetings minutes (or summary minutes) where quality improvement has been discussed and which include practitioner-specific findings, conclusions, recommendations and written plans for actions taken in response to such conclusion and recommendations, and evaluation of those actions taken.Contractor must be accredited by the TJC or maintain a level of service that is in compliance with all current TJC standards. If the Contractor is TJC accredited, he/she will be required to furnish a copy of the accreditation letter(s) upon request by the Contracting Officer prior to award. Listed below is the current outline of topics covered in The TJC manual of standards that must be met by the Contractor:Patient-Focused FunctionsEthics, Rights, and ResponsibilitiesProvision of Care, Treatment, and ServicesMedication ManagementSurveillance, Prevention, and Control of InfectionsOrganization FunctionsImproving Organization PerformanceLeadershipManagement of the Environment of CareManagement of Human ResourcesManagement of InformationStructure with FunctionMedical StaffNursingMedication Management The Contractor shall notify the Chief of Staff in writing whenever a malpractice claim involving a VA patient has been filed against the Contractor. The Contractor will forward a copy of the malpractice claim within three (3) workdays after receiving notification that a claim has been filed. The Contractor will also notify the VA Special Assistant to the Chief of Staff when any provider furnishing services under this contract is reported to the National Practitioner Data Bank. This notification will include the name, title, and specialty of the provider. All written notifications shall be sent to the following address:Raymond G. Murphy NMVAHCSAttn: Chief of Staff1501 San Pedro SEAlbuquerque, NM 87108The Chief of Staff or designee will notify the CO of any notifications received from the Contractor.The Contractor shall permit on-site visits by VA personnel and TJC surveyors accompanied by VA personnel and/or other accrediting agencies to assess contracted services, e.g., adequacy, compliance with contract requirements, record-keeping, etc.The Contractor is responsible for the quality management plan for monthly clinical pertinence review of ambulatory care records. The results shall be forwarded to the Performance Improvement Specialist for Ambulatory Care Service. If in the course of VA business, a concern is identified, the issues must be addressed by the Contractor and a performance improvement plan initiated. Recommendations and implementation of performance improvement activities will be the responsibility of the Program Director of the clinic. The CBOC shall conduct audits of JTC standards that require performance measures. Those audit results shall be sent to the COR on a quarterly basis. The VA is committed to providing high quality primary care. The VA measures quality in primary care through its performance measurement system. Several "process" and "outcome" measures are extracted by external reviewers from random samples of records of veterans who visited VA primary care providers at CBOCs. These measures change from year to year. The current performance measures and method of extraction are available at . The Contractor is responsible for achieving levels of performance on these measures that meet or exceed the annual expectations for performance as outlined in the Network Performance Plan and Network Technical Manual. Revisions/updates to the Network Performance Plan and Network Technical Manual may be obtained from the above website. The Contractor is required to utilize the VISTA CPRS clinical reminder system as a means of both ensuring high performance on these measures and to facilitate monitoring of performance at the site independent of external reviewers. Levels of performance on the quality measures in primary care will be used as a factor in decisions about renewal of the contract.The Contractor shall document in writing on appropriate orientation programs for all employees involved in the delivery of patient care, e.g., infection control procedures, patient confidentiality, handling emergencies, patient safety, etc., and provide a copy to the VA COR. Contractor shall be required to furnish method/guidelines by which he/she intends to meet above requirement. The Contractor will have a quality monitoring/performance improvement program. This program will be available to VA staff and JC. The VA will provide regular feedback on clinic performance measures, including but not limited to the following: licensure verification, workload, consults, drug and lab utilization, formulary compliance, prescription writing patterns, Prevention and Performance measures, patient satisfaction, and medical record completeness. The Contractor shall conduct audits pertaining to access, quality improvement, documentation, safety and performance measures. These reports shall be submitted to the COR on a monthly basis and sent via secured email using PKI or utilizing UPS.The Contractor should comply with all PBM formulary guidance regarding medication use, monitoring and safety. The Contractor should collaborate with VA Pharmacy when CBOC patients are identified that require intervention. The Contractor shall meet all Federal, State, and Local fire and Life Safety Codes.The Contractor shall be responsible for meeting national quality standards and shall comply with mandated policies established by VA Central Office (VACO) Patient Care Services (PCS). Each fiscal year new quality standards are developed by PCS and forwarded to each VISN for implementing at each primary care site to include CBOCs. Those standards are found at the VA website and also provided by the COR for implementing.REQUIRED REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS) - 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 $150,000.00, 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 is required to register with CPARS database at the following web address: cpars.csd.disa.mil.? Help in registering can be obtained by contacting Customer Support Desk @ DSN: 684-1690 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 thirty days to submit any comments and re-assign the report to the VA contracting officer. Failure to have a current registration with the CPARS database, or to re-assign the report to the VA contracting officer within those thirty days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to ERNMENT RESPONSIBILITIES:Oversight of Service/Performance Monitoring:CO Responsibilities:The CO is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the CO on all matters pertaining to contract administration. Only the CO 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 CO shall resolve complaints concerning Contractor’s provider relations with the Government employees or patients. The CO is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the CO 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 the contract staff to be provided by the VA; replacement of the contract staff and/or renegotiation of the contract terms or termination of the contract.The COR:The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor or Contractor’s provider noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.The COR will be responsible for monitoring the Contractor staff performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring is outlined in the QASP.The COR will maintain a record-keeping system of services by reviewing the QASP and invoices submitted by the Contractor. The COR will review this data monthly when invoices are received and certify all invoices for payment. Any evidence of the Contractor's non-compliance 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.Contract Administration: After award of contract, all inquires and correspondence relative to the administration of the contract shall be addressed to:Contracting Officer (CO)?: Mr. Valeria GutierrezPhone/email: 915-491-3902 valeria.gutierrz@ The Contracting Officer's Representative (COR) for this contract is:Name/Address/Phone/email: Karen Y. Smith Karen.smith20@ (see phone number below)Liaison Persons: The VA has designated the following liaison personnel for this resultant contract:TitleRolePhone and emailAssociate Chief of Staff, Ambulatory CareClinical Contact505-265-1711 ext. 2627Acting Rural Health Manager, Ambulatory CareAdmin? and operations Contact505-265-1711 ext. 2660Cell: 505-250-2120CORAdmin Contact505-265-1711 ext. 2660Cell: 505-250-2120Administrative Officer of the DayContact for any administrative and clinical problems that arise after normal working hours of 8:00 AM-4:30 P.M or 5:00 PM., Monday - Friday, weekends and holidays(505) 265-1711 and ask for the AODIRM "Help Desk"Assistance with VISTA505-265-1711 Ext. 2490HAS ADPACAssistance with Patient Information Management System (PIMS)505-265-1711 ext. 2172(Alternate) ext. 4375Eligibility/Enrollment officeAssistance with Patient Eligibility505-265-1711Ext. 2741/2349/2672ext. 4522/2636Contract SpecialistAdministers Contract505-767-6088Contracting OfficerAward of Contract480-466-7902Medical Care Cost RecoveryAssistance with Financial Assessments505-265-1711 Ext. 4206/4351CBOC Outpatient PharmacyOutpatient Pharmacy CBOC staff505-265-1711 Ext. 4844/4245Health Information Management ServiceAssistance with CPRS/GUI and Medical Records505-265-1711Ext. 2449/2285VA Patient AdvocateAssistance with patient complaints, 505-265-1711 ext. 2686Alternate ext. 2612Ancillary Testing CoordinatorQuestions involving lab work, x-rays, and other ancillary testing505-265-1711 ext. 5163Pager 247-5267Pathology and Laboratory MedicineChief Medical Technologist for pathology and laboratory medicine505-265-1711 ext. 2330Women Veterans Health ServicesProgram Manager for women veterans health issues505-265-1711 ext. 2679While the liaison persons identified and other NMVAHCS staff may be contacted for questions/information and/or may visit the CBOCs to oversee policy compliance, only the CO is authorized to make commitments or issue changes which will affect the price, quantity, quality, or delivery terms of this contract. Any guidance provided, which the Contractor feels is beyond the scope of this contract, must be communicated to the CO, via the COR, for possible contract modification.The Contractor shall identify a contact person(s), who shall serve as liaison between the Contractor and the VA. This individual will also ensure the functionality of the clinic according to contract specifications. The contact person(s) will be available during the administrative tour of duty from 8:00 AM - 4:30 PM Monday through Friday. The Contractor’s point of contact for other than its normal working hours should be reachable by phoning the 24-hour Phone Triage number referenced in paragraph Patient Scheduling. Special Contract RequirementsContract Start-up Requirements:The Contractor's start-up requirements must be completed prior to the commencement of the Contractor's treatment of VA enrolled patients. Upon approval by the VA of the Contractor's completion of the start-up requirements, the VA will issue a written Notice to Proceed to the Contractor. The Contractor shall have ninety (90) days from contract award to commencement of the provision of medical care to local veterans. However, the Contractor must have all start-up requirements in place and ready to commence operation NLT eighty-three (83) calendar days from contract award. The final seven (7) days will be used for training and resolution of any last minute or unexpected technical or personnel related challenges. The Contractor shall comply with the following contract requirements prior to commencement of clinical operations:The Contractor will hire, train, and ensure licensure of all necessary personnel.The Contractor shall furnish evidence of insurability of the offeror and/or of all health-care providers, who will perform under this contract (see VAAR 852.237-7, Indemnification and Medical Liability Insurance, OCT l996).All Contractor-provided health care services shall be available:Preventive Health Services.Primary Care Services. Physician Services.Licensed Social Worker to provide Mental Health Assessment, Case Management, time limited psychotherapy and counseling.The Contractor's case management program with primary care providers as case managers for all health care services provided to enrolled patients shall be operational.The Contractor's VA approved performance improvement program shall be operational.The Contractor's facility shall be in compliance with the requirements of this contract.The VA will provide training to the Contractor at the VA relative to data reporting needs, computer system access to VISTA, CPRS, eligibility issues, billing procedures and medical referral procedures within eighty-nine (89) calendar days of contract award. The Contractor is responsible to provide future training to his/her personnel after the initial ninety (90) calendar days of the contract award. The Contractor must provide documentation of training prior to Pathology and Laboratory Medicine providing access to VISTA laboratory software options. The Contractor will be responsible for attendance and performance regarding training sessions. Training will be coordinated by the COR and the Contractor's designee. After contract performance begins, VA staff is readily available by telephone and e-mail to answer questions and provide guidance.Upon receipt of Notice of Award, Contractor will immediately commence the credentialing and privileging process for all physicians and social workers through the VA. A minimum of six (6) calendar weeks is required for VA credentialing after the package has been completed and received from the provider. Patient Transportation: Each patient will be responsible for his/her own transportation to appointments. The Contractor shall assist/refer Veterans for transportation assistance in coordination with the NMVAHCS.Signage: The Contractor shall furnish and install clearly visible signage on the exterior of the building, in the front window, or on the door which displays the VA logo and reads:The Contractor shall provide the Contracting Officer with a diagram of the proposed sign which specifies dimensions and identifies the installation location for approval by the Contracting Officer prior to fabrication of the sign. The VA has renamed Community Based Outpatient Clinics, when necessary, to reflect the county in which they are located. VA PRIMARY CARE CENTERContractor’s Physical Facility:The Contractor's facility or facilities shall be in compliance with, but not limited, to all applicable/current National Fire Protection Association (NFPA) Life/Safety, Occupational Health & Safety Administration (OSHA), or JC requirements and the Americans with Disabilities Act (ADA), whichever is more stringent. It must also assure privacy for women during examinations and with restroom facilities. Restrooms must also provide at least one changing table for infants. Facility or facilities shall be in compliance within ninety (90) calendar days of notice of award. Offeror's proposed facility or facilities shall comply with the VA's Life/Safety requirements and meet applicable current JC standards and Uniform Federal Accessibility Standards and VA Barrier Free Design Handbook H-08-13 guidelines ( ) a minimum of five (5) business days before commencement of patient care activities at the CBOC. VA shall inspect the Contractor's facility. Contractor must be in compliance with these requirements prior to contract start date. Any inspection shall be conducted during normal VA business hours of 8:00 AM – 4:30 PM, Monday through Friday by the VA Safety Specialist. A list of any deficiencies identified during an inspection will be provided to the Contractor along with a required date for correction of the deficiencies. Any planned changes in the physical environment at the CBOC must be reviewed and approved by the VA to ensure that all life safety codes are met. Sufficient parking shall be available for the number of patients (possibly 32 per day) scheduled for daily appointments. Parking shall be provided at no cost to NMVAHCS or to Veterans. Handicapped spaces (minimum of 4) shall meet ADA guidelines. Access to the clinic from the parking lot shall be convenient and easily accessible to all patients. Access to the clinic shall include automatic door(s).Water intrusions shall be abated using the VA’s Moisture and Mold Management Program (M3P) Manual. Contractor shall provide written proof of regulatory compliance to the CO at the NMVAHCS prior to scheduling the NMVAHCS compliance inspection. NMVAHCS shall inspect Contractor’s facility or facilities for compliance within ninety (90) calendar days of the notice of award and after receipt of the compliance verification letter. All inspections shall be conducted during normal business hours. A list of any deficiencies identified during an inspection shall be provided to the Contractor thru the CO along with a required date for correction of the deficiencies.The facility/facilities shall be a permanent structure, with permanent foundation. Any planned changes in the physical environment at the CBOC shall be reviewed and approved by the NMVAHCS and CO to ensure that all life safety codes are met.The following space requirements reflect NMVAHCS CBOC functions and needs. Physical variations in building shall cause deviation in room sizes and arrangement. All walls shall have a gloss or semi-gloss painted surface (infection control cleanable surface); furthermore, all walls shall have vinyl or rubber bases, except for ceramic tile walls, ceramic tile wainscot on painted walls. Vinyl composition floor covering shall be tile. Ceiling shall be fire retardant.Administrative Areas, to include but not limited to:Provider Office(s), including Mental Health Provider(s)Administrator’s OfficeManager’s OfficeSocial Worker OfficeConference Room/Patient Education Room/Group tele-medicine room Toilet, Staff (male/female)Lobby Area: Reception and check-in counter Rest Rooms, Patient (Male/Female) Waiting Area, including area for MyHealtheVet computer station(s) Alcohol Sanitizer dispenserPatient Rest Rooms shall be equipped with:Water closet, wall hung, flush valveDispenser, toilet tissue, double roll with lockGrab Bar, 2 for each water closetLavatory, wall hung 2”x18”x3 ?” apron, for 8” faucet centers. Faucet, 8” centersDispenser, Paper towelLight over lavatoryMirrorSoap dispenserWastebasketIf the electrical outlet is within 6’ of a sink, then it shall be Ground Fault Interrupting type.Infant changing tableWomen’s bathroom, sanitary product dispenser.Call system with cleanable cords.6.5.4.4.General Treatment Areas: 2 Exam rooms for each PCP Tele-Medicine Room(s) Nurse’s station Alcohol Sanitizer dispenserExamination Rooms shall be equipped with:Lavatory 20”x18” x3 ?” apron, for 8” faucet centers, with wrist or foot controlOutlet, telephone, wall mounted (empty conduit system), one each wall Receptacle, electrical, hospital grade, duplex, 120 volt, 20 amps, 2 walls. A quadriplex, 120 volt, 20 amps on one wall between the two walls with the duplex receptacle. If the electrical outlet is within 6’ of a sink, then it shall be Ground Fault Interrupting type. Receptacle electrical, hospital grade, quadriplex, 120 volt, 20 amps, 48” above finished floor at location for otoscope, ophthalmoscope, exam light and electrical thermometer.Cabinets, wall mount, with doors sufficient to meet exam room storage needs. Cleanable surfaceDispenser, paper towel: wall mounted, 40” from finished floor, 10 ?” W x 4”D x 14 ?”H.Soap dispenserAlcohol Sanitizer dispenserSharps Container – Regulated Medical Waste Container 6.5.4.5. Laboratory Specimen Collection Area, including specimen pass through Preparation Lab RoomSpecimen Collection and Preparation Lab Room(s) shall be equipped with: Partitions, movable Prep Area. (Specimen Collections) Countertop sufficient for centrifuge operations, cleanable surfaceCabinets, sufficient to meet the storage needs of the laboratory area. Cleanable surfaceSink for hand washing, with soap dispenser and towel dispenserReceptacle, electrical plug mold, 120 volt, and 20 amp. for centrifugeReceptacle, electrical, quadriplex, 120 volt. 20 amp (6 total) for Refrigerator. If the electrical outlet is within 6’ of a sink, then it shall be Ground Fault Interrupting type. Duplex plate box with outlet for telephone system and outlet for data processing, both served by (1) ?” empty conduit system. One set on each of two walls.Dispenser, paper towel, wall mounted 40” from finished floor. One by each sink.Alcohol Sanitizer dispenserSharps Container – Regulated Medical Waste Container 6.5.4.6. Misc. Storage/Environmental, Communications/Computer Closet, Housekeeping Closet, Separate clean and dirty utility:6.5.4.6.1The contractor shall demonstrate the ability to expand space to accommodate the CBOC potential for growth in services, Tele-medicine and/or Veterans assigned. Approximate 500 square feet shall be needed for future expansion.6.5.4.6.2.The following standard conditions and requirements shall apply: 6.5.4.6.3.Contractor shall provide a valid Occupancy Permit for Intended Use and shall operate the building in conformance with local codes and ordinances. 6.5.4.6.4The space shall be adjoining with potential for future expansion and be on no more than two (2) contiguous floors on ground level and can be provided by new construction or modification of existing space. Space is to be all on one floor is preferred. If space is offered on more than one floor, no less than 90% of the total space shall be located on the first floor. The clinic shall be suitable for medical-purpose use including Mental Health. The facility shall project a professional and aesthetically pleasing appearance including attractive fronts and entrance areas. Street gutters and public sidewalks in front, sides and back of facility shall be well maintained.A monitored security system shall be provided by the Contractor, including panic button systems (number and locations of panic buttons to be agreed upon prior to operations). The Contractor shall provide a level of security that reasonably prevents unauthorized entry to the space during non-duty hours and deters loitering or disruptive acts in and around the Clinic. The Contractor shall have a perimeter Intrusion Detection System (IDS) to be operated and maintained by the Contractor. The IDS shall include silent duress alarms with lights over the doors in patient care areas, alarms at all exterior doors and windows, and motion detection sensors at interior ingress areas. A central alarm panel shall be located in the reception area. Alarms shall be tested on a monthly basis and results shall be available for inspection upon request. Services, utilities, and maintenance shall be provided daily extending 2 hours beyond the CBOC time, based upon the approved schedule of 8 hours minimum daily, Monday through Friday, except Saturday, Sunday, and Federal holidays. (See Contract Start Up Requirements)Contractor as, part of the contract shall provide the following services and utilities:Heat, Electricity, Sewage, Water (hot & cold), Trash Removal, Regulated Medical Waste removal, (Sensitive material removal to be in compliance with HIPPA regulations), Chilled Drinking Water, Air Conditioning, Toilet Supplies, Janitorial Services and Supplies (paper towels, antimicrobial hand soap and alcohol hand-sanitizers); Elevator Service, Window Washing, Carpet Cleaning, Initial and Replacement Lamps, Tubes & Ballasts, Painting, Pest control, and other appropriate services. Medical gases, if provided, shall be maintained by Contractor and certified in accordance with NFPA on an annual basis. Contractor shall maintain the premises, including outside areas, in a clean condition and presentable appearance. Cleaning services shall be conducted after normal operating hours and in accordance with the following: Daily: empty trash receptacles, changing liners, clean and disinfect restrooms and toilets; completely sweep floors and mop all resilient floors; vacuum carpets; wipe down exam tables, counters and sinks with disinfectant/germicide according to NMVAHCS requirements. Clean high touch areas (light switches, door knobs, ) and drinking fountains. Clean visible soil on walls. Weekly: Sweep sidewalks, parking areas and driveways, clean windows, dust mini blinds and flat surfaces (including ledges), clean drinking fountains, dust ventsMonthly: Replace filters in HVAC SystemQuarterly: Clean carpets, wax floors, wash walls, clean windows and remove spider websAnnually: Wash windows.As necessary: Replenish toilet supplies, sanitary products, hand sanitizer, and soap; dispose of all trash and garbage generated in or about the building; dust horizontal surfaces that are readily available and visibly require dusting; remove carpet stains; remove all stains on furniture as needed; sweep or vacuum stairs; damp mop all resilient floors, sweep sidewalks, parking areas and driveway, spot clean all walls, remove insects from lights.Landscape maintenance shall be performed during the growing season on a weekly cycle to keep grass and shrubs trim.Contractor shall provide rodent and pest control for the effective control of rats, mice, ants and roaches and other pests. Documentation of all pest control services including chemicals, amount used and areas used shall be kept on site. Establish an on-going quality assessment monitoring/inspection checklist to maintain survey, address and/or correct cleanliness issues. This needs to involve the cleaning Contractor and administrative officer or designated official on site. Records shall be maintained including correction of any items noted. This meeting shall be at a minimum monthly but as needed if issues present.In the event Contractor fails to perform any service, to provide any item, or meet any requirement of this contract, the Government shall perform the service, provide the item, or meet the requirement, either directly or through contract. The Government shall deduct any costs incurred for the service or item(s), including administrative costs, from that months invoice in which expense was incurred.Schedule of Services: Within 10 calendar days after award of contract and prior to occupancy. Contractor shall provide the CO with a detailed written schedule of services and maintenance to be performed, including sub-contractor name, address and telephone number scheduled to perform the services if not performed by Prime Contractor. Other:All electrical outlets and switches in all areas except offices shall be of “hospital grade” construction. If the electrical outlet is within 6’ of a sink, then it shall be Ground Fault Interrupting type. Emergency lighting, either by battery or emergency power, is required. Ceilings fire resistant to meet codes.100% exhausted air to the exterior of the Medical Clinic Space in the following areas:rest roomsHousekeeping Aids ClosetsClinic Designated Exam RoomsNegative pressure shall be maintained in the following areas:Soiled Utility RoomsRest RoomsHousekeeping Aids ClosetsClinic Designated Exam RoomsAll areas within the Outpatient Clinic shall be designated to have 10 air changes per hour with the exception of the following:Waiting Rooms: 8 changes per hourConference Room: 8 changes per hourOffice and Exam Rooms: 6 changes per hourAuditory privacy in the reception/check in area to allow for privacy upon check in of patients, auditory privacy throughout the CBOC.Privacy Standards:Veterans shall be provided adequate visual and auditory privacy at check-in. Patient names are not posted or called out loudly in hallways or clinic areas.Veterans shall be provided adequate visual and auditory privacy in the interview area. Patient-identified information shall not be visible in the hall including charts where names are visible. Every effort shall be made to restrict unnecessary access to hallways by patients and staff who do not work in that clinic area.Patient dignity and privacy shall be maintained at all times during the course of a physical examination. The examination rooms shall be located in a space where they do not open into a public waiting room or a high-traffic public corridor. Appropriate locks (either electronic or manual) for examination room doors are required (allowing staff to have key or code access in the case of emergency). When doors are closed, all healthcare personnel shall knock, wait and enter only after invited in or it becomes apparent the room is unoccupied.Privacy curtains shall be present and functional in examination rooms. Privacy curtains shall encompass adequate space for the healthcare provider to perform the examination unencumbered by the curtain. A changing area shall be provided behind a privacy curtain.Examination tables shall be placed with the foot facing away from the door. If this is not possible, tables shall be fully shielded by privacy curtains and examination rooms shall have a lock on the door.Patients who are undressed or wearing examination gowns shall have proximity to restrooms that can be accessed without going through public hallways or waiting rooms. If toilet facilities cannot be located in close proximity to the examination room, the Veteran shall be discreetly offered the use of a toilet facility before disrobing for the exam.Sanitary napkin and tampon dispensers and disposal bins shall be available in women’s public restrooms. Tampons and sanitary pads shall also be available in examination rooms where pelvic examinations are performed and in bathrooms within close proximity.Restrooms shall also provide at least one changing table for infants. Contractor shall comply with future revisions to Privacy Standards as shall be issued by NMVAHCS.Privacy Standards:Veterans shall be provided adequate visual and auditory privacy at check-in. Patient names are not posted or called out loudly in hallways or clinic areas.Veterans must be provided adequate visual and auditory privacy in the interview area. Patient-identified information must not be visible in the hall including charts where names are visible. Every effort should be made to restrict unnecessary access to hallways by patients and staff who do not work in that clinic area.Patient dignity and privacy must be maintained at all times during the course of a physical examination.The examination rooms must be located in a space where they do not open into a public waiting room or a high-traffic public corridor. Appropriate locks (either electronic or manual) for examination room doors are required (allowing staff to have key or code access in the case of emergency). When doors are closed, all healthcare personnel must knock, WAIT and enter only after invited in.Privacy curtains must be present and functional in examination rooms. Privacy curtains must encompass adequate space for the healthcare provider to perform the examination unencumbered by the curtain. A changing area must be provided behind a privacy curtain.Examination tables must be placed with the foot facing away from the door. If this is not possible, tables must be fully shielded by privacy curtains.Patients who are undressed or wearing examination gowns must have proximity to women's restrooms that can be accessed without going through public hallways or waiting rooms. If toilet facilities cannot be located in close proximity to the examination room, the woman must be discreetly offered the use of a toilet facility before she disrobes for the exam.Sanitary napkin and tampon dispensers and disposal bins must be available in women’s public restrooms. Tampons and sanitary pads should also be available in examination rooms where pelvic examinations are performed and in bathrooms within close proximity.Restrooms must also provide at least one changing table for infants. Billing-CPT CODES: The Contractor shall adhere to the most current procedural terminology (CPT) coding standards used for primary care and mental health services – examples listed of CPT and Health Care Common Procedural Coding System (HCPCs) – this list is not all inclusive as it is subject to conformance to the Centers for Medicare and Medicaid Services (CMS) regulations. The contractor will submit applicable codes should changes be required based on CMS updates. As such, the contractor is responsible for identifying applicable CPT, HCPCs and any additional coding each year as CMS regulations are updated. (SEE PARAGRAPH 1.8.4.3) Billable Roster:Additions to Billable RosterContractor shall maintain a specific number of vested patients in the clinic. All patients associated with contracted clinic should have current and active VESTING CODE visit per VHA Guidelines. VA has the sole authority to assign Veterans who are treated by the Contractor into the PCMM software program used to track Primary Care Clinic Veteran rosters. Eligibility determination and enrollment of VA eligible enrolled Veterans in the Contractor's plan shall be the responsibility of the VA. The Contractor is responsible for notifying the VA through electronic shared-drive spreadsheets of newly seen Veterans at the Contractor’s site that are not already assigned in the PCMM software program. The VA will then verify that the Veteran was seen through VISTA documentation, and enter the Veteran into the PCMM software as credited to the Contractor’s site and associated clinic roster.If the Contractor seeks to place on the billable roster a Veteran at the Contractor’s site who is already assigned to another primary care team or provider in the VHA, the VA shall have final authority to designate the primary care site for the Veteran. The main basis for this decision will be Veteran preference. Veterans shall not be allowed to be assigned to more than one VA CBOC. In addition, Veterans will not be allowed to be assigned simultaneously at the Contractor’s site and in any of the primary care teams at the VA. A Veteran’s checked out visit to a particular CBOC shall be deemed to be an expression of that Veteran’s preference as to a particular primary care site.For Veterans newly assigned in PCMM, the Contractor shall be paid the monthly capitation rate for the full month in which the first visit occurs where medical care is provided to the Veteran at the Contractor's facility by a PCP completing and properly documenting an appropriate vesting visit and using the proper vesting CPT Codes. (Podiatrists, nurses, dieticians, social workers, psychologists, etc., are not considered appropriate PCPs by VA.). Acceptable Vesting CPT Codes for this purpose are: 99203-99205; 99213-99215; 99243-99245; 99385-99387; or 99395-99397. All payments shall be monthly in arrears.Removal from Billable RosterThe Contractor is responsible for confirming with the VA Veterans who no longer should be included on the billable roster at the Contractor’s site. This includes Veterans who have died, moved to other areas, have decided to receive their primary care elsewhere or whom the Contractor has determined have not received a proper Vesting Exam Visit in the previous 12 months, i.e not have a visit with one a Primary Care Provider which merited at least one of the Vesting CPT Codes Delayed notification that a Veteran should be removed from the billable roster for reasons (9)-(12), in paragraph d below, will result in offsets being taken against subsequent invoices. Delayed notification includes circumstances in which the Contractor or VA, through no fault of their own, do not receive such information until after the fact.In the event that a Veteran has a legitimate complaint and demands disenrollment for cause, payment shall be discontinued the month after the patient is reassigned in PCMM and Contractor is notified. If arbitration is necessary, clinical issues will be referred to the Executive Director of the contracted facility and the Vice President, Primary Care Service Line section of the VA. In the event that a decision cannot be reached at the clinical level, referral shall be made to the CO for final determination. This decision shall be binding.Contractor, with approval of the COR may disenroll a Veteran (remove from billable roster) for legitimate cause that may include:Repeated disruptive behavior in clinic;Threatening behavior towards CBOC personnel;The Contractor shall contact the COR, or his designated representative, to discuss any issues, including possible removal from the billable roster, due to disruptive Veteran behavior.The VA has ultimate authority to remove from the billable roster, at any time, an enrolled Veteran from the responsibility of the Contractor. The VA will notify the Veteran (with the exception of para. 6.1.2.5.9-12 below) and the Contractor of the effective date of removal from the billable roster. Removal of Veterans from the Contractor’s responsibility may occur, but not be limited to, the following reasons:The Veteran loses eligibility for VA care.The VA decides that removal from the billable roster is in the best interest of the Veteran.The Veteran was found to have falsified the application for VA services, and approval was based on false information.When it is determined that a Veteran has abused the VA system by allowing an ineligible person to utilize the Veteran’s identification card to obtain services.When it is determined that the Veteran has willfully and repeatedly refused to comply with the Contractor’s requirements or VA requirements, subject to federal laws and regulations.When it is determined that the Veteran has abused the VA program by using VA identification card to seek or obtain drugs or supplies illegally or for resale, subject to state and federal laws and regulations.The Contractor gives written notification to the VA that the Contractor cannot provide the necessary services to the Veteran or establish an appropriate provider Veteran relationship.If the Veteran fails to show up for two consecutive appointments, Contractor will notify the Veteran by letter after second “no show,” advising of potential disenrollment from the CBOC (and removal from the billable roster) if Veteran does not contact provider within two (2) weeks of notification. The Contractor shall notify the VA of any Veteran that does not respond to disenrollment notification, immediately after the lapse of the two (2) week period from notification of the Veteran.Death of the Veteran.When a Veteran moves to another area.When a Veteran receives his/her primary care elsewhere.The Veteran receives no Vesting Visit treatment from the Contractor within one (1) year of their last visit as defined in this PWS NOTE: These circumstances may become known after the fact. Upon discovery of these situations, the Contractor will credit or reimburse the VA back to the original date of the removal criteria being met for reasons (6.1.2.5.9-12) above.For Veterans removed from the billable roster under the “per Veteran[patient] per month (PPPM)” capitation rate method, the Contractor will be paid the monthly capitation rate for the full month in which the date of removal occurred. If the Contractor disagrees with a removal from the billable roster, the issue will be referred to the VA Contracting Officer for resolution. Provided that such resolution is consistent with the other terms of the contract, the final decision of the CO is binding.Monthly Billable Roster and Invoice Reconciliation:Monthly billable roster and invoice reconciliation shall take place as follows:The VA shall present to the Contractor the VA billable roster for the applicable month to be invoiced.The Contractor shall reconcile the VA billable roster with its records, negotiate any differences between its records and the VA billable roster, and invoice the VA.The VA shall certify the Contractor’s invoice.No later than the seventh (7th) workday of each month, the VA CBOC Coordinator or the COR (or their designee) will submit to the contractor a list of Veteran names who properly meet the billing criteria. This list is the VA “billable roster” for the applicable month to be invoiced. This list will represent the Veterans for whom the VA is willing to provide payment for the previous month. This list will include the names of all Veterans who have received a “vesting” exam from a PCP within the previous 12 calendar months using one or more of the Vesting CPT codes listed earlier in this solicitation / contract. (Example: A list sent to the Contractor on October 7, 2009 will cover the time frame of October 1, 2008 through September 30, 2009.) These “vesting” exams must be completed by an appropriate provider employed by the Contractor and working in that particular CBOC. An appropriate provider can only be a physician trained in Internal Medicine or Family Practice, or a Certified Registered Nurse Practitioner, or a Physician Assistant, or a Psychiatrist (if the psychiatrist actually completes and documents a proper vesting exam and uses a proper vesting CPT code). The list of proper vesting CPT codes is: 99203-99205; 99213-99215; 99243-99245; 99385-99387; or 99395-99397. This billable roster represents all Veterans seen in a “vesting” appointment in the previous 12 months minus any Veterans who may have been seen in that timeframe but have, in the meantime, died, moved to another location and do not plan to receive care at the particular CBOC, or have transferred their care to either another CBOC, a VA Medical Center, or to a private medical practitioner, or who meet any of the remaining disenrollment categories. The VA will also provide the Contractor with an alphabetically arranged lists of names of Veterans who were removed that month from the billable roster due to death, relocation, transfer of care, failure to be seen in a vesting visit for the previous 12 months and/or any one of the reasons listed above. The list shall also include which disenrollment reason is applicable to the particular disenrolled Veteran. Veteran names that come to either the VA’ or the Contractor’s attention “after the fact” will not only be removed from the current list of invoiced names, but the Contractor will also credit or reimburse the VA for any previous months that may have passed during which time the VA and/or the Contractor were unaware of the Veteran’s demise, relocation, receipt of health care at a different location or any other reason listed in above, for which the VA was paying the Contractor for perceived care. The Contractor shall reconcile the VA billable roster with its records. Any perceived discrepancies identified by the Contractor, regarding the VA provided billable roster, will be required to be negotiated between the Contractor and the CBOC Coordinator/COR or the CO or their designee. The final Arbitrator to any disagreements between the Contactor and the VA regarding this billable roster is CO. CO decisions in this regard are final, provided that such decision is consistent with the other terms of the contract. Upon receipt of an electronic invoice from the Contractor, based on the billable roster agreed upon and including supporting data, the VA will certify the invoice for payment. The Contractor shall have 30 calendar days from the date of invoice to justify any additions to the billable roster for the applicable month of invoice. After 30 calendar days, no further changes will be authorized for the applicable month’s invoice.MONTHLY BILLABLE ROSTER AND INVOICE RECONCILIATION NMVAHCS COR shall review the invoice against its records. NMVAHCS shall advise Contractor of invoice discrepancies. Upon resolution of discrepancies, NMVAHCS shall approve the invoice and make payment to Contractor after submission of electronic invoice to the OB10 system.INVOICING AND PAYMENT: Department of Labor Wage Determination The Service Contract Act of 1965 and the Department of Labor Wage Determination at attached applies to the resultant contract(s).Payment in Full. Costs are responsibility of parent VA contracting this service. 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. Payments will only be made for actual services rendered.Payments shall be made monthly, in arrears. The Contractor shall be reimbursed at the capitation rate specified in the Supplies or Services and Prices/Costs Section. The Contractor will be reimbursed upon receipt of a proper invoice. Invoices must contain the following information:Invoices must include the following three separate categories:Total number of listed Veterans from the previous month's invoice.New Veterans added to the billable roster since the previous month's invoice.Veterans removed from the billable roster since the previous month's invoice.Names of Veterans (if any) whose disenrollment’s generate a credit, the amount of the credit, and the calculation(s) used to arrive at the credit.The newly enrolled and disenrolled categories will list, alphabetically; each listed Veteran Patient’s name followed with his/her social security number and date of first visit and/or date of removal, as appropriate. Invoices shall also reference the following:Contract NumberMonth Being InvoicedNumber of Patients Being InvoicedCapitation RateTotal Amount DueInvoices shall be submitted to: Department of Veterans AffairsFinancial Services CenterP.O. Box 149971Austin, TX 78714-8971 Veteran Patients determined to be ineligible for VA medical care will be billed by VA for the care rendered in accordance with VA regulations. VA shall reimburse the Contractor for one visit for patient or Veteran subsequently deemed ineligible by VA. Reimbursement will be at the Medicare rate in effect on date of service for the state of New Mexico for the CPT codes utilized during the initial visit. In accordance with the Description/Specifications/Work Statement Section, the VA is required to verify Veteran eligibility within twenty-four (24) hours from the time the Contractor requests an eligibility determination for each applicant. The VA may deny payment for emergency medical services performed locally outside the Contractor’s facility if the VA physician reviewing the Veteran’s medical record determines that no emergency existed. The Contractor can appeal this determination in writing to the Contracting Officer by submitting supporting documentation. If a dispute still exists after Contractor’s documentation is reviewed, the Contractor may file a claim under the Disputes clause of the contract, FAR 52.212-4(d). ELECTRONIC FUNDS TRANSFER PAYMENT METHOD: Payments under this contract will be made by the Electronic Funds Transfer Payment Method. In accordance with FAR 52.232-34, Payment by Electronic Funds Transfer--Other than Central Contractor Registration, the Contractor must provide the requested information by completing the SF 3881, ACH Vendor/Miscellaneous Payment Enrollment Form and submitting it to Voucher Audit (04XXX), VA USA City USA, fifteen (15) days prior to submission of the first request for payment under this contract, unless already enrolled in Electronic Funds Transfer (EFT). The Contractor is also required to register in Central Contractor Registration (CCR) at in accordance with FAR 52.204-7, Central Contractor Registration, although payment will not be made through CCR until some future date.PROCEDURE REGARDING THIRD PARTY RESOURCES: The VA shall be entitled to, and shall exercise full subrogation rights and shall be responsible for making every reasonable effort to determine the legal liability of third parties to pay for services rendered to enrolled Veterans under this contract and recover any such liability from the third party.If the Contractor has determined that third party liability exists for part or all of the services provided directly by the Contractor to an enrolled patient, the Contractor shall make reasonable efforts to notify VA for recovery from third party liable sources the value of services rendered. All such cases will be referred to the MCCR Section at VA.VA has the authority to bill insurance carriers for treatment provided to Veterans for non-service related conditions. Veterans presenting for care will be asked by the Contractor's staff to provide their insurance and/or Medicare card(s). Per the national mandate, the Contractor's staff will then scan the insurance cards (front and back) into the DSS program for processing. In the event the card is not able to be scanned, a photocopy of the front and back should be made and faxed to the MCCR Section (address below).. The copy of the card must be faxed no later than the end of the second business day the Veteran is seen. The system automatically requires update of this data every six months (180 days) unless the Veteran identifies a change in his insurance status. Contractor is not liable for data older than 6 months if Veteran has not visited. The Contractor shall review the health insurance information at the time of each clinic visit. The Contractor shall provide the VA with Veteran treatment information on a daily basis in order to facilitate third party billing. The Contractor shall also provide copies of medical records, at no charge, when requested by the VA to support billing.New Mexico VA Health Care SystemMedical Care Cost Recovery Unit (04)San Pedro SEAlbuquerque, NM 87108Fax: 505-256-5728The Contractor shall obtain, as required by 38 U.S.C. 7332, a timely special consent for any medical treatment for drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus (HIV), or sickle cell anemia, to a Veteran with health insurance. A special consent from the Veteran is needed to allow VA to release bills and medical records associated with the treatment. This release of Information Form (VA# 10-5345 ) also should be faxed to the Medical Care Cost Recovery (MCCR) Section (see address below). If the Veteran refuses to consent, the Contractor shall document the refusal and notify the Supervisor, MCCR at 505-265-1711 ext. 4206/4351.New Mexico VA Health Care SystemMedical Care Cost Recovery Unit (04)1501 San Pedro SEAlbuquerque, NM 87108Fax: 505-256-5728“VETERANS ONLY” CLINIC REQUIREMENTS FOR CO-LOCATED FACILITIES: To meet VA’s requirements for a “Veterans Only” clinic in a co-located facility, the CBOC must have separate signage, a separate waiting room, and dedicated staff for the CBOC. The clerical/administrative personnel who check patients into and out of the clinic, respond to questions, and resolve issues for veterans must be working with veterans only. Contractor CBOC employees must be working with one computer system only (VA’s VISTA and CPRS system). The system used by the Contractor for tracking veteran patients for billing purposes must be separate from the system used to track and bill non-veterans treated in the co-located clinic. The exam room/treatment area must be separate. Clinical staff providing care to veteran patients must be dedicated solely to the task of serving the veteran patients associated with this clinic. There must be a separate telephone number associated with the veterans’ clinic. 6.23.CONTRACTOR Security Requirement in accordance with VA Hand book 6500.6 appendix a states: “the certification &accrediation (C&A) requirements do not appy, and that a security accreditation package is not required”. 6.24Workload History/Projections:a. Estimates: (1) As of December 1, 2012*, enrollment in the current T or C CBOC was 700 per month. The following is a listing of estimated Veteran population residing in Sierra and surrounding counties as of the end of Fiscal Year 2012**: CountyVeterans (per month)Socorro, New Mexico 1,570Sierra, New Mexico 2,186Dona Ana, New Mexico14,915VSSC, Planning, Projected Veteran Population BY13There are eight (8) Priority Groups to which Veterans shall be assigned after processing. All applications for all eight (8) groups are input into Vista by the NMVAHCS Enrollment and Eligibility Office for reporting and accountability purposes, but those Veterans in Priority Group 8, who applied after 1/17/03, are ineligible and shall not receive services by the Contractor. Veterans are not "assigned" to a CBOC but shall choose either to be seen at NMVAHCS or to be enrolled in a CBOC. NMVAHCS shall notify eligible Veterans about the availability of the T or C CBOC and the services to be provided there. Average number of Primary Care provider Visits for patients seen at the T or C CBOC in Fiscal Year 2012 was 4.2 per patient. (2) The numbers of Veterans residing in the counties identified above and estimated numbers of primary care visits per patient per year are estimates and are to be used for information purposes only. NMVAHCS in no way guarantees the accuracy of the estimates. Contractor fully understands and agrees that costs for any additional visits above the estimated average visits per unique Veteran patient and all primary care services as specified in the Description/Specifications/PWS Section are borne by the Contractor, and are included in the capitation rates agreed to by the Contractor in the Schedule of Services and Prices/Costs section. (3) Patients have the right to receive Primary health care from other than the NMVAHCS or a CBOC. The NMVAHCS, encourages patients to have only one primary care provider; and it is NMVAHCS’ expectation that the patient is seen at the T or C CBOC at least once per twelve (12) month period, or as often as deemed clinically appropriate by the CBOC PCP. Patients are not allowed to have more than one NMVAHCS PCP assigned at a time.b. Statistical Information: T or C CBOC currently located in T or C, Sierra County, New Mexico, has been in operation since April 30, 2001. The following is the most recent statistical information for services provided for T or C CBOC for the period - 10/01/13 thru 09/30/2014:Number of Unique, Number of Visits, and Average Number of Visits per Patient:Number of Visits to Primary Care Provider3,928 per year (NOTE: See below for monthly numbers)Unique (Average billed)743 per monthAverage number of Visits per Patient5.3 per monthSource: Monthly Clinical Performance Report and Monthly billing—represents PCP VisitsNumber of PCP Visits by month during the period 10/01/13 thru 09/30/2014: MonthVisitsOctober 2011216November 2011205December 2011217January 2012256February 2012247March 2012264April 2012236May 2012245June 2012195July 2012209August 2012221September 2012 (thru 9/30/12)217Source: Monthly Clinical Performance Report (2) Age and Sex Distribution:Age GroupNumber< 25125-441435-441945-545255-6416365-7429775-8414685+51TOTAL743GenderNumberMale698Female 45Total743Source: *VSSC, Workload, VA Outpatient\NPCD Outpatient Cube\Age Group Trend w/ slicer for Gender and MT, October 2014 (3) 20 Most Frequent ICD Diagnoses during the period 10/01/13 thru 09/30/2014 Code NumberV65.9Reason For Consultation NOS201401.9Hypertension843272.4Hypertension NEC/NOS714530.81Esophageal Reflux407600.00BPH w/o Urinary Obstruct353724.2Lumbago342305.1Tobacco Use Disorder336311Depressive Disorder, Not Elsewhere Classified323309.81Posttraumatic Stress Disorder336250.00DMII WO CMPNT ST UNCTR229244.9Hypothyroidism NOS208278.00Obesity, UNSO188V04.81Vaccine For Influenza182389.9Hearing Loss NOS177414.9Chr. Ischemic Hrt. Dis NOS175302.72Inhibited Sec Excitement164780.52Insomnia NEC161715.90Osteoarthros NOS-Unspec.160272.0Pure Hypercholesterolem154719.46Joint Pain-L/leg15020 Most Frequent CPT Procedures during the period: CPT Procedure CodeCPT Procedure LabelFrequency99213Office/Outpatient Visit, Est.2,40399212Office/Outpatient Visit, Est.74799211Office/Outpatient Visit, Est.33785610Prothrombin Time32890658Flu Vaccine, 3 Yrs. & >, Im32790806Psytx, Off, 45-50 Min29294760Measure Blood Oxygen Level27899000Specimen Handling24799214Office/Outpatient Visit, Est.21390471Immunization Admin20090804Psytx, Office, 20-30 Min19236415Routine Venipuncture18299203Office/Outpatient Visit, New12090853Group Psychotherapy9299204Office/Outpatient Visit, New91J0696Injection, Ceftriaxone Sodiu70J0900Injection, Testosterone Enan6271020Chest X-Ray6199499Unlisted Eval & Mgmt. Serv.5792250Eye Exam With Photos54Source: VSSC, TopOutptDx, September 30.2012 (4) Laboratory Tests: (a) The following laboratory tests were collected at the NMVAHCS T or C CBOC and performed at the NMVAHCS Medical Center during the period 10/1/13-9/30/14:Test??????????????????????????????????????????????????????????NumberChemistry Panels3245CBC870Coag. (PT,PTT,INR)0Micro Cultures336Cytology4Surgical Pathology0Reference Lab293Miscellaneous Tests3711Occult Blood187Total8646Chemistry Panels: Lipid, Comprehensive Metabolic, Basic Metabolic, Liver Function, IronMiscellaneous Tests: Urinalysis, Urine Microalbumin, Hemoglobin A1C, PSA, TSH, Vitamin B12, Vitamin D, Hepatitis testing, and all other chemistry tests that are not part of a panelCytology: includes Pap TestSource: NMVAHCS CBOC Lab Coordinator(5) The following Point of Care (POC) laboratory tests are the number of POC lab tests done at the existing T or C CBOC as part of the requirement described in B.2.1 a (2) above during the period December 2012.?T or C CBOC??????????? ??????????????? ???September 2014 ??????Whole Blood Glucose-finger stick ????????????0HGBA1C-finger stick???????????????????????????0INR –finger stick??????????????? ?????????????480Pregnancy test-urine?????????????????????????0Occult blood-stool???????????????????????????211Urine Dipstick???????????????????????????????0Breath Alcohol????????????????? ?????????????0TOTAL691Source: Manual Log, T or C CBOC, October 1, 2013-September 30, 2014 (6) X-Rays: The following x-rays were performed by the NMVAHCS T or C CBOC and interpreted and reported by a Contractor, contracted with the T or C CBOC during the period October 1, 2013-September 30, 2014: CHEST 2 VIEWS PA&LAT108SHOULDER 2 OR MORE VIEWS20SPINE LUMBOSACRAL MIN 2 VIEWS21FOOT 3 OR MORE VIEWS18MRI: LUMBAR SPINE W/O CONT0KNEE 2 VIEWS19TOE(S) 2 OR MORE VIEWS2HAND 3 OR MORE VIEWS2MAMMOGRAM SCREENING0ANKLE 3 OR MORE VIEWS4ELBOW 2 VIEWS0HIP 2 OR MORE VIEWS25WRIST 3 OR MORE VIEWS7CT HEAD W/O CONT0KNEE FLEX WB ORTHO (3 VIEWS)0SPINE CERVICAL MIN 4 VIEWS19BONE DENSITOMETRY0TIBIA & FIBULA 2 VIEWS3ECHOGRAM ABDOMEN COMPLETE0SPINE THORACIC 2 VIEWS7CT PELVIS W/CONT0CT THORAX W/CONT0MRI: BRAIN [+ BRAIN STEM] W+W/0HUMERUS 2 OR MORE VIEWS2TOTAL257Source: Manual Log, T or C CBOC, October 1, 2013-September 30, 2014NOTE: All CPT codes shall be reviewed annually in January of each year upon issue of new Medicare CPT Code manual. Any changes shall be added to contract by Modification by the CO.7.0 CONTRACTOR REQUIRED COMPLETING BUSINESS ASSOCIATE AGREEMENT (BAA) and submitting with proposal (Complete ATTACHMENT T).8.0Contractor shall complete CONTRACTOR CERTIFICATION DOCUMENT (SEE ATTACHMENT U) and submit with proposal to Administrative Contracting Officer. (END OF PERFORMANCE WORK STATEMENT)SECTION C - CONTRACT CLAUSESC.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (MAY 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 reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance 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 Governmentwide 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.(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.2 52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS (APR 2014) (a) This contract and employees working on this contract will be subject to the whistleblower rights and remedies in the pilot program on Contractor employee whistleblower protections established at 41 U.S.C. 4712 by section 828 of the National Defense Authorization Act for Fiscal Year 2013 (Pub. L. 112–239) and FAR 3.908. (b) The Contractor shall inform its employees in writing, in the predominant language of the workforce, of employee whistleblower rights and protections under 41 U.S.C. 4712, as described in section 3.908 of the Federal Acquisition Regulation. (c) The Contractor shall insert the substance of this clause, including this paragraph (c), in all subcontracts over the simplified acquisition threshold.(End of Clause)C.3 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.4 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.5 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 Date of Award through End of each Option Year. (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.6 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 , 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 773; (2) Any order for a combination of items in excess of 652; or (3) A series of orders from the same ordering office within 30 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 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.7 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 the last day of the last option year, plus 6 months..(End of Clause)C.8 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.9 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) (a) The Government may extend the term of this contract by written notice to the Contractor within 30 days provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension. (b) If the Government exercises this option, the extended contract shall be considered to include this option clause. (c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed five (5) years.(End of Clause)C.10 52.222-17 NONDISPLACEMENT OF QUALIFIED WORKERS (MAY 2014) (a) Service employee, as used in this clause, means any person engaged in the performance of a service contract other than any person employed in a bona fide executive, administrative, or professional capacity, as those terms are defined in 29 CFR part 541. The term "service employee" includes all such persons regardless of any contractual relationship that may be alleged to exist between a contractor or subcontractor and such persons. (b) The Contractor and its subcontractors shall, except as otherwise provided herein, in good faith offer those service employees employed under the predecessor contract whose employment will be terminated as a result of award of this contract or the expiration of the contract under which the service employees were hired, a right of first refusal of employment under this contract in positions for which the service employees are qualified. (1) The Contractor and its subcontractors shall determine the number of service employees necessary for efficient performance of this contract and may elect to employ fewer employees than the predecessor Contractor employed in connection with performance of the work. (2) Except as provided in paragraph (c) of this clause, there shall be no employment opening under this contract, and the Contractor and any subcontractors shall not offer employment under this contract, to any person prior to having complied fully with this obligation. (i) The successor Contractor and its subcontractors shall make a bona fide express offer of employment to each service employee as provided herein and shall state the time within which the service employee must accept such offer, but in no case shall the period within which the service employee must accept the offer of employment be less than 10 days. (ii) The successor Contractor and its subcontractors shall decide any question concerning a service employee's qualifications based upon the individual's education and employment history, with particular emphasis on the employee's experience on the predecessor contract, and the Contractor may utilize employment screening processes only when such processes are provided for by the contracting agency, are conditions of the service contract, and are consistent with Executive Order 13495. (iii) Where the successor Contractor does not initially offer employment to all the predecessor contract service employees, the obligation to offer employment shall continue for 90 days after the successor contractor's first date of performance on the contract. (iv) An offer of employment will be presumed to be bona fide even if it is not for a position similar to the one the employee previously held, but is one for which the employee is qualified, and even if it is subject to different employment terms and conditions, including changes to pay or benefits. (See 29 CFR 9.12 for a detailed description of a bonafide offer of employment). (c)(1) Notwithstanding the obligation under paragraph (b) of this clause, the successor Contractor and any subcontractors (i) may employ under this contract any service employee who has worked for the contractor or subcontractor for at least three months immediately preceding the commencement of this contract and who would otherwise face lay-off or discharge, (ii) are not required to offer a right of first refusal to any service employee(s) of the predecessor contractor who are not service employees within the meaning of the Service Contract Labor Standards statute, 41 U.S.C. 6701(3), and (iii) are not required to offer a right of first refusal to any service employee(s) of the predecessor contractor whom the Contractor or any of its subcontractors reasonably believes, based on the particular service employee's past performance, has failed to perform suitably on the job (see 29 CFR 9.12(c)(4) for additional information). The successor Contractor bears the responsibility of demonstrating the appropriateness of claiming any of these exceptions. (2) In addition, any Contractor or subcontractor that has been certified by the U.S. Small Business Administration as a HUBZone small business concern must ensure that it complies with the statutory and regulatory requirements of the HUBZone Program (e.g., it must ensure that at least 35 percent of all of its employees reside within a HUBZone). The HUBZone small business Contractor or subcontractor must consider whether it can meet the requirements of this clause and Executive Order 13495 while also ensuring it meets the HUBZone Program's requirements. (3) Nothing in this clause shall be construed to permit a Contractor or subcontractor to fail to comply with any provision of any other Executive order or law. For example, the requirements of the HUBZone Program (see FAR subpart 19.13), Executive Order 11246 (Equal Employment Opportunity), and the Vietnam Era Veterans' Readjustment Assistance Act of 1974 may conflict, in certain circumstances, with the requirements of Executive Order 13495. All applicable laws and Executive orders must be satisfied in tandem with, and if necessary prior to, the requirements of Executive Order 13495, 29 CFR part 9, and this clause. (d)(1) The Contractor shall, not less than 30 days before completion of the Contractor's performance of services on the contract, furnish the Contracting Officer with a certified list of the names of all service employees working under this contract and its subcontracts at the time the list is submitted. The list shall also contain anniversary dates of employment of each service employee under this contract and its predecessor contracts with either the current or predecessor contractors or their subcontractors. Where changes to the workforce are made after the submission of the certified list described in this paragraph, the Contractor shall, in accordance with paragraph (e) of this clause, not less than 10 days before completion of the services on this contract, furnish the Contracting Officer with an updated certified list of the names of all service employees employed within the last month of contract performance. The updated list shall also contain anniversary dates of employment, and, where applicable, dates of separation of each service employee under the contract and its predecessor contracts with either the current or predecessor Contractors or their subcontractors. (2) Immediately upon receipt of the certified service employee list but not before contract award, the contracting officer shall provide the certified service employee list to the successor contractor, and, if requested, to employees of the predecessor contractor or subcontractors or their authorized representatives. (3) The Contracting Officer will direct the predecessor Contractor to provide written notice (Appendix B to 29 CFR chapter 9) to service employees of their possible right to an offer of employment with the successor contractor. Where a significant portion of the predecessor Contractor's workforce is not fluent in English, the notice shall be provided in English and the language(s) with which service employees are more familiar. The written notice shall be— (i) Posted in a conspicuous place at the worksite; or (ii) Delivered to the service employees individually. If such delivery is via email, the notification must result in an electronic delivery receipt or some other reliable confirmation that the intended recipient received the notice. (e)(1) If required in accordance with 52.222-41(n), the predecessor Contractor shall, not less than 10 days before completion of this contract, furnish the Contracting Officer a certified list of the names of all service employees working under this contract and its subcontracts during the last month of contract performance. The list shall also contain anniversary dates of employment of each service employee under this contract and its predecessor contracts either with the current or predecessor Contractors or their subcontractors. If there are no changes to the workforce before the predecessor contract is completed, then the predecessor Contractor is not required to submit a revised list 10 days prior to completion of performance and the requirements of 52.222-41(n) are met. When there are changes to the workforce after submission of the 30-day list, the predecessor Contractor shall submit a revised certified list not less than 10 days prior to performance completion. (2) Immediately upon receipt of the certified service employee list but not before contract award, the contracting officer shall provide the certified service employee list to the successor contractor, and, if requested, to employees of the predecessor contractor or subcontractors or their authorized representatives. (f) The Contractor and subcontractor shall maintain the following records (regardless of format, e.g., paper or electronic) of its compliance with this clause for not less than a period of three years from the date the records were created. (1) Copies of any written offers of employment or a contemporaneous written record of any oral offers of employment, including the date, location, and attendance roster of any service employee meeting(s) at which the offers were extended, a summary of each meeting, a copy of any written notice that may have been distributed, and the names of the service employees from the predecessor contract to whom an offer was made. (2) A copy of any record that forms the basis for any exemption claimed under this part. (3) A copy of the service employee list provided to or received from the contracting agency. (4) An entry on the pay records of the amount of any retroactive payment of wages or compensation under the supervision of the Administrator of the Wage and Hour Division to each service employee, the period covered by such payment, and the date of payment, and a copy of any receipt form provided by or authorized by the Wage and Hour Division. The Contractor shall also deliver a copy of the receipt to the service employee and file the original, as evidence of payment by the Contractor and receipt by the service employee, with the Administrator or an authorized representative within 10 days after payment is made. (g) Disputes concerning the requirements of this clause shall not be subject to the general disputes clause (52.233-1) of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR part 9. Disputes within the meaning of this clause include disputes between or among any of the following: The Contractor, the contracting agency, the U.S. Department of Labor, and the service employees under the contract or its predecessor contract. The Contracting Officer will refer any service employee who wishes to file a complaint, or ask questions concerning this contract clause, to the: Branch of Government Contracts Enforcement, Wage and Hour Division, U.S. Department of Labor, 200 Constitution Avenue NW., Washington, DC 20210. Contact email: displaced@. (h) The Contractor shall cooperate in any review or investigation by the Department of Labor into possible violations of the provisions of this clause and shall make such records requested by such official(s) available for inspection, copying, or transcription upon request. (i) If it is determined, pursuant to regulations issued by the Secretary of Labor (Secretary), that the Contractor or its subcontractors are not in compliance with the requirements of this clause or any regulation or order of the Secretary, appropriate sanctions may be imposed and remedies invoked against the Contractor or its subcontractors, as provided in Executive Order 13495, the regulations, and relevant orders of the Secretary, or as otherwise provided by law. (j) The Contractor shall take such action with respect to any such subcontract as may be directed by the Secretary of Labor as a means of enforcing such provisions, including the imposition of sanctions for noncompliance. However, if the Contractor, as a result of such direction, becomes involved in litigation with a subcontractor, or is threatened with such involvement, the Contractor may request that the United States, through the Secretary, enter into such litigation to protect the interests of the United States. (k) The Contracting Officer will withhold, or cause to be withheld, from the prime Contractor under this or any other Government contract with the same prime Contractor, such sums as an authorized official of the Department of Labor requests, upon a determination by the Administrator, the Administrative Law Judge, or the Administrative Review Board, that there has been a failure to comply with the terms of this clause and that wages lost as a result of the violations are due to service employees or that other monetary relief is appropriate. If the Contracting Officer or the Administrator, upon final order of the Secretary, finds that the Contractor has failed to provide a list of the names of service employees working under the contract, the Contracting Officer may, in his or her discretion, or upon request by the Administrator, take such action as may be necessary to cause the suspension of the payment of contract funds until such time as the list is provided to the Contracting Officer. (l) Subcontracts. In every subcontract over the simplified acquisition threshold entered into in order to perform services under this contract, the Contractor shall include a provision that ensures— (1) That each subcontractor will honor the requirements of paragraphs (b) through (c) of this clause with respect to the service employees of a predecessor subcontractor or subcontractors working under this contract, as well as of a predecessor Contractor and its subcontractors; (2) That the subcontractor will provide the Contractor with the information about the service employees of the subcontractor needed by the Contractor to comply with paragraphs (d) and (e) of this clause; and (3) The recordkeeping requirements of paragraph (f) of this clause.(End of Clause)C.11 52.227-17 RIGHTS IN DATA—SPECIAL WORKS (DEC 2007) (a) Definitions. As used in this clause— "Data" means recorded information, regardless of form or the media on which it may be recorded. The term includes technical data and computer software. The term does not include information incidental to contract administration, such as financial, administrative, cost or pricing, or management information. "Unlimited rights" means the rights of the Government to use, disclose, reproduce, prepare derivative works, distribute copies to the public, and perform publicly and display publicly, in any manner and for any purpose, and to have or permit others to do so. (b) Allocation of Rights. (1) The Government shall have— (i) Unlimited rights in all data delivered under this contract, and in all data first produced in the performance of this contract, except as provided in paragraph (c) of this clause. (ii) The right to limit assertion of copyright in data first produced in the performance of this contract, and to obtain assignment of copyright in that data, in accordance with paragraph (c)(1) of this clause. (iii) The right to limit the release and use of certain data in accordance with paragraph (d) of this clause. (2) The Contractor shall have, to the extent permission is granted in accordance with paragraph (c)(1) of this clause, the right to assert claim to copyright subsisting in data first produced in the performance of this contract. (c) Copyright— (1) Data first produced in the performance of this contract. (i) The Contractor shall not assert or authorize others to assert any claim to copyright subsisting in any data first produced in the performance of this contract without prior written permission of the Contracting Officer. When copyright is asserted, the Contractor shall affix the appropriate copyright notice of 17 U.S.C. 401 or 402 and acknowledgment of Government sponsorship (including contract number) to the data when delivered to the Government, as well as when the data are published or deposited for registration as a published work in the U.S. Copyright Office. The Contractor grants to the Government, and others acting on its behalf, a paid-up, nonexclusive, irrevocable, worldwide license for all delivered data to reproduce, prepare derivative works, distribute copies to the public, and perform publicly and display publicly, by or on behalf of the Government. (ii) If the Government desires to obtain copyright in data first produced in the performance of this contract and permission has not been granted as set forth in paragraph (c)(1)(i) of this clause, the Contracting Officer shall direct the Contractor to assign (with or without registration), or obtain the assignment of, the copyright to the Government or its designated assignee. (2) Data not first produced in the performance of this contract. The Contractor shall not, without prior written permission of the Contracting Officer, incorporate in data delivered under this contract any data not first produced in the performance of this contract and that contain the copyright notice of 17 U.S.C. 401 or 402, unless the Contractor identifies such data and grants to the Government, or acquires on its behalf, a license of the same scope as set forth in paragraph (c)(1) of this clause. (d) Release and use restrictions. Except as otherwise specifically provided for in this contract, the Contractor shall not use, release, reproduce, distribute, or publish any data first produced in the performance of this contract, nor authorize others to do so, without written permission of the Contracting Officer. (e) Indemnity. The Contractor shall indemnify the Government and its officers, agents, and employees acting for the Government against any liability, including costs and expenses, incurred as the result of the violation of trade secrets, copyrights, or right of privacy or publicity, arising out of the creation, delivery, publication, or use of any data furnished under this contract; or any libelous or other unlawful matter contained in such data. The provisions of this paragraph do not apply unless the Government provides notice to the Contractor as soon as practicable of any claim or suit, affords the Contractor an opportunity under applicable laws, rules, or regulations to participate in the defense of the claim or suit, and obtains the Contractor's consent to the settlement of any claim or suit other than as required by final decree of a court of competent jurisdiction; and these provisions do not apply to material furnished to the Contractor by the Government and incorporated in data to which this clause applies. (End of Clause)C.12 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.13 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.14 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984) Funds are not presently available for performance under this contract beyond the initial award for the base year. The Government's obligation for performance of this contract beyond that date is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise for performance under this contract beyond the initial award for the base year, until funds are made available to the Contracting Officer for performance and until the Contractor receives notice of availability, to be confirmed in writing by the Contracting Officer.(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 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (DEC 2009) The offeror agrees, if awarded a contract, to use the service-disabled veteran-owned small businesses or veteran-owned small businesses proposed as subcontractors in accordance with 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, or to substitute one or more service-disabled veteran-owned small businesses or veteran-owned small businesses for subcontract work of the same or similar value.(End of Clause)C.17 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.18 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.19 VAAR 852.219-9 VA SMALL BUSINESS SUBCONTRACTING PLAN MINIMUM REQUIREMENTS (DEC 2009) (a) This clause does not apply to small business concerns. (b) If the offeror is required to submit an individual subcontracting plan, the minimum goals for award of subcontracts to service-disabled veteran-owned small business concerns and veteran-owned small business concerns shall be at least commensurate with the Department's annual service-disabled veteran-owned small business and veteran-owned small business prime contracting goals for the total dollars planned to be subcontracted. (c) For a commercial plan, the minimum goals for award of subcontracts to service-disabled veteran-owned small business concerns and veteran-owned small businesses shall be at least commensurate with the Department's annual service-disabled veteran-owned small business and veteran-owned small business prime contracting goals for the total value of projected subcontracts to support the sales for the commercial plan. (d) To be credited toward goal achievements, businesses must be verified as eligible in the Vendor Information Pages database. The contractor shall annually submit a listing of service-disabled veteran-owned small businesses and veteran-owned small businesses for which credit toward goal achievement is to be applied for the review of personnel in the Office of Small and Disadvantaged Business Utilization. (e) The contractor may appeal any businesses determined not eligible for crediting toward goal achievements by following the procedures contained in 819.407.(End of Clause)C.20 VAAR 852.219-71 VA MENTOR-PROT?G? PROGRAM (DEC 2009) (a) Large businesses are encouraged to participate in the VA Mentor-Protégé Program for the purpose of providing developmental assistance to eligible service-disabled veteran-owned small businesses and veteran-owned small businesses to enhance the small businesses' capabilities and increase their participation as VA prime contractors and as subcontractors. (b) The program consists of: (1) Mentor firms, which are contractors capable of providing developmental assistance; (2) Protégé firms, which are service-disabled veteran-owned small business concerns or veteran-owned small business concerns; and (3) Mentor-Protégé Agreements approved by the VA Office of Small and Disadvantaged Business Utilization. (c) Mentor participation in the program means providing business developmental assistance to aid protégés in developing the requisite expertise to effectively compete for and successfully perform VA prime contracts and subcontracts. (d) Large business prime contractors serving as mentors in the VA Mentor-Protégé Program are eligible for an incentive for subcontracting plan credit. VA will recognize the costs incurred by a mentor firm in providing assistance to a protégé firm and apply those costs for purposes of determining whether the mentor firm attains its subcontracting plan participation goals under a VA contract. The amount of credit given to a mentor firm for these protégé developmental assistance costs shall be calculated on a dollar-for-dollar basis and reported by the large business prime contractor via the Electronic Subcontracting Reporting System (eSRS). (e) Contractors interested in participating in the program are encouraged to contact the VA Office of Small and Disadvantaged Business Utilization for more information.(End of Clause)C.21 852.232-72 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.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 New Mexico. 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 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)C.24 SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011) This solicitation includes FAR 52.219-9, Small Business Subcontracting Plan, and VAAR 852.219-9, VA Small Business Subcontracting Plan Minimum Requirement. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing the contractor's compliance with the plan, including reviewing the contractor's accomplishments in achieving the subcontracting goals in the plan. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting plan.(End of Clause)C.25 MANDATORY WRITTEN DISCLOSURES Mandatory written disclosures required by FAR clause 52.203-13 to the Department of Veterans Affairs, Office of Inspector General (OIG) must be made electronically through the VA OIG Hotline at and clicking on "FAR clause 52.203-13 Reporting." If you experience difficulty accessing the website, call the Hotline at 1-800-488-8244 for further instructions.C.26 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): FAR NumberTitleDate52.232-18AVAILABILITY OF FUNDSAPR 198452.245-1GOVERNMENT PROPERTY ALTERNATE I (APR 2012)APR 201252.245-9USE AND CHARGESAPR 2012(End of Addendum to 52.212-4)(End of Clause)C.27 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.28 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.29 52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS SUBCONTRACTORS (DEC 2013) (a) Upon receipt of accelerated payments from the Government, the Contractor shall make accelerated payments to its small business subcontractors under this contract, to the maximum extent practicable and prior to when such payment is otherwise required under the applicable contract or subcontract, after receipt of a proper invoice and all other required documentation from the small business subcontractor. (b) The acceleration of payments under this clause does not provide any new rights under the Prompt Payment Act. (c) Include the substance of this clause, including this paragraph (c), in all subcontracts with small business concerns, including subcontracts with small business concerns for the acquisition of commercial items.(End of Clause)C.30 52.245-1 GOVERNMENT PROPERTY (APR 2012) (a) Definitions. As used in this clause— "Cannibalize" means to remove parts from Government property for use or for installation on other Government property. "Contractor-acquired property" means property acquired, fabricated, or otherwise provided by the Contractor for performing a contract, and to which the Government has title. "Contractor inventory" means— (1) Any property acquired by and in the possession of a Contractor or subcontractor under a contract for which title is vested in the Government and which exceeds the amounts needed to complete full performance under the entire contract; (2) Any property that the Government is obligated or has the option to take over under any type of contract, e.g., as a result either of any changes in the specifications or plans thereunder or of the termination of the contract (or subcontract thereunder), before completion of the work, for the convenience or at the option of the Government; and (3) Government-furnished property that exceeds the amounts needed to complete full performance under the entire contract. (4) "Contractor's managerial personnel" means the Contractor's directors, officers, managers, superintendents, or equivalent representatives who have supervision or direction of— (1) All or substantially all of the Contractor's business; (2) All or substantially all of the Contractor's operation at any one plant or separate location; or (3) A separate and complete major industrial operation. "Demilitarization" means rendering a product unusable for, and not restorable to, the purpose for which it was designed or is customarily used. "Discrepancies incident to shipment" means any differences (e.g., count or condition) between the items documented to have been shipped and items actually received. "Equipment" means a tangible item that is functionally complete for its intended purpose, durable, nonexpendable, and needed for the performance of a contract. Equipment is not intended for sale, and does not ordinarily lose its identity or become a component part of another article when put into use. Equipment does not include material, real property, special test equipment or special tooling. "Government-furnished property" means property in the possession of, or directly acquired by, the Government and subsequently furnished to the Contractor for performance of a contract. Government-furnished property includes, but is not limited to, spares and property furnished for repair, maintenance, overhaul, or modification. Government-furnished property also includes contractor-acquired property if the contractor-acquired property is a deliverable under a cost contract when accepted by the Government for continued use under the contract. "Government property" means all property owned or leased by the Government. Government property includes both Government-furnished and Contractor-acquired property. Government property includes material, equipment, special tooling, special test equipment, and real property. Government property does not include intellectual property and software. "Loss of Government property" means unintended, unforeseen or accidental loss, damage or destruction to Government property that reduces the Government's expected economic benefits of the property. Loss of Government property does not include purposeful destructive testing, obsolescence, normal wear and tear or manufacturing defects. Loss of Government property includes, but is not limited to— (1) Items that cannot be found after a reasonable search; (2) Theft; (3) Damage resulting in unexpected harm to property requiring repair to restore the item to usable condition; or (4) Destruction resulting from incidents that render the item useless for its intended purpose or beyond economical repair. "Material" means property that may be consumed or expended during the performance of a contract, component parts of a higher assembly, or items that lose their individual identity through incorporation into an end item. Material does not include equipment, special tooling, special test equipment or real property. "Nonseverable" means property that cannot be removed after construction or installation without substantial loss of value or damage to the installed property or to the premises where installed. "Precious metals" means silver, gold, platinum, palladium, iridium, osmium, rhodium, and ruthenium. "Production scrap" means unusable material resulting from production, engineering, operations and maintenance, repair, and research and development contract activities. Production scrap may have value when re-melted or reprocessed, e.g., textile and metal clippings, borings, and faulty castings and forgings. "Property" means all tangible property, both real and personal. "Property Administrator" means an authorized representative of the Contracting Officer appointed in accordance with agency procedures, responsible for administering the contract requirements and obligations relating to Government property in the possession of a Contractor. "Property records" means the records created and maintained by the contractor in support of its stewardship responsibilities for the management of Government property. "Provide" means to furnish, as in Government-furnished property, or to acquire, as in contractor-acquired property. "Real property". See Federal Management Regulation 102-71.20 (41 CFR 102-71.20). "Sensitive property" means property potentially dangerous to the public safety or security if stolen, lost, or misplaced, or that shall be subject to exceptional physical security, protection, control, and accountability. Examples include weapons, ammunition, explosives, controlled substances, radioactive materials, hazardous materials or wastes, or precious metals. "Unit acquisition cost" means— (1) For Government-furnished property, the dollar value assigned by the Government and identified in the contract; and (2) For contractor-acquired property, the cost derived from the Contractor's records that reflect consistently applied generally accepted accounting principles. (b) Property management. (1) The Contractor shall have a system of internal controls to manage (control, use, preserve, protect, repair, and maintain) Government property in its possession. The system shall be adequate to satisfy the requirements of this clause. In doing so, the Contractor shall initiate and maintain the processes, systems, procedures, records, and methodologies necessary for effective and efficient control of Government property. The Contractor shall disclose any significant changes to its property management system to the Property Administrator prior to implementation of the changes. The Contractor may employ customary commercial practices, voluntary consensus standards, or industry-leading practices and standards that provide effective and efficient Government property management that are necessary and appropriate for the performance of this contract (except where inconsistent with law or regulation). (2) The Contractor's responsibility extends from the initial acquisition and receipt of property, through stewardship, custody, and use until formally relieved of responsibility by authorized means, including delivery, consumption, expending, sale (as surplus property), or other disposition, or via a completed investigation, evaluation, and final determination for lost property. This requirement applies to all Government property under the Contractor's accountability, stewardship, possession or control, including its vendors or subcontractors (see paragraph (f)(1)(v) of this clause). (3) The Contractor shall include the requirements of this clause in all subcontracts under which Government property is acquired or furnished for subcontract performance. (4) The Contractor shall establish and maintain procedures necessary to assess its property management system effectiveness and shall perform periodic internal reviews, surveillances, self assessments, or audits. Significant findings or results of such reviews and audits pertaining to Government property shall be made available to the Property Administrator. (c) Use of Government property. (1) The Contractor shall use Government property, either furnished or acquired under this contract, only for performing this contract, unless otherwise provided for in this contract or approved by the Contracting Officer. (2) Modifications or alterations of Government property are prohibited, unless they are— (i) Reasonable and necessary due to the scope of work under this contract or its terms and conditions; (ii) Required for normal maintenance; or (iii) Otherwise authorized by the Contracting Officer. (3) The Contractor shall not cannibalize Government property unless otherwise provided for in this contract or approved by the Contracting Officer. (d) Government-furnished property. (1) The Government shall deliver to the Contractor the Government-furnished property described in this contract. The Government shall furnish related data and information needed for the intended use of the property. The warranties of suitability of use and timely delivery of Government-furnished property do not apply to property acquired or fabricated by the Contractor as contractor-acquired property and subsequently transferred to another contract with this Contractor. (2) The delivery and/or performance dates specified in this contract are based upon the expectation that the Government-furnished property will be suitable for contract performance and will be delivered to the Contractor by the dates stated in the contract. (i) If the property is not delivered to the Contractor by the dates stated in the contract, the Contracting Officer shall, upon the Contractor's timely written request, consider an equitable adjustment to the contract. (ii) In the event property is received by the Contractor, or for Government-furnished property after receipt and installation, in a condition not suitable for its intended use, the Contracting Officer shall, upon the Contractor's timely written request, advise the Contractor on a course of action to remedy the problem. Such action may include repairing, replacing, modifying, returning, or otherwise disposing of the property at the Government's expense. Upon completion of the required action(s), the Contracting Officer shall consider an equitable adjustment to the contract (see also paragraph (f)(1)(ii)(A) of this clause). (iii) The Government may, at its option, furnish property in an "as-is" condition. The Contractor will be given the opportunity to inspect such property prior to the property being provided. In such cases, the Government makes no warranty with respect to the serviceability and/or suitability of the property for contract performance. Any repairs, replacement, and/or refurbishment shall be at the Contractor's expense. (3)(i) The Contracting Officer may by written notice, at any time— (A) Increase or decrease the amount of Government-furnished property under this contract; (B) Substitute other Government-furnished property for the property previously furnished, to be furnished, or to be acquired by the Contractor for the Government under this contract; or (C) Withdraw authority to use property. (ii) Upon completion of any action(s) under paragraph (d)(3)(i) of this clause, and the Contractor's timely written request, the Contracting Officer shall consider an equitable adjustment to the contract. (e) Title to Government property. (1) All Government-furnished property and all property acquired by the Contractor, title to which vests in the Government under this paragraph (collectively referred to as "Government property"), is subject to the provisions of this clause. The Government shall retain title to all Government-furnished property. Title to Government property shall not be affected by its incorporation into or attachment to any property not owned by the Government, nor shall Government property become a fixture or lose its identity as personal property by being attached to any real property. (2) Title vests in the Government for all property acquired or fabricated by the Contractor in accordance with the financing provisions or other specific requirements for passage of title in the contract. Under fixed price type contracts, in the absence of financing provisions or other specific requirements for passage of title in the contract, the Contractor retains title to all property acquired by the Contractor for use on the contract, except for property identified as a deliverable end item. If a deliverable item is to be retained by the Contractor for use after inspection and acceptance by the Government, it shall be made accountable to the contract through a contract modification listing the item as Government-furnished property. (3) Title under Cost-Reimbursement or Time-and-Material Contracts or Cost-Reimbursable contract line items under Fixed-Price contracts. (i) Title to all property purchased by the Contractor for which the Contractor is entitled to be reimbursed as a direct item of cost under this contract shall pass to and vest in the Government upon the vendor's delivery of such property. (ii) Title to all other property, the cost of which is reimbursable to the Contractor, shall pass to and vest in the Government upon— (A) Issuance of the property for use in contract performance; (B) Commencement of processing of the property for use in contract performance; or (C) Reimbursement of the cost of the property by the Government, whichever occurs first. (f) Contractor plans and systems. (1) Contractors shall establish and implement property management plans, systems, and procedures at the contract, program, site or entity level to enable the following outcomes: (i) Acquisition of Property. The Contractor shall document that all property was acquired consistent with its engineering, production planning, and property control operations. (ii) Receipt of Government Property. The Contractor shall receive Government property and document the receipt, record the information necessary to meet the record requirements of paragraph (f)(1)(iii)(A)(1) through (5) of this clause, identify as Government owned in a manner appropriate to the type of property (e.g., stamp, tag, mark, or other identification), and manage any discrepancies incident to shipment. (A) Government-furnished property. The Contractor shall furnish a written statement to the Property Administrator containing all relevant facts, such as cause or condition and a recommended course(s) of action, if overages, shortages, or damages and/or other discrepancies are discovered upon receipt of Government-furnished property. (B) Contractor-acquired property. The Contractor shall take all actions necessary to adjust for overages, shortages, damage and/or other discrepancies discovered upon receipt, in shipment of Contractor-acquired property from a vendor or supplier, so as to ensure the proper allocability and allowability of associated costs. (iii) Records of Government property. The Contractor shall create and maintain records of all Government property accountable to the contract, including Government-furnished and Contractor-acquired property. (A) Property records shall enable a complete, current, auditable record of all transactions and shall, unless otherwise approved by the Property Administrator, contain the following: (1) The name, part number and description, National Stock Number (if needed for additional item identification tracking and/or disposition), and other data elements as necessary and required in accordance with the terms and conditions of the contract. (2) Quantity received (or fabricated), issued, and balance-on-hand. (3) Unit acquisition cost. (4) Unique-item identifier or equivalent (if available and necessary for individual item tracking). (5) Unit of measure. (6) Accountable contract number or equivalent code designation. (7) Location. (8) Disposition. (9) Posting reference and date of transaction. (10) Date placed in service (if required in accordance with the terms and conditions of the contract) (B) Use of a Receipt and Issue System for Government Material. When approved by the Property Administrator, the Contractor may maintain, in lieu of formal property records, a file of appropriately cross-referenced documents evidencing receipt, issue, and use of material that is issued for immediate consumption. (iv) Physical inventory. The Contractor shall periodically perform, record, and disclose physical inventory results. A final physical inventory shall be performed upon contract completion or termination. The Property Administrator may waive this final inventory requirement, depending on the circumstances (e.g., overall reliability of the Contractor's system or the property is to be transferred to a follow-on contract). (v) Subcontractor control. (A) The Contractor shall award subcontracts that clearly identify items to be provided and the extent of any restrictions or limitations on their use. The Contractor shall ensure appropriate flow down of contract terms and conditions (e.g., extent of liability for loss of Government property. (B) The Contractor shall assure its subcontracts are properly administered and reviews are periodically performed to determine the adequacy of the subcontractor's property management system. (vi) Reports. The Contractor shall have a process to create and provide reports of discrepancies, loss of Government property, physical inventory results, audits and self-assessments, corrective actions, and other property-related reports as directed by the Contracting Officer. (vii) Relief of stewardship responsibility and liability. The Contractor shall have a process to enable the prompt recognition, investigation, disclosure and reporting of loss of Government property, including losses that occur at subcontractor or alternate site locations. (A) This process shall include the corrective actions necessary to prevent recurrence. (B) Unless otherwise directed by the Property Administrator, the Contractor shall investigate and report to the Government all incidents of property loss as soon as the facts become known. Such reports shall, at a minimum, contain the following information: (1) Date of incident (if known). (2) The data elements required under paragraph (f)(1)(iii)(A) of this clause. (3) Quantity. (4) Accountable contract number. (5) A statement indicating current or future need. (6) Unit acquisition cost, or if applicable, estimated sales proceeds, estimated repair or replacement costs. (7) All known interests in commingled material of which includes Government material. (8) Cause and corrective action taken or to be taken to prevent recurrence. (9) A statement that the Government will receive compensation covering the loss of Government property, in the event the Contractor was or will be reimbursed or compensated. (10) Copies of all supporting documentation. (11) Last known location. (12) A statement that the property did or did not contain sensitive, export controlled, hazardous, or toxic material, and that the appropriate agencies and authorities were notified. (C) Unless the contract provides otherwise, the Contractor shall be relieved of stewardship responsibility and liability for property when— (1) Such property is consumed or expended, reasonably and properly, or otherwise accounted for, in the performance of the contract, including reasonable inventory adjustments of material as determined by the Property Administrator; (2) Property Administrator grants relief of responsibility and liability for loss of Government property; (3) Property is delivered or shipped from the Contractor's plant, under Government instructions, except when shipment is to a subcontractor or other location of the Contractor; or (4) Property is disposed of in accordance with paragraphs (j) and (k) of this clause. (viii) Utilizing Government property. (A) The Contractor shall utilize, consume, move, and store Government Property only as authorized under this contract. The Contractor shall promptly disclose and report Government property in its possession that is excess to contract performance. (B) Unless otherwise authorized in this contract or by the Property Administrator the Contractor shall not commingle Government material with material not owned by the Government. (ix) Maintenance. The Contractor shall properly maintain Government property. The Contractor's maintenance program shall enable the identification, disclosure, and performance of normal and routine preventative maintenance and repair. The Contractor shall disclose and report to the Property Administrator the need for replacement and/or capital rehabilitation. (x) Property closeout. The Contractor shall promptly perform and report to the Property Administrator contract property closeout, to include reporting, investigating and securing closure of all loss of Government property cases; physically inventorying all property upon termination or completion of this contract; and disposing of items at the time they are determined to be excess to contractual needs. (2) The Contractor shall establish and maintain Government accounting source data, as may be required by this contract, particularly in the areas of recognition of acquisitions, loss of Government property, and disposition of material and equipment. (g) Systems analysis. (1) The Government shall have access to the Contractor's premises and all Government property, at reasonable times, for the purposes of reviewing, inspecting and evaluating the Contractor's property management plan(s), systems, procedures, records, and supporting documentation that pertains to Government property. This access includes all site locations and, with the Contractor's consent, all subcontractor premises. (2) Records of Government property shall be readily available to authorized Government personnel and shall be appropriately safeguarded. (3) Should it be determined by the Government that the Contractor's (or subcontractor's) property management practices are inadequate or not acceptable for the effective management and control of Government property under this contract, or present an undue risk to the Government, the Contractor shall prepare a corrective action plan when requested by the Property Administrator and take all necessary corrective actions as specified by the schedule within the corrective action plan. (h) Contractor Liability for Government Property. (1) Unless otherwise provided for in the contract, the Contractor shall not be liable for loss of Government property furnished or acquired under this contract, except when any one of the following applies— (i) The risk is covered by insurance or the Contractor is otherwise reimbursed (to the extent of such insurance or reimbursement). The allowability of insurance costs shall be determined in accordance with 31.205-19. (ii) Loss of Government property that is the result of willful misconduct or lack of good faith on the part of the Contractor's managerial personnel. (iii) The Contracting Officer has, in writing, revoked the Government's assumption of risk for loss of Government property due to a determination under paragraph (g) of this clause that the Contractor's property management practices are inadequate, and/or present an undue risk to the Government, and the Contractor failed to take timely corrective action. If the Contractor can establish by clear and convincing evidence that the loss of Government property occurred while the Contractor had adequate property management practices or the loss did not result from the Contractor's failure to maintain adequate property management practices, the Contractor shall not be held liable. (2) The Contractor shall take all reasonable actions necessary to protect the property from further loss. The Contractor shall separate the damaged and undamaged property, place all the affected property in the best possible order, and take such other action as the Property Administrator directs. (3) The Contractor shall do nothing to prejudice the Government's rights to recover against third parties for any loss of Government property. (4) The Contractor shall reimburse the Government for loss of Government property, to the extent that the Contractor is financially liable for such loss, as directed by the Contracting Officer. (5) Upon the request of the Contracting Officer, the Contractor shall, at the Government's expense, furnish to the Government all reasonable assistance and cooperation, including the prosecution of suit and the execution of instruments of assignment in favor of the Government in obtaining recovery. (i) Equitable adjustment. Equitable adjustments under this clause shall be made in accordance with the procedures of the Changes clause. However, the Government shall not be liable for breach of contract for the following: (1) Any delay in delivery of Government-furnished property. (2) Delivery of Government-furnished property in a condition not suitable for its intended use. (3) An increase, decrease, or substitution of Government-furnished property. (4) Failure to repair or replace Government property for which the Government is responsible. (j) Contractor inventory disposal. Except as otherwise provided for in this contract, the Contractor shall not dispose of Contractor inventory until authorized to do so by the Plant Clearance Officer or authorizing official. (1) Predisposal requirements. (i) If the Contractor determines that the property has the potential to fulfill requirements under other contracts, the Contractor, in consultation with the Property Administrator, shall request that the Contracting Officer transfer the property to the contract in question, or provide authorization for use, as appropriate. In lieu of transferring the property, the Contracting Officer may authorize the Contractor to credit the costs of Contractor-acquired property (material only) to the losing contract, and debit the gaining contract with the corresponding cost, when such material is needed for use on another contract. Property no longer needed shall be considered contractor inventory. (ii) For any remaining Contractor-acquired property, the Contractor may purchase the property at the unit acquisition cost if desired or make reasonable efforts to return unused property to the appropriate supplier at fair market value (less, if applicable, a reasonable restocking fee that is consistent with the supplier's customary practices.) (2) Inventory disposal schedules. (i) Absent separate contract terms and conditions for property disposition, and provided the property was not reutilized, transferred, or otherwise disposed of, the Contractor, as directed by the Plant Clearance Officer or authorizing official, shall use Standard Form 1428, Inventory Disposal Schedule or electronic equivalent, to identify and report— (A) Government-furnished property that is no longer required for performance of this contract; (B) Contractor-acquired property, to which the Government has obtained title under paragraph (e) of this clause, which is no longer required for performance of that contract; and (C) Termination inventory. (ii) The Contractor may annotate inventory disposal schedules to identify property the Contractor wishes to purchase from the Government, in the event that the property is offered for sale. (iii) Separate inventory disposal schedules are required for aircraft in any condition, flight safety critical aircraft parts, and other items as directed by the Plant Clearance Officer. (A) Special test equipment with commercial components; (B) Special test equipment without commercial components; (C) Printing equipment; (D) Information technology (e.g., computers, computer components, peripheral equipment, and related equipment); (E) Precious metals in raw or bulk form; (F) Nonnuclear hazardous materials or hazardous wastes; or (G) Nuclear materials or nuclear wastes. (iv) The Contractor shall provide the information required by FAR 52.245-1(f)(1)(iii) along with the following: (A) Any additional information that may facilitate understanding of the property's intended use. (B) For work-in-progress, the estimated percentage of completion. (C) For precious metals in raw or bulk form, the type of metal and estimated weight. (D) For hazardous material or property contaminated with hazardous material, the type of hazardous material. (E) For metals in mill product form, the form, shape, treatment, hardness, temper, specification (commercial or Government) and dimensions (thickness, width and length). (v) Property with the same description, condition code, and reporting location may be grouped in a single line item. (vi) Scrap should be reported by "lot" along with metal content, estimated weight and estimated value. (3) Submission requirements. (i) The Contractor shall submit inventory disposal schedules to the Plant Clearance Officer no later than— (A) 30 days following the Contractor's determination that a property item is no longer required for performance of this contract; (B) 60 days, or such longer period as may be approved by the Plant Clearance Officer, following completion of contract deliveries or performance; or (C) 120 days, or such longer period as may be approved by the Termination Contracting Officer, following contract termination in whole or in part. (ii) Unless the Plant Clearance Officer determines otherwise, the Contractor need not identify or report production scrap on inventory disposal schedules, and may process and dispose of production scrap in accordance with its own internal scrap procedures. The processing and disposal of other types of Government-owned scrap will be conducted in accordance with the terms and conditions of the contract or Plant Clearance Officer direction, as appropriate. (iii) 120 days, or such longer period as may be approved by the Termination Contracting Officer following contract termination in whole or in part. (4) Corrections. The Plant Clearance Officer may— (i) Reject a schedule for cause (e.g., contains errors, determined to be inaccurate); and (ii) Require the Contractor to correct an inventory disposal schedule. (5) Post-submission adjustments. The Contractor shall notify the Plant Clearance Officer at least 10 working days in advance of its intent to remove an item from an approved inventory disposal schedule. Upon approval of the Plant Clearance Officer, or upon expiration of the notice period, the Contractor may make the necessary adjustments to the inventory schedule. (6) Storage. (i) The Contractor shall store the property identified on an inventory disposal schedule pending receipt of disposal instructions. The Government's failure to furnish disposal instructions within 120 days following acceptance of an inventory disposal schedule may entitle the Contractor to an equitable adjustment for costs incurred to store such property on or after the 121st day. (ii) The Contractor shall obtain the Plant Clearance Officer's approval to remove property from the premises where the property is currently located prior to receipt of final disposition instructions. If approval is granted, any costs incurred by the Contractor to transport or store the property shall not increase the price or fee of any Government contract. The storage area shall be appropriate for assuring the property's physical safety and suitability for use. Approval does not relieve the Contractor of any liability for such property under this contract. (7) Disposition instructions. (i) The Contractor shall prepare for shipment, deliver f.o.b. origin, or dispose of Contractor inventory as directed by the Plant Clearance Officer. Unless otherwise directed by the Contracting Officer or by the Plant Clearance Officer, the Contractor shall remove and destroy any markings identifying the property as U.S. Government-owned property prior to its disposal. (ii) The Contracting Officer may require the Contractor to demilitarize the property prior to shipment or disposal. In such cases, the Contractor may be entitled to an equitable adjustment under paragraph (i) of this clause. (8) Disposal proceeds. As directed by the Contracting Officer, the Contractor shall credit the net proceeds from the disposal of Contractor inventory to the contract, or to the Treasury of the United States as miscellaneous receipts. (9) Subcontractor inventory disposal schedules. The Contractor shall require its Subcontractors to submit inventory disposal schedules to the Contractor in accordance with the requirements of paragraph (j)(3) of this clause. (k) Abandonment of Government property. (1) The Government shall not abandon sensitive property or termination inventory without the Contractor's written consent. (2) The Government, upon notice to the Contractor, may abandon any non-sensitive property in place, at which time all obligations of the Government regarding such property shall cease. (3) Absent contract terms and conditions to the contrary, the Government may abandon parts removed and replaced from property as a result of normal maintenance actions, or removed from property as a result of the repair, maintenance, overhaul, or modification process. (4) The Government has no obligation to restore or rehabilitate the Contractor's premises under any circumstances; however, if Government—furnished property is withdrawn or is unsuitable for the intended use, or if other Government property is substituted, then the equitable adjustment under paragraph (i) of this clause may properly include restoration or rehabilitation costs. (l) Communication. All communications under this clause shall be in writing. (m) Contracts outside the United States. If this contract is to be performed outside of the United States and its outlying areas, the words "Government" and "Government-furnished" (wherever they appear in this clause) shall be construed as "United States Government" and "United States Government-furnished," respectively.(End of Clause)C.31 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JUL 2014) (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) 52.222-50, Combating Trafficking in Persons (FEB 2009) (22 U.S.C. 7104(g)). Alternate I (AUG 2007) of 52.222-50 (22 U.S.C. 7104 (g)). (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: [] (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) 52.204-11, American Recovery and Reinvestment Act-Reporting Requirements (JUL 2010) (Pub. L. 111-5). [] (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). [] (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) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (MAY 2012) (section 738 of Division C of Pub. L. 112-74, section 740 of Division C of Pub. L. 111-117, section 743 of Division D of Pub. L. 111-8, and section 745 of Division D of Pub. L. 110-161). [] (11) 52.219-3, Notice of HUBZone Set-Aside or Sole Source Award (NOV 2011) (15 U.S.C. 657a). [X] (12) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (JAN 2011) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 U.S.C. 657a). [] (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. [] (16) 52.219-8, Utilization of Small Business Concerns (MAY 2014) (15 U.S.C. 637(d)(2) and (3). [X] (17)(i) 52.219-9, Small Business Subcontracting Plan (Jul 2013) (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 (JUL 2010) 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)(i) 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns (OCT 2008) (10 U.S.C. 2323) (if the offeror elects to waive the adjustment, it shall so indicate in its offer.) [] (ii) Alternate I (June 2003) of 52.219-23. [] (22) 52.219-25, Small Disadvantaged Business Participation Program—Disadvantaged Status and Reporting (Jul 2013) (Pub. L. 103-355, section 7102, and 10 U.S.C. 2323). [] (23) 52.219-26, Small Disadvantaged Business Participation Program—Incentive Subcontracting (Oct 2000) (Pub. L. 103-355, section 7102, and 10 U.S.C. 2323). [] (24) 52.219-27, Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (NOV 2011) (15 U.S.C. 657f). [] (25) 52.219-28, Post Award Small Business Program Rerepresentation (Jul 2013) (15 U.S.C 632(a)(2)). [] (26) 52.219-29, Notice of Set-Aside for Economically Disadvantaged Women-Owned Small Business (EDWOSB) Concerns (Jul 2013) (15 U.S.C. 637(m)). [] (27) 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] (28) 52.222-3, Convict Labor (June 2003) (E.O. 11755). [] (29) 52.222-19, Child Labor—Cooperation with Authorities and Remedies (JAN 2014) (E.O. 13126). [X] (30) 52.222-21, Prohibition of Segregated Facilities (Feb 1999). [X] (31) 52.222-26, Equal Opportunity (Mar 2007) (E.O. 11246). [X] (32) 52.222-35, Equal Opportunity for Veterans (SEP 2010) (38 U.S.C. 4212). [X] (33) 52.222-36, Affirmative Action for Workers with Disabilities (Oct 2010) (29 U.S.C. 793). [X] (34) 52.222-37, Employment Reports on Veterans (SEP 2010) (38 U.S.C. 4212). [] (35) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496). [] (36) 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.) [] (37)(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.) [] (38) 52.223-15, Energy Efficiency in Energy-Consuming Products (DEC 2007)(42 U.S.C. 8259b). [] (39)(i) 52.223-16, IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products (DEC 2007) (E.O. 13423). [] (ii) Alternate I (DEC 2007) 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. [] (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. Approx. 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: [] (1) 52.222-41, Service Contract Labor Standards (MAY 2014) (41 U.S.C. chapter 67). [X] (2) 52.222-42, Statement of Equivalent Rates for Federal Hires (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). [] (3) 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). [] (4) 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). [] (5) 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). [] (6) 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). [] (7) 52.222-17, Nondisplacement of Qualified Workers (MAY 2014) (E.O. 13495). [] (8) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (MAY 2014) (42 U.S.C. 1792). [] (9) 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 (MAY 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) 52.222-26, Equal Opportunity (Mar 2007) (E.O. 11246). (v) 52.222-35, Equal Opportunity for Veterans (SEP 2010) (38 U.S.C. 4212). (vi) 52.222-36, Affirmative Action for Workers with Disabilities (Oct 2010) (29 U.S.C. 793). (vii) 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. (viii) 52.222-41, Service Contract Labor Standards (MAY 2014) (41 U.S.C. chapter 67). (ix) 52.222-50, Combating Trafficking in Persons (FEB 2009) (22 U.S.C. 7104(g)). Alternate I (AUG 2007) of 52.222-50 (22 U.S.C. 7104(g)). (x) 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). (xi) 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). (xii) 52.222-54, Employment Eligibility Verification (AUG 2013). (xiii) 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). (xiv) 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. (xv) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Approx. 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)SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTSTABLE OF CONTENTS – ATTACHMENTS DESCRIPTIONS PAGE(S)ATTACHMENT A – QUALITY ASSURANCE SURVEILLANCE PLAN----------------187ATTACHMENT B - REQUEST FOR TRAVELING VETS----------------------------------197ATTACHMENT C - VETPRO ENROLLMENT SHEET-------------------------------------198ATTACHMENT D - BACKGROUND INVESTIGATION REQUEST WORKSHEET--199ATTACHMENT E - CONTRACTOR RULES OF BEHAVIOR-----------------------------200ATTACHMENT F - VA VPN ACCESS REQUEST FORM-----------------------------------204ATTACHMENT G - CONTRACTOR SECURITY VERIFICATION REQUEST FORM206ATTACHMENT H – MEDICATION INSPECTION FORM----------------------------------208ATTACHMENT I – REPORTS---------------------------------------------------------------------210ATTACHMENT J - AMBULATORY CARE PEER REVIEW FORM----------------------220ATTACHEMNT K – PACT PCMM SETUP------------------------------------------------------222ATTACHEMNT L – WAGE DETERMINATION FOR NEW MEXICO--------------------225ATTACHEMNT M – ENROLLMENT PRIORITY GROUPS---------------------------------236ATTACHEMNT N – PATHOLOGY & LABORATORY SPECIMEN EXAMPLE--------238ATTACHEMNT O – GOVERNMENT EQUIPMENT LIST----------------------------------243 ATTACHEMNT P – COMPUTER ACCESS REQUEST FORM ----------------------------244ATTACHEMNT Q – IT CONTRACT SECURITY FORM------------------------------------245ATTACHEMNT R – SUBCONTRACTING PLAN MODEL FORM-------------------------254ATTACHEMNT S – PAST PERFORMANCE REFERENCES-------------------------------265ATTACHMENT T – BUSNIESS ASSOCIATE AGREEMENT------------------------------269ATTACHEMNT U– CONTRACTOR CERTIFICATION--------------------------------------274ATTACHMENT A Quality Assurance Surveillance Plan (QASP)Truth or Consequences (TorC) CBOC ServiceThe 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: ________________________Organization or Agency: _________________________________________b.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: _________________________________3.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 exceeding, meeting, or not meeting 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. 100% surveillance: Not utilizedb. PERIODIC INSPECTION. Inspections scheduled and reported quarterly per COR delegation or as needed. For example, VA will monitor using data from VA VISTA/CPRS system. VA will monitor progress weekly thru automated reports. VA will send these weekly reports to the contractor to notify them of their current performance, shall be conducted in compliance with VA Privacy and Information security standards.)c. VALIDATED USER/CUSTOMER COMPLAINTS. Not usedd. RANDOM SAMPLING. Not usedTaskPWS ReferenceIndicatorStandardAcceptable Quality LevelMethod ofSurveillanceIncentives Disincentives/(Deducts)Clinical Reminders EPRP & HEDISPWS para. 4.9.4VISTA/CPRS will automatically remind providers to complete the following clinical reminders during patient’s visits.Proper documentation and completion of all clinical reminders as they appear during a patient’s visit 90% completion of clinical reminders each monthVA will monitor using data from VA VISTA/CPRS system. VA will monitor progress weekly thru automated reports. VA will send these weekly reports to the contractor to notify them of their current performance.Incentive: satisfactory or better past performanceFailure to meet VA performance measures shall result in the following penalties:85%-89%: A disincentive equaling 5% of that month’s invoice when the AQL was not met.80%-84%: A disincentive equaling 10% of that month’s invoice when the AQL was not met.79%and below: A disincentive equaling 15% of that month’s invoice when the AQL was not met, in addition, will be considered as noncompliance.Access (Including Radiology Outpatient Procedure Wait Time )PWS para. 4.9.1.5All patients requesting an appointment for any clinic must receive an appointment in a timely manner.The Contractor will schedule routine appointments within SEVEN (7) calendar days of appointment request and urgent appointments within two (2) business days of request as medically indicated Radiology: an appointment within 7 days of the order99.5% monthly Radiology appointment completed no later than 30 days as applicableVA will monitor using data from VISTA/CPRS. Contractor can check status of their performance by running reports in VISTA/CPRS.Contractor can also monitor access data through the PACT COMPASS access metrics and the VSSC Clinic Access Index.Incentive: satisfactory or better past performanceFailure to meet VA performance measures shall result in the following disincentives:95%-99.4%: A disincentive equaling 10% of that month’s invoice when the AQL was not met.90%-94%: A disincentive equaling 15% of that month’s invoice when the AQL was not met,in addition, will be considered as noncompliance.Encounters / ConsultsPWS para. 4.10.2Providers must complete proper documentation for each patient visit and close encounters within 24 hours of the patient visit. Consults will be managed, monitored & closed within 90 days or lessDocumentation must be complete for all fields including whether or not the patient is service connected. The CPT and provider codes must match and codes must accurately reflect complexity of visit. 100% monthly VA will monitor using data from VISTA/CPRS, observation and random (audits). VA will send weekly reports to the contractor to notify them to their current performance.Incentive: satisfactory or better past performance.Failure to meet VA performance measures shall result in the following disincentives: 90%-99%: A disincentive equaling 5% of that month’s invoice when the AQL was not met 80%-89%: A disincentive equaling 10% of that month’s invoice when the AQL was not met 79% and below: A disincentive equaling 15% of that month’s invoice when the AQL was not met, in addition, will be considered as noncompliance.PharmacyPWS para.4.6.10Contractor will submit a non-formulary and restricted drug request in CPRS using the PBM consult option.The contractor shall not exceed 10% disapproval rating for non-formulary and restricted drug requests quarterly.90%-100% quarterlyAutomated reports using data from VISTA/CPRS. VA will send monthly status reports to the contractor to notify them to their current performance.Incentive: satisfactory or better past performance.Failure to meet VA performance measure shall result in the following disincentives.89% and below: A disincentive equaling 10%of the quarter’s invoices when the AQL was not met.Pharmacy-New Drug Order Requests PWS para.4.6.10Contractor will submit new drug orders through CPRS to VAThe contractor will ensure that at least 95% of all new drug order requests follow all GLA prescribing guidelines. This is including but not limited to ensuring all appropriate labs have been previously ordered and that the order is not a non-formulary drug. 95%-100%QuarterlyAutomated reports using data from VISTA/CPRS. VA will send monthly status reports to the contractor to notify them to their current performance. Incentive: satisfactory or better past performance.Failure to meet VA performance measure shall result in the following disincentives. 94% and below: A disincentive equaling 10% of the quarter’s invoices when the AQL was not met. PatientsPWS para. CaptivateRates D.Contractor will maintain a specific number of vested patients in the clinic. Contractor to maintain 700 active vested patients in the clinic for at least three of the option years.700 patients active vested patients for any three of the option yearsVA will monitor using data from VISTA/CPRS annually. Contractor can check the status of their performance by running reports in VISTA/CPRS.Incentive: satisfactory or better past performance.All other measures in the QASP are met at minimum of 90% for each contract year. Appointment CancellationPWSPara. 4Contractor will not unnecessarily cancel patient appointments and will reschedule cancelled appointments in a timely mannerAny appointment cancelled needs to be rescheduled within 2 weeks. This means the patients must be seen within 2 weeks of the original cancelled appointment date100%Quarterly audit by VA.Contractor can check the status of their performance by running reports in VISTA/CPRS. Clinics can also monitor their cancellation rate through the VSSC Clinic Access IndexIncentive: satisfactory or better past performance.Failure to meet VA performance measures shall result in the following disincentives: 95%- 99%: A disincentive equaling 10% of that month’s invoice when the AQL was not met 90%-94%: A disincentive equaling 15% of that month’s invoice when the AQL was not met and in addition will be considered as noncompliance.PACT PERFORMANCETASKPWS ParaIndicatorStandardAcceptable Quality LevelMethod ofSurveillanceIncentives Disincentives/(Deducts)Provide PACT Staffing Infrastructure PWS para. 2.1.4 Clinic will provide a staffing plan consistent with PACT staffing guidelines. Clinic will achieve & maintain staffing ratio goals as currently defined (ECF FY 11) and as defined by VHA in the future. PACT Teamlet staffing ratio >= 3.0 . PCMM Staffing ratio & PACT CompassIncentive: satisfactory or better past performancePCMM Teamlet Set UpPWS SEE ATTCH IAll PACT Teamlets will be set up per guidelines.Reconfigure PCMM such that each provider represents an individual team and other team members (Teamlet, etc.) are identified (authorization VAMC dependent).PACT PCMM Set Up Guidance SEE ATTCH I Teamlets will be set up within 3 mos. of contract initiation. PCMM data on VSSCIncentive: satisfactory or better past performanceEnhance Patient Centered Care DeliveryPWS para. 4.4All clinic staff will participate in education provided by VAMC to enhance Patient Centered Care Patient Centered Care & PACT are VA Secretary’s T21 Transformational InitiativesVHA Directive 2009-019Clinic will provide documentation that staff are educated (as made available by VAMC) within 1 year of contract initiation.100% all patients will be notified via telephone, secure messaging, letter or face to face. CCBOC patients will be notified of all normal test results within 14 days, all abnormal test results within 24 hrs. and all critical test results immediately.Clinic will monitor & report on this measure. Clinic will monitor & report on this measureIncentive: satisfactory or better past performanceEnhance Access to Care-Primary Care Face to Face VisitsPWS para. 4.4Clinic will develop a plan to provide same day access for those patients desiring to be seen today. Clinic will provide access from desired date for new and established pts per prevailing and current VAMC guidelines for patient access.Same day access as desired by patient is VHA PACT goal.Access will be measured using the PACT Compass new and established patient wait times.Clinic will demonstrate progressive improvement in same day access within 3 mos. of contract initiation. Percent of unique patients on the Access List waiting more than 14 days from desired date will not exceed 1.00% for Primary CareMonitoring via PACT CompassPACT CompassIncentive: satisfactory or better past performancEnhance Access to Care-TelephonesPWS para. 4.4Clinic telephones are answered by a live person as much as possibleCalls are resolved by attendant during the telephone call as much as possible Establish & implement a plan to increase telephone care to appropriate patient populationsCCBOCs >5,000 patients are required to implement Automated Call Center Distribution (ACD) hardware/software as well as monitor/report the follow metrics: Volume, Abandonment Rate, Speed of Answer on VSSC Telephone site (Per VHA Directive 2007-033 Telephone Service for Clinical Care).5.2 VHA rules and regulations governing coding and workload support telephone care as an appropriate and accepted method of delivering care to Veterans.PACT promotes increased care delivered by virtual methods (telephone) as a patient centered approach to care. Targets for ACD include—Abandonment Rate <5%, Speed of Answer <30 seconds.Sites with ACD’s should demonstrate progressive improvement efforts to achieve & maintain metric goals.Progressive focus on improving access by increased use of telephone care as evidenced by PACT compass measure Telephone Encounter Ratio within 6 mos. of contract. VSSC Telephone Database—VISN Points of Contact authorize accessPACT CompassIncentive: satisfactory or better past performanceEnhance Access to Care—Group Visit & Shared Medical AppointmentsPWS para. 4.4Clinic will establish a plan with VAMC to implement Group Visits or Shared Medical AppointmentsVHA PACT principles encourage the use of group visits or shared medical appointments as a means to create access. Clinic should collaborate with VAMC to determine appropriate action on establishing Group Visit or Shared Medical Appointment clinic within 6 mos. of contractPACT CompassIncentive: satisfactory or better past performanceEnhance Access to Care—MyHealtheVet (MHV) & Secure Messaging (SM)PWS para. 4.4Clinic will provide onsite support person for “In Person Authentication” processes. Clinic will establish SM as a mode of communication when made available by VAMCClinic will increase enrollment in MHV & SMPACT promotes increased care delivered by virtual methods (MHV & SM) as a patient centered approach to care. Clinic will meet MHV. and SM goals as set by VAMC in within 6 mos. of contract. PACT CompassIncentive: satisfactory or better past performanceEnhance Telehealth & Telemedicine PWS para. 4.4Clinic will increase referrals for HT.Clinic will establish plan with VAMC for increased access to scarce medical services via telemedicine as deemed appropriate by VAMC. FY ECF performance plan requires increased use of TeleHealth. Telehealth technology supports VHA PACT focus on increasing virtual health care delivery.Progressive focus on enhancing care via HT referrals. Clinic will collaborate with VAMC to determine feasibility/need of establishing a telemedicine clinic within 1 year contract. PACT Compass & ECFIncentive: satisfactory or better past performanceEnhance Care Management/Coordination—Critical TransitionsPWS para. 4.4Clinic will improve inpatient to outpatient transition process including appropriate clinical documentation of care delivered. VHA PACT implementation requires improvement in care management and coordination to promote patient safety and reduce gaps in care. Clinic should strive to contact all patients discharged from inpatient facility and emergency department 2 days post discharge. The follow up can be conducted by telephone encounter or face to face visit with appropriate documentation.PACT CompassIncentive: satisfactory or better past performance Enhance Care Management/Coordination—Population ManagementPWS para. 4.4Clinic will develop & implement a plan to improve suboptimal clinical indicesFY 11 ECF Performance PlanEPRP measures meet or exceed goal as established by VAMCEPRP Technical ManualIncentive: satisfactory or better past performanceEnhance Care Management/Coordination—High Risk VeteransPWS para. 4.4Clinic will develop & implement a plan to monitor, intervene and manage identified high risk patients. Clinic will use VHA databases (registries) to identify patients at high risk. Use of VHA PACT Care Management/Coordination principle to improve outcomes for high risk patients related to ED and inpatient utilization. Clinic will monitor and report on # patients being actively managedClinic shall monitor & report on this measureIncentive: satisfactory or better past performanceImprove Practice Design & Flow to Enhance Work Efficiency & Care DeliveryPWS para. 4.4Clinic will develop a plan acceptable to VAMC to optimize & maximize staff functionality/roles/responsibilities consistent with VHA’s PACT guidance. Clinic will conduct daily Teamlet huddles/scrubbing od schedules and conduct weekly team meetingsVHA PACT optimizes the roles and functions of all team members to promote effective and efficient care. Approved plan will be developed and implemented within 1 year of contract. Clinic shall monitor & report on occurrence of daily huddles & weekly team meetingsIncentive: satisfactory or better past performance 7. Ratings:Metrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and acceptable quality level. A rating scale shall be used to determine a positive, neutral, or negative outcome. The following ratings shall be used:Metrics 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. 9. 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 negotiated 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:______________________________________________________________COR NAME/TITLEDATE______________________________________________________________CONTRACTOR NAME/TITLEDATEATTACHMENT BRequest for Supplemental Information for Traveling VeteransCBOC/CLINIC: P.O.C. NAME:PH #:PLEASE COMPLETE/THE FOLLOWING INFOMATION FOR TRAVELING/TRANSFERING VETERANSPRINT CLEARLYTRAVELING VET:? FORMCHECKBOX YES FORMCHECKBOX NOYOUR NAME:LAST, FIRST, (FULL MIDDLE NAME)MAILING ADDRESS:TEMPORARY ADDRESS: FORMCHECKBOX YES FORMCHECKBOX NOSTART DATE: FORMTEXT ?????END DATE:??PHONE NUMBER: HOME FORMTEXT ????? WORK FORMTEXT ????? (Area Code & Number) (Area Code & Number)DATE OF BIRTH: SOCIAL SECURITY NUMBER: SERVICE NUMBER IF KNOWN: CURRENTLY OR PREVIOUSLY ENROLLED AT THE FOLLOWING VA FACILITIES:VETERAN’S PLACE OF BIRTH:WERE YOU IN COMBAT?? If yes, give location and dates: FORMTEXT ?????FATHER’S NAME: Last, First: MOTHER’S NAME: Last, First: MOTHER’S MAIDEN NAME: FAX TO ENROLMENT UNIT: (505) 256-5453 ANY QUESTIONS CALL: (505) 256-2741This message in intended only for the use of the persons or office to whom it is addressed and may contain information that is privileged, confidential, or protected by law.? All others are hereby notified that the receipt of this message does not have any applicable privilege or exemption from disclosure and that any dissemination, distribution, or copying if the communication is prohibited.? If you have received this communication in error, please notify us immediately via telephone at the above telephone number and return the original message to us at the above address via the United States Postal Service.? Thank you.Rept. FL 04-202 (01/09) NMVAHCSATTACHMENT CVetPro Enrollment Sheet(Please Print)NAME:__________________________________________SSN:__________________________________________GENDER:_____MALE____FEMALEPREFERRED ADDRESS:____________________________________________________________________________________CONTACT PHONE:__________________________________________DOB:__________________________________________START DATE: _______________________________________I ATTEST THAT THE ABOVE INFORMATION IS TRUE AND CORRECT_________________________________________________________Signature of ProviderDate Signed(Also, fax a copy of your driver’s license with a clear picture and signature)Please fax the COMPLETED form to:New Mexico VA Health Care SystemAttn: Credentials Office (11C)FAX NUMBER: (505) 767-6013For questions or concerns, call (505) 265-1711, x2818 or x6001Background Investigation Request WorksheetATTACHMENT DThis worksheet should be the cover letter for all paper investigative packages. If you wish the SIC to initiate an individual in EQIP, please fax this completed worksheet to: Fax: 501-257-4018Block 1. Please complete the following fields on the Servicing HR and Billing Station:HR Contact Name: FORMTEXT ????? Phone: FORMTEXT ???Alternate HR Contact Name: FORMTEXT ????? Phone: FORMTEXT ???Employer Station Name: FORMTEXT ????Station #: FORMTEXT ?????Station to be Billed Name: FORMTEXT ????? Station #: FORMTEXT ?????Block 2. Please complete the following fields on each VA employee:Name, Last: FORMTEXT ???First: FORMTEXT ???? Middle: FORMTEXT ????? If none (NMN)SSN: FORMTEXT ?????Date of Birth: FORMTEXT ????? Place of Birth: FORMTEXT ?????(VA) Civil Service Job Series code: FORMTEXT ????? VA Job Title: FORMTEXT ?????(ALL) E-Mail Address: FORMTEXT ????? Phone: FORMTEXT ?????Computer/ADP: Yes FORMCHECKBOX EQIP: FORMCHECKBOX No FORMCHECKBOX EQIP: Re-initiation: FORMCHECKBOX Type of Investigation requested (Indicate one): High Risk FORMCHECKBOX Moderate Risk FORMCHECKBOX Low Risk FORMCHECKBOX Below is for National Security investigations “ONLY”Classified Information Access: Top Secret FORMCHECKBOX Secret FORMCHECKBOX Confidential FORMCHECKBOX Special-Sensitive FORMCHECKBOX Critical-Sensitive FORMCHECKBOX NonCritical-Sensitive FORMCHECKBOX Block 3. Reason individual is subject to investigation: FORMCHECKBOX This person is an applicant for new employment within the VA. FORMCHECKBOX This Person is an incumbent and sensitivity of the current position has changed. FORMCHECKBOX This is a request for a Periodic Reinvestigation (complete block below).Below is for Re-investigations “ONLY”High Risk FORMCHECKBOX (PRI for individuals with a previous “BI”, required every 5 years)Moderate Risk FORMCHECKBOX (NACLC for Police Officers, required every 5 yearsCritical Sensitive FORMCHECKBOX (SSBI-PR for Top Secret, required every 5 years)Non-Critical Sensitive FORMCHECKBOX (ANACI for Secret, required every 10 years)Attachment E MARCH 12, 2010VA HANDBOOK 6500.6APPENDIX DCONTRACTOR RULES OF BEHAVIORThis User Agreement contains rights and authorizations regarding my access to and use of any information assets or resources associated with my performance of services under the contract terms with the Department of Veterans Affairs (VA). This User Agreement covers my access to all VA data whether electronic or hard copy ("Data"), VA information systems and resources ("Systems"), and VA sites ("Sites"). This User Agreement incorporates Rules of Behavior for using VA, and other information systems and resources under the contract.1. GENERAL TERMS AND CONDITIONS FOR ALL ACTIONS AND ACTIVITIES UNDER THE CONTRACT:I understand and agree that I have no reasonable expectation of privacy in accessing or using any VA, or other Federal Government information systems.I consent to reviews and actions by the Office of Information & Technology (OI&T) staff designated and authorized by the VA Chief Information Officer (CIO) and to the VA OIG regarding my access to and use of any information assets or resources associated with my performance of services under the contract terms with the VA. These actions may include monitoring, recording, copying, inspecting, restricting access, blocking, tracking, and disclosing to all authorized OI&T, VA, and law enforcement personnel as directed by the VA CIO without my prior consent or notification.I consent to reviews and actions by authorized VA systems administrators and Information Security Officers solely for protection of the VA infrastructure, including, but not limited to monitoring, recording, auditing, inspecting, investigating, restricting access, blocking, tracking, disclosing to authorized personnel, or any other authorized actions by all authorized OI&T, VA, and law enforcement personnel.I understand and accept that unauthorized attempts or acts to access, upload, change, or delete information on Federal Government systems; modify Federal government systems; deny access to Federal government systems; accrue resources for unauthorized use on Federal government systems; or otherwise misuse Federal government systems or resources are prohibited.I understand that such unauthorized attempts or acts are subject to action that may result in criminal, civil, or administrative penalties. This includes penalties for violations of Federal laws including, but not limited to, 18 U.S.C. §1030 (fraud and related activity in connection with computers) and 18 U.S.C. §2701 (unlawful access to stored communications).I agree that OI&T staff, in the course of obtaining access to information or systems on my behalf for performance under the contract, may provide information about me including, but not limited to, appropriate unique personal identifiers such as date of birth and social security number to other system administrators, Information Security Officers (ISOs), or other authorized staff without further notifying me or obtaining additional written or verbal permission from me.I understand I must comply with VA’s security and data privacy directives and handbooks. I understand that copies of those directives and handbooks can be obtained from the Contracting Officer's Technical Representative (COTR). If the contractor believes the policies and guidance provided by the COTR is a material unilateral change to the contract, the contractor must elevate such concerns to the Contracting Officer for resolution.I will report suspected or identified information security/privacy incidents to the COTR and to the local ISO or Privacy Officer as appropriate.2. GENERAL RULES OF BEHAVIORRules of Behavior are part of a comprehensive program to provide complete information security. These rules establish standards of behavior in recognition of the fact that knowledgeable users are the foundation of a successful security program. Users must understand that taking personal responsibility for the security of their computer and the information it contains is an essential part of their job.The following rules apply to all VA contractors. I agree to:Follow established procedures for requesting, accessing, and closing user accounts and access. I will not request or obtain access beyond what is normally granted to users or by what is outlined in the contract.Use only systems, software, databases, and data which I am authorized to use, including any copyright restrictions.I will not use other equipment (OE) (non-contractor owned) for the storage, transfer, or processing of VA sensitive information without a VA CIO approved waiver, unless it has been reviewed and approved by local management and is included in the language of the contract. If authorized to use OE IT equipment, I must ensure that the system meets all applicable 6500 Handbook requirements for OE.Not use my position of trust and access rights to exploit system controls or access information for any reason other than in the performance of the contract.Not attempt to override or disable security, technical, or management controls unless expressly permitted to do so as an explicit requirement under the contract or at the direction of the COTR or ISO. If I am allowed or required to have a local administrator account on a government-owned computer, that local administrative account does notconfer me unrestricted access or use, nor the authority to bypass security or other controls except as expressly permitted by the VA CIO or CIO's designee.Contractors’ use of systems, information, or sites is strictly limited to fulfill the terms of the contract. I understand no personal use is authorized. I will only use other Federal government information systems as expressly authorized by the terms of those systems. I accept that the restrictions under ethics regulations and criminal law still apply.Grant access to systems and information only to those who have an official need to know.Protect passwords from access by other individuals.Create and change passwords in accordance with VA Handbook 6500 on systems and any devices protecting VA information as well as the rules of behavior and security settings for the particular system in question.Protect information and systems from unauthorized disclosure, use, modification, or destruction. I will only use encryption that is FIPS 140-2 validated to safeguard VA sensitive information, both safeguarding VA sensitive information in storage and in transit regarding my access to and use of any information assets or resources associated with my performance of services under the contract terms with the VA.Follow VA Handbook 6500.1, Electronic Media Sanitization to protect VA information. I will contact the COTR for policies and guidance on complying with this requirement and will follow the COTR's orders.Ensure that the COTR has previously approved VA information for public dissemination, including e-mail communications outside of the VA as appropriate. I will not make any unauthorized disclosure of any VA sensitive information through the use of any means of communication including but not limited to e-mail, instant messaging, online chat, and web bulletin boards or logs.Not host, set up, administer, or run an Internet server related to my access to and use of any information assets or resources associated with my performance of services under the contract terms with the VA unless explicitly authorized under the contract or in writing by the COTR.Protect government property from theft, destruction, or misuse. I will follow VA directives and handbooks on handling Federal government IT equipment, information, and systems. I will not take VA sensitive information from the workplace without authorization from the COTR.Only use anti-virus software, antispyware, and firewall/intrusion detection software authorized by VA. I will contact the COTR for policies and guidance on complying with this requirement and will follow the COTR's orders regarding my access to and use of any information assets or resources associated with my performance of services under the contract terms with VA.Not disable or degrade the standard anti-virus software, antispyware, and/or firewall/intrusion detection software on the computer I use to access and use information assets or resources associated with my performance of services under the contract terms with VA. I will report anti-virus, antispyware, firewall or intrusion detection software errors, or significant alert messages to the COTR.Understand that restoration of service of any VA system is a concern of all users of the plete required information security and privacy training, and complete required training for the particular systems to which I require access.3. ADDITIONAL CONDITIONS FOR USE OF NON- VA INFORMATION TECHNOLOGY RESOURCESWhen required to complete work under the contract, I will directly connect to the VA network whenever possible. If a direct connection to the VA network is not possible, then I will use VA approved remote access software and services.Remote access to non-public VA information technology resources is prohibited from publicly-available IT computers, such as remotely connecting to the internal VA network from computers in a public library.I will not have both a VA network line and any kind of non-VA network line including a wireless network card, modem with phone line, or other network device physically connected to my computer at the same time, unless the dual connection is explicitly authorized by the COTR.I understand that I may not obviate or evade my responsibility to adhere to VA security requirements by subcontracting any work under any given contract or agreement with VA, and that any subcontractor(s) I engage shall likewise be bound by the same security requirements and penalties for violating the same.4. STATEMENT ON LITIGATIONThis User Agreement does not and should not be relied upon to create any other right or benefit, substantive or procedural, enforceable by law, by a party to litigation with the United States Government.5. ACKNOWLEDGEMENT AND ACCEPTANCEI acknowledge receipt of this User Agreement. I understand and accept all terms and conditions of this User Agreement, and I will comply with the terms and conditions of this agreement and any additional VA warning banners, directives, handbooks, notices, or directions regarding access to or use of information systems or information. The terms and conditions of this document do not supersede the terms and conditions of the signatory’s employer and VA.Print or type your full nameSignatureLast 4 digits of SSNDateOffice PhonePosition TitleContractor’s Company NamePlease complete and return the original signed document to the COR within the timeframe stated in the terms of the contract.New Mexico VA Health Care SystemONE VA VPN REQUESTATTACHMENT FAll requests for One VA VPN accounts must be approved by the Service Supervisor, the Facility Chief Information Officer (FCIO)and the Facility Information Security Officer (FISO).Note: All remote access service computer users must provide proper justification of the need for access and sign the Rules of Behavior for One-VA VPN Service prior to remote access being granted. Approved remote access users can access VA systems from their residence or while they are on travel status using approved government furnished equipment (GFE). If non-VA owned equipment must be used in certain circumstances, a waiver must be in place. All of the security controls required for GFE must be utilized in approved non-VA owned equipment and must be funded by the owner of the equipment. Approved remote access users are governed under the same local policies, federal laws and regulations that apply to all local users of VA computer systems and the security and privacy of the information contained therein.First Name:________________________Middle Initial:______Last Name:____________________VA Email Address: ___________________________@ (For example: John.Doe@) Routing Symbol: _____________VA Telephone Number: (____) -______________, Ext. _______Last 6 digits of SSAN: _____ _____ - _____ _____ _____ _____ Date of Request:___________Windows User ID: _________________________________________ (For example: VHAABQDOEJ1)Type of Equipment : FORMCHECKBOX Government Furnished Equipment FORMCHECKBOX Non-Government Furnished EquipmentJustification for Remote Access:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Requestor’s Signature:________________________________________ Date: _____________Service Supervisor’s Name (Typed or Printed) :_____________________________________________________________Service Supervisor’s Approval Signature: ______________________________ Date: _____________Service Supervisor’s Email Address:__________________________________________________@ Service Supervisor’s Telephone Number: (______) -____________________, Ext. _________Service Administrator’s Name:__________________________________________________________________________Service Administrator’s Approval Signature: _____________________________ Date: _____________Chief of Staff Approval Signature: _____________________________ Date: _____________Associate\Assistant Director: FORMCHECKBOX Approved FORMCHECKBOX Disapproved (Required for Non-Government Furnished Equipment)Associate\Assistant Director’s Signature: _______________________________ Date: _____________Facility Chief Information Officer (CIO): FORMCHECKBOX Concur FORMCHECKBOX Non-Concur Facility Chief Information Officer’s Signature: ____________________________ Date: _____________Facility Information Security Officer (ISO): FORMCHECKBOX Concur FORMCHECKBOX Non-Concur Facility Information Security Officer’s Signature: _________________________ Date: ____________Repetitive Form Letter 001-201, Rules of Behavior for One-VA VPN Service, located on the NMVAHCS Intranet Site at: must accompany this request.Department of Veterans AffairsMemorandum ATTACHMENT GDate FORMTEXT Insert Date HereFrom:Director, New Mexico VA Health Care SystemsThruDirector, Field Security Services;“OCS Policy Management” Mail group “OCS Policy Management” Mail groupSubj:Request for Approval for Waiver/Compensating Control for VA 6500 Handbook, Information Security Program (Program Office/Administration)Subj:To:Office of Information and Technology, Associate Deputy Assistant Secretary for Cyber Security (005R2)1. The NMVAHCS requests a waiver to the following 6500 Handbook requirement: AC-17 Remote Access, (d) VA Requirements for Controlling Remote Access, 8. If non-VA owned equipment must be used in certain circumstances, a waiver must be in place. All of the security controls required for GFE must be utilized in approved non-VA owned equipment and must be funded by the owner of the equipment.2. This waiver is necessary because: (Name), who provides direct patient care as a (title), has not received a VA GFE laptop. 3. The compensating measure we plan to incorporate has been determined by our CIO and ISO to be the equivalent of the security control requirements in Appendix D of 6500 Handbook. The control has been tested to ensure it meets the equivalent requirements as outlined in Appendix D and our facility accepts the risk with employing this compensating control. The compensating security control is: AC-17, (d), 8. All of the security controls required for GFE will be implemented in the non- VA owned personal computer. (Computer model and operating system)Hard drive encryption (FIPS 140-2 VA approved brand)Anti-virus software (VA approved brand of anti-virus software)Firewall (FIPS 140-2 VA approved brand)AC-17, (f), 4. The configuration of the system uses encryption to protect the confidentiality of remote access sessions. Access to the VA information will be encrypted at the transport layer level by the VA Rescue VPN connection and will be encrypted at the application level by the New Mexico VA Health Care System Citrix computer servers, where the VA data will be accessed.Rept. FL 001-218 (09/09) NMVAHCSThe Facility Information Security Officer will confirm the non-VA computer’s compliance with the above requirements initially and quarterly afterwards, until the provider no longer requires the use of a non-VA computer. When a non-VA computer is no longer being used for Rescue VPN, it will be checked by the Facility Information Security Officer to confirm that no VA information resides on the hard drive.4. The New Mexico VA Health Care System understands this is a temporary solution and full compliance with 6500 Handbook will be achieved by early fiscal year 2010. Our plan to become compliant consists of: Providing VA encrypted laptop computers to the providers who have an approved business need to use Rescue VPN.5. Once approved, we will make a copy of this approval and attach to our current security plan for the system.6. Please contact Robert McCall, FISO, (505) 256-5759 for any questions regarding this waiver request._________________________________Robert L McCallFacility ISO_________________________________Jerome NutterFacility CIO_________________________________James GoffChief of Staff_________________________________Andrew M. Welch, FACHEDirector, New Mexico VA Health Care System FORMCHECKBOX Approved FORMCHECKBOX Disapproved (Comments)Associate Deputy Assistant Secretary for Cyber SecurityOffice of Information and TechnologyDepartment of Veterans AffairsATTACHMENT HMEDICATION INSPECTION FORMFOR WARDS AND CLINICSWARD/CLINIC INSPECTEDDATEREVIEW SUBJECTCHECKED & OKPROBLEMNOTEDCOMMENTS/ACTION TAKEN (for additional comments, use last page)A. Ward/Clinic AreaMedication cart and medication room are properly secured.The storage area is clean (free of visible dust, spilled liquids, etc.).Arrangement and general neatness is satisfactory.Shelf labels, when present, are readable (not soiled, marked or defaced)Metric and apothecary conversion sheet is posted or available electronically.Poison control center telephone number is posted or available electronically.Antidote chart is posted or available electronically.B. MedicationsMedications are stored under conditions suitable for product stability. (e.g., appropriate temperature, light, etc)All medications are securely stored in accordance with medical center policy and medications are not left unattended outside the med room.Internal medications are separated from external medications.Patient medications are separated from ward stock and stored in accordance with medical center policy.Non-medication items are separated from medications.Medications are stocked with earliest dated items placed forward in the storage location.All medications are within their expiration date.Only approved medications are stocked/stored (on the approved ward stock list, no samples, restricted or non-formulary drugs).Concentrated electrolytes (e.g, potassium chloride, sodium chloride > 0.9%, potassium phosphate) are not present. (Exception: areas that have been approved to store concentrated electrolytes. In these areas, precautions are in place in accordance with medical center policy to prevent inadvertent administration.)Medication quantities are within the approved stock levels.Medications are properly labeled (this includes any medication or solution transferred from the original packaging to another container)Medication labels are readable (not soiled, marked or defaced).Opened multi-dose vials are dated and stored in accordance with Medical Center policy.Medications and parenteral fluids show no signs of obvious deterioration.All expired, damaged, and/or contaminated medications are segregated until they are removed from the storage area.Investigational medications are properly labeled and stored in accordance with medical center policy.VA FORM OCT 200710-0053Page 1 of 2WARD/CLINIC INSPECTEDDATEREVIEW SUBJECTCHECKED& OKPROBLEMNOTEDCOMMENTS/ACTION TAKEN(for additional comments,use last page)24. Look alike/sound alike medications are labeled and/or stored in accordance with medical center policy.25. High Alert medications are labeled and/or stored in accordance with medical center policy.26. Medications are available in the most ready to administer forms available from the manufacturer.27. Controlled medications (CII through CV) are secured in accordance with medical center policy.28. No prescription pads are in unsecured, open areas.C. Refrigerator29. The refrigerator contains only medications and admixtures requiring storage at reduced temperatures (i.e. no food, lab specimens, etc. are present).30. The refrigerator is clean (free of visible dust, spilled liquids, etc.).31. The refrigerator is locked if not in med room.32. If the refrigerator contains controlled substances, it is locked or the controlled substances are locked within a secure, non-removable box within the refrigerator.33. Refrigerator temperature is monitored in accordance with Medical Center policy and the log is up to date.34. Refrigerator temperature reading:35. The temperature reading is between 36 and 46 degrees Fahrenheit.D. Crash Carts36. The crash cart(s) is in date.37. The crash cart lock(s) are intact and secured to prevent tampering (i.e the tab pulled all the way through to the end).38. Please list crash cart #(s), lock #s, and expiration dates(s) below.Crash cart #:Crash cart lock #:exp. date:Crash cart #:Crash cart lock #:exp. date:Facility-Specific RequirementsAdditional Comments (indicate review subject and number)Nursing ReviewerPharmacy ReviewerPrint Name:Print Name:Signature:Signature:Date:Date:Original Copy retained in Pharmacy. Copies of completed form to Nursing Service and Chief of StaffVA FORM OCT 200710-0053ATTACHMENT I REPORTSa) The Contractor and NMVAHCS are responsible for complying with all reporting requirements established by the Contract. Contractor and NMVAHCS are 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. b) The following brief descriptions of required documents that must be submitted by Contractor: immediately after award; weekly; monthly; quarterly’; annually, etc. identified throughout Part II, Standards/Specifications/Statement of Work and are provided here as a guide for Contractor convenience. If an item is within the SOW and not listed here, the Contractor remains responsible for the delivery of the item. Submit with Proposal and as noted WhatSubmit ToWhereCompliance√ and upon renewal of licensesCopies of any and all licenses, to include primary source verification of all licensed and certified staff (Section XI) Contracting OfficerNMVAHCSWith Contract √ and upon new hiresCertification that staff list have been compared to OIG list (Section XV)Contracting OfficerNMVAHCSWith Contract √Ability to expand 500 sq. ft. (Section XVI)Contracting OfficerNMVAHCSWith proposal√ upon renewalsIndemnification and Medical Liability Insurance (Section XXIII)Contracting OfficerNMVAHCSVAAR 852.237-7, Indemnification and Medical Liability Insurance, (OCT l996)√ and upon renewal of certificatesLaboratory accreditation certificates(Section IX)Contracting OfficerNMVAHCSPI/IWith Contract √Performance Improvement/Quality Improvement Plan/Quality Assurance Surveillance Plan (Section XII.)Contracting OfficerNMVAHCSWith Contract√Schedule of Work Hours (XXII.)Contracting OfficerNMVAHCSWith Contract√Price proposal separate from technical proposal (FAR 52.212-2, pg 95)Contracting OfficerNMVAHCSWith Contract√ and throughout contractCredentialing, Privileging, VetPro Application (Attch F) (Section XV) Contracting OfficerNMVAHCSWith Contract √ and throughout contractBackground Investigation Application (Attch G) (Section XV) Contracting OfficerNMVAHCSWith Contract √ upon change, quarterlySubcontracting Plan (Section IX)Revised subcontractor reports of subcontractors approved by NMVAHCSContracting OfficerNMVAHCSWith Contract,Submit Before Commencement of Services and as noted WhatSubmit ToWhereCompliance√ and upon renewal of licenses, credentialing or certification, quarterlySubcontracted services for pharmacy, laboratory and radiology: all current documents of licensure, credentialing or certifications (Section IX)Contracting OfficerNMVAHCSWith Contract √ and upon changesListing of all providers subcontracted for in the plan, and documentation that they meet current JC Standards (Section IX)Contract provider shall sign and agree to adhere to Medical Staff Bylaws, Rules and Regulations. (Section XVII)Contract nurse practitioners or physicians’ assistants shall provide a Scope of Practice/Collaborative Agreement completed and signed by the practitioner and the Collaborating PhysicianStaffing Plan (Section XV)Contracting OfficerCredentialing CoordinatorCredentialing CoordinatorContracting OfficerNMVAHCSWith Contract √ and upon changesContractor shall provide medical provider coverage after normal business hours and weekends responsible for critical test results on samples sent to NMVHCS LaboratoryNMVHCS Lab and Contracting OfficerNMVAHCSWith Contract√ and upon changesEmergency Preparedness PlanContracting OfficerNMVAHCSWith ContractSubmit Within 10 Days After AwardWhatSubmit ToWhereCompliance√ award and upon change/annuallyDetailed written Schedule of Services and Maintenance to be performed, including subcontractor name, address and telephone number scheduled to perform the services if not performed by Prime Contractor (Section XIV )Contracting OfficerNMVAHCSEnsure MaintenanceServicesSubmit Within 30 Days After AwardWhatSubmit ToWhereCompliance√ and annual training and new hiresCertificates of Completion forCyber Security and Patient Privacy Training Courses (Section XV.)Contracting OfficerNMVAHCSWith Contract √ and upon annual training and new hiresSigned/dated Statements of Commitment (Section XV)Contracting OfficerNMVAHCSWith Contract √And upon changesCompetence annuallyRoster to include name and title of all PCP's and support staff who are responsible for providing direct and/or indirect patient care to assigned veterans and competence annually (Section XV) CORNMVAHCSWith Contract√And upon changesComputer Access Request Form (001-215 (10/07) (Section XXII)Submit Within 45 Days After AwardWhatSubmit ToWhereCompliance√Be in compliance with National Fire Protection Association (NFPA) 101, Life Safety Code (LSC) (2003 Edition) and Americans with Disabilities Act (ADA) requirements; provide written proof of LSC/ADA compliance to NMVAHCS prior to scheduling NMVAHCS compliance inspection. NMVAHCS will inspect Contractor's facility or facilities for compliance within forty-five (45) calendar days of the notice of award and after receipt of the compliance verification letter. (Section XIV )Contracting OfficerNMVAHCSWith ContractSubmit WeeklyWhatSubmit ToWhereCompliance√ for new enrollmentApplication for Health Benefits, VA Form 10-10EZR(Section IV) Benefits Of, attn: EligibilityNMVAHCSWith Contract√Copy of Veteran’s health insurance cardMedical Cost Care Recovery UnitNMVAHCSWith ContractSubmit MonthlyWhatSubmit ToWhereCompliance√Summary of patient complaints to be provided to the Coordinator, Clinic/Community Based Outpatient Clinic Program (OO3B1), and to NMVAHCS (Section VI)CORNMVAHCSWith Contract√Reports of Grievance Procedures and resolutions (Section VI)CORNMVAHCSWith Contract√QuarterlyAnnuallyAnnuallyDuring the first three months following award, all Performance Improvement/Quality Improvement (PI/QI)activity results/data shall be reported monthly (Section XII) Submit “Hire, Orientation, Evaluation report monthly (PI/QI) data shall be reported (Section XV)After the first three months following award, all PI/QI activity results/data shall be reported quarterly (Section XII)PI/QI Program Plan(Section XII)Proactive Analyses of high risk processes, as described by current JC standards (Section XII)CORNMVAHCSPI/QIWith ContractOccurrenceOccurrenceOccurrenceThe NMVAHCS shall inform the contractor of all applicable Sentinel Events, Patient Safety Alerts or other patient safety notices, contractor shall take the necessary steps to redesign processes. Written feedback to the NMVAHCS Business Manager and Patient Safety Manager describing prevention actions taken within 90 days of notification.Verbally notify the NMVAHCS COR immediately when a Sentinel Event has occurred, which is to be followed by written notification within 3 working days. Root Cause Analysis as directed by NMVAHCSMonthly report on unsigned documents Health Information Management (HIM) departmentBusiness Manager and Safety ManagerCOR and Safety ManagerHealth Information Management (HIM) departmentNMVAHCSNMVAHCSNMVAHCSWith ContractWith ContractWith Contract√Testing of the emergency lighting system.Maintain records for reviewNMVAHCS InspectionsWith Contract√Veteran assignment to PCPPCMM Coordinator, CORNMVAHCSWith ContractSubmit QuarterlyWhatSubmit ToWhereCompliance√And upon incidentAll medication errors and medication related incidents (Section IX) Chief, Pharmacy Service, NMVAHCSNMVAHCSWith ContractCompliance Over Life of ContractCritical ElementSubmit ToWhereComplianceMonthlyPerformance Measures not meeting targets require a plan of correction. (Section IX)COR and Business ManagerNMVAHCSWith ContractPrior to distributionPatient education materials and outreach materials, not supplied by the NMVAHCSCOR, Business ManagerNMVAHCSWith ContractWithin 72 hours of occurrence-- Vista CPRS outage“contingency report” (Section XVII)CORNMVAHCSWith ContractAnnually and as requiredInventory of government equipment (Section XVI)COR, ISO, IRMNMVAHCSWith ContractSubmit Within 21 Days Following Contract Termination or CompletionWhatSubmit ToWhereCompliance√All written records, correspondence, and notes for all assigned patients who were assigned throughout the term of the Contract (Section __CORNMVAHCSWith ContractLIST OF REPORTS AND DUE DATESREPORT TITLEFREQUENCYDUE DATESUBMIT TOLicenses and Certifications that expire within 30 days (Section XV)Monthly 30 days prior to expiration of license COR Performance Improvement Meeting minutes Monthly 5th workday after end of month COR Patient Reports (Section XI)??? (a) # ER (by patient name, SSN, date, location of ER) to Managed Care OfficeOccurrenceWithin 24 hoursCOR (b) #ER visits within 48 hours after seeing provider.Monthly ?5th workday after end of month for monthly reports?COR (c) Hospitalizations outside of NMVAHSC (By patient name, SSN, date, location of facility) to Managed Care OfficeOccurrence ??CORStaff Education Completed – By type of Training & number of hours, Including Basic Life Support training (Section XV)Monthly 5th workday after end of month. COR Patient Grievances – Number filed by name, SSN, date, description of complaint and resolution action for each (Section VI)Monthly 5th workday after end of month COR Patient Written Compliments-copies to be submitted (Section VI)Monthly 5th workday after end of month COR QA/QI Assessment Report ???(a) Freedom of Information Act Requests Annual5th of October COR (b) Privacy Act Requests Annual5th of October ?(c) Patient Incident Reports OccurrenceNext Business day ?(d) Adverse findings OccurrenceNext Business day ?(e) Alleged Privacy Violation OccurrenceNext Business day ?Monthly Billing: (Section XXI) Current Veterans Newly enrolled/assigned Veterans (identified if new to NMVAHCS or new to clinic) Veterans dis-assigned and the reason for dis-assignment. Traveling VeteransFor each category above: list alphabetically, SSN, date of last qualifying visit, assigned PCPMonthly10th day of each monthCORCompetency assessment findings (Section XV)???(a) Provision of retraining for identified deficiencies; Annual No later than 30 days after expiration of the Base Year and all Option Years exercised COR (b) Reassessment following retraining; Annual No later than 30 days after expiration of the Base Year and all Option Years exercised COR (c) Performance evaluation aggregate data, by staff position. Annual No later than 30 days after expiration of the Base Year and all Option Years exercised COR Inspection Compliance - addressing (Section XIV)(a) Preventative Maintenance Inspections(b) Safety/Environmental/Infection Control Inspections(c) Fire Drills(d) Disaster Drills?AnnualQuarterlyAnnually?No later than the 28th day of the last month of the contract year and all Option Years exercised?COR17. Infection Control (Section XIX)??? (a) Committee Minutes Monthly 10th workday after the end of monthCOR (b) Quarterly Reports Monthly ?COR ATTACHMENTJDate Submitted _______________Ambulatory Care Peer Review FormAmbulatory Care Peer Review FormProvider Reviewing: ______________________________________All providers are required to complete two peer reviews each monthDate of progress note/1st initial & last fourDate of progress note/1st initial & last fourYNN/AYNN/AWere abnormal vital signs addressed?Was the Physical exam adequate for the visit?Were clinically abnormal studies addressed in a timely manner?Is an assessment present?Is the plan documented and appropriate for the patient’s condition?Is the note organized?Based on the progress note would you be able to provide continuity of care for this patient at their next visit?MEDICAL MANAGEMENTRate as 1, 2 or 3 based on the following definitions:Level 1: Most experienced practitioners would handle the case similar.Level 2: Most experienced practitioners might handle the case differently.Level 3: Most experienced practitioners would handle the case differently.Case 1: Rate as 1, 2, or 3 (circle)Case 2: Rate as 1, 2, or 3 (circle)Comments: (Required for level 2 or 3 ratings)Comments: (Required for level 2 or 3 ratings)Provider Reviewed: _______________________________________Peer Review General GuidelinesThe Purpose of Peer Review is: To enhance the assessment, maintenance, and improvement of staff competence (see JCAHO Management of Human Resources) through the participation of the Ambulatory Care medical staff.Procedure: Choose records at random for the month you have chosen. Select assigned PCP and two visits for the month you have chosen. Review the visit note and any accompanying notes, labs, orders, or studies accompanying that visit. You may elect to review beyond that time period keeping in mind studies done after the visit will not have been available to the provider on the visit date. Recognize pertinent information may be present in other notes such as medication reconciliation, letters to patients and other documentation. Two reviews are required each month. Submit your completed reviews to Karen Smith, Ambulatory Care office pleting the Form: Enter your name as the provider conducting the review. Enter the name of the provider you are reviewing. Circle your rating. For any ratings of 2 or 3, you must provide an explanation for your rating in each instance. Place completed forms in the Peer Review Lock box located in or near your work area. Scoring: Ratings will be reviewed by the Department Chief. Two or more “No” responses will be addressed with the reviewed provider by the Department Chief with focus on performance improvement. Results: Peer Review data will be analyzed for trends each quarter by ACOS, ACS and returned back through the COR; for example, are certain areas never a problem and therefore no longer require review? Are certain areas consistently incomplete and warrants provider training or system redesign? Stratified data will be reviewed by the Committee at regular intervals. Providers may review their results at any time. Results will be kept on file for 2 years. Guiding Principles for this Peer Review Process include JCAHO Standard HR 4.32, Deliberations by organization leaders in developing recommendations for initial granting of clinical privileges and revision or revocation of clinical privileges includes information provided by peers of the applicant; and R 4.34 There is a process that defines circumstances requiring a focused review of a practitioner’s performance and evaluation of a practitioner’s performance by peers. Rept. FL 115-200 (09/09) NMVAHCSATTACHMENT KPACT PCMM (Primary Care Management Module) SetupPACT Staffing RecommendationsPrimary Care has recommended staffing levels and panel sizes for teams for many years. Staffing has been monitored through the VSSC Staffing and Rooms Database, and is used as one of the factors in determining Primary Care panel size. Recommended staffing levels have included those individuals and disciplines that were felt to directly contribute to the efficiency and day-to-day operation of the Primary Care clinic.The PCMM Staffing Ratio includes?Primary Care Provider FTE?FTE to prepare for, provide, and follow-up on the clinical needs of Primary Care patients?MD?NP?PA?Support Staff FTE?Present in the clinic area assisting with delivery of Primary Care?RN?LPN?MA?Clerk?Pharmacist/Clinical Pharmacist?Telephone Staff FTE?Telephone Care for Primary Care patients during regular clinic hours, even if located in a separate area?RN?LPN?MA?Clerk?Pharmacist/Clinical Pharmacist?Anticoagulation Staff FTE?Involved with Primary Care patients in the anticoagulation clinic during regular clinic hours, even if located in a separate area?RN?LPN?MA?Clerk?Pharmacist/Clinical PharmacistWith the advent of PACT, staffing recommendations have focused on the Teamlet: those individuals who are responsible for a single panel of patients and work closely together on a day-to-day basis. However, recommendations for other team members for PACT teams have been made and included in implementation guidance that has already been disseminated. We continue to monitor overall Primary Care staffing, which includes teamlet staff. Other staff continues to be included in the staffing ratio because their support is still considered essential to the smooth functioning of the Primary Care clinic. To insure that sites retain the flexibility to configure their Primary Care clinics to reflect local needs and resources and to maintain continuity of staffing measures used for panel size determination, we use the overall Primary Care staffing ratio to monitor PACT implementation. PCMM SetupPCMM (Primary care Management Module) is the software used to designate, track, and monitor patient assignments to Primary Care teams and providers. The assignments and related aggregate data are transmitted regularly to Austin and are reported on the VSSC website. By properly configuring teams within PCMM, features of the software such as team alerts can be fully enabled. In addition, configuration of PCMM teams in accordance with the updated guidelines will allow capture and correct attribution of workload data for PACT. The general principles of the setup are:1.Assignment of Primary Care Providers (PCP), Associate Providers (AP), team staff and patient transfers need to be carefully planned, timed and correctly sequenced. Assignment in PCMM is for monitoring and tracking team and patient panel allocations, and does not indicate a supervisory relationship.2.Each PACT will have only one Primary Care Provider.3.An RN care manager, LPN Medical Assistant or Health Tech and a clerk (the teamlet) will be part of each PACT.4.Residents and other providers whose scopes of practice require direct linkage to a preceptor physician will be established as Associate Providers in PCMM.5.Part-time providers should not be grouped into a single team.6.Team members that cover multiple panels, whether for part-time providers or because of their discipline (e.g. pharmacists, social workers, dieticians), can be included in multiple teams.7.FTE cannot exceed 1.0 across all positions individual staff members may occupy in PCMM. 8.Team and team position names should never incorporate the name of the Primary Care Provider. 9.Team names and clinic names may retain local group designations (Red Team, Blue Team, etc.)10.Teams for special Primary Care practices such as SCI or HBPC will use specific naming conventions (see attachment) to allow easy identification and data collection. 11.Future modifications to PCMM are planned that will correct some of the software deficiencies that necessitated these configuration changes.WD 05-2361 (Rev.-16) was first posted on on 12/30/2014ATTACHMENT L************************************************************************************************************************REGISTER OF WAGE DETERMINATIONS | U.S. DEPARTMENT OF LABOR UNDER | EMPLOYMENT STANDARDS ADMINISTRATION THE SERVICE CONTRACT ACT By direction of the Secretary of Labor | WAGE AND HOUR DIVISION | WASHINGTON D.C. 20210 | Wage Determination No.: 2005-2361Diane C. Koplewski Division of | Revision No.: 16Director Wage Determinations| Date Of Revision: 12/22/2014_________________________________________________________________________________Note: Executive Order (EO) 13658 establishes an hourly minimum wage of $10.10for 2015 that applies to all contracts subject to the Service Contract Act forwhich the solicitation is issued on or after January 1, 2015. If this contractis covered by the EO, the contractor must pay all workers in anyclassification listed on this wage determination at least $10.10 (or theapplicable wage rate listed on this wage determination, if it is higher) forall hours spent performing on the contract. The EO minimum wage rate will beadjusted annually. Additional information on contractor requirements andworker protections under the EO is available at whd/govcontracts.____________________________________________________________________________________State: New MexicoArea: New Mexico Counties of Bernalillo, Catron, Cibola, Colfax, De Baca,Guadalupe, Harding, Los Alamos, McKinley, Mora, Rio Arriba, San Juan, SanMiguel, Sandoval, Santa Fe, Socorro, Taos, Torrance, Valencia____________________________________________________________________________________ **Fringe Benefits Required Follow the Occupational Listing**OCCUPATION CODE - TITLE FOOTNOTE RATE01000 - Administrative Support And Clerical Occupations 01011 - Accounting Clerk I 13.01 01012 - Accounting Clerk II 14.60 01013 - Accounting Clerk III 16.33 01020 - Administrative Assistant 18.17 01040 - Court Reporter 18.61 01051 - Data Entry Operator I 11.03 01052 - Data Entry Operator II 13.44 01060 - Dispatcher, Motor Vehicle 15.56 01070 - Document Preparation Clerk 13.86 01090 - Duplicating Machine Operator 13.86 01111 - General Clerk I 11.35 01112 - General Clerk II 12.39 01113 - General Clerk III 13.90 01120 - Housing Referral Assistant 16.74 01141 - Messenger Courier 9.98 01191 - Order Clerk I 11.33 01192 - Order Clerk II 12.91 01261 - Personnel Assistant (Employment) I 13.80 01262 - Personnel Assistant (Employment) II 15.44 01263 - Personnel Assistant (Employment) III 17.22 01270 - Production Control Clerk 21.06 01280 - Receptionist 11.02 01290 - Rental Clerk 12.25 01300 - Scheduler, Maintenance 13.42 01311 - Secretary I 13.42 01312 - Secretary II 15.01 01313 - Secretary III 16.74 01320 - Service Order Dispatcher 14.08 01410 - Supply Technician 18.60 01420 - Survey Worker 14.01 01531 - Travel Clerk I 11.82 01532 - Travel Clerk II 12.76 01533 - Travel Clerk III 13.57 01611 - Word Processor I 11.91 01612 - Word Processor II 13.37 01613 - Word Processor III 14.9505000 - Automotive Service Occupations 05005 - Automobile Body Repairer, Fiberglass 18.06 05010 - Automotive Electrician 18.12 05040 - Automotive Glass Installer 15.82 05070 - Automotive Worker 15.82 05110 - Mobile Equipment Servicer 13.50 05130 - Motor Equipment Metal Mechanic 17.99 05160 - Motor Equipment Metal Worker 15.82 05190 - Motor Vehicle Mechanic 18.12 05220 - Motor Vehicle Mechanic Helper 13.62 05250 - Motor Vehicle Upholstery Worker 15.82 05280 - Motor Vehicle Wrecker 15.82 05310 - Painter, Automotive 17.19 05340 - Radiator Repair Specialist 15.82 05370 - Tire Repairer 11.49 05400 - Transmission Repair Specialist 17.9907000 - Food Preparation And Service Occupations 07010 - Baker 11.60 07041 - Cook I 9.75 07042 - Cook II 11.64 07070 - Dishwasher 7.89 07130 - Food Service Worker 9.36 07210 - Meat Cutter 16.07 07260 - Waiter/Waitress 7.8009000 - Furniture Maintenance And Repair Occupations 09010 - Electrostatic Spray Painter 14.65 09040 - Furniture Handler 11.44 09080 - Furniture Refinisher 14.65 09090 - Furniture Refinisher Helper 12.45 09110 - Furniture Repairer, Minor 13.85 09130 - Upholsterer 14.6511000 - General Services And Support Occupations 11030 - Cleaner, Vehicles 9.11 11060 - Elevator Operator 9.11 11090 - Gardener 14.29 11122 - Housekeeping Aide 9.73 11150 - Janitor 9.73 11210 - Laborer, Grounds Maintenance 10.39 11240 - Maid or Houseman 8.48 11260 - Pruner 8.88 11270 - Tractor Operator 13.22 11330 - Trail Maintenance Worker 10.39 11360 - Window Cleaner 11.3912000 - Health Occupations 12010 - Ambulance Driver 15.94 12011 - Breath Alcohol Technician 18.04 12012 - Certified Occupational Therapist Assistant 25.32 12015 - Certified Physical Therapist Assistant 21.02 12020 - Dental Assistant 14.93 12025 - Dental Hygienist 36.30 12030 - EKG Technician 26.19 12035 - Electroneurodiagnostic Technologist 26.19 12040 - Emergency Medical Technician 15.94 12071 - Licensed Practical Nurse I 18.73 12072 - Licensed Practical Nurse II 20.92 12073 - Licensed Practical Nurse III 23.32 12100 - Medical Assistant 13.10 12130 - Medical Laboratory Technician 18.44 12160 - Medical Record Clerk 13.62 12190 - Medical Record Technician 15.65 12195 - Medical Transcriptionist 14.42 12210 - Nuclear Medicine Technologist 36.03 12221 - Nursing Assistant I 10.38 12222 - Nursing Assistant II 11.67 12223 - Nursing Assistant III 12.74 12224 - Nursing Assistant IV 14.29 12235 - Optical Dispenser 14.29 12236 - Optical Technician 14.53 12250 - Pharmacy Technician 14.09 12280 - Phlebotomist 14.29 12305 - Radiologic Technologist 26.71 12311 - Registered Nurse I 25.39 12312 - Registered Nurse II 31.06 12313 - Registered Nurse II, Specialist 31.06 12314 - Registered Nurse III 37.58 12315 - Registered Nurse III, Anesthetist 37.58 12316 - Registered Nurse IV 45.04 12317 - Scheduler (Drug and Alcohol Testing) 20.3113000 - Information And Arts Occupations 13011 - Exhibits Specialist I 17.35 13012 - Exhibits Specialist II 21.18 13013 - Exhibits Specialist III 25.33 13041 - Illustrator I 16.10 13042 - Illustrator II 19.95 13043 - Illustrator III 23.03 13047 - Librarian 22.91 13050 - Library Aide/Clerk 9.11 13054 - Library Information Technology Systems 20.67 Administrator 13058 - Library Technician 13.73 13061 - Media Specialist I 15.31 13062 - Media Specialist II 17.18 13063 - Media Specialist III 19.07 13071 - Photographer I 15.88 13072 - Photographer II 17.63 13073 - Photographer III 21.70 13074 - Photographer IV 24.30 13075 - Photographer V 29.39 13110 - Video Teleconference Technician 18.5714000 - Information Technology Occupations 14041 - Computer Operator I 14.98 14042 - Computer Operator II 16.76 14043 - Computer Operator III 19.12 14044 - Computer Operator IV 21.26 14045 - Computer Operator V 24.34 14071 - Computer Programmer I (see 1) 22.41 14072 - Computer Programmer II (see 1) 26.14 14073 - Computer Programmer III (see 1) 14074 - Computer Programmer IV (see 1) 14101 - Computer Systems Analyst I (see 1) 14102 - Computer Systems Analyst II (see 1) 14103 - Computer Systems Analyst III (see 1) 14150 - Peripheral Equipment Operator 14.98 14160 - Personal Computer Support Technician 21.5215000 - Instructional Occupations 15010 - Aircrew Training Devices Instructor (Non-Rated) 27.62 15020 - Aircrew Training Devices Instructor (Rated) 33.39 15030 - Air Crew Training Devices Instructor (Pilot) 40.05 15050 - Computer Based Training Specialist / Instructor 27.62 15060 - Educational Technologist 25.93 15070 - Flight Instructor (Pilot) 40.05 15080 - Graphic Artist 22.41 15090 - Technical Instructor 18.61 15095 - Technical Instructor/Course Developer 25.06 15110 - Test Proctor 15.01 15120 - Tutor 15.0116000 - Laundry, Dry-Cleaning, Pressing And Related Occupations 16010 - Assembler 8.80 16030 - Counter Attendant 8.80 16040 - Dry Cleaner 10.58 16070 - Finisher, Flatwork, Machine 8.80 16090 - Presser, Hand 8.80 16110 - Presser, Machine, Drycleaning 8.80 16130 - Presser, Machine, Shirts 8.80 16160 - Presser, Machine, Wearing Apparel, Laundry 8.80 16190 - Sewing Machine Operator 11.15 16220 - Tailor 11.73 16250 - Washer, Machine 9.3919000 - Machine Tool Operation And Repair Occupations 19010 - Machine-Tool Operator (Tool Room) 19.95 19040 - Tool And Die Maker 24.0921000 - Materials Handling And Packing Occupations 21020 - Forklift Operator 14.21 21030 - Material Coordinator 21.06 21040 - Material Expediter 21.06 21050 - Material Handling Laborer 10.90 21071 - Order Filler 11.53 21080 - Production Line Worker (Food Processing) 14.21 21110 - Shipping Packer 13.14 21130 - Shipping/Receiving Clerk 13.14 21140 - Store Worker I 8.78 21150 - Stock Clerk 13.78 21210 - Tools And Parts Attendant 14.21 21410 - Warehouse Specialist 14.2123000 - Mechanics And Maintenance And Repair Occupations 23010 - Aerospace Structural Welder 24.01 23021 - Aircraft Mechanic I 22.48 23022 - Aircraft Mechanic II 24.01 23023 - Aircraft Mechanic III 25.31 23040 - Aircraft Mechanic Helper 16.62 23050 - Aircraft, Painter 20.56 23060 - Aircraft Servicer 18.79 23080 - Aircraft Worker 20.11 23110 - Appliance Mechanic 14.70 23120 - Bicycle Repairer 10.94 23125 - Cable Splicer 21.67 23130 - Carpenter, Maintenance 16.70 23140 - Carpet Layer 17.16 23160 - Electrician, Maintenance 21.52 23181 - Electronics Technician Maintenance I 25.16 23182 - Electronics Technician Maintenance II 27.32 23183 - Electronics Technician Maintenance III 29.47 23260 - Fabric Worker 15.70 23290 - Fire Alarm System Mechanic 18.76 23310 - Fire Extinguisher Repairer 14.23 23311 - Fuel Distribution System Mechanic 21.10 23312 - Fuel Distribution System Operator 16.38 23370 - General Maintenance Worker 15.10 23380 - Ground Support Equipment Mechanic 22.48 23381 - Ground Support Equipment Servicer 18.79 23382 - Ground Support Equipment Worker 20.11 23391 - Gunsmith I 14.23 23392 - Gunsmith II 17.16 23393 - Gunsmith III 20.11 23410 - Heating, Ventilation and Air-Conditioning 19.25 Mechanic 23411 - Heating, Ventilation and Air Conditioning 21.26 Mechanic (Research Facility) 23430 - Heavy Equipment Mechanic 19.48 23440 - Heavy Equipment Operator 17.25 23460 - Instrument Mechanic 27.47 23465 - Laboratory/Shelter Mechanic 18.64 23470 - Laborer 10.90 23510 - Locksmith 18.64 23530 - Machinery Maintenance Mechanic 22.60 23550 - Machinist, Maintenance 21.25 23580 - Maintenance Trades Helper 12.56 23591 - Metrology Technician I 27.47 23592 - Metrology Technician II 29.34 23593 - Metrology Technician III 30.82 23640 - Millwright 20.11 23710 - Office Appliance Repairer 19.21 23760 - Painter, Maintenance 15.94 23790 - Pipefitter, Maintenance 22.03 23810 - Plumber, Maintenance 20.60 23820 - Pneudraulic Systems Mechanic 20.11 23850 - Rigger 20.11 23870 - Scale Mechanic 17.16 23890 - Sheet-Metal Worker, Maintenance 19.22 23910 - Small Engine Mechanic 15.07 23931 - Telecommunications Mechanic I 24.06 23932 - Telecommunications Mechanic II 25.71 23950 - Telephone Lineman 21.26 23960 - Welder, Combination, Maintenance 18.39 23965 - Well Driller 19.77 23970 - Woodcraft Worker 20.11 23980 - Woodworker 16.6124000 - Personal Needs Occupations 24570 - Child Care Attendant 10.31 24580 - Child Care Center Clerk 14.77 24610 - Chore Aide 9.40 24620 - Family Readiness and Support Services 13.49 Coordinator 24630 - Homemaker 17.4925000 - Plant And System Operations Occupations 25010 - Boiler Tender 19.77 25040 - Sewage Plant Operator 18.32 25070 - Stationary Engineer 19.77 25190 - Ventilation Equipment Tender 12.56 25210 - Water Treatment Plant Operator 17.3827000 - Protective Service Occupations 27004 - Alarm Monitor 13.86 27007 - Baggage Inspector 11.23 27008 - Corrections Officer 15.36 27010 - Court Security Officer 16.86 27030 - Detection Dog Handler 13.16 27040 - Detention Officer 15.36 27070 - Firefighter 16.86 27101 - Guard I 11.23 27102 - Guard II 12.56 27131 - Police Officer I 18.47 27132 - Police Officer II 20.5228000 - Recreation Occupations 28041 - Carnival Equipment Operator 13.55 28042 - Carnival Equipment Repairer 14.77 28043 - Carnival Equipment Worker 9.34 28210 - Gate Attendant/Gate Tender 13.59 28310 - Lifeguard 11.34 28350 - Park Attendant (Aide) 15.21 28510 - Recreation Aide/Health Facility Attendant 11.10 28515 - Recreation Specialist 18.06 28630 - Sports Official 12.11 28690 - Swimming Pool Operator 18.3629000 - Stevedoring/Longshoremen Occupational Services 29010 - Blocker And Bracer 20.42 29020 - Hatch Tender 20.42 29030 - Line Handler 20.42 29041 - Stevedore I 19.04 29042 - Stevedore II 22.1730000 - Technical Occupations 30010 - Air Traffic Control Specialist, Center (HFO) (see 2) 35.77 30011 - Air Traffic Control Specialist, Station (HFO) (see 2) 24.66 30012 - Air Traffic Control Specialist, Terminal (HFO) (see 2) 27.16 30021 - Archeological Technician I 17.39 30022 - Archeological Technician II 19.50 30023 - Archeological Technician III 23.87 30030 - Cartographic Technician 24.17 30040 - Civil Engineering Technician 24.00 30061 - Drafter/CAD Operator I 17.39 30062 - Drafter/CAD Operator II 19.50 30063 - Drafter/CAD Operator III 21.75 30064 - Drafter/CAD Operator IV 25.91 30081 - Engineering Technician I 15.18 30082 - Engineering Technician II 17.03 30083 - Engineering Technician III 19.05 30084 - Engineering Technician IV 23.61 30085 - Engineering Technician V 28.88 30086 - Engineering Technician VI 34.94 30090 - Environmental Technician 20.36 30210 - Laboratory Technician 22.61 30240 - Mathematical Technician 24.17 30361 - Paralegal/Legal Assistant I 15.40 30362 - Paralegal/Legal Assistant II 19.08 30363 - Paralegal/Legal Assistant III 23.34 30364 - Paralegal/Legal Assistant IV 28.24 30390 - Photo-Optics Technician 24.17 30461 - Technical Writer I 21.22 30462 - Technical Writer II 25.96 30463 - Technical Writer III 31.40 30491 - Unexploded Ordnance (UXO) Technician I 22.74 30492 - Unexploded Ordnance (UXO) Technician II 27.51 30493 - Unexploded Ordnance (UXO) Technician III 32.97 30494 - Unexploded (UXO) Safety Escort 22.74 30495 - Unexploded (UXO) Sweep Personnel 22.74 30620 - Weather Observer, Combined Upper Air Or (see 2) 21.75 Surface Programs 30621 - Weather Observer, Senior (see 2) 24.1731000 - Transportation/Mobile Equipment Operation Occupations 31020 - Bus Aide 10.73 31030 - Bus Driver 17.17 31043 - Driver Courier 13.34 31260 - Parking and Lot Attendant 9.72 31290 - Shuttle Bus Driver 13.56 31310 - Taxi Driver 10.53 31361 – Truck driver, Light 13.56 31362 – Truck driver, Medium 16.66 31363 – Truck driver, Heavy 18.93 31364 – Truck driver, Tractor-Trailer 18.9399000 - Miscellaneous Occupations 99030 - Cashier 9.11 99050 - Desk Clerk 9.14 99095 - Embalmer 23.74 99251 - Laboratory Animal Caretaker I 11.13 99252 - Laboratory Animal Caretaker II 12.42 99310 - Mortician 23.75 99410 - Pest Controller 17.07 99510 - Photofinishing Worker 12.14 99710 - Recycling Laborer 12.03 99711 - Recycling Specialist 15.57 99730 - Refuse Collector 10.99 99810 - Sales Clerk 11.98 99820 - School Crossing Guard 10.28 99830 - Survey Party Chief 19.48 99831 - Surveying Aide 17.72 99832 - Surveying Technician 17.87 99840 - Vending Machine Attendant 11.72 99841 - Vending Machine Repairer 14.59 99842 - Vending Machine Repairer Helper 10.51____________________________________________________________________________________ALL OCCUPATIONS LISTED ABOVE RECEIVE THE FOLLOWING BENEFITS:HEALTH & WELFARE: $4.02 per hour or $160.80 per week or $696.79 per monthVACATION: 2 weeks paid vacation after 1 year of service with a contractor or successor; 3 weeks after 10 years, and 4 after 15 years. Length of service includes the whole span of continuous service with the present contractor or successor, wherever employed, and with the predecessor contractors in the performance of similar work at the same Federal facility. (Reg. 29 CFR 4.173)HOLIDAYS: A minimum of ten paid holidays per year: New Year's Day, Martin Luther King Jr.'s Birthday, Washington's Birthday, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans' Day, Thanksgiving Day, and Christmas Day. (A contractor may substitute for any of the named holidays another day off with pay in accordance with a plan communicated to the employees involved.) (See 29 CFR 4.174)THE OCCUPATIONS WHICH HAVE NUMBERED FOOTNOTES IN PARENTHESES RECEIVE THE FOLLOWING:1) COMPUTER EMPLOYEES: Under the SCA at section 8(b), this wage determination does not apply to any employee who individually qualifies as a bona fide executive, administrative, or professional employee as defined in 29 C.F.R. Part 541. Because most Computer System Analysts and Computer Programmers who are compensated at a rate not less than $27.63 (or on a salary or fee basis at a rate not less than $455 per week) an hour would likely qualify as exempt computer professionals, (29 C.F.R. 541. 400) wage rates may not be listed on this wage determination for all occupations within those job families. In addition, because this wage determination may not list a wage rate for some or all occupations within those job families if the survey data indicates that the prevailing wage rate for the occupation equals or exceeds $27.63 per hour conformances may be necessary for certain nonexempt employees. For example, if an individual employee is nonexempt but nevertheless performs dutieswithin the scope of one of the Computer Systems Analyst or Computer Programmer occupations for which this wage determination does not specify an SCA wage rate, then the wage rate for that employee must be conformed in accordance with the conformance procedures described in the conformance note included on this wage determination.Additionally, because job titles vary widely and change quickly in the computer industry, job titles are not determinative of the application of the computer professional exemption. Therefore, the exemption applies only to computer employees who satisfy the compensation requirements and whose primary duty consists of: (1) The application of systems analysis techniques and procedures, including consulting with users, to determine hardware, software or system functional specifications; (2) The design, development, documentation, analysis, creation, testing or modification of computer systems or programs, including prototypes, based on and related to user or system design specifications; (3) The design, documentation, testing, creation or modification of computer programs related to machine operating systems; or (4) A combination of the aforementioned duties, the performance of which requires the same level of skills. (29 C.F.R. 541.400)2) AIR TRAFFIC CONTROLLERS AND WEATHER OBSERVERS - NIGHT PAY & SUNDAY PAY: If youwork at night as part of a regular tour of duty, you will earn a night differential and receive an additional 10% of basic pay for any hours worked between 6pm and 6am. If you are a full-time employed (40 hours a week) and Sunday is part of your regularly scheduled workweek, you are paid at your rate of basic pay plus a Sunday premium of 25% of your basic rate for each hour of Sunday work which is not overtime(i.e. occasional work on Sunday outside the normal tour of duty is considered overtime work).HAZARDOUS PAY DIFFERENTIAL: An 8 percent differential is applicable to employees employed in a position that represents a high degree of hazard when working with or in close proximity to ordinance, explosives, and incendiary materials. This includes work such as screening, blending, dying, mixing, and pressing of sensitive ordnance, explosives, and pyrotechnic compositions such as lead azide, black powder and photoflash powder. All dry-house activities involving propellants or explosives. Demilitarization, modification, renovation, demolition, and maintenance operationson sensitive ordnance, explosives and incendiary materials. All operations involving regarding and cleaning of artillery ranges.A 4 percent differential is applicable to employees employed in a position that represents a low degree of hazard when working with, or in close proximity to ordnance, (or employees possibly adjacent to) explosives and incendiary materials which involves potential injury such as laceration of hands, face, or arms of the employee engaged in the operation, irritation of the skin, minor burns and the like; minimal damage to immediate or adjacent work area or equipment being used. All operations involving, unloading, storage, and hauling of ordnance, explosive, and incendiary ordnance material other than small arms ammunition. These differentials are only applicable to work that has been specifically designated by the agency for ordnance, explosives, and incendiary material differential pay.** UNIFORM ALLOWANCE **If employees are required to wear uniforms in the performance of this contract (either by the terms of the Government contract, by the employer, by the state or local law, etc.), the cost of furnishing such uniforms and maintaining (by laundering or dry cleaning) such uniforms is an expense that may not be borne by anEmployee where such cost reduces the hourly rate below that required by the wage determination. The Department of Labor will accept payment in accordance with the following standards as compliance:The contractor or subcontractor is required to furnish all employees with an adequate number of uniforms without cost or to reimburse employees for the actual cost of the uniforms. In addition, where uniform cleaning and maintenance is made the responsibility of the employee, all contractors and subcontractors subject to this wage determination shall (in the absence of a bona fide collective bargaining agreement providing for a different amount, or the furnishing of contrary affirmative proof as to the actual cost), reimburse all employees for such cleaning and maintenance at a rate of $3.35 per week (or $.67 cents per day). However, in those instances where the uniforms furnished are made of "wash and wear"materials, may be routinely washed and dried with other personal garments, and do not require any special treatment such as dry cleaning, daily washing, or commercial laundering in order to meet the cleanliness or appearance standards set by the terms of the Government contract, by the contractor, by law, or by the nature of the work, there is no requirement that employees be reimbursed for uniform maintenance costs.The duties of employees under job titles listed are those described in the "Service Contract Act Directory of Occupations", Fifth Edition, April 2006, unless otherwise indicated. Copies of the Directory are available on the Internet. A links to the Directory may be found on the WHD home page at or through the Wage Determinations On-Line (WDOL) Web site at FOR AUTHORIZATION OF ADDITIONAL CLASSIFICATION AND WAGE RATE {Standard Form 1444 (SF 1444)}Conformance Process:The contracting officer shall require that any class of service employee which is not listed herein and which is to be employed under the contract (i.e., the work to be performed is not performed by any classification listed in the wage determination), be classified by the contractor so as to provide a reasonable relationship (i.e., appropriate level of skill comparison) between such unlisted classifications and the classifications listed in the wage determination. Such conformed classes of employees shall be paid the monetary wages and furnished the fringe benefits as are determined. Such conforming process shall be initiated by the contractor prior to the performance of contract work by such unlisted class(es)of employees. The conformed classification, wage rate, and/or fringe benefits shall be retroactive to the commencement date of the contract. {See Section 4.6 (C)(vi)} When multiple wage determinations are included in a contract, a separate SF 1444 should be prepared for each wage determination to which a class(es) is to be conformed.The process for preparing a conformance request is as follows:1) When preparing the bid, the contractor identifies the need for a conformed occupation(s) and computes a proposed rate(s).2) After contract award, the contractor prepares a written report listing in order proposed classification title(s), a Federal grade equivalency (FGE) for each proposed classification(s), job description(s), and rationale for proposed wage rate(s), including information regarding the agreement or disagreement of the authorized representative of the employees involved, or where there is no authorized representative, the employees themselves. This report should be submitted to the contracting officer no later than 30 days after such unlisted class(es) of employees performs any contract work.3) The contracting officer reviews the proposed action and promptly submits a report of the action, together with the agency's recommendations and pertinent information including the position of the contractor and the employees, to the Wage and Hour Division, Employment Standards Administration, U.S. Department of Labor, for review. (See section 4.6(b)(2) of Regulations 29 CFR Part 4).4) Within 30 days of receipt, the Wage and Hour Division approves, modifies, or disapproves the action via transmittal to the agency contracting officer, or notifies the contracting officer that additional time will be required to process the request.5) The contracting officer transmits the Wage and Hour decision to the contractor.6) The contractor informs the affected rmation required by the Regulations must be submitted on SF 1444 or bond paper.When preparing a conformance request, the "Service Contract Act Directory of Occupations" (the Directory) should be used to compare job definitions to insure that duties requested are not performed by a classification already listed in the wage determination. Remember, it is not the job title, but the required tasks that determine whether a class is included in an established wage determination. Conformances may not be used to artificially split, combine, or subdivide classifications listed in the wage determination.Attachment M Enrollment Priority GroupsFact Sheet 164-2June 2010Priority Definition1? Veterans with VA-rated service-connected disabilities 50% or more disabling? Veterans determined by VA to be unemployable due to service-connected conditions2 ? Veterans with VA-rated service-connected disabilities 30% or 40% disabling3? Veterans who are Former Prisoners of War (POWs)? Veterans awarded a Purple Heart medal? Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty? Veterans with VA-rated service-connected disabilities 10% or 20% disabling? Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation”? Veterans awarded the Medal Of Honor (MOH)4? Veterans who are receiving aid and attendance or housebound benefits from VA? Veterans who have been determined by VA to be catastrophically disabled5? Nonservice-connected veterans and non-compensable service-connected veterans rated 0% disabled by VA with annual income and/or net worth below the VA national income threshold and geographically-adjusted income threshold for their resident location? Veterans receiving VA pension benefits? Veterans eligible for Medicaid programs6? World War I veterans? Compensable 0% service-connected veterans? Veterans exposed to Ionizing Radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki? Project 112/SHAD participants? Veterans exposed to the defoliant Agent Orange while serving in the Republic of Vietnam between 1962 and 1975? Veterans of the Persian Gulf War that served between August 2, 1990 and November 11, 1998? Veterans who served in a theater of combat operations after November 11, 1998 as follows:Currently enrolled Veterans and new enrollees who were discharged from active duty on or after January 28, 2003, are eligible for the enhanced benefits for 5 years post dischargeVeterans discharged from active duty before January 28, 2003, who apply for enrollment on or after January 28, 2008 are eligible for this enhanced enrollment benefit through January 27, 2011Note: At the end of this enhanced enrollment priority group placement time period Veterans will be assigned to the highest Priority Group their unique eligibility status at that time qualifies for.7? Veterans with gross household income below the geographically-adjusted income threshold (GMT) for their resident location and who agree to pay copays.8? Veterans with gross household income above the VA national income threshold and the geographically-adjusted income threshold for their resident location and who agrees to pay copaysVeterans eligible for enrollment: Non-compensable 0% service-connected and:Sub-priority a: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub-priority due to changed eligibility statusSub-priority b: Enrolled on or after June 15, 2009 whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or lessVeterans eligible for enrollment: Nonservice-connected and:Sub-priority c: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub-priority due to changed eligibility statusSub-priority d: Enrolled on or after June 15, 2009 whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or lessVeterans not eligible for enrollment: Veterans not meeting the criteria above:Sub-priority e: Non-compensable 0% service-connectedSub-priority g: Non-service-connectedTITILE: CBOC Specimen Processing & ShippingAttachment N (EXAMPLE)I. Purpose:To establish guidelines for the appropriate processing and shipping of patient specimens from the Community Based Clinics to the NMVAHCS Laboratory. Proper collection, handling, and transporting of specimens are fundamental to the quality of specimens for analytical testing in the laboratory. The transportation of specimens requires compliance with Federal transportation regulations.II. Safety:Practice Universal Precautions. Follow all facility Infection Control procedures to prevent exposure to blood borne pathogens.Discard all blood collection sharps in biohazard waste containers approved for sharps disposal.Transferring a sample collected using a syringe to a tube is not recommended. Additional manipulation of sharps increases the potential for needle stick injury.III. Procedure:Review and Print Lab OrdersRefer to the Lab Test Information in CPRS for specimen requirements, completion times, and process accordingly.Print the lab orders to be collected from CPRS.The printed orders specify the appropriate specimen type for collection.Not all tests can be shipped due to specimen stability limitations. Contact Pathology & Laboratory Medicine service 7 days/week, 24 hours/day at ext. 2383 for clarification on collection instructions.Serum and Plasma SpecimensSpecimen CollectionPatient IdentificationIdentify the patient using two identifiers prior to collectionFull name, birth date, and SSN are acceptable identifiersWhenever possible, have the patient state his identifiers: “Please tell me your date of birth.” - do not ask, “Is your birthday May 7th?” Collect sample according to the procedure described in POC.0053“CBOC Venipuncture Procedure”.Allow tubes to fill until the vacuum is exhausted to ensure the proper blood-to-additive ratio. Overfilling or under filling of tubes will result in an incorrect blood-to-additive ratio and may lead to incorrect analytical results.Specimen LabelingLabel collection tubes in the presence of the patient.Label with the patient’s full name, full SSN, date and collector’s initials.CentrifugationAllow blood Vacutainer tubes for Serum to clot thoroughly before centrifugation. BD recommends:Tube Minimum Clotting TimeRed Top (no gel separator)60 minutesMarble Top (BD SST)30 minutesNote: Patients with abnormal clotting times due to disease or anticoagulant therapy require more time for complete clot formation. Separation of serum from cells should take place within 1 hours of collection.Tubes for Plasma (e.g., green top Lithium Heparin gel-separator tube) do not need to sit for any period of time prior to centrifugation as these tubes are not intended to clot.Balance tubes in the centrifuge. Match tubes of the same fill level and ensure that tubes are properly seated.Centrifuge gel tubes at 1100 – 1300 RCF (g) for 15 minutes if using a fixed angle centrifuge or 10 minutes if using a swing rotor centrifuge. All non-gel tubes at less than or equal to 1300 RCF (g) for 10 minutes.Allow centrifuge to come to a complete stop before attempting to remove tubes. Important Note: Do not re-centrifuge gel separator tubes. Aspirate serum or plasma from the tube and place in a clean test tube to re-centrifuge.Transfer Sample to Transport TubeCarefully remove tube stoppers to prevent aerosolization, gauze or a stopper removal device may be used.Transfer serum or plasma to a plastic transport tube using a polyethylene transfer pipette.Securely fix lid on transport tube to prevent leakage.Label all tubes with the patient’s full name, full social security number, date and initials of collector.Mark all tubes containing Plasma with a green marker on the lid and label.Refrigerate samples until just prior to packing the shipping box.Urine SamplesRandom Urine Collections:Instruct the patient to collect the urine into a labeled (full name & full SSN) specimen cup.Transfer the urine to the appropriate transport tube using a polyethylene transfer pipette or BD urine transfer device (straw).Ship urine samples in the appropriate preservative transport tube:Urinalysis: UA Transport tubeUrine Culture & Sensitivity (C&S): Urine C&S TubeMicroalbumin: No preservative is required, but it is advised to ship in the BD No Additive (Z) tube.Urine Tox Screen: No preservative required. Label tubes with the patient’s full name, full social security number, and date of collection. Refrigerate all urine samples until just prior to packing the shipping box.24-Hour Urine CollectionsNo preservative is required for most 24-Hour collections.Write the Total Volume (in mLs) of the collection on the printed test orders.Pour off a portion (30-40 mLs) into a transport tube labeled with:Patient’s full nameFull SSNTotal Volume of the 24-hour collection.Discard the remainder of the sample. Do not send the entire 24-hour collection container to the NMVAHCS Lab.Other SamplesLavender top tubes for CBC, Retic, Hemoglobin A1C, and Folate are not to be centrifuged.Carefully seal specimen cups in re-closeable biohazard bags along with an absorbent pad, such as a paper towel. (Thin Prep Pap, Cytology and Histology, etc.).Packing Samples for ShipmentShip all Serum, Plasma, Urine and Lavender top tubes with ice packs unless otherwise indicated in VistA,Packing the Shipping BoxPlace the tubes in a biohazard-labeled plastic bag along with an absorbent pad. Carefully seal the bag.Next, place the samples in a pressure-tested leak proof canister.Line the bottom of a Styrofoam-lined shipping container with ice packs. Place the canisters in the box.Place the accompanying printed orders in the box, separate from the tubes. Complete a Shipping Manifest for the box. The manifest should exactly match the contents of the box. Do not indicate any samples on the manifest that will not be shipped.Place the manifest in the box, separate from the specimens.Seal the box and apply appropriate labels. A label reading “UN3373 Biological Substance Category B” should be clearly visible indicating that the box contains samples for diagnostic testing. Complete the courier’s waybill according to the courier’s instructions.Email the tracking information to the NMVAHCS Laboratory.IV. Laboratory ContactsContact Pathology & Laboratory Medicine service 7 days/week, 24 hours/day at ext. 2383 for clarification on collection instructions.Additionally, the Ancillary Testing Department is available to answer any questions on collection, processing or shipping of specimens Monday through Friday 7:00am to 4:00pm at ext. 5087.V. References:“BD Vacutainer Evacuated Blood Collection System”, Becton Dickinson Co, Franklin Lakes, NJ, 07417, 2010.IATA Dangerous Goods Regulations, Packing Instruction 650, 52nd EDITION, 01/02/2011GOVERNMENT FURNISHED EQUIPMENT LISTATTACHMENT OThe Contractor shall have the knowledge and skill necessary to utilize Government Furnished equipment to perform these services as necessary to carry out the requirements as described in the solicitation as follows: 22 desktop computers with VISTA access2 printers2 routers2 computer cages2 Tandberg Units for TeleHealthATTACHEMNT P Computer Access Request FormRequest and Authorization for Computer Access To Albuquerque VAHCS AISTHIS INFORMATION IS TO BE FURNISHED BY THE APPLICANT(PLEASE PRINT LEGIBLY) 2) FIRST NAME3) MIDDLE INITIAL4) SEXMaleFemale5) SERVICE / POSITION6) DOB7) MAIL CODE8) WORK PHONE #9) LICENSING / CREDENTIALING10) SSN11) SPECIALIZATIONPatient Care Providers Only:12) National Provider ID (NPI):13) User Class: VA Code - VTO BE COMPLETED BY ADPAC, SERVICE CHIEF, OR SUPERVISOR (PLEASE PRINT LEGIBLY)ACCESSIBILITY TO THE FOLLOWING SYSTEMS:TYPE OF EMPLOYMENT: (check one) VA EmployeeResearch AssociateContractorResident/Student/InternPGY Level __INETWORKVISTAEXCHANGE (e-mail) PKI EncryptionINTERNETOtherTemporary/Consultant OtherTermination Date:Primary Menu Option: _18) Primary Menu Security Key___19) File Manager Access Level: _______ 20) Secondary Menu Options and Security Keys:MenuOptionsSecurity KeyADPAC SignatureJustification for Access Request:REQUIRED SIGNATURE BY THE APPLICANT’S SECTION SUPERVISOR OR SERVICE CHIEF:Requesting Official Printed Name: FORWARD TO THE INFORMATIONRequesting Official Signature: SECURITY OFFICERTelephone/Ext:ISO Signature and Date: ConcurDo Not ConcurApproval, Facility CIO:Date of Information Security Training:Access Agreement on File:YES NONotes: ATTACHMENT QVA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY LANGUAGE FORINCLUSION INTO CONTRACTS, AS APPROPRIATE1. GENERALContractors, 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 SYSTEMSa. A contractor/sub-contractor 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 LANGUAGEa. 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 DEVELOPMENTa. 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 inAccordance 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;(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 redesign, development, or operation of a SOR on individuals that is subject to the Privacy Act; and (3) 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, hot fixes, 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 2 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 5 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 USEa. 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 vulnerability 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 toPeriodic 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, and 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 thatContain 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 preapproved 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 INVESTIGATIONa. 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 BREACHA. 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 TESTINGOn 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. TRAININGa. 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 completeU.S. Department of Veterans Affairs (VA)ATTACHMENT ROffice of Small and Disadvantaged Business Utilization (00SB)Subcontracting Plan ModelJuly 2010 In accordance with FAR 19.704, 52.219 and P.L. 109-461Prime Contractor: Address: City: State: Zipcode:Solicitation/Contract Number: Description of Requirement: Total Contract Amount (Including Option Years): $Period of Contract Performance Including Option Years (Month and Year): Activity Awarding Contract: Contracting Officer Name:Prime Contractor is:[ ] Architect-Engineer [ ] Janitorial[ ] Blood [ ] Laboratory Testing Services[ ] Bulk Oxygen Services [ ] Laundry and Linen Services[ ] Clinical Diagnostic Equipment[ ] Medical Equipment[ ] Community Based Outpatient Clinic [ ] Medical Equipment and Supplies[ ] Construction [ ] Medical Equipment and Supplies[ ] Consulting Services and Pharmaceuticals[ ] Dental Equipment[ ] Medical Gas and Medical Bulk[ ] Dental Equipment and Supplies Oxygen[ ] Dental Supplies[ ] Medical Healthcare Services[ ] Diagnostic Imaging Equipment and Supplies[ ] Medical Surgical Prime Vendor[ ] Diagnostic X-Ray and Related Systems and Equipment[ ] Niche Markers Including Installation[ ] Pharmaceuticals[ ] Dietary Supplements[ ] Pharmaceutical and Cost Per Test[ ] Digital Hearing Aids and Batteries[ ] Prosthetics[ ] Elevator Maintenance[ ] Publisher/Subscription Services[ ] External Peer Review [ ] Radiation Therapy Systems[ ] Healthcare Staffing[ ] Real Estate[ ] Home Healthcare Services[ ] Studies[ ] Home Medical Equipment[ ] Support Services[ ] Home Oxygen[ ] Telephone System Hardware/[ ] Information Technology Software Maintenance[ ] InVitro Diagnostics Reagents[ ] Transportation[ ] InVitro Diagnostics Substances Reagents, Test Kits and[ ] Other (Not Checked) Blood Laboratory ___________________________Prime Contractor (Please check if you are):[ ] Manufacturer[ ] Distributor[ ] Manufacturer/DistributorType of Plan (Check One)___Commercial Plan - means a subcontracting plan (including goals) that covers the offeror’s fiscal year and that applies to the entire production of commercial items sold by either the entire company or a portion thereof (e.g., division, plant, or product line).(Represents ______% of Total Annual Sales)____Individual Plan - means a subcontracting plan that covers the entire contract period (including option periods), applies to a specific contract, and has goals that are based on the offeror’s planned subcontracting in support of the specific contract, except that indirect costs incurred for common or joint purposes may be allocated on a prorated basis to the contract.1 - 2.GOALS - Please state separate dollar and percentage goals for Small Business (including Alaska Native Corporation’s (ANCs)); Service-Disabled Veteran-Owned Small Business, Veteran-Owned Small Business; Small Disadvantaged, Women-Owned, and Historically Underutilized Business Zone (HUBZone) Small Business Concerns. NOTE: VA’s required percentage goals are shown below. “Zero” percent value for goals or “N/A” are unacceptable. Goals and percentages must be rounded to the nearst dollar and tenth of a percent. Example of how to calculate the goals:DOLLARSPERCENTTotal Contract Price$1,500,000Total to be Subcontracted1,000,000100%Subcontract to Small Business (including Alaska Native Corporations (ANC) and Indian tribes)177,00017.7%Subcontract to Service Disabled Veteran-Owned Small Business30,0003.0%Subcontract to Veteran-Owned Small Business50,0005.0%Small Disadvantaged Business (including ANC and Indian tribes)50,0005.0%Women-Owned Small Business50,0005.0%Subcontract to HUBZone Small Businesses30,0003.0%If percentage goals below are lower than example above, please submit justification as to why.Please enter the information listed below:Total dollars to be subcontracted:$____________________________ Total dollars to be subcontracted to Small Business (SB) (including Alaska Native Corporation’s (ANCs) and Indian tribes):$_______________ ______%Total dollars to be subcontracted to Service-Disabled Veteran-Owned Small Business (SDVOSB) – P.L. 109-461 signed by the President December 22, 2006. Goal shall not be less than 3.0%. $_______________ ______%Total dollars to be subcontracted to Veteran-Owned Small Business (VOSB) – P.L. 109-461 signed by the President December 22, 2006. Goal shall not be less than the 7.0% as mandated by the Secretary, Department of Veterans Affairs: $_______________ ______%Total dollars to be subcontracted to Small Disadvantaged Business (SDB) (including Alaska Native Corporation’s (ANCs) and Indian tribes): $_______________ ______%Total dollars to be subcontracted to Women-Owned Small Business (WOSB): $_______________ ______%Total dollars to be subcontracted to HUBZone Small Business Concerns: $_______________ ______%Total dollars to be subcontracted to Large Business: $_______________ ______%3.Provide a description of the principal types of supplies and services to be subcontracted under this contract, and an identification of the types planned for subcontracting to small (including ANCs and Indian tribes), service-disabled veteran-owned and veteran-owned small business concerns), small disadvantaged (including ANCs and Indian tribes), women-owned, HUBZone.You must identify the products/services to be subcontracted in each category. (Example: office supplies, maintenance and repair)Products/ServicesLarge BusinessSmall businessSmall disadvantaged businessWomen-Owned Small businessHUBZone Small businessService-Disabled Veteran-Owned Small Business (sdvosb) – in accordance with P.L. 109-461, signed by the President December 22, 2006, please list the name, address, and telephone number for each service-disabled and veteran-owned small business concerns as follows. Please ensure that the service-disabled veteran-owned small business concerns are registered in the Central Contractor’s Registry and the Vendor Information Pages . If more than one, please utilize the format listed below to indicate additional service-disabled veteran-owned small business:Name of SDVOSB:Address:City/State/Zipcode:Email address of point of contact:Telephone: FAX: Veteran-Owned Small Business (vosb) - In accordance with P.L. 109-461, signed by President December 22, 3006, please list the name, address, and telephone number for each veteran-owned small business concerns as follows. Please ensure that the veteran-owned small business concerns are registered in the Central Contractor’s Registry and the Vendor Information Pages .. If more than one, please utilize the format listed below to indicate additional veteran-owned small business:Name of VOSB:Address:City/State/Zipcode:Email address of point of contact:Telephone: FAX: In accordance with P.L. 109-461, verification process is mandated to certify that the service-disabled and veteran-owned small business concerns listed for subcontracting opportunities do have a subcontract with you as the prime contractor.This information will be a report to the Department of Veterans Affairs, Office of Small and Disadvantaged Business Utilization (00SB) on a quarterly basis, (form attached) for the service-disabled and veteran-owned small business concerns to report.4.A description of the method used to develop the subcontracting goals. 5. A description of the method used to identify potential sources for solicitation purposes (e.g., existing company source lists, the Central Contractor Registration database (CCR), veterans service organizations, the National Minority Purchasing Council Vendor Information Service, the Research and Information Division of the Minority Business Development Agency in the U.S. Department of Commerce, or small, HUBZone, small disadvantaged and women-owned small business trade associations). A firm may rely on the information contained in CCR as an accurate representation of a concern’s size and ownership characteristics for the purposes of maintaining a small, veteran-owned small, service-disabled veteran-owned small, HUBZone small, small disadvantaged, and women-owned small business source list. Use of CCR as its source list does not relieve a firm of its responsibilities (e.g., outreach, assistance, counseling, or publicizing subcontracting opportunities)NOTE: VA expects contractors to advertise subcontracting opportunities at: . Contractors should also search the Vendor Information Pages (VIP) Database at the web portal ), to ensure maximum practicable consideration in subcontracting with Veteran-Owned and Service-Disabled Veteran-Owned Small Businesses. 6. A statement as to whether or not the offeror included indirect costs in establishing subcontracting goals, and a description of the method used to determine the proportionate share of indirect costs to be incurred with small business (including ANC and Indian tribes); service-disabled veteran-owned small business; veteran-owned small business; small disadvantaged business concern (including ANC and Indian tribes); women-owned small business, and HUBZone small business concerns.[ ] Yes[ ] No7.Name of the individual employed by the offeror who will administer the offeror’s subcontracting program and a description of the duties of the individual.SUBCONTRACTING PLAN ADMINISTRATORNAME:TITLE:ADDRESS:CITY: STATE: ZIPCODE: TELEPHONE: FAX NUMBER:E-MAIL: DUTIES: List duties and responsibilities of the Plan Administrator and a statement of the extent and scope of the Plan Administrator’s authority in subcontracting source selections: Attach duties of the Subcontracting Plan Administrator8. A description of the efforts the offeror will make to assure that small business, service-disabled veteran-owned small business; veteran-owned small business, small disadvantaged business, women-owned small business and HUBZone small business concerns have an equitable opportunity to compete for subcontracts.9. Assurances that the offeror will include the clause of this contract entitled “Utilization of Small Business Concerns” in all subcontracts that offer further subcontracting opportunities, and that the offeror will require all subcontractors (except small business concerns) that receive subcontracts in excess of $550,000 ($1,000,000 for construction) to adopt a subcontracting plan that complies with the requirements of this clause.[ ] Yes[ ] No10. Assurances that the offeror will—(i) cooperate in any studies or surveys as may be required; (ii) Submit periodic reports so that the Government can determine the extent of compliance by the offeror with the subcontracting plan; Submit the Subcontracting Report for Individual Contracts (ISR) and/or the Summary Subcontract Report (SSR), in accordance using the Electronic Subcontracting Reporting System (eSRS) at following the instruction in the eSRS;Ensure that its subcontractors with subcontracting plans agree to submit the ISR and/or the SSR using eSRS; (v) Provide its prime contract number, its DUNS number, and the e-mail address of the Government or Contractor official responsible for acknowledging or rejecting the reports, to all first-tier subcontractors with subcontracting plans so they can enter this information into the eSRS when submitting their reports; and Require that each subcontractor with a subcontracting plan provide the prime contract number, its own DUNS number, and the e-mail address of the Government or Contractor official responsible for acknowledging or rejecting the reports, to its subcontractors with subcontracting plans. [ ] Yes[ ] NoNOTE:When entering your subcontracting information, you must include the email address of the following individuals whom will be reviewing the Subcontracting Report for Individual Contracts ISR 294, as well as, SSR 295 “Summary Subcontracting Report”.Reporting Agency (Veterans Affairs, Department of (3600)Please enter the contracting officer’s email address: ____________________________________11. A description of the types of records that will be maintained concerning procedures that have been adopted to comply with the requirements and goals in the plan, includingestablishing source lists; and a description of the offeror’s efforts to locate small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns and award subcontracts to them. The records shall include at least the following (on a plant-wide or company-wide basis, unless otherwise indicated): (i) Source lists (e.g., CCR, Vendor Information Pages (VIP) Database at the web portal (), to ensure maximum practicable consideration of Veteran-Owned and Service-Disabled Veteran-Owned Small Businesses:), guides, and other data that identify small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns. (ii) Organizations contacted in an attempt to locate sources that are small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, or women-owned small business concerns. (iii) Records on each subcontract solicitation resulting in an award of more than $100,000, indicating:(A) Whether small business concerns were solicited and, if not, why not;(B) Whether veteran-owned small business concerns were solicited and, if not, why not; (C) Whether service-disabled veteran-owned small business concerns were solicited and, if not, why not; (D) Whether HUBZone small business concerns were solicited and, if not, why not;(E) Whether small disadvantaged business concerns were solicited and, if not, why not;(F) Whether women-owned small business concerns were solicited and, if not, why not; and (G) If applicable, the reason award was not made to a small business concern. (iv) Records of any outreach efforts to contact:(A) Trade associations;(B) Business development organizations;(C) Conferences and trade fairs to locate small, HUBZone small, small disadvantaged, and women-owned small business sources; and (D) Veterans service organizations. (v) Records of internal guidance and encouragement provided to buyers through:Workshops, seminars, training, etc.; Monitoring performance to evaluate compliance with the program’s requirements.(vi) On a contract-by-contract basis, records to support award data submitted by the offeror to the Government, including the name, address, and business size of each subcontractor.(vii) Contractors having commercial plans need not comply with this requirement. (e) In order to effectively implement this plan to the extent consistent with efficient contract performance, the Contractor shall perform the following functions:(1) Assist small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns by arranging solicitations, time for the preparation of bids, quantities, specifications, and delivery schedules so as to facilitate the participation by such concerns. Where the Contractor’s lists of potential small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business subcontractors are excessively long, reasonable effort shall be made to give all such small business concerns an opportunity to compete over a period of time. (2) Provide adequate and timely consideration of the potentialities of small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns in all “make-or-buy” decisions. (3) Counsel and discuss subcontracting opportunities with representatives of small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business firms. (4) Confirm that a subcontractor representing itself as a HUBZone small business concern is identified as a certified HUBZone small business concern by accessing the Central Contractor Registration (CCR) database or by contacting SBA. (5) Provide notice to subcontractors concerning penalties and remedies for misrepresentations of business status as small, veteran-owned small business, HUBZone small, small disadvantaged, or women-owned small business for the purpose of obtaining a subcontract that is to be included as part or all of a goal contained in the Contractor’s subcontracting plan.SIGNATURES REQUIREDPRIME CONTRACTOR: _____________________________DATE: ______________PRINT/TYPE NAME: TITLE: DATE: EMAIL: CONTRACTING OFFICER NAME WHOAPPROVED BY: __________________________________DATE: _________TYPE NAME: TITLE: EMAIL: For Commercial Plans OnlyEffective period of this subcontracting plan is:______________________________________thru__________________________CONTRACTING OFFICER NAME WHOAPPROVED BY: __________________________________DATE: _________TYPE NAME: TITLE: EMAIL: PAST PERFORMANCESUBCONTRACTING ACCOMPLISHMENTS PRIOR YEAR PRIOR YEAR GOALS ACCOMPLISHMENTSTOTAL SUBCONTRACTING $______________$__________________SMALL BUSINESS $______________$__________________PERCENT______________% __________________%SMALL DISADVANTAGED $______________$__________________PERCENT ______________% __________________%WOMEN-OWNED SMALL BUSINESS$______________$__________________PERCENT______________% __________________%HUBZONE SMALL BUSINESS $ ______________$__________________PERCENT______________% __________________%SERVICE-DISABLED VETERAN-OWNED$______________$__________________PERCENT ______________% __________________%VETERAN-OWNED $______________$__________________PERCENT______________% __________________%CERTIFY THAT THE ABOVE SUBCONTRACTING ACCOMPLISHMENTS ARE ACCURATE AND WAS ALSO ENTERED IN THE ELECTRONIC SUBCONTRACTING REPORTING SYSTEM (eSRS) FOR REPORT PERIOD:YEAR: ___________________[ ] YES[ ] NOPAST PERFORMANCE REFERENCESATTACHMENT SREFERENCE #1POC Name: _______________________________________________________________Title: _____________________________________________________________________Agency Address: ___________________________________________________________ ___________________________________________________________Phone Number: ____________________________________________________________Email address: _____________________________________________________________Contract Title: ______________________________________________________________Contract No: _______________________________________________________________Contract POP: ______________________________________________________________Contract Value: _____________________________________________________________Relevant Work Description: ____________________________________________________ ____________________________________________________ ____________________________________________________REFERENCE #2POC Name: _______________________________________________________________Title: _____________________________________________________________________Agency Address: ___________________________________________________________ ___________________________________________________________Phone Number: ____________________________________________________________Email address: _____________________________________________________________Contract Title: ______________________________________________________________Contract No: _______________________________________________________________Contract POP: ______________________________________________________________Contract Value: _____________________________________________________________Relevant Work Description: ____________________________________________________ ____________________________________________________ ____________________________________________________REFERENCE #3POC Name: _______________________________________________________________Title: _____________________________________________________________________Agency Address: ___________________________________________________________ ___________________________________________________________Phone Number: ____________________________________________________________Email address: _____________________________________________________________Contract Title: ______________________________________________________________Contract No: _______________________________________________________________Contract POP: ______________________________________________________________Contract Value: _____________________________________________________________Relevant Work Description: ____________________________________________________ ____________________________________________________ ____________________________________________________Provide verified, up-to-date contact information.PRESENT/PAST PERFORMANCE QUESTIONNAIRECONTRACTOR PERFORMANCE REPORTService(s) provided to you by the contractor: (please check all that apply)Information Engineering (Development & Data Management)External Application IntegrationTransition PlanningOther (please specify in space below)Has the Offeror worked for you in the last 3-year period?YESNOContractor performed as the _____ Prime, _______Sub-Contractor, _____ Key PersonnelContractor Number: ___________________________________________________________________Contract Value: ______________________________________________________________________Contract Award Period: ____________________ to ______________________Contractor Name: __________________________Contractor Address: ________________________Reference Name: ________________________________Submitted for: ____________________Reference Telephone #: ___________________________Reference Activity: ________________________________Description: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Ratings: Please summarize the contractor’s performance and circle in the column on the right the letter that corresponds to the performance rating for each rating category Assign each area a rating of E (Exceptional), A (Acceptable), or U (Unacceptable)Factors RatedKey QuestionsComments: (continue on additional sheets if desired)RatingPerformance/ Quality:1. How would you rate the contractor’s conformance with contract quality standards? EAU2. Were there sufficient internal quality control or review systems in place from the onset of the contract?EAUPersonnel:3. Did the contractor provide an appropriate labor mix including experienced key personnel?EAU4. How would you rate your level of satisfaction with the effectiveness of their performance?EAUTechnical Performance5. How would you rate ability to provide the full range of services covered under their contract?EAU6. How would you rate the contractor’s ability to monitor quality, appropriateness of care, access, and patient satisfactionEAU7. How would you rate the contractor’s ability maintain up-to-date medical records in a computerized Record Tracking package EAUOverall Satisfaction:8. How would you rate the likelihood that you would use the contractor again, and why?EAUATTACHMENT TBUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF VETERANS AFFAIRS VETERANS HEALTH ADMINISTRATION AND Purpose. The purpose of this Business Associate Agreement (Agreement) is to establish requirements for the Department of Veterans Affairs (VA) Veterans Health Administration (VHA) and in accordance with the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH) Act, and the HIPAA Privacy, Security, Breach Notification, and Enforcement Rules (“HIPAA Rules”), 45 C.F.R. Parts 160 and 164, for the Use and Disclosure of Protected Health Information (PHI) under the terms and conditions specified below.Scope. Under this Agreement and other applicable contracts or agreements, will provide services to, for, or on behalf of VHA.In order for to provide such services, VHA will disclose Protected Health Information to and will use or disclose Protected Health Information in accordance with this Agreement.Definitions. Unless otherwise provided, the following terms used in this Agreement have the same meaning as defined by the HIPAA Rules: Breach, Data Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices, Protected Health Information (PHI), Required by Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health Information, and Use.“Business Associate” shall have the same meaning as described at 45 C.F.R. § 160.103. For the purposes of this Agreement, Business Associate shall refer to , including its employees, officers, or any other agents that create, receive, maintain, or transmit PHI as described below.“Covered Entity” shall have the same meaning as the term is defined at 45 C.F.R. § 160.103. For the purposes of this Agreement, Covered Entity shall refer to VHA.“Protected Health Information” or “PHI” shall have the same meaning as described at 45 C.F.R. § 160.103. “Protected Health Information” and “PHI” as used in this Agreement include “Electronic Protected Health Information” and “EPHI.” For the purposes of this Agreement and unless otherwise provided, the term shall also refer to PHI that Business Associate creates, receives, maintains, or transmits on behalf of Covered Entity or receives from Covered Entity or another Business Associate.“Subcontractor” shall have the same meaning as the term is defined at 45 C.F.R. § 160.103. For the purposes of this Agreement, Subcontractor shall refer to a contractor of any person or entity, other than Covered Entity, that creates, receives, maintains, or transmits PHI under the terms of this Agreement.Terms and Conditions. Covered Entity and Business Associate agree as follows:1. Ownership of PHI. PHI is and remains the property of Covered Entity as long as Business Associate creates, receives, maintains, or transmits PHI, regardless of whether a compliant Business Associate agreement is in place. 2. Use and Disclosure of PHI by Business Associate. Unless otherwise provided, Business Associate: A. May not use or disclose PHI other than as permitted or required by this Agreement, or in a manner that would violate the HIPAA Privacy Rule if done by Covered Entity, except that it may use or disclose PHI: (1) As required by law or to carry out its legal responsibilities; (2) For the proper management and administration of Business Associate; or (3) To provide Data Aggregation services relating to the health care operations of Covered Entity. B. Must use or disclose PHI in a manner that complies with Covered Entity’s minimum necessary policies and procedures. C. May de-identify PHI created or received by Business Associate under this Agreement at the request of the Covered Entity, provided that the de-identification conforms to the requirements of the HIPAA Privacy Rule.3. Obligations of Business Associate. In connection with any Use or Disclosure of PHI, Business Associate must: A. Consult with Covered Entity before using or disclosing PHI whenever Business Associate is uncertain whether the Use or Disclosure is authorized under this Agreement. B. Implement appropriate administrative, physical, and technical safeguards and controls to protect PHI and document applicable policies and procedures to prevent any Use or Disclosure of PHI other than as provided by this Agreement. C. Provide satisfactory assurances that PHI created or received by Business Associate under this Agreement is protected to the greatest extent feasible. D. Notify Covered Entity within twenty-four (24) hours of Business Associate’s discovery of any potential access, acquisition, use, disclosure, modification, or destruction of either secured or unsecured PHI in violation of this Agreement, including any Breach of PHI. (1) Any incident as described above will be treated as discovered as of the first day on which such event is known to Business Associate or, by exercising reasonable diligence, would have been known to Business Associate. (2) Notification shall be sent to the Director, Health Information Governance, by email to VHABAAIssues@. (3) Business Associate shall not notify individuals or HHS directly unless Business Associate is not acting as an agent of Covered Entity but in its capacity as a Covered Entity itself. E. Provide a written report to Covered Entity of any potential access, acquisition, use, disclosure, modification, or destruction of either secured or unsecured PHI in violation of this Agreement, including any Breach of PHI, within ten (10) business days of the initial notification. (1) The written report of an incident as described above will document the following: (a) The identity of each Individual whose PHI has been, or is reasonably believed by Business Associate to have been, accessed, acquired, used, disclosed, modified, or destroyed; (b) A description of what occurred, including the date of the incident and the date of the discovery of the incident (if known); (c) A description of the types of secured or unsecured PHI that was involved; (d) A description of what is being done to investigate the incident, to mitigate further harm to Individuals, and to protect against future incidents; and (e) Any other information as required by 45 C.F.R. §§ 164.404(c) and 164.410. (2) The written report shall be addressed to:Director, Health Information GovernanceDepartment of Veterans Affairs – Veterans Health AdministrationOffice of Informatics and Analytics (10P)810 Vermont Avenue NWWashington, DC 20420and submitted by email at VHABAAIssues@ F. To the greatest extent feasible, mitigate any harm due to a Use or Disclosure of PHI by Business Associate in violation of this Agreement that is known or, by exercising reasonable diligence, should have been known to Business Associate. G. Use only contractors and Subcontractors that are physically located within a jurisdiction subject to the laws of the United States, and ensure that no contractor or Subcontractor maintains, processes, uses, or discloses PHI in any way that will remove the information from such jurisdiction. Any modification to this provision must be approved by Covered Entity in advance and in writing. H. Enter into Business Associate Agreements with contractors and Subcontractors as appropriate under the HIPAA Rules and this Agreement. Business Associate: (1) Must ensure that the terms of any Agreement between Business Associate and a contractor or Subcontractor are at least as restrictive as Business Associate Agreement between Business Associate and Covered Entity. (2) Must ensure that contractors and Subcontractors agree to the same restrictions and conditions that apply to Business Associate and obtain satisfactory written assurances from them that they agree to those restrictions and conditions. (3) May not amend any terms of such Agreement without Covered Entity’s prior written approval. I. Within five (5) business days of a written request from Covered Entity: (1) Make available information for Covered Entity to respond to an Individual’s request for access to PHI about him/her. (2) Make available information for Covered Entity to respond to an Individual’s request for amendment of PHI about him/her and, as determined by and under the direction of Covered Entity, incorporate any amendment to the PHI. (3) Make available PHI for Covered Entity to respond to an Individual’s request for an accounting of Disclosures of PHI about him/her. J. Business Associate may not take any action concerning an individual’s request for access, amendment, or accounting other than as instructed by Covered Entity. K. To the extent Business Associate is required to carry out Covered Entity's obligations under Subpart E of 45 CFR Part 164, comply with the provisions that apply to Covered Entity in the performance of such obligations. L. Provide to the Secretary of Health and Human Services and to Covered Entity records related to Use or Disclosure of PHI, including its policies, procedures, and practices, for the purpose of determining Covered Entity’s, Business Associate’s, or a Subcontractor’s compliance with the HIPAA Rules. M. Upon completion or termination of the applicable contract(s) or agreement(s), return or destroy, as determined by and under the direction of Covered Entity, all PHI and other VA data created or received by Business Associate during the performance of the contract(s) or agreement(s). No such information will be retained by Business Associate unless retention is required by law or specifically permitted by Covered Entity. If return or destruction is not feasible, Business Associate shall continue to protect the PHI in accordance with the Agreement and use or disclose the information only for the purpose of making the return or destruction feasible, or as required by law or specifically permitted by Covered Entity. Business Associate shall provide written assurance that either all PHI has been returned or destroyed, or any information retained will be safeguarded and used and disclosed only as permitted under this paragraph. N. Be liable to Covered Entity for civil or criminal penalties imposed on Covered Entity, in accordance with 45 C.F.R. §§ 164.402 and 164.410, and with the HITECH Act, 42 U.S.C. §§ 17931(b), 17934(c), for any violation of the HIPAA Rules or this Agreement by Business Associate.4. Obligations of Covered Entity. Covered Entity agrees that it: A. Will not request Business Associate to make any Use or Disclosure of PHI in a manner that would not be permissible under Subpart E of 45 C.F.R. Part 164 if made by Covered Entity, except as permitted under Section 2 of this Agreement. B. Will promptly notify Business Associate in writing of any restrictions on Covered Entity’s authority to use or disclose PHI that may limit Business Associate’s Use or Disclosure of PHI or otherwise affect its ability to fulfill its obligations under this Agreement. C. Has obtained or will obtain from Individuals any authorization necessary for Business Associate to fulfill its obligations under this Agreement. D. Will promptly notify Business Associate in writing of any change in Covered Entity’s Notice of Privacy Practices, or any modification or revocation of an Individual’s authorization to use or disclose PHI, if such change or revocation may limit Business Associate’s Use and Disclosure of PHI or otherwise affect its ability to perform its obligations under this Agreement.5. Amendment. Business Associate and Covered Entity will take such action as is necessary to amend this Agreement for Covered Entity to comply with the requirements of the HIPAA Rules or other applicable law.6. Termination. A. Automatic Termination. This Agreement will automatically terminate upon completion of Business Associate’s duties under all underlying Agreements or by termination of such underlying Agreements. B. Termination Upon Review. This Agreement may be terminated by Covered Entity, at its discretion, upon review as provided by Section 9 of this Agreement. C. Termination for Cause. In the event of a material breach by Business Associate, Covered Entity: (1) Will provide an opportunity for Business Associate to cure the breach or end the violation within the time specified by Covered Entity; (2) May terminate this Agreement and underlying contract(s) if Business Associate does not cure the breach or end the violation within the time specified by Covered Entity. D. Effect of Termination. Termination of this Agreement will result in cessation of activities by Business Associate involving PHI under this Agreement. E. Survival. The obligations of Business Associate under this Section shall survive the termination of this Agreement as long as Business Associate creates, receives, maintains, or transmits PHI, regardless of whether a compliant Business Associate Agreement is in place.7. No Third Party Beneficiaries. Nothing expressed or implied in this Agreement confers any rights, remedies, obligations, or liabilities whatsoever upon any person or entity other than Covered Entity and Business Associate, including their respective successors or assigns.8. Other Applicable Law. This Agreement does not abrogate any responsibilities of the parties under any other applicable law.9. Review Date. The provisions of this Agreement will be reviewed by Covered Entity every two years from Effective Date to determine the applicability and accuracy of the Agreement based on the circumstances that exist at the time of review.10. Effective Date. This Agreement shall be effective on the last signature date below.Department of Veterans Affairs Veterans Health AdministrationBy: By: Name: Name: Title: Title: Date: Date: ATTACHEMNT UCONTRACTOR CERTIFICATIONThe 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.The Contractor agrees to obtain a similar certification from its subcontractors.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. 1001SECTION 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 90 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 pre-award 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.(End of Provision)ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS Technical Evaluation CriteriaQualityManagement, Experience, Staffing and Transition PlanGeographic LocationService Disabled Veteran Owned Small Business/Veteran Owned Small Business Participation (SDVOSB/BOSB):Price See paragraph E.2 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014).a. For additional requirements:b. The proposal should describe the past experience of the company in providing maintenance on the equipment specified in this solicitation within the past three (3) years. List three references that can validate company’s level of performance by providing company’s name, address, telephone number and point of contact.c. Transmittal Instructions:d. No price information shall be included in the technical proposal. The price proposal shall be submitted on enclosed pages marked continuation of SF 1449 and shall contain all information relative to cost and pricing.e. All transmittal envelopes shall be clearly marked with RFP VA258-14-R-175 at the lower left corner on both the technical and price proposal.f. All completed signed copies of proposals shall be delivered to the address specified on page 1, block 15, Standard Form 1449 by date and time specified.g. Offeror shall provide three (3) copies of the technical and separate cost proposals. h. Offerors shall complete and submit all attachments to be considered acceptable, failure to submit the required information would render the proposal unacceptable.NOTE: Cost proposal shall be separate from technical for evaluation purposes.ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS Provisions 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 provisions are incorporated into 52.212-1 as an addendum to this solicitation:E.2 52.212-2 EVALUATION—COMMERCIAL ITEMS (JAN 1999) (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 factors shall be used to evaluate offers:Offers will be evaluated based on the following factors listed in descending order of importance (technical sub factors are of equal importance)Technical Evaluation CriteriaQualityManagement, Experience, Staffing and Transition PlanGeographic LocationPast PerformanceService Disabled Veteran Owned Small Business/Veteran Owned Small Business Participation (SDVOSB/BOSB):Price Technical and past performance, when combined, and All evaluation factors, other than price, when combined, are significantly more important when compared to price and shall be rated in order of precedence as listed above, technical capability and past performance being rated most important, then the socioeconomic factor for SDVOSB and VOSB. EVALUATION METHODOLOGY: The evaluation of qualifying proposals shall consist of three parts.TECHNICAL PROPOSAL: The SSEB will evaluate an Offeror’s technical proposal using an adjectival rating that combines technical merit and proposal risk that most accurately defines the Offeror’s performance risk.The evaluation of each technical proposal will access and measure the ability of the offeror to provide the specified requirements outlined in the Request for Proposal (RFP). The areas of significance in their relative order of importance are:1. Quality2. Management, Experience, Staffing and Transition Plan3. Geographic locationTECHNICAL EVALUATION CRITERIAFACTOR 1 – QUALITYSub-factors 1-5 of Factor 1 are of equal importance:Provide results of latest Joint Commission accreditation including date and recommendations. If not accredited, provide evidence of a working knowledge of applicable Joint Commission regulations and ability to meet requirements. Provide date of last survey, expiration date of present accreditation, and date of next survey. Indicate any conditions to accreditation.Describe the performance measurement process that will be implemented to monitor quality, appropriateness of care, access, and patient satisfaction.Provide information on proposed quality improvement plan.Describe procedures to be implemented for accountability and safeguarding of medications provided by the Parent Facility.If contractor is not accredited by the Joint Commission, Contractor shall provide Infection Control Plan, Blood borne Pathogen Plan and Tuberculosis Control Plan.FACTOR 2 – MANAGEMENT, EXPERIENCE AND STAFFING AND TRANSITION PLANSub-factors 1-7 of Factor 2 are of equal importance:Describe methods for scheduling appointments, means of scheduling staff, and other factors to provide adequate, timely access/service for patients. Describe contingency plans for staffing clinic(s) in the event of absence of regularly scheduled staff.Describe the Offeror’s length and breadth of experience in providing healthcare.(a) Coordination and Continuity of Care: Described the ability to provide the full range of services covered under this solicitation.Described the contingency plan for computer downtime.Provide an organization chart of personnel involved in the performance of this contract. This chart shall clearly show organizational relationships, lines of authority and responsibility, as well as span of control.Describe capability and/or mechanisms to be used to begin contract performance within required time frames after contract award including staffing plan for first 90 days of clinic operation.Describe method(s) for providing Stat lab tests.Proposed Staffing: Contractors are required to certify in their proposal that the persons listed in the contractor’s proposal have been compared against the OIG list and not listed:Provide a list of the names of the qualified physicians, physician assistants, nurse practitioners, and other primary care provider staff intended to be utilized in the performance of this contract and/or describe the mechanism used to provide qualified physicians, physician assistants, nurse practitioners, and primary care provider staff to perform the contract work. Providers:Provided a list of the names of the qualified physicians and other primary care provider staff intended to be utilized in the performance of this contract and/or describe the mechanism used to provide qualified physicians and primary care provider staff to perform the contract work. Also submit a copy of licenses for all staffing.Provide copies of the following information on any physician to be assigned to this solicitation. Include physicians providing coverage relief.Curriculum Vitae Nurse Practitioners:Transcripts from an Accredited Nurse Practitioner ProgramListed the number of administrative support staff and describe the level of training and experience that will be utilized to meet the administrative support functions of this contract, including, such functions as patient scheduling, medical record documentation, record processing and reporting, grievance system and quality assurance and performance improvement.Described your organization structure and management practices relative to the requirements contained in this solicitation.Described average personnel turnover rate and how it may affect contract performance. Describe the capability to recruit adequate staffing to meet the needs of this contract.The Contractors shall have a written contingency plan for computer downtime that defines the processes in order to ensure continuity of patient care and maintenance of the integrity of the patient’s medical record during periods of loss of computer functions. The contingency plan shall include alternative internet access (high speed = 2mb or better) for VA laptops running VPN.Identified all relevant company experience in providing the same/similar types of services identified in this solicitation, including VA experience, and other government and/or private sector experience. Provide a clinical and administrative contact point for each experience episode provided.List the number of administrative support staff and describe the level of training and experience that will be utilized to meet the administrative support functions of this contract, including such functions as patient scheduling, medical record documentation, record processing and reporting.Describe average personnel turnover rate and how it might affect contract performance. Describe the capability to recruit adequate staffing to meet the needs of this contract.Transition Plan – Provide a transition plan covering a phase-in period prior to assuming responsibility under the contract. This plan should address specific steps and key milestones necessary to assume full responsibility for the management and operating activities required to become fully operational under the resulting contract. The objectives of this transition plan are to minimize the impacts on startup of operation and/or continuity of operations, identify key issues, and overcome barriers to transition. Upon award the successful Offeror is responsible for performing due diligence to ensure that all the transition activities are completed and that they are prepared to assume full operational responsibility.FACTOR 3 - GEOGRAPHIC LOCATIONSub-factors 1-7 of Factor 3 are of equal importance:Proposed contractor’s facility must be located within the city limits of TorC, NM and must be at least 30 minutes from an existing VA primary care site. A map of the existing primary care sites can be found at the following website: . Parent facility is the New Mexico Veteran Affair Health Care System (NMVAHCS) located in Albuquerque, NM. A site visit may be conducted as part of the evaluation process. Describe location of proposed facility to be utilized under this contract.? Include mailing address, street address, city, village, town and county as applicable.? If Offer proposes to use a temporary location in order to meet the requirement that the successful Contractor begin providing services no later than 90 days after award, provide address of the proposed temporary location and plan to transition into the final VA approved location.Describe access to public transportation at facility, location of facility in relation to major highways.Describe the physical resources including number/type of patient care areas, offices, parking facilities (including handicapped parking), etc.? Provide copies of floor plans for proposed space and schematics or maps showing locations relative to other services, etc. Describe compliance with Americans with Disabilities Act requirements.Describe whether or not the intended facilities/resources will be devoted exclusively to the service of VA patients.? If not, describe how specific contract requirements can be met when providing service within a general population setting. See paragraph B2.41 for meeting requirements in a co-located facility. VA preference is for facilities to provide services in space exclusively dedicated to veterans.Provide narrative of how the facility's geographic location can best serve the clients anticipated to use the program.Specify the hours of operations that will be provided with the offer. TECHNICAL EVALUATION DOCUMENTATION REQUIREMENTSThe evaluations panel must identify if there are any clarifications, deficiencies, or weaknesses with the proposals.? Clarification questions to be presented to the Offeror for response by the Contracting Officer.? The following are definitions used for evaluation purposes:1)? Clarifications are written communication with offerors to improve the panel's understanding of the proposal, to allow reasonable interpretation of the proposal, or to resolve minor informalities in the proposal.? These communications will not be used to allow the Offeror to revise the proposal.2)? Deficiencies are a failure to meet the RFP requirements.? These can be areas in which the proposal does not satisfy the requirement and must be corrected before it can be considered for award.? Deficiencies can relate to substantive issues, such as an offer that proposes something that does not meet the capability requirements.? It can also be related to informational inadequacies, such as if the Offeror fails to address particular issues in their technical proposal.? Deficiencies should be categorized as either susceptible to correction by making a change in the proposal or not correctable.3)? Weaknesses are flaws in the proposal that are not so bad as to be categorized as a deficiency, but are important enough that it affects the rating of the proposal.? A weakness should be described in the evaluation PAST PERFORMANCE EVALUATION CRITERIA: The SSEB in conjunction with SSA will evaluate an Offeror’s past performance. Where an offeror is unable to provide adequate past performance the offer will be rated as neutral in accordance with FAR Part 15.305(a)(2).FACTOR 4 – PAST PERFORMANCEOfferors shall submit the following information as part of their technical proposal. Each Offeror will be evaluated on his/her performance under existing and prior contracts for similar primary care services. Performance information will be used for both responsibility determinations and as an evaluation factor against which Offerors relative rankings will be compared to assure best value to the Government. The VA will focus on information that demonstrates quality of performance relative to the size and complexity of the procurement under consideration. Offerors shall submit the following:A list of contracts completed during the past three (3) years for primary care services and all contracts and subcontracts currently in process for primary care services. Contracts listed may include those entered into by the Federal Government, agencies of state and local governments, and commercial customers. Offerors that are newly formed entities without prior contracts should list contracts and subcontracts as required above for all key personnel. Include the following information for each contract and subcontract:Name, address and email address of contracting activityName, email address and telephone number of Contracting OfficerName, email address and telephone number of Program Manager/CORDates of contract performancePrice schedule and total contract valueSubmitted documentation of the following, including chronic preventative index and facility rating in each measure:Experience using Computerized Medical Records SystemsPreventative and chronic care index factorsPatient Satisfaction Survey and Results for past two (2) yearsIn addition to the information required above, each Offeror shall provide their references with a copy of the Past Performance Survey (Attachment S) and have it returned to Francis Lee Reynolds by the response date. Surveys should be faxed to the attention of Francis Lee Reynolds/Lorine Duran at (505) 767-6088 or can be scanned and emailed to Francis.Reynolds@ or Lorine.Duran@ . Offerors should send their listed private sector references a letter, authorizing the reference to provide past performance information to the Government.Offers shall provide a description of any material legal proceedings against the Contractor by a Federal or state regulatory agencies that might impact a contract for these services.The Offeror may provide information on problems encountered on the contracts identified above and corrective actions taken to resolve those problems. Offerors should not provide general information on their performance on the identified contracts. General performance information will be obtained from the references. In the case of an Offeror with no record of relevant past performance or from whom information on past performance is available, the Offeror shall be shall be evaluated as “unknown confidence”. PAST PERFORMANCE RATING SYSTEMPAST PERFORMANCE: The SSEB will conduct a performance confidence assessment based upon the past performance of the offeror as it relates to the probability of successful accomplishment of the work required by the solicitation. The Evaluator shall evaluate past performance information through the use of questionnaires completed by the Offeror’s references: use data independently from other Government or commercial sources, to include but not limited to Government databases; or reliance upon personal business experience with the offeror. The evaluation will also consider information provided relative to corrective actions taken to resolve problems on past or existing contracts. The evaluators may contact references and parties other than those identified by the offeror, and information received may be used in the evaluation of the Offeror’s past performance. While the Government may elect to consider data obtained from other sources the burden of providing current, accurate and complete past performance information rests with the offeror.A proposal containing no relevant past performance shall have past performance evaluated as “unknown confidence”. An “unknown confidence” rated proposal may not represent the most advantageous proposal to the Government and thus, may be an unsuccessful proposal when compared to the proposal of other offerors. In the evaluation of Past Performance, the evaluator will use the following adjectives and related definitions to define the performance confidence the Contractor poses:Service Disabled Veteran Owned Small Business/Veteran Owned Small Business (SDVOSB/VOSB) Participation:The SSA shall evaluate an Offeror’s SDVOSB/VOSB participation to determine if credit is earned.FACTOR 5 : Service Disabled Veteran Owned Small Business/Veteran Owned Small Business Participation (SDVOSB/BOSB)::NOTICE: ONCE SOCIOECONOMIC CREDIT IS VERFIED, CREDIT WILL BE GIVEN FOR BELOW:In accordance with VAAR 852.215-70 included herein, eligible service-disabled veteran-owned Offerors will receive full credit, and Offerors qualifying as veteran-owned small businesses will receive partial credit for the Service-Disabled Veteran-Owned and Veteran-owned Small Business Status evaluation factor. To receive credit, an Offeror must be registered and verified in Vendor Information Pages (VIP) database. (). Non-veteran Offerors proposing to use service-disabled veteran-owned small businesses or veteran-owned small businesses as subcontractors will receive some consideration under this evaluation factor. Offerors must state in their proposals the names of the SDVOSBs and VOSBs with whom they intend to subcontract and provide a brief description of the proposed subcontracts and the approximate dollar values of the proposed subcontracts. In addition, the proposed subcontractors must be registered and verified in the VIP database (). Please read “VAAR 852.215-70 Service-Disabled Veteran-Owned and Veteran-Owned small business Evaluation Factors (DEC 2009)” very carefully and proceed with your answer. (1) For SDVOSBs/VOSBs: In order to receive credit under this Factor, an Offeror shall submit a statement of compliance that it qualifies as a SDVOSB or VOSB in accordance with VAAR 852.215-70 (Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors). Offerors are cautioned that they must be registered and verified in Vendor Information Pages (VIP) database ().(2) For Non SDVOSB/VOSB Offerors Proposing to Subcontract to SDVOSBs/VOSBs: To receive some consideration under this Factor, an Offeror must state in its proposal the names of SDVOSB(s) and/or VOSB(s) with whom it intends to subcontract, and provide a brief description and the approximate dollar values of the proposed subcontracts. Additionally, proposed SDVOSB/VOSB subcontractors must be registered and verified in Vendor Information Pages (VIP) database () in order to receive some consideration under the Veterans Involvement Factor.(3) With regard to the requirements for registration and verification in the VetBiz database, reference VAAR 804.1102 (Vendor Information Pages (VIP) Database).In an effort to achieve socioeconomic small business goals, NMVAHCS shall encourage offerors to utilize small businesses’ based on their service-disabled Veteran-owned or Veteran-owned small business status as subcontractors.NOTE: Consideration shall be given to use of Sub-Contractors who meet the criteria. No sub-Contractor shall not make Contractor Non-responsive.COST/PRICE: FACTOR 6 – PRICE(a) The prices stated in the Schedule of Services are to be all inclusive of all Primary Care Services as stated as a capitation rate per member per month.Discounts: Prompt payment discounts will not be considered in the evaluation of offers.Options: 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 significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).Offeror’s are not required to submit detailed pricing information with their initial offer. However, in order to adequately evaluate offers, it may be necessary for the Government to request a breakdown of the cost components that make-up the Offeror’s proposed price. (b) Options. 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 significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). (c) 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)E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013) (a) Definitions. As used in this provision— "Administrative proceeding" means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables. "Federal contracts and grants with total value greater than $10,000,000" means— (1) The total value of all current, active contracts and grants, including all priced options; and (2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules). "Principal" means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions). (b) The offeror [ ] has [ ] does not have current active Federal contracts and grants with total value greater than $10,000,000. (c) If the offeror checked "has" in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information: (1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions: (i) In a criminal proceeding, a conviction. (ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more. (iii) In an administrative proceeding, a finding of fault and liability that results in— (A) The payment of a monetary fine or penalty of $5,000 or more; or (B) The payment of a reimbursement, restitution, or damages in excess of $100,000. (iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision. (2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence. (d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management database via (see 52.204-7).(End of Provision)E.4 52.209-5 REPRESENTATION BY CORPORATIONS REGARDING AN UNPAID TAX LIABILITY OR A FELONY CONVICTION UNDER ANY FEDERAL LAW (DEVIATION)(MAR 2012) (a) In accordance with Division H, sections 8124 and 8125 of P.L. 112-74 and sections 738 and 739 of P.L. 112-55 none of the funds made available by either Act may be used to enter into a contract with any corporation that— (1) Has an unpaid federal tax liability, unless the agency has considered suspension or debarment of the corporation and the Suspension and Debarment Official has made a determination that this action is not necessary to protect the interests of the Government. (2) Has a felony criminal violation under any Federal or State law within the preceding 24 months, unless the agency has considered suspension or debarment of the corporation and Suspension and Debarment Official has made a determination that this action is not necessary to protect the interests of the Government. (b) The Offeror represents that— (1) The offeror does [ ] does not [ ] have any unpaid Federal tax liability that has been assessed and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability. (2) The offeror, its officers or agents acting on its behalf have [ ] have not [ ] been convicted of a felony criminal violation under a Federal or State law within the preceding 24 months.(End of Provision)E.5 52.216-1 TYPE OF CONTRACT (APR 1984) The Government contemplates award of a Firm Fixed Price Indefinite Delivery Indefinite Quantity contract resulting from this solicitation.(End of Provision)E.6 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) This solicitation incorporates one or more solicitation provisions by reference, with 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 offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es): (End of Provision)FAR NumberTitleDate52.232-38SUBMISSION OF ELECTRONIC FUNDS TRANSFER INFORMATION WITH OFFERJUL 201352.225-25PROHIBITION ON CONTRACTING WITH ENTITIES ENGAGING IN CERTAIN ACTIVITIES OR TRANSACTIONS RELATING TO IRAN—REPRESENTATION AND CERTIFICATIONSDEC 2012E.7 52.233-2 SERVICE OF PROTEST (SEP 2006) Protests, as defined in section 33.101 of the Federal Acquisition Regulation, that are filed directly with an agency, and copies of any protests that are filed with the Government Accountability Office (GAO), shall be served on the Contracting Officer (addressed as follows) by obtaining written and dated acknowledgment of receipt from: Hand-Carried Address: Department of Veterans Affairs Contracting Office (501/90C) New Mexico VA Health Care System 1501 San Pedro Drive SE Albuquerque NM 87108 Mailing Address: Department of Veterans Affairs Contracting Office (501/90C) New Mexico VA Health Care System 1501 San Pedro Drive SE Albuquerque NM 87108 (b) The copy of any protest shall be received in the office designated above within one day of filing a protest with the GAO.(End of Provision)(End of Addendum to 52.212-1)E.8 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008) (a) It is in the best interest of the Government to avoid situations which might create an organizational conflict of interest or where the offeror's performance of work under the contract may provide the contractor with an unfair competitive advantage. The term "organizational conflict of interest" means that because of other activities or relationships with other persons, a person is unable to render impartial assistance or advice to the Government, or the person's objectivity in performing the contract work is or might be otherwise impaired, or the person has an unfair competitive advantage. (b) The offeror shall provide a statement with its offer 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 under this solicitation. The offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. (c) Based on this information and any other information solicited or obtained by the contracting officer, the contracting officer may determine that an organizational conflict of interest exists which would warrant disqualifying the contractor for award of the contract unless the organizational conflict of interest can be mitigated to the contracting officer's satisfaction by negotiating terms and conditions of the contract to that effect. If the conflict of interest cannot be mitigated and if the contracting officer finds that it is in the best interest of the United States to award the contract, the contracting officer shall request a waiver in accordance with FAR 9.503 and 48 CFR 809.503. (d) Nondisclosure or misrepresentation of actual or potential organizational conflicts of interest at the time of the offer, or arising as a result of a modification to the contract, may result in the termination of the contract at no expense to the Government.(End of Provision)E.9 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-OWNED SMALL BUSINESS EVALUATION FACTORS (DEC 2009) (a) In an effort to achieve socioeconomic small business goals, depending on the evaluation factors included in the solicitation, VA shall evaluate offerors based on their service-disabled veteran-owned or veteran-owned small business status and their proposed use of eligible service-disabled veteran-owned small businesses and veteran-owned small businesses as subcontractors. (b) Eligible service-disabled veteran-owned offerors will receive full credit, and offerors qualifying as veteran-owned small businesses will receive partial credit for the Service-Disabled Veteran-Owned and Veteran-owned Small Business Status evaluation factor. To receive credit, an offeror must be registered and verified in Vendor Information Pages (VIP) database. (). (c) Non-veteran offerors proposing to use service-disabled veteran-owned small businesses or veteran-owned small businesses as subcontractors will receive some consideration under this evaluation factor. Offerors must state in their proposals the names of the SDVOSBs and VOSBs with whom they intend to subcontract and provide a brief description of the proposed subcontracts and the approximate dollar values of the proposed subcontracts. In addition, the proposed subcontractors must be registered and verified in the VIP database ().(End of Provision)815.304 Evaluation factors and significant sub-factors.(a) In an effort to assist SDVOSBs and VOSBs, contracting officers shall include evaluation factors providing additional consideration to such offerors in competitively negotiated solicitations that are not set aside for SDVOSBs or VOSBs.(b) Additional consideration shall also be given to any offeror, regardless of size status, that proposes to subcontract with SDVOSBs or VOSBs.E.10 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION (JAN 2008) (a) Any protest filed by an interested party shall: (1) Include the name, address, fax number, and telephone number of the protester; (2) Identify the solicitation and/or contract number; (3) Include an original signed by the protester or the protester's representative and at least one copy; (4) Set forth a detailed statement of the legal and factual grounds of the protest, including a description of resulting prejudice to the protester, and provide copies of relevant documents; (5) Specifically request a ruling of the individual upon whom the protest is served; (6) State the form of relief requested; and (7) Provide all information establishing the timeliness of the protest. (b) Failure to comply with the above may result in dismissal of the protest without further consideration. (c) Bidders/offerors and contracting officers are encouraged to use alternative dispute resolution (ADR) procedures to resolve protests at any stage in the protest process. If ADR is used, the Department of Veterans Affairs will not furnish any documentation in an ADR proceeding beyond what is allowed by the Federal Acquisition Regulation.(End of Provision)E.11 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998) As an alternative to filing a protest with the contracting officer, an interested party may file a protest with the Deputy Assistant Secretary for Acquisition and Materiel Management, Acquisition Administration Team, Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, or for solicitations issued by the Office of Construction and Facilities Management, the Director, Office of Construction and Facilities Management, 810 Vermont Avenue, NW., Washington, DC 20420. The protest will not be considered if the interested party has a protest on the same or similar issues pending with the contracting officer.(End of Provision) PLEASE NOTE: The correct mailing information for filing alternate protests is as follows:Deputy Assistant Secretary for Acquisition and Logistics,Risk Management Team, Department of Veterans Affairs810 Vermont Avenue, N.W.Washington, DC 20420 Or for solicitations issued by the Office of Construction and Facilities Management:Director, Office of Construction and Facilities Management811 Vermont Avenue, N.W.Washington, DC 20420E.12 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)E.13 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)E.14 VAAR 852.273-71 ALTERNATIVE NEGOTIATION TECHNIQUES (JAN 2003) The contracting officer may elect to use the alternative negotiation techniques described in section 873.111(e) of 48 Code of Federal Regulations Chapter 8 in conducting this procurement. If used, offerors may respond by maintaining offers as originally submitted, revising offers, or submitting an alternative offer. The Government may consider initial offers unless revised or withdrawn, revised offers, and alternative offers in making the award. Revising an offer does not guarantee an offeror an award.(End of Provision)E.15 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003) The Government intends to evaluate proposals and award a contract without exchanges with offerors. Therefore, each initial offer should contain the offeror's best terms from a cost or price and technical standpoint. However, the Government reserves the right to conduct exchanges if later determined by the contracting officer to be necessary.(End of Provision)E.16 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 (NO EXEMPTIONS). (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.17 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: *SEE BELOW. 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:General Liability $1-3 M, Excess/umbrella $5M, Workers Compensation $1M, Employers Liability $1M(End of Clause)(END OF SOLICITATION) ................
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