Quality Assurance Surveillance Plan (QASP) Page 16 of 16 Revised6/6/2014 This is a Sources Sought Notice. THERE IS NO SOLICITATION AT THIS TIME Wilkes-Barre VAMC needs an Invasive Cardiologist to join its experience staff of physicians and health professionals full time in the Department of Medicine. The successful candidate will be responsible for providing comprehensive care for patients within the scope of his or hers Invasive Cardiologist practice focusing on the evaluation, diagnosis, and treatment of both inpatients and outpatients within the medical center s Cardiology clinic. Attached is the Performance Work Statement(PWS) which has not been finalized. If interested, please provide capability statement and organization name, address, website address, telephone number etc. Submit response by: Tuesday, September 18, 2018 Please email capability statements to: JoAnn Chukinas, Contract Specialist @ [email protected] Please note RFQ#36C24418q9746 Sources Sought Notice in the subject line of email. See attached document: Emergency Cardiologist PWSQASP WBVAMC 9-10-2018 Performance Work Statement (PWS) QASP Wilkes-Barre VA Medical Center SCHEDULE OF SERVICES The Contractor shall furnish all personnel to provide services necessary to perform onsite General Cardiology Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Wilkes-Barre, PA (hereinafter referred to as VAMC). The contract physician(s) care shall cover the range of general cardiology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards. http://www.cardiosource.org/Science-And-Quality/Practice-Guidelines-and-Quality-Standards.aspx . Place of Performance: Services shall be provided on site, Wilkes-Barre VAMC, 1111 East End BLVD, Wilkes-Barre, PA 18711 Pricing Instructions: The offeror is instructed to edit the number of sub-clins to correspond with the number of key personnel submitted for the contract line item number (CLIN). Affiliate Offerors shall include the title of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SUB-CLINs if adding or removing Key Personnel. The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments, VA Directive 1663 Appendix The Contractor shall propose 1 key personnel to be credentialed and be available for scheduling to meet the requirements of the contract. One FTE is defined by VA as a minimum of 80 hours every two week per year and does not include holidays PERIODS OF PERFORMANCE Period of Performance: BASE Period: 1 year CLIN No. SUB-CLIN Description Qty. Unit Unit Cost Total Annual Cost 0001 None General Cardiology Physician Services to include primarily cardiology clinic 2080 total 40 Hours DO NOT PRICE DO NOT PRICE KEY PERSONNEL None 0001 Board Certified General Cardiologist Services NAME:____________ TITLE/LEVEL OF EXPERIENCE:____________ 2080 (each/ 1 year) Hours $__/hr $__ TOTAL FOR BASE Period 2080 Hours $___________________ OPTION 1: 6 month extension: ______ to _______ CLIN No. SUB-CLIN Description Qty. Unit Unit Cost Total Annual Cost 1001 None General Cardiology Physician Services to include primarily cardiology clinic 2080 Hours DO NOT PRICE DO NOT PRICE KEY PERSONNEL None 1001 Board Certified General Cardiologist Services NAME:____________ TITLE/LEVEL OF EXPERIENCE:____________ 2080 (each/ 1 year) Hours $__/hr $__ TOTAL FOR OPTION Period 1 2080 Hours $___________________ OPTION 2: 6 month extension: ______ to _______ CLIN No. SUB-CLIN Description Qty. Unit Unit Cost Total Annual Cost 2001 None General Cardiology Physician Services to include primarily cardiology clinic 2080 Hours DO NOT PRICE DO NOT PRICE KEY PERSONNEL None 1001 Board Certified General Cardiologist Services NAME:____________ TITLE/LEVEL OF EXPERIENCE:____________ 2080 (each/ 1 year) Hours $__/hr $__ TOTAL FOR OPTION Period 2 2080 Hours $___________________ GENERAL: Services Provided: The Contractor shall provide Board Certified General Cardiologist Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and Wilkes-Barre VAMC. Place of Performance - Wilkes-Barre VAMC, 1111 East End BLVD, Wilkes-Barre, PA 18711 Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority. Policy/Handbooks: - VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347 VHA Directive 2006-041 Veterans Health Care Service Standards (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 - VHA Handbook 1100.17: National Practitioner Data Bank Reports - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 - VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 - VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910 - VHA Handbook 1400.01 Resident Supervision http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847 VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 - Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm Definitions/Acronyms- Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern. ACGME: Accreditation Council for Graduate Medical Education CDC: Centers for Disease Control and Prevention CEU: Certified Education Unit CME: Continuing Medical Education Contracting Officer (CO) The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings. Contracting Officer s Representative (COR) A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken. COS: Chief of Staff CPARS: Contractor Performance Assessment Reporting System CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status. DEA: Drug Enforcement Agency FSMB: Federation of State Medical Boards HHS: Department of Health and Human Services HIPAA: Health Insurance Portability and Accountability Act ISO: Information Security Officer POP: Period of Performance PPD: Purified Protein Derivative PWS: Performance Work Statement Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for 8independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual s license, based upon the individual s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific. QA/QI: Quality Assurance/Quality Improvement QM/PI: Quality Management/Performance Improvement QASP: Quality Assurance Surveillance Plan National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C. Veterans Integrated Services Network (VISN) : The regional oversight for the VA medical centers in Michigan and Indiana. VISTA (Veterans Integrated Systems Technology Architecture) : A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient s medical record and with the hospital information system. VETPro: a federal web-based credentialing program for healthcare providers. Veterans Affairs Medical Center (VAMC) : Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the Wilkes-Barre VA Medical Center. QUALIFICATIONS: Staff/Facility License - Contract physician(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contract physician(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract. Board Certification - All contract physician(s) shall be board certified or board eligible by the American Board of Internal Medicine and the American Board of Cardiovascular Medicine or Interventional Cardiology http://www.abim.org/ and be currently certified in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance. Credentialing and Privileging Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract physician(s) prior to obtaining approval by the Wilkes-Barre VAMC Professional Standards Board, Medical Executive Council and Medical Center Director. If a contract physician(s) is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government. Technical Proficiency - Contract physician(s) shall be technically proficient in the skills necessary to fulfill the government s requirements, including the ability to speak, understand, read and write English fluently. Contract physician(s), should possess at minimum, four years of general cardiology experience. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract physician(s) and contract physician(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contract physician(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s). Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all educational requirements and mandatory course requirements defined herein; all training must be completed by the contract physician(s) as required by the VA. TMS Courses: VHA Privacy & Information Security Awareness, & Rules of Behavior and the VHA Privacy & HIPAA training. These are to be completed prior to the start of contracted work and annually thereafter before expiration dates of previous training. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract physician(s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually. RUBELLA TESTING: Contractor shall provide proof of immunization for all contract physician(s) for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contract physician(s); provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal. DEA (as required) - Contractor shall provide copy of current DEA certificate. Conflict of Interest: The Contractor and all contract physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided.  The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services.  The Contractor must also provide relevant facts that show how it s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document. Citizenship related Requirements: The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals; While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all E-Verify requirements consistent with Executive Order 12989 and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contract physician(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries. By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed. Clinical/Professional Direction: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional direction of all clinical personnel covered by this contract will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract. Non Personal Healthcare Services: The parties agree that the Contractor and all contract physician(s) shall not be considered VA employees for any purpose. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees. Prohibition Against Self-Referral: Contractor s physicians are prohibited from referring VA patients to contractor s or their own practice(s) Inherent Government Functions: Contractor and Contract physician(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy. No Employee status: The Contractor shall be responsible for protecting Contract physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract: Workers compensation Professional liability insurance Health examinations Income tax withholding, and Social security payments. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s). When a Contractor or contract physician(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier. Key Personnel: The VA Full Time Equivalency (FTE) for the services required is 1 FTEs. FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays. The number of Board Certified General Cardiologists required to be on site five days per week is (1), as defined in paragraph Hours of Operation in this section. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled physician is unable to complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) at the Wilkes-Barre VAMC immediately of the schedule change. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel. For temporary substitutions where the key person shall not be reporting to work for three consecutive work days or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor s physician (s), s/he may request, without cause, immediate replacement of said Contractor s physician (s) .The CO and COR shall deal with issues raised concerning Contractor s physician (s) conduct. The final arbiter on questions of acceptability is the CO. Contingency Plan: Because continuity of care is an essential part of VAMC s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor s physician (s) leaves Contractor s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract. VA HOURS OF OPERATION/SCHEDULING: VA Business Hours: Regular scheduled business hours for outpatient services are Monday-Friday, 8:00 a.m. 4:30 p.m. Work Schedule: The designated work schedule will be Monday thru Friday, 8:00 a.m. 4:30 pm. Patients must be seen by a contract physician(s) on-site at the Wilkes-Barre VAMC in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure. Contract Physicians shall be available and present in clinic during normal Wilkes-Barre VAMC clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are 8:00 a.m. 4:30 p.m. .   Federal Holidays: The following holidays are observed by the Department of Veterans Affairs: New Year s Day President s Day Martin Luther King s Birthday Memorial Day Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Christmas Any day specifically declared by the President of the United States to be a national holiday. Cancellations: Clinic patients which are affected by the cancellation will be reviewed by the contracting physician, and the patient will be rescheduled according to the clinical urgency (1 to 2 weeks). Unless a state of emergency has been declared, the Contractor shall be responsible for providing services. CONTRACTOR RESPONSIBILITIES Clinical Personnel Required: The Contractor shall provide contract physician(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties. Contract physician(s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor s invoices. Standards of Care: The contract physician(s) care shall cover the range of general cardiology and diagnostic services to include as a back-up to staff physicians EKG, Holter, stress and echo interpretations. Stat studies will be interpreted and signed off the same day. Routine studies need to be completed and signed off within 5 (five) working days. All outpatient clinic notes and encounters will be completed and signed off within 24 hours of seeing the patient, inpatient notes and encounters must be completed same day. Care should be equivalent or exceed that which would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as established by: The American College of Cardiology (ACC):http://www.cardiosource.org/Science-And-Quality/Practice-Guidelines-and-Quality-Standards.aspx . VA Standards: VHA Directive 2006-041 Veterans Health Care Service Standards (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 The professional standards of The Joint Commission (TJC) http://www.jointcommission.org/standards_information/hap_requirements.aspx The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and; The requirements contained in this PWS Resident Supervision and Teaching: Resident Supervision/Teaching: According to the guidelines dictated by the Residency Review Committee of ACGME, the Contractor s physician(s) performing the services shall be responsible for residents. Contractor s physician(s) shall be responsible for: Academic environment: Provide for an academic environment conducive to the training and professional development for residents rotating through the Cardiology Service. Resident patient care documentation: Contractor s physician(s) shall be responsible for complying with the Residency review documentation and insuring that all notes and encounters are completed and shall appropriately document medical records in accordance with VA standards, equivalent to TJC compliance guidelines, standard commercial practice and guidelines established by Wilkes-Barre VAMC . The Contractor shall also perform any administrative duties relative to documentation of resident training, as required and directed by the VA COS or designated representative. Clinical Direction and Oversight: Contractor s physician(s) shall provide clinical direction to and oversight of residents/fellows consistent with current accreditation guidelines, clinical research, protocol development, data management of protocols, quality assurance conferences and meetings, and affiliate /VA staff meetings. Ensure on-site resident supervision in accordance with the national VHA Handbook 1400.01, Resident Supervision, dated December 19, 2012. http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847 Attending Physician: Clinics/Cardiac Catheterization Lab procedures shall not be conducted by residents in the absence of an attending physician. All procedures, inpatient admissions and consults shall be the responsibility of an attending physician. MEDICAL RECORDS Authorities: Contract physician(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA). HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled Patient Medical Records-VA (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date. Disclosure: Contract physician(s) may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA s records, at VA s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAMC. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual s Records, to process Release of Information Requests. In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer Donna Boyer, at the following address: Wilkes-Barre VA Medical Center 1111 East End BLVD, Wilkes-Barre, PA 18711. Direct Patient Care: 99% of the time involved in direct patient care. Scope of Care: Contract physician(s) (as appropriate and within scope of practice/privileging) shall be responsible for providing diagnostic cardiology care, including, but not limited to : Patient assessment and cardiac care management, including but not limited to seeing and assessing patients in the cardiology clinic, and as a backup to staff physicians echo, holters, and ecg interpretation. Stat studies will be interpreted and signed off the same day. Routine studies need to be completed and signed off within 5 (five) working days. All outpatient clinic notes and encounters will be completed and signed off within 24 hours of seeing the patient, inpatient notes and encounters must be completed same day. Correspondence with VA providers. Clinic Responsibilities: Contractor physician(s) shall provide clinical, diagnostic cardiology services. Contractor physician(s) shall be present on time for any scheduled clinics/procedures as documented by physical presence in the clinic at the scheduled start time. A be collegial with all staff members. Approximate case load is as follows: There are 18 20 minute slots per/day for F/U patients and new patients get two 20 minute slots. Contractor physician(s) shall provide consultative services at the patient s bedside if the patient is not ambulatory and in the clinic setting if the patient is able to report to the outpatient clinic. Medications: Contractor physician(s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients. Discharge education: Contractor physician(s) shall provide discharge education and follow up instructions that are coordinated with the next care setting for all cardiology patients. ADMINISTRATIVE: 1% of time not involved in direct patient care Quality Improvement Meetings: The contract physician(s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the VAMC Chief of Service, Chief of Staff, or designee. Staff Meetings: The Contractor s physician(s) shall attend staff meetings as required by the VAMC Chief of Service, Chief of Staff, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement. Cardiology Meeting-meets monthly QA/QI documentation: The contract physician(s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations. All charting must be complete within 24 hours. Patient Safety Compliance and Reporting: Contract physician(s) shall follow all established patient safety and infection control standards of care. Contract physician(s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours). Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI) Quality Management/Quality Assurance Surveillance: Contractor physician(s) shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that The Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor s conduct. The final arbiter on questions of acceptability is the CO. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor s conduct. The final arbiter on questions of acceptability is the CO. Performance Standards: Measure: Focused Provider Practice Evaluation Performance Requirement: FPPE documentation for all (100%) staff providing services under the contract Standard: FPPE documentation for all (100%) staff providing services under the contract. All staff (100%) meet Standards . Acceptable Quality Level: 100% meets Standards Surveillance Method: Random Inspection of qualification documents Frequency: for first 3 months, 10 patients records will be reviewed for clinical pertinence. ***Ongoing practice evaluation OPPE will start after the provider has completed FPPE satisfactorily. Incentive: Favorable contactor performance evaluation. Disincentive: Unfavorable contractor performance evaluation.. Deduction Measure: Provider Quality Performance Performance Requirement: Standard: OPPE documentation for all (100%) staff providing services under the contract. All staff (100%) meet Standards. Acceptable Quality Level: 100%_meet Standards Surveillance Method: Ongoing Provider Performance Evaluation (OPPE) data pertinent to care performed for each provider working under this contract. OPPE data will review the following elements: A. Patient Care Performance B. Medical/Clinical knowledge C. Practiced Based Learning and Improvement D. Interpersonal and Communication Skills E. Professionalism F. System Based Practice Frequency: Quarterly Incentive: Positive Past Performance Disincentive: Negative Past Performance, (should there be deductions for this standard) Measure: Qualifications of Key Personnel Performance Requirement: All Contractor s physician(s) shall be Board Certified in accordance with ACC Standards. Standard: All (100%) Contractor s physician(s) s are board certified. Acceptable Quality Level: __100_% Surveillance Method: Random Inspection of qualification documents Frequency: yearly Incentive: Favorable contactor performance evaluation. Disincentive: Unfavorable contractor performance evaluation.. Deduction: Measure: Scope of Practice/Privileging Performance Requirement: Contractor s physician(s) perform within their individual scopes of practice/privileging. Standard: All (100%) Contractor s physician(s) perform within their scope of practice/privileges 100% of the time. Acceptable Quality Level: _100%Contractor s physician(s) perform within their scope of practice/privileges 100% of the time. Surveillance Method: Random Inspection of records. Frequency: continuously Incentive: Favorable contactor performance evaluation. Disincentive: Unfavorable contractor performance evaluation. Deduction: Measure: Patient Access Performance Requirement: The Contractor shall provide Contractor s physician(s) in accordance with the operating hours and VA clinical schedule outlined in this PWS. Standard: All (100%) Contractor s physician(s) are on time and available to perform services. Acceptable Quality Level: Contractor s physician(s) are on-time and available to perform services 100%of the time Surveillance Method: Periodic Sampling of Time and Attendance Sheets Frequency :Continuously Incentive: Favorable contactor performance evaluation. Disincentive: Unfavorable contractor performance evaluation, Deduction: Measure: Patient Safety Performance Requirement: Patient safety incidents shall t be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.) Standard: All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident. Acceptable Quality Level: 100%of patient safety incidents are reported using Patient Safety Report within 24 hours of incident. Surveillance Method: Direct Observation Frequency: continuously Incentive: Favorable contactor performance evaluation. Disincentive: Unfavorable contractor performance evaluation, Deduction: Measure: Maintains licensing, registration, and certification Performance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current. Standard: All (100%) licensing, registration(s) and certification(s) for Contractor s physician(s) shall be provided as they are renewed. Licensing and registration information kept current. Acceptable Quality Level: 100%licensing, registration(s) and certification(s) for Contractor s physician(s) shall be provided as they are renewed. Licensing and registration information kept current. Surveillance Method: Periodic Sampling and Random Sampling Frequency :continuously Incentive: Favorable contactor performance evaluation. Disincentive: Unfavorable contractor performance evaluation, Deduction: Measure: Mandatory Training Performance Requirement: Contractor shall complete all required training on time per VAMC policy Standard: All (100%) of required training is complete on time by Contractor s physician(s) Acceptable Quality Level: ___%completions, Surveillance Method: Periodic Sampling Frequency: Incentive: Favorable contactor performance evaluation. Disincentive: Unfavorable contractor performance evaluation, Deduction: Measure: Privacy, Confidentiality and HIPAA Performance Requirement: Standard: All (100%) Contractor s physician(s) comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA Acceptable Quality Level: 100_%compliance Surveillance Method: Periodic Sampling; Contractor shall provide evidence of annual training required by VAMC, reports violations per VA Directive 6500.6. Frequency: continuously Incentive: Favorable contactor performance evaluation. Disincentive: Unfavorable contactor performance evaluation. Deduction: Registration with Contractor Performance Assessment Reporting System As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials.  The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing.  To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire.  CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS.  CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS).  FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information. Each Contractor whose contract award is estimated to exceed $150,000 requires a CPARS evaluation.    A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations).   Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690. For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete.  For contracts exceeding one year, the contracting officer will evaluate the Contractor s performance annually.  Interim reports will be filed each year until the last year of the contract, when the final report will be completed.  The report shall be assigned in CPARS to the Contractor s designated representative for comment.  The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO. Failure for the Contractor s representative to respond to the evaluation within those sixty (60) days, will result in the Government s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor s representative will be locked out of the evaluation and may no longer send comments. GOVERNMENT RESPONSIBILITIES VA Support Personnel, Services or Equipment: The Wilkes- Barre VAMC will provide clinic staff, clinic space, and the equipment for the performance of all on-site general cardiology services. Any additional equipment needs will be based on mutual agreement. Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to: Primary Contracting Officer Representative at (570)824-3521 extension 7684; Wilkes-Barre VAMC Contracting Officer at (570) 824-3521 extension _______, and Clinical Point of Contact: ,Supervisor of Cardiology at CO RESPONSIBILITIES: CO-_________________, VAMC, 1111 East End BLVD, Wilkes-Barre, PA 18711. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract. The Contracting Officer shall resolve complaints concerning Contractor relations with the Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof. In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for Contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract. COR Responsibilities: The COR for this contract is: Richard Weaver RCIS, VAMC, 1111 East End BLVD, Wilkes-Barre, PA [email protected] The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer. The COR will be responsible for monitoring the Contractor s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected. The COR will maintain a record-keeping system of services by paper sign-in timesheet located in the cardiac catheterization laboratory of Wilkes-Barre VAMC. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the Contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer. The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference. All contract administration functions will be retained by the VA.

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