SCHEDULE OF SERVICESThe Contractor shall furnish all personnel to provide services necessary to perform onsite Multi-Specialty Registered Nurse (RN), Licensed Practical Nurse (LPN), Certified Nursing Assistant (CAN), Certified Registered Nurse Anesthetist (CRNA), Nurse Practitioner (NP), Monitor Watcher (MW), and Sitter Locum Services to eligible beneficiaries of the Department of Veterans Affairs; Veterans Affairs Health Care System (VAPHS), (hereinafter referred to as VAPHS). The contractor’s physician assistant(s)’ care shall cover the range of Multi-Specialty RN, LPN, CNA, CRNA, NP, MW, and Sitter Locum 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.

Place of Performance: Services shall be provided on site, VAPHS University Drive Campus, University Drive C, Pittsburgh, PA 15240 and H.J. Heinz Campus, 1015 Delafield Road, Pittsburgh, PA 15215.

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). 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, The Contractor shall propose a minimum of with nineteen (19) Full Time and one(1) Part time FTEE for a six (6) Month base period for Multi-Specialty RN, LPN, CNA, CRNA, NP, MW, and Sitter Locum Services key personnel to be credentialed (if required), background checked, and be available for scheduling to meet the requirements of the contract.

Performance Work Statement for Onsite Surgery Physician Services

Legend:Red= Instruction- Remove from final document.Yellow= fill in information

1. GENERAL: Services Provided: The Contractor shall initially provide the VA Pittsburgh Healthcare System with nineteen (19) Full Time and one(1) Part time FTEE for a six (6) Month base period for Multi-Specialty RN, LPN, CNA, CRNA, NP, MW, and Sitter Locum Services. Contract will be certified in their field according to VAPHS regulations in order to perform the requirements of this BPA which is expected to include a series of short term orders to meet emergent needs of the medical center. Other specialties will be sought throughout the duration of the contract on an as-needed basis.

1.1. Place of Performance - Contractor shall furnish services On-site at VA Pittsburgh Healthcare System (VAPHS) UD Division, University Drive, Pittsburgh, PA 15240 and HJ Heinz Division, 1010 Delafield Road, Pittsburgh, PA 15215

1.2. Authority: Title 38 USC 8153

1.3. Policy/Handbooks :1.3.1. VA Directive 1663: Health Care Resources Contracting - Buying

https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

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

1.1.1. VHA Directive 2010-018 “Facility Infrastructure”

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227

1.1.2. VHA Directive 1192 “Seasonal Influenza Prevention Program”https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep

1.3.3. VHA Handbook 1100.17: National Practitioner Data Bank Reports - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.3.4. VHA Handbook 1100.18 Reporting and Responding To State Licensing Boards - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

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

1.3.6. VHA Handbook 1400.01 Resident Supervision https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847

1.3.7. VHA Handbook 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

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

1.3.9. VHA Handbook 5005-78 Part II Appendix G8 Physician Assistant Qualifications Standardshttps://vaww.va.gov/OHRM/Directives-Handbooks/Documents/5005-78.pdf

1.4. Definitions/Acronyms- Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.4.1. DEFINITIONS:

1.4.1.1. CONTRACTOR. A supplier or vendor awarded a Contract to provide specific supplies or services to the government. The term used in this Contract refers to the prime Contractor.

1.4.1.2. CONTRACTING OFFICER. A person with authority to enter into, administer, and or terminate Contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

1.4.1.3. CONTRACTING OFFICER’S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the Contracting Officer to administer the Contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the Contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the Contract.

1.4.1.4. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a Contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

1.4.1.5. QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

1.4.1.6. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of Contractor performance.

1.4.2. ACRONYMS:

1.4.2.1. ACLS : Advanced Cardiac Life Support

1.4.2.2. AOD: Admitting Officer of the Day

1.4.2.3. BLS: Basic Life Support1.4.2.4. CCN E: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation1.4.2.5. CDC: Centers for Disease Control and Prevention1.4.2.6. CDR: Contract Discrepancy Report1.4.2.7. CEU: Certified Education Unit 1.4.2.8. CME: Continuing Medical Education1.4.2.9. CMS: Centers for Medicare and Medicaid Services1.4.2.10. Contracting Officer (CO) – The person executing this contract on behalf of the Government with the

authority to enter into and administer contracts and make related determinations and findings.

1.4.2.11. Contracting Officer’s Representative (COR ) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.4.2.12. COS : Chief of Staff1.4.2.13. CPARS: Contractor Performance Assessment Reporting System1.4.2.14. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.1.4.2.15. Credentialing : Credentialing is the systematic process of screening and evaluating qualification and

other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.4.2.16. DEA : Drug Enforcement Agency1.4.3. FSMB : Federation of State Medical Boards

1.4.4. Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.4.5. HHS: Department of Health and Human Services

1.4.6. HIPAA: Health Insurance Portability and Accountability Act1.4.7. HR: Human Resources

1.4.8. ISO: Information Security Officer

1.4.9. Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.4.10. MOD: Medical Officer of the Day

1.4.11. NCCPA: National Commission on Certification of Physician Assistants

1.4.12. National Provider Identifier (NPI) : NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

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

1.4.14. NP: Nurse Practitioner1.4.15. NPPES: National Plan and Provider Enumeration System

1.4.16. PA : Physician Assistant1.4.17. PANCE : Physician Assistant National Certifying Examination

1.4.18. PALS : Pediatric Advanced Life Support

1.4.19. POP: Period of Performance

1.4.20. PPD: Purified Protein Derivative

1.4.21. PWS : Performance Work Statement1.4.22. 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.

1.4.23. QA/QI : Quality Assurance/Quality Improvement

1.4.24. QM/PI : Quality Management/Performance Improvement

1.4.25. QASP: Quality Assurance Surveillance Plan

1.4.26. VAPHS: Veterans Affairs Pittsburgh Healthcare System Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the VAPHS

1.4.27. Veterans’ Health Administration (VHA) : The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

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

1.4.29. VISTA (Veterans Integrated Systems Technology Architecture) : A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

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

2. QUALIFICATIONS:2.1. Staff/Facility

2.1 Certification Registered Nurse (RN)

2.1.1. Qualifications: Each RN shall:2.1.1.1. Hold a Diploma, Associates Degree (AD) or Bachelor of Science in Nursing (BSN) degree from

an NLN accredited program, college or university and hold a current license to practice as a Registered Nurse (RN) in any State. A BSN is preferred.

2.1.1.2. Have been actively practicing as a registered nurse in an acute or long-term setting for at least the last two years.

2.1.1.3. Be capable of providing complex and comprehensive nursing care for adult medical and surgical patients.

2.1.1.4. Have and maintain current Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) certification.

2.1.1.5. Have no health or physical disability restrictions that interfere with the performance of assigned duties.

2.1.1.6. Have documented training and skills verification.2.1.1.7. If a PA’s NCCPA certification is suspended, revoked or expires, the PA must be removed from the

occupation which may result in termination of employment2.1.1.7.1. Hemodialysis RN- Have been actively practicing as a registered nurse in a

Hemodialysis setting for the past two years. The Dialysis unit is an outpatient chronic dialysis facility providing hemodialysis. Staff also provides inpatient dialysis in the ICUs. The RN is accountable when assigned as a primary nurse for a defined group of patients for the entire episode of care. As the assigned caregiver for a specific shift, the RN is accountable for the care of defined groups of patients on that shift.

2.1.1.7.2. Cardiac Catherization/ EP Lab - Registered Nurse (RN)-. Be capable of providing complex and comprehensive nursing care for adult medical and surgical patients.

2.1.1.7.3. Neurology RN-

Licensed Practical Nurse (LPN)2.1.2. Qualifications: Each LPN shall:

2.1.2.1. Possess a valid, current license (with no limitations, stipulations, or pending adverse actions) to practice nursing as an LPN and be licensed to practice in the state of Pennsylvania. All licenses must be unencumbered and remain in effect during contract employment.

2.1.2.2. Have been actively practicing as a licensed practical nurse for at least one ye within the past three years.

2.1.2.3. Be capable of providing nursing care for adult medical and surgical patients.2.1.2.4. Have and maintain current Basic Cardiac Life Support (BCLS) certification.2.1.2.5. Have no health or physical disability restrictions that interfere with the performance of assigned duties.2.1.2.6. Have documented training and skills verification.

.

Certified Nursing Assistant (C.NA)

2.1.3. Qualifications: Each C.NA shall: 2.1.3.1. Be a certified nursing assistant in the state of Pennsylvania.2.1.3.2. Be trained and experienced in hospital nursing.2.1.3.3. Have at least one-year experience working as a CNA.2.1.3.4. Be capable of providing nursing care for adult medical and surgical patients.2.1.3.5. Have and maintain current Basic Cardiac Life Support (BCLS) certification.2.1.3.6. Have no health or physical disability restrictions that interfere with the performance of assigned

duties.2.1.3.7. Have documented training and skills verification.

Certified Registered Nurse Anesthetist-CRNA2.1.4. Qualifications: Each CRNA shall:

2.1.4.1. Graduate of an approved school of nursing and hold active current state registration as a graduate professional nurse in a state, territory, or commonwealth of the United States or District of Columbia.

2.1.4.2. Graduate from a nurse anesthesia education program accredited by the American Association of Nurse Anesthetists (AANA) Council on Accreditation of Nurse Anesthesia Education Program.

2.1.4.3. Successfully complete the certification examination administered by NBCRNA.2.1.4.4. Comply with criteria for biennial recertification as defined by the NBCRNA. This criterion includes

evidence of a current registered nurse license.2.1.4.5. Entry Level Grade Nurse II based is based on the level of education and experience in the CRNA

profession. The Grade II CRNA will:

2.1.4.5.1. Demonstrate knowledge, skills, and abilities at the minimum skill set expected of an Entry Level Nurse.

2.1.4.5.2. Demonstrate the ability to translate the principles of professional nursing practice in the care of assigned patients in order to provide appropriate care.

2.1.4.5.3. Demonstrate the ability to do a pre-anesthetic patient history and physical, which includes collecting pre-operative consults and data.

2.1.4.5.4. Demonstrate the ability to formulate an anesthetic plan and describe the anesthetic risks, benefits, and options to the patient.

2.1.4.5.5. Demonstrate the ability to administer inhalational, regional, intravenous, local, andtopical anesthetics and to detect unfavorable reactions in order to continuously evaluate the patient’s physical status.

2.1.4.5.6. Demonstrate the ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and using appropriate resuscitation procedures for patient care.

2.1.4.5.7. Demonstrate the ability to provide patient care that is abreast of changing concepts and advancements in the profession.

2.1.4.5.8. Demonstrate the ability to work effectively in an interdisciplinary environment for the improvement of services for patient care.

2.1.4.5.9. Demonstrate the ability to practice nurse anesthesia with colleagues and peers

utilizing a collaborative team concept of care.2.1.4.5.10. Full performance is Nurse III. This CRNA will typically have 2 years of progressively

responsible experience in the administration of anesthesia which includes demonstrated accomplishments in upgrading services to patients or involves

program responsibilities.

Experience and Education. In addition to meeting the requirements for Entry Level, the CRNA has had progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. These individuals must demonstrate the ability to participate in a program for nurse anesthesia care and demonstrate knowledge of anesthetizing locations, methods, equipment and procedures. At this level, the CRNA has experience in the administration of anesthetics that has demonstrated the nurse anesthetist’s ability to participate in team programs that are technically challenging and/or complicated. Typically candidates can demonstrate the knowledge, skills and abilities of Full Performance Level within 2 years from entering the occupation. VA HANDBOOK 5005/37,PART II ,App G7

2.1.4.6. CRNAs are an advanced practice nurse who utilizes specialized clinical skills and education to administer anesthesia care throughout the medical center. The practice of nurse anesthesia is a recognized specialty within the profession of nursing. As independently licensed health professionals, CRNAs are responsible and accountable for their practice. The scope of practice includes direct patient care, administration, educational, and research activities.

2.1.4.7. CRNAs practice in collaboration with other health care professionals in a collegial relationship to achieve common goals for care, safety, and welfare of patients. In their position, CRNAs provide anesthetic services within four general categories:

2.1.4.7.1. Pre-anesthesia preparation and evaluation that includes a patient history, physical examination, and the collection of preoperative consults and data, from which an

appropriate anesthetic plan can be formulated.2.1.4.7.2. Anesthesia induction, maintenance and emergence.2.1.4.7.3. Post anesthesia care2.1.4.7.4. Peri-anesthetic and clinical support functions outside the OR suite.

Nurse Practitioner2.1.5. Qualifications: Each Nurse Practitioner shall:

2.1.5.1. U.S. citizenship. Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

2.1.5.2. Graduate of a school of professional nursing approved by the appropriate State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing.

2.1.5.3. The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (Reference VA Handbook 5005, Appendix G6)

2.1.5.4. Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia.

Health Care Technician (HCT)2.1.6. Qualifications: Each HCT shall:

2.1.6.1. Be a certified nursing assistant or possess comparable certification in a related healthcare field including medical assistant, paramedic or emergency medical technician.

2.1.6.2. Have documented training and skills verification.

2.1.6.3. Be trained and experienced in patient care.2.1.6.4. Have at least one-year experience working in direct patient care; ambulatory or emergency care

preferred. 2.1.6.5. Be capable of providing nursing care for adult medical and surgical patients.2.1.6.6. Have and maintain current Basic Life Support (BLS) certification.2.1.6.7. Have no health or physical disability restrictions that interfere with the performance of assigned

duties.2.1.6.7.1. Gastro-intestinal (GI) Technician

Monitor 2.1.7. Qualifications: Each Monitor shall:

2.1.7.1. Specialized Experience: You must have 3 months of general experience OR,2.1.7.2. Education: Applicants may substitute education for the required experience. To qualify based on

education for this grade level you must have a high school diploma or equivalent from an accredited institution

COT/Sitters2.1.8. Qualifications: Each COT/Sitter shall:

2.1.8.1. No education, experience or certification requirements for these positions. Contractor Agency sitters will be monitored by staff Registered Nurses.

SKILLS, KNOWLEDGE, AND ABILITIESa. Excellent verbal, written and interpersonal communication skillsb. Demonstrates an independent work initiative, sound judgment and attention to detailc. Ability to organize workload and use effective time managementd. Ability to work effectively in a team environment

e. Basic knowledge of medical terminology

f. Demonstrate sensitivity to cultural diversity, race, gender, and others individual differences in the workplace

2.2. If one of the Multi-Specialty RN, LPN, CNA, CRNA, NP, MW, and Sitter certification is suspended, revoked or expires, the PA must be removed from the occupation which may result in termination of employment for the services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Veterans Affairs Health Care System (VAPHS).

2.3. Credentialing and Privileging –Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contractor’s physician(s) prior to obtaining approval by VAPHS Professional Standards Board, Medical Executive Board and Medical Center Director.

2.3.1. If a contractor’s 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.

2.4. Technical Proficiency - Contractor’s physician assistant (s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed.

Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s physician(s) and contractor’s 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.

2.5. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements : Contractor shall provide the COR copies of current CMEs as required or requested by the VAPHS. Contractor’s 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 contractor’s physician(s).

2.6. Training (ACLS, BLS, CPRS and VA MANDATORY) : Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician(s) as required by the VA.Other training may become required. VA will communicate any changes to the training requirement to the contractor:

Training Frequency (once a year, etc)

Annual Hours

Active Threat TrainingBlood Administration: ComplicationsBlood Administration: Administration (all contract employees who administer blood components)Government EthicsVA Privacy and Information Security Awareness and Rules of BehaviorVHA Privacy and HIPAA Focused TrainingACLS/BLSPatient SafetyPatient RightsPatient AbusePrevention/Management of Disruptive Behavior/Violence Prevention Level ISuicide Prevention: Suicide Risk Management Training for CliniciansSUX Infection Control and Bood Borne PathogensCPRSVISTA ImagingList other Training per local facility

2.7. Standard Personnel Testing (PPD, etc.) : Contractor shall provide proof of the following tests for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

2.7.1. TUBERCULOSIS TESTING :  Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician (s) {This is applicable to all health care workers}. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results.  The TST or IGRA testing shall be repeated annually.

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

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

2.7.3.1. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}.

2.7.3.2. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season . {This is applicable to all health care workers}.

2.7.3.3. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS:  Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s physician (s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.7.3.4. The VAPHS shall notify the Contractor of any significant communicable disease exposures as appropriate.  Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control.  Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.7.4. National Provider Identifier (NPI) : NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.7.5. DEA ( as required) - Contractor shall provide copy of current DEA certificate.

2.7.6. Conflict of Interest: The Contractor and all contractor’s physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided.  The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services.  The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.7.7. Citizenship related Requirements :

2.7.7.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2.7.7.2. While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.7.7.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs

Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.7.7.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.7.7.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

1.1.3. 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.

2.7.7.6. 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 contractor’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.

2.7.7.7. By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.8. Clinical/Professional Performance : The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAPHS COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.9. Non Personal Healthcare Services : The parties agree that the Contractor and all contractor’s specialties shall not be considered VA employees for any purpose.

2.10. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.

2.11. Inherent Government Functions : Contractor shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.12. No Employee status : The Contractor shall be responsible for protecting Contractor’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:

2.12.1.Workers’ compensation2.12.2.Professional liability insurance2.12.3.Health examinations2.12.4. Income tax withholding, and2.12.5.Social security payments.

2.13. Tort Liability: The Federal Tort Claims Act does not cover Contractors. When a Contractor 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 (action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.1.4. ADDITIONAL REQUIRED QUALIFICATIONS

In addition to the immunizations mentioned in section 2.1.2, the vendor will also include, at their expense, in the orientation profile file for each employee, the following information from the VA Orientation Profile Checklist. A copy of the current checklist will be provided to the vendor. This list is determined by the Service Line Representative and changes from time to time. The CO or COR will notify the vendor of changes via e-mail.

Name: Position:Projected/Requested work area E-Mail of Credential Review Completed:Background Check (within 90 days)Physical (within 90 days) include VA provided templatePPD (2-step within 90 days) Chest X-Ray & Questionnaire for Hx positive PPD CPR Card (American Red Cross, American Heart Association, or the Military Network)Flu or Declination with copy of Appendix B (attached at the bottom of this document)

Hepatitis B or DeclinationMMR or DeclinationRubella or DeclinationVaricella or DeclinationHepatitis C or Declination Tetanus (within 10 years) Facility Staffing Guide (FSG)OSHA ExamMinimum work/Training Requirement Resume

2.1.5. Key Personnel:

2.1.6. The VA Full Time Equivalency Employee (FTEE): FTEE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.1.7. The Contractor shall initially provide the VA Pittsburgh Healthcare System with nineteen (19) Full Time and one (1) Part time FTEE for a six (6) Month base period for Multi-Specialty RN, LPN, CNA, CRNA, NP, MW, and Sitter Locum Services. Contract will be certified in their field according to VAPHS regulations in order to perform the requirements of this BPA which is expected to include a series of short term orders to meet emergent needs of the medical center. Other specialty will be sought throughout the duration of the contract on an as-needed basis.

2.1.8. 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 contractor is unable to complete an assigned shift, the contractor shall provide replacement contractor coverage within 2 hours and notify the Contracting Office Representative (COR) at the VAPHS immediately of the schedule change.

2.1.9. 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 fifteen (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 fifteen (15) calendar days prior to making any permanent substitutions.

2.1.9.1. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced.

The CO will notify the Contractor within _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.

2.1.9.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive work days or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two (2) weeks will require the procedure as stated above.

2.1.9.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the 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.

2.1.9.4. Contingency Plan: Because continuity of care is an essential part of VAPHS’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.

3. VA HOURS OF OPERATION/SCHEDULING: 3.1. VA Business Hours : Business Hours: 24 hours per day, 7 days a week or as required. Specific times will be defined

per specialty and job requirement.

3.1.1. Work hours : Personnel shall typically perform services across various 8.5 hour shifts, 40 hours a day, seven days a week, including Federal Holidays with actual work schedules to be mutually agreed upon by Contractor and VA based on patient care needs. A 30 minute, unpaid, lunch break is included in each shift. Each shift has two 15 minute paid breaks. A mutual agreement between VAPHS and the contractor will be made, concerning the hours required for each individual task order against this contract.

3.1.2. Alternate Shifts are acceptable provided they are approved by the COR prior to implantation.

3.1.3. Off-hours Coverage : If required per specialty, Contractor’s must be available on-call during all hours when the (VAPHS) clinic is closed, including evenings, weekends and holidays.

3.1.4. On-call contractor’s must be available at all times for phone consultations with VA residents and physicians if required in their job description or task order.  

3.2. Federal Holidays : The following holidays are observed by the Department of Veterans Affairs: (Holiday pay is only paid if the person works on the holiday per the FSS schedule and VAPHS contract, these are not considered paid holiday’s off for temporary staffing).

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.

3.3. Unless a state of emergency has been declared, the Contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES

4.1. SERVICES REQUIRED: Nursing and Nursing Support Services4.2. STANDARDS OF PRACTICE: Contractor shall be responsible for meeting or exceeding VA and Joint Commission

(or equivalent) standards.

All personnel performing services for the Contractor under this Contract must be credentialed and privileged by the VAPHS and shall abide by the Medical Staff Bylaws, VA regulations and policies, Customer Service Standards, and Patient and Nursing Home Resident Rights and Responsibilities. (Medical Staff Bylaws are available on the VAPHS SharePoint site at: https://vaww.visn4.portal.va.gov/pittsburgh/home/KC/Documents/Forms/MCMCategory.aspx Veterans Health Administration (VHA) publications are available at http://www1.va.gov/vhapublications/searchresults/cfm and VA publications are available at http://www1.va.gov/vapubs/index.cfm; Customer Service Standards are available in VHA Directive 2006-041, Veterans Health Care Service Standards dated June 27, 2006, at http://www1.va.gov/vhapublications/ViewPublication.asp?pub ID=1443; and Patient and Nursing Home Resident Rights and Responsibilities are available at http://www.patientadvocate.va.gov/Rights.asp.) The Contractor will be responsible for meeting all quality standards set forth in the most current The Joint Commission Manual for Hospitals, and for compliance with The Centers for Medicare and Medicaid Services (CMS) guidelines, and other applicable VA quality measures. Outcomes from Contractor employee specific data collection, peer review activities, and the patient compliment/complaint process will be used in the performance improvement process, and considered at the time of re-privileging.

d. All personnel providing services under this Contract shall speak and write English proficiently.

e. The Contractor shall meet or exceed all The Joint Commission and National Council of Quality Assurance (NCQA) standards including, but not limited to patient rights, staff competence, infection control, ongoing organizational performance, patient education, information management, and VAPHS performance measures. The Contractor is responsible for achieving levels of performance for patient care management as outlined in the current Network Performance Plan and Performance Measurement Technical manual which can be accessed at: http://vaww.oqp.med.va.gov/oqp_services/performance_measurement/tech_man.asp#TablesTM. Revisions/updates may be obtained from the above website

f. The Contractor and patient care services provided shall be included in VAPHS data collection activities related to patient satisfaction.

4.3. THE JOINT COMMISSION AND OTHER SPECIAL REQUIREMENTS:a. The Contractor will be responsible to ensure that Nursing and Nursing Support Services personnel providing work on this Contract are fully trained and completely competent to perform the required work.

b. Although this Contract does not require The Joint Commission accreditation or other regulatory requirements regarding worker competency, the Contractor must perform the required work in accordance with The Joint Commission orequivalent standards. The Contractor is required to provide a current performance evaluation (proficiency or competency) on each person providing services under the Contract. The Contractor will provide current copies of the performance evaluations at the time of Contract award and annually on the anniversary date of Contract award to the VA Contracting Officer, or upon request.

VAPHS will provide the vendor an initial list of minimum skills, qualifications and experience for each position. VAPHS will provide updates to the vendor as they occur.

c. The Contractor will provide and document a general orientation for all Contractor Nursing and Nursing Support Services personnel who provide work on this Contract before commencement of work. VA will provide the content of the orientation to the Contractor at the time of Contract award. Documentation of the orientation will be provided to the Contracting Officer. This orientation will include the following topics:

Fire and safety policy and procedure Infection control policy and procedureEmergency Preparedness/Disaster policy and procedure

d. The vendor will submit names and paperwork of potential orientation candidates not later than two weeks prior to the Orientation date specified by the VAPHS. VAPHS will issue a Final Orientation List not later than two days prior to Day One of the orientation.Contractor Nursing and Nursing Support Services personnel will attend an area/program/unit-specific orientation meeting before the commencement of work. The VA will schedule, conduct and document this meeting which will include discussion of the following area-specific topics:

Fire and safety policy and procedure Infection control policy and procedureEmergency preparedness/disaster policy and procedure Initial competence assessmentArea/program/unit specific orientation

If a Contract employee is new to VAPHS, he or she must also attend an Orientation session conducted by Nursing Education. This orientation takes one to three days and is scheduled monthly through the Contracting agency.

e. The VA will monitor the Contractor personnel’s work to ensure Contract compliance.

f. From time to time, the VAPHS will require training for Contract employees. The nature of the training varies. VAPHS will pay for required training either based on the hours worked and submitted via the electronic time keeping system or via submission of TMS certificates indicating completion of required courses. TMS certificates will be reimbursed based on the hours listed as “Learning Hours” within each course regardless of actual time expended completing the course. Copies of all completed training will be provided to the COR as they occur.

g. Not with standing other Contract requirements, upon request of the Contracting Officer, the Contractor will remove from the work site, any Contractor personnel who does not comply with orientation requirements or meet competency requirements for the work being performed.

Agency personnel who have not worked at least one shift within the last 90 days will have to be cleared by the appropriate Associate Chief Nurse or designee prior to returning to shift work. Clearance from the ACN may require attendance at an orientation and/or competency class. The Agency may have to complete a full profile, PIV request and UAR request as determined by the COR.

Vendor employees who do not maintain their training currency via the VA Talent Management System (TMS) will be placed into a Do Not Return (DNR) status. This is permanent. Vendor may move an employee from an active to inactive role, for a minimum of 30 days, prior to expiration of their training to avoid the DNR.Vendor employees may also be placed on the DNR list because of failure to properly perform their duties, repeated tardiness or lateness, or insubordination. These will be substantiated through the VA Report of Contact (ROC) process. Official notification of the DNR status will come from the Contracting Office (CO) or Contracting Officer Representative (COR). The vendor will accept an e-mail notification from a Patient Care Coordinator or a Nurse Manager as a temporary request to remove a Contract employee from the work schedule pending further discussions with the CO or COR.

h. Vendor will maintain current resumes or work histories of all employees.

i. Vendor will schedule work for their employees based on requirements given by VAPHS. These requirements will normally be given 1 – 2 weeks in advance but could be same day or a matter of hours. For notifications less than 24 hours, the fill or non-fill will not be counted as a performance metric.

VAPHS will provide at least 2 hours of notice for cancellations. If the VAPHS does not provide the two hour minimum, the VAPHS will pay for 4 hours at the normal pay rate for Time and Trouble.If a vendor employee chooses to return home rather than accept a re-assignment during a shift, the VAPHS will only pay for the hours worked even if they are less than 4 hours.

j. The process to bring a Contract employee is complex. The process is also constantly changing due to changes in technology and security requirements. During the post award conference, the CO and COR will work with the vendor

to explain the process. Vendor will develop internal processes to work within the VAPHS hiring process. As a minimum, this will involve vendor created orientation packets, vendor coordination with VAPHS agencies for finger prints and Personal Identity Verification (PIV) cards, and vendor coordination for training and orientation.

All vendor submissions of resumes, profiles, training, etc. will follow the VAPHS prescribed file naming conventions. This is as follows:

The type of reports are UAR, PIV, Profile, Physical, Training, Resume. This list may be updated periodically with advance notice to be given to the vendor.

k. All permanent full-time vendor employees involved in the Contract must employ an e-mail encryption system compatible with the VAPHS e-mail system.Vendor is required to provide and qualify a minimum of two full-time Contractor employees to assist with the VetPro process. VetPro is the VA credentialing software system and the Contractor employees would do the initial data entry.

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

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

4.4.1. Contractors 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.

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

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

4.5.2. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

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

4.5.3.1. Academic environment: Provide for an academic environment conducive to the training and professional development for residents rotating through the Internal Medicine/Surgery Service.

4.5.3.2. Resident patient care documentation: If applicable, Contractor’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 VAPHS ______. 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.

4.5.3.3. Clinical Direction and Oversight: Contractor’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

4.6. MEDICAL RECORDS

4.6.1. Authorities : Contractor’s 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).

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

4.6.3. Disclosure : Contractor’s 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.

4.6.4. 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 VAPHS.

4.6.4.1. 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 at the following address:

Jeffrey Adamson                            Lisa Hoss     Privacy Officer                          Privacy Officerjeffrey.adamson@va.gov              lisa.hoss@va.gov Office:  (412) 822-1124              Office: (412) 822-1123          4.7. Direct Patient Care: 90 % of the time involved in direct patient care.

4.7.1. Per the qualification section of this PWS, the Contractor shall provide the following staff:

4.7.1.1. Qualifications:

SIN Description Job Description

621-025 Registered Nurse-General and Specialty

621-025-1

Operating Room (Circulator)-Surgery

The incumbent practices as a registered nurse in the Operating Rooms, Nursing Section of Surgical Services within VAPHS. The incumbent must demonstrate and maintain competencies required for all process, procedures and equipment used in the Operating Room. The VAPHS operating rooms specialize in caring for adult and geriatric veterans during the perioperative experience. The operating rooms provide the following services: General surgery, Gyne surgery, ear, nose and throat, ophthalmic, peripheral vascular, thoracic, urologic, plastic, podiatric, endoscopic and laparoscopic, Cardiac Open Heart, Neurosurgery, Transplant, Major Orthopedic, i.e. Total Joints. The nurse has the technical and operational knowledge and clinical skills to function as a circulating and scrub nurse in all the services. The nurse must demonstrate a variety of specialized diagnostic and treatment procedures.

621-025-2

Same Day Surgery (GI check in only)-Surgery-

The Same Day Procedure Unit provides pre- and post-procedural education and care to the medical and surgical patients who are processed through this area for their procedure. The admitting pre-procedure nurse is responsible for assisting the anesthesia staff with patients that require regional block anesthesia for their surgery or procedure. Discharge planning is initiated at the time of the nursing assessment, reassessed and revised throughout the same day process. The same day patient will be discharged when meeting established discharge criteria as outlined below. Patients will receive written discharge instructions upon discharge. A pre-procedural phone call will be made to outpatients the business day prior to their scheduled surgery. Nursing staff will function in the role of family liaison. Both of these responsibilities will be done following the SOP for SDPU Pre/call and Family Liaison Nurse Assignment. The patient will receive nursing care and continuous assessment based on written nursing standards of care and orders by the physician or PA-C/CRNP. The admitting pre-procedure nurse will be responsible for assessment, pre-procedure admission documentation, and approved point of care testing, verifying presence of necessary pre-procedure documentation, obtaining baseline vital signs, and carrying out all pre-procedure orders. The post procedure nurse will be responsible for assessment, pain management, obtaining vital signs every 15 minutes until discharge criteria have been met, discharge instructions, and post procedure patient education. Monitor, maintain, and/or improve respiratory function, circulatory function, and neurologic function to include level of consciousness. Monitor intake and output. Monitor sensory and motor function. Promote normothermia. Promote and maintain effective pain relief, comfort management, and emotional comfort. Monitor surgical/procedure site. Document assessment, nursing action/intervention, medication administration, discharge instructions/education, level of understanding and outcomes. Notify appropriate anesthesia to evaluate prior to discharge from SDPU when meeting discharge criteria. A post-procedure phone call is made by the SDPU nursing staff to each patient that underwent an invasive procedure and was discharged to home from SDPU on the first working day following discharge.

621-025-3

Surgical Clinics-Surgery Assesses patient post op meds and develops sound plan of care based on assessment. Knowledgeable of the nursing care needs of patients as it relates to medical/surgical diagnosis. Demonstrates knowledge of the principles of wound prevention of care. Provides IV care based on medical center policies. Performs accuchecks. Recognizes and responds to emergency situations to include Code Blue (cardiac arrest); Code White (aggressive patients); Code Red (fire); Code Black (disaster). Appropriately assess need for safety devices and utilizes same in accordance with policy. Provides patient health education to patients and families with regard to current treatment, health issues, and patient/family concerns in accordance with educational level of patient/family. Complies with documentation standards. Administers medications in accordance with medical center policies via B.C.M.A. Provides guidance to para professional and nonprofessional staff. Able to care for patients withdrawing from alcohol, responding to significant symptoms and maintaining patient safety during detoxification. Directs care of the patient in restraints, assessing for physical needs i.e. nutrition, hydration, toileting and range of motion exercises.

621-025-4

(Short Stay)-Surgery The nurse will provide nursing care and continuous assessment based on written nursing standards of care, policies and orders by the provider. The admitting pre-procedure nurse will be responsible for assessment, pre-procedure admission documentation, insertion of peripheral intravenous access, obtaining ordered bloodwork, obtaining baseline vital signs, and carrying out all pre-procedure orders. Post-procedurally, the nurse will be responsible for assessment, pain, management, obtaining vital signs as ordered, discharge instructions, and post procedure patient education. The nurse will monitor surgical/procedure site. The nurse will administer oral and intravenous medications as ordered by the provider. The nurse will provide care for cardiac monitored patients per TX-217, 9West Short Stay Unit and the 9W Cardiac Monitoring SOP. The nurse will promote and maintain effective pain relief, comfort management, and emotional comfort. The nurse will conduct initial and ongoing assessment and document per TX-217. A post-procedure follow-up call will be made by the 9W nursing staff to each patient that underwent a surgical or electrophysiology procedure per the 9W Follow-Up Phone Call SOP. Other duties include, but are not limited to answering the telephone, paging physicians, paging ancillary departments for services, looking up physician orders, facilitating carrying orders out, printing lab labels and patient wristbands, taking verbal orders in an emergency, assisting with transportation, coordinating patient bed flow with bed coordinator, completing encounters, checking for expired supplies, and cleaning non-critical reusable medical equipment.

SIN Description Job Description

621-025-5

Cardiac Catherization/EP Lab RN-Medicine

Prepares, monitors, and recovers patients prior to and following invasive cardiac cath/EP procedures, including continuous ECG and hemodynamic monitoring, identification of cardiac a rithmia , response to medications, titration of vasoactive IV medications, and hemodynamic assist devices such as intra – aortic balloon pumps and ventricular assist devices. Performs removal of intra-arterial and intravenous sheaths with monitoring of vital signs and attainment of hemostasis. Documents patient data during recovery phase. Administers medication, including ACLS medications and anticoagulants utilizing all safety precautions. Administers moderate sedation with appropriate patient monitoring, assessment and documentation. Conducts quality control procedures on equipment. Follows strict adherence to sterile procedures on equipment. Follows strict adherence to sterile technique, infection control and safety practices. Participates in maintaining a clean environment. Participates and functions independently with Cardiac Cath/EP projects and Quality Assurance.

SIN Description Job Description

621-025-6

Hemodialysis RN-Medicine

Provide complex and comprehensive professional nursing services within the professional scope of practice for a variety of diagnoses for patients of all ages. Conduct initial assessment on patients; develop nursing care plans based on identified patient needs, coordinate with ancillary services to assure provision of care, document all plans, assessments and care provided. Provide patient and family education throughout the hospitalization. Initiate discharge planning. Administer oxygen, IV fluids, blood transfusions, prescribed medications and titrate medications in accordance with VA policy. Observe and assess patients' clinical condition, recognize and promptly report significant changes indicative of complications. Initiate resuscitative measures in emergency situations. Operate and monitor specialized equipment including, but not limited to: portable dialysis machines, oxygen, hypothermia units, various types of suction apparatus, infusion equipment, patient controlled analgesia pumps (PCA), epidural pumps, sequential compression devices, cardio-respiratory monitors vital sign monitors, and assist with patients in the Intensive Care settings who have invasive hemodynamic catheters and monitors and ventilators. Make nursing care assignments for various skill levels of professional and assistive personnel as assigned. Prepare patients for surgical and diagnostic procedures and assist with procedures as necessary. Provide post-procedure and post-operative recovery care. Ensure that all JC standards for professional nursing care are met during performance of care. Complete appropriate medical record forms in compliance with VA guidelines and policies on each patient. Verify the content and correctness of all recorded entries in the patient record. All documentation/records/reports must meet or exceed established VA standards to include, but not limited to: timeliness, legibility, accuracy, content and signature. The outpatient record shall be completed the same day the patient is seen. Respond to emergency codes as directed and summon appropriate backup from the clinical and hospital staff. Demonstrate sensitivity to cultural diversity, race, gender, and others individual differences in the workforce, in the Veteran population and in the Community. Other duties, as assigned.

621-025-7

Neurology RN-Medicine Documents information in EMR regarding assessment, diagnosis, treatment, and education for patients with acute and chronic neurological illnesses. Perform initial patient screenings via consult triage. Coordinates neurology planning services and screening services. Coordinates diagnostic procedures, injections and pharmacological treatments. Prepare patients for medical procedures. Administers medication as necessary and ordered by prescribing clinicians within the Neurology Department. Maintains all skills and competencies necessary to promote and enhance the mission of the Neurology Department. Serve as the resource r/t patients need for ongoing care information, counseling and provide guidance for any patients with critical conditions. Procures and organizes patient handouts in a readily available manner for clinical use by professionals and patients in conjunction with the Ambulatory Care Medical Liaison and appropriate Quality Assurance team. Responds to all Codes; expedites pt. disposition to appropriate level of care. Facilitates admissions including ensuring report is called to receiving units and that transport is provided by licensed staff only. Monitors clinic wide schedules; completes scheduled rounds in waiting area. Serves as point of contact for clinic walk-ins/phone calls/inquiries including telephone triage to increase access and promote good customer service. Collects and analyzes data to monitor nurse sensitive metrics for benchmarking; Participates in Quality Improvement. Develops collaborative relationships with other departments, services, and community health care agencies to facilitate and support quality neurology care. Maintains professional growth and development through seminars, workshops and professional affiliations to keep abreast of the latest trends in field of expertise. Completes Environment of Care Rounds as per facility policy

SIN Description Job Description

621-025-8

Diabetes RN-Medicine Must demonstrate comprehensive knowledge of and experience in diabetes management, prediabetes, and diabetes prevention and hold a current National Certification Board for Diabetes Educators certification. Maintains equipment and supplies as per facility policy. Provides outpatient diabetes and self-management training and education to type 1, type2, and gestational diabetic patients. Education includes, but is not limited to, signs/symptoms and respective treatments for hyperglycemia, hypoglycemia, DKA, HHNK, and sick day therapies. Plans, develops, and implements individual and group diabetes education for adults, their families, and caregivers. Provides specialized counseling in self-care to individuals and groups. Instructs patients and family members on glucometers, lancets, syringes, insulin pens and insulin pumps to assure consistent technique and safety. Obtains, reviews, and analyzes information including laboratory findings, glucometer readings, and subject self-reports in collaboration with patients, family members, and health care team members to manage diabetes care and treatment. Monitors and evaluates short and long-term patient responses to therapeutic interventions in collaboration with providers; provides and maintains necessary follow-up for patients and families. Teaches patients about monitoring insulin levels and managing medications. Teach patients to develop long-term strategies for maintaining a healthy diet; informs patients about wise food choices, provide nutritional counseling for weight control and disease management. Coaches patients to increase physical activity Follows patient’s progress for control of blood sugar, lipids, renal function and prevention of diabetes complications. Provides specialized training to other healthcare professionals in diabetes, health, and clinical procedures; coordinates in-service training, continuing education, and other related diabetes and clinical health training. Leads initiatives to promote evidence based diabetes practice across the facility; assist in the development of policies and procedures for diabetes and health education guidelines. Collects and processes specimens to determine blood glucose, hemoglobin A1C, cholesterol, lipids, and urinalysis; maintain equipment and assist in ordering laboratory supplies as needed; maintains annual competencies in bench top laboratory assays. Procures and organizes patient handouts in a readily available manner for clinical use by professionals and patients in conjunction with the Ambulatory Care Medical Liaison and appropriate Quality Assurance team. Administers medication as necessary and ordered by prescribing clinicians within the Endocrinology Department. Maintains all skills and competencies necessary to promote and enhance the mission of the Endocrinology Department. Participates in Quality Improvement. Develops collaborative relationships with other departments, services, and community health care agencies to facilitate and support quality diabetes care. Maintains professional growth and development through seminars, workshops and professional affiliations to keep abreast of the latest trends in field of expertise. Must demonstrate comprehensive knowledge of and experience in diabetes management, prediabetes, and diabetes prevention and hold a current National Certification Board for Diabetes Educators certification. Maintains equipment and supplies as per facility policy. Provides outpatient diabetes and self-management training and education to type 1, type2, and gestational diabetic patients. Education includes, but is not limited to, signs/symptoms and respective treatments for hyperglycemia, hypoglycemia, DKA, HHNK, and sick day therapies. Plans, develops, and implements individual and group diabetes education for adults, their families, and caregivers. Provides specialized counseling in self-care to individuals and groups. Instructs patients and family members on glucometers, lancets, syringes, insulin pens and insulin pumps to assure consistent technique and safety. Obtains, reviews, and analyzes information including laboratory findings, glucometer readings, and subject self-reports in collaboration with patients, family members, and health care team members to manage diabetes care and treatment. Monitors and evaluates short and long-term patient responses to therapeutic interventions in collaboration with providers; provides and maintains necessary follow-up for patients and families. Teaches patients about monitoring insulin levels and managing medications. Teach patients to develop long-term strategies for maintaining a healthy diet; informs patients about wise food choices, provide nutritional counseling for weight control and disease management. Coaches patients to increase physical activity Follows patient’s progress for control of blood sugar, lipids, renal function and prevention of diabetes complications. Provides specialized training to other healthcare professionals in

diabetes, health, and clinical procedures; coordinates in-service training, continuing education, and other related diabetes and clinical health training. Leads initiatives to promote evidence based diabetes practice across the facility; assist in the development of policies and procedures for diabetes and health education guidelines. Collects and processes specimens to determine blood glucose, hemoglobin A1C, cholesterol, lipids, and urinalysis; maintain equipment and assist in ordering laboratory supplies as needed; maintains annual competencies in bench top laboratory assays. Procures and organizes patient handouts in a readily available manner for clinical use by professionals and patients in conjunction with the Ambulatory Care Medical Liaison and appropriate Quality Assurance team. Administers medication as necessary and ordered by prescribing clinicians within the Endocrinology Department. Maintains all skills and competencies necessary to promote and enhance the mission of the Endocrinology Department. Participates in Quality Improvement. Develops collaborative relationships with other departments, services, and community health care agencies to facilitate and support quality diabetes care.Maintains professional growth and development through seminars, workshops and professional affiliations to keep abreast of the latest trends in field of expertise.Must demonstrate comprehensive knowledge of and experience in diabetes management, prediabetes, and diabetes prevention and hold a current National Certification Board for Diabetes Educators certification. Maintains equipment and supplies as per facility policy. Provides outpatient diabetes and self-management training and education to type 1, type2, and gestational diabetic patients. Education includes, but is not limited to, signs/symptoms and respective treatments for hyperglycemia, hypoglycemia, DKA, HHNK, and sick day therapies. Plans, develops, and implements individual and group diabetes education for adults, their families, and caregivers. Provides specialized counseling in self-care to individuals and groups. Instructs patients and family members on glucometers, lancets, syringes, insulin pens and insulin pumps to assure consistent technique and safety. Obtains, reviews, and analyzes information including laboratory findings, glucometer readings, and subject self-reports in collaboration with patients, family members, and health care team members to manage diabetes care and treatment. Monitors and evaluates short and long-term patient responses to therapeutic interventions in collaboration with providers; provides and maintains necessary follow-up for patients and families. Teaches patients about monitoring insulin levels and managing medications. Teach patients to develop long-term strategies for maintaining a healthy diet; informs patients about wise food choices, provide nutritional counseling for weight control and disease management. Coaches patients to increase physical activity Follows patient’s progress for control of blood sugar, lipids, renal function and prevention of diabetes complications. Provides specialized training to other healthcare professionals in diabetes, health, and clinical procedures; coordinates in-service training, continuing education, and other related diabetes and clinical health training. Leads initiatives to promote evidence based diabetes practice across the facility; assist in the development of policies and procedures for diabetes and health education guidelines. Collects and processes specimens to determine blood glucose, hemoglobin A1C, cholesterol, lipids, and urinalysis; maintain equipment and assist in ordering laboratory supplies as needed; maintains annual competencies in bench top laboratory assays. Procures and organizes patient handouts in a readily available manner for clinical use by professionals and patients in conjunction with the Ambulatory Care Medical Liaison and appropriate Quality Assurance team. Administers medication as necessary and ordered by prescribing clinicians within the Endocrinology Department. Maintains all skills and competencies necessary to promote and enhance the mission of the Endocrinology Department. Participates in Quality Improvement. Develops collaborative relationships with other departments, services, and community health care agencies to facilitate and support quality diabetes care.Maintains professional growth and development through seminars, workshops and professional affiliations to keep abreast of the latest trends in field of expertise.

621-025-9

Oncology/Chemotherapy RN-Medicine

Must demonstrate competence and hold a current Oncology Nursing Society (ONS) issued Chemotherapy/Biotherapy provider card or are an Oncology Certified Nurse (OCN) with recent experience administering cytotoxic agents by the intravenous (IV) infusion, IV push, intramuscular (IM), and subcutaneous routes. Provide an advanced level of specialized professional nursing care to the adult Hematology/Oncology patient and adult Bone Marrow Transplant patients. Maintain a cancer-specific knowledge base and clinical expertise in cancer care through the use and application of current VAPHS policies, evidence based protocols/guidelines, and current research studies and reports. Formulate care plan based upon assessment of each patient's physical performance status, psychosocial functioning, cultural/ethnic background, spiritual/religious beliefs, and cognitive status. Perform comprehensive assessments, document and review physician orders. Educate patient and/or family members about their disease, treatments, and potential side effects/complications. Administer complex chemotherapy drugs such as Southwest Oncology Group regimens, biological response modifiers, and monoclonal antibody therapy in accordance with prescribed protocols using various routes, including oral, intravenous, intramuscular, subcutaneous, intradermal, and intraperitoneal. Monitors patient's response for side effects, toxicities, and contraindications. Provide specialized care for the most immunosuppressed patient population as the primary healthcare provider. Communicate and collaborate with other staff members, health care providers, and inpatient units to maintain continuity of care. Assist in training nurses, residents and students to care for oncology patients and acts as preceptor for nurses undergoing chemotherapy certification. Perform or participate in a variety of procedures independently or in assistance of our physicians, fellows, and advance practice physician extenders. Initiates and manages a wide variety of central and peripheral access devices. Demonstrates excellent communication and collaboration skills.

SIN Description Job Description

621-025-10

Pulmonary/Bronchoscopy RN-Medicine

Performs cardiopulmonary functions such as assistance with diagnostic/therapeutic bronchoscopies and other interventional/diagnostic cardiopulmonary procedures within the registered nurse scope of practice. Administers moderate sedation during bronchoscopy procedures; monitors patient condition and response to anesthesia throughout procedure; ensures patient safety and stability through recovery phase. Have and maintain current Advanced Cardiovascular Life Support (ACLS). Administers conscious sedation during bronchoscopy procedures; monitors patient condition and response to anesthesia throughout procedure; ensures patient safety and stability through recovery phase. Applies knowledge of WAKE Scoring. Demonstrates skills and techniques needed for airway management. Demonstrates appropriate care, handling, and cleaning of critical, semi critical and non-critical RME. Demonstrates skill in the insertion of intravenous lines and performs venipunctures. Administers IV medications. Performs 6-minute walk to determine oxygen needed at rest and with activity. Responsible for oxygen vendor communications, emailing and faxing. Responsible for quality assurance tracking and data input to prevent loss of rental equipment. Coordinates home oxygen set up and delivery at primary residence and for travel. Manages oxygen delivery systems and supply. Ensures patients have appropriate oxygen prescription including initial and annual reassessments. Teaches patients and families safe and proper use of home oxygen (including compressed gas, liquid, portable and stationary concentrators).Manages and maintains respiratory care equipment and procedures, to include training, cleaning, documentation, infection control, quality improvement, and accountability. Performs arterial blood gas sampling. Administers breathing treatments. Teaches patients to use nebulizers and inhalers Assists with liquid oxygen refills. Collect, manages and reports quality improvement and safety data. Administers medication as necessary and ordered by prescribing clinicians within the Pulmonary Department. Maintains all skills and competencies necessary to promote and enhance the mission of the Pulmonary Department. Participate in Quality Improvement. Develop collaborative relationships with other departments, services, and community health care agencies to facilitate and support quality pulmonary care. Maintain professional growth and development through seminars, workshops and professional affiliations to keep abreast of latest trends in field of expertise.

621-025-11

RN Charge Nurse-Medicine

Responds to all rapid response codes and leads team to expedite disposition to appropriate level of care. Provides direct patient care across multiple specialties. Provides care for complex patients, including but not limited to allergy injections, port flushes, therapeutic phlebotomy, wound care, suture removal, and oxygen evaluations as needed. Competency training will be provided. Monitors clinic wide schedules; completes observation rounds in waiting area. Facilitates admissions including ensuring report is called to receiving units and that transport is provided by licensed staff only. Works with administration to coordinate room grid to accommodate providers within scheduled clinics; Coordination of provider room assignments daily. Serves as point of contact for clinic walk-ins/phone calls/inquiries including telephone triage to increase access and promote good customer service. Collects data to monitor nurse sensitive metrics for benchmarking. Makes daily staffing assignments. Oversees and mentors staff during assigned shift. Determines staffing level and assignments based on staff availability, staff abilities, census, and patient acuity. Floats between staff to assist with problem-solving. May take staffing assignments to meet patient needs across multiple clinics to ensure staff are assigned productively and efficiently throughout the course of the day. Evaluates the effectiveness of patient care, including formal evaluation, and identifies any issues that affect desired patient outcomes. Responds to complaints about patient care and related services, and manages through established channels in accordance with VAPHS policies and industry standards. Responds to safety concerns throughout the clinic and any required related services, and manages through established channels in accordance with VAPHS policies and industry standards. Performs role-specific duties as assigned, including entering orders, coordinating transfers, and ensuring staff has necessary equipment and supplies to provide safe, quality patient care. Maintains all skills and competencies necessary to promote and enhance the mission of the Medical Specialty Clinics et al. including: Allergy competency; CVAD access competency; Eligard competency; Home O2 evaluation competency; Moderate sedation competency; Therapeutic phlebotomy competency

SIN Description Job Description

621-025-12

RN- Med/Surg Provide comprehensive nursing care within the professional scope of practice for a variety of diagnoses for adult through geriatric patients. Conduct initial assessment on patients; develop nursing care plans based on identified patient needs, coordinate with ancillary services to assure provision of care, document all plans, assessments and care provided. Provide patient and family education throughout the hospitalization. Initiate discharge planning. Administer oxygen, IV fluids, blood transfusions, prescribed medications and titrate medications in accordance with VA policy. Observe and assess patients' clinical condition, recognize and promptly report significant changes indicative of complications. Initiate resuscitative measures in emergency situations. Operate and monitor specialized equipment including, but not limited to: oxygen, hypothermia units, and various types of suction apparatus, infusion equipment, and patient controlled analgesia pumps (PCA), epidural pumps, sequential compression devices and vital sign monitors. Prepare patients for surgical and diagnostic procedures and assist with procedures as necessary. Provide post-procedure and post-operative recovery care. Ensure that all Joint Commission standards for professional nursing care are met during performance of care. Complete appropriate medical record forms in compliance with VA guidelines and policies on each patient.

621-025-13

RN - Primary Care UD Participates in direct patient care surrounding scheduled and unscheduled visits. Triages walk-in/urgent visits and utilizes RN protocols to assist with triagingManages same day patient care needs and coordinates procedures, labs, transitions, education, and follow-up if indicated. Conducts telephone triaging and nurse health advice calls. Based on the daily

huddle, identifies patients that will require special nursing care that day and collaborates with the teamlet about how best to meet that patient’s needs. Manages secure messages assigned to RN. Reviews and completes clinical reminders during RN visits. Provides patient-centered, evidence-based, patient-driven care in all patient interactions. Ensures patients are linked with all appropriate services, resources, and opportunities based on his or her needs. Educates patients to promote independence in navigating through the healthcare system. Initiates consults to extended team including mental health, Home Telehealth (HT), nutrition, social work, HBPC, OEF/OIF, palliative care, hospice, specialists, and non-VA care. Conducts follow up calls related to clinic visits if indicated. Conducts follow up calls for ER visits and hospitalizations, reviews records, and coordinates follow up procedures, labs, transitions, education, and follow-up visits if indicatedActs as an advocate for patients to ensure their needs are met.

621-025-14

RN - Primary Care HJH Same as above

SIN Description Job Description

621-038 Licensed Practical/Vocational Nurse (Includes: Specialty Oriented; Clinical; Med/Surg)

621-038-1

Surgical Clinics-Surgery Contractor will ensure that Contract LPN provides skilled nursing care to Intermediate/Medical, Nursing Home Care Unit, and Psychiatric patients. He/she may perform those approved Medical Center procedures that are described in the Licensed Practical Nurse Act, Vocational Nurse VA Qualification Standards. The Contract LPN demonstrates increasingly more independence in his/her management of patient care. The Contract LPN demonstrates competence in caring for adult psychiatric, medical, and geriatric patients

621-038-2

Heinz Community Living Center (CLC)

Obtain patient history and pertinent family history. Perform quality control checks and operator maintenance for a variety of patient care equipment. Assist in identifying patient needs and implementing the plan of care. Document care given and patient response in the medical record. Prepare patient for physical examination. Carry out prescribed nurse initiated, nurse practitioner and physician orders and document in patient medical record. Communicate pertinent patient data to the appropriate provider. Possess knowledge of actions and usual dosages of most commonly used emergency drugs and their location. Recognize emergency situations and initiate appropriate resuscitative measures. Assist in patient/family education regarding prescribed medications/therapies/diagnostic procedures. Assess patient/family knowledge level, implement plan of instructions and record patient/family demonstrated level of understanding. Assure content and correctness of a prepared report and sign document to validate its content. Participate in monitoring quality of care according to professional standards and established procedures. Respond to telephone inquiries regarding ward services and/or follow-up ancillary reports. Assist with ward related administrative tasks. Administer oxygen, intravenous fluids and prescribed medications in accordance with MVAMC policy. Demonstrate sensitivity to cultural diversity, race, gender, and others individual differences in the workforce, in the Veteran population and in the Community. Other duties, as assigned.

621-038-3

Specialty LPN-Medicine Responsible for review of physician orders (includes labs, EKGs, etc.) prior to the intake of all patients. Responsible for utilizing sound judgment to prioritize patients with acute medical needs and ensure they are seen in a timely manner. Participates in improving patient flow in the clinic. This includes receiving patients/family members in a timely manner, providing clear directions to assist patient with navigation during their visit, and securing or providing escort assistance when necessary. Responsible for thorough documentation in the electronic medical record as well as record maintenance in the clinic as necessary. Responsible for safeguarding patient information during the appointment visit in accordance with HIPAA, the Privacy Act and medical confidentiality regulations. The Licensed Practical Nurse provides clinical support and assists physicians and nurses as needed. Duties include, but are not limited to: initial patient intake, obtaining and documenting vital signs, performing EKG's, preparation of patient for examination, administration of vaccines, administration of allergy injections and assistance with various treatments and procedures. All abnormal results will be reported to the provider or RN immediately. The Licensed Practical Nurse is required to maintain BLS certification. He/she participates and/or assists physicians, nurse practitioners and nurses in any patient medical emergency and must comply with existing fire, safety, hazardous material and other occupational health and safety policies and regulations. Must be knowledgeable of and practice standard precautions in all patient contacts, including infection control. Reusable medical equipment will be cleaned and stored according to facility policy. Collects, labels, and processes a variety of specimens (drawing blood by means of venipuncture, obtaining urine and other specimens) as necessary. Must be proficient to perform a wide range of diagnostic and therapeutic procedures (electrocardiograms, glucose monitoring, dressing changes, bladder scans, oxygen administration, urinary catheterization, suture removal), and routine lab tests as necessary. Maintains examination rooms with medical supplies and forms. Supplies are ordered from SPD as needed. Ensures that equipment is checked for proper functioning prior to use each day. Assesses rooms at the end of clinic and removes patient identifiers. Prepares and administers medications, performs allergy injections and administers vaccines correctly fully understanding the action and side effects of all medications administered. Observes for changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reports any deviations from normal to provider or RN. Communicates with patients and families in a calming, reassuring, and supportive manner. Recognizes patient care management difficulties or problems, and makes suggestions for

change Motivates patients to participate in learning activities to improve their quality of life.621-038-4

LPN -Primary Care UD Completes pre-visit phone calls to Veteran to include reason for visit and complete any clinical reminders that are not sensitive. Orients Veteran to PACT concepts and orientation materials. Rooms patients/checks vital signs for clinic visits including group visits. Collects other data as ordered or indicated including blood sugar, EKG, bladder scans. Completes nurse-driven clinical reminders during check-in and informs the provider of any positive behavioral screens (via highlighting, communication sheets, or instant messaging. Performs clinical reminder driven patient education Coaches patients in health behavior related changes. Rooms patients/checks vital signs and check blood sugars, EKGs, bladder scans, and other data collecting activities as indicated or ordered within scope of practice. Reviews chief complaint (keep it brief) and communicates any urgent needs to the RN or provider Administers medications to be given in clinic if ordered including nebulizer treatments, injections (LPN). Administers and tracks immunizations before and/or after visit with provider. Administers PPD if ordered by provider (LPN)Performs wound care within the scope of practice. Assists providers with exams/procedures. Patient education- glucometer skills, home blood pressure kit, injection techniques, immunization education (LPN). Continues to assess and address the Veteran’s care needs throughout his or her time in the clinic that day, recognizes and reports any changes in patient’s condition that may be urgent or emergent, promptly responds and alerts to care team. Keeps the Veteran informed if the provider is running more than 15 minutes late and keeps Veteran updated regularly until seen by the provider. Assists the RN with patient care during triaging when needed. Assists with call backs for normal labs, follow up care calls, and general telephone education based calls (LPN). Follows up with no-show patients to identify care needs and rationale for missed appointments. Follows-up with patient education and self-management based on provider recommendations in collaboration with the RN (LPN). Assists to coordinate group visits and checks patients in for group visits. Acts as an advocate for patients to ensure their needs are met. Interacts with the Veteran from a patient-centered perspective. Conducts Post-Discharge Calls as assigned, alerting RN Care Manager of any needs or concerns following the call (LPN).

621-038-5

LPN -Primary Care HJH Same as above

621-038-6

Flu LPN- (VAPHS) LPN to administer vaccines to include Influenza and Pneumonia, monitor patient for adverse reactions to vaccine administrations, provide patient and family education on the vaccines. LPN must be proficient in responding in emergent situations, must be CPR citified, proficient in IM injection administrations, proficient in providing patient information, is knowledgeable on and follows infection prevention precautions and proficient in documenting using an electronic system with adequate typing skills. They are needed to assist with the added volume of unscheduled appointments for flu vaccine. We vaccinate a couple thousand patients and this is a beneficial service because it is walk-in. It saves the Veteran from making an appointment and it also reduces the workload in the clinics.

SIN Description Job Description

621-040 Certified Nursing Assistant

621-040-1

Heinz Community Living Center-(CLC)

Take/record blood pressure, pulse, respiration, temperature, height and weight. Measure/record intake and output. Provide routine care to pre- and postoperative patients.Obtain routine specimens for laboratory analysis and perform standard tests. Apply/remove bandages, binders, simple dressings and hot and cold packs. Assist patients in walking, moving and changing positions. Prevent obstruction, dislodgment and unnecessary movement of drainage, suction and parenteral fluid apparatus. Assist physicians and/or nursing staff as appropriate during patient examinations and treatments. Provide personal care to include bathing, shaving and feeding. Make equipment available to patients such as bedpans, linen and grooming items. Accompany patients in wheelchairs, on litters or ambulatory within the hospital. Motivate patients to manage their illnesses and provide patient instructions as directed by unit standard operating procedures. Perform general maintenance duties including, but not limited to, making beds, cleaning/sorting supplies, handling linen according to policies and cleaning patient units. Perform patient treatment procedures within established guidelines. Communicate pertinent patient data to charge nurse and/or physician as appropriate. Recognize and respond to emergency situations according to preplanned emergency response measures. Provide patient care as assigned to include documentation of nursing activities in the patient record as appropriate. Assist with the admission and discharge of patients as well as the maintenance of patient information and filling out laboratory/x-ray/EKG slips. Perform CPR. Demonstrate sensitivity to cultural diversity, race, gender, and others individual differences in the workforce, in the Veteran population and in the Community. Other duties, as assigned.

621-053 CRNA-Certified Registered Nurse Anesthetist (Surgery)

Demonstrates current clinical practice and act as a consultant in nurse anesthesia practice. Attends Medical Center and community meetings, seminars, conferences, and represents a professional image of the Surgical Service Line and VA Pittsburgh Healthcare System. Designs/revises formal standards of practice to improve patient outcomes and health care delivery processes at the service, functional group, Medical Center, network, or community levels. Participates and collaborates with multidisciplinary teams in implementing and improving standards of practice.Acquires and maintains current knowledge in practice (assessments, therapies, procedures, and technology) to effectively meet program, service, functional area, or system performance. Addresses ethical issues that impact individual patients, families, peers, and functional groups in collaboration with service, interdisciplinary, and administrative staff. Responsible for maintaining competencies in all Reusable Medical Equipment (RME), technology, and Medical Center requirements.

621-054 Nurse Practitioner

621-054-1

Gastroenterology Nurse Practitioner (Medicine)

Participate in the care of patients seen in various outpatient clinics, including but not limited to the GI, Hepatology and CVT. Coordination of veteran care related to GI and Hepatology condition, surveillance, diagnosis, treatment, and Veteran education to maintain or improve health. Serve as consultant to nursing staff in initiating and implementing problem-solving strategies for patient with complex gastro problems. Coordinates and participates in research designed specifically to improve quality of services provided by GI and Hepatology staff. Serve as a resource to PCP for veteran management. Support and enhance VAPHS philosophy and goals. Develop a professional practice by leadership and accomplishments in the development and implementation of best-practice guidelines in patient care and healthcare delivery.

621-054-2

Nurse Practitioner (Primary Care)

Participates in direct patient-centered care to include scheduled visits and unscheduled/urgent visits as well as group visits, and phone visitsProvides group visit (shared medical appointment) options for patients in collaboration with other teamlet members. Focuses on care of medically complex, higher level management patients on the panel and patients experiencing acute exacerbations of their chronic conditions. Performs a comprehensive history and physical once a year for each patient on the panel. Returns patient phone calls as delegated by the RN. Responds to triaged secure messaging assigned by the MSA or RNReviews labs and diagnostics in a timely fashion and communicates lab/imaging/test results to Veteran via telephone, face-to-face, secure messaging, or correspondence letter within 14 days. Depending on findings, follow up may be assigned to other teamlet members as appropriate based on the sensitivity of the result. Develops the treatment plan for all Veterans on the panel. Prescribes and renews medications consistent with the treatment plan. Consults with specialty services when indicated and adheres to service line agreements. Works with RN care manager to coordinate post-hospitalization transitions. Provides patient education to assist Veteran with disease management and improve self- management skills. Orders diagnostic tests to evaluate the patient utilizing practice guidelines. Provides appropriate health screening and preventive care according to NCP guidelines. Utilizes Health Coaching and Motivational Interviewing to partner with patients and assist with behavior change and guidance toward his or her goals. Completes clinical reminders for positive PTSD, depression, alcohol and other provider required reminders. 

621-099 Introduction of New Products/Services (INS) (Includes Categories and Subcategories)

Monitor Watchers/COT (Constant Observation Technician) Social Science Aid

621-099-1A

Monitor Watcher Contractor will ensure that Contract Monitor Watcher with minimal monitoring by a Registered Nurse (RN) provides basic, appropriate, effective interventions to individual patient needs according to established facility policies, safety standards and procedures. The Contract MW refers to the professional RN when deviations and problems not covered in the assignment occur. The MW anticipates the needs of professional staff and works with them as a team member.

621-099-2

COT/Sitters at Heinz Community Living Center-CLC

621-099-2A

COT/Sitter at Heinz Community Living Center-CLC

Contractor will ensure that Contract Sitter in this position will provide assistance to the Nursing Staff of the Patient Care Service Line to assure coordinated and efficient delivery of patient care services. Contractor agency sitters will be utilized to provide continuous observation of selected inpatients as assigned by Nursing Administration in Patient Care Services at the University Drive and HJ Heinz Divisions of the VA Pittsburgh Healthcare System. It is estimated that approximately 100% of the sitter’s time will be expended in patient care activities after training is completed. The Contract sitter may be assigned to one or two inpatients requiring continuous observation. The work is performed on all tours, weekends and holidays. There are no education, experience or certification requirements for these positions. Contractor Agency sitters will be monitored by staff Registered Nurses.

SIN Description Job Description

621-099-3

Health Care Technicians (HCT)

621-099-3A

Surgical Clinics- Surgery Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision and delegatory authority of a surgeon to facilitate the safe and effective conduct of invasive and non-invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure isconducted under conditions that maximize patient safety. Surgical technologists are experts in the theory and application of the principles of asepsis and sterile technique to combine the knowledge of human anatomy, surgical procedures, and implementation and tools and technologies to facilitate a physician’s performance of invasive therapeutic and diagnostic procedures.” Taken from the Association of Surgical Technologist (AST) Job DescriptionSurgical Technicians (ST) are graduates from an AST approved associate degree program. Certification testing is available and preferred for this position.

621-099-3B

Same Day Surgery (procedures)-Surgery

Performs or assists nursing staff with personal care, such as dressing/undressing and toileting for those patients requiring assistance. Assists nursing staff in patient care as directed to include but not limited to; dressing changes, patient positioning, and transfer of patients using lift equipment. Assists provider staff during patient examination with handling of surgical instruments and scopes. Obtains and records vital signs in Computerized Patient Record System (CPRS) and notifies nursing staff of results.Collects and sends routine specimens. Obtains nasal cultures for MRSA as needed Ensures appropriate labeling of lab specimens and transports to lab. Performs glucometer checks and notifies nursing staff of results. Performs 12 lead EKG’s. Assists with transfer and ambulation of patients. Rooms patients from clinic waiting room to clinic exam room, verifying patient identification using appropriate identifiers. Participates in time out prior to designated invasive procedures when needed Assists visitors with way-finding. Transports patients, as directed, to designated areas, using the appropriate method of transporting

621-099-3C

GI Tech: Medical Instrument Tech- Medicine

The GI Tech provides assistance to the patient, physician and other members during endoscopy procedures. The Technician must be an active member of the team, participating with the team members in planning and implementing complex procedures under the general supervision of the team. Functions as a primary technician responsible for handling instruments, supplies and equipment during all diagnostic and complex endoscopic procedures such as but not limited to: colonoscopy, esophagogastroduodenoscopy, (EGD), colonoscopy, esophagogastroduodenoscopy, endoscopy, esophageal dilatations, ileostomy, flexible sigmoidoscopy, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound. Functions as a primary or secondary technician assisting in therapeutic procedures such as but not limited to: endoscopic sphincterotomy, feeding tube placement, dilatation of strictures of the esophagus, stomach, small bowel, colon and biliary system, stent placement and fine needle aspiration. During therapeutic procedures he/she will need knowledge and technical expertise in the operation of electro-surgical cautery and devices us. Plans daily work and patient schedule effectively, sets priorities and coordinates flow of work to support patient continuity of care, education for homeostasis of acute bleeding. Sets up Procedure room with all required items for each procedure. Utilizes universal precautions and follows all infection control policies and procedures when handling specimens, supplies and equipment.

621-099-3D

HCT-Medicine Performs venipuncture and other specimen collection duties; coordinates procurement of supplies and deliver of specimens to 2nd floor laboratory; transports products from blood bank. Cleaning RME to include but not be limited to chairs and other equipment after each patient use as per RME policies and protocols; performs other cleaning task throughout the day and at closing. Manages the proper storage of oxygen tanks in accordance with VAPHS safety policies. Performs vital signs – not limited to start of visit. Escorts patient in non-emergent situations to other outpatient areas. Identifies patient using 2 patient identifiers and provides armbands. Performs stocking and cleaning. Manages linen and makes beds as needed

4.7.2. ADMINISTRATIVE : estimated_10% of time not involved in direct patient

4.7.2.1. Contractor shall be responsible for:

4.7.2.1.1. TASK 1:

COMPUTERIZED PATIENT RECORD SYSTEM : The Contractor is responsible for utilizing the Computerized Patient Record System (CPRS) in Veterans Health Information Systems and Technology Architecture (VISTA) at the VAPHS. Access and training will be provided for the Contractor as needed. Technician personnel will be expected to fully use the system since CPRS will be the sole means of patient record keeping. Record keeping should ensure compliance with applicable The Joint Commission (TJC) and VHA requirements to include data entry into CPRS by appropriate contract employees for documentation of medical records.

4.7.2.1.2. TASK 2:

VA will provide the content of the orientation to the Contractor at the time of contract award. Documentation of the orientation will be provided to the Contracting Officer. This orientation will include the following topics:

Fire and safety policy and procedureInfection control policy and procedureEmergency Preparedness/Disaster policy and procedure

d. Contractor personnel will attend an area/program/unit-specific orientation meeting before the commencement of work. The VA will schedule, conduct and document this meeting which will include discussion of the following area-specific topics:

Fire and safety policy and procedureInfection control policy and procedureEmergency preparedness/disaster policy and procedureInitial competence assessmentArea/program/unit specific orientation

If a contract employee is new to VAPHS, he or she must also attend an Orientation session conducted by Service Line Representative. This orientation takes one to three days and is scheduled monthly through the contracting agency. The COR will notify the agency of upcoming orientations.

The VA will monitor the Professional and Allied Healthcare Staffing Services personnel work to ensure contract compliance.

Notwithstanding other contract requirements, upon request of the Contracting Officer, the Contractor will remove from the work site, any Professional and Allied Healthcare Staffing Services personnel who does not comply with orientation requirements or meet competency requirements for the work being performed.

4.7.2.1.3. TASK 3:

Contractor employees are required to complete the online training classes within TMS entitled “VA Privacy and Information Security Awareness and Rules of Behavior” course number VA 10176, and “HIPAA and Privacy Training” course number VA 10203. Other training may be added or deleted as policies and guidance from higher authority is received. A Certificate of successful completion will be generated for each course. Copies of the certificates shall be maintained by the vendor and can be obtained from the COR if the contract employee cannot print them. Completion of these training courses is required on an annual basis based on the VA’s fiscal year.

4.7.2.2. Patient Safety Compliance and Reporting : Contractor’s physician(s) shall follow all established patient safety and infection control standards of care. Contractor’s 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.

4.8. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI) 4.8.1. Quality Management/Quality Assurance Surveillance: Contractor’s physician(s) shall be subject to Quality

Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined

in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.8.2. 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.

4.8.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

4.8.4. Performance Standards :

4.8.4.1. 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: _90%_meet StandardsSurveillance 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 PerformanceB. Medical/Clinical knowledgeC. Practiced Based Learning and ImprovementD. Interpersonal and Communication SkillsE. ProfessionalismF. System Based Practice

Frequency: Quarterly4.8.4.2. Measure : Qualifications of Key Personnel

Performance Requirement: All contractor(s) shall be qualified in accordance with each specialties requirements and standards. Standard: All (100%) contractor certified if required per their specialtyAcceptable Quality Level: _100% . Surveillance Method: Random Inspection of qualification documentsFrequency: Annually or as required

4.8.4.3. 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: __95_% contractor’s physician(s) perform within their scope of practice/privileges _95__% of the time. Surveillance Method: Random Inspection of records.Frequency: As Required

4.8.4.4. Measure : Patient Access

Performance Requirement: The Contractor shall provide services in accordance with the operating hours and VA clinical schedule outlined in this PWS.Standard: All (100%) contractor(s) are on time and available to perform services.Acceptable Quality Level: Contractor’s physician(s) is on-time and available to perform services 90 % of the timeSurveillance Method: Periodic Sampling of Time and Attendance SheetsFrequency: Daily

4.8.4.5. Measure : Patient SafetyPerformance Requirement: Patient safety incidents shall be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)Standard: All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident.Acceptable Quality Level: All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident. No acceptable deviation.Surveillance Method: Direct ObservationFrequency: Daily

4.8.4.6. Measure : Maintains licensing, registration, and certificationPerformance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current.Standard: All (100%) licensing, registration(s) and certification(s) for contractor’s physician(s) shall be provided as they are renewed. Licensing and registration information kept current.Acceptable Quality Level: _90% licensing, registration(s) and certification(s) for contractor’s physician(s) shall be provided as they are renewed. Licensing and registration information kept current. No acceptable deviation.Surveillance Method: Periodic Sampling and Random SamplingFrequency: As Required

4.8.4.7. Measure : Mandatory TrainingPerformance Requirement: Contractor shall complete all required training on time per VAPHS policyStandard: All (100%) of required training is complete on time by contract physician (s).Acceptable Quality Level: _100% completions.Surveillance Method: Periodic SamplingFrequency: As Required

4.8.4.8. Measure : Privacy, Confidentiality and HIPAAPerformance Requirement: Standard: All (100%) contractor 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 VAPHS, reports violations per VA Directive 6500.6.Frequency: Annually

4.8.5. Registration with Contractor Performance Assessment Reporting System

4.8.5.1. 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 the Simplified Acquisition Threshold, 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.

4.8.5.2. Each Contractor whose contract award is estimated to exceed the Simplified Acquisition Threshold 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.

4.8.5.3. 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.

4.8.5.4. 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.

5. GOVERNMENT RESPONSIBILITIES

5.1. VA Support Personnel, Services or Equipment: 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.

5.2. SPECIAL CONTRACT REQUIREMENTS : Under the authority of Public Law 104-262 and 38 USC 8153, the contractor agrees to provide Professional and Allied Healthcare Staffing Services personnel and services in accordance with the terms and conditions stated herein, to furnish to and at the VA Pittsburgh Healthcare System (VAPHS), the services and prices specified in the Section entitled Schedule of Services and Prices/Costs of this contract.

5.3. Contract Administration/Performance Monitoring : After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to: (enter contract administration if not already listed in another area- list the title (not name) and contact information for COR, Clinical point of contact, and any other relevant personnel involved).

5.3.1. CO RESPONSIBILITIES:

CO - Name/Address/Phone/email

5.3.1.1. 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.

5.3.1.2. 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.

5.3.1.3. 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.

5.3.2. COR Responsibilities:

The COR for this contract is: Title/Address/Phone/email

5.3.2.1. 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.

5.3.2.2. 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.

5.3.2.3. The COR will maintain a record-keeping system of services by sign in logs and quarterly COR reports. 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.

5.3.2.4. 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.

5.3.2.5. All contract administration functions will be retained by the VA.

6. SPECIAL CONTRACT REQUIREMENTS

6.1. Reports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each. Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required.

6.1.1. The following are brief descriptions of required documents that must be submitted by Contractor: upon award; weekly; monthly; quarterly’; annually, etc. identified throughout the PWS and is provided here as a guide for Contractor convenience. If an item is within the PWS and not listed here, the Contractor remains responsible for the delivery of the item.

What Submit as noted Submit ToQuality Control Plan: Description and reporting reflecting the contractor’s plan for meeting of contract requirements and performance standards

Upon proposal and as frequently as indicated in the performance standards.

Contracting Officer

Copies of all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff

Upon proposal and upon renewal of licenses and upon renewal of option periods or change of key personnel.

COR with proposal; renewal submitted to VETPRO system.

Certification that staff list have been compared to OIG list

Upon proposal and upon new hires. Contracting Officer

Certificates of Completion for Cyber Security and Patient Privacy Training Courses

Before receiving an account on VA Network and annual training and new hires.

COR

ACLS/BLS Certification as required per the specialty Upon award and every two years after award.

COR

Contingency plan for replacing key personnel to maintain services as required under the terms of the contract

Upon proposal and as updated COR

6.2. Billing :

6.2.1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th workday of the month. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:

6.2.1.1. Name and Address of Contractor

6.2.1.2. Invoice Date and Invoice Number

6.2.1.3. Contract Number and Purchase/Task Order Number

6.2.1.4. Date of Service

6.2.1.5. Contractor’s physician(s) (Name of Contractor’s employee)

6.2.1.6. Hourly Rate

6.2.1.7. Quantity of hours worked

6.2.1.8. Total price

6.3. Vendor Electronic Invoice Submission Methods- Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below:

6.3.1. Invoices will be electronically submitted to the Tungsten website at http://www.tungstennetwork.com/uk/en/ Tungsten direct vendor support number is 877-489-6135 for VA contracts.  The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. In order to successfully submit an

invoice to VA-FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact:

Tungsten SupportPhone: 1-877-489-6135Website: http://www.tungsten-network.com/uk/en/Department of Veterans Affairs Financial Service CenterPhone: 1-877-353-9791 Email: vafscched@va.gov 

6.4. Payment Adjustments :

6.4.1. Invoices will be prorated for partial days/hours worked. The contractor shall be paid only for actual work performed onsite. In the event that the Contract provider works a portion of an hour, the government may adjust payments by 15-minute increments. Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed.

6.4.1.1. The contract shall be adjusted in accordance with actual performance if the all contracted hours are not used on the contract a de-obligation of funds will be submitted to decrease excess funding.

6.5. Payments in full/no billing VA beneficiaries : The Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Contractor, even if VA does not pay for those services. This provision shall survive the termination or ending of the contract.

6.5.1. 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.

6.5.2. 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.

6.6. Contractor Security Requirements (Handbook 6500.6) - PULLED FROM ECMS, TEAM SHOULD SELECT LANGUAGE FROM EACH SECTION AS APPLICABLE