This is a SOURCES SOUGHT ANNOUNCEMENT ONLY The intent of this Sources Sought Announcement is to assist in our decision-making process for services procurement. This is not a solicitation, nor request for quotes or proposals. Through the receipt of responses, this will enable a more precise type of procurement process. The Government is not obligated to nor will it pay for or reimburse any costs associated with responding to this sources sought synopsis request. This notice shall not be construed as a commitment by the Government to issue a solicitation or ultimately award of a contract, nor does it restrict the Government to a particular acquisition approach. Any inquiries are to be made in writing by email to the point of contact, Larry Facio, Contracting Officer. Responses to this notice shall be sent by email to larry.facio@va.gov by the due date and time of 06/26/2024 by 1:00 p.m. (Pacific Time). Upon receipt of capabilities statement, Contracting Officer may request additional market research aide such as informal pricing. Services Required: The Contractor shall provide Board Certified/Board Eligible GENERAL SURGERY Physician Services onsite in accordance with the specifications contained herein to beneficiaries of the VA and the Central California Health Care System (VACCHCS), Fresno, CA. Place of Performance: Contractor shall furnish services at the VACCHCS Fresno, 2615 E. Clinton Ave, Fresno, CA. 93703. Authority Title 38 USC 8153, Health Care Resources (HCR) sharing Authority OR Title 38 USC 513 General Contracting Policy/Directives/Handbooks. The contractor shall be subject to the following policies, including any subsequent updates during the period of performance. The policies listed below can be accessed electronically at the following: VA Publications VHA Publications VA Directive 1663: Health Care Resources (HCR) Contracting Buying Title 38 U.S.C. 8153 1.4.2. VHA Directive 1003.04: VHA Patient Advocacy VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider Group Practice VHA Directive 1088(1): Communicating Test Results to Providers and Patients VHA Directive 1100.18: Reporting and Responding to State Licensing Boards VHA Directive 1100.20: Credentialing of Health Care Providers VHA Directive 1100.21: Privileging VHA Directive 1192.01: Seasonal Influenza Vaccination Program for VHA Health Care Personnel VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures in Any Clinical Setting VHA Directive 1605.01: Privacy and Release of Information VHA Directive 1907.01: VHA Health Information Management and Health Records VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports Privacy Act of 1974 (5 U.S.C. 552a) as amended: http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm Acronyms/Definitions: 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. ABS: American Board of Surgery http://www.absurgery.org/ ACGME: Accreditation Council for Graduate Medical Education ACLS: Advanced Cardiac Life Support AJIC: American Journal for Infection Control AQL: Acceptable Quality Level BAA: Business Associate Agreement BBA: Balanced Budget Act BLS: Basic Life Support CDC: Centers for Disease Control and Prevention CDR: Contract Deficiency Report CEU: Certified Education Unit Clinical Privileging: Clinical Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual s license, based upon the individual s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific, and within available resources. CME: Continuing Medical Education CMP: Civil Monetary Penalty CMS: Centers for Medicare and Medicaid Services CO: Contracting Officer: 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. COI: Conflict of Interest COR: Contracting Officer s Representative: A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken. COS: Chief of Staff CPARS: Contractor Performance Assessment Reporting System Credentialing: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health care provider to provide care or services in or for the VA health care system. Credentials are documented evidence of licensure, education, training, experience, or other qualifications. DEA: Drug Enforcement Agency EHR: Electronic Health Record - electronic health record system used by the VA EPA: Environmental Protection Agency FAPIIS: Federal Awardee Performance and Integrity Information System FAR: Federal Acquisition Regulation FOIA: Freedom of Information Act FPPE: Focused Provider Practice Evaluation FSMB: Federation of State Medical Boards FTE: Full Time Equivalent: VA s standard definition is for full time working the equivalent of 80 hours every two weeks, 2080 hours per year.  However, providers may propose using their standard FTE definition. HHS: Department of Health and Human Services HICPAC: Hospital Infection Practices Advisory Committee HIPAA: Health Insurance Portability and Accountability Act IGRA: Interferon-gamma Release Assays ISO: Information Security Officer Key Personnel: The individuals specified in this contract who are essential to work performance. MRI: Magnetic Resonance Imaging MST: Military Sexual Trauma NPI: National Provider Identifier. NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The VHA must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). NPPES: National Plan and Provider Enumeration System NSO: National Surgery Office OGC: Office of General Counsel OIG: Office of Inspector General OPPE: Ongoing Provider Practice Evaluation OR: Operating Room POP: Period of Performance PPD: Purified Protein Derivative PPIRS: Past Performance Information Retrieval System PWS: Performance Work Statement QA/QI: Quality Assurance/Quality Improvement QM/PI: Quality Management/Performance Improvement QASP: Quality Assurance Surveillance Plan RFP: Request for Proposal SCS: Specialty Care Services SSAC: Sole Source Affiliate Contract TJC: the Joint Commission TST: Tuberculosis Skin Test USC: United States Code VA: Department of Veterans Affairs VA-FSC: VA Financial Services Center VAAR: VA Acquisition Regulation VETPro: is VHA s mandatory credentialing software platform to document the credentialing of VHA health care Providers. This system facilitates completion of a uniform, accurate and complete credentials file. VHA: Veterans Health Administration VistA: Veterans Integrated Systems Technology Architecture QUALIFICATIONS: Staff/Facility License: The Contractor s physician(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property. All licenses held by the key personnel working on this contract shall be full and unrestricted licenses. Contractor s physician(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract. Board Certification: All Contractor s physician(s) shall be Board Certified/Board Eligible by the ABS http://www.absurgery.org/, and be currently certified in BLS, ACLS or equivalency. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive 1100.21 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 the Facility Medical Executive Board and Medical Center Director. If a Contractor s physician(s) and/or other contract provider(s) are not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government. Technical Proficiency: Contractor s physician(s) shall be technically proficient in the skills necessary to fulfill the government s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all 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. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the facility. 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). Training (ACLS, BLS, EHR 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 (The following training is mandatory per VHACO for Contracted Physicians) Frequency (once a year, etc.) Annual Hours ACLS/BLS Annually 1 Active Threat Training Annually 1 Blood Administration: Complications Annually 1 EHR Annually 1 Government Ethics Annually 1 Hospice and Palliative Care for VA Clinicians Annually 1 Military Sexual Trauma (MST) for Medical Providers Annually 1 Moderate Sedation In-Service Training Annually 1 PACT Act 2022 Toxic Exposure Screening (TES) Annually 1 Patient Abuse Annually 1 Patient Rights Annually 1 Patient Safety Annually 1 Prevention/Management of Disruptive Behavior/Violence Prevention Level I Annually 1 Prevention of Workplace Harassment/No Fear Act Annually 1 Suicide Prevention: Suicide Risk Management Training for Clinicians Annually 1 SUX Infection Control and Blood Borne Pathogens Annually 1 VA Core Values Training (ICARE Recommitment) Annually 1 VA Privacy and Information Security Awareness and Rules of Behavior Annually 1 VHA MRI Safety Training Level 1 Training (all who enter MRI suites) Annually 1 VHA Privacy and HIPAA Focused Training Annually 1 VistA Imaging Annually 1 STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.): Contractor shall provide proof of the following for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and CO. Tests shall be current within the past year. 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) upon hire in accordance with CDC guidance. (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. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}. 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}. COVID-19: Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP). 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. The facility 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. NPI: NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The VHA 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 CMS NPPES be provided to the CO with the proposal. DEA: Contractor shall provide copy of current DEA certificate. Conflict of Interest (COI): 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 and fully outlined in response to the subject attachment in Section D of the solicitation document. Citizenship related Requirements: The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to VA patient referrals. While performing services for the VA, 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 FAR. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the VA 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 VA patient referrals; or other place where the Contractor provides services to veterans who have been referred by the VA; and shall form the basis for termination of this contract for breach. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document. Annual OIG Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the HHS OIG has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed Contractor s physician(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries. By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by facility COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Directive 1100.20 and VHA Directive 1100.21. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the facility COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract. Non Personal Healthcare Services: The parties agree that the Contractor and all Contractor s physician(s) shall not be considered VA employees for any purpose. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees. Prohibition against Self-Referral: Contractor s physicians are prohibited from referring VA patients to contractor s or their own practice(s). Inherent Government Functions: Contractor and Contractor s physician(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy. No Employee status: The Contractor shall be responsible for protecting Contractor s physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract: Workers compensation Professional liability insurance Health examinations Income tax withholding, and Social security payments. Tort Liability: The Federal Tort Claims Act does not cover Contractor or Contractor s physician(s). When a Contractor or Contractor s physician(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor s (or Contractor s physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier. Key Personnel: The VA Full Time Equivalent (FTE) for the services required is 40 hours each week and does not include Holidays. 2736 hours of (after hour) call per year that may include Holidays = 1.0 VA FTE. The minimum number of Board Certified/Board Eligible GENERAL SURGERY physicians required to be onsite daily is 1 physician to be onsite as defined in paragraph Hours of Operation in this section. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled physician is unable to complete an assigned shift, the Contractor shall provide replacement physician coverage within 2 hours and notify the COR immediately of the schedule change. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar days after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel. For temporary substitutions where the key person shall not be reporting to work for 3 consecutive workdays or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor s physician(s), s/he may request, without cause, immediate replacement of said Contractor s physician(s). The CO and COR shall deal with issues raised concerning Contractor s physician(s) conduct. The final arbiter on questions of acceptability is the CO. Contingency Plan: Because continuity of care is an essential part of Facility s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor s physician(s) leaves Contractor s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract. VA HOURS OF OPERATION/SCHEDULING: VA Business Hours: VA tour of duty will be Monday through Friday, 7:30 AM to 4:00 PM. Clinic days are Mondays and Wednesdays (or mutually agreeable alternative days as necessary). OR scheduled days are Tuesday, Thursday, and Friday (or mutually agreeable alternative days as necessary). On call coverage is from 4:00 PM to 7:30 AM, Monday through Friday; twenty-four (24) hours on weekends and holidays. Patients must be seen by a Contractor s physician(s) onsite at the Fresno VA in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure. Contractor s physician(s) shall be available and present in clinic during normal General Surgery clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff or Surgical Chief of Surgery. Currently, normal clinic hours are from 7:30 AM to 4:00 PM. Off-hours Coverage: 4:00 PM to 7:30 AM, Monday through Friday; Twenty-four-hour weekend and holiday coverage. Contractor must make the Contractor s physician(s) available on-call during all hours when the Fresno VA Medical Center, General Surgery clinic is closed, including evenings, weekends, and holidays. On-call Contractor s physician(s) must be available at all times for phone consultations with VA residents and physicians. On-call providers must be available within 15 minutes by phone and onsite within 60 minutes. Federal Holidays: The following holidays are observed by the VA: New Year s Day President s Day Martin Luther King s Birthday Memorial Day Juneteenth Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Christmas Any day specifically declared to be a national holiday. Cancellations: All cancellations will be handled following the VACCHCS Fresno clinic cancellation policy if necessary. Unless a state of emergency has been declared, the Contractor shall be responsible for providing services. CONTRACTOR RESPONSIBILITIES: Clinical Personnel Required: The Contractor shall provide Contractor s physician(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties. Contractor s physician(s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor s invoices. Standards of Care: The Contractor s physician(s) care shall cover the range of General Surgery services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized the Joint Commission (TJC), VA and national standards as established by: The ABS http://www.absurgery.org/ The professional standards of TJC: http://www.jointcommission.org/standards_information/standards.aspx The standards of the American Hospital Association (AHA): http://www.hpoe.org/resources?show=100&type=8 The requirements contained in this PWS Resident Supervision and Teaching: Resident Supervision/Teaching: According to the guidelines dictated by the Residency Review Committee of ACGME, the contractor s physician(s) performing the services shall be responsible for residents. Contractor s physician(s) shall be responsible for: Academic environment: Provide for an academic environment conducive to the training and professional development for residents rotating through the Surgical Service. Resident patient care documentation: Contractor s physician(s) shall be responsible for complying with the Residency review documentation and insuring that all notes and encounters are completed and shall appropriately document medical records in accordance with VA standards, equivalent to TJC compliance guidelines, standard commercial practice and guidelines established by VANCHCS. The Contractor shall also perform any administrative duties relative to documentation of resident training, as required and directed by the VA COS or designated representative. Clinical Direction and Oversight: Contractor s physician(s) shall provide clinical direction to and oversight of residents/fellows consistent with current accreditation guidelines, clinical research, protocol development, data management of protocols, quality assurance conferences and meetings, and affiliate /VA staff meetings. Ensure on-site resident supervision in accordance with the national VHA Directive 1400.01: Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents, dated November 07, 2019. https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8579 Attending Physician: Clinics/General Surgery procedures shall not be conducted by residents in the absence of an attending physician. All procedures, inpatient admissions and consults shall be the responsibility of an attending physician. Medical Records: Authorities: 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 5 U.S.C.552a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA). HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment of VA patients. Based on this exception, a BAA is not required for this contract. Health records generated by this contract or provided to the Contractors by the VA are covered by the VA Privacy Act system of records entitled Patient Medical Records-VA (24VA10A7). 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 provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 4.4.4. Disclosure: Contractor s physician(s) may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under the contract; however, Contractor shall obtain permission from the VA before disclosing any patient information outside VA. VA authorizes the Contractor to discuss patient health information for coordination of care within community health care providers in compliance with VA regulations, HIPAA and VHA Directive 1605.1, Privacy and Release of Information. The VA will provide the Contractor with a copy of VHA Directive 1907.01, Health Information Management and Health Records and VHA Directive1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Directive 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 and all guidelines provided by the facility. Release of Information: The VA shall maintain control of releasing any copies of patient health information or health records and will follow policies and standards as defined, but not limited to Privacy Act requirements. The Contractor will not release or disclose copies of records and will refer all such requests to the Release of Information Department at the VA facility where assigned. Management for Medical Records: National Archives and Records Administration record disposition requirements are found in RCS 10-1 Chapter 6, 6000 series. Direct Patient Care: Estimated 90% of the time involved in direct patient care. Contractor shall be responsible for: Scope of Care: Contractor s physician(s) shall be responsible for providing GENERAL SURGERY Physician care, including, but not limited to: Clinic and Surgical Responsibilities: Contractor physician(s) shall be present on time for any scheduled clinics/surgeries start times as documented by physical presence in the clinic or OR at the scheduled start time. Operative Services: Contractor physician(s) shall provide comprehensive clinical General Surgery services including a full range of General Surgery procedures (approved VA Fresno) privileges. Intraoperative Follow-up: The contractor physician(s) shall be present in the operating suite for all General Surgery procedures. Postoperative Follow-up: Contractor Physician rounds shall be conducted on postoperative General Surgery patients in the Intensive Care Unit (ICU) and on the wards. All cases will be discussed in morbidity and mortality conferences, and the contractor physician(s) will provide appropriate information to the COR for inclusion in departmental reports. Communication of Test Results: Mechanisms must be in-place to provide notification of test results for patients receiving care in accordance with VHA Directive 1088, Communicating Test Results to Providers and Patients. Medications: Contractor s physician(s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients. Discharge education: Provide discharge education and follow up instructions that are coordinated with the next care setting for all GENERAL SURGERY clinical or surgical patients. Call coverage: Contractor physician(s) shall provide after hours call Monday through Friday from 4:00 PM to 7:30 AM and twenty-four (24) hour coverage on weekends and Holidays. ADMINISTRATIVE: Estimated 10% of time not involved in direct patient care. Administrative duties include progress notes, surgery scheduling, morbidity and Mortality meetings, and patient contact. Quality Improvement Meetings: The Contractor s physician(s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the facility Chief of Service, COS, or designee. List all meetings, associated time and frequency. Meeting Frequency (once a year, etc.) Annual Hours Morbidity and Mortality meetings. Weekly 52 Staff Meetings: The Contractor s physician(s) shall attend staff meetings as required by the facility Chief of Service, COS, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement. List all meetings, associated time and frequency. Meeting Frequency (once a year, etc.) Annual Hours Department staff meetings. Weekly 52 QA/QI documentation: The Contractor s physician(s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations. 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 documented in the medical record of those impacted and disclosed to the patient or surrogate. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit an entry in the VA Patient Safety Reporting System, following up with COR as required or requested. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI): Quality Management/Quality Assurance Surveillance: Contract personnel 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 PWS and methods of surveillance detailed in the QASP. The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. If the Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor s conduct. The final arbiter on questions of acceptability is the CO. Performance Standards: Measure: Provider Quality Performance Performance Requirement: All Contractor s physician(s) shall perform in accordance with clinical standards. Standard: OPPE documentation for all (100%) staff providing services under the contract. All staff (100%) meet Standards. AQL: 100% meet Standards Surveillance Method: OPPE data pertinent to care performed for each provider working under this contract. OPPE data will review the following elements: Patient Care Performance Medical/Clinical knowledge Practiced Based Learning and Improvement Interpersonal and Communication Skills Professionalism System Based Practice Frequency: Semi-Annual Measure: Qualifications of Key Personnel Performance Requirement: All Contractor s physician(s) shall be Board Certified/Board Eligible in accordance with ABS Standards for General Surgery Standard: All (100%) Contractor s physician(s) are Board Certified/Board Eligible AQL: 100% Surveillance Method: Periodic Inspection or Random Sampling of qualification documents Frequency: Annually 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 AQL: 100% Contractor s physician(s) perform within their scope of practice/privileges 100% of the time Surveillance Method: Random Sampling of records Frequency: Semi-Annual Measure: Patient Access Performance Requirement: The Contractor shall provide Contractor s physician(s) in accordance with the operating hours and VA clinical schedule outlined in this PWS. Standard: All (100%) Contractor s physician(s) are on time and available to perform services AQL: Contractor s physician(s) is on-time and available to perform services 100% of the time Surveillance Method: Periodic Inspection of Time and Attendance Sheets Frequency: Twice per month Measure: Patient Safety Performance Requirement: Patient safety incidents shall be reported using VA Patient Safety Reporting System. All incidents reported immediately (within 24 hours.) Standard: All (100%) of patient safety incidents are reported using VA Patient Safety Reporting System within 24 hours of incident AQL: 100% of patient safety incidents are reported using VA Patient Safety Reporting System within 24 hours of incident Surveillance Method: Periodic Inspection or Random Sampling Frequency: Semi-Annually Measure: Maintains licensing, registration, and certification Performance Requirement: Updated licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current. Standard: All (100%) licensing, registration(s) and certification(s) for Contractor s physician(s) shall be provided as they are renewed. Licensing and registration information kept current. AQL: 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. No acceptable deviation. Surveillance Method: Periodic Inspection or Random Sampling Frequency: Annual Measure: Mandatory Training Performance Requirement: Contractor shall complete all required training on time per facility policy. Standard: All (100%) of required training is complete on time by Contractor s physician(s) AQL: 100% completions Surveillance Method: Periodic Inspection or Random Sampling Frequency: Annual Measure: Privacy, Confidentiality and HIPAA Performance Requirement: Contractor is aware of all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA and complies with all standards Zero breaches of privacy or confidentiality Standard: All (100%) Contractor s physician(s) comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA AQL: 100% compliance Surveillance Method: Periodic Inspection; Contractor shall provide evidence of annual training required by the facility, reports violations per VA Handbook 6500.6 Frequency: Annual Registration with Contractor Performance Assessment Reporting System As prescribed in FAR Part 42.15, the 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 Sea Logistics Center in Portsmouth, New Hampshire. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the Federal Awardee Performance and Integrity Information System (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information. Each Contractor whose contract award is estimated to exceed 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. For contracts with a period of one year or less, the CO will perform a single evaluation when the contract is complete. For contracts exceeding one year, the CO will evaluate the Contractor s performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the Contractor s designated representative for comment. The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO. Failure for the Contractor s representative to respond to the evaluation within those sixty (60) days, will result in the Government s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor s representative will be locked out of the evaluation and may no longer send comments. Response Method: The Government requests capability statements and comments from interested businesses regarding the requirements described above. Responsible sources are encouraged to submit a response to this notice with a statement of interest on company letterhead.
When responding, in Subject line insert: Sources Sought VACCHCS GenSurg SAM. At a minimum, the following information shall be provided: 1. Company Name; 2. Company Mailing Address; 3. Point(s) of Contact including telephone number(s) & email address(es); 4. Socio-Economic (i.e. Small/Large Business, HUBZone, Service Disabled Veteran Owned, 8(a), etc.) as it relates to NAICS Code 561320 ($30 Million). 5. Provide a summary of the type of services performed and experience as it relates to staffing General Surgery Physicians or Healthcare Providers. 6. UEI Number 7. Sub-Contracting Intentions (provide above items 1 thru 6 of intended vendor along with description of sub-contractor duties). 9. Additional information and/or comments. Veterans First Contracting Program and the VA Rule of Two (Kingdomware v. United States) 38 U.S.C. 8127 - 8128: Service-disabled veteran owned small business (SDVOSB) or Veteran owned small business (VOSB) concern must be registered and verified in VA's Vendor Information Pages (VIP) database at www.vip.vetbiz.gov to be eligible for award as a SDVOSB or VOSB if/when a solicitation is issued for this requirement as a SDVOSB or VOSB set aside. In addition, this requirement has been determined to be set aside as SDVOSB or VOSB acquisition, only SDVOSB or VOSB that respond to this specific notice with in the above stated due date will be eligible for award.
