This is a SOURCES SOUGHT NOTICE. This notice is a market survey and is for information only, to be used for preliminary planning purposes. No proposals are being requested or accepted with this notice. THIS IS NOT A SOLICITATION FOR PROPOSALS AND NO CONTRACT SHALL BE AWARDED FROM THIS NOTICE. The VA NCO 15 Contracting Center has been tasked to solicit for and award a contract for Primary Care CBOC Services for the Harry S. Truman Memorial Veteran s Hospital (HSTMVH). The following services to be provided in a private hospital, office or clinic environment to Veterans, primarily residing in Kirksville, MO and surrounding counties catchment area (including Adair, Knox, Lewis, Linn, Macon, Putnam, Schuyler, Scotland, Shelby, and Sullivan counties). Potential sources are responsible for the complete performance of the technical aspects of the Primary Care CBOC. The type of solicitation to be issued will depend upon the responses to this notice. No reimbursement will be made for any costs associated with providing information in response to this notice or any follow up information requested. The purpose of this notice is to gain knowledge of interest, capabilities and qualifications of various members of the Business Community to include Small Business or Large Business, Veteran Owned Small Business, Service-Disabled Veteran-Owned Small Business (SDVOSB), HUBZONE, 8(a), etc., to complete and perform a Firm, Fixed-Price contract. After review of the responses to this sources sought announcement, a synopsis and/or solicitation announcement may be published at a later time. The Government must ensure there is adequate competition among the potential pool of responsive contractors. The duration of the requirement is for a base period (start-TBD and end TBD) with four each one-year option periods. The North American Industrial Classification System (NAICS) Code applicable to this acquisition is 621498. The Small Business Size Standard for this acquisition is $22.0M. Please limit your response to this synopsis to five pages and please include the following information: - Your company's name, addresses, point of contact, phone number, and email address. - Your company's interest in submitting a proposal on the solicitation when it is issued. - Your company's capability to meet the requirements. - Your company's capability to perform a contract of this type and comparable work performed within the past three years to include a brief description of the project, customer's name, phone number and address, period of performance, and dollar value of the project. - Your company's Business Size (Large or Small) and Socioeconomic Status (Veteran Owned, SDVOSB, HUBZONE, 8(a), etc.). Please provide a capability statement addressing your organization's ability to perform as a prime contractor the work described in the draft PWS (below). Index your firm's capabilities to the tasks in the draft PWS so that your firm's capabilities can be readily assessed. This is not a request for proposal and in no way obligates the Government to award any contract. Interested companies are asked to respond to this Sources Sought Notice no later-than 5:00 PM (CST) on February 11, 2022. All interested companies must be registered in SAM (http://www.sam.gov/) to be eligible for award of government contracts. Please email your response to: Jason Condiff, Email Address: Jason.Condiff@va.gov. Please reference the following solicitation number in the subject line of all correspondence submitted: 36C25522R0052. Work Description GENERAL: SERVICES REQUIRED: The Harry S. Truman Memorial Veteran s Hospital (HSTMVH), requires the following services to be provided in a private hospital, office or clinic environment to Veterans, primarily residing in Kirksville, MO and surrounding counties catchment area (including Adair, Knox, Lewis, Linn, Macon, Putnam, Schuyler, Scotland, Shelby, and Sullivan counties). [X] Primary Care CBOC: offers both medical and mental health care (physically on site and by telehealth) and may offer support services such as pharmacy, laboratory, and x-ray. Primary Care CBOCs are required to provide both primary care and mental health services. Mental Health services will be provided physically on site by contractor staff and by VA staff via telehealth. PLACE OF PERFORMANCE: This facility shall be located within the city limits of Kirksville, MO in Adair county. Facility: The facility shall be located in a modern quality building of sound and substantial construction with a façade of stone, marble, brick, stainless steel, aluminum, or other permanent material in good condition. The facility must be located in an office, research, technology, or business park that is modern in design or an attractively landscaped site containing one or more modern office buildings that are professional and prestigious in appearance with the surrounding development well maintained. Streets and public sidewalks shall be well maintained. Facility shall be one level with direct parking lot access. Entrance shall be handicap accessible. Facility parking with 50 parking spaces, with a minimum of 5 handicapped accessible parking spaces. Handicapped accessible parking spaces must be immediately adjacent to the building. Parking and drive facilities must be well lit, kept pothole free and repaved, seal coated, and restriped as necessary to assure the facility is safe and sound for patients and staff. STAFFING AND QUALIFICATIONS MINIMUM PATIENT ALIGNED CARE TEAM (PACT) STAFFING REQUIREMENTS: PACTs comprise the patients, the patients personal support persons, teamlets (Primary Care Providers (PCPs), Registered Nurse Care Managers (RNCMs), Clinical Associates, Administrative Associates), and discipline specific team members (Clinical Pharmacy Specialists (CPSs), Licensed Clinical Social Workers (LCSWs), Registered Dietician/Nutritionists, and Primary Care-Mental Health Integration (PCMHI) staff). The Contractor shall provide PACT staffing in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The Contractor shall provide a sufficient number of primary care providers so that each primary care provider has a caseload ratio to meet VA standards. Current standards are 1200 active patients per full time physician and 900 active patients per full time midlevel provider. Actual panel sizes can be determined by the VA in accordance with VHA Directive 1406 Patient Centered Management Module (PCMM) for Primary Care. The staffing standard for support staff shall be in ratios to Primary Care Providers of at least three full time equivalent (FTE) support staff (1 FTE RNCM, 1 FTE Clinical Associate, 1 FTE Administrative Associate) for each FTE Primary Care Provider. The Clinical Pharmacy Specialist (CPS) shall be provided the same support staffing given to other providers on the team when they are working in the capacity of a mid-level provider. The Contractor shall provide personnel in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract. The Contractor must establish and implement contingency plans for ensuring patients receive continuity of and access to appropriate primary care during periods of inadequate resources, extended staff absences, staff turnover, understaffing, and nature-related events (e.g., extreme weather conditions, natural disasters). If the number of patients reaches 90% of maximum panel size assigned by the facility the Contractor shall communicate to the VA the Contractor s future staffing plan to ensure staffing ratio standards remain in accordance with PCMM staffing standards. Total Estimated Patients enrolled/assigned to site: 2,200. PHYSICIAN DIRECTOR (MANDATORY FOR ALL SITES): FTE Ratio Performance Standard: 0.05 FTE per PACT Responsible Party: Shall be provided by Contractor. Qualifications: Contractor s Physicians (including subcontractors) providing physician director services under the resultant contract shall demonstrate evidence of education, training, and experience in Internal Medicine or Family Practice. Contactor s Physicians performing under this contract shall be board certified (or board eligible) by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. If proposed staff do not meet VA credentialing requirements, the Contractor shall propose substitute acceptable personnel within five (5) calendar days. May also be credentialed and privileged as a PCP. (If so, authorization for prescriptive authority is required). Physicians shall be licensed in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G2 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities: Serves as medical director to oversee and be responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site. https://s1.sos.mo.gov/cmsimages/adrules/csr/current/20csr/20c2200-4.pdf PRIMARY CARE TEAMLET STAFFING (MANDATORY FOR ALL SITES): All primary care teamlet staffing shall be provided by Contractor. TEAMLET MEMBER 1: Primary Care Provider (PCP): FTE Ratio Performance Standard: Current standards are 1200 active patients per full time physician and 900 active patients per full time midlevel provider. Contractor shall propose quantity of FTE to meet Standard FTE ratio to panel size. Contractor to propose mix of PCP from the options below. Requirement exists that at least 1 FTE PCP be a physician. This physician may act as Physician Director/PCP. OPTION 1: Physician (MD): Qualifications: Physicians shall demonstrate evidence of education, training, and experience in Internal Medicine or Family Practice. Physicians performing under this contract shall be board certified (or board eligible) by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. Authorization for prescriptive authority is required. . If proposed staff do not meet VA credentialing requirements, the Contractor shall propose substitute acceptable personnel within five (5) calendar days. Physicians shall be licensed in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G2 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP s licensure and clinical privileges or scope of practice, ensuring the patient s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face, telehealth, and telephone care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient s needs. OPTION 2: Certified Registered Nurse Practitioner (CRNP): Qualifications: CRNP s (including subcontractors) must have a MSN from a NLN accredited nursing program and have ANA Certification as a Nurse Practitioner in either Adult Health or Family Practice. Authorization for prescriptive authority is required. Three years of clinical nursing experience is required. A minimum of one (1) year clinical experience as a CRNP is required (three (3) years preferred). Experience in outpatient care in a Family Medicine or Internal Medicine environment is preferred. CRNP shall have current, full, active, and unrestricted license and registration as a graduate professional nurse in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G6 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. . Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP s licensure and clinical privileges or scope of practice, ensuring the patient s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face, telehealth, and telephone care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient s needs. OPTION 3: Physician Assistant (PA):Qualifications: PA s (including subcontractors) must meet one of the three following educational criteria: a) A bachelor s degree from a PA training program which is certified by the CAHEA; or b) Graduation from a PA training program of at least twelve (12) months duration, which is certified by the CAHEA and a bachelor s degree in a health care occupation or health related science; or c) graduation from a PA training program of at least twelve (12) months duration which is certified by the CAHEA and a period of progressively responsible health care experience such as independent duty medical corpsman, licensed practical nurse, registered nurse, medical technologist, or medical technician. The duration of approved academic training and health care experience must total at least five (5) years. Authorization for prescriptive authority is required. PAs must be certified by the NCCPA. PA shall have current, full, active, and unrestricted license and registration in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005 APPENDIX G8 PHYSICIAN ASSISTANT QUALIFICATION STANDARD located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2 . Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP s licensure and clinical privileges or scope of practice, ensuring the patient s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face, telehealth, and telephone care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient s needs. TEAMLET MEMBER 2: Registered Nurse (RN) Care Manager: FTE Ratio Performance Standard: Current standard is 1.0 FTE RNCM per 1.0 FTE PCPQualifications: 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). Current, full, active, and unrestricted registration as a graduate professional nurse in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G6 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing all aspects of professional nursing services consistent with licensure, certification, nursing professional standards of practice, and the clinician s Functional Statement with elements of practice, enhancing patient safety and quality of care by collaborating with PACT staff to develop, oversee, and manage care management plans and care coordination for patients assigned to PACTs, participating in modes of communication and care delivery including, but not limited to, secure messaging, telephone care, view alerts management, shared medical appointments, clinical video telehealth visits, face to face visits, etc., as part of care management, identifying patient needs for involvement of discipline-specific team members and discussing nursing recommendations with the PCP, engaging relevant PACT staff to support nursing care, according to locally established informal and formal communication processes, including entering consultation requests to discipline-specific PACT members, if required for formal communications, assuming full accountability for the appropriateness of assignments made by the RNCM to clinical associates or administrative associates related to care management, care coordination, nursing services, and outcomes of care, entering orders in the VA EHR for tests per approved standardized RN care management protocols or PCP orders, ensuring the RNCM has same-day access for face-to-face and telephone care visits, using nursing expertise, evidence-based guidelines, standardized nursing protocols, and professionally accepted practice standards to promote patient engagement, self-care and wellness, and provide care to patients and determine care management requirements for individual patients or cohorts of patients. The RN collaborates for the improvement of patient care outcomes in the Patient Aligned Care Team. Promotes systems to improve access and continuity of care, uses advanced clinical knowledge and critical thinking skills to mentor staff in planning, implementing and evaluating interventions that improve patient outcomes, designs and provides age and population specific health promotion and risk reduction strategies, translates evidence-based research into practice to ensure that patients benefit from the latest innovations in nursing science, manages patients in transition between levels of care, serves as an expert resource to implement and teach skills, including motivational interviewing to promote patient self-management toward patient-driven holistic care plan for life. PRIMARY CARE STAFFING CLINICAL ASSOCIATE [X] Mandatory for all sites TEAMLET MEMBER 3: CLINICAL ASSOCIATE FTE Ratio Performance Standard: Current standard is 1.0 FTE clinical associate per 1.0 FTE PCP. Contractor to propose the mix of Clinical Associates from the options below. OPTION 1: Licensed Practical Nurse (LPN): Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005 APPENDIX G13 LICENSED PRACTICAL OR VOCATIONAL NURSE QUALIFICATION STANDARD located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2 . CBOC) Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification, and functional statement with elements of practice, to patients assigned PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner, and providing direction to patients as they move through the clinic environment. Duties include but are not limited to the aability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. OPTION 2: Licensed Vocational Nurse (LVN):Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005 APPENDIX G13 LICENSED PRACTICAL OR VOCATIONAL NURSE QUALIFICATION STANDARD located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2 . Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification, and functional statement with elements of practice, to patients assigned PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner, and providing direction to patients as they move through the clinic environment. Duties include but are not limited to the aability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. OPTION 3: Medical Assistant (MA):Qualifications: Completion of an approved medical assistant training program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES), or by any accrediting agency recognized by the United States Department of Education or a current and active Certified Medical Assistant (CMA) or Registered Medical Assistant (RMA) from The American Association of Medical Assistants (AAMA) or the American Medical Technologists (AMT). Other credentials such as completion of a medical services training program of the Armed Forces of the United States may be accepted based on Chief of Staff determination.Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification, and functional statement with elements of practice, to patients assigned PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner, and providing direction to patients as they move through the clinic environment. Duties include but are not limited to the aability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. OPTION 4: Health Care Technician (HCT) (as part of PACT teamlet, not primary telehealth technician) : Qualifications: Completion of an approved medical assistant training program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES), or by any accrediting agency recognized by the United States Department of Education or a current and active Certified Medical Assistant (CMA) or Registered Medical Assistant (RMA) from The American Association of Medical Assistants (AAMA) or the American Medical Technologists (AMT). Other credentials such as completion of a medical services training program of the Armed Forces of the United States may be accepted based on Chief of Staff determination. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification, and functional statement with elements of practice, to patients assigned PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner, and providing direction to patients as they move through the clinic environment. Duties include but are not limited to the aability to perform a variety of specialized clinical support skills, ability to perform basic patient care service, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies and procedures. Shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. PRIMARY CARE STAFFING CLERICAL ASSOCIATE [X] Mandatory for all sites TEAMLET MEMBER 4: ADMINISTRATIVE ASSOCIATE: FTE Ratio Performance Standard: Current standard is 1.0 FTE administrative associate per 1.0 FTE PCP. Qualifications: Required education and experience demonstrating skills and abilities to perform duties ensuring smooth site operations .Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing clerical support and administrative functions to PACT staff, collaborating with PACT staff to incorporate the logistical elements of care coordination into comprehensive care management plans, providing guidance and direction to patients and personal support persons for navigating the VA health care system and administrative functions in VA, and coordinating care for patients assigned to the PACT. DISCIPLINE SPECIFIC PACT TEAM MEMBERS (REQUIRED FOR ALL SITES): Discipline-specific team members are designated in PCMM for one or more PACT(s). Discipline-specific team members provide continuity of direct discipline-specific care to all patients assigned to PACT(s) for which the team member is designated. DISCIPLINE SPECIFIC 1: CLINICAL PHARMACY SPECIALIST (CPS) This service shall be provided by the VA through referral via telehealth or telephone. DISCIPLINE SPECIFIC 2: CLINICAL PHARMACY SPECIALIST (CPS) ANTI-COAGULATION: This service shall be provided by the VA through referral via telehealth or telephone. PA D PACT STAF DISCIPLINE SPECIFIC 3: LICENSED CLINICAL SOCIAL WORKER (this position provides general/medical social work services): This service shall be provided by the VA through referral via telehealth or telephone. DISCIPLINE SPECIFIC 4: REGISTERED DIETITIAN/NUTRITIONIST: This service shall be provided by the VA through referral via telehealth or telephone. DISCIPLINE SPECIFIC 5: PRIMARY CARE MENTAL HEALTH INTEGRATION (PC-MHI): FTE Ratio Performance Standard - 0.67 FTE per PACT. PC-MHI staff provide services in collaboration with PCPs for mild to moderate MH needs. PC-MHI services include co-located collaborative care (usually provided face-to-face by options 2,4, and 5 below), disease-specific care management (usually provided via telephone by options 5 and 6 below) and medication/treatment consultation (usually provided via e-consult, telephone, or face-to-face by options 1 and 3 below) to PCPs who prescribe medications for mild to moderate MH needs. (See the Uniform Mental Health Services Handbook 1160.01 for PC-MHI requirements). A mix of the following disciplines shall be selected to meet the PC-MHI FTE ratio performance standard and PC-MHI service requirements. Staffing ratio outlined is minimum and may be adjusted by the VA to provide appropriate mental health care. OPTION 1: Psychiatrist: Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G2 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities: Responsible for collaboration with PACT team for the provision of mental health services to enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. OPTION 2:Psychologist:Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005 PART II APPENDIX G18 PSYCHOLOGIST QUALIFICATION STANDARD GS-180 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. A doctoral degree in psychology from a graduate program in psychology accredited by the American Psychological Association (APA), the Psychological Clinical Science Accreditation System (PCSAS), or the Canadian Psychological Association (CPA) at the time the program was completed and successfully completed a professional psychology internship training program that has been accredited by APA. or, if they did an internship that was not accredited by APA or CPA at the time the program was completed may be considered eligible for hire only if they are currently board certified by the American Board of Professional Psychology in a specialty area that is consistent with the assignment for which the applicant is to be employed and they maintain their board certification. Position Responsibilities: Responsible for collaboration with PACT team for the provision of mental health services to enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. OPTION 3: Advanced Practice Nurse: Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G6 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2 . Position Responsibilities: Responsible for collaboration with PACT team for the provision of mental health services to enrolled and unassigned patients presenting for care per to VHA Handbook 1160.01 and the requirements of this contract. OPTION 4: Licensed Professional Mental Health Counselor (LPMHC): Qualifications: Hold a master s degree in mental health counseling, or a related field, from a program accredited by the Council on Accreditation of Counseling and Related Educational Programs (CACREP). Examples of related mental health counseling fields include, but are not limited to, Addiction Counseling; Community Counseling; Gerontology Counseling; Marital, Couple, and Family Counseling; and Marriage and Family Therapy. A doctoral degree in mental health counseling may not be substituted for the master s degree in mental health counseling. Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located to independently practice mental health counseling, which includes diagnosis and treatment; otherwise qualifications as per VA Handbook 5005 Appendix G43 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities: Responsible for collaboration with PACT team for the provision of mental health services to enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. OPTION 5: Licensed Clinical Social Worker (this position provides mental health services as part of the PC-MHI team): Qualifications: Social Workers providing services under this contract must have a Master s degree in Social Work (MSW) from a school accredited by Council on Social Work Education (CSWE). Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005/120 PART II APPENDIX G39 SOCIAL WORKER QUALIFCATION STANDARD GS-0185 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities: Responsible for collaboration with PACT team for the provision of mental health services to enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. Covered services would include, but are not be limited to, conducting bio-psychosocial assessments to determine needs of Veterans, Veteran s family members and caregivers. Provide a full range of clinical social work services within established standards of social work practice which includes treatment planning, individual, family and group counseling, VA and community based resource referrals, case management and other services as appropriate. OPTION 6: Registered Nurse (RN): Qualifications: 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). Current, full, active, and unrestricted registration as a graduate professional nurse in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G6 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities: Responsible for disease-specific care management for enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. SPECIALTY CARE STAFFING: PODIATRIST: This service shall be provided by the VA through referral. ANCILLARY SUPPORT SERVICES STAFFING: DIAGNOSTIC RADIOLOGIC TECHNOLOGIST: Radiology services shall be provided by the VA via referral to community or parent facility. 2.6.2 PHLEBOTOMIST/LABORATORY TECHNICIAN: This position shall be provided by Licensed Practical Nurse (LPN): Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005 APPENDIX G13 LICENSED PRACTICAL OR VOCATIONAL NURSE QUALIFICATION STANDARD located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2 . CBOC) Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site, providing evaluation and care consistent with licensure, certification, and functional statement with elements of practice, to patients assigned PACTs, collaborating with PACT staff to develop comprehensive health care plans and care management plans for patients assigned to patient panels, managing clinic workflow, ensuring patients are placed in examination rooms in a timely manner, and providing direction to patients as they move through the clinic environment. Duties include but are not limited to the ability to perform a variety of specialized clinical support skills, ability to perform basic patient care services, have knowledge of medical terminology, demonstrate skills in interpersonal communication, demonstrate knowledge of aseptic technique and infection control and knowledge of patient confidentiality, policies and procedures. LPN shall assist all health care providers in performing patient care services and duties pertaining to the effective and efficient delivery of patient centered care in all clinical areas. This staff member will serve as back-up for PACT nurse staff and will receive training as back-up for telehealth services (e.g. S&F, CVT). GENERAL AND SPECIALTY MENTAL HEALTH STAFFING: The following specialty staffing shall be provided by the Contractor. MH staffing FTE ratio performance standard is 7.72 total FTE per 1000 Veterans seen in outpatient MH, which includes 1.22 psychiatrist FTE per 1000 outpatient MH and 0.67 PCMHI FTE per PC panel. A mix of the following disciplines may be selected to meet general and specialty MH FTE ratio performance standard and general and specialty MH service requirements. Staffing ratio outlined is minimum and may be adjusted by the VA to provide appropriate Mental Health Care. See the Uniform Mental Health Services Handbook 1160.01 for General and Specialty Mental Health requirements. OPTION 1: Psychiatrist Ratio Performance Standard: 1.22 FTE per 1000 patients requiring mental health services. Staffing ratio may be adjusted upward locally to provide appropriate Mental Health Care. Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G2 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Board certified physician in psychiatry. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. OPTION 2: Psychologist: Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005PART II APPENDIX G18 PSYCHOLOGIST QUALIFICATION STANDARD GS-180 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. A doctoral degree in psychology from a graduate program in psychology accredited by the American Psychological Association (APA) and successfully completed a professional psychology internship training program that has been accredited by APA. the Psychological Clinical Science Accreditation System (PCSAS), or the Canadian Psychological Association (CPA) at the time the program was completed and successfully completed a professional psychology internship training program that has been accredited by APA. or, if they did an internship that was not accredited by APA or CPA at the time the program was completed may be considered eligible for hire only if they are currently board certified by the American Board of Professional Psychology in a specialty area that is consistent with the assignment for which the applicant is to be employed and they maintain their board certification. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care according to VHA Handbook 1160.01 and the requirements of this contract. OPTION 3: Advanced practice registered nurse: Qualifications: 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). Current, full, active, and unrestricted registration as a graduate professional nurse in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Appendix G6 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Authorization for prescriptive authority is required. Documentation of mental health licensure or prior experience in mental health settings required. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. OPTION 4: Physician s Assistant: Qualifications: Contractor s PA s (including subcontractors) must meet one of the three following educational criteria: a) A bachelor s degree from a PA training program which is certified by the CAHEA; or b) Graduation from a PA training program of at least twelve (12) months duration, which is certified by the CAHEA and a bachelor s degree in a health care occupation or health related science; or c) graduation from a PA training program of at least twelve (12) months duration which is certified by the CAHEA and a period of progressively responsible health care experience such as independent duty medical corpsman, licensed practical nurse, registered nurse, medical technologist, or medical technician. The duration of approved academic training and health care experience must total at least five (5) years. Authorization for prescriptive authority is required. PAs must be certified by the NCCPA. PA shall have current, full, active, and unrestricted license and registration in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005 PART II APPENDIX G8 PHYSICIAN ASSISTANT QUALIFICATION STANDARD located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2 Documentation of mental health licensure or prior experience in mental health settings required. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. OPTION 5: Mental Health Licensed Clinical Social Worker: Qualifications: Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA HANDBOOK 5005 PART II APPENDIX G39 SOCIAL WORKER QUALIFCATION STANDARD GS-185 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Social Workers providing services under this contract must have a Master s degree in Social Work (MSW) from a school accredited by Council on Social Work Education (CSWE). Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care according to VHA Handbook 1160.01 and the requirements of this contract. OPTION 6: Licensed Professional Mental Health Counselor (LPMHC): Qualifications: Hold a master s degree in mental health counseling, or a related field, from a program accredited by the Council on Accreditation of Counseling and Related Educational Programs (CACREP). Examples of related mental health counseling fields include, but are not limited to, Addiction Counseling; Community Counseling; Gerontology Counseling; Marital, Couple, and Family Counseling; and Marriage and Family Therapy. A doctoral degree in mental health counseling may not be substituted for the master s degree in mental health counseling. Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located to independently practice mental health counseling, which includes diagnosis and treatment; otherwise qualifications as per VA Handbook 5005 Appendix G43 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. Position Responsibilities: Responsible for collaboration with PACT team for the provision of Mental Health services to enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. OPTION 7: Marriage and Family Therapist: Qualifications:  Hold a master s degree in marriage and family therapy from a program approved by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) or have graduated from a nationally accredited program conferring a comparable mental health degree as specified in the qualification standards of those disciplines (Social Work, Psychiatric Nursing, Psychology, and Psychiatry). All additional course work taken to be accepted for MFT licensure must come from a nationally accredited program in one of the above areas. Current, full, active, and unrestricted license in the state in which the Outpatient Site of Care (i.e. CBOC) is located to independently practice mental health counseling, which includes diagnosis and treatment; otherwise qualifications as per VA Handbook 5005 Appendix G44 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1006&FType=2. . Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care per VHA Handbook 1160.01 and the requirements of this contract. Suicide Prevention Coordinator (SPC): The VA performance standard for sites with 10,000 patients or more is maintaining a Suicide Prevention Coordinator (SPC) with a full-time commitment to suicide prevention activities. In smaller sites serving less than 10,000, this may be a collateral assignment. Homeless Outreach Specialist: To ensure the availability of outreach and referral services to homeless Veterans, all sites with 10,000 patients or more must designate at least one outreach specialist, usually a clinical social worker, to provide services to homeless Veterans. NOTE: In smaller facilities, this may be a collateral assignment. TELEHEALTH SERVICES CLINICAL STAFF: The following telehealth staffing shall be provided by the Contractor. Telehealth Clinical Technician (TCT) FTE Ratio performance standard 1.0 FTE Telehealth Clinical Technician (TCT) per estimated 5,000 patients at clinic, with a trained back-up (e.g., another TCT or a member of the PACT Teamlet (LIP, RNCM, or LPN), depending on size of clinic/clinic workload/clinic telehealth services). All staff providing telehealth related services (primary TCT(s) and back-ups) must be trained in teleretinal imaging, teledermatology, teleaudiology, tele-mental health, teleprimary care etc. The qualifications, competencies, and position responsibilities noted below apply to primary TCT(s) and back-ups. The Telepresenter can be any clinically trained person assisting the provider in the presentation of the Veteran using video-conferencing. Depending on the skills needed for the encounter, the Telepresenter can be a licensed independent provider (LIP), Registered Nurse, LPN, or Telehealth Clinical Technician (TCT). Telepresenters can also serve as TCT back-ups. The number and discipline of Contractor s staff trained to function as a TCT back-up or Telepresenter will be based on the volume and type of telehealth services provided. Qualifications: All staff providing telehealth related services into the clinic shall be appropriately credentialed and; where necessary, privileged. All contractor staff who support and manage telehealth services must be working within permitted licensure and scope of practice. Where non-licensed staff is supporting telehealth services the Contractor s licensed staff must provide appropriate clinical supervision. Competency TCTs, Telepresenters, Store and Forward Imagers et al. and their back-ups, shall be expected to provide clinical care in compliance with established clinical protocol. Additional guidelines governing operations will be utilized and provided to Contractor by VA. TCTs, Telepresenters, Store and Forward Imagers and back-ups shall be expected to successfully complete training programs required for certification as a TCT, Telepresenter and/ or Store and Forward Imager and back-up including VA required training and any VA training mandated for TCT, Telepresenter, Teleretinal Imagers. TCTs, Telepresenters, and Store and Forward Imagers shall be responsible for maintaining imager and/or other required certification. TCTs, Telepresenters, and Store and Forward Imagers and back-ups shall be expected to demonstrate competency on the function and use of the telehealth equipment including digital retinal and dermatology imaging system, teleaudiology hardware and software. VA will provide training to TCTs, Telepresenters, Store and Forward Imagers and back-ups and document competency. Training: Contractor s TCTs, RNs, LPNs, LIPs and support staff providing telehealth services shall be required to complete all Telehealth required training, both virtual and in-person. Contractor s Telehealth Staff shall be required to attend conference calls intended to support and maximize delivery of care as required by the VA. TCT Position Responsibilities: TCT manages the Telehealth Services offered by the clinic (i.e., presenting, equipment management, training, imaging, audiology services, etc.) and is responsible for the provision of covered services to enrolled and unassigned patients presenting for care. The Contractor s telehealth services shall include but are not limited to: coordinating telehealth clinic set up, scheduling, equipment management, provision of data on request, attendance on VA or Network Telehealth Team calls, maintaining records required for quality control processes, and participating in performance improvement activities. The TCT shall be responsible for conveyance of clinically appropriate in-person interaction or on-site observations (e.g., assisting with hearing aid fittings, detection of alcohol use, etc.) with the Veteran patient to the telehealth provider. The TCT shall be responsible for gathering and transmitting telehealth images, sounds, data and all other supporting data to the assigned VA providers or reading centers within time lines established by policy. The TCT shall provide technology education to patients including but not limited to: review of acquired data or images for anatomic and general findings, review of photos, and provision of VA approved handouts. The TCT shall communicate regularly with the Facility Telehealth Coordinator (FTC) to work out any process issues, equipment needs/problems, data collection and any other logistical issues. Telepresenter Position Responsibilities: Include, but are not limited to the following: Assist the primary care or specialty care provider with the Veteran physical exam as needed, provide Veteran education, documentation and assistance with workload capture for the completion of the visit, per scope of practice and manage required screenings and complete clinical reminders, documentation, scheduling and opening and closing the encounter. NON-PERSONAL SERVICES: The parties agree that The Contractor, contract staff, agents and sub-Contractors shall not be considered VA employees for any purpose. All individuals that provide services under this resultant contract and are not employees of the Contractor shall be regarded as subcontractors. The Contractor shall be responsible and accountable for the quality of care delivered by all its subcontractors. The Contractor shall be responsible for strict compliance of all contract terms and conditions without regard to who provides the service. HOURS OF OPERATION: The following outlines the required hours of operation: 3.1 BUSINESS HOURS: Hours of operations will be Monday Friday, from 8:00 am 4:30 pm, except for Federal holidays as outlined in 3.4 below. The contractor is not required to be closed on Federal holidays. If backlog occurs, contractor can be open during extended hours or weekends with permission from parent facility. 3.2 EVENING HOURS: N/A 3.3 WEEKEND HOURS: N/A 3.4 FEDERAL HOLIDAYS: The following holidays are observed by the Department of Veterans Affairs: New Year s Day, Washington s Birthday, Martin Luther King s Birthday, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving, Christmas, any day specifically declared to be a national holiday. END OF WORK DESCRIPTION
