STATEMENT OF WORK Roseburg VA Healthcare System 937 NW Garden Valley Blvd. Roseburg, OR 97471 541-440-1000 ext 44724 Scope Contractor shall provide urgent and emergent Laboratory testing services and perform tests as requested by Roseburg VAHCS seven (7) days a week. Contractor shall provide all labor, equipment, and materials required to perform requested tests. Tests shall be performed to the satisfaction of the Roseburg VA Healthcare System ( RVAHCS ), Chief of Service (P&LMS) and the POC. Contractor shall provide to the POC the methodology and ranges for results on any tests that are requested. Professional services provided will be verified by a record keeping system maintained by the Manager of the Laboratory Services at RVAHCS, which assures that the VA pays for only those services actually requested. Contractor shall be responsible to follow the privacy guidelines for VA Information & Information System Security in the attached documents. This contract is an agreement between Roseburg VA Medical Care System and its community outpatient centers only. Specific Tasks Contractor shall provide urgent and emergent laboratory testing services and perform tests as requested by Roseburg VAHCS seven (7) days a week. Contractor shall provide all labor, equipment, and materials required to perform requested tests. Tests shall be performed to the satisfaction of the Roseburg VA Healthcare System ( RVAHCS ), Chief of Service (P&LMS) and the POC. Contractor shall provide to the POC the methodology and ranges for results on any tests that are requested. Professional services provided will be verified by a record keeping system maintained by the Manager of the Laboratory Services at RVAHCS, which assures that the VA pays for only those services actually requested. Contractor shall be responsible to follow the privacy guidelines for VA Information & Information System Security in the attached documents. Contractor shall provide Blood Banking services to include Packed Red Blood Cells, Leukoreduced Blood Cells as well as all testing and all other blood components as needed. Contractor shall provide Anatomic Pathology services. Any Pathology services provided must be performed and signed by an American Board of Pathology and Anatomic Pathology certified Pathologist. Malignancies are confirmed by a second Pathologist prior to issuance of the final report. Malignancies are called to the ordering provider. Communication is documented on the report that includes the information of who called, who was notified, the specific diagnosis that was communicated, and the date and time of the communication. Communication is completed within 1 calendar day for critical diagnoses and within 2 business days for urgent diagnoses. Performance Monitoring Performance Monitoring will be performed through Contracting Officer Representative (COR) by continuous observance of Medical Technologist satisfaction. COR will check monthly that invoices are correctly billed. Security Requirements All contractor employees are subject to the same level of investigation as VA employees who have access to VA sensitive information or access to VA facilities. The background investigation includes the following requirements: 1) Completed documentation 2) Fingerprints 3) Completion of OPM s e-QIP Questionnaire. The Contractor is required to fulfill all of the security requirements. The Contractor, upon completion of fingerprinting, and an initial suitability determination, may be authorized tentative access to start the performance period of the contract, but only on condition of completion of all security requirements. This requirement is applicable to all subcontractor personnel requiring the same access. The contractor shall bear the expense of obtaining background investigations. If the investigation is conducted by the Office of Personnel Management (OPM) through the VA, the contractor shall reimburse the VA within 30 days. Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI) Not Applicable (N/A) Other Pertinent Information or Special Considerations A test list will be included in the contract to include Blood Banking services (I.E. Packed Red Blood Cells, and Leukoreduced Blood Cells. Inspection and Acceptance Criteria The COR is responsible for certifying that the work done under the contract is performed to time and standard. They are also responsible for assure the inspection and acceptance of products provided incidental to services. Transportation services for drop of specimens is provided by the Roseburg VA Supply Chain Management Delivery Schedule / Reporting All lab reports shall at a minimum contain the following information: A) Patient s full name B) Physician name C) Date and time specimen collected D) Test ordered E) Date and time test completed F) Test results G) Flag abnormal H) Reference range I) Type of specimen J) Patient s Social Security Number K) Patient Date of Birth L) Requesting Facility Routine Results: Contractor shall print/fax results of all tests ordered to the RVAHCS within 1 business day, or 5 business days in the case of anatomic pathology specimens, of the request. i.e. if services are performed on the weekend, Contractor shall report results on Monday morning. STAT Results: All STAT results shall be called to the Laboratory at 541-440-1000 ext. 44748 and faxed, 541-440-1315, to the RVAHCS within one (1) hours of the request. Critical Value Results: All Critical Value results shall be called to the Laboratory, 541-440-1000 ext. 44748, and faxed, 541-440-1315 to RVAHCS immediately. After Hours Reporting: Contractor shall contact the following individual in order to report STAT and Critical Value test results: A) Person (s) name (s): MEDICAL OFFICER OF THE DAY B) Telephone number: 541-440-1000 ext 45368 C) Fax number: (541) 440-1315 Invoicing Contractor shall provide billing summaries beginning the first day of the month and include the last full day of the month. Invoices must be submitted through Tungsten within 30 days of last full day of the month in order to be paid. Incorrect, Rejected, or Refused invoices must be corrected and resubmitted to Tungsten for payment within 30 calendar days of rejection/refusal. Invoices must contain at a minimum the following information. Contractor shall provide this information on one original invoice: A) Contract number B) Patient (s) Name (s) C) Proper CPT Code D) Unit Cost E) Total Cost F) Date of Service
