Q--Community Home Health
Department of Veterans Affairs, VA El Paso Health Care Center | Published November 19, 2015 - Deadline November 27, 2015
This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued.
(ii) SAO West NCO 18 is issuing this combined synopsis/solicitation, VA258-16-Q-0054, as a request for proposal (RFP) using FAR Part 12, Acquisition of Commercial Item and FAR Part 13, Simplified Acquisition Procedures.
(iii) The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular (FAC) 2005-83 (effective 11/01/2015).
(iv) This solicitation will be issued Total Small Business Set-Aside. The North American Industrial Classification System (NAICS) code for this procurement is 621610, with a small business standard of $15 Million.
(v) Price/Cost Schedule
All pricing is based on the standard Medicare/Medicaid/AHCCCS rates for the local area (see Attachment A). A visit is service of up to two hours as defined by the commercial market. The contractor is required to use the corresponding HCPC for the length of visit. It is understood that each visit will use either the one hour (quantity 2) or 15 minute HCPC (quantity 8) for the initial two hours and whichever is needed past the initial timeframe, dependent upon the pre-authorized service. HCPCs used outside of this guidance must be approved by the VA program manager prior to use.
Rural rates MUST be pre-authorized in writing.
Time and Trouble authorization MUST be requested within 24 hours of the occurrence, by verbally speaking to the CHNC/HHC, or leaving a voicemail AND following up with a fax request.
(vi) SCOPE OF WORK
The SAO West Network Contracting Office (NCO) 18, El Paso, TX, (hereafter referred to as the NCO) will solicit and award this contract using Simplified Acquisition Procedures in accordance with Acquisition of Commercial Items in FAR Part 12 and Part 13. NCO anticipates award of a fixed price Basic Ordering Agreement. The North American Industry Classification System (NAICS) code is for this procurement is 621610- Home Health Care Agencies and the small business size standard is $15 Million. This will be a nonpersonal health care services contract.
Federal Acquisition Regulations (FAR) require all contractors conducting business with the Government to be registered in the following database:
System for Award Management (SAM) - http://www.sam.gov
All responding vendors must be registered in SAM and have NAICS code 621610 in order to receive an award.
IT IS IMPERATIVE THAT YOU COMPLETE THESE REGISTRATIONS IN ORDER TO BE CONSIDERED FOR CONTRACT AWARD. AWARD CANNOT BE MADE TO A CONTRACTOR NOT REGISTERED IN THIS DATABASE SYSTEM.
PERFORMANCE WORK STATEMENT
The Department of Veteran's Affairs (VA), Southern Arizona VA Health Care System (SAVAHCS) requires non-personal health care services for Home Health Care and Hospice Services. This will be a fixed price Basic Ordering Agreement, and will be awarded using the Best Value Trade Off method, under the authority of Federal Acquisition Regulation (FAR) Part 12 - Acquisition of Commercial Items and FAR Part 13 - Simplified Acquisition Procedures (SAP). The period of performance of resulting agreement shall consist of a base year, followed by up to four (4) option years, to be exercised at the government's discretion.
The Southern Arizona Veterans Administration Health Care System (SAVAHCS) mission is to provide quality healthcare to veterans in an environment of compassion, education, and research. The Department of Veterans Affairs (VA) long-term care includes a continuum of services for the delivery of care to veterans needing assistance due to chronic illness, physical disability, or end of life care.
The Contractor shall provide all Home Health Care Services as described herein when an enrolled/eligible veteran is unable to receive care at the SAVAHCS, for the areas for which they are awarded a contract. The types of Home Health Care Services to be provided under this contract are defined as follows:
2.1 Skilled Registered Nursing Services are required by the SAVAHCS to provide a broad range of skilled home nursing care that allows the veteran to remain living at home. Skilled registered nursing services may include, but are not limited to, skilled observation and assessment, data collection, formulation of treatment plans, teaching and technical procedures.
2.2 Licensed Practical Nursing Services in the home are required by the SAVAHCS to assist veterans with a wide range of technical nursing duties including, but not limited to, dressing changes, medication set-ups and ostomy care that will permit the veteran to remain at home.
2.3 Homemaker Services are required by the SAVAHCS to assist veterans with light housekeeping duties in order for the veteran to remain as independent as possible in their place of residence and delay/avoid placement in a long term care facility. Homemaker services may include, light housekeeping, laundry, meal preparation, grocery shopping, escorting the patient to appointments, assuring patient safety, and other services that are consistent with the homemaker's level of responsibility and the patient's care plan.
2.4 Home Health Aide Services are required by the SAVAHCS to assist veterans with personal care duties in order for the veteran to remain as independent as possible in their place of residence and delay/avoid placement in a long term care facility. Home Health Aide services may include bathing, grooming, personal hygiene, transferring, dressing, eating, and other services that are consistent with the home health aide's level of responsibility and the patient's care plan.
2.5 Respite Care Services are required by the SAVAHCS to assist veterans and their unpaid caregivers with the opportunity to remain as independent as possible in their place of residence and delay/avoid placement in a long term care facility. Respite services may be provided by skilled or unskilled workers as appropriate for the individual veteran. Respite services are provided to allow the veteran's unpaid caregiver the opportunity for relief from care giving responsibilities.
2.6 Hospice Care Services are required by the SAVAHCS to provide the final stage of palliative care in which the primary goal of treatment is comfort rather than cure for patients with advanced disease that is life-limiting and refractory to disease-modifying treatment. Hospice services are provided by a team of professionals, emphasizing relief of suffering and maintenance of functional capacity as long as possible through comprehensive management of the physical, psychological, social and spiritual needs of the patient. These services also provide support for the families or other caregivers, including bereavement support following the death of the patient.
2.6.1 Home Hospice Services may include, but are not limited to the following:
18.104.22.168 Chaplain Service to provide care to terminally ill veterans and their families that include spiritual support, emotional support, pastoral care, bereavement counseling, and assist with memorial services and funeral arrangements.
22.214.171.124 Home Social Service to provide assistance with practical and financial concerns as well as help meet the psychosocial needs of the terminally ill veterans and their family members.
126.96.36.199 Skilled Registered Nursing Service to provide a broad range of nursing care as identified in paragraph 2.1.
188.8.131.52 Licensed Practical Nursing Service to provide a wide range of technical nursing duties as identified in paragraph 2.2.
184.108.40.206 Home Health Aide Services as identified in paragraph 2.4.
The agency shall provide all labor, supervision and management necessary to carry out the services described herein.
3.1 Skilled Registered Nursing Service-to/may include but is not limited to, the following:
a. Skilled observation and assessment
b. Data collection
c. Formulating treatment plan
d. Patient and caregiver/family teaching
e. Technical procedures
f. Home safety evaluation
g. Discharge planning
h. Works closely with the primary physician for pain management and symptom control
i. Bowel and Bladder care
j. Ventilation care
k. Infusion care
3.2 Licensed Practical Nurse Service-to/may include, but is not limited to, the following:
a. Dressing changes
b. Giving injections
c. Setting -up medication boxes
d. Providing bowel/bladder care
e. Providing ostomy care
f. Bowel and Bladder care
g. Ventilation care
3.3 Physical Therapy Services-to/may include, but is not limited to, the following:
a. Provide initial and continued assessment of the patient's functional status and safety.
b. Evaluate patient's home for needed structural modifications to make the home environment safe and accessible.
c. Determine the need and measure the patient for assistive devices and special equipment.
d. Fit devices for patient's needs and instruct patient in the safe use of such devices.
e. Teach caregiver body mechanics to minimize risk of injury.
f. Develop therapeutic home program for the patient and caregiver to maintain or enhance function or retard deterioration of the patient's functional status.
g. Provide hand-outs and demonstrations to patients regarding treatment techniques and theory.
h. Set short and long term goals for the patients.
i. Document initial findings, treatment, goals, equipment recommendations, and follow-up progress in patient's medical record.
j. Serve as consultant to members of treatment team on matters specific to physical
k. Recognize indications of patient's intolerance of procedures, unanticipated rate of progress, significantly altered physical/mental status of patient or undesirable secondary effects of treatment.
3.4 Occupational Therapy Services-to/may include, but is not limited to, the following:
a. Provide initial and continued assessment of patient.
b. Plan, implement, and coordinate complex therapeutic OT program for the patient and caregiver to maintain or enhance function or retard deterioration in the patient's functional status.
c. Perform evaluations, set treatment goals, and implement treatment program in OT.
d. Evaluate patient's home for needed structural modifications to make the home environment safe and accessible.
e. Determine the need for assistive devices, teach, and monitor in the safe use of these devices.
f. Teach caregiver body mechanics to minimize risk of injury.
g. Provide hand-outs and demonstrations to patients regarding treatment techniques and theory.
h. Record and compile patient treatment data.
3.5 Speech Therapy Services-to/may include, but is not limited to, the following:
a. Evaluate patients with disorders of communication and swallowing. Administer and interpret speech, language and voice tests. Perform and interpret clinical (bedside) swallowing evaluations.
b. Interview patient and family members to obtain an in-depth history of the problem(s).
c. Recommend necessary follow-up or additional medical or therapeutic evaluations indicated by assessment of patient (i.e. audiometric evaluation, otolaryngological or neurological evaluation, videofluoroscopic evaluation, laryngeal videstroboscopic evaluation, etc.).
d. Determine appropriate diagnosis of disorder(s) following completion of all of the necessary evaluations.
e. Complete written report integrating information from all of the above sources. The report will include subjective history, objective findings, and a detailed assessment of the disorder, prognosis for improvement and suggested plan of treatment with short-term goals.
f. Determine prognosis for improvement after completing the evaluation.
g. Develop treatment program utilizing information from formal and informal assessment as well as information provided by the patient's medical record, family members, and required additional assessments. Ensure that patient and caretaker understand the treatment plan.
h. Counsel patient and patient's family regarding type and severity or disorder and prognosis for improvement with treatment.
i. Provide consultation services to medical personnel requiring information regarding patient's status and instruct those who may be involved in the plan of patient care. j. Fit and adjust various speech appliances. Advise patient or caretaker on care of therapeutic equipment. Provide instruction on the use and maintenance of prosthetic and therapeutic devices.
3.6 Social Work Services (SWS)-to/may include, but is not limited to, the following:
a. Diagnose emotional stress on patient and family/significant others and use a variety of psychotherapeutic approaches based on the diagnostic assessment to minimize the anxiety of both the patient and/or significant others during the transition to other forms of care.
b. Perform diagnostic assessment of patient's present mental and social functioning, based on developmental and vocational history and evaluation tools, as appropriate.
c. Develop and initiate a treatment plan to reduce stressors.
d. Apply knowledge of special emotional aspects of loss to diagnose the social and emotional problems and carry out therapeutic intervention to assist in resolving the social and emotional issues confronted by the patient
e. Utilize special knowledge related to social and emotional impacts of serious disability upon the patient and their family, diagnoses dysfunction in the patient and family, and carry out a system of therapeutic intervention to relieve stress and assist the patient to achieve maximum independence.
f. Diagnose dysfunction of a social or emotional nature and develop and implement a treatment approach to relieve symptoms of confusion, depression, or family dysfunction.
g. Assessment and treatment for mental illness, behavioral mal-adaptions, and other problems of an emotional nature.
h. Use diagnostic knowledge of the patient's need(s) to recommend referrals to a variety of VA and non-VA resources in support of the treatment objective of the patient.
3.7 Homemaker Service-to/may includes, but is not limited to, the following:
a. Light housekeeping
b. Making and changing beds
c. Dusting and vacuuming the room the patient uses
e. Tiding the kitchen
f. Tiding the patient's bedroom
g. Tiding the patient's bathroom
h. Doing the patient's personal laundry if no family member is available or able; this may include necessary ironing and mending
i. Meal planning and preparation
j. Grocery shopping
k. Shopping for patient if no other arrangement is possible
l. Assuring patient safety
m. Personal care supervision
n. Escorting the patient to appointments
3.8 Home Health Aide Service-to/may include, but is not limited to, the following:
a. Assistance with care of teeth and mouth
b. Assistance with personal grooming care
c. Assistance with bathing of patient in bed, in the bathtub, or in the shower
d. Assisting the patient on/off the bedpan, commode or toilet
e. Assisting the patient in moving from bed to chair/wheelchair, or vice versa
f. Assisting the patient in walking
g. Assisting the patient with eating
h. Assisting the patient with dressing
i. Prepare and serve meals according to instructions
j. Making and changing beds
k. Listing needed supplies
l. Send linens to laundry
m. Assure patient safety
n. Assistance with active/passive exercise o. Assistance with medical equipment and non-skilled, routine health monitoring
3.9 Respite Care Service-to/may includes, but is not limited to, the following:
a. Unskilled respite care service
b. Skilled respite care service
3.10 Hospice Care Service-to/may includes, but is not limited to, the following:
(1) Chaplain Service is required to provide care to terminally ill veterans and their families; the service includes:
(2) Spiritual support
(3) Emotional support
(4) Pastoral care
(5) Bereavement counseling
(6) Assist with memorial services and funeral arrangements
a. Social Service is used to provide assistance with practical and financial concerns as well as help meet the psychosocial needs of the terminally ill veterans and their family members. Social service includes:
(1) Advanced Directive planning/assistance
(2) Emotional support
(3) Counseling and bereavement follow-up
(4) Facilitate communication between the patient/family and community agencies
(5) Evaluate the need for support services
b. Skilled Registered Nursing Service is used to provide a broad range of care in accordance with paragraph 3.1 of the Statement of Work.
c. Licensed Practical Nursing Service is used to provide a broad range to technical nursing care in accordance with paragraph 3.2 of the Statement of Work.
d. Homemaker Service is used to provide a wide range of services in accordance with paragraph 3.7 of the Statement of Work
e. Home Health Aide Service provides a variety of personal care services in accordance with paragraph of the Statement of Work.
3.11 Infusion Services-Home infusion therapy is defined as any therapy that requires continuous or intermittent peripheral or central vein access for administration of prescribed therapy. Intravenous (IV) Home Infusion Therapy services may include, but is not limited to, the following:
d. Other non-internal medications
1) Home infusion therapy will be provided in a safe and timely manner, appropriate to the patients' condition and needs.
2) The patient must reside in a geographical area that is feasible to the provision of the appropriate and necessary prescribed infusion services.
3) The patient/caregiver must be motivated, reliable and capable of understating and learning all required activities and basic concepts related to care, i.e. infection control measures.
4) The environment in which the care is to be delivered must be safe for patients, caregivers and staff, as well as conducive to the provisions of services. This will include:
5) Adequate, clean storage space for medications and supplies; and
6) Telephone access or an alternative method of communication if no home telephone service is available.
7) An adequate plan must be in place to ensure IV access for the patient.
3.12 Ventilator Services-to/may include, but is not limited to, the following:
a. Ventilator weaning and management
b. Tracheotomy care
c. Bronchial hygiene
d. Oxygen therapy and monitoring
e. On-site monitoring of arterial blood gases
f. Nebulizer and aerosol treatments
g. Patient/family respiratory education
3.13 VETERAN SERVICES:
3.13.1 Skilled services shall include home health registered nursing, home health licensed practical nursing and social work service. Skilled services shall be provided in accordance with a plan of care and by a licensed health care professional as ordered by the medical staff of the VA. Supervision shall be provided in accordance with VA policy and regulation. The Home Health Care Agency shall be responsible for admitting veterans; assessing veterans, including initial and ongoing assessments; care planning; including the cue-planning process; coordinating, supervising, and evaluating the care and services provided; scheduling visits or hours; and discharge planning. The Home Health Care Agency shall provide the following services upon request:
a. Nursing services, treatment, and diagnostic and preventive procedures requiring substantial specialized skill
b. Veteran safety monitoring
c. Medication administration, including intravenous fluids, medicines, pain management, TPN, chemotherapy, and necessary care of the delivery lines and equipment
d. Required lab work with reports to the physician/provider
e. Veteran education and follow-up
f. Teaching, supervision, and counseling veteran and family members regarding nursing care and other related veteran problems
g. Rehabilitation regimen
h. Evaluation and regular re-evaluation of veteran home care needs; make appropriate recommendations
i. Development, implementation, oversight, and modification of the veteran plan of care
j. Documentation of the veteran's care and progress in the clinical record, including a discharge summary within 72 hours of discharge
k. Physical assessment and re-assessment per written policy
l. Documentation of outcomes of care/services provided
220.127.116.11 Bowel and Bladder care, if ordered, shall be provided by the HHCA and only be performed by a Registered Nurse (RN) or Licensed Practical Nurse (LPN) and shall include the following services: Train, supervise, and counsel Spinal Cord Injury (SCI) Bowel and Bladder veterans and their significant other/caretaker, to assume bowel and bladder care as appropriate
a. Inserting of a suppository
b. Digital stimulation
e. Intermittent catheterization
f. Indwelling catheterization.
3.13.2 Unskilled services shall include homemaker and home health aide services. Unskilled services shall be provided in accordance with a plan of care and by fully qualified personnel that have the requisite credentials and experience to perform services under the terms and conditions of this written agreement. Services are to be performed as ordered by the medical staff of the VA. Supervision shall be provided in accordance with VA policy and regulations. The Home Health Care Agency (HHCA) shall be responsible for admitting veterans; assessing veterans, including initial and ongoing assessments; care plans; coordinating, supervising, and evaluating the care and services provided; scheduling visits or hours; and discharge planning. The MICA shall provide the all unskilled home health services upon request in accordance with paragraph 3.7 and 3.8 of the Statement of Work.
3.14 QUALITY ASSESSMENT STANDARDS:
3.14.1 HHCA health care providers shall be subject to the same quality assessment standards as established by VA, state and Joint Commission. The health care provider shall perform services in accordance with ethical, professional, and technical standards of the health care industry. Persons provided by the HHCA shall be technically proficient in the skills necessary to perform the services described herein. HHCA personnel shall be responsible for compliance with all procedures in accordance with applicable VA written policies and procedures. They shall not introduce new procedures or services without prior recommendation to and approval of the VA or authorized representative.
3.14.2 Non-acceptance of HHCA personnel does not relieve the agency from satisfying and fulfilling the requirements.
3.14.3 Proposed costs awarded shall inclusive of all incidental costs including housing, transportation, and premium payments for applicable malpractice insurance coverage. This contract represents a firm-fixed price service contract. Services performed outside the scope of this agreement are not authorized and will not be reimbursed by the Government without prior approval.
3.14.4 HHCA must have a written Performance Improvement Plan and provide to the SAVAHCS prior to award. This plan must be reviewed and approved by the COR.
3.14.5 Evidence of all performance improvement activities shall be made available to the SAVAHCS CHNC including veteran satisfaction indicators upon request. The HHCA shall maintain a separate record of veteran complaints (including problem resolution) which will also be available upon request of the CHNC.
3.14.6 HHCA shall develop a written emergency preparedness plan to ensure continuing care and support in the event of an emergency, which would interrupt normal services to veterans.
3.14.7 HHCA shall develop a written plan for ensuring the evaluation, reporting, and maintenance of records related to infections among veterans and, as appropriate, among staff. Documentation of plan implementation shall be provided during annual inspection by SAVAHCS staff, and as requested. The VA shall be notified of significant variances.
3.14.8 HHCA shall document and immediately FAX a report to the CHNC of any known incidents of death, accidents, injury, or infection related to furnished medications, supplies, or medical equipment, and any life-threatening equipment malfunctions or equipment recalls. The HHCA shall develop and maintain an equipment recall plan.
3.14.9 HHCA shall abide by local laws and regulations with regard to abuse, neglect, and exploitation of the elderly, and will develop policies for prevention and dealing with any reports of such. Additionally, the HHCA will notify the VA of any suspected or confirmed situations of neglect, exploitation, or abuse of a veteran or the expression of the intent to commit harm to self or others by a veteran.
3.14.10 The HHCA must be licensed by the State of Arizona and approved for the care of Medicare and/or Medicaid veterans. All contract health care providers performing services covered by this agreement shall be licensed and/or certified by the States where services are being provided.
a. If the HHCA is not Medicare and Medicaid certified the SAVAHCS CHNC will follow VA protocol for obtaining permission to join into an agreement with the Home Health Care Agency. Proof of VA approval to waive the Medicare and Medicaid certification requirement will be furnished to the Contract Officer by the COR prior to award.
3.14.11 The HHCA must meet VA and state standards to provide home care services.
3.14.12 The HHCA must be a regularly established business providing the type of services described in this agreement, is financially responsible, and have the necessary equipment and personnel to furnish services in the volume required by this solicitation. The HHCA shall meet all requirements of Federal, State, and local governments' codes regarding operation of this type of service.
3.14.13 When requested, the HHCA shall provide the VA with proof of its reliability, ability, and experience by furnishing the following information:
a. A list of personnel who will perform under the agreement showing the length and type of experience of such personnel, and
b. The names and addresses of other concerns and/or Government agencies for which this type of services were rendered by the HHCA.
3.14.14 The VA reserves the right to thoroughly inspect and investigate the establishment, facilities, business reputation, and other qualifications of any Offeror and to reject any offer, irrespective of price, that shall be administratively determined to be lacking in any of the essentials necessary to assure acceptable standards of performance.
3.15 PROGRESS AND COMPLIANCE/EVALUATION FACTORS:
3.15.1 The SAVAHCS CHNC shall be responsible for:
a. Designing and implementing a SAVAHCS quality improvement program for the HHCA services being provided.
b. Informing the HHCA of the quality assurance indicators are being monitored and the status of the agency's performance in meeting those indicators.
c. Ongoing quality assurance indicators will always include:
(1) Monitor for service quality
(2) Monitor for patient safety
d. Ongoing quality assurance indicators will be documented at least quarterly and will
Be included as a routine part of the SAVAHCS CHNC Quality Assurance Report.
e. Immediately Informing the HHCA of any quality concerns or issues.
f. Monitoring, documenting, and following up on all concerns and complaints received about care provided by the HHCA.
g. Monitoring the HHCA's current plan of care. Any changes that alter the frequency of visits or level of services shall require prior approval of the SAVAHCS CHNC, who is responsible for oversight and final approval of services rendered.
a. The SAVAHCS reserves the right to evaluate the care services provided by reviews of clinical notes, visits verification records, and surveys of patients.
b. Monitoring the HHCA's compliance with this agreement and following-up with the agency on any issues regarding compliance.
c. Meeting at least quarterly with the SAVAHCS Contracting Officer assigned to the CHNC contracts to:
(1) Review quarterly documentation done by the SAVAHCS CHNC regarding the HHCA's compliance with this agreement. Compliance review will include:
I Service delivery
ii Business practices
(2) Update the agreement as needed to avoid a lapse in the SAVAHCS documented service period for this agreement.
3.15.2 The HHCA shall be responsible for:
a. Designing and implementing a quality improvement program. The quality improvement program shall be designed to include SAVAHCS patient involvement in quality improvement.
b. Providing, upon SAVAHCS CHNC or Contracting Officer request, agency quality improvement documentation.
c. Providing the SAVAHCS with the following reports:
(1) A care verification form or each visit under this agreement. The agency shall complete this form indicating the date each visit is made, length of visit and services provided. The patient or caregiver shall initial this form to serve as evidence that care has been provided.
(2) An up-dated list of active VA patients' names, types of services required and delivered; frequency of services and total number of hours of service. The HHCA shall provide this list to the SAVAHCS CHNC on a monthly basis.
(3) A copy of the 60-day supervisory visit documentation following the home visit. This report should include a detailed review of the home situation; support services available; mental, emotional and physical condition of the patient. A complete plan of care shall be used for this purpose. The agency shall be responsible for developing, reviewing and devising the plan of acre as indicated by the patient needs. This will be review and approved by the SAVAHCS CHNC prior to the implementation of the agency plan of care.
3.16 CONFLICT OF INTEREST:
3.16.1 The HHCA shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The HHCA shall not employ any person who is an employee of the Department of Veterans Affairs, unless such person seeks and receives approval in accordance with VA Regulations, policy, and public law. Nor shall the HHCA employ any person who is a member of the immediate family of a VA employee employed at the VA if the employment of that family member would create a conflict of interest or the appearance of a conflict of interest, particularly with regard to influencing the negotiations, terms of the agreement, or the work carried out under the agreement. In any such case, VA must review the matter and give its approval in accordance with agency ethics rules.
3.17 VETERAN SENSITIVITY:
3.17.1 HHCA health care provider/s shall respect and maintain the basic rights of veterans, demonstrating concern for personal dignity and human relationships.
3.17.2 Complaints shall be investigated individually. HHCA health care providers receiving more than two (2) verified complaints from COR, Veteran Advocate, CHNC, Case Managers or social workers related to sensitivity within any consecutive three (3) month period shall require the health care provider to complete a sensitivity training class before continuing to provide services under this agreement. HHCA health care provider's participation in sensitivity training class shall be the sole responsibility of the HHCA at no expense to the Government. Depending upon the nature and severity of the complaint, the Government reserves the right to suspend performance of subject agreement health care provider or prohibit performance altogether, as deemed appropriate.
3.18.1 HHCA shall ensure that health care providers maintain open and professional communication with veterans and members of the VA staff. Validated complaints of unprofessional behavior shall be reported to the COR in writing and referred to the HHCA for action. Failure by the HHCA to correct validated complaints identified to or by the COR shall be considered failure to perform and referred to the Contracting Officer for appropriate action.
3.19 DRUG SCREENING:
3.19.1 HHCA health care providers are subject to random drug testing. They are also subject to drug testing when there is a reasonable suspicion that they use or are impaired by illegal drugs while on duty. Reasonable suspicion of drug use or impairment includes, but is not limited, to the following:
a. Observable phenomena, such as direct observation of drug use, possession or the physical symptoms of being under the influence of a drug;
b. A pattern of abnormal conduct or erratic behavior;
c. Arrest or conviction for a drug-related offense or the identification of a HHCA
health care provider as the focus of a criminal investigation into illegal drug possession, use, or trafficking;
d. Information provided either by reliable and credible sources or independently corroborated; or
e. Newly discovered evidence that the health care provider has tampered with a previous drug test.
3.20 POINTS OF CONTACT (POC):
3.20.1 The HHCA shall provide a point of contact (POC) who shall be responsible for the performance of the work under this agreement. The POC shall have full authority to act for the HHCA on all matters relating to the daily operation of this agreement. The POC must be a health care provider performing in accordance with the terms and conditions of this agreement. An alternate may be designated, but the HHCA shall identify, in writing, those times when the alternate shall act as the POC. The HHCA shall identify the POC and alternate in writing to the SAVAHCS COR at the time of acceptance. The HHCA shall give written notification to the COR of those times when the alternate will act as the POC. The POC shall be available by telephone Monday through Friday, 8:00AM through 4:30PM, including Federal holidays.
3.21 ALTERNATE SOURCES:
3.21.1 If routine services are not performed for more than two (2) scheduled consecutive visits or Skilled Nursing Health Care service is not performed within twenty-four hours of scheduled or emergent response requests, the Government reserves the right to procure such services from an alternate source, until routine services are restored by the HHCA. When the Government exercises its right to procure these services from an alternate source, the HHCA shall reimburse the government for all charges in excess of the amount that would have normally been incurred by the agreement, including VA administrative costs for re-procurement.
3.21.2 A copy of the other source's invoice and/or other verifiable documentation shall be used as the basis for any reimbursement.
3.22 MONITORING PROCEDURES:
3.22.1 The COR for this agreement is appointed in writing; the COR is the SAVAHCS CHNC. The COR is responsible for routinely monitoring and reporting the Home Health Care Agency's performance to the SAVAHCS Contracting Officer, SAVAHCS Quality Improvement Coordinator, and the Home and Community Services Committee. The COR has is appointed act on behalf of the government on all matters as long as they do not obligate the government financially. Any and all changes to this agreement will be made with written approval of the Contracting Officer.
3.23 CALL LIMITATION/PERSONNEL AUTHORIZED:
3.23.1 No individual call under the Agreement shall exceed $150,000 and any or all calls are only to be placed by authorized personnel.
(1) The following individuals are authorized to place telephone orders:
SAVAHCS Community Health Nurse Coordinators
SAVAHCS Attending Physicians
3.24 ORDERING PROCEDURES:
3.24.1 Referral of each Veteran to the HHCA shall be generated by the SAVAHCS CHNC staff. Referrals will be made to each HHCA based upon location and need of the veteran as well as the appropriate home health care services available.
3.24.2 All services shall be prescribed by a SAVAHCS physician and must meet quality standards set forth within the most current federal and state regulations.
18.104.22.168 The SAVAHCS CHNC shall:
a. Provide the home care agency with a Homemaker/Home Health Aide referral when a SAVAHCS interdisciplinary team has made a clinical judgment that the veteran under consideration for services meets the following criteria:
i. Three (3) or more activity of daily living dependencies, or
ii. Significant cognitive impairment, or
iii. Require services as adjunct care to community hospice services, or
iv. Two (2) activity of daily living dependencies, and two (2) or more of the following conditions:
1. Had dependency in three (3) or more instrumental activities of daily living;
2. Has been recently discharged from a nursing facility, or has an upcoming nursing home discharge plan contingent on receipt of home and community-based care services;
3. Is seventy-five (75) years old, or older;
4. Has had high use of medical services defined as three (3) or more hospitalizations in the past year of has utilized outpatient clinics or emergency evaluation units twelve (12) or more times in the past year;
5. Has been diagnosed with clinical depression;
6. Lives alone in the community.
b. Provide the home care agency with a Skilled referral when a SAVAHCS clinical judgment has been made that the veteran is appropriate for such care.
c. Provide relevant medical information on referred patients to the agency.
d. Review the agency plan of care for each client referred or updated to determine appropriateness of the plan.
e. If it is determined the plan of care is not appropriate the SAVAHCS CHNC will contact the agency to amend the plan of care as required to meet the needs of the patient.
f. Authorize the number of hours/days and duration of services.
g. Review the veteran's authorization for services every 6 months from the start of service.
h. Visit the HHCA at least every six (6) months to review performance and
i. At least one visit will include an annual SAVAHCS inspection.
22.214.171.124 The HHCA shall:
a. Evaluate all patients within 48 hours after notice of referral. Care shall be established within a time frame not to exceed 72 hours after the initial assessment.
b. Complete a patient needs assessment and develop a plan of care. The agency shall complete the Agency portion of the referral form and return it along with a plan of care, to the SAVAHCS CHNC. Special attention shall be given to differentiate Homemaker and Home Health Aide services and the plan shall clearly state the frequency and duration being requested for each type of service.
c. The agency shall not provide any services without the prior approval from the SAVAHCS.
d. Be responsible for developing, reviewing and devising the plan of care as indicated by patient needs. These plans will be forwarded to the SAVAHCS CHNC for review and approval.
e. Provide a registered nurse to conduct a home visit to re-assess the patient and update the plan of care every 90 days.
f. Schedule visits in accordance with the care plan and patient acceptance of service recommended. Refusal of service by the patient will be communicated to the SAVAHCS CHNC.
g. Report any problems that arise between the agency employees and the SAVAHCS clients immediately to the CHNC for mediation. The agency shall not suspend nor cancel patient care under any circumstance.
h. Report consistent patient no-shows to the SAVAHCS CHNC for follow-up. The agency shall not suspend nor cancel patient care due to no-shows.
i. Ensure services are provided by qualified and competent personnel in accordance with the terms and conditions of this agreement.
j. Begin services within one (1) week of initial referral.
k. Provide a registered nurse who will, upon initial client visit, provide the client, patient rights and responsibilities, advance directive information, and obtain authorization for care from the patient and/or appropriate family member/legal representative.
l. Revise the plan of care as necessary according to changes in the patient's condition.
m. Immediately report any significant changes in the patient's medical, emotional, or family condition to the SAVAHCS CHNC.
n. Provide documentation of services provided and an updated plan of care upon request of the SAVAHCS CHNC.
o. Notify the SAVAHCS CHNC if the veteran or caregivers terminates their services.
p. Notify the SAVAHCS CHNC immediately if the patient or caregiver refuses services or is determine by the Home Care Agency to no longer require services.
q. Notify the SAVAHCS CHNC in the event of a death of a patient receiving services.
3.25 DESIRED QUANTITY:
3.25.1 It is impossible to determine the exact or estimated amount which will be expended under the agreement. It is understood that no obligation will be incurred by the SAVAHCS under this agreement until authorizations are issued by the SAVAHCS CHNC for treatment/service for specific beneficiaries.
3.26 EXTENT OF OBLIGATION:
3.26.1 The Government is obligated only to the extent of calls that are actually made against this BPA. It is understood that this document in no way obligates the SAVAHCS to purchase a minimum or maximum quantity. This agreement can terminated at any time by either party as long as 60 day notice is provided.
As defined below for the purpose of this agreement the following terms and definitions are provided:
- Certified Home Health Care Agency means a home and community support service that provides skilled, home health services and is certified by Medicare/Medicaid and/or State of Arizona and meets the standards.
- Home Health Care Service" means the provision of one or more of the following health services required by an individual in a residence or independent living environment:
1. Registered Nursing
2. Licensed Practical Nursing
3. Homemaker Services
4. Home Health Aide Services
5. Respite Care
6. Hospice Care
- SAVAHCS - Southern Arizona Veterans Administration Health Care System
- HHCA - Home Health Care Agency
- CFR - Code of Federal Regulations
- VHA - Veterans Healthcare Administration
- BPA - Blanket Purchase Agreement (also referred throughout as "agreement")
- BOA - Basic Ordering Agreement (also referred throughout as "agreement")
- CHNC - Community Health Nurse Coordinator
- COR - Contracting Officer's Representative
- HCPCS - Healthcare Common Procedure Coding System
- VISN 18 Policy Memorandum No. 5: Network Contracting Process.
- Current Edition of Comprehensive Accreditation Manual for Home Care is incorporated by reference, as published by Joint Commission.
- Title 38 Code of Federal Regulations (CFR) 17.38(a) (1)(ix)
- Federal Acquisition Regulation (FAR)
- Veterans Administration Acquisition Regulation (VAAR)
- Attachment A: SAVAHCS Claims Rejection Form
SKILLED NURSING/HOMEMAKER HOME HEALTH AIDE/HOME HOSPICE PROGRAMS
Agency: ________________________________ Date: _____________________
The invoices are being returned due to:
? CMS 1500 claim form not used
? Invoice claim is for more than one veteran's services
? One or more of the required elements are missing from the claim form:
Veteran's social security number
Veteran's address, including zip code where services were rendered
Description of services
? Information on the claim form not typed
? Pen/ink (hand written) changes made on the claim form
? Missing or incorrect ICD9 code/s
? Missing or incorrect CPT and/or HCPCS code/s
(End of Description/Specifications/Work Statement)
APPENDIX A - SPECIAL CONTRACT REQUIREMENTS
1.0. INTRODUCTION: The Contractor shall provide Health Care Resources in accordance with the terms and conditions stated herein, to furnish to the Southern Arizona VA Health Care Systems, the services and prices specified in the Performance Work Schedule of this contract. Award will be made for non-personal services, as defined in FAR 37.01, under which the Contractor is an independent contractor.
2.1. The services specified in the Special Contract Requirements and the Price/Cost Schedule may be changed by written modifications in accordance with FAR Part 52.212-4.
3.0. QUALIFICATIONS: Personnel assigned by the Contractor to perform the services covered by this contract shall be qualified in accordance with the Performance Work Statement.
4.0. CONTRACT MODIFICATIONS: The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue changes that will affect price, quantity, or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered to have been made without authority and no adjustment will be made in contract price to cover any increase in prices incurred as a result thereof. The Contractor shall obtain written authorization from the Contracting Officer for any services required outside the scope of work provided herein.
5.0. MEDICAL RECORDS:
6.1. Medical records and other patient information shall be provided pursuant to VA policy and standards which are designed to protect the confidentiality of the patient's medical records in accordance with applicable state and federal laws and recognized standards of professional practice.
6.1. The Contractor shall provide monthly invoices in arrears that reference the contract number and, the Contract Line Item Number(s).
6.2. The VA agrees to reimburse the Contractor according to the terms of the contract for services performed under this contract.
7.0. HIPAA COMPLIANCE: In accordance with 45 C.F.R. Parts 160, 162 and 164 (Health Insurance Portability and Accountability Act) and 38 U.S.C. 5701, 38 U.S.C. 5705, 38 U.S.C. 7332,5 U.S.C. 552a (Privacy Act), the Parties agree to hold all individually identifiable health information as that term is defined in the Health Insurance Portability and Accountability Act and regulations promulgated thereunder (collectively, "HIPAA") shared with, transferred or transmitted to, or otherwise obtained by the Contractor on or from or on behalf of the VA in the course of the Contractor providing the services under this contract ("Protected Health Information") strictly confidential, and provide protections to prevent the unauthorized disclosure of such information, including, but not limited to the protection required by applicable federal, VA, state and local laws, policies and/or regulations regarding the security and the confidentiality of patient health care information including, but not limited to, HIPAA. Specifically, the
Contractor agrees as follows:
a. To maintain safeguards as necessary to ensure that the Protected Health Information is not used or disclosed except as required to perform its obligations under the contract, as expressly permitted herein or as required or permitted by law;
b. To ensure that any sub-Contractors or agents to whom it provides Protected Health Information agree to the same restrictions and conditions that applies with respect to such information;
c. To make available its internal practices, books and records relating to the use and disclosure of Protected Health Information to the Department of Health and Human Services or its agents as required by HIPAA;
d. To incorporate any amendments or corrections to Protected Health Information when notified by the VA that the information is inaccurate or incomplete;
e. To, at termination of this contract and as feasible, return or destroy all Protected Health Information that it still maintains or archive to meet the Contractor's legal obligations related to retention of records;
f. To ensure that, as to any Protected Health Information held by the Contractor, the Contractor policies are in place to allow access to that Protected Health Information by the subject of that information as required by HIPAA;
g. To report to the VA any use or disclosure of Protected Health Information which is not allowed under the terms of the contract. If at any time after the effective date of this Agreement it is determined that either party is in breach of this Section, the other party, in its sole discretion, may immediately terminate this contract.
8.0. BAA: The VA has recognized the Contractor as an entity that does require a Business Associate Agreement (BAA). Within five (5) days after award of the contract, the Contractor shall execute and return to the VA a copy of the BAA included as Attachment A to the solicitation.
(vii) Period of Performance:
The Period of Performance of Resulting Agreement shall be for a Period of five (5) years form the effective date of the ward.
(viii) The provision at 52.212-1, Instructions to Offerors-Commercial Items (APR 2014) applies to this acquisition.
Addendum to FAR 52.212-1
The following instructions are provided to ensure the submission of information necessary to properly evaluate each Offeror's proposal. Submit complete proposals as detailed in this section and VAAR 852.273-73, Evaluation-Health-Care Resources. Include only information relevant to this solicitation. If the solicitation is amended, the Offeror is responsible to acknowledge receipt of the amendment prior to the hour and date specified in the amendment. Failure to acknowledge receipt of the amendment may result in rejection of your proposal. Instructions on how to acknowledge receipt of the amendment are contained in the amendment. Failure to properly provide all information required by this solicitation may result in an invalid proposal.
Read entire solicitation and follow instructions accordingly because lack of required information and/or documents could result in a determination that the proposal is non-responsive.
North American Industry Classification System (NAICS) Code 621610 applies to this acquisition. Offerors must be registered for NAICS 621610 and must be represented as such within its SAM registration to be considered for award.
1. To assure the timely and equitable evaluation of proposals, the Offeror must follow the instructions contained herein. The proposal must be complete and respond directly to the requirements of the solicitation. The response shall consist of a total of one (1) proposal copy.
a. Part I:
i. Price\Rate Schedule (Attachment A)
ii. Arizona State License - (If Applicable)
iii. Medicare License - (If Applicable)
iv. Contract Administration Data
v. Past Performance
Past performance information will be collected by the technical evaluator at the Medicare site listed below. This criterion will result in either a pass or fail rating.
Offerors shall submit their Arizona State License.
Offerors that are not Medicare Certified shall review the Medicare website listed above, and submit their agency's percentages in the categories listed on the website. Enter NA for information that is not available from your agency's quality monitors.
C. PROVISION INFORMATION