Table of Contents section b continuation of sf 1449 blocks 2



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SECTION B - CONTINUATION OF SF 1449 BLOCKS 2

B.1 CONTRACT ADMINISTRATION DATA 2

11. LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011) 2

12. SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011) 2

13. SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011) 2

B3. GENERAL: 2

B3.22. CONTRACTOR RESPONSIBILITIES: 2

B3.23. DIRECT PATIENT CARE: 2



B3.25. SPACE REQUIREMENTS: Space standards shall meet the PACT model and are found at http://www.cfm.va.gov/til/dGuide/dgPACT.pdf. The Accessibility design standards are defined in the following guide: http://www.cfm.va.gov/til/dGuide/dgBarrFree.pdf . 2

B3.25.1. Information Technology Closet Space Requirements: 2

B3.25.2. The Contractor's facility shall be in compliance with National Fire Protection Association (NFPA) Life/Safety requirements and the Americans with Disabilities Act. VA will inspect the Contractor's facility before contract start date and retains a rite of inspection throughout the period of performance during normal business hours of 8am to 4:30pm, Monday through Friday. Contractor shall be in compliance with these requirements prior to contract start date. A list of any deficiencies identified during an inspection shall be provided to the Contractor along with a required date for correction of the deficiencies. Any planned changes in the physical environment at the Outpatient Site of Care shall be reviewed and approved by the VA to ensure that all life safety codes are met. Parking shall be adequate enough to accommodate veteran patients, and shall include at least two (2) handicapped parking spaces. 2

B3.25.3. Privacy Standards: Veterans shall be provided adequate visual and auditory privacy at check-in. Patient names shall not be posted or called out loudly in hallways or clinic areas. Veterans shall be provided adequate visual and auditory privacy in the interview area. Patient-identified information shall not be visible in the hall including charts where names are visible. Every reasonable effort shall be made to restrict unnecessary access to hallways by patients and staff who do not work in that clinic area. Patient dignity and privacy shall be maintained at all times during the course of a physical examination. . 2

B3.26. INFORMATION TECHNOLOGY REQUIREMENTS: 2

B3.26.1. Private Branch Exchange (PBX) Requirement: VA will provide, install, and maintain a PBX (Telephone system) and Internet Protocol (IP) telephones installed in all applicable rooms. This system will allow each extension to be able to dial to the main site and VISN 10 by five-digit dialing. Each telephone shall have its own unique extension number. Contractor shall provide a Primary Rate Interface (PRI) circuit per location for all inbound and outbound calling whether local, long distance or 800. This PRI shall also be used for 911 calling. VA will configure 911 to go to the VA police, and 9-911 to go outside to the local emergency services. Contractor contingency plan for 911 calling should the phone system go down or if the PRI goes down, shall be contractor provided or personal cell phones. Contractor shall provide a minimum of 20 Direct-In-Dial (DID) numbers to be used by the contractor staff. VA will provide secure faxing and will be accomplished by VA provided Stream solution. 2

B3.26.2. Network Requirement: VA will supply all network gear and installation/maintenance to the remote facility including switches, routers, computers, and printers. VA will provide and maintain Multiprotocol Label Switching (MPLS) Data circuit. This data circuit will be an AT&T circuit delivered to the facility via fiber transport by the local Telco carrier, in some instances other than AT&T. As the VA will provide the circuit, the contractor shall incur all other cost associated with installing the circuit should a local Telco carrier charge for installation services. These fees are always waived for VA in AT&T areas. The contractor shall provide a contractor staff individual to be an Automated Data Processing Application Coordinator (ADPAC). The ADPAC shall be the interface to Office of Information and Technology (OI&T), provide all help desk calls, OI&T assistance in trouble shooting before dispatch, and assistance with equipment inventory. Any specialty equipment required by the site (i.e.; Radiology equipment whether it requires a computer or not) shall need a case-by-case approval and may not be provided by OI&T. Any equipment not purchased by OI&T needing network connectivity shall be approved on a case-by-case instance. 2

B3.26.3. Outside Telco Connectivity: High speed Internet capability via Fiber transport into the building demarcation point with multiple MPLS T1/T3/DSL/Cable-line accessibility. If selected lease space does not have this capability according to the local Telco (such as AT&T), then the capability shall be added at the contractor landlord’s expense before VA can occupy the space. In most cases this is provided by AT&T at no charge to government facilities. If telephone landline capability to the building allows either PRI’s and/or multiple Measured Business (MB) line accessibility and the space does not have this capability according to the local Telco (such as AT&T), then the capability shall be added at the contractor landlord’s expense before VA can occupy the space. In most cases this is provided by AT&T at no charge to government facilities. 2

B3.26.4. Outside Facility Access With Equipment: Contractor shall provide one loading/unloading area for shipments, which shall accommodate unloading of Pallets into the building. Loading dock is preferred but is not required. However, it is a requirement that a pallet shall be able to fit through the equipment entrance doorway. 2

B3.26.5. Data Jacks (Contractor Responsibilities): To connect to the wired VHA network: There shall be a minimum of two data locations in each room (to be based on tenant furniture layout and excluding bathrooms) consisting of two Cat6 data cables each that can be used for voice or data, each to have its own printed (not handwritten) unique identifiable number, and all to be terminated on a patch panel in the grounded data rack (not a server rack) in the data closet sequentially. Placement of data jacks shall be subject to the approved furniture layout and subject to approval of the VA. In the reception desk and the doctor team rooms, multiple data jacks shall be required to accommodate the many layers of equipment that shall be installed at the desk. The official quantity will be identified by VA personnel. Cabling shall be installed according to BISCI standards. If the ceiling is an air return ceiling, the cable shall be plenum rated. All cabling shall be continuous runs with no splices and be less than 328’ including a seven foot patch cord at each end. Patch panels, jacks, and cable shall all be rated at Cat6 or higher and be tested and certified with a passer rating. The capability to add additional data locations as determined by occupants shall be provided by the contractor within 10 days from request. RLR VAMC can recommend a cable contractor if necessary but it shall not be a requirement to use recommended contractor. 2

B3.26.6. Data Jacks (Contractor Responsibilities): To connect to VHA Wireless Network: Locations for the ceiling mounted Access Points (AP) and the cabling will be determined by the VA based upon wireless survey or walk thru (to validate quality of service for voice, locality based services and data access). One Cat6 cable per AP shall be above ceiling and clearly marked with a unique identifiable number, and ran back to the data closet and terminated in the data rack on the same patch panels as the other facility data cabling. A six foot service loop on the data cabling at the AP shall be required to allow the AP to be moved if necessary. Cable contractor shall install the VA provided AP. 2

B3.26.7. Voice Jacks (Contractor Responsibilities): To connect to the VHA PBX: Voice cabling requirement is based strictly on the furniture layout. The requirement is it may be necessary to wall mount a phone and a Cat6 cable and wall jack shall be required capable of hanging a wall phone, such as in a break room. Locations will be discussed according to the blue print layouts prior to move in. 2

B3.26.8. Data Closet (Contractor Responsibilities): A minimum of 75 square feet of free space shall be required with the entrance door opening outward. If fire code does not allow the door to open outward, then the square footage shall be a minimum of 85 square feet. Overhead lighting shall be controllable from within the room. Flooring shall either be static resistant tile, or bare concrete. No carpet, no laminate. A Solid door construction with no vents shall be required. Hinges shall either be on the inside or to contain a prohibiting measure in removing the hinge pins if they are on the outside. The door handle shall be auto locking, unable to unlock from the inside (twist unlock style) when open. The lockset shall be capable of receiving a seven pin BEST core. VA will provide the core and keys for this lock. The data closet shall be secured to VA access only and shall not be shared with any other tenant. A single cable shall be required in the data closet for a wall phone to be terminated on a wall jack at 48” center and be placed near light switch. Services such as T1/T3/DSL/Cable and a 911 line shall be extended from the building demarcation point to the data closet by the contractor or designee. This can be accomplished by providing four Cat6 data cables from Demarc to IT closet. The VA may opt to choose Ethernet or fiber Demarc extension based on circuit delivery. Data closet shall have a dedicated 110 (quad outlet) electrical circuit near the data rack. This location will be determined by the VA according to desired IT closet layout. Data closet shall have a dedicated single L5-30L (twist lock) 30amp 120v electrical circuit near the data rack. This location shall be determined by the VA according to desired IT closet layout. Data closet shall have an available ground and the data rack(s) shall be grounded. Building ground is acceptable. Room shall be temperature controlled and able to be cooled and heated to 69 degrees F. If an in-room cooling unit is used, then the cooling condensation shall drain outside of the room. Data closet shall be secure from floor-to-ceiling (deck) and not able to be accessed by removing a ceiling tile. The specific location to be identified by the tenant once the area has been reviewed. Two data racks shall be required, possibly more, based on size of facility and is at the discretion of the VA. Eight inch vertical wire management shall be required for installation between the racks that have a closing cover-to-cover up the cabling loops in the management. Horizontal wire management shall be required to be installed between the patch panels that have a closing cover to cover up the cabling loops in the management. Data racks shall have sufficient space to mount patch panels, data equipment, PBX and UPS. Adequate space for growth shall be figured in. Data racks shall be secured to the floor. 2

B3.27. Physical Security: The contract clinic site for the VA clinic shall comply with VA Physical Security requirements, which may be found at the following site: http://www.cfm.va.gov/til/dGuide/dgLBOPC.pdf. The minimum requirements for physical security at a VA field facility are outlined in appendix B of VA Handbook 0730. These include specifications for physical barrier security, lock set hardware, alarms, and storage containers for high value items and dangerous drugs. 2

B3.28. Panic Alarms: The CBOC shall provide a panic alarm system per VA Handbook 0730/2, “Security and Law Enforcement.” This system shall be used to provide rapid notification to on-site staff at the CBOC who shall ascertain the need for notification of local law enforcement. The alarm may be activated by a covertly placed switch or button and enough switches/buttons shall be available to personnel receiving patients. The alarm annunciator shall be monitored by local staff (and paid for if necessary) by the contract clinic company. The exact location of panic/duress alarm switches shall be determined by a physical security survey of the protected area. VA Police will provide annual physical security surveys. Compliance with items marked as “Findings” shall be corrected at the contractor’s expense. A written response for any “Findings” shall be sent to VA Police within 30 days of receiving the letter. All alarm switches or buttons shall be tested once per month by the contract clinic company to ensure operational effectiveness with results provided monthly to the VA Police located at the Richard L. Roudebush VA Medical Center. 2

B3.29. Intrusion Detection System (IDS): At a minimum, there shall be motion detection provided near all entry doors to the clinic from an outside area. Door switch type alarms shall be used in conjunction with the motion detection equipment. It is highly recommended that all IDS be monitored by an outside contracted agency to summon local law enforcement to the CBOC. 2

B3.29.1. Contractor shall meet VHA standards regarding Environment of Care (EOC) and shall provide the following Safety and Health EOC documents, as required by TJC, within 15 calendar days after contract award. EOC Management Plans addressing Safety, Security, Hazardous Materials, Hazardous Waste, Emergency Preparedness, Life Safety, Medical Equipment and Utility Systems. The VA Safety Officer shall approve the EOC documents prior to commencement of patient care activities at the clinic. The EOC Management Plans shall be updated annually, along with a summary of performance and opportunities for improvement. 2

B3.30. Equipment, Office Supplies and Technical Support: In accordance with VA and VHA directives, policies, and handbooks, all equipment attaching to a VA network will be owned by the VA and controlled by the VA. No other equipment shall be connected to this network. The use of the equipment shall be for the benefit of the Government in providing care to our veterans. The equipment shall only be used by those expressly authorized in support of the Terre Haute CBOC. All users shall comply with and adhere to VA Directives and VA Cyber Security policies. The Contractor shall be responsible for: 2

B3.30.1. the installation and maintenance of the network infrastructure within the facility including, but not limited to, cabling located inside the walls of the structure and a secure communications closet space to house the patch panels and networking equipment. 2

B3.30.2. the backup, contingency and continuity of operations, the Contractor shall provide connectivity to the Internet via cable modem, DSL or T1 circuits to the communications closet space. 2

B3.30.3. the maintenance and on-going technical support for all data and voice wiring within the walls and ceilings from the data closet to the endpoints of the network. 2

B3.30.4. all charges related to the backup, contingency, and COOP connectivity. 2

B3.30.5. the procurement, installation and maintenance of all printers, copiers, scanners, fax machines*, shredders, or other peripheral office equipment and all related and ongoing supplies (paper, toner, ink cartridges) required to operate the equipment in support of the facility under the specifications of this contract.* VA Handbook 6500 that requires the following statement on all fax cover sheets be included: This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. if you have received this fax in error, please notify this office immediately at the telephone number listed above.” 2

B3.30.6. all office supplies (pens, paper, pencils, folders, paper clips and other supplies to facilitate operation of the clinic. 2

B3.30.7. all clinical supplies to accomplish all required work in this contract, other than those provided by the VA specifically mentioned in this document. 2

B3.30.8. ensuring hardware/software compatibility with VA approved list: the following printers have passed compatibility testing with the VISTA Encounter Form: Lexmark T642n, Lexmark T644n and Lexmark E342n or compatible; the following scanner has passed compatibility testing with the VISTA Imaging System: Fujitsu fiI-4340C Sheet Feed Scanner (Any other model used will require approval and certification for Vista Imaging) 2

B3.30.9. one small desktop color printer for printing patient education information 2

B3.30.10. having a contingency plan for computer downtime that defines the processes in order to ensure continuity of patient care and maintenance of the integrity of the patient’s medical record during periods of loss of computer functions. The contingency plan shall be reviewed and approved by the Contracting Officer prior to award. In addition, a contingency plan template that designates criticality of application/system, estimate of impact, locations of equipment, and contact persons will be provided to the Contractor for completion after award. 2

B3.30.11. The VA will be responsible for: 2

B3.30.11.1. providing PC workstations, software, primary telecommunications lines and networking equipment required to access the VISTA system. 2

B3.30.11.2. providing antivirus software for PC workstations and ensure that data definition files are current. In addition the VA will ensure that all Microsoft critical updates and patches are current. 2

B3.30.11.3. the connection and management from that Contractor’s connectivity to the Internet via cable modem, DSL or T1 circuits to the VA owned networking equipment in the closet. 2

B3.30.11.4. the backup, contingency, COOP connectivity to the VA and will be established through a VA provided Site-to-Site VPN connection utilizing Contractor provided Internet Service Provider (ISP). 2

B3.30.11.5. providing advisory technical support to the Contractor’s technical support person for the initial site set-up relative to VISTA, CPRS and VPN connectivity. The VA will provide on-going technical support for VISTA and CPRS software and any other VA software applications. Technical support shall be through an escalation process. The Contractor’s employee technical representative will submit a “Help Desk” request by calling (1-855-673-4357). Initial technical support will be provided by the VA via telephone, which will consist of a VA technical representative speaking to a Contractor employed representative to identify the problem, trouble-shoot and attempt to resolve the problem with the Contractor’s end-user. If the problem cannot be resolved the VA will provide on-site support for VA owned equipment, VISTA, CPRS software and other VA software applications, if necessary within two business days or less depending on the nature and severity of the problem. 2

B3.32. Performance Standards and Surveillance 2

B3.32.1. Measure: Clinical Reminders 2

B3.32.2. Measure: NEW PC PATIENT WAIT TIME (PC 14) 2

B3.32.3. Measure: ESTABLISHED PC PATIENT WAIT TIME (PC17) 2

B3.32.4. Measure: Same Day Appointments with Primary Care Provider (PCP) [PACT 7] 2

B3.32.5. Measure: Clinical Encounters 2

B3.32.7. Measure: Pharmacy New Drug Order Requests 2

B3.32.8. Measure: PACT Patients enrolled in Home Telehealth (HT) [PACT 13] 2

B3.32.9. Measure: Primary Care Patients in Mental Health Integration (PCMHI) [PACT 15] 2

B3.32.10. Measure: Ratio of non-traditional encounters [PACT 16] 2

B3.32.11. Measure: Post Discharge Contact by PACT Team [PACT 17] 2

B3.32.12. Measure: Patient satisfaction with Access measure Composite [PCMH 4; SHEP] 2

B3.32.13. Measure: Appointment Cancellations 2

B3.32.14. Measure: Primary Care Provider Continuity (PACT 19) 2

B3.32.15. Measure: Patient satisfaction with DISCUSSION OF DIFFICULTIES FOR CARING FOR SELF (SHEP Q38) 2

B3.33. REQUIRED REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS): As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed $150,000.00, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the Contractor shall be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire.  CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS.  CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS).  FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information. 2

B3.33.1. Each Contractor whose contract award is estimated to exceed $150,000.00 shall be required to register with CPARS database at the following web address: www.cpars.csd.disa.mil.  Help in registering can be obtained by contacting Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690. Registration shall occur no later than 30 days after contract award, and shall be kept current should there be any change to the Contractor’s registered representative.  2

B3.33.2. For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete.  For contracts exceeding one year, the contracting officer will evaluate the Contractor’s performance annually.  Interim reports shall be filed each year until the last year of the contract, when the final report shall be completed.  The report shall be assigned in CPARS to the Contractor’s designated representative for comment.  The Contractor representative shall have 30 days to submit any comments and re-assign the report to the VA contracting officer. 2

B3.33.3. Failure to have a current registration with the CPARS database, or to re-assign the report to the VA contracting officer within those 30 days, shall result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond. 2



B3.34. GOVERNMENT RESPONSIBILITIES 2

B3.37. EVALUATION AND MANAGEMENT AND Billable Roster: 2

B3.37.1. Additions to Billable Roster: All patients assigned to the contracted clinic shall have a minimum of a Level 3 Evaluation and Management (E&M) exam performed and documented within the last 12 months by an authorized provider. Authorized providers include physicians (residents are physicians), physician assistants, clinical nurse specialists and nurse practitioners. CPT codes that meet this purpose include: 90791, 90792, 99203, 99204, 99205, 99213, 99214, 99215, 99243, 99244, 99245, 99283, 99284, 99285, 99343, 99344, 99345, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397, 99455, and 99456. 2

B3.37.2. VA has the sole authority to assign Veterans who are treated by the Contractor into the PCMM software program used to track Primary Care Clinic Veteran rosters. Eligibility determination and enrollment of VA eligible enrolled Veterans in the Contractor's plan shall be the responsibility of the VA. The Contractor shall be responsible for notifying the VA through electronic shared-drive spreadsheets of newly seen Veterans at the Contractor’s site that are not already assigned in the PCMM software program. The VA will then verify that the Veteran was seen through VISTA documentation, and enter the Veteran into the PCMM software as credited to the Contractor’s site and associated clinic roster. 2



B.4 IT CONTRACT SECURITY: VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY 2



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