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THIS REQUEST FOR INFORMATION (RFI) SOURCES SOUGHT IS ISSUED SOLELY FOR MARKET RESEARCH AND PLANNING PURPOSES ONLY AND DOES NOT CONSTITUTE A SOLICITATION.
1. Responses to this Sources Sought must be in writing. The purpose of this Sources Sought Announcement is for market research only to make appropriate acquisition decisions and to gain knowledge of Small Business Capability, including Service-Disabled Veteran Owned Small Businesses and Veteran Owned Small Businesses (SDVOSB/VOSB) interested and capable of performing the work.
2. The NAICS for this requirement is NACIS 621111 Offices of Physicians (Except Mental Health Specialists)

3. Interested and capable Contractors should respond to this notice not later than 3:00 PM (PST) on March 28, 2023 by providing the following via email only to Tashodra Rogers at Tashodra.Rogers@va.gov
Please provide the following:

a) company name
b) address
c) point of contact
d) phone, fax, and email of primary point of contact
e) UEI number
f) Type of small business, if applicable, (e.g. Services Disabled Veteran Owned Small Business
(SDVOSB), Veteran-owned small business (VOSB), 8(a), HUB-Zone, Women Owned Small
Business, Small disadvantaged business, or Small Business).

g) A capability statement that addresses the organization s qualifications and ability to perform as
a contractor specifically for the work described in the Performance Work Statement (PWS).
Respondents are also encouraged to provide specific examples (e.g. contract number, point of
contact information) of the Contractor s experience providing the same or similar services to
that described in the DRAFT PWS.

h) Respondents are also requested to include an informal quote. This informal quote is not
binding but will assist the Government with its market research. Please include the quote for
the base and four (4) option years.

4. SDVOSB/VOSB respondents.

a) If respondent is VOSB or SDVOSB, respondent is encouraged to provide proof of www.vetbiz.gov certification. In addition, SDVOSB/VOSB Contractors are asked to acknowledge that they understand the limitations on sub-contracting pursuant to FAR 52.219-14, Limitations on Sub-Contracting, which will be included in the impending solicitation. Further SDVOSB/VOSB contractors are asked to respond that they are capable of providing the requested services keeping within the parameters of this clause.
b) Small businesses, including SDVOSB/VOSBS are also advised that per 13 CFR, § 125.6 the prime contractor's limitations on subcontracting are as follows:
1) General. In order to be awarded a full or partial small business set-aside contract with a value greater than $150,000, an 8(a) contract, an SDVO SBC contract, a HUBZone contract, a WOSB or EDWOSB contract pursuant to part 127 of this chapter, a small business concern must agree that:
2) In the case of a contract for services (except construction), it will not pay more than 50% of the amount paid by the government to it to firms that are not similarly situated. Any work that a similarly situated subcontractor further subcontracts will count towards the 50% subcontract amount that cannot be exceeded.
5. Required Services. The Contractor shall furnish all personnel to provide services necessary to perform onsite Family Medicine and Internal Medicine Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego CA, 92161.
6. Please note that if VA s pending market research establishes that two or more VOSB or SDVOSB, who are certified in VA s Vendor Information Pages (VIP) site Home  · VetBiz Portal (va.gov), can provide the services, VA will set aside the underlying solicitation per 38 U.S.C. §8127.Â
7. All Offerors who provide goods or services to the United States Federal Government must be registered in the System for Award Management (SAM) database found at https://www.sam.gov. Registration must include Representations and Certifications.

Draft Performance Work Statement (PWS)

QUALIFICATIONS:
2.1 Staff/Facility:
2.1.1 License: The Contractor s physician (s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property.

All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor s physician (s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2 Board Certification and Experience: All contractor s physician (s) shall be Board Certified/Board Eligible in Family Medicine or Internal Medicine, have experience in providing scope of care as described and be currently certified in VHA-approved Basic Life Support (BLS) or equivalency All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.
2.1.3 Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 and VHA Directive 1100.20 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contractor s physician (s) prior to obtaining approval by the VASDHS Professional Standards Board, Medical Executive Board and Medical Center Director.
If a contractor s physician (s) is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.
2.1.4 Technical Proficiency: Contractor s physician (s) shall be technically proficient in the skills necessary to fulfill the government s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor s physician (s) and contractor s physician (s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.
2.1.5 Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractor s physician (s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credential s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

3. CONTRACTOR RESPONSIBILITIES:
Clinical Personnel Required: The Contractor shall provide contractor s physician (s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties. Contractor s physician (s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor s invoices.
Standards of Care: The contractor s physician (s) care shall cover the range of Primary Care Physician services as would be provided in a state-of-the-art health care treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:
The American Board of Family Medicine American Board of Family Medicine | ABFM | American Board of Family Medicine (theabfm.org)
The American Board of Internal Medicine http://www.abim.org/
The professional standards of the The Joint Commission (TJC) http://www.jointcommission.org/
The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;
The requirements contained in this PWS.
Medical Records:
Authorities: Contractor s physician (s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 5 U.S.C.552a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).
HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled Patient Medical Records-VA (24VA10A7 ). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 3.4.6.
Disclosure: Contractor s physician(s) may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under the contract; however, Contractor shall obtain permission from the VA before disclosing any patient information outside VA. VA authorizes the Contractor to discuss patient health information for coordination of care with community health care providers in compliance with VA regulations, HIPAA and VHA Directive 1605.01, Privacy and Release of Information. The VA will provide the Contractor with a copy of VHA Directive 1907.01, Health Information Management and Health Records and VHA Directive 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.
Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Directive 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 and all guidelines provided by the VAMC.
Release of Information: The VA shall maintain control of releasing any copies of patient health information or health records and will follow policies and standards as defined, but not limited to Privacy Act requirements. Contractor will not release or disclose copies of records and will refer all such requests to the Release of Information Department at the VA facility were assigned.
Management for Medical Records: National Archives and Records Administration record disposition requirements are found in RCS 10-1 Chapter 6, 6000 series.

Direct Patient Care: estimated 85 percent of the time involved in direct patient care.
Scope of Care: Contractor s physician (s) (as appropriate and within scope of practice/privileging) shall be responsible for providing Family Medicine and Internal Medicine Primary Care Physician care, including, but not limited to:
Evaluation, Treatment and Management: Contractor s physicians shall coordinate all aspects of care for VASDHS Primary Care Service patients including:
Physicians are responsible for providing comprehensive Primary Care for Veterans
The primary care provider should, in the context of a longitudinal relationship, fulfill all primary care needs, including acute and chronic illness, gender-specific PC, mental health (screen for conditions such as depression, substance use/abuse, military sexual trauma and PTSD, and evaluate and treat uncomplicated mental health disorders as well as substance use disorders and refer patients appropriately for further evaluation and treatment of sexual assault and military sexual trauma, mental health disorders and substance use disorders) and preventative care (age-appropriate cancer screening e.g., colon, breast and cervical cancer as well as weight management counseling, smoking cessation and immunizations, etc.) along with coordination of care delivery (when specialty care is needed, the primary care provider will coordinate this care and communicate with the specialty provider regarding the evaluation and treatment plan to ensure continuity of care).
Physicians are responsible to have read the Medical Staff Bylaws and to comply with the Bylaws. All physicians are responsible to timely complete all mandatory training.
On the outpatient side, primary care physicians will be responsible for delivery of primary care to patients enrolled in VASDHS. Physicians will manage a panel of primary care patients during this assignment.
Consultations with sub-specialists Clinical reminders and view alerts should be addressed timely and as medically appropriate. Quality of care should be able to meet professional standards at all times.
All physicians will work within their privileges at all times, unless necessitated by an emergency.
Clinic: Contractor s physician (s) shall be present on time for any scheduled clinics as documented by physical presence in the clinic at the scheduled start time.
Medications: Contractor s physician (s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients.
Communication of Test Results: Mechanisms must be in-place to provide notification of test results for patients receiving care in accordance with VHA Directive 1088, Communicating Test Results to Providers and Patients.
Administrative: estimated 15 percent of time not involved in direct patient care
5.1. Quality Improvement Meetings: The contractor s physician (s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the VAMC Chief of Service, Chief of Staff, or designee.
5.2. Staff Meetings: The contractor s physician (s) shall attend staff meetings as required by the VAMC Chief of Service, Chief of Staff, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.
5.3. QA/QI documentation: The contractor s physician (s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations.
5.4. Specialized EHR Documentation Procedures: Patient documentation is completed using the current Electronic Health Record (EHR).
5.5. Procedure Documentation: Contractor s physician (s) shall document care given and select appropriate Evaluation and Management (E&M) procedure codes in CPRS as required by the VAMC Chief of Service, Chief of Staff, or designee. Documentation must be sufficient to support both the E&M and procedure codes. Documentation and coding functions must be completed by the end of each patient care encounter.
5.6. Patient Safety Compliance and Reporting: Contractor s physician (s) shall follow all established patient safety and infection control standards of care. Contractor s physician(s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.
5.1 Customer Service: Contractor s physician (s) shall refer all patient/customer service issues to the Supervisory Physician and/or Nurse Manager or designee.

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