SOLICITATION NOTICE
Q -- NAVAHCS Home Health Hospice Services
- Notice Date
- 9/17/2010
- Notice Type
- Combined Synopsis/Solicitation
- NAICS
- 621610
— Home Health Care Services
- Contracting Office
- Department of Veterans Affairs;Northern Arizona VA Health Care System;Contracting Section;500 U.S. Hwy N;Prescott AZ 86313
- ZIP Code
- 86313
- Solicitation Number
- VA25810RP0187
- Response Due
- 9/27/2010
- Archive Date
- 10/27/2010
- Point of Contact
- Kristin Tanner
- Small Business Set-Aside
- N/A
- Description
- 1. 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. 2. Solicitation documents and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-44. The NAICS Code is 621610, and is unrestricted.. 3. The agreement period of performance will be on or about October 1, 2010 to September 30, 2015. 4. Vendors offering a response to this notice should ensure that they are registered in the Central Contractor Registration (CCR) Database, http://www.ccr.gov/ and ensure that the NAICS code 621610 is included in the CCR profile prior to submission of offer. 5. Offers will only be considered from offerors who are regularly established in the business call for; state-licensed or CMS-certified for level of care required; and who are financially responsible. Offerors must have the necessary equipment and personnel to furnish services as described in the Statement of Work and Schedule of Services. B.1 ADMINISTRATION DATA (continuation from Standard Form 1449, block 18A.) 1. Administration: All administration matters will be handled by the following individuals: a. CONTRACTOR: b. GOVERNMENT: Contracting Officer (90C) POC: Kristin Tanner Department of Veterans Affairs NAVAHCS Contracting Section 500 U.S. Hwy N Prescott AZ 86313 2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address: 3. INVOICES: Invoices shall be submitted in arrears: a. Quarterly[] b. Semi-Annually[] c. Other[Monthly in arrears] 4. GOVERNMENT INVOICE ADDRESS: All invoices from the contractor shall be mailed to the following address: Department of Veterans Affairs Northern Arizona VA Health Care System/GEC 500 US Highway 89 North Prescott AZ 86313-5000 B.2 SPECIAL CONTRACT REQUIREMENTS Under the authority of 38 CFR 1738(a)(1)(xi)(A), the contractor agrees to provide Home Health and Hospice Care in accordance with the terms and conditions stated herein, to furnish to and at the Department of Veterans Affairs Medical Center, the services and prices specified in the Section entitled Schedule of Supplies/Services of this Basic Ordering Agreement (BOA). B.3 - SUPPLIES OR SERVICES AND PRICE/COSTS THIS IS A BASIC ORDERING AGREEMENT (a written instrument of understanding) and not a contract for the period from October 1, 2010 (or date of signature of both parties) not to exceed five years from effective date of this agreement or through September 30, 2015, in accordance with FAR 16.7. A contract is formed, in accordance with the terms and conditions of this agreement, only when VA places an order for HOSPICE Care. Upon acceptance by the contractor of beneficiaries of Department of Veterans Affairs (VA), all terms and conditions of this agreement shall apply during such time as the VA patient remains under authorized hospice care at the expense of VA. Upon acceptance of an order for hospice care for a VA patient, if and when requested by the Contracting Officer or authorized representative, the contractor shall furnish all supplies and services herein described, at the per diem rates for the levels of care specified below. VA is obligated only to the extent authorized placements of patients are made under this agreement. B.4 PER DIEM CEILING RATE DETERMINATION VA uses locally calculated Medicare hospice payment rates as the maximum reimbursement rates to purchase a comprehensive package of bundled services pursuant to VHA Directive 1140.5. The rate reflects fair market value for services. The per diem charge must be an all-inclusive rate for Routine Home Care (care provided in the patient's place of residence), and Respite Care (care provided in an inpatient setting to relieve the primary caregiver). MAXIMUM HOME HOSPICE URBAN RATES CY2010 - YAVAPAI COUNTY, ARIZONA Hospice Rates shown come from Hospice Wage Index for Fiscal Year 2010: Final Rule; Federal Register/ Vol.70, No. 149 dated August 4, 2005. The payment rates below are adjusted for regional differences in wages. The hospice wage index is published in the Federal Register each year, and is effective October 1 of that year through September 30 of the following year. Current wage index values can be obtained from the Federal Register Notice announcing the update or from your Medicare intermediary. HOSPICE LEVELS OF CAREYavapai County FINAL PER DIEM RATE Routine Home Care$150.66 Continuous Home Care (Note 2)$879.32 Inpatient Respite Care$154.14 General Inpatient Care (Note 1)$667.85 "FINAL RATE = (Weighted Rate * Geographic Wage Index) + Non-Weighted Rate "EXAMPLE Routine Home Care CY2010 = (98.19 * 1.0789) + 44.72 = $149.78 NOTE 1: If the VA is purchasing hospice care for a contracted community nursing home (CNH) patient, the NAVAHCS has the option of paying the Medicare hospice routine home care rate for the usual comprehensive services, medications and supplies or a $60.00 per diem rate for hospice consultation services, which does not include hospice -related medications, biologicals and durable medical equipment. NOTE 2: Continuous Home Care will seldom if ever be authorized by the NAVAHCS. B.5 CONTRACTOR PRICELIST Any discount offered by the Contractor to the annual per diem rates shall be applied to the annually adjusted rates as per the economic price adjustment provision above. HOSPICE LEVELS OF CARE CAPPED PER DIEM RATEDiscount (%)Offered to CAP Rate Routine Home Care$150.66 Continuous Home Care (Note 2)$879.32 Inpatient Respite Care$154.14 General Inpatient Care (Note 1)$667.85 B.6- DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK Provide home hospice and inpatient respite services, as specified, for eligible veterans who are designated by, and are living within the service area of the VA Medical Center, Prescott, Arizona (Yavapai, Coconino, and Mohave Counties) and patients who are followed primarily by this VAMC but who may live outside the service area within the state of Arizona. Contract performance will be in accordance with this RFP and the offer that is accepted by the VA. Referrals generated from the Bob Stump Northern Arizona VA Healthcare System (NAVAHCS) payment source will depend on eligibility and appropriateness for referral and will be coordinated through designated community health nurses under the direction of the Program Director, Home Care Services. VA uses locally calculated Medicare hospice payment rates as the maximum reimbursement rates to purchase a comprehensive package of bundled services. The rate reflects fair market value for services. The per diem charge will be an all-inclusive rate for the four levels of Hospice Care as described by Medicare: (1) Routine Home Care (delivered in the patient's place of residence); (2) Continuous Care (more than 8 hours per day of predominantly nursing care delivered in the patient's place of residence); (3) Inpatient Respite Care (care given to hospice patient in order that the usual caregiver can rest); and (4) General Inpatient Care (care requiring and delivered in an inpatient setting). The per diem rate will apply throughout the terms of this agreement and any resultant contract, including extension period(s). The rate may be adjusted only to reflect a change in the Medicare rate by Centers for Medicare and Medicaid Services (CMS) for each Metropolitan Statistical Area and Non-Metropolitan Statistical Area, when published by Geriatrics/Extended. To cover physician services that are beyond the scope of routine hospice care, VA may add $1.00 per day to the local rate. If the VA is purchasing hospice care for a contracted community nursing home patient, the VA has the option of paying the Medicare hospice routine home care rate for the usual comprehensive services, medications and supplies or a $60.00 per diem rate for hospice consultation services, which does not include hospice -related medications, biologicals and durable medical equipment. The patient is Medicare eligible and Medicare is paying the hospice portion of the inpatient charges then, NAVAHCS will pay the room and board charges only that are not covered by Medicare. The NAVAHCS will determine eligibility of the beneficiary through the Home Care Services Program, the attending physician and the interdisciplinary team. All hospice services will be under the specific orders of NAVAHCS physicians. These include orders of patient admission and discharge to the program. DEFINITION Hospice Care: Hospice is the final stage of the palliative care continuum 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, provided by an interdisciplinary team of professionals and volunteers, emphasize 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 programs also provide support for the patients' families or other caregivers, including bereavement support following the death of the patient. MINIMUM GENERAL REQUIREMENTS Contractor Will Provide: "Capability of initiating services within 24 hours of referral to include: Hospice Services: Based on the needs of the patient/family, as determined by the hospice agency and VA and documented in the patient's care plan and interdisciplinary medical record, the following services related to the management of the terminal illness will be provided to the patient/family. "Physician Services "Nursing Services "Home Health Aide/Homemaker Services "Social Work Services "Physical, Occupational and Speech Therapy "Pastoral Counseling "Dietary Counseling "Volunteer services "Bereavement and other counseling services "Drugs and biologicals related to the management of the terminal illness "Durable Medical /Equipment/Supplies related to the management of the terminal illness "Delivery of medications and supplies, including all travel. "Patient/caregiver education in the mechanics of all equipment and procedures prior to discharge from the acute care setting, and as necessary in the home environment. This will include all necessary tools and materials that will meet the approval of NAVAHCS and be appropriate for our patient population. "Instruction given to the patient/caregiver that will include at a minimum: "safe and appropriate use of the medical equipment and/or supplies, administration of medications and signs/symptoms of reactions "basic home safety "patients rights and responsibilities "when and how the patient can contact the contractor for problems, and equipment maintenance or repair "an emergency preparedness plan to prevent interruption of services "standard precautions "cleaning, handling, and storage of equipment "Documentation of patient education that will be provided to the Program Director, Home Care Services or designee upon request and will also be kept by the Contractor in a retrievable file. "Care planning process and documentation according to Medicare or Medicaid standards. "Initial patient admission, assessment and reassessment as determined by patient needs performed by a trained and qualified hospice Registered Nurse. NAVAHCS will be notified of any problems that may arise. "Nursing visits to hospice home care patients will be made by hospice qualified licensed Nurses only. A hospice Registered Nurse will be assigned as the case manager the each patient. "Designated individual for developing and revising the care plan based on physician orders including the discharge plan. "Scheduling of all patient visits. "Monitoring, according to the patients needs of proper storage including space, cleanliness, temperature, etc. and disposal of supplies. "Delivery, assembly and set-up of hospice home care equipment in the area of the patient's preference, on a regular basis by trained personnel. Contractor shall adequately prepare the site in the patient's home and shall unpack and assemble equipment in a condition to be used. Appropriate instruction in the use of equipment will be given to patient/caregiver. This will be accomplished by competent personnel who are experienced and familiar with the item(s) and able to handle the instructions in a courteous, simplified manner. Patient/caregiver education will be documented. "Ongoing inventory management and delivery service to the veterans residence on a regular schedule. "All required maintenance of equipment provided for hospice home care needs under a preventative maintenance plan which includes electrical safety. "A 1-800 -number available 24-hours a day, 365 days a year, for patients/caregivers to call for problems that arise. Assistance will be given for any questions or concerns that patients/caregivers have during the course of their hospice care. "Twenty four (24) hours, 365 days per year, nursing and pharmaceutical coverage for the patient including emergency services for replacement and/or back-up equipment/supplies when necessary. "Discharge planning, in conjunction with a NAVAHCS physician and designated community health nurse. Under the terms of this agreement the contractor must: "Assure licensure and competency of all employees according to Medicare or Medicaid standards and provide proof of same to NAVAHCS upon request. These should include an annual update of the following: 1)Job/position description 2)Scheduled performance evaluations 3) Initial assessment of competence in providing hospice care 4)On-going (at least annually) assessment of hospice skills 5) Verification and Copy of license, certification or registration and background checks 6)Documentation of initial and annual training/in-service In conjunction with the Contracting Officers Technical Representative, NAVAHCS Office of Performance Improvement may suggest periodic changes in the competency process and review requirements in order to maintain compliance with current Medicare or Medicaid standards and other regulatory/accrediting agencies. "Provide coordination, supervision, and evaluation of staff and services according to Medicare or Medicaid standards "Adhere, as appropriate, to applicable NAVAHCS policies and procedures, and applicable personnel qualifications. "Have an on-going quality improvement program designed to objectively and systematically monitor and evaluate the quality and appropriateness of patient care, resolve identified problems, and pursue opportunities to improve patient care. Documentation of such will be provided upon request of NAVAHCS. "Have outcome measures and patient satisfaction indicators in place and reported at least quarterly upon request to the Program Director, Home Care Services program at the NAVAHCS. The Contractor will maintain a record of patient complaints, to include problem/resolution in a retrievable file. "Have an emergency preparedness plan designed to provide continuing care and support, appropriate to the care provided, in the event of an emergency that would result in interruption of patient services. This written plan will be provided to the NAVAHCS for review and approval. "Have a system in place to coordinate care with the NAVAHCS and provide the referring physician with a care plan for review and with information following a patient/client encounter, including a note documenting the patients progress and lab results in a timely manner. "Comply with standard precautions. The Contractor is responsible for having a mechanism for evaluating, reporting, and maintaining records of infection among patients and, as appropriate, among staff. Documentation of same shall be provided on a quarterly basis to the Program Director, Home Care Services program at the NAVAHCS upon request. The NAVAHCS will be notified if significant variances occur. "Document and immediately fax a report to the Program Director, Home Care Services program any known incidents of death, accident, injury, or infection related to furnished medications, supplies or medical equipment and any life-threatening equipment malfunctions or equipment recalls. The Contractor will maintain a recall plan. "When a veteran needs to be hospitalized it should be the nearest VA whenever possible but the closest hospital if a life threatening emergency occurs. "If the patient relocates permanently outside the service area of the NAVAHCS, the payment source will become the responsibility of the VA serving the new locality. "On a monthly basis, the hospice agency will fax to NAVAHCS Home Care Services a list of all VA patients provided hospice care and the number of per diem days each patient received services. This will be faxed by the 10th of the month for the previous month's services rendered. A list of patients discharge and date of discharge will also be faxed on a monthly basis. RESPONSIBILITIES OF THE HOSPICE 1. Certification: A certified hospice agency is licensed or otherwise state-approved and is certified by Medicare as a hospice agency. Agency personnel must be qualified in all states in which such personnel provide services. Hospice shall maintain all other licenses and certificates as required by law. Hospice shall promptly notify the VA of the commencement of any action or preceding against it with respect its license, certification or other legal authorizations. 2. The hospice agency will work cooperatively with the VA so that patients referred for hospice care meet the criteria for admission, as defined by the agency. The hospice agency will verify that the patient is initially certified as terminally ill by the VA attending physician and Hospice Medical Director/designee upon admission and each 60 days thereafter by the VA attending physician and Hospice Medical Director/designee. Hospice shall discharge patients who, as determined by hospice and VA no longer meet the defined admission criteria. 3. The hospice agency will work with VA staff to ensure timely communication regarding changes in the condition of patients, need for updated or new orders or any other change necessitating physician consultation for implementation of the plan of care. 4. The hospice agency agrees to provide services to eligible veterans according to a hospice care plan. Hospice services shall be comprised of all of the services, facilities, and equipment made available to those patients otherwise enrolled in the hospice program. 5. All level of care changes will be authorized by the referring VA. If a patient requires more than the level of care authorized by the VA, the hospice will discuss the patient's status with the designated VA community health nurse, VA hospice consultation team physician and/or VA attending physician. All inpatient admissions require the prior authorization of the VA. When hospital care is needed, VA will offer to provide the care in a VA hospital. VA will pay for a veteran's care in a non-VA hospital only in exceptional circumstances and with prior VA authorization. The hospice agency will work cooperatively with the VA in all level of care reviews. 6. At the time of patient death, the hospice will promptly notify the VA facility that authorized the patient's hospice admission. 7. The hospice will submit to VA an initial plan of care/progress note within 21 days and subsequent care plan/ progress note every 90 days and a discharge summary within 30 days of patient death/discharge from the hospice program. 8. All medical records concerning veteran's care in the hospice will be readily accessible to VA. Upon discharge or death of patient, medical records will be retained by the hospice for a period of at least three years following termination of care. Patient records will be maintained in conformance with the Privacy Act (5 U.S.C. 552a) and the Health Insurance Portability and Accountability Act (HIPAA) - Privacy Rule (45 CFR Part 160 and 164. 9. The hospice agency will have no obligation to render services requested by hospice patients which are not identified or required to be provided in patient's care plan or which are unrelated to the palliation of patient's terminal illness. VAMC Procedures: 1. Upon referral for hospice care, the VA will provide all relevant medical information to the hospice agency. Release of information is performed in accordance with disclosure policies outlined in VHA Handbook 1605.1 2. All referrals for community hospice care must be approved by a VA health care professional. VA staff will obtain physician signatures for renewal and additional orders, and review treatment plans, renewals and orders for appropriateness and medical necessity, as well as coordinate follow-up with the patient's physician as appropriate. Extensions of authorizations for services must be obtained prior to expiration of the current authorization by contacting the designated community health nurse. 3. It is agreed that the hospice agency shall submit progress reports to the NAVAHCS, when requested, with their invoices for beneficiaries receiving services under this agreement. The report should also contain a safety status assessment of the patient's home. 4. The NAVAHCS has the option to conduct at least an annual on-site inspection of the hospice agency's operating offices. 5. VA reserves right to remove VA patients from hospice care at any time, when removal is determined to be in best interest of the VA or the patients, without additional costs to the Government. To the extent that this agreement is terminated, VA will be liable only for payment for services rendered prior to the effective date of termination. Service Areas: The VAMC services a large area encompassing multiple counties; however, Participating Agencies will only be required to provide care in service areas where they are licensed. As a result, NAVAHCS anticipates multiple Agreements to cover all areas and to provide veterans with a choice. ANNUAL OIG STATEMENT Providers and contracting entities have an affirmative duty to check the program exclusion status of individuals and entities prior to entering into employment or contractual relationships, or run the risk of civil monetary penalties (CMP) liability if they fail to do so. The Contractor shall provide a signed annual report, to the Network Compliance Officer with a copy to the Contracting Officer and COTR, stating each individual or entity under this agreement has been checked against the Health and Human Services - Office of Inspector General (HHS/OIG) List of Excluded Individuals/Entities on the OIG Website (http://www.hhs.gov/oig) and found no individual or entity had been excluded from participation in Medicare, Medicaid and other Federal health care programs. The report will be due each year on the anniversary agreement date. The provision at FAR 52.212-1, Instructions to Offerors -- Commercial, applies to this acquisition along with additional addenda. FAR 52.212-2, Evaluation - Commercial Items, offers will be evaluated on capability and price. Offeror is to include a completed copy of the provision at 52.212-3, Offeror Representations and Certifications -- Commercial Items. Provisions incorporated by reference are 52.232-38, Submission of Electronic Funds Transfer, and 52.216-27, Single or Multiple Awards. VAAR Provisions applicable to solicitation are: VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION (JAN 2008), VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998), 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICER (JAN 2008), 852.273-70 LATE OFFERS (JAN 2003). FAR clause 52.212-4, Contract Terms and Conditions -- Commercial Items, applies to this acquisition. The FAR clause at 52.212-5, Contract Terms and Conditions Required To Implement Statutes Or Executive Orders -- Commercial Items, also applies to this acquisition and the following clauses cited in the clause are applicable to this acquisition: 52.219-8, Utilization of Small Business Concerns (May 2004) (15 U.S.C. 637(d)(2) and (3)), 52.219-28, Post Award Small Business Program Rerepresentation (June 2007) (15 U.S.C 632(a)(2)), Convict Labor (June 2003) (E.O. 11755), 52.222-19, Child Labor--Cooperation with Authorities and Remedies (FEB 2008) (E.O. 13126), 52.222-21, Prohibition of Segregated Facilities (Feb 1999), 52.222-26, Equal Opportunity (Mar 2007) (E.O. 11246), 52.222-35, Equal Opportunity for Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans (Sept 2006) (38 U.S.C. 4212), 52.222-36, Affirmative Action for Workers with Disabilities (Jun 1998) (29 U.S.C. 793), 52.222-37, Employment Reports on Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans (Sept 2006) (38 U.S.C. 4212), 52.222-54, Employment Eligibility Verification (Jan 2009). (Executive Order 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803.), 52.225-13, Restrictions on Certain Foreign Purchases (JUN 2008) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury), 52.232-34, Payment by Electronic Funds Transfer--Other than Central Contractor Registration (May 1999) (31 U.S.C. 3332), 52.222-41, Service Contract Act of 1965 (Nov 2007) (41 U.S.C. 351, et seq.), 52.222-42, Statement of Equivalent Rates for Federal Hires (May 1989) (29 U.S.C. 206 and 41 U.S.C. 351, et seq.). Employee ClassMonetary Wage-Fringe Benefits Registered NurseVN-0610/00-00$25.66 - 46.51 per hr Nursing AssistantGS-0621/03-06$11.99 - 24.25 per hr Practical NurseGS-0620/05-06$18.62 - 24.25 per hr Social Service AssistantGS-0186/7$22.42 - 29.15 per hr Social WorkerGS-0185/11-12$27.60 - 43.00 per hr Physical TherapistGS-0633/11-12$27.60 - 43.00 per hr Occupational TherapistGS-0631/11-12$27.60 - 43.00 per hr Speech PathologistGS-0665/09-12$20.65 - 43.00 per hr ChaplainGS-0060/09$20.65 - 43.00 per hr Dietician and NutritionistGS-0630/07-12$22.42 - 43.00 per hr. VAAR Clauses applicable to this acquisition are: VAAR 852.203-70 COMMERCIAL ADVERTISING (JAN 2008), VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (JAN 2008), VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984), VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO BENEFICIARIES (JAN 2008), VAAR 852.273-75 SECURITY REQUIREMENTS FOR UNCLASSIFIED INFORMATION TECHNOLOGY RESOURCES (Interim - October 2008), VAAR 852.273-76 ELECTRONIC INVOICE SUBMISSION (Interim - October 2008). Offers are due by 10:00 a.m. local time on September 27, 2010. Offers may be mailed, faxed or emailed to Kristin Tanner at the Department of Veterans Affairs, Northern Arizona VA Health Care System, 500 U.S. Highway 89 North, Prescott, AZ 86313, fax: 928-717-7444, email: kristin.tanner@va.gov. For additional information regarding this solicitation please contact Kristin Tanner at the email address provided above.
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