Inactive

End Of Document

Inactive Total Small Business Set-Aside (FAR 19.5)

VETERANS HEALTH ADMINISTRATION (VHA) MEDICAL SHARING/AFFILIATE NATIONAL PROGRAM OFFICE (MSO) ONSITE GENERAL SURGERY PHYSICIAN SERVICES MASTER PACKAGE INCLUDES: SCHEDULE OF SERVICES (Page 1) PERFORMANC... VETERANS HEALTH ADMINISTRATION (VHA) MEDICAL SHARING/AFFILIATE NATIONAL PROGRAM OFFICE (MSO) ONSITE GENERAL SURGERY PHYSICIAN SERVICES MASTER PACKAGE INCLUDES: SCHEDULE OF SERVICES (Page 1) PERFORMANCE WORK STATEMENT (PWS) (Page 6) QUALITY ASSURANCE SURVEILLANCE PLAN (QASP) (Page 26) SCHEDULE OF SERVICES The Contractor shall furnish all key personnel to provide services necessary to perform onsite and on call Vascular Surgery Physician Services to eligible beneficiaries of the Department of Veterans Affairs (VA) Lebanon Medical Center. The Contractor s physician(s) care shall cover the range of Vascular Surgery services as would be provided in a state-of-the-art civilian medical 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 Surgery (ABS): http://www.absurgery.org/default.jsp?cc_gs Place of Performance: Services shall be provided onsite, Lebanon VA Medical Center (LVAMC), 1700 South Lincoln Ave, Lebanon, PA 17042. The Contractor shall propose a minimum of 1 key personnel to be credentialed and be available for scheduling to meet the requirements of the contract. MEDICAL AND SURGICAL SPECIALTY CONSULTATIONS DURING OFF-TOUR HOURS Lebanon VA Medical Center Lebanon, PA 17042 Signatory Authority: Associate Chief of Staff (ACOS), Surgery & Medicine Responsible Owner: ACOS Surgery & Medicine/Specialty Care Staff SOP 175-09 Service Line(s): Surgery & Medicine Care Lines Effective Date: October 31, 2021 Recertification Date: October 31, 2026 Quality Assurance Surveillance Plan (QASP) PURPOSE AND AUTHORITY The purpose of this standard operating procedure (SOP) is to establish procedures to ensure our Veterans receive timely care for pre-operative risk assessments and post-operative consultations. This SOP ensures patients will be seen by an on-call specialist or transferred out of fee basis within 60 minutes for pre- operative risk assessments and post-operative consultations. This SOP sets forth mandatory procedures and processes to ensure compliance with VHA Directive 2010-01. PROCEDURES The Surgery Care Line has a 24 hour a day for 7 days a week (24/7) on-call schedule for many of its specialties. The specialist providers will be available within 15 minutes by phone and 60 minutes in person (for specialty services, such as PFTs and cardiac catheterization provided by fee or contract, the patient may be seen either on-site or off-site): Cardiology b. If a specialist is unavailable within the time constraints above, 15 minutes by phone or 60 minutes in person, the Lebanon Veterans Affairs Medical Center (VAMC) will transfer the patient within 60 minutes on fee basis for the following specialties: Gastroenterology Hematology Infectious Disease Interventional Radiology Nephrology Neurology Orthopedic Surgery Pathology Pulmonary Urology ASSIGNMENT OF RESPONSIBILITIES The Associate Chief of Staff (ACOS), Surgery is responsible for maintaining appropriate staffing levels to provide on-call service and ensuring the SOP is followed. The Associate Chief of Staff (ACOS), Medicine is responsible for maintaining appropriate staffing levels to provide on-call service and ensuring the SOP is followed. The Specialty Care Staff are responsible for following this SOP. DEFINITIONS None REFERENCES Veterans Administration Central Office (VACO) Requirements per Complexity Level VHA Directive 2010-01 REVIEW This SOP must be reviewed at minimum at recertification. RECERTIFICATION This SOP is scheduled for recertification on or before the last working day of October 31, 2026. In the event of contradiction with national policy, the national policy supersedes and controls. Periods of Performance (POP): 9/28/2025 to 9/27/2030. Ordering Period 1: 9/28/2025 to 9/27/2026. LIN Description Qty. Unit Unit Cost Total Annual Cost 0001 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services for after hour coverage 1630-0800, up to 5 days per week, Monday through Friday. 4030 Hours 0002 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services for up to all weekends, Friday 1630 through Monday 0800 and all Federal Holidays. 2760 Hours 0003 Board Certified VASCULAR SURGERY Physician Services On-Call Vascular Services , Weekday In-house Coverage, up to 40 days per year. 960 Hours Ordering Period 2: 9/28/2026 to 9/27/2027 LIN Description Qty. Unit Unit Cost Total Annual Cost 0004 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services for after hour coverage 1630-0800, up to 5 days per week, Monday through Friday. 4030 Hours 0005 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services up to for all weekends, Friday 1630 through Monday 0800 and all Federal Holidays. 2760 Hours 0006 Board Certified VASCULAR SURGERY Physician Services On-Call Vascular Services , Weekday In-house Coverage, up to 40 days per year. 960 Hours Ordering Period 3: 9/28/2027 to 9/27/2028 LIN Description Qty. Unit Unit Cost Total Annual Cost 0007 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services for after hour coverage 1630-0800, up to 5 days per week, Monday through Friday. 4030 Hours 0008 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services for up to all weekends, Friday 1630 through Monday 0800 and all Federal Holidays. 2760 Hours 0009 Board Certified VASCULAR SURGERY Physician Services On-Call Vascular Services , Weekday In-house Coverage, up to 40 days per year. 960 Hours Ordering Period 4: 9/28/2028 to 9/27/2029 LIN Description Qty. Unit Unit Cost Total Annual Cost 0010 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services for after hour coverage 1630-0800, up to 5 days per week, Monday through Friday. 4030 Hours 0011 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services for up to all weekends, Friday 1630 through Monday 0800 and all Federal Holidays. 2760 Hours 0012 Board Certified VASCULAR SURGERY Physician Services On-Call Vascular Services , Weekday In-house Coverage, up to 40 days per year. 960 Hours Ordering Period 5: 9/28/2029 to 9/27/2030 LIN Description Qty. Unit Unit Cost Total Annual Cost 0013 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services for after hour coverage 1630-0800, up to 5 days per week, Monday through Friday. 4030 Hours 0014 Board Certified VASCULAR SURGERY Physician Services On Call Vascular Services for up to all weekends, Friday 1630 through Monday 0800 and all Federal Holidays. 2760 Hours 0015 Board Certified VASCULAR SURGERY Physician Services On-Call Vascular Services , Weekday In-house Coverage, up to 40 days per year. 960 Hours Total price for all Ordering Periods: $ Performance Work Statement (PWS) for Onsite General Surgery Physician Services GENERAL: Services Provided: The Contractor shall provide Board Certified Vascular SURGERY Physician Services onsite in accordance with the specifications contained herein to beneficiaries of the VA and the Lebanon VAMC.The proposed action will allow the LVAMC to maintain its Level Ib Surgical Complexity Level. It will provide on-call coverage in the event of a surgical emergency of a vascular nature. Place of Performance: The Contractor shall provide services at the Lebanon VA Medical Center, 1700 South Lincoln Ave, Lebanon, PA 17042. Authority:Title 38 USC 8153, Health Care Resources (HCR) sharing Authority. Policy/Directives/Handbooks. The contractor shall be subject to the following policies, including any subsequent updates during the period of performance. The policies listed below can be accessed electronically at the following: VA Publications VHA Publications VA Directive 1663: Health Care Resources (HCR) Contracting Buying Title 38 U.S.C. 8153 1.4.2. VHA Directive 1003.04: VHA Patient Advocacy VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider Group Practice VHA Directive 1088(1): Communicating Test Results to Providers and Patients VHA Directive 1100.18: Reporting and Responding to State Licensing Boards VHA Directive 1100.20: Credentialing of Health Care Providers VHA Directive 1100.21: Privileging VHA Directive 1192.01: Seasonal Influenza Vaccination Program for VHA Health Care Personnel VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures in Any Clinical Setting VHA Directive 1605.01: Privacy and Release of Information VHA Directive 1907.01: VHA Health Information Management and Health Records VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports Privacy Act of 1974 (5 U.S.C. 552a) as amended: http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm Acronyms/Definitions: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern. ABS: American Board of Surgery http://www.absurgery.org/ ACGME: Accreditation Council for Graduate Medical Education ACLS: Advanced Cardiac Life Support AJIC: American Journal for Infection Control AQL: Acceptable Quality Level BAA: Business Associate Agreement BBA: Balanced Budget Act BLS: Basic Life Support CDC: Centers for Disease Control and Prevention CDR: Contract Deficiency Report CEU: Certified Education Unit Clinical Privileging: Clinical Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual s license, based upon the individual s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific, and within available resources. CME: Continuing Medical Education CMP: Civil Monetary Penalty CMS: Centers for Medicare and Medicaid Services CO: Contracting Officer: The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings. COI: Conflict of Interest COR: Contracting Officer s Representative: A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken. COS: Chief of Staff CPARS: Contractor Performance Assessment Reporting System Credentialing: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health care provider to provide care or services in or for the VA health care system. Credentials are documented evidence of licensure, education, training, experience or other qualifications. DEA: Drug Enforcement Agency EHR: Electronic Health Record - electronic health record system used by the VA EPA: Environmental Protection Agency FAPIIS: Federal Awardee Performance and Integrity Information System FAR: Federal Acquisition Regulation FOIA: Freedom of Information Act FPPE: Focused Provider Practice Evaluation FSMB: Federation of State Medical Boards FTE: Full Time Equivalent: VA s standard definition is for full time working the equivalent of 80 hours every two weeks, 2080 hours per year.  However, providers may propose using their standard FTE definition. HHS: Department of Health and Human Services HICPAC: Hospital Infection Practices Advisory Committee HIPAA: Health Insurance Portability and Accountability Act IGRA: Interferon-gamma Release Assays ISO: Information Security Officer Key Personnel: The individuals specified in this contract who are essential to work performance. MRI: Magnetic Resonance Imaging MST: Military Sexual Trauma NPI: National Provider Identifier. NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The VHA must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). NPPES: National Plan and Provider Enumeration System NSO: National Surgery Office OGC: Office of General Counsel OIG: Office of Inspector General OPPE: Ongoing Provider Practice Evaluation OR: Operating Room POP: Period of Performance PPD: Purified Protein Derivative PPIRS: Past Performance Information Retrieval System PWS: Performance Work Statement QA/QI: Quality Assurance/Quality Improvement QM/PI: Quality Management/Performance Improvement QASP: Quality Assurance Surveillance Plan RFP: Request for Proposal SCS: Specialty Care Services SSAC: Sole Source Affiliate Contract TJC: the Joint Commission TST: Tuberculosis Skin Test USC: United States Code VA: Department of Veterans Affairs VA-FSC: VA Financial Services Center VAAR: VA Acquisition Regulation VETPro: is VHA s mandatory credentialing software platform to document the credentialing of VHA health care Providers. This system facilitates completion of a uniform, accurate and complete credentials file. VHA: Veterans Health Administration VistA: Veterans Integrated Systems Technology Architecture QUALIFICATIONS: Staff/Facility 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 key 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. Board Certification: All Contractor s physician(s) shall be Board Certified by the ABS http://www.absurgery.org/, and be currently certified in BLS, ACLS 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. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive 1100.21 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 Facility Medical Executive Board and Medical Center Director. If a Contractor s physician(s) and/or other contract provider(s) are 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. 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. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the facility. 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 credentials office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for Contractor s physician(s). Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor s physician(s) as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contractor. Training Frequency Annual Hours ACLS/BLS Yearly 1 hour Active Threat Training N/A Blood Administration: Complications N/A EHR N/A Government Ethics N/A Hospice and Palliative Care for VA Clinicians N/A Military Sexual Trauma (MST) for Medical Providers N/A Moderate Sedation In-Service Training N/A PACT Act 2022 Toxic Exposure Screening (TES) N/A Patient Abuse N/A Patient Rights N/A Patient Safety N/A Prevention/Management of Disruptive Behavior/Violence Prevention Level I N/A Prevention of Workplace Harassment/No Fear Act N/A Suicide Prevention: Suicide Risk Management Training for Clinicians N/A SUX Infection Control and Blood Borne Pathogens N/A VA Core Values Training (ICARE Recommitment) N/A VA Privacy and Information Security Awareness and Rules of Behavior Yearly 1 hour VHA MRI Safety Training Level 1 Training (all who enter MRI suites) N/A VHA Privacy and HIPAA Focused Training Yearly 1 hour VistA Imaging N/A STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.): Contractor shall provide proof of the following for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and CO. Tests shall be current within the past year. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor s physician(s) upon hire in accordance with CDC guidance. (This is applicable to all health care workers). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}. COVID-19: Vaccination required or request an exemption. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor s physician(s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The facility shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control - AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return. NPI: NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The VHA must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the CMS NPPES be provided to the CO with the proposal. DEA: Contractor shall provide copy of current DEA certificate. Conflict of Interest (COI): The Contractor and all Contractor s physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest and fully outlined in response to the subject attachment in Section D of the solicitation document. Citizenship related Requirements: The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to VA patient referrals. While performing services for the VA, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all E-Verify requirements consistent with Executive Order 12989 and any related pertinent Amendments, as well as applicable FAR. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the VA may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor s place of business that services VA patient referrals; or other place where the Contractor provides services to veterans who have been referred by the VA; and shall form the basis for termination of this contract for breach. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document. Annual OIG Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the HHS OIG has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed Contractor s physician(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries. By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by facility COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Directive 1100.20 and VHA Directive 1100.21. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the facility COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract. Non Personal Healthcare Services: The parties agree that the Contractor and all Contractor s physician(s) shall not be considered VA employees for any purpose. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees. Prohibition against Self-Referral: Contractor s physicians are prohibited from referring VA patients to contractor s or their own practice(s). Inherent Government Functions: Contractor and Contractor s physician(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy. No Employee status: The Contractor shall be responsible for protecting Contractor s physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract: Workers compensation Professional liability insurance Health examinations Income tax withholding, and Social security payments. Tort Liability: The Federal Tort Claims Act does not cover Contractor or Contractor s physician(s). When a Contractor or Contractor s physician(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor s (or Contractor s physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier. Key Personnel: The VA Full Time Equivalent (FTE) for the services required is 2. (enter the number of VA FTE that the resultant contract will provide hours of service coverage for example 2080 hours = 1.0 VA FTE). The minimum number of Board Certified Vascular SURGERY physicians required to be onsite daily is 1 to be onsite as defined in paragraph Hours of Operation in this section. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled physician is unable to complete an assigned shift, the Contractor shall provide replacement physician coverage within 2 hours and notify the COR immediately of the schedule change. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar day(s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel. For temporary substitutions where the key person shall not be reporting to work for 3 consecutive workdays or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor s physician(s), s/he may request, without cause, immediate replacement of said Contractor s physician(s). The CO and COR shall deal with issues raised concerning Contractor s physician(s) conduct. The final arbiter on questions of acceptability is the CO. Contingency Plan: Because continuity of care is an essential part of Facility s medical servic...