Inactive

THIS IS A SOURCES SOUGHT NOTICE ONLY. This is not a solicitation for bids, proposals, proposal abstracts, or quotations. The purpose of this Sources Sought Notice is to obtain information regarding th... THIS IS A SOURCES SOUGHT NOTICE ONLY. This is not a solicitation for bids, proposals, proposal abstracts, or quotations. The purpose of this Sources Sought Notice is to obtain information regarding the availability and capability of all qualified sources to perform a potential requirement. The responses received from interested contractors will assist the Government in determining the appropriate acquisition method. The intended contract is a firm-fixed price supply purchase. The Department of Veterans Affairs (VA), Network Contracting Office (NCO) 20, is conducting market research to identify potential sources which can provide the following in support of the Veterans Health Administration, Veterans Integrated Service Network (VISN) 20. VISN 20 includes services areas in Alaska, Idaho, Oregon, and Washington. VISN 20 has a need for a Base Plus Four (4) Option Year contract for Cancer Registry Abstracting Services for the following period of performance: Base Year: 01/01/2025 - 12/31/2025 Option Year 1: 01/01/2026 - 12/31/2026 Option Year 2: 01/01/2027 - 12/31/2027 Option Year 3: 01/01/2028 - 12/31/2028 Potential candidates having the capabilities necessary to provide the stated services at a fair and reasonable price are invited to respond to this Sources Sought Notice via e-mail to Jennifer Robles at jennifer.robles1@va.gov no later than October 23, 2024, 5PM, Mountain Time. No telephone inquiries will be accepted. RESPONSES SHOULD INCLUDE THE FOLLOWING INFORMATION: Company name, address, SAM UEI, and business size; point of contact name, phone number, and e-mail address; whether services are presently offered on a current GSA Federal Supply Schedule contract or any other Federal contract. NAICS Code 5416611, $24.5 Million, is applicable to determine business size standard. Any questions or concerns may also be directed via email to Jennifer Robles at jennifer.robles1@va.gov. GENERAL PROCEDURE: 1.1. The Contractor shall provide all necessary labor, personnel, equipment, supplies, materials, supervision, and other related services necessary to provide Cancer Registry services in accordance with VA and all applicable national standards. 1.2. The goal of this procurement is to establish a safe and uniform process for maintaining an efficient & accurate cancer registry database in accordance with 100% of current Commission on Cancer (COC) standards, VHA cancer registry requirements, and State requirements (where applicable). 1.3. Interested vendors must have at least three (3) years of experience in providing cancer registry services and recent experience with the COC standards. 1.4 The contractor shall provide proof of adequate CTRs (Certified Tumor Registrar) in good standing per NCRA (National Cancer Registrar Association) to cover all the Cancer Registry services for each facility listed in item 1.1 above prior to being awarded the contract. All registry services under this contract must be performed by CTRs. Contractor must always have a minimum of 12 CTR s.  Eligible contractor CTRs must have current background clearance and shall be PIV ready to reduce onboarding time.  No current VA employees on or off tour will not be allowed to perform any services under this contract to avoid conflict of interest with other VA registries. The Contractor shall have one (1) assigned Lead CTR to oversee work done by other CTRs of the same contractor group and to do quality control to ensure high quality service is being delivered to the VA. The findings of this monitoring report shall be sent to the COR and facility POC monthly, at a minimum. Per Industry Standard, one (1) full time employee (FTE) is needed for abstraction of every 350 cases. Therefore, each facility with an annual caseload of 700 cases and above requires a minimum of two full time contractor CTR to be assigned to each facility. Work to be completed 8:00am to 4:30pm Monday-Friday to ensure proper IT support and facility POC availability. 1.5 No guarantees are made as to the estimated work or volumes, or the quantities. The estimate information provided in the scope of work is based on historical data. The estimates and actual work are subject to change by the Government. The Government shall notify the contractor of location changes within five working days of any changes. The contractor shall provide Cancer Registry Services for the following VA Medical Centers in Veterans Integrated Service Network 20 (VISN 20) facilities as follows and as applicable: Alaska VA Healthcare System and Regional Office (463) Boise VA Medical Center (531) Jonathan M. Wainwright Memorial VA Medical Center at Walla Walla (687) Mann-Grandstaff VA Medical Center at Spokane (668) VA Portland Healthcare System (648) VA Puget Sound Healthcare System (663) VA Roseburg Healthcare System (653) All services will be performed as needed and in accordance with the Statement of Work and all contract clauses. 2.0 STATEMENT OF WORK The Contractor shall provide all necessary staffing and resources needed to properly maintain and provided VISN 20 VAMC s Cancer Registry database services in accordance with 100% of the current American College of Surgeons Commission on Cancer Registry standards and Veterans Health Administration (VHA) Cancer Registry requirements. VA reportable list will be shared with the receiving contractor after award. The Contractor shall have current experience managing a Cancer Registry program within the last two years and have recent experience with the American College of Surgeons (ACOS) Commission on Cancer (CoC) Standards. The duties and responsibilities of the Contractor shall include: 2.1. Case Finding The Contractor shall electronically screen and accept all cases into the Cancer Registry database and shall flag all cases as suspense with demographics and ensure cases are primary site coded. The Contractor shall be responsible for monthly review of disease indices, pathology reports, radiology reports, treatment logs, and other computerized methods to identify reportable cancer cases. The Contractor shall be responsible for transcribing and interpreting information from patient records regarding treatment of an estimated 11,400 new VISN 20 VAMCs cancer patients annually using the approved Veterans Administration (VA) abstracting software program (currently the VistA Oncotrax). The Contractor shall review all new cases for inclusion in the Oncotrax database in compliance with the industry standards of the North American Association of Central Cancer Registries (NAACCR), National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER), World Health Organization International Classification of Diseases for Oncology (ICDC), American Joint Commission on Cancer (AJCC) Staging Manual Criteria, VA Central Cancer Registry (VACCR) Reportable List, American College of Surgeons/Commission on Cancer (ACOS/CoC) and the VISN 20 Cancer Registry criteria. The Contractor shall return a monthly list of cases accessioned along with the Contractor's monthly invoice to the COR and POC. 2.2 Case Abstracting and Coding Abstracting is defined as coding and entering patient and disease specific information into the Veterans Administration VistA Cancer Registry database or other databases as identified within this statement of work, e.g. the Rapid Quality Reporting System (RQRS database). The Contractor shall provide complete, accurate quality abstraction services and shall ensure that all cases are cleared (within pre-established timeframes) in terms of passing edits required by the VA Central Cancer Registry or by the American College of Surgeons Commission on Cancer, e.g., National Cancer Database edits, Vista Oncology package edits, Gen-edits, Program edits, etc. The Contractor shall abstract oncology cases with 100% accuracy and shall ensure that all Commission on Cancer requirements/standards are met. Contractor is responsible to transcribe and interpret information form patient records regarding treatment provided to new cancer patients annually using the approved Veterans Administration (VA) abstracting software program (currently the VistA Oncotrax). The Contractor shall review and abstract the cancer patient s medical record on an ongoing basis in compliance with the industry standards of the North American Association of Central Cancer Registries (NAACCR), National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER), World Health Organization International Classification of Diseases for Oncology (ICDC), American Joint Commission on Cancer (AJCC) Staging Manual Criteria, VA Central Cancer Registry (VACCR) Reportable List, American College of Surgeons/Commission on Cancer (ACOS/CoC) and the VISN 20 Cancer Registry criteria. The contractor will be a Certified Tumor Registrar (CTR), and produce and provide proof of current credential status, to provide abstracting services. The Contractor shall abstract cases within 4-6 months of the cancer diagnosis. The Contractor shall return a monthly list of case abstracts completed along with the Contractor's monthly invoice to the COR and POC. 2.3. Follow-up- The Contractor shall complete data entry to include all required Commission on Cancer Registry fields, including but not limited to text, recurrence, treatment and required death information fields. The Contractor shall be responsible for tracking the care all patients receive in accordance with the current standard being-until the cancer survivor reaches the age of 100 years and following their cancer diagnosis at VISN 20 VAMCs and at all other health care institutions. The Contractor shall provide the Cancer Registry function of follow-up as described in the Standards of the American College of Surgeons/Commission on Cancer (ACOS/CoC), Facility Oncology Registry Data Standards (FORDS). These functions shall include computer input, data review and report generation tailored to the needs of the VA as described herein. The Contractor shall maintain follow-up at a minimum of 90% on all patients in the registry data base, this is required to use registry data for survival (outcome) analysis, which is industry standard. Cases are delinquent (lost) if the follow-up interval exceeds 15 months. The Contractor shall provide a monthly list of follow-up cases completed along with the Contractor s monthly invoice to the COR and POC. 2.4. Consult Hours: The Contractor shall provide Consult Hours if requested by the facility, that shall include time spent working with the Cancer Committee and the Cancer Program Administrator. Consult hours shall also ensure all current ACOS and related Cancer Registry standards pertaining to the applicable VISN 20 VAMC Cancer Registry have been met such that all data entered the Cancer Registry is 100% accurate and all pre-established timeframes related to the Cancer Registry are met. Consult hours shall include producing reports, ensuring that the Cancer Registry Policy and Procedure Manual meets the Commission on Cancer Standards and is up to date, and assisting and advising all Cancer Program staff and related staff with Commission on Cancer survey readiness and preparation. Consult hours shall also include preparation of data for transmission to the State Tumor Registry and any other entity as required by the VA, such as the NCDB for American College of Surgeons. The contractor will provide consultative services both by telephone and on site to assist in the Commission on Cancer approval process. Currently, the VA Medical Centers in Alaska, Boise, Roseburg, Spokane, and Walla Walla are not accredited by the ACoS. Should any VISN 20 VAMC facility that is not accredited with to pursue and obtain accreditation at present time or at any point in the future during the period of performance of this contract, the Contractor shall provide needed consultative services to ensure the applicable VISN 20 VAMC facility program meets accreditation program standards. 2.5. Rapid Quality Reporting System: The Contractor shall monitor the quality of the Cancer Registry data. The Contractor shall monitor the facility's performance based on the CoC performance indicators, using the CoC reporting tools for the Rapid Quality Reporting System (RQRS) if requested by the facility, when facility does not have subject matter experts. The Contractor shall keep the Program Manager, the Cancer Liaison Physician, and the Chair of the Cancer Program Committee and the Cancer Program Coordinator advised of the performance status as requested by the above-mentioned staff, and no less than once monthly. (RQRS is a real-time data collection program to assess hospital-level performance using National Quality Forum (NQF) endorsed quality of cancer measures). 2.6. Quality Assurance Surveillance Plan (QASP) The Contractor shall provide quality work, complete work, and accuracy as evidenced by meeting Commission on Cancer, National Cancer Data Base, National Cancer Registrars Association (NCRA) and VA Central Cancer Registry standards and requirements. The Contractor shall perform a 100% quality assurance review on all newly abstracted cases for compliance noting any deficiencies or non-deficiencies. The Contractor shall forward a list to the COR via e-mail monthly noting any deficiencies or non-deficiencies. The Contractor shall institute a Cancer Registry Quality Assurance Surveillance Plan/Program to evaluate the quality of 100% of their staff s Cancer Registry data and 100% of their staff s Cancer Registry activities done on behalf of the VISN 20 VAMCs. The Contractors quality assurance plan shall do the following: 1. Set the review criteria 2. Set the quality control timetable 3. Specify the quality control methods, sources, and individuals involved »» Required activities. Random sampling of annual analytic caseload Identify the activities to be evaluated: QASP required activities. »» Case finding. »» Abstracting timeliness »» Accuracy of abstracted data Class of Case Primary Site Histology AJCC Stage Collaborative Stage First Course of Treatment Follow-up information, including Date of First Recurrence, Type of First Recurrence, and Cancer Status »» The percentage of information coded as unknown (usually coded as 9 or a string of 9s) »» NCDB data submission, correction of data errors, and resubmission of corrected data. Required accuracy 100% »» Cancer Registry data submitted to the NCDB meet the established quality criteria included in the annual NCDB. **All other standards as outlined in the most current edition of the ACOS Commission on Cancer manual are met or exceeded. The Contractor shall conduct monitoring at least once monthly and shall send their Quality Assurance Surveillance Plan (QASP) report findings to the COR and POC monthly, at a minimum. The QASP report findings should also include the Contractor s process for conducting monthly random case finding audits and include a sample of the audit findings to demonstrate that all eligible analytical cases are reviewed and processed. The Contractor shall send report findings back to the applicable facilities CORs and Administrative Officer monthly and upon request as applicable. Monthly abstracting quality control audit checks shall be performed on 100% of cases abstracted by the Contractor s staff to ensure abstracts are 100% edit and error free prior to invoicing. Reports shall reflect the Contractor s process for error corrections for all tasks performed by the Contractor s staff and all tasks as required by the American College of Surgeons-Commission on Cancer for full accreditation, all errors. identified either by the Contractor or by the applicable VISN 20 Government representative should be corrected within one business week. The Contractor shall monitor each area of Cancer Registry activity and shall ensure all duties performed e.g., case finding, accessioning, follow up, edit corrections, data submissions, abstracting, etc. (i.e., all Cancer Registry tasks required by the American College of Surgeons- Commission on Cancer) are performed by a Certified Cancer Registrar. The Contractor shall provide written reports at least once monthly and upon request to the applicable COR and/or applicable Administrative Officer and take corrective action on any areas that fall below the measures specified in the QASP. Deliverables: The Contractor performance shall be evaluated, and deductions applied if performance is found deficient as per Quality Assurance Surveillance Plan as follows as required to maintain data and performance quality. 2.7. Education/CTR Certification: The contractor shall show proof that those providing abstracting services are Certified Tumor Registrars through the National Cancer Registrars Association. Contractor personnel functioning under this contract shall be certified by the National Cancer Registrars Association. The Contractor shall verify its personnel s current certification status with the National Cancer Registrars Association and shall provide evidence of certification with their proposal submission. Ongoing cancer related education enhances knowledge and skills. All Contractor Cancer Registry staff who performs case abstracting must: Hold a current Certified Tumor Registrar (CTR) credential. The CTR credential is granted through the National Cancer Registrars Association, which provides details on eligibility, testing, and re-credentialing. High-quality Cancer Registry data is essential to accurately access treatment outcomes and patient survival. Successful operation of the Cancer Registry requires credentialed staff that is trained and knowledgeable in all aspects of oncology data collection and case abstracting. Abstracting is defined as coding and entering patient- and disease specific information into the Cancer Registry data base. Certified Tumor Registrars apply knowledge obtained from formal education and work experience to correctly interpret and code cancer diagnosis and stage treatment and outcomes information for each case that is seen at VISN 20 VAMCs that meets CoC reporting requirements. The case abstracting responsibilities of the CTR are documented by the Contractor. Each CTR contractor staff who are working in a COC Accredited facility should attend a National or Regional cancer related educational meeting at least once during the current three-year survey cycle. This is per COC Std. 1.11. The Contractor shall therefore provide documentation to facility POC annually and upon request of all educational activity CEUs completed by contract registry staff every year and furnish documentation of attending one (1) National or Regional cancer related educational meeting every three years for each contractor CTR. Contractor should also show documentation upon request and annually that their CTRS are maintaining their CTR status through NCRA.  Per the Commission on Cancer Standards, full-time and part-time registry staff for whom annual education is required are: CTR staff Contract CTR staff who are contracted to work for 3 or more consecutive months during the calendar year, regardless of the number of hours worked Management or supervisory personnel This education could include topics in the following areas: Advances in cancer diagnosis and treatment Changes in cancer program standards Changes in data collection requirements Educational activities that can be used to fulfill the standard include, but are not limited to, the following: A cancer-related lecture offered by the program (local activity) A face-to-face meeting or workshop Local involves 1 program or facilities located in 1 city (local activity) State involves 1 state (state activity) Regional involves more than one state organization working collaboratively to develop the workshop. Agendas and meeting notices indicate the collaborative effort (regional activity) National is sponsored by a national organization and targeted to a national audience (national meeting) A video conference (local activity) A webinar (local activity) A Web-based training module (local activity) Journal-based articles that offer continuing education credits (local activity) Educational activities exclude patient management cancer conferences in any format. National organizations that sponsor national meetings include: American Health Information Management Association (cancer-related educational activities) Association of Community Cancer Centers Commission on Cancer National Cancer Registrars Association National Comprehensive Cancer Network North American Association of Central Cancer Registries 2.8. Policy and Procedure Manual - The Contractor shall maintain current Cancer Registry policies and procedures in compliance with CoC, NCDB and VACCR standards, and submit them to the COR at the applicable VISN 20 VAMC annually (or upon request) for review. The Contractor s Cancer Registry policy and procedure manual must be specific to the applicable VISN 20 VAMC and specifying current CoC data definitions and coding instructions used to describe all reportable cases. The Contractor shall use the data standards defined by the CoC appropriate for the year of diagnosis for any specific case. The Contractor s Cancer registrars shall be required to comply with additional mandates pertaining to case and data reporting as established by the Veterans Administration, federal or state government or by the applicable VISN 20 VAMC cancer committee. The Cancer Registry policy and procedure manual includes: Abstracting American Joint Committee on Cancer (AJCC) and Collaborative Stage staging policies Cancer Registry reference date Case eligibility Case finding Case accessions Confidentiality and release of information Computer operations Dates of implementation or changes in policies for registry operations Disaster recovery policy Documentation of first course of treatment Follow-up History of the registry for the program or health system (which may include facility mergers, network formation, facility name changes, vendor information, and identification of previous staff) Job descriptions Maintaining and using the suspense system NCDB reporting requirements and mechanisms Operational requirements for facility-based cancer registries Policy for CoC SAR documentation Quality control of registry data Registry purpose Request log Required coding manuals Retention of documents State registry reporting requirements and mechanisms For the Policy and Procedure Cancer Registry manual, the Contractor provides a table of contents in accordance with Commission on Cancer standards. 2.9. Outcome Studies / Special Studies: The Contractor shall provide Cancer Registry data for outcome studies / special studies and assisting with preparation of the reports. The Contractor shall provide outcome studies / special studies for the medical staff, Cancer Committee, Cancer Conference / Tumor Board, Veterans Administration Central Cancer Registry (VACCR), and quality management upon request. The Contractor shall compare the data to the national data to determine effectiveness of treatment, programs, and survival. The contractor shall also provide patient care evaluation studies for the annual cancer program report. 2.10. Corrections: The Contractor shall correct any mistakes in the registry cases made by them. This includes any data corrections because of edit error reports received from the NCDB or VACCR or records rejected because they lack supporting English text and/or have missing data elements. The Contractor shall correct all inconsistencies found through any quality assurance review within 1 month (or sooner if it impacts adversely on accreditation of the cancer program) of submission of inconsistencies, errors, warnings, or any other data quality problems. 2.11. Other At the time if any of the VISN 20 VAMCs are prepared to seek accreditation through the American College of Surgeons Commission on Cancer, the Contractor shall assist the applicable VISN 20 VAMC to obtain and maintain accreditation. This will ensure that requirements and initiatives are implemented and met; this includes ensuring all Rapid Quality Reporting System (RQRS) requirements are met and includes developing a Cancer Registry policy and procedure manual which meets the current Commission on Cancer Standards. If abstracts are inadvertently re-opened after being in the completed status (e.g. when Vista Oncotrax patches are put in for example) , the Contractor shall maintain thorough documentation as to the reason the case reopened on 100% of the cases entered into by the Contractor, and shall resolve the issue within one month after discovery and shall re-close the case and send the documentation to the POC, COR or designee monthly with the monthly invoice (this documentation may be reviewed by the ACOS Surveyor during the accreditation process). The Contractor may be asked to speak directly to an ACOS Cancer Program Surveyor; if requested, the Contractor shall speak with the ACOS Surveyor. The Contractor shall be responsible for preparing Cancer Registry reports for the Cancer Committee which meets 4-6 times a year as applicable to the VISN 20 VAMC facility that is being provided services. The Contractor shall prepare reports on TNM staging completion, timeliness of abstracting, follow-up, and quality improvement of the Cancer Registry services. The Contractor shall bear all the costs of reports prepared for Cancer Committee meetings. (Omit this). 2.12. ACoS / Commission on Cancer Approval: The Contractor shall be responsible for coordinating the Cancer Registry portion of the Commission on Cancer / American College of Surgeons survey when requested by the facility, in collaboration with the facility POC, facility Certified Tumor Registrar and facility Cancer Program Administrator and/or Physician Cancer Liaison; for assisting with preparation of the survey; and updating the Survey Application Record in collaboration with the assigned and applicable VISN 20 VAMC representatives. The Contractor shall ensure that applicable VISN 20 VAMCs meets the standards of the American College of Surgeons Commission on Cancer Registry standards. The Contractor and the Cancer Program Administrator share responsibility for the survey by the CoC with respect to the accreditation standards pertaining to Cancer Registry. The Contractor shall also provide phone consultation about Cancer Registry issues to VISN 20 VAMCs upon request by facility as needed, during normal working hours, Mondays through Fridays, 8:00am -4:30pm, Eastern Standard Time. 2.13. Reporting Cancer Data / Transmission of Data: The Contractor shall be responsible for transmitting required submissions / resubmissions to the VA Center Cancer Registry (VACCR) and the National Cancer Data Base (NCDB) within prescribed timeframes when requested by the facility; shall request/maintain the required software for the transmissions; shall submit/and complete accurate reports, and make corrections, as required. The Contractor shall demonstrate knowledge of the VACCR and NCDB reporting requirements, complete required privacy reports and submit them to the privacy officer in collaboration with the applicable VISN 20 VAMC Cancer Registry contact. If applicable, (VAMC and prospective State has a Data Transfer Agreement (DTA) enforced), state transmission is submitted in accordance with state requirements. 2.14. Continuing Education / Competency: The Contractor shall show proof of attendance at recent continuing education activities including state Cancer Registry trainings and Cancer Registry association education meetings. The Contractor shall maintain competency/training folders and to be made available upon request by VISN 20 VAMCs staff. If the COR has a concern about competency, the Contractor staff may be requested to take the NCRA Cancer Registrar Employment Screening at the contractor s cost (see: http://www.ncra-usa.org, under the tab Certification Verification, to evaluate competency), or the COR may request a VA CTR review a specified number of abstracts to evaluate competency and ensure required elements are being properly completed. If the National VA Central Cancer Registrar and/or other Quality Assurance reviewer s documents continue to be processed with uncorrected errors and quality control deficiencies from the Contractor continue uncorrected, this shall be considered adequate basis and documentation to terminate the contract because of non-adherence to contractually required quality control standards. Contract CTRs working in a CoC accredited facility will comply with the CoC requirements for education. Contractor will be responsible for providing proof of annual education by all CTRs to the VISN 20 facility POC by the end of the calendar year. Contract CTR staff who are contracted to work for three or more consecutive months during the calendar year, regardless of the number of hours work must participate in one cancer-related educational activity applicable to their role. All CTRs should attend a National or Regional cancer-related educational meeting at least once during the three-year survey cycle. 2.15. VA-Specific / Privacy Training - The contractor will complete the VHA Privacy Policy Training and Cyber Security training, and any other mandated training is at no cost to the government. 2.16. Computerized Patient Record System (CPRS) in VISTA. VA will provide contractor with electronic access to CPRS for use by the Certified Tumor Registrars. Contractor employees are responsible to access the system a minimum of once every ninety (90) days. Failure to access VA system at least once every ninety (90) days will result in the contractor s employees being locked out of the VA system. If necessary, VA will provide Contractor with remote access to the Computerized Patient Record System (CPRS) in VISTA. It is expected that electronic access will be done monthly by Contractor s abstracting personnel. There are going to be times (such as survey prep) that the contractor and or contractor abstracting personnel may or will need to be onsite, at such times transportation and lodging shall be the responsibility of the Contractor, to perform the abstracting functions and/or from remote locations by computer modem and shall comply with the VA standard of case completion of four to six (6) months after date of diagnosis. A list of cases completed shall be provided to the Contracting Officer s Representative (COR) along with monthly invoices submitted. Abstracting shall encompass the full and complete data set (required, optional and supplemental fields) to present a complete patient. summary in the VistA Oncotrax package. Text field shall be utilized to document finds on Physical Exam, Scans, Scopes, Labs, Diagnostic OPS and Pathology. Collaborative Stage and American Joint Committee on Cancer, Topography, Nodes, Metastatic (TNM) staging shall be performed on all cases meeting the criteria as established by SEER and the American Joint commission on Cancer, latest Manual for the Staging of Cancer, in conjunction with accepted principles. All required abstract fields must be completed with 100% accuracy. 2.17. Security Applicable staff background information checks and VA systems training, and certifications will be required before system access is granted by the Veterans Service Center (VSC) and the local facility Information Security Officer (ISO) prior to commencement of work. 2.18. VistA Oncotrax System Applicable system software functionality training will be provided by VISN Cancer Tumor Registry (CTR) staff as needed. Prior to commencement of work the Contractor and Contractor staff shall have a working knowledge and competencies required for effective utilization of the VA abstracting software programs and computer hardware. Work will begin within 30-60 days from date of contract award. 2.19 CERTIFICATION/ Logs of monthly work completion The Contractor shall prepare and submit to the V-2...