Q--HOME INFUSION SERVICES TO BE PROVIDED THE THE VETERANS OF THE SOUTHEAST LOUISIANA VETERANS HEALTHCARE SYSTEM IN NEW ORLEANS LOUISIANA AND SURROUNDING AREAS

SOURCES SOUGHT The Southeast Louisiana Veterans Healthcare System (SLVHCS) anticipates awarding a firm, fixed-price indefinite delivery contract to provide Home Infusion Services to Veterans and their beneficiaries. Interested contractors will be required to services the following catchment areas: Baton Rouge LA, New Orleans LA, Slidell LA, Hammond LA, Saint John LA, Houma LA, Bogalusa LA and Franklin LA. Interested contractors shall have Joint Commission or equal accreditation as a home infusion therapy provider. All Offerors are required to provide proof that they have all Licenses and or Certificates required by the State of Louisiana required as part of the Proposal. Interested contractors are required to carefully review the attached Statement of Work to ensure that they can meet or exceed contract expectations. The resulting contract will be effective for a period of one (1) year with four (4) one-year options for renewal. The NAICS code for this procurement is 621610 Contractor should thoroughly review the specifications and become familiar with the areas of coverage in order to become fully aware of the scope of requirements. Failure to understand the contract requirements shall not relieve the contractor from performing in accordance with the meaning and intent of the specifications. All interested contractors shall contact Sherry Marvin/Contract Specialist at [email protected] . SOUTHEAST LOUISIANA VHCS HOME INFUSION AND SKILLED NURSING SERVICES STATEMENT OF WORK The contractor shall provide all supplies, equipment, medication and infusion solutions and nursing services in accordance with the statement of work, including any required subcontracting coordination. List of subcontractors to be used under the terms of this contract shall be provided to the contracting officer with proposal and at any time throughout the term of the contract that the initial subcontractors are changed. The contractor will perform all pharmacy compounding using aseptic techniques in a laminar flow hood and provide all other in home skilled care and supervision necessary to provide home infusion therapy services and other nursing services in conjunction with home infusion if ordered by physician to eligible veterans of the VA Healthcare System (SLVHCS), as indicated in the scope of work. The SLVCHS VA Healthcare System catchment area serves the following CBOC’S: Baton Rouge, New Orleans, Slidell, Hammond, St.John, Houma, Bogolusa, and Franklin. The contractor shall be able to provide services in these areas as SLVHCS has Veterans located in all these catchment areas. All patient eligibility shall be determined by the referring SLVHCS and referrals shall be generated and authorized by the SLVHCS VA Health Care System attending Physician/Primary Care team. If the patient relocates outside the service area of SLVHCS, after 30 days the payment will become the responsibility of the VA Healthcare System servicing the new locality. All infusion therapy, nursing services, and other in home skilled care shall be provided under the specific orders of the SLVHCS Attending Physician/Primary Care team. The specific order shall outline the level and duration of service required for an eligible patient and any extension of services beyond the indicated duration, changes in medication, or any interim services, shall require approval of the attending physician/primary care physician. When the Veteran is discharged from a referred hospital and SLVHCS is responsible for arranging home infusion services, the SLVHCS Primary Care Physician is responsible for writing the original orders and is the contact person for any changes to the original order After initial physician’s order and team assessment, monitoring and adjustment of antibiotic, TPN therapy and other skilled in home services will be the responsibility of the Contractor. This will include the ordering and assessment of all necessary labs. The contractor shall provide an Infusion Case Coordinator who will coordinate all information needed by home care nursing and pharmacy for each patient to receive home infusion services and other related in home skilled services as ordered by the referring Physician within (2) hours of notification by the SLVHCS team. The Infusion Case Coordinator will meet with patient prior to discharge for patient care interview and will assume responsibility for acquiring the following information: Patient demographic information, diagnosis, valid prescription order, physician information, ht, wt, allergy status, IV access, medical history (i.e. diabetic; HTN, wheelchair bound etc.), specific nursing orders (i.e. wound care; Physical Therapy, Occupational Therapy, etc); and labs after discharge related to infusion therapy. Infusion Therapies will include: 1.Antibiotic/Antiviral 2.Pain Management 3.Hydration 4.Total Parenteral Nutrition 5.Enteral Nutrition 6.Inotropic Therapy 7.IVIG 8.Anti-Coagulation Therapy 9.Human Growth Hormone 10.Interferon 11.Anti-Emetic 12.Blood Component Stimulation Factor 13.Anti- Hemophilic Factors 14.Miscellaneous Self Injectables Other in home skilled services in conjunction will include, but not be limited to: 1. Wound Care 2. Physical Therapy 3. Occupational Therapy 4. Speech Therapy 5. Vital Sign checks 6. Respiratory Therapy 7. Medication Compliance The level of service required for each patient shall be determined by the SLVHCS team and shall be in accordance with any of the above listed items and other in home skilled care as deemed necessary. The contractor shall provide: 1.All medication, supplies, equipment, and infusion solutions, including pharmacy compounding using aseptic techniques in a laminar flow hood when applicable (first dose of a medication shall be administered in a supervised care setting to guard against an allergic reaction). Location of pharmacy providing compounding is required upon start of services. 2.All skilled in home skilled services that are ordered by the VA Physician in correlation with home infusion services. Skilled Services include, but are not limited to the following: RN Assessment, Physical Therapy, Occupational Therapy, and Speech Therapy. Patient must meet homebound criteria for continuation of services. These skilled services are to assess functional status and safety, improve function, and provide continued assessment for related MD orders in regards to wound care, medication compliance and care management. The visits are not to exceed the original MD order without prior authorization. 3.Training of patient/caregiver, by a qualified healthcare professional (registered nurse, or pharmacist), in the skill required for self-administration of infusion therapy. The contractor initial patient assessment may be conducted at the SLVHCS facility or any outside facility/hospital where a Veteran is residing. SLVHCS is responsible for arranging and paying for home skilled services. The Contractor shall meet patient’s family and begin the patients/caregiver education program. The contractor’s healthcare professional shall be responsible for ongoing patient reassessment and education, as required. If patient and /or caregiver are found not teachable after discharge, the contractor shall notify SLVHCS Primary Care team with these issues. 4.Delivery, assembly set-up, and pick up of infusion equipment within (3) working days by trained personnel in patient’s home, in an area of patient’s preference. Delivery and pick up of equipment shall meet all applicable Federal, State and local laws i.e. OSHA, FDA, etc. 5.Training of the patient/caregiver in the proper use and monitoring of infusion equipment. The contractor personnel who are familiar and experienced with the type of equipment being utilized shall conduct training. All training shall be provided in a courteous and simplified manner, which can be understood by the patient/caregiver. 6.Maintenance of equipment under a preventative maintenance plan that includes electrical service. 7.Clinical pharmacy consultative service. 8.Patient monitoring and all additional follow-up care required. This shall include coordination, supervision, evaluation and assessment of the appropriateness of care. Maintenance of any necessary parenteral devices shall include central line placement care and de-clotting/repair. Insertion of central line devices must not be performed in the home by the contractor unless prior approval from SLVHCS has been obtained. 9.Routine laboratory test, drawn as ordered, in accordance with standard medical practice for the disease and medication as indicated. Laboratory test shall be run at the SLVHCSs expense at a VA approved outside source. Lab results will be monitored by the infusion company's Clinical Pharmacist - as ordered in the initial referral by SLVHCS Physician. Any changes made to the initial orders shall be reflected in the patient's chart within 48 hours and scanned into the SLVHCS electronic medical record (CPRS). Labs needing urgent attention will be communicated to the SLVHCS Provider by the Infusion Case Coordinator and shall be processed in accordance with VAHCS Memorandum 516-09-113-006 (Attachment A). 10.Delivery, inventory and re-supply of all ancillary medical supplies required for infusion therapy. 11.Instruction in patient rights and responsibilities which shall include a compliant process that identifies the Contractor’s and VA’s specific points of contact for compliant reporting and resolution (the SLVHCS will provide the Contractor with a contact person for this purpose). 12.The contractor or the Infusion Care Coordinator shall provide the SLVHCS physician with a copy of the initial care plan within (7) working days that includes its development, review and revisions. Any changes to the initial care plan, must have prior approval by the SLVHCS provider/team. 13.Skilled nursing visits, by a trained and qualified Registered Nurse. The contractor shall notify the SLVHCS team of any changes in the frequency of nursing visits that deviated from the initial care plan. 14.A system in place to provide the SLVHCS with information following a patient/caregiver encounter, including notes documenting the patients progress and labs results. Documentation must be kept and available for quarterly review. 15.A 1-800 number available 24-hours a day, 365 days per year, for patient/caregiver to call for problems or questions that arise during the course of the home therapy. Patient/caregiver shall receive assistance and answers within 2 hours of making initial contact with Contractor. Assistance shall be provided by a qualified, appropriate, healthcare professional. The Contractor shall notify the SLVHCS team within 24 hours of any problems patient encounters with their home therapy. The contractor shall respond with a delivery time and nursing schedule for the home IV therapy and other in home skilled needs, as required, within (8) hours of SLVHCS contacting Contractor with order. 16.Twenty-four hours, 365 days per year, pharmaceutical and nursing coverage for the patient, including emergency service supply of replacement/back-up equipment and /or supplies if necessary. 17.Compliance with universal standard precautions as required in the preparation, delivery and storage process. The contractor is responsible for the following The Joint Commission (TJC), CHAP and/or ACHC standards in tracking, trending, reporting and maintaining records of infections among patient and as appropriate, among staff. Documentation shall be provided to the SLVHCS on a quarterly basis and as required. 18.Documentation and reporting within (24) hours to the SLVHCS team member of any incidents of patient death, accident, injury, infection or adverse drug reactions related to indicated medications, supplies or equipment. The contractor shall also document and report any life –threatening equipment malfunctions or equipment recalls. The contractor shall maintain a recall plan. 19.Discharge planning, which shall be coordinated in conjunction with the SLVHCS Primary Care team. Upon completion of services to each patient, the Contractor shall prepare a discharge summary, describing the services provided and forwarded to Release of Information for chart scanning. Under the terms of the Contract, the Contractor shall: 1.Meet or exceed TJC, CHAP, and/or ACHC accreditation and/or USP 797 compliance standards for home infusion therapy and in home skilled services. Proof of meeting this requirement shall be submitted to the SLVHCS Contracting Officer with proposal and yearly at time of contract renewal. 2. Assure licensure and competency of all employees and provide proof of the same to the SLVHCS Contracting Officer with proposal and yearly at time of contract renewal. These shall include an annual update of the following: a. Job/position description b. Annual performance evaluation c. Initial and continuous assessment of competence in providing employee’s specialty service (i.e. infusion therapy, training, knowledge of equipment, etc.) d. Continuing education credits e. Copy of license, certificate or registration with primary source verification f. Documentation of initial and annual training/in-service to include age-specific training in treating patients, especially elderly patients g. Annual Tuberculin (TB) testing and vaccines as required by the Department of Veterans Affairs Medical Facilities. 3. The contractor shall have documented emergency preparedness plan available for patient treatment in the event of a natural or man-made disaster such as fire, flood, electrical power outage, hurricane, etc. The Contractor shall coordinate formulation of specific emergency preparedness plans with the SLVHCS Contracting Officer with proposal and yearly at time of contract renewal. 4. The contractor shall provide the SLVHCS Contracting Officer with quality assurance (QA) data with proposal and thereafter on a quarterly basis. Patient satisfaction indicators must be in place and reported to the VA team with proposal and thereafter on a quarterly basis, with a record of patient complaints and their resolutions. All documentation shall be kept in a retrievable file. 5. Services provided by the prime and any subcontractors, shall meet or exceed all current Home Care TJC, CHAP, and/or ACHC standards, Center for Disease Control (CDC) guidelines, and standards for equipment management and Federal Drug Administration (FDA) requirements. In addition, the contractor shall comply with all Department of Transportation and FDA regulations. 6. The contractor shall furnish to the SLVHCS a certificate of insurance evidencing that all required coverage has been obtained with proposal and yearly at time of contract renewal. The SLVHCS reserves the right to conduct on site inspection of any of the Contractor’s facilities as often as necessary to insure compliance with the terms of this agreement. When a patient needs to be hospitalized he/she shall be instructed to go to the nearest VA facility when possible. In a life-threatening emergency, the patient shall call 911 or go to the nearest hospital available. Upon patient hospitalization, payment for Contractor services shall stop the day of the patient’s admission, unless a skilled nursing visit was made the same day of the admission. If any medication or supplies have been delivered, these are billable to the SLVHCS if they are deemed un-returnable. INVOICING The Contractor shall submit a separate invoice for each veteran receiving services approved under the terms of this contract in accordance with the billing instructions provided. Only items identified in the Contract Price-Fee Schedule will be reimbursed under this contract. Invoices shall be submitted monthly and not later than 30 days after treatment is completed and payment shall be prorated based on the actual number of days that services were provided. The invoice shall include all services/items provided by the prime contractor, subcontractors and shall include the following information: 1. Date of invoice 2. Contract Number 3. Invoice Number 4. Dates of service 5. Contract Price-Fee Schedule Item Number (and CPT Code-Description) 6. Per diem and other cost (to include items, quantities, unit cost, extended totals and total cost) 7. Patient’s name and social security number 8. The contractor shall supply a copy of the discharge summary with the final invoice. Invoices shall be submitted monthly, to the following address: Southeast Louisiana VA Healthcare System 1515 Poydras Rm 2110 Attn: Pharmacy 119 New Orleans, LA 70112 SKILLED NURSING- HEALTH CARE SERVICES REIMBURSEMENT Skilled home health care services include services provided by qualified personnel that include skilled nursing, physical therapy, occupational therapy, speech therapy, and social work services. Care includes assessment, treatment planning, treatment provision, patient and/or family education, health status monitoring, reassessment, referral and follow-up. These types of services will be reimbursed based on an hourly rate. The maximum hourly rate/price shall be determined by multiplying the annually published Home Healthcare benchmark Medicare LUPA rate by the applicable Geographical Wage Index to derive a final hourly rate/price for each discipline. ESTIMATED WORKLOAD The anticipated number of patients requiring treatment under this contract is estimated at 15-20 per month. The actual amount may vary during the contract. PATIENT & EXPENDITURE REPORTING The Contractor shall provide a quarterly expenditure report identifying the total number of patients and total invoiced/claimed amount for all services/items provided under this contract (do not provide patient names, social security numbers or any private/personal information). The quarterly invoiced/claimed amount will be reported by the Contracting Officer in the Federal Procurement Data System (FPDS). The report shall be submitted to the SLVHCS Contracting Officer, 1515 Poydras. Failure to provide this report in a timely manner will be identified as a performance issue and recorded in the official contract file. 1st Qtr Report: Submit by January 15th for the prior quarter (October thru December) 2nd Qtr Report: Submit by April 15th for the prior quarter (January thru March) 3rd Qtr Report: Submit by July 15th for the prior quarter (April thru June) 4th Qtr Report: Submit by October 15th for the prior quarter (July thru September). This submittal must provide a summary of all prior quarters (total annual dollars and patients for the government fiscal year) NATIONAL HOLIDAYS The Contractor is required to provide services on the following U.S. Government holidays: New Year’s Day 1 January Labor Day 1st Mon. in September M.L. King’s Birthday 3rd Mon. in January Columbus Day 2nd Mon. in October President’s Day 3rd Mon. in February Veterans Day 11 November Memorial Day Last Mon. in May Thanksgiving Day 4th Thurs. in November Independence Day 4 July Christmas Day 25 December When a holiday falls on a Sunday, the following Monday shall be observed as a legal holiday by U.S. Government agencies. When a holiday falls on a Saturday, the preceding Friday shall be observed as a legal holiday. Also, included would be any other day specifically declared by the President of the United States to be a Government Holiday. PARKING POLICY It is the responsibility of Contractor personnel to park only in designated parking areas. Parking information is available from the VA Police. The SLVHCS will not validate or make reimbursement for parking violations of the Contractor’s personnel under any circumstances. BADGES/CREDENTIALING The Contractor's Home Infusion Coordinator will be required to complete the credentialing process as outlined by SLVHCS Human Resources Policy. All Contractor personnel are required to wear identification (I.D.) badges during the entire time they are on the SLVHCS grounds. SMOKING POLICY Smoking is not permitted within or around the VA Healthcare System facilities, except in designated areas. CELLULAR PHONES Cellular phones shall be turned off prior to entering the VA facility and are prohibited for use inside the building.