Sevc Audiology Services

PROJECT STATEMENT and SCOPE OF WORK

AUDIOLOGY SERVICES FOR

THE PENNSYLVANIA DEPARTMENT OF MILITARY AND VETERANS’ AFFAIRS

SOUTHEASTERN VETERANS’ CENTER

I. Objectives.

A. General. The Department of Military and Veterans Affairs (DMVA) is seeking to award a purchase order (PO) for the provision of audiology services at Southeastern Veterans’ Center (SEVC) in accordance with this Project Statement.

B. Specific. SEVC is located at One Veterans Drive Spring City, PA 19475.

The PO will cover all monthly audiology services in accordance with this Project Statement. These services will be all-inclusive and on an as-needed basis. Services are to include but not limited to examinations and treatment given and/or prescribed to approximately 258 residents.

The estimated number of treatments per fiscal year is 1,000. Payment will be made only for the number of treatments prescribed by the attending physician and provided by the contractor awarded during the term of the contract. This number of treatments includes what Medicare, Medicaid, and the contract will pay.

C. DMVA Contracting Officer. The DMVA Contracting Officer responsible for the solicitation and PO award is:

Kayla Brill, Purchasing Agent Supervisor

Procurement & Contracting

Bldg. 0-47

Fort Indiantown Gap

Annville, PA 17003-5002

Phone: 717-861-6400

Fax: 717-861-2932

Email: kbrill@pa.gov

D. Method of Award and Term of PO. DMVA shall award the PO to the lowest responsive bidder. The award will encompass the total of all line items completed in the Appendix A.

It is DMVA’s intent to establish a one year PO with four one-year renewal options. The term of the PO shall commence on the executed effective date and shall end on the expiration date identified on the PO. Services shall begin as specified in the project statement or notice to proceed letter, whichever is the later. DMVA reserves the right, upon written notice to the awarded contractor, to extend the term of the PO or any part of the PO for up to 90 days under the same terms and conditions.

E. Reserve Conditions. Each resident reserves the right to accept or reject participation in the service offered under the awarded PO. The residents or the residents' families may choose to obtain services from another provider at their own discretion and at their sole expense. In accordance with Federal Veterans Affairs regulations, DMVA and SEVC cannot guarantee that all services will be provided by the awarded contractor

II. Minimum Qualification Requirements.

A. Contractor Experience. The potential bidder shall provide proof of a minimum of 5 years’ experience in audiology services.

B. Contractor License. The potential bidder shall provide their current license to practice audiology with the Commonwealth of Pennsylvania. The potential bidder shall provide a practitioner license number, expiration date, and if appropriate, Drug Enforcement Agency (DEA) number.

C. Pricing. Potential bidders shall incorporate all pricing into the Appendix A price sheet.

D. Location. The potential bidder’s facility shall be located within a twenty (20) mile radius of SEVC.

III. Project Statement.

A. Contractor Services. The awarded contractor shall provide audiology services coordinated under the direction of the SEVC Commandant, Deputy Commandant, Director of Nursing, or designee on an as needed basis. The awarded contractor shall provide services as an independent contractor and not an employee of the Commonwealth of Pennsylvania. The awarded contractor shall at all times in the performance of this contract, render professional services in accordance with SEVC policies, procedures, rules, and standards, by the Veterans Administration, the Healthcare Financing Administration (HCFA), Medicare, and any other standards of quality of service as mandated by Federal, State, and Local Regulations.

The awarded contractor shall provide a hearing screening on all residents annually. The awarded contractor shall screen all new admissions. The awarded contractor shall screen all residents on an annual basis then monthly visits on the grounds of SEVC to recommend care, and maintenance of resident hearing aid devices. The awarded contractor shall furnish all equipment needed to perform services to residents. The following services shall include but not limited to:

i. Hearing testing

ii. Hearing Aid fitting, repairs, and reprogramming

iii. Counseling and use of hearing aids

iv. Provide in-service(s) to staff

v. Assistive listening devices

vi. Cerumen removal

vii. Fall Risk Management

The awarded contractor shall always ensure the resident(s) privacy and dignity. The awarded contractor shall refer residents that need extended services to SEVC staff physician and consult with that physician to facilitate continuity of care.

The awarded contractor shall provide a backup Audiologist in the event of unexpected absence with the approval from the facility. The back-up Audiologist shall follow specifications stated for contracted Audiologist and abide by all contract Terms & Conditions within the Project Statement and Statement of Work.

The SEVC Nursing Assistant(s) assisting the audiologist is to transport residents back and forth and provide reassurance to the resident as needed. The Nursing Assistants at no time will help in completing any paperwork for the awarded Audiologist.

B. Scheduling. The awarded contractor shall coordinate the appointment scheduling for the residents with facility. Prior to beginning services under this contract, the awarded contractor shall provide a schedule for the dates and times that services will be provided. All residents requiring treatment shall be seen on the scheduled date. The awarded contractor shall provide the resident schedules to the facility scheduling clerk at least one (1) week in advance of scheduled dates. The awarded contractor shall complete all required services within the specified hours of service. By mutual agreement with the contractor awarded, SEVC may modify the specified hours of service to meet the facility’s needs.

C. Documentation. The awarded contractor shall provide documentation of each resident visit consultation to SEVC at the end of each service day. Documentation of visit will be an agreed upon method and format between the awarded contractor and SEVC. The awarded contractor shall complete individual reports on the services provided for the resident’s chart on forms provided by the facility. Documentation must indicate all recommendations to the attending physician for both follow-through care to be provided by the Facility as well as recommendations on any other clinical/medical services indicated.

The awarded contractor shall document service on resident’s medical record. This shall include date, time, and service rendered, along with resident’s response to therapy, and any additional comments that might be useful to the attending physician or nursing staff. This documentation must be done at time of service. The awarded contractor shall be responsible for completing all required paperwork. The awarded contractor shall maintain an accurate file of audiology services rendered. The awarded contractor shall provide documentation of the screening and recommended care of residents to SEVC at the end of each visit day.

The awarded contractor documentation shall include long-term/short-term goals to be addressed with the residents’ and should be described and updated as needed in progress notes. If the resident is not considered an appropriate candidate for intervention, an explanation should be provided.

D. Infection Control. The awarded contractor must comply with all Commonwealth of PA infection control requirements, Centers for Disease Control and Prevention (CDC) guidance, and COVID-19 guidelines for the duration of the contract period. The awarded contractor shall practice infection control procedures by adhering to universal precautions as directed by the Center for Disease Control (CDC). Audiologist shall use aseptic techniques with all services.

i. Audiologist must clean instruments between each resident according to the CDC.

ii. Audiologist must wash hands between each resident according to the good hand hygiene control.

E. Resident Master List. The awarded contractor shall provide a hearing aid master list to each SEVC nursing unit, and a revised hearing aid master list whenever a resident is fitted with a new hearing aid. The awarded contractor shall include the following information on the master list:

i. the degree of assistance necessary from nursing staff/caregivers also should be specified (e.g., full assist, partial assist, supervised use, etc.).

ii. resident's name and room number;

iii. hearing aid make, model and serial number;

iv. ear(s) fitted;

v. hearing aid battery size;

vi. any other pertinent comments (e.g., high-risk for loss of aid, volume control setting).

F. Off-site Services. Services may be rendered off-grounds when medically necessary with the advanced approval of the facility. The awarded contractor’s facility shall be accessible by ramps and/or elevators for residents that require wheelchairs. The awarded contractor shall provide appropriate staff and equipment for resident transportation to off-site locations.

G. Emergency Services. Prior to treatment of any audiology emergencies, the facility must complete the “Certification of Medical Necessity” and forward it to the Facility Commandant, Deputy Commandant, and/or Director of Nursing so they can determine if emergency service(s) are required.

The awarded contractor shall respond to any emergency within twenty-four (24) hours after approval has been provided and initial call to the awarded contractor from the facility.

H. In-Service Education. The awarded contractor shall present in-service education programs and educational resources to the facility’s personnel on care that is applicable to residents with hearing impairments and for devices associated.

The awarded contractor shall cooperate with the facility’s administration regarding planning, implementation, evaluation, and problem-solving of the audiology service program.

The awarded contractor shall incorporate all in-service education programs and educational resources in submitted pricing. No additional line items will be established to pay for any additional costs associated with this service.

I. Compliance. All services and supplies provided must be compliant with the most current applicable Federal, State, and Local, Standards, Laws, Guidelines, Licensure Requirements, and Regulations (Requirements).  In any event where the awarded contractor creates a scenario where the contracting agency is found to be out of compliance with any Requirements the awarded contractor will be liable and responsible for any damages suffered by DMVA.  All non-compliance issues must be addressed and resolved by the awarded contractor within (48) forty-eight hours of notification to the awarded contractor.  It is the awarded contractor’s responsibility to ensure they are complying with all Requirements, including any updates throughout the duration of the contract, regardless of being provided them specifically by DMVA.

J. Hours of Operation. The awarded contractor shall perform audiology services within normal business hours. Emergency or special requests may be performed outside of normal business hours. All work performed outside of normal business hours must be pre-approved by the SEVC Deputy Commandant, Director of Nursing, or designee. Normal business hours are Monday - Friday between the hours of 8:00 a.m. and 4:00 p.m.

K. Facility Security Procedures. Each time the awarded contractor’s employees provide services for DMVA, they will be required to sign in at the security desk at the main entrance of the facility, obtain contractor identification badges, and report to DMVA POC, prior to the provision of services under this PO. Upon completion of the services, the awarded contractor’s employees must return to the security desk, sign out, and return all badges issued to them. For the Veterans Homes, any medical providers or individuals providing services directly to residents will be required to punch in and out at a time clock or access device.  The awarded contractor shall follow all required security procedures of each location within the facility in addition to any other pertinent identification or requirements as deemed necessary by DMVA. Particularly sensitive areas may require DMVA staff to accompany the awarded contractor’s employees. These procedures may vary from work location to work location and must be adhered to. The awarded contractor will provide all necessary paperwork for facility designee to sign verifying services rendered.

L. Facility Policies and Procedures.  The awarded contractor’s employees providing services at the DMVA location shall follow all policies and procedures of the location(s).  The awarded contractor may obtain a copy of all policies and procedures from the Program Office POC.

M. Removal of Contractor Personnel. The POC or designee reserves the right to direct the awarded contractor to permanently remove any contractor personnel from duty under the PO when the performance does not meet the standards outlined in these Specifications or when DMVA determines that it is in the best interest of the Commonwealth to have the personnel removed. The POC or designee shall notify the awarded contractor in writing of the reason(s) the removal of contracted personnel is required. Removal of contractor personnel will not relieve the awarded contractor of any performance requirements under the PO or create an entitlement of the contractor to receive an equitable payment adjustment. The awarded contractor shall not, without the POC or designee’s consent, assign a permanently removed individual to DMVA at any time.

N. Final Inspection. DMVA reserves the right to conduct a final inspection and acceptance test of all work or deliverables acquired under this PO.

O. Like Services/Increase and Decrease Quantities. The DMVA Reserves the right to add like services or supplies to the contract not listed in the original solicitation or contract if a need arises. The awarded contractor will be notified in writing when services or supplies have been added. DMVA reserves the right to increase and decrease quantities as needed throughout the term of the contract.

P. Qualification/Scope of Work Changes.  The DMVA reserves the right to change qualifications and/or scope of work items to enhance the success of the service.

Q. Background Checks. The awarded contractor shall be required to certify compliance with the Commonwealth Standard Terms and Conditions Section V.43 Contract-036.1 Background Checks (February 2016).

The awarded contractor shall, at its expense, perform a background check on each of his/her/its employees who will provide services at SEVC. Backgrounds checks can be conducted via the Request for Criminal Record Check form and procedure found at https://uenroll.identogo.com/. The awarded contractor shall certify that a background check has been performed of each of the awarded contractor’s employees not less than five (5) days prior to that employee providing services at SEVC. Thereafter, the awarded contractor shall certify that a background check has been conducted on each employee on an annual basis. If an employee of the awarded contractor has not been a resident of Pennsylvania for at least two (2) consecutive years prior to providing services at SEVC, the award contractor shall also have an FBI check conducted on the employee.

The awarded contractor shall maintain documentation confirming that the required background checks and FBI checks, if required. In the event of an investigation or audit by DMVA or another governmental entity, the awarded contractor will be required to provide the documentation to DMVA.

The awarded contractor shall complete and return the background certification form and the RFQ to DMVA’s point of contact (POC) prior to commencement of services and annually thereafter.

R. Background Check Restrictions. The awarded contractor’s employees, contractors, or resources shall not be employable by DMVA if they have been found guilty of abuse, neglect, exploitation, misappropriation of property or mistreatment by a court of law, or have had a finding entered into the Pennsylvania nurse aide registry or any State registry if applicable, concerning abuse, neglect, exploitation, mistreatment of residents or misappropriation of resident property, or have disciplinary action in effect against his/her professional license by at state licensure body as a result of finding of abuse, neglect, exploitation, mistreatment of residents or misappropriation of resident property.  DMVA has the right to review each individuals background check on a case by case basis for any other infractions.

S. DMVA Payment Authorization. For all services provided under the Contract, DMVA reserves the right to authorize the Veterans Home to pay for the services provided.  The awarded contractor shall bill DMVA and DMVA shall pay for services with DMVA payment authorization.  DMVA shall provide pre-authorization in writing to the awarded contractor prior to the provision of services. The awarded contractor shall provide an itemized invoice by resident for all services billed to DMVA.

T. Insurance Billing – Enhanced Veterans Reimbursement (EVR).  The awarded contractor shall bill Medicare and other third-party payers for services provided.  The awarded contractor shall bill Medicaid, when participating.  The awarded contractor is required to make a good faith effort to obtain reimbursement from third-party insurance and Medicaid if the awarded contractor is participating.  The awarded contractor shall send all remaining bills directly to the State Veterans Home for payment. The awarded contractor shall agree to direct billing for all services and procedures provided, as follows: Medicare, Primary Insurance, Medical Assistance, Supplemental Insurance (Medicare deductible/co-insurance), the resident may be billed for applicable deductible and coinsurance amounts, lastly the State Veterans Home. The awarded contractor shall accept the insurer’s Usual, Customary and Reasonable (UCR) rates as the acceptable rate for the service provided. The State Veterans Home shall not be responsible to pay the difference between the UCR and the awarded contractor’s rate for a given service. DMVA shall not cover any outstanding costs or expenses associated with the provision of services under this contract.

U. Insurance Billing – Resident Pay, non-Enhanced Veterans Reimbursement (EVR). The awarded contractor shall bill Medicare and other third-party payers for services provided.  The awarded contractor shall bill Medicaid, when participating.  The awarded contractor is required to make a good faith effort to obtain reimbursement from third-party insurance and Medicaid if the awarded contractor is participating.  The awarded contractor shall send all remaining bills directly to the resident for payment. The awarded contractor shall agree to direct billing for all services and procedures provided, as follows: Medicare, Primary Insurance, Medical Assistance, Supplemental Insurance (Medicare deductible/co-insurance), lastly the Resident. The awarded contractor shall accept the insurer’s Usual, Customary and Reasonable (UCR) rates as the acceptable rate for the service provided. The resident shall not be responsible to pay the difference between the UCR and the awarded contractor’s rate for a given service. DMVA shall not cover any outstanding costs or expenses associated with the provision of services under this contract.

V. Insurance Billing – DMVA Payor of Last Resort. The awarded contractor is required to have a provider number and bill Medicare, Medicaid, and other third-party payers that provide coverage for any resident.  With respect to services rendered to residents who are Medicare, Medicaid, or third-party insurer beneficiaries, the awarded contractor shall bill the insurer.  All bills for cost-sharing amounts must be sent directly to the Veterans Home.  The awarded contractor cannot bill the residents or their families for any cost-sharing amounts.  The Veterans Home will reimburse the awarded contractor without limitation for all cost sharing amounts owed up to the UCR rate, when required by regulation.  The awarded contractor is required to make a good faith effort to obtain reimbursement from third party insurance.  The awarded contractor shall agree to direct billing for all services and procedures provided to residents by adhering to the following terms and order of payers for allowable charges:  Medicaid, Medicare, Insurance, Supplemental Insurance, Veterans Homes.  The awarded contractor shall accept the insurer’s Usual, Customary and Reasonable (UCR) rates as the acceptable rate for the service provided. Neither DMVA nor the resident shall be responsible to pay the difference between the UCR and the awarded contractor’s rate for a given service. The Veterans Home will be payer of last resort for any/all co-pay & deductible amounts and for uninsured residents up to the Medicare/Medicaid, UCR rates. Requests for submission of any necessary corrections or waiver appeals must be submitted by the awarded contractor within seventy-two (72) hours of request. The Veterans Home shall provide the awarded contractor with updated resident insurance information as changes occur. The awarded contractor shall make all corrections to rejected claims; assist with waiver appeals, and correction of billings. The awarded contractor shall provide an itemized invoice for services based on the PO. The awarded contractor shall bill for services when completed, not to exceed thirty (30) days from date of service. Insured and uninsured residents shall be invoiced and billed separately.  The awarded contractor shall provide individual invoices for all cost sharing amounts (co-pays and deductibles) to the Veterans Home for reimbursement as they occur. Invoice backup shall be in the form of an itemized spreadsheet detailing the medical specialty service, a copy of the explanation of benefits (EOB), from the awarded contractor and below fields provided on-site and off-site at the Veterans Home.  The awarded contractor shall provide billing reports to the Veterans Home, as requested.

W. Confidentiality. The awarded contractor shall maintain as confidential all information relating to the policies and procedures and records of the Veterans Homes, including all resident medical records and maintain such records in a secured locked fashion and in compliance with the Health Insurance Portability and Accountability Act (HIPAA). The awarded contractor will be required to adhere to the requirements of the Business Associate Agreement (see attached)

X. Medical Screening The awarded contractor will present proof for all staff assigned to Facility of having received a current, completed two-step PPD (purified-protein-derivative) test with negative/no reaction result within the past ninety (90) days. If the awarded contractor has written proof of a PPD within the last six months, Facility will accept this documentation in lieu of administration of a repeat test. If the awarded contractor’s employees are unwilling to submit to the test due to previous positive reading, allergy to PPD material or refusal, then, Risk Assessment Questionnaire must be completed.

The awarded contractor will present proof for all staff assigned to the Facility of having received a current, completed two-step tuberculin skin test (TST) or chest X-Ray, with negative/no reaction result, within the past ninety (90) days. If the awarded contractor can show evidence that the contracted employees have had tuberculin skin testing in the recent past, the two-step tuberculin skin testing requirement may be waived at the discretion of the Medical Director of the Veterans Home following Centers for Disease Control and Prevention (CDC) guidelines on tuberculin skin testing for long-term care facilities. The awarded contractor will conduct a TB Assessment worksheet according to CDC guidelines for staff that have documentation of a negative two (2) step PPD test performed within the past 12 months. All staff assigned to Veterans Home must have an Annual Tuberculosis Assessment/ risk assessment questionnaire completed annually. A physician at the Veterans Home will evaluate any person with a known history of having a positive TST before that individual is permitted to work at the Veterans Home. For those individuals with a prior positive TST, a risk assessment questionnaire for tuberculosis must be completed annually. The TST is safe for infants, children, pregnant women, HIV-infected people, or those who have been vaccinated with the TB vaccine bacilli Calmette-Guerin (BCG).

The awarded contractor, with prior approval from the Veterans Homes, may utilize the PPD or QuantiFERON testing prior to the start of the contract term and perform symptomatic screening for TST annually. If at any time symptomatic screening is positive, the awarded contractor will need to perform PPD or QuantiFERON testing.

It is the awarded contractor’s responsibility to make sure that the Veterans Home is provided with the most current documentation throughout the term of the PO. Failure to provide the required documentation will be interpreted as the awarded contractor not complying with the Terms and Conditions of the PO.

Y. Ongoing Screenings.  The awarded contractor is responsible for providing required information, Provider Screening for Exclusion from Participation in Federal Health Care Programs Contractor Attestation to comply with the Medical Assistance Bulletin No. 99-11-05 (attached).  This attestation must be provided directly to the Veterans’ Home upon hiring or assigning individuals to the Veterans’ Home and monthly thereafter.  In the event one of the awarded contractor’s employees or their subcontracted employees, are identified, it is the awarded contractor’s responsibility to suspend the individual from the Veterans’ Home immediately and ensure the proper levels of care continue to be met with an appropriate, equivalent substitution. It is the contractor’s responsibility to make sure that the Veterans’ Home is provided with this documentation throughout the term of the contract. Failure to provide the required documentation will be interpreted as the awarded contractor not complying with the Terms and Conditions of the Contract.

Z. Annual Training of Contracted Staff: All awarded contractors, contractor personnel, and subcontractors that encounter residents during the performance under their contract at a Veterans Homes shall complete annual training.  The training will consist of safety topics, emergency preparedness, residents’ rights, abuse, infection control, reporting, incidents, HIPAA, and compliance.  The approximate length of all combined trainings is estimated at no more than 2 hours per person. The cost associated with the annual trainings shall be included in contract amount and shall not be billed separately. 

AA. Service Deficiencies. DMVA will notify awarded contractor verbally and in writing of any unsatisfactory services rendered. The awarded contractor shall correct the deficiency within the timeframe as specified by DMVA after such notification. If service deficiencies are ongoing and documented, DMVA will issue a Cure letter to the awarded contractor stating the ongoing deficiencies, with a requirement that the awarded contractor submit a formal Plan of Corrective Action for resolution of the deficiency issues, as specified in the letter. The formal Plan of Correction must be submitted to DMVA within ten (10) calendar days of the date on the Cure letter. Ongoing service deficiencies that are not resolved may result in termination of the contract.

BB. Reporting Requirements. The awarded contractor shall supply current copies of required current licensure, current certification, relevant education, training and experience, current competence, and a statement that the individual is able to perform the services that he or she is applying to provide in the Commonwealth of Pennsylvania, as specified in the Statement of Work and/or the Terms & Conditions. This documentation must be provided to Keith Wood at kowood@pa.gov at SEVC. The awarded contractor shall mail, fax, or hand deliver copies of all necessary information to the Veterans’ Home where services are to be provided within the timeframe as designated in the Statement of Work. It is the awarded contractor’s responsibility to make sure the Veterans’ Home is provided with the most current documentation throughout the term of the contract. Failure to provide the required documentation will be interpreted as the Contractor not complying with the Terms and Conditions of the contract.

CC. Laws/Statutes/Acts/Etc. (as applicable)

i. Stark Law. The awarded contractor shall comply with the Physician Self-Referral Law [42 U.S.C. § 1395nn] (Stark Law).

ii. Anti-Kickback Statute. The awarded contractor shall comply with the Anti-Kickback Statute [42 U.S.C. § 1320a-7b].

iii. False Claims Act. The awarded contractor shall comply with the False Claims Act [31 U.S.C. § § 3729-3733].

iv. Exclusion Statute. The awarded contractor shall comply with the Exclusion Statute [42 U.S.C. § 1320a-7].

v. Annual Checks. The awarded contractor shall ensure all contract staff who will have contact with residents complete the following checks annually:

a. The Pennsylvania Department of Human Services Medicheck (Precluded Providers) List

b. The Office of Inspector General, U.S. Department of Health and Human Services Exclusion Database Check

c. The U.S. Department of Health and Human Services National Practitioners Data Bank Check

d. Background Check Certification Form

The awarded contractor shall immediately report to DMVA any individual that does have a clean check and remove them from providing services to DMVA. The awarded contractor shall provide certifications that the checks have been completed upon request by DMVA.

DD. Program Office POC. The awarded contractor shall provide all required documentation throughout the term of the executed PO to the POC for the program office:

Keith Wood, Procurement Specialist

Department of Military & Veterans Affairs

Southeastern Veterans’ Center

One Veterans Drive

Spring City PA 19475

Telephone: 610-948-2400

Email Address: kowood@pa.gov