Federal Supply Schedules for Medical Staffing Services

1. Federal Supply Schedules for Medical Staffing Services And the Mysteries of the Service Contract Act (VA)

2. What is the FSS Program? • Listing of contracts to multiple companies supplying comparable commercial supplies and services. • National contracts awarded to responsible vendors to provide supplies and services at established prices, terms and conditions.

3. Federal Supply Schedule Program GSA (All other commodity/service groups) NAC (Medical related Supplies/services) Authority – GSA delegated to Veterans Affairs National Acquisition Center the responsibility for the Federal Supply Schedule program for medical care related supplies, equipment, pharmaceuticals and services.

4. What is the FSS Program? Structure • Product/Service Groups delineated by Federal Supply Class (FSC)/Product Service Codes (PSC). • 65 & 66 – medical-related • 621 – medical service-related • Products/Services also further delineated by Special Item Numbers (SIN) and Subcategories.

5. Federal Supply Schedule Service Overview of the VA Schedules Program 65 I B - Drugs and Pharmaceutical-related Products 65 II A - Medical Equipment and Supplies 65 II C - Dental Equipment and Supplies 65 II F - Patient Mobility Devices 65 V A - X-Ray Film, Equipment and Supplies 65 VII - Diagnostic, Reagents, Test Kits and Sets 66 III -Cost-Per-Test for Clinical Laboratory Analyzers 621 I – Professional and Allied Healthcare Staffing Services 621 II – Medical Laboratory Testing and Analysis Services

6. Overview of VA Federal Supply Schedule Program • Multiple Award Schedule • Open and Continuous Solicitation • IDIQ Contracts w/EPA • Contracts are 5 years w/5 option years (except 65IB Pharmaceuticals) • Pre-negotiated Pricing & Terms • Electronic Tools – shared with GSA

7. Overview of VA Federal Supply Schedule Program Benefits for Contractors: • Closely mirrors commercial buying practices. • Streamlined contract vehicle for selling to the entire Federal Government. • New supplies/services may continually be introduced to the system.

8. Overview of VA Federal Supply Schedule Program Benefits for Agencies: • Prices have already been determined fair and reasonable. • All ordering activities, large or small, even those in remote locations, are provided with quality service or product. • Shorter lead-times, lower administrative costs.

9. INTRODUCTION TO FSS 621I Services – Professional and Allied Healthcare Care Staffing: • Provides customer with “on site” staffing options • Sold commercially at hourly rates • 58 general categories of healthcare occupations • Classified by Special Item Numbers (SINs) • Further broken down into sub-categories(approximately 150 total)

10. FSS 621 I Professional & Allied Healthcare Staffing Services • Geographic Coverage • Past experience in state • Technical Evaluation • Malpractice of Insurance (at least $1 million per claim/$3 million aggregate) • Shared policies not accepted

11. FSS 621 I Professional & Allied Healthcare Staffing Services • Recruitment and Retention • Substitution/Replacement Policy • Corporate experience • Qualification of Personnel • Experience/License/Certifications • Past performance

12. FSS 621 I Professional & Allied Healthcare Staffing Services Healthcare Staffing Services: • Physicians • Allied Healthcare Service Geographic Scope: • Nationwide • State specific (at least one entire state)

13. FSS 621 I PROFESSIONAL & ALLIED HEALTHCARE STAFFING SERVICES Supplemental and Per-Diem Staffing • Long Term Requirements • Day to Day Needs • Malpractice Insurance • Services Provided at Government Healthcare Facilities • Over 280 contracts currently

14. FSS 621 I Professional & Allied Healthcare Staffing Services Types of Labor Categories: • Physicians/Surgeons • Registered Nurses (General and Specialized) • Pharmacists/Pharmacy Technicians • Counseling Related Services • Dental • Radiologic Technology • Medical Assistants and Technicians • Ophthalmic Services Physicians/Surgeons Physicians/Surgeons • Registered Nurses (General and Specialized) Radiologic Technology

15. FSS 621 I Professional & Allied Healthcare Staffing Services Negotiated Terms under FSS 621I: • FSS Net Ceiling Price • Hourly “Not to Exceed” Rates • Excludes travel and lodging • Shift Differentials • Nights, Evenings and Weekends • Holiday Rates (all federal holidays)

16. FSS 621 I Professional & Allied Healthcare Staffing Services • Overtime Rates • Payment Terms • Minimum Order • Minimum Qualifications • Background Investigation Levels • Credit Card Acceptance (above the micro-purchase threshold) • Work Week • On-Call/Call Back Terms

17. FSS 621 I Professional & Allied Healthcare Staffing Services • For Services - Customer Ordering Procedures FAR 8.405-2 applies • Requires Statement of Work (SOW) SOW shall contain the following: • Location • Period of Performance • Deliverable Schedule • Applicable performance standards • Any special requirements (ex. Travel, security clearances, special knowledge and etc.)

18. Ordering under FAR 8.405-2 • Performance Work Statement (PWS): • PWS can be prepared by the Government or • Prepared by offeror in response the Government Statement of Objectives (S00) • Measurable Performance Standards • Method(s) of Accessing Performance • Performance Incentives (where appropriate) • In accordance with FAR Part 12 • To encourage competitors to develop and institute innovative and cost-effective methods of performing

19. Ordering under FAR 8.405-2 • Small business set asides are not permitted • Ordering agencies may take credit for socio-economic status • May consider socio-economic status when identifying contractor(s) for consideration • Task orders (like BPA’s) can extend beyond the term of the contract • Provided there are option periods that (if exercised) would cover the term of the order • Contact FSS Contracting Officer to ensure that the contract has been extended

20. Contractor Teaming Agreements (CTA) - meets Government agency needs on orders by combining supplies and/or services from team members with separate FSS contracts

21. FSS 621 I Professional & Allied Healthcare Staffing Services

22. FSS 621 I Professional & Allied Healthcare Staffing Services (Dollars are in millions)

23. FSS 621 I Professional & Allied Healthcare Staffing Services

24. FSS 621 I Professional & Allied Healthcare Staffing Services

25. FSS 621 I Professional & Allied Healthcare Staffing Services • Service Contract Act/Fair Labor Standard Act Requirements • Requires contractors and subcontractors performing federal service contracts over $2,500 to observe minimum wages, health and welfare fringe benefits and other employment standards • Applicable for all allied healthcare labor categories wages • Managed nationally under the basic FSS contract

26. Requirements of SCA • Service Contract Act: • SCA became effective in January 1966 and amended in 1972 and 1976 • SCA is the most recent of government contract labor standard laws administered by the Wage and Hour Division (WHD) • Payment of FLSA minimum wage for federal service contracts of $2,500 or less is $6.55 per hr. Effective 7/24/09 will increase to $7.25.

27. Requirements of SCA • Most Federal service contracts in excess of $2,500 must contain the labor standards clauses and: • Minimum monetary wages and fringe benefits determined by the Secretary of Labor • Record keeping - Posting requirements • Safety and health provisions (29 CFR 1925) • Statement of rates paid to Federal employees

28. FSS 621 I Professional & Allied Healthcare Staffing Services • Definition of Service Contract (FAR 22.1001) • Principal purpose – furnish services in U.S. • Exemptions (FAR 22.1003) • Definition of Service Employee - contracts(29 CFR Part 541) • Coverage by subcontractors

29. Professional Exemption? • 3 General Categories • High-level professionals (Physicians) (Fair Labor Standard Act (FLSA) and Service Contract Act (SCA) do not apply • Mid-level professionals (Pharmacists, RN’s) (FLSA and SCA do apply) • Lower-level professionals (Nursing, Dental Assistants, other) (FLSA and SCA do apply)

30. Solutions • Concept: • Identify commercial occupations • Requirements of SCA Incorporated at the National Level • Incorporate DoL Wage Determinations (WD) into FSS at national contract level • Update wages annually on FY • All Orders, BPAs and Option Periods • Cross walk commercial occupations to SCA Occupational Index Codes

31. FSS 621 I Professional & Allied Healthcare Staffing Services • October 1, 2006 – SCA Clauses Incorporated into Sch 621I • January 1, 2007 – US DoL WD’s incorporated into FSS nationwide • US DoL WD’s and Health & Welfare fringe benefits are updated each year anniversary date of October lst (FAR 22.1007)

32. FSS 621I Professional & Allied Healthcare Staffing Services October lst Each Fiscal Year: • All FSS 621I Contracts are modified at the FSS Contract Level to incorporate the updated SCA WD’s and H&W benefits • The new SCA rates are effective from October lst through September 30th for all new task orders • WD’s in effect on October lst apply for the entire year (even if the WD is revised by the Department of Labor (DOL) during the Fiscal Year) • For existing orders, the new SCA rates/WD’s will be effective the next option is exercised • The new SCA rates are effective from October lst through September 30th for all new task orders • effectiveOctober lst each fiscal year SCA updated on all FSS 621I Contracts are modified at the FSS Contract Level

33. FSS 621I Professional & Allied Healthcare Staffing Services • For existing orders, the new SCA rates/WD’s will be effective the next option is exercised • The WD’s in effect October lst applies once the option is exercised - until the next option period. • FSS 621I Solicitation is amended to incorporate the new updated WD’s/H&W

34. The Challenges of Where We Have Been • Industry • Updating Systems • Pricing • Educating Customers • Resistance • Price Adjustments addressed - identifying parallel categories

35. Lessons Learned • Educating Customers • Price Adjustments • Timing of Orders • Consistency

36. FSS 621I Professional & Allied Healthcare Staffing Services Educating our Customers: • Recommend CO to compare the functional descriptions of the work with SCA Directory of Occupations • Ensure consistency with FSS matches • If found inconsistent recommend: • Federal Acquisition Part 22.10 • SCA Director of Occupations (5th ed) • Federal Classification and Job Grading Systems • DOL Wage Determinations Online • DOL Agency Labor Advisors • DOL SCA Library

37. FSS 621I Professional & Allied Healthcare Staffing Services How to obtain assistance with SCA: • FSS 621I Help Desk Home Page • Current WD’s available for download • 621I Labor Category Classification Published • Other SCA Guidance • DOL Emergency Wage Determination Hotline: 202-693-0073

38. What is Next? • A team has been formed to establish consistency across the MAS Program in the application of SCA • Team intends to update policies and procedures • New proposed CSP disclosures

39. Federal Supply Schedule 66 III COST PER TEST SERVICES • All inclusive solution provides everything needed to produce a valid test result • Pricing Options: • Priced “Cost Per Test” • Priced “Cost Per Reportable Result”

40. Federal Supply Schedule 66 III • Pricing includes: • Leasing Costs of Equipment • For chemistry, coagulation, urinalysis, microbiology, and immunochemistry • Reagents, Standards, Controls, Consumables • End User Training • Maintenance & Support • Delivery & Installation **outright purchase of equipment is under GSA Schedule 66IIN

41. Negotiated Terms under FSS 66 III Cost-per-Test (CPT) Prices Cost-per-Reportable-Result (CPRR) Pricing Incremental Analyzers Accessories / Options Geographic Coverage Billing Procedures Payment Terms TrainingDelivery Times / Terms Maintenance & Support 24/7 Emergency Repairs Standard Business Hour Repairs Available Minimum Order Credit Card Acceptance Terms

42. Federal Supply Schedule 621 II REFERENCE LABOROTORY TESTING & ANALYSIS SERVICES • Includes: • Transportation of Specimens • Performance of Tests & Reporting of Test Results • Consultative Services • All Necessary Supplies • Service and Maintenance (of communication equipment used to deliver test results)

43. Reference Laboratory 621 II Negotiated terms Discount / Net Prices Per Test Turn Around Time (TAT) STAT – Expedited Turn Around Time Holiday Charges Workweek Payment & Credit Card Acceptance Terms Minimum Order Geographic Coverage

44. FSS Service – Point of Contacts Help Desk 708-786-7722helpdesk.fss621i@va.gov

45. FSS Service – Point of Contacts Dore Fessler Assistant Director for FSS (708) 786-5223 Linda Smith Schedule Manager 621 I – Professional and Allied Healthcare Staffing Services (708) 786-5194 Andrew Morgan Schedule Manager 66 II – Cost Per Test 621 II – Medical Laboratory Testing and Analysis Services (708) 786-4950

46. Assistance for FSS Supply Contracts Help Desk Assistance • Supply Contracts • 708-786-7737 Helpdesk.ammhinfss@va.gov

47. FSS – Supply Point of Contacts Paul Skalman Assistant Director for FSS (708) 786-5247 Monee Robinson Schedule Manager – 65IIA Medical Equipment & Supplies (708) 786-5183

48. FSS – Supply Point of Contacts Cheryl Ward-Roberts Assistant Director for FSS (708) 786-5259 Lynda O’Neil Schedule Manager 65IIC – Dental Equipment & Supplies 65 II F - Patient Mobility Devices (708) 786-4958 William Satterfield Schedule Manager 65 I B - Drugs and Pharmaceutical-related Products 65 VII - Diagnostic, Reagents, Test Kits and Sets (708) 786-4955

49. Federal Supply Schedule Service Carole O’Brien Director, Federal Supply Schedule Service (708) 786-4957

50. Questions and Open Discussion