RFP_Podiatry_Foot_Surgery_Services.pdf

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Phoenix Indian Medical Center 4212 North Sixteenth Street Phoenix, Arizona 85016

November 12, 2013

Dear Prospective Contractor, This Request for Proposal (RFP) package (14-247-SOL-00008) enclosed explains the Indian Health Services (IHS) requirement for Podiatry Foot Surgery Services at the Phoenix Indian Medical Center (PIMC). If your company is interested in providing services to the Phoenix Indian Medical Center, then please complete the attached package and return to my attention.

For your convenience a Document Submission Checklist has been provided to assist you in responding to the minimum requirements of the RFP. To meet the requirements, the enclosed forms will need to be completed and returned with the necessary documents, no later than 11/27/13, 12:00 PM, Phoenix Arizona Time to the address on page 1, block 8 of the RFP. You may submit a completed PDF copy to bradley.platero@ihs.gov, however the original RFP package signed by you will need to be mailed.

Note that the selected contractor shall be registered in the System for Award Management (www.sam.gov) website prior to award of any government contract.

Should you have any questions please call the undersigned at 602-200-5371.

Sincerely, Bradley Platero Contract Specialist

Enclosures

CC: RFP 14-247-SOL-00008

mailto:bradley.platero@ihs.gov

Document Submission Checklist

Request for Proposal (RFP: 14-247-SOL-00008)

Podiatry Foot Surgery Services

The following checklist is to assist you in ensuring that the acceptable minimum documents are submitted with your quote and signed by an official authorized to bind your organization.

Document Requirement Number of Copies

1. Standard Form 1449, Request for Proposal 1 Copy with Original Signature

2. B.5 Pricing 1 Copy

3. H.9 Indemnity and Insurance 1 Copy

6. K.4 52.212-3 Offeror Representations and 1 Copy Certifications Commercial Items

7. L.5 Instructions for Submission of 1 Copy Quote/Offer

8. Data Universal Numbering System Provide Number (Type on page 1 of the SF1449)

9. Register in www.sam.gov (replaces www.ccr.gov).

Note: A complete xerox copy of the RFP package is to be retained for your reference.

http://www.sam.gov/

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

Phoenix AZ 85016 4212 North 16th Street Phoenix Indian Medical CTR

CODE 16. ADMINISTERED BYCODE

X

X

X

621391

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR12

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

11/27/2013 1200 LT

11/12/2013

(602) 200-5371BRADLEY PLATERO

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

14-247-SOL-00008

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 2 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Phoenix AZ 85016 4212 North 16th Street

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$7.0

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Phoenix Indian Medical CTR

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

This Solicitation is a 100% Total Small Business Set-Aside.

The Health and Human Services (HHS), Indian Health Service (IHS), Phoenix Indian Medical Center (PIMC), has a requirement for on-site Podiatry Foot Surgery services for the Phoenix Indian Medical Center, Phoenix, Arizona. Offers must meet the minimum qualifications and/or requirements set forth within the Request for Proposal (RFP) and must be capable of providing

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

X

DATED

TENNYSON L. WELBOURNE

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDEND

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT:

REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

all core services set forth in the Scope of Work

(SOW).

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

2 2 of

SOLICITATION NUMBER 14-247-SOL-00008– PODIATRY FOOT SURGERY SERVICES

AT THE PHOENIX INDIAN MEDICAL CENTER (PIMC), INDIAN HEALTH SERVICE

Table of Contents

SECTION B- SUPPLIES, SERVICES AND PRICES/COST

B.1 PURPOSE OF CONTRACT

B.2 SERVICES

B.3 NON-PERSONAL SERVICES CONTRACT

B.4 SCHEDULE

B.5 PRICE

SECTION C-DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

C.1 DESCRIPTION OF SERVICE

C.2 SCOPE OF WORK (SOW)

C.3 STAFFING REQUIREMENTS

C.4 CONTRACTOR MINIMUM REQUIREMENTS/QUALIFICATIONS:

C.5 OTHER CONTRACTOR RESPONSIBILITY FACTORS

C.6 CLIENT BACKGROUND

C.7 PERSONNEL QUALIFICATION REQUIREMENTS:

SECTION D – PACKAGING AND MARKING

D.1 WRITTEN CORRESPONDENCE

SECTION E – INSPECTION AND ACCEPTANCE

E.1 FAR 52.246-4, INSPECTION OF SERVICES - FIXED PRICE (8/96)

E.2 REVIEW AND APPROVAL AND EVALUATION

E.3 VERIFICATION OF LICENSURE

E.4 CONTRACTING OFFICER RESPONSIBILITY

E.5 POST-AWARD ADMINISTRATION MONITORING

E.6 INSPECTION AND COMPLIANCE

E.7 BACKGROUND CHECK

SECTION F – DELIVERIES OR PERFORMANCE

F.1 PERFORMANCE

F.2 PLACE AND HOURS OF PERFORMANCE

F.3 REPORTING REQUIREMENTS AND DELIVERABLES

SECTION G – CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

G.2 DESIGNATED PROJECT OFFICER

G.3 PROJECT OFFICER AUTHORITY

G.4 COMPENSATION

G.5 PAYMENT OFFICE

G.6 INVOICE SUBMISSION

G.7 PAYMENT

G.8 TAX

SECTION H – SPECIAL CONTRACT REQUIREMENTS

H.1 LEGAL REQUIREMENTS

H.2 MEDICAL RECORDS

H.3 PRIVACY ACT NOTIFICATION

H.4 PRIVACY ACT VIOLATION NOTIFICATION

H.5 NON-DISCRIMINATION IN SERVICES, BENEFITS, AND FACILITIES

H.6 CHILD CARE NATIONAL AGENCY CHECK AND INVESTIGATION (CNACI)

H.7 SECURITY

H.8 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

H.9 52.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (JAN 1997)

H.10 SYSTEM AWARD MANAGEMENT (SAM)

PART II – CONTRACT CLAUSES

I.1 CONTRACT ORDER TERMS AND CONDITIONS:

I.2 HEALTH & HUMAN SERVICES ACQUISITION REGULATION CLAUSES (48 CFR CHAPTER 3)

I.3 52.204-1 APPROVAL OF CONTRACT (12/89)

I.4 352.203-7 ANTI-LOBBING (1/06)

I.5 352.224–70 PRIVACY ACT (1/06)

I.6 352.237-7 PRO-CHILDREN ACT OF 1994 (1/06)

I.7 352.237–71 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE (1/06)

I.8 352.237–72 CRIME CONTROL ACT—REQUIREMENT FOR BACKGROUND CHECKS (1/06)

I.9 352.242-70 KEY PERSONNEL (1/06)

I.10 352.242–71 TOBACCO-FREE FACILITIES (1/06)

I.11 P.L. 101-630, THE INDIAN CHILD PROTECTION AND FAMILY VIOLENCE PREVENTION ACT

I.12 5 USC 552A PRIVACY ACT OF 1984 AND 45 CFR 5 HEALTH AND HUMAN SERVICE ACT

I.13 FAR 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL (1/06)

I.14 52.216-18 ORDERING. (10/95)

I.15 52.216-19 ORDER LIMITATIONS. (10/95)

PART III-LIST OF DOCUMENTS, EXHIBITS, AND OTHER INSTRUCTIONS

SECTION J – LIST OF ATTACHMENTS:

PART IV-REPRESENTATION AND INSTRUCTIONS

SECTION K – REPRESENTATIONS, CERTIFICATIONS & OTHER STATEMENT OF OFFERORS

K.1 52.404-6 DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER (JUL 2013)

K.2 52.204-7 SYSTEM AWARD MANAGEMENT

K.3 52.212-2 EVALUATION – COMMERCIAL ITEMS (JAN 1999)

K.4 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS-COMMERCIAL ITEMS (APR 2013)

K.5 52.212-4 CONTRACT TERMS AND CONDITIONS-COMMERCIAL ITEMS (SEP 2013)

K.6 52.212-4 CONTRACT TERMS AND CONDITIONS-COMMERCIAL ITEMS (SEP 2013)

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICE TO OFFERORS OR QUOTERS

L.1 FAR 52.212-1 INSTRUCTIONS TO OFFERORS - COMMERCIAL ITEMS (JUL 2013)

L.2 FAR 52.216.1 TYPE OF CONTRACT (APR 1984)

L.3 FAR 52.233.2 SERVICE OF PROTEST (SEP 2006)

L.4 FAR 52.252.1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

L.5 INSTRUCTIONS FOR SUBMISSION OF QUOTE/OFFER

SECTION M – EVALUATION FACTORS FOR AWARD

M.1 52.217-5 EVALUATION OF OPTIONS (JULY 1990):

M.2 EVALUATION FACTORS

PART I – THE SCHEDULE

SECTION B- SUPPLIES, SERVICES AND PRICES/COST

B.1 Purpose of Contract

This Solicitation is a 100% Total Small Business Set-Aside.

The Health and Human Services (HHS), Indian Health Service (IHS), Phoenix Indian Medical Center (PIMC), has a requirement for on-site Podiatry Foot Surgery services for the Phoenix Indian Medical Center, Phoenix, Arizona. Offers must meet the minimum qualifications and/or requirements set forth within the Request for Proposal (RFP) and must be capable of providing all core services set forth in the Scope of Work (SOW).

B.2 Services

Health services contract to acquire on-site Podiatry Foot Surgery services at the Phoenix Indian Medical Center (PIMC). The Indian Health Service shall award one (1) requriments contract with this solicitation to cover 125 clinics per year.

Health services contract to acquire on-site Podiatry Clinics and onsite Podiatry foot surgical services at the Phoenix Indian Medical Center. The Indian Health Service shall awarad one (1) requirments contract with this solicitation to cover 200 clinics per year for the Podiatry clinical and foot surgical physician coverage plus Podiatry specialty procedures. The contractor should provide a full schedule of those physician(s) providing coverage 8 weeks in advance in coordination with the Medical Staff Clinical Director. The contractor(s) shall provide physician(s), who can be fully credentialed to provide emergency medical services to patients within the specifications of the "scope of work", within the standards of medical practice, and in accordance with the Medical By-laws and Rules and Regulations as established and approved by the Phoenix Indian Medical Center Medical Staff. The physician(s) need to be Boarded in Podiatry or "Board Eligible" with a minimum of five (5) years of concurrent Podiatry clinical and surgical experience.

The contractor has been credentialed by providing documentation of his/her experience background, training, demonstrated ability. Physical and mental health status with sufficient adequacy to demonstrate to the medical staff and the governing body that any patient treated by him/her will receive care of the generally recognized professional level established by Phoenix Indian Medical Center.

The Indian Health Service shall award one Indefinite Delivery, Indefinite Quantity (IDIQ) contract with this solicitation.

B.3 Non-Personal Services Contract

Pursuant to the Federal Acquisition Regulations (FAR), Part 37, Subpart 37.101, this contract is awarded as a non-personal services contract; to mean a contract under which the personnel rendering services are not subject to supervision and control of the Government. However, minimum administrative orientation may be provided by the Government for purpose of work assignment.

B.4 Schedule

Clinics will be mutually agreeable between the Contractor and Project Officer. Project Officer will plan out contactor work clinics 4 weeks in advance. Clinics may be cancelled or shortened without time restriction or monetary penalty before the physician arrives on duty.

1) Phoenix Indian Medical Center (Phoenix, AZ):

The Podiatry clinical and foot surgical physician shall provide 200 on-site Podiatry Physician clinic services per year, as requested by PIMC. Contractor shall work an 8 hour clinic between the hours of 7:00am-5:00pm as scheduled per patient care requirments.

The facility reserves the right to accept or reject any particular contractor personal who is not suitable for their assignment at any time during this contract period or; the facility may cancel this contract in its entirety.

Contractors who apply for positions with the Indian Health Service may be hired without penalty to the contractor, Podiatry Physician Services or the Indian Health Service.

B.5 Price

The unit price paid to the Contractor shall be considered as payment in full for services provided under this contract. In no way, unless directed by the IHS, shall any provider attempt to bill or collect from any IHS patient or from any alternate resource for which the patient may be eligible any monies for services provided under this contract.

Item Number

Description of Service Unit of Issue Unit Price

1 Base Year: Podiatry Foot Surgeon Services 200 Clinics $ 2 1st Year Option: Podiatry Foot Surgeon Services 200 Clinics $ 3 2nd Year Option: Podiatry Foot Surgeon Services 200 Clinics $ 4 3rd Year Option: Podiatry Foot Surgeon Services 200 Clinics $ 5 4th Year Option: Podiatry Foot Surgeon Services 200 Clinics $

Any time the Government may request the Contractor to stay beyond Clinic hours the Contractor shall be required to stay to complete continuity of patient care.

Hourly Rate Beyond Clinic hours: $_____________.

On Call/Call Back Rate: $_____________.

SECTION C-DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

C.1 Description of Service

Services by the Contractor will include: The staffing of one (1) Podiatry Foot Surgeon at Phoenix Indian Medical Center, in Phoenix, Arizona, for 200 Clinics per year. Diagnosis and treatment within the limits of the physician’s usual professional qualification as a Podiatrist and within the standards of quality generally provided by the other similarly qualified Podiatrist in the State of Arizona. In providing these services, the Contractor shall assume and provide guidance and quality of treatment to patients under the terms of this contract, as is provided the general public.

C.2 Scope of Work (SOW)

Specific work duties and services that the contractor shall provide under this contract include, but not be limited to the following:

A. Performs professional work involved in the care and treatment of the feet, including in the prevention, diagnosis and treatment of foot diseases and disorders by physical medical and/or surgical methods.

B. Non-Surgical:

1. Diagnosis

a) Interpretation of radiographs of the feet.

b) Interpretation of standard laboratory studies CBC, UA, Glucose, etc.

c) Biomechanical examination.

d) Other standard diagnosis, including patient history and physical examination.

2. Treatment

a) Non-surgical podiatric care including examination, consultation and non-invasive procedures (i.e. casting, taping, manipulation).

b) Injection or aspiration of medication or liquids, feet.

c) Prescription and/or application of topical medications in the treatment of pathology of the feet and legs.

d) Prescription of oral medications in the treatment of pathology of the feet.

e) Prescription of parenteral medications in the treatment of pathology of the feet.

f) Record pertinent data; write orders and post-operative notes in the medical record.

g) Accurate and timely documentation in EHR (Electronic Health Record)

h) Accurate and timely ICD-9 and CPT coding entry.

C. Surgical

1) Closed reduction of dislocations and fractures of the foot.

2) Debride wounds and ulcers of the foot involving bone, joint, tendon and/or fascia.

3) Reconstructive surgery of the foot including complex flatfoot reconstruction.

4) Surgery of the tendons of the foot including repair of ligaments and tendons, including the

Achilles tendon, peroneal tendons, extensor and flexor tendons.

5) Surgical repair of fractures and dislocations of the foot.

6) Performance of pediatric surgery including repair of Salter Harris foot and ankle fractures.

7) Provide accurate and timely documentation in the electronic health record.

8) Respond to on-call summons as required and within the required timelines.

9) Debride calluses and nails

10) Debride wounds and ulcers forefoot not involving bone, joint, tendon or fascia.

11) Debride wound and ulcers of the foot and ankle not involving bone, joint, tendon or fascia.

12) Toenail removal, total or partial simple or chemical.

13) Surgical procedures as granted in privileges.

C.3 Staffing Requirements

In accordance, with the specifications as outlined in the Scope of Work, the contractor will be required to have adequate staffing to provide the coverage needed as well as backup coverage in case of an emergency in which their scheduled contract provider cannot cover.

C.4 Contractor Minimum Requirements/Qualifications:

All Contractors/Contractor Employees working at the PIMC shall adhere to the following:

1. Professional Degree as a Doctor of Podiatry Medicine (DPM).

2. Required Board Certified by the American Board of Podiatric Surgery (ABPS) in Foot

Surgery.

3. Required five consecutive years of medical center based multi-disciplinary practice in the past five years.

4. Expert knowledge in the area of Podiatry specialty medicine. Provider must be board certified by the American Board of Podiatric Surgery.

5. An active and unrestricted license to practice in the state of Arizona or, one of the other 49 states in the USA, in the District of Columbia, or in the Commonwealth of Puerto Rico. The specialist should have at least three (5) years of current Podiatry specialty medicine experience.

6. The Contractor shall meet the same credentialing/privileging requirements as permanent IHS medical officers before being allowed to provide physician services for the Phoenix Indian Medical Center. Physical and mental health status with sufficient adequacy to demonstrate to the medical staff and the Governing Body that any patient treated by him/her will receive care at the generally recognized professional level established by Phoenix Indian Medical Center.

7. All contractors shall present an original current license when reporting to the Phoenix Indian Medical Center Podiatry Department for duty or for orientation whichever comes first. A copy is required for the contract file. No reimbursement will be made for those individuals who report to work with an expired license or a license that is not in good standing.

8. Contractor is subject to a character investigation in the performance of the contract in accordance with P.L. 101-630, Indian Child Protection and Family Violence Act of 1990.

9. All contractors must provide a copy of their resume for file. Contractor file will be kept by the Phoenix Indian Medical Center for verification of license or certificate, also file will contain personal information such as home address, phone number, next of kin, person to notify in case of emergency, health requirements, mandatory in-service and continuing education, competency assessments, and awards or disciplinary action.

10. Contractor is responsible for his/her own reliable transportation, travel and per diem expenses in the performance of this contract.

11. Contractor is responsible for maintaining satisfactory standard of competence, conduct, appearance and integrity. The quality of work performance of the contractor shall be subject to review.

12. Contractor shall abide by the Service Unit’s Standard of Conduct and policies and procedures.

Contractor shall adhere to the guidelines for his/her behavior and action as outlined in Service Excellence Guidelines to enhance relations between employees, departments, patients, patient’s families and visitors. The contractor shall abide by the bylaws, rules and regulations, general conduct of care, and Policy & Procedures set forth at PIMC.

13. Contractor shall abide by the lawful ethical principles of his/her profession.

14. Contractor/Contractor Employees is responsible for notifying their immediate supervisor and

Project Officer if he/she will be late or will be unable to work due to illness or any other reason.

15. Contractor is compensated only for scheduled hours actually worked at the agreed rate.

Contractors who become sick while on duty will seek medical care from their own private physician, unless contractor is eligible to receive health care from Indian Health Service.

16. Contractor/Contractor Employees is responsible for completing time sheets for actual hours worked which shall be verified by the Chief of Podiatry Department or his/her designee.

17. Contractor shall subject his/her performance to the hospital’s Quality Improvement Program, in accordance with the requirements of the Joint Commission, the responsible peer review organization and external regulatory agencies.

18. If the performance of a contractor employee is unacceptable, the Federal Government retains the right to restrict further employment of the physician.

19. Contract Physicians are required to be immunized. Indian Health Service (IHS) employee immunization policy requires that all IHS employees working in an IHS hospital or clinic be immunized for the following: Hepatitis B, Rubeola/Rubella and PPD screening yearly.

20. Contractor shall provide documentation of immunity by record of laboratory, evidence of immunity or documented immunization with live virus vaccine.

21. Clinical privileges are documented in writing, signed and granted by the Chief Executive Officer and Clinical Director, and formally approved by the Governing Body.

22. Contractor assures that the following minimum limit of malpractice insurance coverage is $1,000,000. Per occurrence. Refer to H.9.

23. Contractor shall ensure that proposed providers cooperate with and assist the Government in the conduction of any necessary background checks.

C.5 Other Contractor Responsibility Factors

To be considered for award the offer must comply with the following responsibility factors. Failure to provide the following responsibility factors in the response may disqualify an offer from further consideration.

The Contractor may be an individual, group or organization in which a qualified provider providing services meets the stated qualification requirements described herein.

A qualified provider shall be in attendance at every scheduled clinic.

Pursuant to the Public Law (PL) 101-630, Indian Child Protection and Family Violence Prevention Act and Public Law (PL) 101-647, Crime Control Act, the Contractor shall be responsible for completion of all applications and forms required for the purpose of a background character investigation. If the Contractor is a group practice, all professionals scheduled to provide services at the designated IHS facility are required to complete the appropriate forms. The Contractor shall be required to schedule an appointment with the PIMC Human Resource (HR) Staff Coordinator for completing the forms and for fingerprinting.

The Contractor shall provide services in such a manner as to meet the highest standards of professional ethics and conduct particularly in regard to confidentiality and patient rights. If at any time during the term of the contract, the Government suspects unprofessional behavior and practices, the Contractor will be contacted and requested to take appropriate action in accordance with applicable Federal Acquisition Regulations (FAR).

The Contractor shall possess a professional medical education from a post-secondary academic institution or be licensed in a field of medical study.

The Contractor shall contact the Project Officer and be responsible for all documentation required for eligibility and temporary physician staff privileges at the Phoenix Indian Medical Center (PIMC).

The Contractor shall be responsible for notifying the Project Officer in Section G.2 in case of an emergency or inclement weather that would prevent him/her from providing his/her schedule/shift/clinic.

The Contractor shall proficient in writing, typing and have a basic working knowledge and understanding of computer hardware and software.

The Contractor shall not be authorized to perform any services for the Government until the IHS Governing body has granted the contractor such privileges in writing. Federal contract employees do not accrue any form of retirement, social security, insurance or any other form of benefits.

The Privacy Act of 1974 mandates that the Contractor shall maintain complete confidentiality of all administrative, medical and personnel records and all other pertinent information that comes to his/her attention or knowledge. The Privacy Act carries both civil and criminal penalties for unlawful disclosure of records. Violations of such confidentiality shall be cause for immediate termination of the contract.

The IHS shall provide training on the Freedom of Information (as Amended) and the Privacy Act. All IHS regulations and policies applicable to these acts shall be enforced. The Contractor shall not serve as an “expert witness” in any suit against the Federal Government.

The Contractor shall comply with all IHS facility infection control and safety procedures, and standards.

The Contractor shall provide for the consistent performance of patient care process according to the standards of the JCAHO or Accreditation Association for Ambulatory Health Care (AAAHC) and/or Centers for Medicare Services (CMS) who supplies accreditation to the Phoenix Area Indian Health Service hospitals and health centers. These standards shall include: The Comprehensive Accreditation Manual for Hospitals, the Laboratory Standards, and Ambulatory Care Standards as they represent the scope of services of this contract.

The Contractor shall assist and provide services and duties as may be requested for normal operational requirements for the department and personnel. The Contractor shall provide work that is consistent with the guidelines and procedures of the IHS. Failure of the Contractor to meet these standards can result in the cancellation of the contract.

The Contractor shall have sufficient knowledge, competence and experience in providing these services on a regular scheduled clinic in the Phoenix Indian Medical Center. The Contractor shall possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that the Contractor can relate constructively to IHS employees, contractors, PIMC patients, client and individuals from the Native American Community.

If appropriate and necessary, the Contractor can provide recommendations to the Supervisor on better improving and enhancing the program environment and delivery of services. The Contractor shall inform the Project Officer, Contracting Officer or Program Manager or their designated representative of any problems encountered or which may be encountered in connection with meeting the needs of the Contractor’s duties.

The Contractor shall not have any work or health restrictions, which could directly or indirectly interfere with the performance of providing services as there will be some moderate lifting and moving of furniture as well as boxes of office supplies and equipment. The Contractor shall maintain acceptable standards of personal hygiene and grooming such that their image as a Federal contract employee is compatible with the expectations of the IHS staff.

The Contractor shall be expected to meet all the requirements as set forth in the statement of work. The contract staff will be required to attend the "New Employee" orientation provided by PIMC. This will provide each contractor an orientation to the layout of the facility as well as valuable background information and insight into the Native American Culture and beliefs.

Contractor shall refer patients to appropriate contracted medical (or other) facilities, providing full clinical information for care and diagnostic procedures, for those medical services that cannot be adequately provided at local IHS facilities.

Contractor shall complete all necessary Contract Health documentation for each patient referred outside of PIMC for care.

Contractor shall work with PIMC to insure that the required documentation is entered into the patient's medical record to adequately document patient condition on admission as well as the patient’s progress during the hospital stay.

Contractor shall coordinate and integrate information obtained into the ongoing health care record at the Service Unit and assures timely follow-up care as required.

Contractor agrees to strict adherence to any and all CMS and Joint Commission standards. The Contractor, at a minimum, will follow unapproved abbreviation guidelines and will provide timely completion and sign off on all medical records per Joint Commission standards.

The Podiatrist shall meet the same privileging requirements as permanent IHS physicians before being allowed to provide medical services in this facility.

Ability to perform special screening and developmental tests and routine and specialized laboratory and radiological services.

Knowledge of pharmaceuticals in order to recognize their desired effects, side effects and complications of their use.

Knowledge of human behavior during stressful situations in order to exercise emotional control, tact, patience and reliability in carrying out patient care.

Knowledge of the availability and use of resources designated as primary care and referral services.

Ability to provide individual and family counseling, guidance an health instruction to help patients to understand how to prevent disease and maintain good physical and mental health.

Knowledge of quality assurance and evaluation process to improve care and facilitate monitoring and program planning.

Knowledge of health record aspects of patient care and ability to accurately and completely document related clinical data.

Ability to provide guidance and leadership to other healthcare providers.

C.6 Client Background

Some of the IHS patients receiving services under this contract may only speak a native language or Spanish or may have limited comprehension of the English language, and/or may reside on a Native American Indian Reservation. The Contractor is expected to demonstrate sensitivity to cross-cultural and language difference and have the ability to work through interpreters as necessary. Consideration must be given to potentially limited transportation and/or home environment facilities. PIMC shall provide translators when needed.

C.7 PERSONNEL QUALIFICATION REQUIREMENTS:

At the time of the issue of the Task Order the Contractor shall provide the following information for each contractor employee providing services at PIMC.

a. The contractor shall certify to the contracting officer that the Podiatry Physician Services meet all the minimum requirements listed below prior to award.

1. Professional Degree as a Doctor of Podiatry Medicine (DPM).

2. Required Board Certification by the American Board of Podiatric Surgery (ABPS) in Foot

Surgery.

3. An active and unrestricted license to practice in the state of Arizona or, one of the other 49 states in the USA, in the District of Columbia, or in the Commonwealth of Puerto Rico. The specialist should have at least five (5) years of current Podiatry specialty medicine experience.

4. Required five consecutive years of medical center based multi-disciplinary practice in the past five years.

b. The following documents are required from the contractor in order for the Indian Health Service to make a proper evaluation: (Return Copies with RFP).

1. Current Resume or C.V., Standard Form (SF) 171, (OF)-612/OF-306 Applications for

Federal Government

2. OMB NO 0917, Addendum to Declaration of Federal Employment (OF-306).

3. Conferred degrees and certified training in the field.

4. Two (2) letter of reference from current or pervious employers.

5. Past Work Performance Statement, applicants must describe their present/previous experiences in this field.

6. Credentialing documents and degree conferred.

7. Copy of active unrestricted License to Practice Medicine.

8. Current Health Status Report.

9. Certificate of Immunization. Contractor shall provide documentation of immunity by record of laboratory evidence of immunity or documented immunization with live virus vaccine.

10. Child Care Form, Addendum OMB Approved Form-2012

11. Copy of Licenses and Certifications.

c. Medical Malpractice Insurance (Submit copy with RFP)

1. Evidence of medical malpractice insurance shall be submitted with the contractor’s proposals.

2. After contract award, the contractor shall provide a completed Certification for each provider to the project officer.

3. Evidence of medical malpractice insurance for continuous coverage, including license renewals, etc. shall be submitted to the project officer on a yearly basis.

C.8 Monitoring of Contractor

a. Peer review for quality of performance will be accomplished by an active member of the medical staff. Each contract physician will be fully credentialed and be required to be actively involved in the quality assurance/performance improvement in regards to Q.A. activities and policy development for the Podiatry Clinic. The contract physician will be required to comply with the Phoenix In d i a n Medical Center Medical Staff By-laws and Rules & Regulations, and, shall meet the same privileging requirements as permanent IHS physician prior to providing physician services in this facility. These physician(s) will be subject to the same peer review as permanent members of our medical staff.

b. PIMC shall provide an ongoing method of monitoring and evaluation of the quality and appropriateness of patient care and of identifying deficiencies in the quality of services performed before the level of performance becomes unacceptable. This will be accomplished through written evaluation of the contract physician’s and through bi-yearly (or sooner if circumstances warrant) t e l econfe rences between the Contractor, Project Officer(s) and Department Chief.

c. If a contract physician fails to arrive at the PIMC for a scheduled c l i n i c , the contractor must provide coverage by another provider with temporary, provisional or courtesy privileges approved by the PIMC Medical staff and the Governing Body. If no coverage is provided, the contractor will be required to pay the Indian Health Service for the costs incurred for providing that coverage. Not providing physician coverage on more than one occasion will be reviewed and discussed by the PIMC Medical Staff as to whether there was a compromise of patient care. If performance has been found to be unsatisfactory, the Medical Staff and Governing Body will convene and determine whether to penalize the contractor by withholding payments or if the contract should be terminated due to default.

d. The physician must complete all CMS-8551 and CMS-855R- Medicare Enrollment applications and any other insurance paperwork. Phoenix Indian Medical Center will process all eligible third party claims for reimbursement for services provided by the contractor(s). Copies of and/or access to patient medical records will be provided to business office personnel for the purpose of financial matters regarding billing and insurance collections.

SECTION D – PACKAGING AND MARKING

D.1 Written Correspondence

All Written Correspondence must cite the Solicitation Number on page 1 of the SF 1449. After the award of the contract all written correspondence must cite the assigned contract number.

SECTION E – INSPECTION AND ACCEPTANCE

E.1 FAR 52.246-4, Inspection of Services - Fixed Price (8/96)

(a) Definition: “Services,” as used in this clause, includes services performed, workmanship, and material furnished or utilized in the performance of services.

(b) The Contractor shall provide and maintain an inspection system acceptable to the Government covering the services under this contract. Complete records of all inspection work performed by the Contractor shall be maintained and made available to the Government during contract performance and for as long afterwards as the contract requires.

(c) The Government has the right to inspect and test all services called for by the contract, to the extent practicable at all times and places during the term of the contract. The Government shall perform inspections and tests in a manner that will not unduly delay the work.

(d) If the Government performs inspections or tests on the premises of the Contractor or a subcontractor, the Contractor shall furnish, and shall require subcontractors to furnish, at no increase in contract price, all reasonable facilities and assistance for the safe and convenient performance of these duties.

(e) If any of the services do not conform with contract requirements, the Government may require the Contractor to perform the services again in conformity with contract requirements, at no increase in contract amount. When the defects in services cannot be corrected by re-performance, the Government may --

(1) Require the Contractor to take necessary action to ensure that future performance conforms to contract requirements; and

(2) Reduce the contract price to reflect the reduced value of the services performed.

(f) If the Contractor fails to promptly perform the services again or to take the necessary action to ensure future performance in conformity with contract requirements, the Government may --

(1) By contract or otherwise, perform the services and charge to the Contractor any cost incurred by the Government that is directly related to the performance of such service; or

(2) Terminate the contract for default.

E.2 Review and Approval and Evaluation

The Contracting Officer or his duly authorized representative shall review and approve services provided under the terms and conditions of the contract.

The Contracting Officer, the designated Government Project Officer and the Contractor shall evaluate the services during the term of contract and the report of the evaluation will be made a part of the official contract file. The evaluation will be objective and directed toward the progress made in meeting the contract objectives and statement of work, resolve problems encountered, clarify issues that may arise unexpectedly and to evaluate the accomplishments. The evaluation will be conducted on dates mutually agreed to by all parties.

E.3 Verification of Licensure

To assure that all medical, Professional, and Technical professionals providing services under this contract are properly licensed and that the IHS is aware of any disciplinary actions, which may have been taken against them the Contractor shall:

Verify through appropriate State Boards, all licenses or certifications, active/inactive/lapsed that are providing services under this contract may hold or have held.

Inform the IHS of the statuses of all licenses/certifications, including the reasons for inactive or lapsed licenses; furnish a letter of reference from other health care providers familiar with the candidate’s professional technical practice skills. Provide any performance of disciplinary data that they may have on a candidate and found no reason to reject the candidate.

The information shall be provided to the Project Officer of the receiving facility no fewer than 15 working days prior to the Candidate’s projected date of arrival at the facility. In emergency situations, where there is no time available, a telephone call from the Contractor providing assurance of the above is acceptable. These instances must be well documented, justified and kept to a minimum.

E.4 Contracting Officer Responsibility

The authority to negotiate changes in the terms and conditions or the amounts cited in the contract is reserved to the Contracting Officer.

E.5 Post-Award Administration Monitoring

a) The Contract physician provider will be required to comply with the PIMC Policies & Procedures and shall meet the same licensing/educational requirements as permanent IHS physician provider prior to providing services in this facility. These providers will be subject to the same peer review as permanent members of our physician team.

b) PIMC shall provide an ongoing method of monitoring and evaluation of the quality and appropriateness of patient care and of identifying deficiencies in the quality of services performed before the level of performance becomes unacceptable.

c) If a contract provider fails to arrive at the PIMC for a scheduled clinic, the contractor must provide coverage by another provider with temporary, provisional or courtesy privileges approved by the PIMC Medical staff and the Governing Body. If no coverage is provided, the contractor shall be required to pay the IHS for the cost incurred for providing that coverage. Not providing physician coverage on more than one occasion will be reviewed and discussed by the PIMC Project Officer/COTR Staff and the Contracting Officer as to whether there was a compromise of patient care. All compromised situations that arise from lack of patient care by the contractor shall be referred to the Contracting Officer for action and resolution.

d) Once the Contract is awarded, contractor(s) must complete all credentialing and privileging paperwork in accordance with JCAHO, CMS and the PIMC Staff Bi-laws and Rules and Regulations. The Contract provider must meet the same licensing/certification requirements as permanent IHS physician provider before being allowed to provide services in this facility.

The physician provider must also complete all CMS-8551 and CMS-855R-Medical Enrollment Applications and any other insurance paperwork. Copies and/or access to patient medical records will be provided to the business office personnel for the purpose of financial matters regarding billing and insurance collections. PIMC will process all eligible third party claims for reimbursement for services provided by the contractor(s).

E.6 Inspection and Compliance

a. Compliance Inspection: The Project Officer (PO) will, by formal inspection, determine if the specified progress or methods of work are being carried out. Failure to comply with specified work standards may be cause for termination of the Contractor’s right to proceed.

b. Contract Personnel: If the Contractor is absent from the project area, a Contractor’s representative (designated in writing) shall be available for communication on a daily basis while work is in progress.

c. Inspection of Work: Periodic inspection of work shall be made by the PO to ensure compliance with contract specifications. Work not completed to contract specifications shall be reworked at no additional cost to the Government.

d. Determination of Acceptable Work: Inspection as stated above shall be performed by the PO for evaluation of contract specification compliance. The Contractor will be notified in writing of any work not meeting contract specifications. Portions of the service work which do not meet contract specifications shall be re-accomplished by the Contractor and the identified items shall be brought up to the required standard(s) before the service will be considered acceptable.

E.7 Background Check

Contractor’s employees are not able to work a scheduled clinic until the security check is performed and clearance has been obtained by the appropriate agency. At a minimum fingerprints are required and upon clearance at this stage a contractor’s may work a scheduled clinic. However, contractors are required to complete the detail background application and application is to be completed within 30 days once the contractor’s employee has been given access.

All Contractors’ are subject to criminal background check prior to performing services in accordance with the contract terms and conditions. The contractor shall ensure that each of their provider complete the, Certification of Criminal History and Background Check Packet. The completed forms are to be returned to the Project Officer. Additional Background Check packets can be obtained through the Project Officer.

Contractors (and their employees) requiring routine, long-term access (i.e., greater than 6 months) to IHS facilities and/or systems; or providing services to children under 18 year of age are subject to criminal background checks prior to performing services. The contractor shall ensure that each employee(s) complete the Certification of Criminal History and Background Check Packets to initiate the Child & Youth Services National Agency Check with Inquiries (CNACI). The PO is responsible for providing the contractor with all necessary background check forms. The PO is also responsible for ensuring all background check forms are fully completed and processed prior to commencement of service. The contractor shall return all completed forms to the PIMC Human Resource Office (PIMCHR) located at the Phoenix Indian Medical Center (PIMC), Phoenix, Arizona. Contractors may be directed to the e-QIP website to complete the necessary background investigation forms online (inquire with the PIMCHR should you wish to complete forms electronically). All contractors (or their employees) must appear in person to IHS (or an IHS facility) with two acceptable forms of identity; fingerprints will be taken electronically, or on paper, at this time. This must occur prior to the first date of service (realistically allow a 14 - 30 day processing time before the actual start date). At a minimum, if results are not received within 5 days, the identity credentials can be issued based on a favorable FBI National Criminal History Check (fingerprint check). Note: These timeframes are based on complete and acceptable package, including legible fingerprints.

FOR MORE INFORMATION ON SECURITY REQUIREMENTS PLEASE REFER TO DHHS SITE:

http://intranet.hhs.gov/pivcard/brochure.html http://intranet.hhs.gov/pivcard/brochure.html

SECTION F – DELIVERIES OR PERFORMANCE

F.1 Performance

Contract performance shall be for a base year and four (4) one (1) year option for renewal commencing on January 1, 2014 and shall not extend beyond the contract completion date of December 31, 2014, unless changed by a written amendment to the contract and approved by the Contracting Officer.

If the Government exercises its option to renew pursuit to FAR Clause: 52-217-9, Option to Extend the Term of this Contract, the following schedule shall prevail:

1st Year Option: 1/1/15 - 12/31/15 2nd Year Option: 1/1/16 - 12/31/16 3rd Year Option: 1/1/17 - 12/31/17 4th Year Option: 1/1/18 - 12/31/18

Option renewals will be on the basis of the existing requirement of the Government, performance of satisfactory service provided during the base year, and contingent upon availability of funds for the appropriate fiscal year.

F.2 Place and Hours of Performance

Refer to Section C.

F.3 Reporting Requirements and Deliverables

1) The Contractor will be required to actively participate in quality assurance/performance improvement activities and policy development for the department.

2) Once contract is awarded, contractor(s) must complete all credentialing and privileging paperwork in accordance with JCAHO, CMS, and Phoenix Indian Medical Center Medical Staff By-Laws and Rules & Regulations. The physician(s) must meet the same credentialing/privileging requirements as permanent IHS physician’s before being allowed to provide physician services in this facility. The physician(s) must also complete all CMS-855I and CMS-855R – Medicare Enrollment Applications.

3) The Contractor will be required to provide regular report of hours worked to the Designated

Project Officer with an invoice. This report shall be verified by the Project Officer, or, his/her designee, that can confirm the coverage.

4) If a locum tenens company, the Contractor(s) will designate an individual who will be the

“contact person” that will be available to discuss any problems or issues that arise with the Project Officer.

F.4 Ordering Official

A. The only individuals authorized to place an order against this IDIQ contract and the individual order limits of their authority are as follows:

Ordering Official Name and Location Dollar Limit for Order

a) Dr. Eugene Dannels, Project Officer, PIMC $15,000.00 per Mo

b) Dr. Matthew Pettengill, Alternate Project Officer, PIMC $15,000.00 per Mo

C. Both parties recognize that on occasion there shall be a need to fill coverage requests with less than a 24 hour notification. In such of an emergency scheduling situation, the Contractor shall make a full, good-faith effort to accommodate the emergency request. If the Contractor is unable to meet the emergency scheduling request, they shall immediately notify the individual who placed the order and the Project Officer.

D. Upon an agreed schedule of coverage, the IHS authorized ordering official will provide a IDIQ task order number to the Contractor.

F.5 Performance Conditions

1. Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment).

2. None of…