RFP_Tele-Health_GPA_Final_.pdf

Section A

Indian Health Service Request for Proposal for Great Plains Area (GPA)

Telehealth Support Services

(RFP) 16-236-SOL-00023

You are invited to submit a proposal in accordance with the requirements of the following Solicitation.

Proposals must be received by the Government no later than the local time on the Due Date stated in the table below.

Issue Date: 05/05/2016

Due Date: 06/06/2016

Time: 4:00 p.m., EST

Points of Contact:

Paul Premoe

(301) 443-5774 paul.premoe@ihs.gov

Stephen Yuter stephen.yuter@ihs.gov mailto:paul.premoe@ihs.gov mailto:stephen.yuter@ihs.gov

SECTION B – PRODUCTS OR SERVICES AND PRICES/COSTS

B.1. CONSIDERATION

The Contractor shall provide the commercial services described in Section C, Description/ Specifications/Performance Work Statement (PWS). Except as otherwise specified in the task order, the Contractor shall furnish the necessary personnel, equipment, materials, services, and otherwise do all things necessary for the performance of the work set forth herein.

B.2. CONTRACT PRICING

The Indian Health Service (IHS) is planning to issue a hybrid Indefinite Delivery, Indefinite Quantity (IDIQ) contract vehicle containing Fixed-Price and Labor-Hour line items. The requirement is being solicited among all qualified contractors with no set-aside restrictions.

You are invited to submit a written proposal utilizing the below Schedule of Prices for the services specified in Section C, under Request for Proposal (RFP) 16-236-SOL-00023.

Schedule of Prices Base Year: 12 Months Period

CLINs

RFP Labor Category Unit

Min Max Unit Price Total Price (Max Qty)

0001 Tele-Health Kiosk for Specialty Referrals Services

EA

0002 Annual Maintenance Services for Tele-Health Kiosk

0003 Emergency Services Equipment Set

0004 Annual Maintenance Services for Emergency Services Equipment Set

0005 Emergency Services – Monthly Baseline Facility Fee

Emergency Services – Monthly Subscription Fee per number of Beds.

This CLIN has four optional pricing scenarios (0006a ~ 0006d). A determination of the appropriate option will be based on a number of ED beds that the Service Unit chooses to utilize through support of this contract vehicle.

0006a

(Option 1) Emergency Services – Monthly Subscription Fee

1-3 Beds

0006b

(Option 2) Emergency Services – Monthly Subscription Fee

4-6 Beds

0006c

(Option 3) Emergency Services – Monthly Subscription Fee

7-9 Beds

0006d

(Option 4) Emergency Services – Monthly Subscription Fee

10+ Beds

Provider to provider consultation = flat rate 15 Minute interval

15 Minute

Consultation

20,000

Specialty Referral Services -- New Patient Office Visits

Accurate Common Procedural Terminology (CPT) 99202 – Expanded

Incident

2,000

CPT 99203 – Detailed

3,000

7,500

CPT 99204 – Comprehensive

5,000

13,000

CPT 99205 –Complex

6,500

Specialty Referral Services -- Office Visits - Established

CPT 99212 – Focused

1,500

CPT 99213 – Expanded

10,000

26,000

CPT 99214 – Detailed

25,000

CPT 99215 – Comprehensive

1,000

3,200

Behavior Health Counseling

Counselor

Hour

5,300

Psychologist

2,500

0018 Travel *See B.4.

N/A N/A N/A NTE

$30,000

TOTAL CEILING AMOUNT $ $

Option Year I: 12 Months Period

Min Max Unit Price Total Price

0019 Tele-Health Kiosk for

0020 Annual Maintenance

0021 Emergency Services

0022 Annual Maintenance

0023 Emergency Services – Monthly Baseline Facility Fee per number of Beds.

This CLIN has three optional price scenarios (0006a ~ 0006c) and only one pricing is to be applied to each task order. A determination of the appropriate option will be based on a number of ED beds that the Service Unit chooses to utilize through support of this contract vehicle.

00024a (Option 1) Emergency Services – Monthly Subscription Fee

00024b

(Option 2) Emergency Services – Monthly Subscription Fee

0024c

Emergency Services – Monthly Subscription Fee

0024d

Emergency Services – Monthly Subscription Fee

CPT 99202 – Expanded

CPT 99204 –

Comprehensive

0036 Travel

Option Year II: 12 Months Period

0037 Tele-Health Kiosk for

0038 Annual Maintenance

0039 Emergency Services

0040 Annual Maintenance

0041 Emergency Services –

This CLIN has three optional price scenarios (0006a ~ 0006c) and only one pricing is to be applied to each task order. A determination of the appropriate option will be based on a number of ED beds that the Service Unit chooses to utilize through

0042a

Emergency Services – Monthly Subscription Fee

0042b

Emergency Services – Monthly Subscription Fee

0042c

Emergency Services – Monthly Subscription Fee

0042d

Emergency Services – Monthly Subscription Fee

0054 Travel

Option Year III: 12 Months Period

0055 Tele-Health Kiosk for

0056 Annual Maintenance

0057 Emergency Services

0058 Annual Maintenance

0059 Emergency Services – per number of Beds.

This CLIN has three optional price scenarios (0006a ~ 0006c) and only one pricing is to be applied to each task order. A determination of the appropriate option will be based on a number of ED beds that the Service Unit chooses to utilize through

0060a

Emergency Services – Monthly Subscription Fee

0060b

(Option 2) Emergency Services – Monthly Subscription Fee

0060c

Emergency Services – Monthly Subscription Fee

0060d

Emergency Services – Monthly Subscription Fee

0072 Travel

Option Year IV: 12 Months Period

0073 Tele-Health Kiosk for

0074 Annual Maintenance

0075 Emergency Services

0076 Annual Maintenance

0077 Emergency Services –

This CLIN has three optional price scenarios (0006a ~ 0006c) and only one pricing is to be applied to each task order. A determination of the appropriate option will be based on a number of ED beds that the Service Unit chooses to utilize through

0078a

Emergency Services – Monthly Subscription Fee

0078b

Emergency Services – Monthly Subscription Fee

0078c

Emergency Services – Monthly Subscription Fee

0078d

Emergency Services – Monthly Subscription Fee

0090 Travel

B.3. NUMBER OF HOURS INCURRED

Contractor shall include a time sheet with each invoice showing the number of hours worked. This time sheet shall show the number of hours worked per person and by labor category during the time period invoiced.

B.4. TRAVEL LINE ITEMS

Travel Line items shall be treated as part of the effort for the purposes of this contract and shall be handled in the following manner. The Contractor will notify the COR of the requirement at least 30 business days prior to the scheduled travel. Upon COR’s approval, the Contractor shall prepare a proposal reflecting the actual cost of the items and submit it to the COR within 5 business days. The pricing for the proposal shall be based on the commercial catalog pricing and receipts of the all items over $300 shall be included with the invoice.

The Contractor shall be reimbursed for travel costs in accordance with FAR 31.205-46.

Local. The cost of local travel, meal, and/or incidental expenses cost will not be reimbursed for Contractor performance when involving local travels.

Non-local. In the event that non-local travel is required, the Government will reimburse the cost via appropriate contract line item.

Section C – Description/Specifications/Performance Work Statement

C.1 Index

C.2 Background

C.3 General Requirements C.3.1 Non-Personal Services C.3.2 Business Relations C.3.3 Contract Administration and Management C.3.3.1 Contract Management C.3.3.2 Contract Administration C.3.3.3 Personnel Administration C.3.4 Subcontract Management C.3.5 Contractor Personnel, Disciplines, and Specialties C.3.6 Location and Hours of Work C.3.7 Travel / Temporary Duty (TDY)

C.4 Performance Requirements C.4.1 Telehealth Systems Implementation C4.1.1 Telehealth Equipment C.4.1.2 Electronic Health Record (EHR) System & VPN C.4.1.3 Contractor Staff Credentials C.4.1.4 Clinical Contractor Staff Credentialing & Privileging C.4.1.5 Training C.4.2 Telehealth Systems Maintenance Support C.4.2.1 Speciality Telehealth Clinics Operations C.4.2.2 Tele-Emergency Department Operations C.4.2.3 Helpdesk Support C.4.2.4 Contractor Staff Credentials Maintenance C.4.2.5 Clinical Contractor Staff Credentialing & Privileging Maintenance C.4.2.6 Communication Standard C.4..2.7 Customer Services Standard

C.5 Special Requirements C.5.1 Security and sAfety C.5.2 Reporting C.5.3 Storage and Disposition of Materials C.5.4 Correspondence and Conference Calls

C.6 Deliverables C.6.1 Deliverables Schedule

(Appendix A) Site Emergency Department Description and Capabilities (Appendix B) Telehealth Specialty Clinic Sites (Appendix C) Specialty Telehealth Clinics Requirement (Appendix D) IHS System Environment (Appendix E) OCIO Deliverables (Appendix F) Cloud Services Definition and Requirement (Appendix G) Instruction for Task Order Issuance (Appendix H) Past Performance Survey

C.2 Background The Great Plains Area Office of the Indian Health Service (IHS) is charged with providing health care services to the eligible Native American population within North Dakota, South Dakota, Iowa, and Nebraska. In order to achieve IHS' commitment for improving Great Plains Area's health care system to allow better access and efficient spending to patients, the IHS intends to expand the utilization of health care services provided through telehealth services.

C.3.1 General Requirements Under this contract, the Contractor is responsible for the planning, coordination, development, implementation, delivery, and quality assurance of a telehealth solution that will allow IHS patients access to Telehealth Specialty Clinics for defined clinical domains and Scope of Service within their Service Unit, significantly improving access to care by reducing the delay and costs involving patient travel. Specifically, the purpose of this requirement is to acquire a solution for the provision of telehealth in two key areas: emergency services and specialty referrals services including option for provider-to-provider consultations. Tele-emergency services will support the Emergency Departments within the IHS Great Plains facilities (Appendix A). These Telehealth services provided by the contractor will allow the existing GPA ED providers and support staff immediate access to providers specifically trained in emergency medicine. Specialty Clinics will also include behavioral health support.

This section describes the general requirements for this effort. The following sub-sections provide details of various considerations on this effort. The following schedule of tasks and deliverables outlines the requirements necessary to plan, organize, develop, implement, operate, and evaluate the required tele-health services.

C.3.1 Non-Personal Services The Government shall neither supervise contractor employees nor control the method by which the contractor performs the required tasks. Under no circumstances shall the Government assign tasks to, or prepare work schedules for, individual contractor employees. It shall be the responsibility of the contractor to manage its employees and to guard against any actions that are of the nature of personal services, or give the perception of personal services. If the contractor believes that any actions constitute, or are perceived to constitute personal services, it shall be the contractor's responsibility to notify the Contracting Officer (CO) immediately.

C.3.2 Business Relations The contractor shall successfully integrate and coordinate all activity needed to execute the requirement. The contractor is required to provide quality assurance services and effective management of subcontractors. The contractor shall seek to ensure customer satisfaction and professional and ethical behavior of all contractor personnel.

C.3.3 Contract Administration and Management The following subsections specify requirements for contract, management, and personnel administration.

C.3.3.1 Contract Management The contractor shall establish clear organizational lines of authority and responsibility to ensure effective management of the resources assigned to the requirement. The contractor must maintain and ensure continuity of the tele-health operations between the contractor's corporate offices and the Indian Health Service.

C.3.3.2 Contract Administration The contractor shall establish processes and assign appropriate resources to effectively administer the requirement. The contractor shall respond to Government requests for contractual actions in a timely fashion. The contractor shall have a single point of contact between the Government and Contractor personnel assigned to support contracts or task orders. The contractor shall assign work effort and maintain proper and accurate time keeping records of personnel assigned to work on the requirement.

The Contractor will meet with the Contracting Officer Representative (COR) and IHS officials within seven days of the contract award to become acquainted with the IHS staff, review the Performance Work Statement (PWS), discuss timelines and deliverables, and to begin initial planning. The Contractor and COR will hold kick-off meetings at the beginning of each option year of the contract to revisit and make adjustments (if necessary) to the comprehensive action plan, quality assurance plan, communications plan, evaluation plan, and project plan, to discuss ongoing tasks in the PWS, and deliverables for each option year.

C.3.3.3 Personnel Administration The contractor shall maintain the currency of their employees by providing initial and refresher training as required to meet the PWS requirements. The contractor shall make necessary travel arrangements for employees and maintain adequate infrastructure to support contract tasks.

C.3.4 Subcontract Management The contractor shall be responsible for any subcontract management necessary to integrate work performed on this requirement and shall be responsible and accountable for subcontractor performance on this requirement. The prime contractor will manage work distribution to ensure there are no Organizational Conflict of Interest (OCI) considerations. Contractors may add subcontractors to their team after notification to the CO and COR.

C.3.5 Contractor Personnel, Disciplines, and Specialties The contractor shall accomplish the assigned work by employing and utilizing qualified personnel with appropriate combinations of education, training, licensure/certification and experience. The contractor will maintain accreditation for telehealth services by a nationally recognized accreditation organization. The contractor shall ensure the labor categories and labor rates utilized for the performance under the awarded contract will be maintained throughout the performance period.

C.3.6 Location and Hours of Work Accomplishment of the results contained in this PWS requires work at various Government (IHS) facilities. Normal workdays are Monday through Friday except US Federal Holidays. Workers typically work eight (8) hours per day, 40 hours per week.

Flextime workers start not earlier than 0600 and not later than 2100 (Central time zone).

Core hours of work are from 0900 to 1700 daily. All employees and required services are expected to be available during core hours. Emergency Departments operate 24 hours/day, 365 days/year typically and staff expected to be available according to the departmental shift schedule.

The Contractor will be responsible for coordinating the logistics of all training to include but not limited to securing a site (with priority given to Federal facilities) for the trainings, payment of non-federal sites, and on-site and web-based registration services.

The terms used in this PWS, originating site and distant site, are defined as below:

Originating site: An originating site is the location of an eligible IHS beneficiary at the time the service furnished via a telecommunications system occurs.

Distant site: A distant site is the remote location from which a healthcare service is furnished to an eligible IHS beneficiary via a telecommunications system.

C.3.7 Travel / Temporary Duty (TDY) All travel requirements (including plans, agenda, itinerary, or dates) shall be pre-approved by the government (subject to IHS and local policy procedures), and is on a strictly cost reimbursable basis. Costs for travel shall be billed in accordance with the regulatory implementation of Public Law 99-234 and FAR 31.205-46 Travel Costs (subject to IHS and local policy & procedures; may reference FAR).

The Contractor will be responsible for coordinating the logistics of all training to include travel, per diem, lodging of non-federal subject matter expert instructors. Travel for training participants will not be covered under this contract.

C.4 Performance Requirements The Contractor shall provide the necessary personal resources, equipment and infrastructure to manage, perform, and administer the contract throughout the performance period.

The Contractor shall be responsible for establishing and maintaining a Tele-Emergency Department (Tele-ED) program to be deployed across the IHS Emergency Departments within the GPA. Appendix A contains a list of the EDs, staffing, most common diagnoses, and capabilities.

The Contractor shall be responsible for establishing and maintaining Specialty Telehealth Clinics (Appendix C) in the IHS Service Units and Clinics within the GPA. Appendix B contains a list of service sites, most common diagnoses, staffing, and available services.

The following section specifies the Performance Objectives and Performance Elements for the contract.

C.4.1 The Contractor shall implement telehealth systems for health care facilities in the Great Plains Area. This will include Tele-ED deployments (Appendix A) and Specialty Referrals Clinics, including options for provider-to-provider consultations (Appendix B).

C.4.1.1 The Contractor shall determine and provide necessary equipment and software to enable telehealth solutions (not inclusive of the IHS network). This includes, but is not limited all telehealth acquisition modalities and supporting Health Information Technology (HIT) as required by the scope of the Tele-ED and Specialty Telehealth Clinics (see below).

Performance Standards and Acceptable Quality Level (AQL)

1) Timely

a. AQL: Deployment shall occur in accordance with the deliverables schedule in accordance with subsection 4.1 – Deliverables Schedule.

2) Services

a. AQL: All required specialty referrals services shall be provided by the contractor.

3) Space

a. AQL: Contractor shall design and execute the tele-health system implementation based on availability of space at the originating site.

4) Complexity

a. AQL: Telehealth equipment must be easily used by a wide range of staff with minimal training.

b. AQL: At minimum, Tele-ED support equipment shall be composed of remote control enabled monitor, camera, and microphone.

c. AQL: Specialty Referrals Kiosk shall be capable of supporting all of the required

Specialty Telehealth Requirements as listed in Appendix C.

d. AQL: Specialty Telehealth Kiosk shall be mobile and portable.

e. AQL: All medical devices or medical components of devices shall be FDA approved for their intended use.

f. AQL: All video/audio conferencing equipment shall be Cisco/Polycom compatible.

Deliverables A001 Telehealth Equipment Deployment Schedule A002 Catalog of Available Equipment A003 Site Service Needs Report

A004 Training Agenda A005 Mandated OCIO Deliverables **See Appendix E

C.4.1.2 The contractor shall use the IHS Electronic Health Record (EHR) system to maintain accurate and up-to-date information on clinical care provided to patients.

EHR systems are located at each IHS facility and remote access to each EHR system will be enabled through the IHS VPN system. The tele-health services is to be provided via the agency’s existing video and network infrastructure as delineated in the Appendix D, IT System Environment. Cloud services are not to be utilized for this contract, unless, the contractor’s system meets the requirements described under Appendix F, Cloud Services Definition and Requirement.

Performance Standards and AQL

1) Timely

a. AQL: Tele-health solution shall integrate with IHS system environment in accordance with the PWS subsection 4.1 - Deliverables Schedule.

2) Security

a. AQL: Telehealth equipment shall encrypt Personally Identifiable Information (PII) for storage and transmission.

3) Connectivity

a. AQL: Prior to deployment, contractor shall assess network and system connectivity at each originating site for a proper guide service.

B001 Telehealth Deployment Schedule B002 Security Compliance Report B003 Site Connectivity Report

C.4.1.3 Upon contract award, the contractor shall ensure an adequate level of staffing is organized to meet the requirements and all contractor staff’s credentials (e.g., security clearance, computer security training, and degrees and/or certifications, etc.)

are current.

1) Timely

a. AQL: Site and/or Area Credentialing and Privileging Report shall be provided in accordance with the deliverables schedule in accordance with subsection 4.1 – Deliverables Schedule.

2) Security Standard

a. AQL: All contractor staff shall meet the required minimum standards under Title

42 CFR Part 136 Subpart K. and Title 5 CFR 731.

C001 Site and/or Area Credentialing and Privileging Report C002 Fingerprints, eQIP questionnaire and all required accompanying documents

C.4.1.4 Upon contract award, the contractor shall ensure all clinical contractor staff meet requirements for being Credentialed and Privileged in accordance with HHS Regulation and IHS policy. Credentialing and Privileging shall include, but is not limited to: verification of U.S. licensure, board-certification, periodic quality assurance review, and provider database queries, including the National Practitioner Data Bank.

Performance Standards and AQL

1) Credentialing and Privileging

a. AQL: Clinical staff shall be fully credentialed and privileged at each site they practice in.

2) Quality Assurance Reviews

a. AQL: No delinquent Quality Assurance Reviews

3) Credential Standard

a. AQL: All credentials shall be issued by accredited institutions in the United States and subject to Prime Source Verification. The contractor will make available their credentialing policy and procedures for review by IHS after which time IHS may decide to offer or decline privileging by proxy.

D001 Site and/or Area Credentialing and Privileging Report D002 Provider Quality Assurance Reviews

C.4.1.5 The Contractor shall provide adequate level of training to the IHS staff to successfully support the telehealth services at the originating site.

Performance Standards and AQL

1) Timely

a. AQL: Contractor will schedule regular, ongoing training regarding the use and support of the telehealth equipment.

2) Materials

a. AQL: Contractor will develop and/or provide enduring training materials in the form of recorded video or online learning modules in appropriate formats consistent with current technology and accessibility standards.

b. AQL: Contractor will guide and assist with the development of IHS-approved standardized protocols for initiation of Tele-ED services, to include indications and method(s) for initiation.

3) Evaluation

a. AQL: Training plans and materials will be provided at the request of IHS and are subject to review and approval by IHS no less than annually.

E001 Training Agenda & Schedule E002 Training Materials

C.4.2 The Contractor shall support and maintain telehealth systems for IHS (not inclusive of the IHS network) in Great Plains Area.

C.4.2.1 The Contractor shall establish and support specialty referrals clinics (Appendix C) at GPA health care sites (Appendix B). Distant site specialty telehealth providers will evaluate, treat, and follow-up originating site IHS patients facilitated by an originating site Presenter, or will provide consultation services to an originating site IHS provider. Originating site Presenter services will be provided to initiate and conclude each encounter. Upon request of the distant site specialist and/or the originating site IHS patient, the Presenter may depart the encounter but remain available nearby to conclude the encounter upon notification.

Performance Standards and AQL

1) Documentation

a. AQL: Contracted staff will document all patient encounters in the IHS EHR.

b. AQL: Accurate Common Procedural Terminology (CPT) coding shall be documented for all patient encounters.

2) Timely

a. AQL: Contracted staff will provide telehealth clinics at the appointed time agreed upon by the site, during regular business hours, and meeting access to care standards for the visit type.

b. Documentation will be completed within 48 hours of patient contact.

3) Communication

a. AQL: As evidenced by no more than two substantiated complaints from the originating site in any three month period.

4) Best-Practice care

a. AQL: No practice below the level of Best-Practice shall be provided, as determined by chart and/or quality assurance review.

b. AQL: If Specialty Consultant employs mid-level providers, the Specialty Consultant must be directly involved in every medical encounter.

F001 Published Schedule and Contact Information F002 Quarterly CPT Coding Audit Report F003 Monthly and Annual Report of Complaints F004 Chart or Quality Assurance Review Reports

C.4.2.2 The Contractor shall provide real-time tele-emergency support services to the IHS GPA Emergency Departments (see Appendix A) upon request.

Performance Standards and AQL

1) Meets Schedules

a. AQL: Services shall be available 24 hours a day, seven days a week, every day of the year.

2) Timely

a. AQL: Contractor distant site clinical staff will respond within 2 minutes of being summoned by the originating site.

3) Communication

a. AQL: As evidenced by no more than two substantiated complaints for the

4) Best-Practice consultations/recommendations

a. AQL: No consultations/recommendations below the level of Best-Practice shall be provided, as determined by chart and/or quality review.

5) EHR Utilization for Tele-emergency care

a. AQL: All documentation of care shall be completed in the IHS EHR within 24 hours. Care orders will be documented and signed timely during the episode of care and completed/finalized prior to patient disposition. Documentation for patient transfers will be completed with haste and prior to the physical departure of the originating site IHS patient to another care facility.

6) Qualification

a. AQL: Physicians shall be board certified, or eligible, by the American Board of Emergency Medicine, Family Practice, Internal Medicine (with competencies in pediatric emergencies), Pediatrics (with competencies in adult emergencies) or other recognized board.

G001 Published Schedule and Contact Information G002 Monthly and Annual Report of Complaints G003 Chart or Quality Assurance Review Reports

C.4.2.3 The Contractor shall provide helpdesk support for the telehealth equipment, associated software, and other system issues.

Performance Standards and AQL

1) Meets Schedules

a. AQL: Services and equipment are available 24 hours a day, seven days a week, every day of the year.

2) Timely

a. AQL: Contractor staff will respond within 15 minutes of being contacted by the originating site.

3) Communication

a. AQL: As evidenced by no more than two substantiated complaints from the

4) Working Order

a. AQL: Contractor will ensure that all telehealth equipment and any axillary appliances are in working order.

5) Updates

a. AQL: Contractor will keep telehealth equipment up to date, including software security updates, functional updates, and updates that allow for additional clinical services upon request by the originating site.

H001 Published Schedule and Contact Information H002 Monthly or Annual Report of Complaints H003 Report of Provider Complaints regarding telehealth equipment H004 Annual Report of Originating Site Telehealth Satisfaction H005 Annual Equipment Management Report

C.4.2.4 The Contractor shall ensure an adequate level of staffing to meet the requirements and that all contractor staff’s credentials (e.g., security clearance, computer security training, and degrees and/or certifications, etc.) are current and approved within either IHS or nationally recognized accreditation standards

1) Credential continuity maintenance

a. AQL: Contractor staff shall meet all federal, HHS and IHS rules, regulations, and policies regarding security, protected information, etc.

b. AQL: There shall be no lapse involving contract staff security credentials or training.

2) Service availability

a. AQL: Services shall be adequately staffed with required security clearance status at all time.

b. AQL: Immediate action shall be taken to remove unsuitable/ineligible staff from services and replacement of the staff shall be made within 24 hours with appropriately cleared staff.

3) New Credentials

a. AQL: All required documentation required for security clearance process shall be submitted at least 30 days prior to the subject staff’s performance start date.

I001 Report on contractor staff’s security and training status I002 Reports of service lapses.

I003 Fingerprints, eQIP questionnaire and all required accompanying documents

C.4.2.5 The Contractor shall ensure all clinical contractor staff are eligible for Credentialing and Privileging at each site. Credentialing and Privileging may include, but is not limited to: U.S. licensure, board-certification, peer review, and provider database queries.

Performance Standards and AQL

1) Credentialing and Privileging

a. AQL: Clinical staff that are fully credentialed and privileged for each site they practice in.

2) Quality Assurance Reviews

a. AQL: No delinquent Quality Assurance Reviews.

J001 Site and/or Area Credentialing and Privileging Report J002 Provider Peer Reviews

C.4.2.6 The Contractor shall ensure all contractor staff communicate and coordinate effectively and efficiently with the originating site staff.

Performance Standards and AQL

1) Communication

a. AQL: No more than two substantiated complaints related to communication within a year.

2) Adverse Events

a. AQL: No more than one substantiated adverse patient event within a year due to communication errors.

Deliverables K001 Annual Report of Staff Complaints K002 Site-Specific Reports of Adverse Events

C.4.2.7 The Contractor shall ensure all contractor staff are culturally sensitive and appropriate.

Performance Standards and AQL

1) Training Provides evidence of training in cultural sensitivity/competence

a. AQL: All contractor staff shall take one hour of CME/CE training on cultural sensitivity/competence each year.

2) Customer Service

a. AQL: No more than two substantiated complaints from patient or staff related to culture sensitivity/competence within a year

L001 Annual Training Report L002 Annual Report of Patient & Staff Complaints

C.5 Special Requirements This section describes the special requirements for this effort. The following sub-sections provide details of various considerations on this effort.

C.5.1 Security and Safety Contractor staff will be required to follow the procedures for obtaining a full Federal background investigation and preliminary clearance. No 3rd party investigation is allowed. In order to obtain a Personal Identity Verification (PIV) card, contractor staff shall complete and pass a Federal background investigation conducted by the Office of Personnel Management. IHS will process the investigations through the Office of Personnel Management on all contractor staff.

Processing of PIV cards shall be completed by the Great Plains Area HSPD-12/Suitability Office in conjunction with the physical locations throughout IHS and HHS that have PIV card stations. The contractors will be required to be physically present at one of the HSDP-12 enrollment and issuance workstations to obtain a PIV card. Biometric identification is required.

Each contractor shall complete each of the requirements below and receive pre-employment clearance from IHS prior to performing services under this contract:

1) Fingerprints must be captured electronically at a HHS enrollment workstation or via hard-copy card then sent to the Great Plains Area (GPA) for digital processing;

2) The OF-306, Declaration for Federal Employment, shall be completed;

3) The Addendum to the OF-306, shall be completed;

4) eQIP Information request must be turned into the HSPD-12/Suitability Office;

5) The eQIP questionnaire must be fully and accurately submitted; and

6) The contractor must be enrolled for a PIV card at a HHS HSPD-12 enrollment workstation. Upon receipt of the card, the contractor must activate it at a HHS HSPD-12 card issuance workstation.

The Contractor shall ensure that the employees it proposes for work under this contract have a reasonable chance for approval. If at any point during the investigation process a contractor staff is deemed ineligible or found to have other than favorable suitability, the individual must be removed from providing services under this contract.

The Government may investigate personnel at no cost to the Contractor. However, multiple investigations for the same position due to contractor personnel’s employment change, termination or consequent re-investigations within one (1) year period, will lead to the reduction in the contract price of no more than the cost of the additional investigation.

C.5.2 Reporting The contractor shall follow the reporting plan submitted as part of the proposal and keep the Government fully informed of status throughout the contract period.

Throughout the contract periods, it is essential that attention be given to minimize interruptions or delays to work in progress that would impact the mission. All reports generated under the scope of the contract shall be Section 508 compliant.

The Contractor shall provide status reports to the COR to include:

Tele-ED:

Number of consultations by site

Date and Time of consultations

Level of involvement (second opinion/consultation, providing direction, issuing orders, overseeing/assisting with procedure(s), total management in the presence of another provider (non-ED trained physician, physician assistant, nurse practitioner)

Acuity of all patients seen

Dispositions of all patients

Compliance with EMTALA regulations

Types of Contractor providers involved in care

Any official complaints

Any adverse outcomes

Telehealth Specialty Clinics:

Number of patients seen o By clinic o By site

Number of patients referred back to the referral source for continued care

Number of patients requiring continued referral care via telehealth

Number of patients requiring additional unique referrals to other specialists

Any official complaints

Any adverse outcomes

The Contractor shall provide to the COR, annual performance reports that include but are not limited to project plan status and accomplishments, fiscal accountability, evaluation data, sub-Contractor performance reports (if applicable) and a Contractor self-evaluation report. The Contractor shall provide a written outline of the annual report to the COR for approval according to the deliverable schedule. The annual reports shall be delivered by e-mail and postal service according to the deliverable schedule before the end of the contract period. The annual report shall be discussed at the kick-off meeting.

C.5.3 Storage and Disposition of Materials Disposition of any national training and marketing materials will be determined in the kick-off meeting. Storage should be available as soon as national materials are generated. A disposition schedule will be discussed with the COR during the kick-off meeting.

C.5.4 Correspondence and Conference Calls The Contractor shall provide weekly updates and correspondence as determined necessary by the COR or GPA CMO. The weekly conference call schedule may be adjusted as determined by the COR.

C.6 Deliverables The contractor shall provide deliverables as described in subsequent task orders.

Deliverables shall be specified by the Government.

C.6.1 Deliverables Schedule

Deadline Deliverable Schedule for Contract Base Year

Monthly Deliverables

Section C.4.1.2 B002 Security Compliance Report

Section C.4.2.1 F001 Published Schedule and Contact Information F002 Monthly and Annual Report of Complaints

Section C.4.2.2 G001 Published Schedule and Contact Information G002 Monthly or Annual Report of Complaints G003 Chart or Quality Assurance Review Reports

Section C.4.2.3 H001 Published Schedule and Contact Information H002 Monthly or Annual Report of Complaints H003 Report of Provider Complaints regarding telehealth equipment

Section C.4.2.4 I001 Report on contractor staff’s security and training status I002 Reports of service lapses

Section C.4.2.6 K002 Site-Specific Reports of Adverse Events

Quarterly Deliverables

Section C.4.1.4 D002 Provider Quality Assurance Reviews

Section C.4.2.1 F002 Quarterly CPT Coding Audit Report F003 Chart or Quality Assurance Review Reports

Section C.4.2.5 J002 Provider Quality Assurance Reviews

Biannual Deliverables Section C.4.2.5 J001 Site and/or Area Credentialing and Privileging Report

Annual Deliverables

Section C.4.2.2 G002 Monthly or Annual Report of Complaints

Section C.4.2.3 H004 Annual Report of Originating Site Telehealth Satisfaction H005 Annual Equipment Management Report

Section C.4.2.6 K001 Annual Report of Staff Complaints

Section C.4.2.7 L001 Annual Training Report L002 Annual Report of Patient & Staff Complaints

Within 7 days of contract execution

Kick-off Meeting

Within 1 month of contract award

Section C.4.1.1 A001 Telehealth Equipment Deployment Schedule A002 Catalog of Available Equipment A003 Site Service Needs Report A004 Training Agenda A005 Mandated OCIO Deliverables **See Appendix E

Section C.4.1.2 B001 Telehealth Deployment Schedule B003 Site Connectivity Report

Section C.4.1.4 D001 Site and/or Area Credentialing and Privileging Report

Within 45 days of contract award

Section C.4.1.3 C001 Site and/or Area Credentialing and Privileging Report C002 Fingerprints, eQIP questionnaire and all required accompanying documents

Section C.4.1.5 E001 Training Agenda & Schedule E002 Training Materials

2 months after award

Initiate training at all sites for Tele-emergency and Tele-specialty consultation

3 months after award Initiate services at all sites for Tele-emergency and Tele-specialty consultation

SECTION G – CONTRACT ADMINISTRATION DATA

G.1. AUTHORITIES OF GOVERNMENT PERSONNEL

Notwithstanding the Contractor’s responsibility for total management during the performance of this contract, the administration of the contract will require coordination between the Government and the Contractor. The following individuals will be the Government’s points of contact during performance of the contract.

G.1.1 Contracting Officer (CO) All contractual actions shall be authorized by:

Stephen Yuter, Head of the Contracting Activity Indian Health Service, HQ Division of Acquisition Policy 5600 Fishers Lane, Mail Stop 09E70 Rockville, MD 20857 Phone: (301)443-5774 Email: stephen.yuter@ihs.gov

G.1.2 Contract Specialist (CS)

Paul Premoe Phone: (301)443-5774 Email: paul.premoe@ihs.gov

G.1.3 Contracting Officer's Technical Representative (COR) To Be Disclosed Upon Award

G.1.4 Technical Monitoring

a) Performance of work under this contract must be subject to the technical direction of the COR identified above, or a representative designated in writing. The term “technical direction” includes, without limitation, direction to the contractor that directs or redirects the labor effort, shifts the work between work areas or locations, fills in details and otherwise serves to ensure that tasks outlined in the work statement are accomplished satisfactorily.

(b) Technical direction must be within the scope of the specification(s)/work statement.

The Contracting Officers’ Representative does not have authority to issue technical direction that:

(1) Constitutes a change of assignment or additional work outside the specification(s)/performance work statement;

(2) Constitutes a change as defined in the clause entitled “Changes”;

(3) In any manner causes an increase or decrease in the contract price, or the time required for contract performance;

(4) Changes any of the terms, conditions, or specification(s)/work statement of the contract;

mailto:paul.premoe@ihs.gov

(5) Interferes with the contractor's right to perform under the terms and conditions of the contract; or

(6) Directs, supervises or otherwise controls the actions of the contractor's employees.

(c) Technical direction may be oral or in writing. The Contracting Officers’ Representative shall confirm oral direction in writing within five work days, with a copy to the Contracting Officer.

(d) The contractor shall proceed promptly with performance resulting from the technical direction issued by the Contracting Officers’ Representative. If, in the opinion of the contractor, any direction of the Contracting Officers’ Representative, or his/her designee, falls within the limitations in (b), above, the contractor shall immediately notify the Contracting Officer no later than the beginning of the next Government work day.

(e) Failure of the contractor and the Contracting Officer to agree that technical direction is within the scope of the contract shall be subject to the terms of the clause entitled “Disputes.”

G.2. INVOICE SUBMISSION

The Contractor shall submit invoices once per month. A complete invoice with all required back-up documentation shall be sent electronically, via email, to:

1. Contract Specialist: paul.premoe@ihs.gov

2. Contracting Officer’s Representative (COR):To be Disclosed Upon Award

3. Office of Finance and Accounting (OFA): TBD

* No other non-invoice related documents (i.e. deliverables, reports, balance statements) shall be sent to the CS or [TBD]. Failure to submit directly to the offices listed above will delay prompt payment of your invoice.

For invoices submitted by email: the subject line of your email invoice submission shall contain the contractor name, contract/ task order number, and invoice number (e.g.

Company Name, Contract HHSIXXXXX, Invoice #123). The Contractor shall send one email per contract/order per month. The email may have multiple invoices for the contract. Invoices must be in one of the following formats: PDF, TIFF, or Word. No Excel formats will be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word).

Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on each invoice. For additional information about the Dun & Bradstreet (D&B) DUNS number, please visit http://fedgov.dnb.com/webform.

Invoices shall be submitted in accordance with the contract terms, i.e. payment schedule, progress payments, partial payments, deliverables, etc.

http://fedgov.dnb.com/webform

All information set forth in FAR Clause 52.212-4(g), Invoice, must be included in all invoices for it to constitute a proper invoice.

FAR 52.212-4(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, contract line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi)Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—Central Contractor Registration, or 52.232-34, Payment by Electronic Funds Transfer—Other Than Central Contractor Registration), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as “Small Business.”

https://www.acquisition.gov/far/current/html/52_232.html#wp1153351 https://www.acquisition.gov/far/current/html/52_232.html#wp1153375 http://uscode.house.gov/uscode-cgi/fastweb.exe?getdoc+uscview+t29t32+1665+30++%2831%29%20%20AND%20%28%2831%29%20ADJ%20USC%29%3ACITE%20%20%20%20%20%20%20%20%20

Additionally, in accordance with OMB Memorandum, M-12-16, all prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner. To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors. Consistent with OMB Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation. In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this order will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution information to the Finance Office designated above in accordance with FAR 52.232-33 Payment by Electronic Funds Transfer – Central Contractor Registration.

G.3. PAYMENT BY ELECTRONIC FUNDS TRANSFER

Pursuant to FAR 52.232-33, Payment by Electronic Funds Transfer –Central Contractor Registration, payments under this contract shall be made by electronic funds transfer. The Contractor shall register in the Central Contractor Registration database.

G.4 HHSAR 352.237-75 KEY PERSONNEL (DEC 2015)

The key personnel specified in this contract are considered to be essential to work performance. At least 30 days prior to the contractor voluntarily diverting any of the specified individuals to other programs or contracts the Contractor shall notify the

Contracting Officer and shall submit a justification for the diversion or replacement and a request to replace the individual. The request must identify the proposed replacement and provide an explanation of how the replacement's skills, experience, and credentials meet or exceed the requirements of the contract (including, when applicable, Human Subjects

Testing requirements). If the employee of the contractor is terminated for cause or separates from the contractor voluntarily with less than thirty days’ notice, the Contractor shall provide the maximum notice practicable under the circumstances. The Contractor shall not divert, replace, or announce any such change to key personnel without the written consent of the Contracting Officer. The contract will be modified to add or delete key personnel as necessary to reflect the agreement of the parties.

It is up to the contractor to decide and propose key personnel to provide the performance under this contract. However, at minimum, the following labor categories shall be proposed as key personnel: Chief Medical Officer (CMO), Project Manager / Specialty Referrals Clinics, Project Manager / Tele-Emergency Departments, Chief Nurse, and Chief of IT. These required key personnel shall possess the years of experience as specified in below table.

Title Required Years of

Experience

Chief Medical Officer (CMO) 10 years as a physician & 2 years as

CMO

Project Manager / Specialty Referrals Clinics 3 years of Managing Telehealth Project(s)

Project Manager / Tele-Emergency Departments 3 years of Managing Telehealth Project(s)

Chief Nurse 10 years as a nurse & 2 years as Chief Nurse

Chief of IT 5 Years of Managing Relevant IT Environment

Other Key Personnel are to be proposed by the contractor.

(End of clause)

G.5. DATA TO BE DELIVERED

Any working papers, interim reports, data given by the government or first produced by the contractor under the contract or collected or otherwise obtained by the contractor under the contract, or results obtained or developed by the contractor (subcontractor or consultants) pursuant to the fulfillment of this contract are to be delivered, documented, and formatted as directed by the COR.

In addition, information and data, which are held by the contractor related to the operation of their business and/or institution and which are obtained without the use of federal funds, shall be considered “PROPRIETARY DATA” and are not “subject data” to be delivered under this task order.

G.6. GOVERNMENT FURNISHED INFORMATION

The Government will provide necessary background information, applicable rules and regulations, and all applicable HHS guidelines and policies. This information will be supplied by the COR upon award.

G.7. RIGHTS IN DATA

The Contractor shall be prohibited from publicizing or disseminating information without prior written approval of the Contracting Officer’s Technical Representative (COR).

SECTION H– SPECIAL CONTRACT REQUIREMENTS

H.1. ORGANIZATIONAL CONFLICT OF INTEREST AND CONFIDENTIALITY

In order to avoid any organizational conflict of interest, the contractor…