RFP-18-241-SOL-00002_FellowshipH-PineRidgeSD.pdf

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

Aberdeen SD 57401 115 Fourth Ave, SE Federal Building Aberdeen Area Indian Health Servic

CODE 16. ADMINISTERED BYCODE

X

X

621111

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR159

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

11/30/2017 1700 ET

10/26/2017

605-685-2880 x 2813LINDA SUESS (No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

18-241-SOL-00002

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

Aberdeen SD 57401 115 Fourth Ave, SE Federal Building

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$11.00

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)

Aberdeen Area Indian Health Servic

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.

The Great Plains Area Indian Health Service is requesting responses to this Request for Proposal for a Hospitalist from a University Fellowship or Medical School Program to provide non-personal healthcare services at Pine Ridge IHS Healthcare facility in Pine Ridge, South Dakota.

The Great Plains Area-IHS anticipates awarding a Firm Fixed Price, Indefinite Delivery/Indefinite Quantity (ID/IQ), a non-personal service type of contract from this solicitation.

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

HEREIN, IS ACCEPTED AS TO ITEMS:

X

DATED

CRAIG J. WELLS

. 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. ADDENDA

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.

The contract is for one (1) base year from

February 1, 2018 through January 31, 2019 with four (4)- one (1) year options in a twelve (12) month period. The Indian Health Service reserves the discretionary authority to exercise any one of the four (4) option years.

IHS intends to award an Indefinite Delivery -

Indefinite Quantity (ID/IQ) contract or

(contracts), where Individual Task Orders will be issued for performance of this contract. For details please refer to the attached clauses in full text; FAR 52.216-18, FAR 52.216-19, and FAR

52.216-21.

Period of Performance: 02/01/2018 to 01/31/2019

1 See attached Bid Schedule

The Unit Price is an all inclusive cost. All inclusive cost is defined to include travel, lodging, per diem, fringe benefits, i.e., life insurance, social security, federal, state, and local taxes, plus all other costs pertinent to the performance of this Contract.

Contractor will need a DUNS number, TIN number and be registered with the System for Award

Management at www.SAM.gov

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

2 2 of

SECTION B

IHS Service Unit Description Quantity Unit of Issue Unit Price Total Cost 1 Pine Ridge Service Unit University Fellowship for Hospitalist Services 12 Month Base Yr: 2‐1‐18 to 1‐31‐19

2 Pine Ridge Service Unit University Fellowship for Hospitalist Services 12 Month Opt. Yr.1: 2‐1‐19 to 1‐31‐20

3 Pine Ridge Service Unit University Fellowship for Hospitalist Services 12 Month Opt. Yr.2: 2‐1‐20 to 1‐31‐21

4 Pine Ridge Service Unit University Fellowship for Hospitalist Services 12 Month Opt. Yr.3: 2‐1‐21 to 1‐31‐22

5 Pine Ridge Service Unit University Fellowship for Hospitalist Services 12 Month Opt. Yr.4: 2‐1‐22 to 1‐31‐23

Subtotal Cost Schedule Option Year Three (3) ‐ Pine Ridge IHS =

Subtotal Cost Schedule A Option Year Four (4) ‐ Pine Ridge IHS =

Total Cost Schedule for Base Year and all Option Years ‐ Pine Ridge IHS =

Bid Schedule ‐ Pine Ridge IHS Hospital, SD

RFP‐18‐241‐SOL‐0002 ‐ University Fellowship for a Hospitalist at Pine Ridge, SD

Subtotal Cost Schedule Base Year ‐ Pine Ridge IHS =

Subtotal Cost Schedule Option Year One (1) ‐ Pine Ridge IHS =

Subtotal Cost Schedule Option Year Two (2) ‐ Pine Ridge IHS =

Section B Solicitation No.: RFP‐18‐241‐SOL‐00002 Great Plains Area IHS – University Fellowship for Hospitalist Services, Pine Ridge, SD

SECTION B – PRODUCTS OR SERVICES AND PRICES/COST

B.1. TYPE OF CONTRACT (FAR 52.216‐1 (APR 1984))

The Great Plains Area ‐ Indian Health Service (IHS) is requesting proposals in accordance with the Request for Proposal to provide professional Health Care Services through the University Fellowship or similar health care program. The fellow or Hospitalist will be required to provide services at the Pine Ridge Indian Health Service Healthcare facility in Pine Ridge, South Dakota.

The Great Plains Area ‐ IHS anticipates awarding a non‐personal service type, Firm Fixed Price, Indefinite Delivery/Indefinite Quantity (ID/IQ), service type of contract from this solicitation. The contract is for one (1) base year from February 1, 2018 through January 31, 2019 with four (4) – one (1) year options in a twelve (12) month period. One or more contracts may be awarded.

The Indian Health Service reserves the discretionary authority to exercise any one of the options.

B.2. CONSIDERATION AND PAYMENT

The Contractor shall provide the commercial services described in Section C, Description/ Specifications/Work Statement. Except as otherwise specified in the contract, the Contractor shall furnish the necessary personnel, materials, services, facilities, and otherwise provide all tasks necessary for or incident to the performance of the work set forth herein.

The Contractor shall be paid upon submission of an invoice and completion and acceptance (if deliverable) or verification (if service) by the Point of Contact at the location where the Task Order has been issued on behalf of or where the services have been rendered, of the deliverables and/or services clause 52.232‐25, Prompt Payment, and Section G.2 of this contract.

This is a Full and Open (Unrestricted) competitive solicitation and the offer your firm submits will be used by the Indian Health Service to determine, which offer is the “Best Value” to the government. Be advised that the quantities listed within are, “estimates only” and it is not the intent of IHS to be obligated to order the “maximum quantities”.

B.3. CONTRACT PRICE

a. Upon delivery and acceptance of the item(s) specified in the Delivery Article in Section F of this contract, the Government shall pay to the Contractor resulting from the firm‐fixed price cost.

b. Upon delivery and acceptance of the services described in the Statement of Work of this contract and identified in the schedule of charges below, the Government shall pay to the Contractor the total prices set forth below and will be paid from the following Contract Line Item Numbers (CLINs) accordingly:

BASE PERIOD PLUS FOUR (4) OPTION YEARS TOTAL ($)

BASE PERIOD: 2/1/2018 through 1/31/2019 TBD OPTION YEAR ONE: 2/1/2019 through 1/31/2020 TBD OPTION YEAR TWO: 2/1/2020 through 1/31/2021 TBD OPTION YEAR THREE: 2/1/2021 through 1/31/2022 TBD OPTION YEAR FOUR: 2/1/2022 through 1/31/2023 TBD

Total Cost for Base Period plus Four Options = TBD

Section B Solicitation No.: RFP‐18‐241‐SOL‐00002

B.4. OPTION PRICES

a. Unless the Government exercises its option pursuant to the option clause referenced in Contract Clauses section of this contract consists only of the Base Period specified in this contract.

b. Pursuant to FAR Clause 52.217‐8, Option to Extend Services and FAR Clause 52.217‐9, Option to Extend the Term of the Contract, set forth in Contract Clauses of this contract, the Government may, by unilateral contract modification, require the Contract to perform the Option Period (s) as defined in the Statement of Work of this contract. If the Government exercises this/these option (s), notice must be given before the expiration date of the contract.

c. Upon the delivery and acceptance of the Option Services described in the Statement of Work of the contract and identified in the bid schedule. The Government shall pay the Contractor the unit price (s) set in the bid schedule and will be paid from the Contract Line Item Numbers (CLINs) accordingly.

d. If the Government exercises its option pursuant to the Option Provision of this contract, the Government’s total estimated contract amount, represented by the sum of the price of base plus option periods as set forth the bud schedule.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

Hospitalist / Adult Medicine On‐Call /Clinic Physician Pine Ridge IHS Service Unit, Great Plains Area Indian Health Service

C.1 General:

The Statement of Work (SOW) describes the requirements of Professional Health Care Services for the Great Plains Area Indian Health Service (GPAIHS) at the Pine Ridge IHS Service Unit in Pine Ridge, South Dakota. The Contractor shall provide professional Health Care Services through the University Fellowship or similar health care program. This Statement of Work (SOW) describes the requirements for non‐personal professional health care services to support the mission of Indian Health Service (IHS).

C.2 Background:

Agency: The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. The mission of IHS is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level and assure that comprehensive, culturally acceptable personal and public health services are available and accessible to members of the 567 federally recognized Tribes across the United States.

There is a nationwide shortage of medical providers in certain specialties, which is amplified by the remote and rural areas served by the Indian Health Service (IHS). This Statement of Work (SOW) covers requirements for the Pine Ridge Indian Health Service that could be affected by establishment of a fellowship relationship with a University or Medical School Program.

The Great Plains Area: The Great Plains Area Office in Aberdeen, South Dakota, works in conjunction with its 19 IHS Service Units and Tribal Managed Service Units to provide health care to approximately 130,100 Native Americans located in North Dakota, South Dakota, Nebraska, and Iowa. The GPAO Service Units include seven hospitals, eight health centers, and several smaller health stations and satellite clinics. Each facility incorporates a comprehensive health care delivery system. The hospitals, health centers, and satellite clinics provide inpatient and outpatient care and conduct preventive and curative clinics.

C.3 Purpose:

The Intent of this Non‐Personal Services Contract is to acquire a Hospitalist through a Fellowship Program from a University or Medical School Program to provide Inpatient and Outpatient healthcare services. A Fellowship is formal, full‐time training program that focuses on a particular area within the specialty, with requirements beyond the related residency. A fellowship is the period of medical training in the United States and Canada that a physician may undertake after completing a specialty training (residency). The training programs for these fields are known as fellowships and their participants are fellows, to denote that they already have completed a residency and are board eligible or board certified in their basic specialty. The Fellow/Hospitalist will be placed at the Pine Ridge IHS Hospital in Pine Ridge, South Dakota.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

The primary purpose of this non‐personal service contract position is to provide direct patient care. The mission of the Pine Ridge IHS Hospital, Pine Ridge Service Unit, Great Plains Area Indian Health Service is to provide the best possible health care services to the Native American people on the Oglala Lakota (Sioux) Indian Reservation in South Dakota.

Many of the I H S patients receiving services may only speak a native language and/or reside on a Native American Reservation, therefore, they must demonstrate sensitivity to cross‐cultural and language differences.

To meet the mission, the Pine Ridge Hospital requires contracting support to assist the service unit in the recruitment of one‐(1) in‐patient adult medicine physician with alternating complimentary work shifts functioning as hospitalists for one or two weeks. These contract hospitalists are likely to be expected to perform scheduled rotating shifts involving day adult medicine. Contracting support will hereafter be referred to as the Contractor. The care and prevention activities shall be as comprehensive as our service unit permits.

The Contractor is responsible for providing medically qualified physicians whom provide direct patient care meeting the requirements in the Statement of Work section of this document and adhering to the policies and procedures of the Pine Ridge Indian Health Service Hospital.

The contract resulting from this solicitation shall:

Be a non‐personal health care service contract under which the Contractor is under the administrative supervision of the Pine Ridge Indian Health Service Hospital’s Medical Director, or the Contract Officer Representative (COR).

Allow the government to evaluate the quality of professional and administrative services provided.

C.4 Government Furnished Property, Facilities, and Services:

The Hospital shall provide a patient examination area and all medical and non‐medical equipment and supplies used in the Indian Health Service facility for the care and maintenance of patients.

The Hospital shall provide an on‐going 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. Methodology involves peer review on patient charting, peer evaluations, support personnel evaluations, documented complaints, incident reports, and monitors performed by Performance Improvement (PI) processes.

The Contractor shall be provided with an orientation to the Indian Health Service and the Indian Community being served. The Service Unit/Hospital personnel shall provide the initial orientation and continuing orientation.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

C.5 Contractor Furnished Property, Facilities and Services:

The Government does not anticipate any required Contractor furnished property, facilities, or services for the duration of this contract.

C.6 Statement of Work:

The primary function of the adult medicine Physician (MD or DO) Hospitalist shall include the following:

The specific needs for a MD as described in this statement of work is being dictated by the recommendations of accreditation bodies such as the Center for Medicare & Medicaid services (CMS) or the Joint Commission in combination with the ultimate decisions by the Pine Ridge IHS Hospital Governing Body.

The contract Providers will not serve in permanent or temporary administrative positions for the IHS without direct agreement between the Rural Health Leadership faculty team and the IHS area administration in each case.

The Service unit will provide a protected half‐day per week from the clinical work for administrative, educational, and community‐centered activities. The provider(s) will be available to make up this time on a weekend day.

The contract Hospitalists shall be fingerprinted prior to arrival to Pine Ridge IHS hospital in order to be cleared as a background check and cannot see patients until their fingerprints clear.

The provider will not be allowed to see patients until the provider is cleared and will not be paid during this time. The agency will be responsible for any additional cost caused by the delay.

All required credential documentation shall be provided to the Pine Ridge credentialing office a minimum of fourteen‐14 days before an MD can start treating patients. IF any required credentialing documents have not been provided to the Pine Ridge credentialing office the terms of this contract will not have been satisfied. Please see the Credentialing Section sited below in this statement of work. This list sites all required documentation required to meet the credentialing requirements of this contract.

The provider shall have the Flu and H1N1 vaccinations.

**All Medicare B and other insurance provider enrollment documentation submitted to the contracted provider by Pine Ridge IHS Hospital credential and business office personnel SHALL BE completed by the Hospitalist to the satisfaction of the Pine Ridge IHS billing department. Initial contract Physician’s hospital orientation list is required to be signed off by the business office for insurance enrollment confirmation. NO INITIAL TIME SHEETS OR

INVOICES WILL BE APPROVED AND PROCESSED UNTIL THE RESPECTIVE PROVIDER HAS

COMPLETED ALL INSURANCE FORM DOCUMENTATION. The deciding authority for provider enrollment insurance documents will be the supervisor, or acting, of the business department.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

**All patient health record documentation initiated by the contract MD from patient encounters SHALL BE completed to the satisfaction of the supervisor, or designee, of the HIM (Health Information Management) Department & Business office supervisor or designee. The approving authority of the contract provider’s time sheets will NOT sign off on the final time sheets unless the provider has successfully completed all required patient medical encounter documentation (medical records). Further, if the provider has delinquent medical records as determined by the supervisor, or designee, of the HIM department, the approving authority will NOT sign off on any time sheets or process any invoices generated from “unauthorized” time sheet signatures. This is a condition of the Statement of Work

(SOW).

Time sheets SHALL BE signed by the 8AM‐5PM clinical director or Contract Officer Representative (COR). No invoices will be processed unless properly signed time sheets have been provided to the Pine Ridge Administrative officer monitoring and overseeing this contract and its invoices. A record must be maintained in order to follow the budget of the contract.

The contracting company shall provide one‐(1) Adult Medicine allopathic (MD) or osteopathic (DO) physicians functioning as an Adult Medicine In‐Patient Hospitalist on an alternating rotational seven‐(7) day to fourteen‐(14) day work week schedule as described below for the entire duration of the contracted period. Each contracted adult medicine physician shall be referred as “Hospitalist” here after for the purposes of this Statement of Work (SOW) document.

***The rotation of this one‐(1) contract hospitalist may be incorporated into a rotating hospitalist schedule that may include one‐(1) permanent full time Indian Health Services (IHS) Internal medicine hospitalist physician. In this scenario, the contract hospitalist will alternate rotations with the permanent IHS hospitalist. i.e., this schedule could result in 2 (two) weeks with the IHS physician functioning as the hospitalist, the subsequent two weeks the contract hospitalist will perform duties as the hospitalist.

The primary function of the adult medicine Physician (MD or DO) Hospitalist shall include the following:

Hospitalist shall work a twelve‐(12) hour daily shift physically based on the in‐patient ward (ACN).

These twelve‐(12) hour daily shifts shall be scheduled for a period of time ranging between seven‐

(7) to fourteen‐(14) consecutive days. Scheduling shall be based on the contracting company but shall not extend greater than 14 consecutive days for the safety of the provider and their patients.

The Hospitalist on occasion may need to work for short periods of time beyond their respective shift hours, at times when such extra time is necessary to finish a patient care, admission, inter‐ hospital transfer, or hospitalist change of shift transfer of care. The Hospitalist will work under the direct supervision of the Pine Ridge IHS Hospital Clinical Director, or designee.

The Hospitalist may need to remain a short time after their seven‐(7) to fourteen‐(14) day work schedule in order to complete outstanding medical recording documentation. This time will be billable.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

The Hospitalist shall remain physically with the confines of the hospital at all times during their twelve‐(12) hour duty shifts. Responsibilities include providing direct patient medical care to adult medicine patients currently admitted on the in‐patient ward facility (ACN), admitting adult medicine patients to the ACN, discharging adult medicine patients from the ACN, accepting as well as performing inter‐hospital transfers, being “on‐call” to the Pine Ridge IHS Hospital and other Pine Ridge IHS hospital outpatient clinics for adult medicine consultations which includes the responsibility of performing the admission orders, and history and physical. The hospitalist shall attend discharge planning every day.

*The Hospitalist may be on call to other Departments to evaluate and treat adult medicine patients if other physicians becomes overwhelmed with patient care creating a scenario in which the safety of waiting or triaged ED patients becomes in question. The decision to call the Hospitalist is determined by the attending physician’s assessment of the current situation and potential safety hazard to the waiting triaged ED patients. The Hospitals will under no circumstances be expected to function as an Emergency Department physician and will only perform medical evaluations and treatments he/she is trained, experienced, and credentialed.

The Hospitalist will provide physician consultation to Outpatient/Improve Patient Care (IPC) providers involved with evaluating and treating patients in the adult medicine clinic.

The Hospitalist will provide diagnostic, preventive, and therapeutic health services to patients and family members within the Pine Ridge IHS Hospital’s Acute Care Nursing ward, and Adult Medicine Outpatient clinic. The Hospitalist may be consulted to outpatient specialty clinics in cases where the specialist provider feels a need to initiate a same day adult medicine consultation. This may simply involve an exchange of information over the telephone or having the need for the Hospitalist to physically present to the respective specialty clinic for consultation. This consultation may merely require information from the Hospitalist to the consulting provider to act upon, or the Hospitalist to admit the patient or even transfer the patient to the ED. Specialty clinics can be but not limited to the Dental, Optometry, Women’s Health (in collaboration with the OB/GYN physician), Podiatry, Diabetic, Ophthalmology, ENT, PT, and Orthopedic clinics.

This Hospitalist shall perform all In‐Patient medical documentation and Out‐Patient clinic consults in Pine Ridge IHS Hospital’s Electronic Health records (EHR). Opportunity shall be provided to receive EHR orientation and practice with the EHR Clinical Application Coordinator (CAC). Complete and properly documentation must be annotated in the patient’s EHR medical record chart. All medical records must meet acceptable standards as determined by the hospital’s Performance Improvement (PI) department and the Health Information Management (HIM) Department. All Hospitalists are expected to complete all EHR patient encounter notes, Purposes of Visits (POV) and medical levels on every patient and in a timely manner. Medical records personnel will monitor any deficiencies and inform the Hospitalist and Clinical Director or designee. Medical record deficiencies can seriously impact the ability of the hospital to bill alternate resources. Therefore, any significant medical deficiencies may prevent processing of final purchase orders. If this situation occurs the Area Office contracting office and contracting company shall be promptly notified in order to quickly rectify.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

The Hospitalist’s medical records will be reviewed to determine if the Hospitalist is providing acceptable medical care. This care will be in the form of Utilization Review and in the form of peer review. The Hospitalist shall secure a thorough health history from the patient or family member and record findings. Physical examination shall be performed which is consist with the patient’s presenting complaints and/or presenting signs and symptoms. Appropriate diagnostic testing shall be ordered, reviewed, interpreted, and acted upon to address and treat the patients’ complaints, signs, symptoms, and in the patient’s best medical interests. The Hospitalist will discriminate between normal and abnormal findings to recognize early stages of serious physical, emotional, or mental problems. The Hospitalist will make decisions with available physicians, surgeons, or specialists that may be available concerning medical care needs of patients. The Hospitalist will consult available in‐house medical services when indicated and available. If consulting services are not available in‐house the Hospitalist will perform diagnostic and therapeutic consultations with surrounding health care facilities.

Chronic pain patients presenting to the Hospitalist will be assessed for new specific chief complaints or general health evaluations and assessments. Any treatment involving chronic pain issues, including controlled substances, shall be referred to the Chronic Pain Medical Management Team (CPMMT) for assessment and recommendations. All patients currently holding signed pain contracts shall be honored as the contract has dictated. The Hospitalist will abide to the agreements of all signed and current (less than one year old) chronic pain contracts.

Chronic pain contracts are to be respected.

Participates with other health professionals and agencies involved in providing health care and services required to include immunization and disease control, environmental health and health education.

Evaluates the medical aspects of treatment plans, periodically recognizing the need for reassessment by a physician or other health professional.

Provides medical care and preventive services to healthy individuals, including guidance in nutrition, common illnesses, and accidents.

Evaluates total health care needs of patients and develops or initiates plans to meet these needs.

Maintains records and reports on patients, personal activities and other required information for use in program operation, quality control and other purposes. All medical record information generated in the performance of this contract will remain the property and subject to the exclusive control of the Indian Health Service.

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

The Hospitalist shall meet all applicable Joint Commission and Centers for Medicare/Medicaid Services (CMS) standards during the performance of this contract, and must be in compliance with the Service Unit’s Medical Staff Bylaws.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

This individual must be eligible for enrollment in the service unit’s Medicare part B program, so as to enable the hospital to bill for the Hospitalist’s services.

The Hospitalist shall respect and maintain the basic rights of patients, to include but not be limited to personal dignity.

The contractor will be required to utilize facility EHR (Electronic Health Record) for all patient encounter documentation. Experience is highly recommended. The contractor shall type all their notes and complete all documentation required by the Health Information Management department (HIM). This includes completing all coding and purpose of visit diagnoses.

This individual must be eligible for enrollment in the service unit’s Medicare part B program, so as to enable the hospital to bill for the Hospitalist’s services.

The Hospitalist shall respect and maintain the basic rights of patients, to include but not be limited to personal dignity.

C.7 EHR/Health Records:

The contractor will be required to utilize the facility Electronic Health Record (EHR) for all patient encounter documentation. Experience is highly recommended. The contractor shall type all their notes and complete all documentation required by the Health Information management department (HIM). This includes completing all coding and purpose of visit diagnoses.

** All patient health record documentation initiated by the contract Hospitalist from patient encounters SHALL BE completed to the satisfaction of the supervisor, or designee, of the Health Information Management department & Business Office supervisor or designee. The approving authority of the contractor’s timesheets will not sign off on the timesheets unless the provider has successfully completed all required patient medical encounter documentation (health records). Further, if the contractor has delinquent health records as determined by the supervisor or designee, of the HIM department, the approving authority will NOT sign off on any time sheets or process any invoices generated from “unauthorized” time sheet signatures. This is a condition of the SOW.

C.8 Knowledge Required:

Skill and knowledge of established concepts, principles, and practices related to health care assignments requiring training equivalent to a Medical Doctorate or Osteopathic Doctorate degree and successful completion of an Internal Medicine residency.

Board Certification in Internal Medicine, or Board Eligible if recently graduated from an accredited Internal Medicine residency program within the past four‐(4) years.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

Ability to collect, organize, record and communicate, in a meaningful way, data relevant to primary health assessments including detailed family and medical history, physical examinations and selective laboratory tests in order to evaluate and treat adult medicine patients on an inpatient ward facility.

Able to identify medical conditions that warrant medical treatment available at the local hospital facility and when to transfer patient to higher level of care hospital facility for indicated medical care. Pine Ridge does not possess an ICU. There are 24/7 OB/GYN and CRNA on‐call services.

There is a general surgeon with surgical privileges on staff. Generally there is limited evening and weekend general surgical on call services, but on call during the normal duty hours. Hospitalist must be comfortable treating diabetes and its complicating manifestations.

Closest higher level of care hospital is 35 minutes away by life flight and 1 hour and 30 minutes by ground ambulance. Transfer weather conditions at times can be inclement precluding air or even ground transfer.

Skill in typing all inpatient and outpatient clinical patient encounter notes.

Ability to assess the physical‐psychosocial health status of patients and family based upon the knowledge of growth and development patterns and health conditions that require medical management.

Knowledge of pharmaceuticals in order to recognize the 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 providing urgent patient care.

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

C.9 Qualifications:

The Hospitalist must be a graduate of an accredited school of allopathic or osteopathic medicine.

The Hospitalist must hold an active, current, and unrestricted state medical license with a medical doctor or doctor of osteopathy degree from any of the 50 United States or the Commonwealth of Puerto Rico.

Must be Board eligible or certified in Internal Medicine (preferred).

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

Internal medicine

Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists.

Internists are skilled in the management of patients who have undifferentiated or multi‐system disease processes. Internists care for hospitalized and ambulatory patients and may play a major role in teaching and research.

Because internal medicine patients are often seriously ill or require complex investigations, internists do much of their work in hospitals.

Must have served as a credentialed full‐time Hospitalist for a minimum of six‐(6) consecutive months without a hiatus of longer than six consecutive weeks, and must have provided a portion of these Hospitalist duties less than three‐(3) months ago unless just recently graduating from Internal Medicine Residency training.

The Hospitalist cannot be under any exclusions or sanctions from the Medicare/ Medicaid programs.

The Hospitalist must fulfill all the requirements for appointment to the Pine Ridge IHS Medical Staff and for the granting of privileges in at Adult Medicine, in accordance with IHS policies and with the Service Unit Medical Staff Bylaws.

The Hospitalist must have, at minimum, current BLS and ACLS certification.

The Contractor must have three‐(3) written letters of recommendation less than one year old from medical providers.

The Contractor must have had a PPD performed and read in the past year. Documentation of PPD is required. If positive, treatment type and dates must be provided along with a statement if applicant is symptomatic or not. If positive PPD and previously symptomatic a chest radiograph is required.

Pine Ridge Indian Health Service hospital policy requires all staff with direct patient contact, be able to provide proof of Tdap (Tetanus, Diphtheria, acellular Pertussis). This includes all permanent employees, volunteers, and contractors (for all contractors in this category, acceptable proof can be in the form of an immunization record or written documentation from a physician). This proof must be provided as part of the application submission process prior to being accepted for a position. Contractor personnel currently serving in a contract position can receive these immunizations from the facility. In addition, all contractors must have a current Basic Life Support (BLS), certificate prior to arrival at Pine Ridge hospital.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

All Civil Service employees, contract staff, temporary employees, students, and volunteers, who work in an IHS health care facility, must receive a seasonal influenza vaccination by October 31 of each year or have on file a valid medical exemption for vaccination signed by a licensed independent practitioner. Commissioned Corps Officers of the United States Public Health Service (PHS) are already required to obtain their annual seasonal influenza immunization (per Manual Circular ‐ Commissioned Corps Personnel ‐ PHS No. 377, Subchapter CC26.1 Instruction 8, PHS Readiness Standards).

1. Individuals with a valid medical exemption for vaccination will be required to wear a mask provided by IHS during the influenza season (November 1 through March 31) and during other periods of increased influenza activity as defined by the Centers for Disease Control and Prevention and/or State public health authorities.

2. All employees, contract staff, temporary employees, students, and volunteers, must be provided access to influenza vaccinations at no charge.

The Contractor shall ensure that services meet the required standard of the specialty provided as defined by professional governing bodies, state, and federal agencies. The Contractor shall retain, privilege/credential, train, and manage, quality health care professionals and ensure that a full spectrum of health care services are provided to beneficiaries which meets the standards of governing bodies, laws and regulations of the Pine Ridge IHS Hospital, South Dakota. The Contractor shall ensure that health care providers perform essentially the same functions, within the scope of acceptable practice for the specific specialty or position, as those required by GPA health care professionals of similar experience and in similar duty assignments.

Policy/Handbooks: the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

IHS Manual – “Health Care Service Standards”

National Practitioner Data Bank Reports

Credentialing and Privileging

Health Information Management and Health Records

Privacy Act of 1974 (5 U.S.C. 552a) as amended

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

C.10 Credential Documentation:

The provider shall have core privileges granted upon verification of all credentialing processes.

The following documents must be returned with the application so that the required verifications can be completed:

__ Clear copy of photo ID (Driver’s License) __ Copies of pre‐professional and professional school degree __ Copies of certificates of completion of post‐graduate training __ Copies of all current licenses (include inactive licenses on application only) __ Copy of current DEA license __ Copy of board certification (certificate or letter) __ Current CV or Resume – employment history in chronological order with months and years (Employment gaps greater than 2 months must be explained) __ Current Medical Malpractice Insurance __ Statement of Health signed by a medical provider attesting to health status __ Immunization record (Tdap vaccination) __ PPD Test (Annually) __ Flu Vaccination record __ Provider signature card (attached form) __ NPI Letter __ Privileges from facility currently on staff or previously staff member privileges (copy) __ Medical Privileges Form (attached) __ Confidentiality statement and release of information (Attached) __ Medical staff bylaws attestation signature form (Attached) __ CME for the past two years __ Current BLS/CPR, ATLS, ACLS, PALS, NRP __ 3 professional references (form attached) * please note the application has space for only 2, Bylaws requirement of 3 references.

__ OF 306 Declaration for Federal Employment __ Addendum to Declaration of Federal Employment (Child care) __ Provider Fact Sheet __ Waiver

C.11 Quality Assurance/Supervisory Control:

Is under the administrative supervision of the Medical Director the Pine Ridge Service Unit or COR. The Pine Ridge Hospital medical staff will perform peer reviews of the incumbents’ work.

In addition, the Clinical Director or designee, and or COR will monitor the contractors work and provide feedback to the contractor.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

Performance expectations will include a written summary provided to the Contract Provider as well as the Physician summarizing the provider’s performance while on duty at the Pine Ridge IHS Hospital. Criteria for evaluation will be as follows:

Medical Practice must be within the standards of their credentialed specialty.

Documents medical assessments, History and Physicals, observations, discharge summaries and daily progress notes.

Utilizes EHR/RPMS computer system to enter and sign off lab results, pharmacy orders, notes; must be signed off at the end of each shift.

Complies with safety policies.

Consults with other specialty practitioners.

Maintains patient privacy/confidentiality

Adheres to work duties and schedule for shift.

Adheres to CMS Conditions of Participation

Pine Ridge Indian Health Service Hospital Clinical Director or designee will conduct an exit interview with the provider to obtain any feedback from the contract provider regarding the work conducted. If the contractor provider is unable to meet with the Clinical Director in person, the Pine Ridge IHS Hospital requests feedback to be provided in writing within two (2) days prior to departure from the Pine Ridge IHS Hospital, South Dakota.

C.12 Guidelines:

Guidelines include standing orders, protocols and agency procedures. Guidelines are not completely applicable. Uses judgment in interpreting guidelines.

C.13 Complexity:

The work consists of providing a range of health services from assessment through intervention, counseling, teaching and treating illnesses. Health care services are being delivered to the patients of the Pine Ridge Native American reservation where a very rate of Diabetes Mellitus (DM) is prevalent along with the usual DM co‐morbidities. Determines health services needed in the community, and assists the community in planning, developing, and evaluating their local health care delivery system.

C.14 Reporting Requirements:

Contractor is required to report to work on time and will notify the supervisor if he/she will be late for any reason. Contractor must wear the appropriate IHS badge at all time while working in the IHS facility.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

C.15 Scope and Effect:

The purpose of the work is to deliver health care to Native American individuals and families, and eligible members of the USPHS Uniformed Services. The work affects the physical wellbeing of persons in the community.

C. 16 IRS Reporting Requirements:

Contractor is required to pay all Federal, State, and local taxes. The Indian Health Service will not withhold taxes of any kind.

C.17 Personal Contacts:

The Contractor shall communicate with patients, families, and various staff members in all departments in the facility.

C.18 Purpose of Contact:

To provide health care, and to collaborate with the Medical Director of the Pine Ridge Service Unit or his/her designee on review of work.

C.19 Physical Demands:

Must be able to work at least twelve‐(12) consecutive hour shifts for a period of seven‐(7) or even fourteen‐(14) consecutive days. Prolonged standing and bending is required in treating patients.

C.20 Meals:

Breakfast, lunch & dinner (supper) are available in the Pine Ridge IHS hospital cafeteria with the purchase of a meal ticket. Meal tickets may be purchased in the hospital administration department between the hours of 10:00AM to 11:45AM and 12:45PM to 2:00PM on Monday through Fridays. Cash and checks are accepted. The hospital is not equipped to perform credit or debit cards transactions.

C.21 Work Environment:

Exposure to contagious diseases is possible in the OPC, field clinic, and ER setting. Also, possible exposure to bodily fluids may occur in the course of caring for trauma patients.

Pine Ridge, South Dakota is a geographic area with wide temperature span. The winters can be very cold and windy. Contract providers should expect to drive in weather conditions they may not be accustomed. The sole authority to close the hospital or clinics rests with the CEO. This decision is based on National and regional weather reports. If the hospital remains open the contract provider shall be expected to report to work on time as all other hospital employees will be required.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

C.22 Character Investigation

Individuals providing services on personal or non‐personal services contract (the duties and responsibilities of which involve regular contract with, or control over Indian children) are subject to a character investigation. IHS Personnel Office will conduct these investigations following awards of personal or non‐personal service contract unless in the judgment of the Contracting Officer, investigation may be waived based on prior investigations on file. Until the character investigation has been completed and the Contracting Officer notified such individuals shall not have unsupervised contact with Indian Children.

C.23 Definitions/Acronyms

Definitions/Acronyms‐ Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

ABIM: American Board of Internal Medicine http://www.abim.org/

ACLS: Advanced Cardiac Life Support

ATLS: Advanced Trauma Life Support

BLS: Basic Life Support

CDC: Centers for Disease Control and Prevention

CMS: Centers for Medicare and Medicaid Services

Contracting Officer (CO) – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non‐compliance in order that appropriate action can be taken.

Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

EMTALA: Emergency Medical Treatment and Labor Act: https://www.acep.org/news‐media‐ top‐banner/emtala/

Governing Body/Governing Board (GB): GB is the final authority on granting, restricting, suspending, or revoking delineated clinical privileges.

HIPAA: Health Insurance Portability and Accountability Act

Medical Staff (MS): MS is the body that has the overall responsibility for the quality of the professional services provided by individuals with clinical privileges and is accountable to the GB. Members have delineated clinical privileges that allow them to provide patient care services independently or collaboratively within the scope of their clinical privileges as permitted by law and the organization. MS members and other persons with clinical privileges are subject to the hospital Bylaws, Rules & Regulations, departmental rules and regulations, and performance improvement activities. Standards are applied to evaluate the quality of MS performance.

Physician (MD, DO): A medical doctor or doctor of osteopathy who, by virtue of education and training, is qualified and licensed to practice medicine in at least one U.S. jurisdiction.

PALS: Pediatric Advanced Life Support

POP: Period of Performance

Privileges: The authorization granted by the GB to a provider to provide specific care. Clinical privileges are delineated functions, procedures, treatments, surgeries and prerogatives of practice an individual may perform in the organization. Clinical privileges are dependent on provider qualifications, current competency, and the capacity of the institution to support the execution of requested privileges.

Peer Review: The evaluation of an individual practitioner’s professional performance and includes the identification of opportunities to improve care

Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility‐specific and provider‐specific.

Provider: Provider means a Medical Staff member who holds an unrestricted license, certification, or registration as applicable and is privileged by the facility to practice independently in their professional category, collaboratively, or under supervision when required by state licensure.

Section C Solicitation No.: RFP‐18‐241‐SOL‐00002

C.23 Housing:

Housing may not be provided on the Pine Ridge Hospital housing compound due to a shortage reserved for essential personnel who have on‐call duties or have special command functions.

There are area hotels/motels…