20150420_245-M15-0012_SOLICITATION_-_BOA_Physician_Services.pdf

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SOLICITATION NO: 245‐M15‐0012

ISSUE DATE: April 20, 2015

DUE DATE: May 20, 2015

The Navajo Area Indian Health Service (NAIHS) is requesting proposals from interested Offerors to provide Physician Services to NAIHS facilities. It is requested that you review the enclosed

Solicitation instructions and provide this office with a proposal, utilizing the information contained therein.

COMPLETION OF SOLICITATION REQUIREMENTS

Ensure all forms and additional information is completed in its entirety. Verify calculations before signing the proposal. Provide (5) copies of offer. Offer shall include the following required items:

1. Section No. 10 (Proposal Evaluation Criteria)—Pages No. 9‐10.

2. Section No. 25 (Fee Schedule)—Page No. 14.

3. Section No. 29 (Contractor’s Representative)—Page No. 17.

4. Section No. 40 (Offeror Representation and Certifications‐Commercial Items)‐‐Pages 33 through 45.

All proposals must be received in the Division of Acquisition Management and Contracts by the due date listed above.

Chinle Comprehensive Health Care Facility

Division of Acquisition Management & Contracts

ATTN: Tanya Begay, Contract Specialist

PO Drawer “PH”

Hwy 191 & Hospital Drive

Chinle, AZ 86503

MARK YOUR ENVELOPE “PHYSICIAN SERVICES”

The anticipated period of performance will be for one (1) basic year with one (1) option year.

Navajo Area Indian Health Service Physician Services

Table of Contents

Section Title Page

1.0 General 1‐2

2.0 Applicable Documents 2

3.0 Definitions 3‐5

4.0 Government Furnished Information, Property and Services 5‐6

5.0 Contractor Furnished Property 6

6.0 Performance‐Based Requirements 6‐8

7.0 Supervision 9

8.0 Work Schedule 9

9.0 Contractor’s Fellow Qualification & Evaluation Factors 9

10.0 Proposal Evaluation Criteria 9‐10

11.0 Billing of Professional and Facility Fee 10

12.0 Conduct 10

13.0 Performance Evaluation 10

14.0 Identification of Contractor 10

15.0 Management of Medical Information 10‐11

16.0 IHS Information Technology Systems 11

17.0 Health Requirements/Conditions of Employment 11

18.0 Language Requirements and Cultural Awareness 11

19.0 Information Technology Skills 12

20.0 Orientation 12

21.0 Background Checks 12

22.0 Challenges to Conflicts 12

23.0 Privacy Act Notification 12

24.0 Performance Based Matrix 13

25.0 Fee Schedule 14

26.0 Period of Performance 14

27.0 Orders 14‐16

28.0 Program Managers for Each Medical Facility 17

29.0 Contractor’s Representative 17

30.0 52.237‐7 Indemnification And Medical Liability Insurance 17‐18

31.0 52.204‐9 Personal Identity Verification Of Contractor Personnel

32.0 Privacy Act Notification 19

33.0 Termination 19

34.0 Non‐Exclusive 19

35.0 52.232‐18 Availability of Funds 19

36.0 52.212‐4 Contract Terms and Conditions—Commercial Items 19‐24

37.0 52.212‐5 Contract Terms and Conditions Required to Implement Statutes or Executive order‐Commercial Items

24‐29

38.0 Department Of Health And Human Services Acquisition

Regulation Clauses

39.0 52.212‐1 Instructions to Offerors ‐ Commercial Items 29‐33

40.0 52.212‐3 Offeror Representations and Certifications – Commercial Items

33‐45

PHYSICIAN SERVICES – NAVAJO AREA INDIAN HEALTH SERVICE

SOLICITATION NO.: 245‐M15‐0012

NAVAJO AREA INDIAN HEALTH SERVICE (hereinafter referred to as the “NAIHS”) and

__________________________________________________________________ “CONTRACTOR”

enter into the Basic Ordering Agreement (BOA) for the provision of Professional Health Care Services at NAIHS Medical Facilities listed herein. THIS BASIC ORDERING AGREEMENT IS NOT A CONTRACT, pursuant to 48 C.F.R. Part 16.703(a). A binding contract is established at the time an individual Task Order is issued to the Contractor by an Ordering Official, as identified in Section VIII.

1.0 General: This performance work statement describes the requirements for non‐personal physician services to support the mission of the Indian Health Service (IHS).

1.1 Background: IHS is an agency within the U.S. Department of Health and Human Services and is responsible for providing federal health services to American Indians and Alaska Natives.

The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes. The IHS is the principal federal health care provider and health advocate for the Indian people. The goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indians and Alaska Natives. The IHS currently provides health services to approximately 2.0 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 34 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. This performance work statement covers requirements for the Navajo Area. The positions to be filled include:

Physicians for the provision of outpatient and inpatient medical and surgical services.

1.2 Navajo Area Indian Health Service (NAIHS) administers health centers and hospitals providing health care to approximately 201,583 members of the Navajo Nation. The Navajo Nation is the largest Indian tribe in the United States and has the largest reservation, which encompasses more than 25,516 square miles in northern Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico. The NAIHS is the primary provider of inpatient, ambulatory care, preventive and community health, and environmental health services for members of the Navajo Nation and the San Juan Southern Paiute Tribe.

1.3 Navajo Area Indian Health Services desires to participate in the Global Health Fellowship Programs established by Universities and medical schools throughout the United State in support of rural health care unmet needs. The goal is to recruit fellows who are passionate about, and dedicated to, improving the health of underserved populations who frequently have limited access to healthcare. Via on‐the‐job training, these fellows will gain the skills to combat the challenges of working in a resource‐limited setting as well as receive mentorship to allow for a sustainable career in this type of work. Additionally, the skills that the fellow will be gaining (eg. health systems strengthening, tools for improving quality and patient safety) via a concurrent MPH (Masters in Public Health) training will be an added benefit to the quality of care provided at NAIHS Medical Facilities. This fellowship has the added benefit of the government being able to recruit the individual at the completion of the fellowship period, for a career with the Indian Health Service.

1.4 Scope: The Contractor shall provide medical physician services “fellows” in accordance with section 7.0, performance based requirements.

1.4.1 Duties and responsibilities may encompass outpatient and inpatient services to IHS patients. NAIHS/Service Unit(s) will provide the facility, supplies, mentorship, and clinical experiences to host and enhance any fellowship program of any eligible university or medical school.

1.5 Place of Performance: Services are to be performed at hospitals, clinics, and other healthcare facilities under the jurisdiction of the Navajo Area Indian Health Service (See Attachment #1‐Organizational Chart).

1.6 Period of Performance: This will be a two (2) year agreement.

1.7 NAIHS retains the right to recruit and offer available government position vacancies to qualified (Fellows) physicians assigned to this program.

2.0 Applicable Documents: Please see the web link listed unless document is listed as an attachment.

2.1 Joint Commission on Accreditation of Healthcare Organizations (TJC) http://www.JAC.org

2.2 Centers for Medicare and Medicaid Services (CMS) Standards http://www.cms.hhs.gov

2.3 Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaahc.org

2.4 Section 231 of Public Law 101‐647, the Crime Control Act of 1990.

http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml

2.5 Section 4087 of Public Law 101‐630, the Indian Child and Family Violence

Act. http://www.nicwa.org/policy/law/protection/index.asp

2.6 Health Insurance Portability and Accountability Act (HIPAA) of 1996.

http://www.cms.gov/HIPAAGenInfo/

2.7 Privacy Act of 1974 http://www.justice.gov/opcl/privacyact1974.htm

2.8 Revised American Nurses Association Code of Ethics and Standards of Practice and Care

(1996) http://www.nursingworld.org

2.9 State Nurse Practice Act for the Contractor’s licensing state http://www.medi‐smart.com/

2.10 IHS Service Unit and Health Center Policies, Procedures and Protocols.

2.11 Computer Security Act of 1987

http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt

2.12 Federal Code of Conduct http://www.ihs.gov

2.13 IHS General Directives http://www.ihs.gov/index.cfm?module=AtoZ&option=index

2.14 IHS Computer Security Directives http://security.ihs.gov/index.cfm

3.0 Definitions

3.1 Acceptance: Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart 46.5 and subject to other terms and conditions of the contract.

3.2 Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements.

Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

3.3 Area: A defined geographical region for Indian Health Service administrative purposes.

Each Area Office may administer several Service Units.

3.4 Code of Ethics: Code ethics as described by the American Medical Association (AMA) and any code of ethics described by individual specialty organizations.

3.5 Contractor: The individual awarded a legal binding contract to provide supplies and services.

3.6 Contractor Performance Assessment Report (CPAR): A report that assesses a contractor’s performance and provides a record, both positive and negative, on a given contract for specific period of time.

3.7 Cooperative Attitude: Behavior that is positive and displays a willingness to perform assigned patient care tasks and to be a team player.

3.8 Cultural Awareness: Realization and respect for American Indian and Alaska Native practices.

3.9 Customer: IHS Beneficiaries.

3.10 Customer Evaluation/Input: Written comments made to the Contracting Officer regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor’s performance.

3.11 Dependability: Qualities of being trusted and being able to repeat the same task to yield the same result.

3.12 Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal Executive agencies in their acquisition of supplies and services with appropriated funds.

3.13 Focused Professional Practice Evaluation (FPPE): The FPPE involves specific and time‐ limited monitoring of a provider’s practice performance.

3.14 Health Center: A facility physically separated from a hospital, with a full range of ambulatory services including at least primary care providers, nursing, laboratory, and x‐ ray, which are available at least 40 hours a week for outpatient care.

3.15 Hospital Representative (HR): A federal employee who assists the ordering/issuing activity contracting officer in the administration of task orders issued under this contract. The HR is primarily responsible for the technical assistance and day‐to‐day program management of the ordering activity’s task orders. Ordering activities may have different designators for this employee (e.g. GTR – Government Technical Representative, COR–Contracting Officer’s Representative, or PO ‐ Project Officer).

3.16 Ongoing Professional Practice Evaluation (OPPE): The OPPE is a means of evaluating professional performance on an ongoing basis.

3.17 Ordering Activity: An authorized user of IHS that may issue a task order to obtain required services under this contract.

3.18 Ordering Official/Contracting Officer: A Government employee of IHS authorized and warranted to issue task orders and to make subsequent task order modification(s) under this agreement. The Ordering Activity CO has the authority to make initial determinations on all matters of dispute regarding task orders.

3.19 Orientation: An activity designed to provide basic familiarization of the facility and transition the fellow into the IHS Service Unit and/or Health Center and the medical setting where the services will be provided.

3.20 Past Performance Information: Relevant information regarding a contractor’s actions under previously awarded contracts. This includes the contractor’s record of conformance to specifications and to standards of good workmanship; the contractor’s record of containing and forecasting costs on any previously performed cost reimbursable contracts; the contractor’s adherence to contract schedules, including the administrative aspects of performance; the contractor’s history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business‐like concern for the interest of the customer.

3.21 Patient Outcome: End result of medical and surgical care.

3.22 Performance based Matrix: Lists the services to be monitored and the standards to be applied.

3.23 Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

3.24 Service Unit: The local administrative unit of IHS.

3.25 Standards of Practice and Standards of Care: Authoritative statements by which the medical profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for professional medical practice and a framework for the evaluation of practice. The standards of professional medical practice may pertain to general or specialty practice.

3.26 Supervisor: Government employee authorized to provide verbal and written performance direction to the fellow that the Contractor must follow without exception.

3.27 Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activities written order to obtain services, at a minimum will include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activities task order number.

3.28 Tour of Duty: The time of day the provider is scheduled to perform medical care; also considered the shift of the day. The time can vary according to the needs of each facility and/or clinic, e.g. 12 hour Tour of Duty, 8 hour Tour of Duty, 10 hour Tour of Duty.

Includes nights, weekends and holidays.

3.29 Valid Patient Complaint: Justifiable accusation made by a patient and supported by investigation.

3.30 Verifiable Emergency: An unexpected/unplanned absence by the contractor requiring valid documentation to confirm the occurrence.

4.0 Government Furnished Information, Property and Services

4.1 Information: Government unique information related to this requirement, which is necessary for Contractor performance, will be made available to the Contractor. The Contracting Officer or designee will be the point of contact for identification of any required information to be supplied by the Government.

4.2 Joint Use by the Government and the Contractor: The Government will provide, for joint use by the Government and the Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

4.3 Contractor Exclusive Use:

4.3.1 Personal Protective Equipment (PPE). The Government will furnish the Contractor with appropriate PPE other than specified in Section 5.0. The Government will be responsible for any repair, cleaning, and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

4.4 The fellow will provide facility specific contractor identification badges for each contractor.

A minimum fee of $25.00 will be charged for lost or destroyed badges.

4.5 Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures.

Training will be provided ONLY if the subject matter is necessary to improve or enhance the quality of physician services or includes mandates made by the IHS Service Units/Health Centers while the nurse is working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

5.0 Contractor Furnished Property

5.1 Except for the property specified in Section 4.0 as government furnished, the fellow shall provide all uniforms and other personal medical instruments subject to the following:

5.2 Uniforms and Lab Coats: Uniforms and Lab Coats shall conform to the requirements of the Indian Health Service Manual, Part 3 Chapter 4 and meet the approval of the Clinical Director at each IHS facility.

5.3 Other personal medical instruments: “Other personal medical instruments” are defined as Contractor/fellow owned items may include but not limited to stethoscope, scissors, as appropriate to the work unit. The Contractor/fellow shall not use unsafe equipment or supplies at any time during performance of this contract. All Contractor/fellow furnished equipment and supplies shall be subject to inspection by the Government and must be approved by the HR prior to use by the Contractor/fellow. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

6.0 Performance‐Based Requirements. Contractor shall provide medical physician services “fellows” in the delivery of patient care at the NAIHS/Service Unit(s). Specific tasks include the following:

6.1 Major Duties and Responsibilities:

6.1.1 Contractor shall perform diagnosis, care, and treatment of IHS Beneficiaries relative to the specific medical disciplines listed herein.

6.1.1.1 Internal Medicine, Family Medicine, Anesthesiology, Pediatrics, Obstetrics/Gynecology, Emergency Medicine, General Surgery, Neurology, Psychiatry, Pulmonary, Endocrinology, Gastroenterology, Orthopedic Surgery and Cardiology; while they concurrently provide clinical care of patients at our facility.

6.1.2 Contractor shall interview and examine medical patients, review past medical history, and requests and/or perform diagnostic tests and examinations, deemed necessary to obtain all possible information related to each case.

6.1.3 Contractor shall make preliminary diagnoses, directs, prescribes, or provides treatment, or arranges for specialized care or patient referral as required. Bases decisions upon information obtained, professional medical knowledge and skills and prescribed policies and procedures.

6.1.4 Contractor shall consult with other specialists or providers from other medical disciplines whenever necessary to more clearly define a patient’s problem and seek assistance to safely provide the necessary medical interventions.

6.1.5 Contractor shall make notes of observations to be incorporated into clinical records.

6.1.6 Contractor shall provide emergency care as required.

6.1.7 Contractor shall provide definitive management in all medical categories for cases that do not require referral. Gives total patient care including health maintenance, early diagnosis, and treatment, and arranging of follow up services to medical patients under his/her care.

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

Coordinates and integrates information obtained into the ongoing health care program at the Service Unit and assures the provision of timely follow up care as required.

6.1.9 Contractor shall complete appropriate medical records for patients seen to assure the accumulation and organization of all pertinent clinical data needed to provide comprehensive medical care. Dictates clinical reports and correspondence concerning medical patients under his/her care to physicians, hospitals, and other individuals and facilities.

6.1.10 Contractor shall evaluate patient symptoms, designing treatment plans and educate the patient and family about their condition and initiating care.

6.1.11 Contractor shall prepare prescriptions accurately following Federal and U.S.

Public Health Service laws and policies. Contractor agrees to assure appropriateness of drug therapy. The provider will assure that drug therapy is safe, efficacious, and cost effective. Standards of care developed or adopted by the professional staff of the facility shall be the criteria for appropriateness of drug therapy. The provider shall screen the patient health record to avoid inappropriate drug interactions and monitor patients for the appropriateness of therapy.

6.1.12 Contractor shall participate in journal clubs, prepare presentations in their area of expertise for the medical staff and work on quality improvement projects as assigned by the Clinical Director or designee.

6.1.13 Contractor shall perform in accordance with the approved privileges through the credentialing process.

6.1.14 Contractor shall provide real time medical direction to EMS, if necessary.

6.2 Adherence to policies and quality improvement processes

6.2.1 Contractor shall provide services in accordance with standards of The Joint

Commission (TJC) and professional standards of the American boards in their appropriate specialty.

6.2.2 Contractor shall participate in the NAIHS Medical Specialty Department peer review system and to make practice modifications in accordance with the peer review group’s findings and recommendations.

6.2.3 Contractor shall participate in the NAIHS performance improvement program within the scope of clinical activity. This includes working with Discharge Planning to help facilitate timely accommodation of patient needs and prompt dispositions.

6.2.4 Contractor shall maintain patient records in the Problem Oriented Medical

Record format utilizing the Patient Care Component of the Resource Patient Management System. Inpatient records require close attention to documentation policies for frequency and content of note, dictated summaries, abbreviation use, timeliness for processing and legibility. Signatures in all places should be clarified with a printed or stamped name beneath the scripted entry in accordance with NAIHS Medical Specialty Department policies.

6.2.5 Contractor shall complete all medical records at the end of each work session.

The contractor shall be reviewed in the routine performance assessment system, performance improvement program, and surgical performance improvement program.

7.0 Supervision

7.1 Contractor shall be under the supervision of the Service Unit(s) Clinical Director or designee. Work that involves out of the ordinary diagnostic decisions or treatment is discussed with appropriate consultant and supervisor, who shall be kept aware of the condition of such patients and all aspects of treatment regimen. Work performance is reviewed for conformance to policies, procedures, and practices relating to delivery of adult primary care services.

8.0 Work Schedule:

8.1 The Supervisor will determine the specific tour of duty based on need to support patient care. It is the NAIHS’ preference that Contractor’s tailor fellow assignments in six (6) month details to the medical facilities listed herein.

8.2 Contractor shall keep the Service Unit Clinical Director or designee informed of general time of arrival and departure for each day and submit timesheets at the end of the week/ last shift. Contractor will only be paid for actual hours worked within the medical facility.

Appropriate accounting and payment is contingent upon accurately completed timesheet.

8.3 The Contractor shall notify the Service Unit Clinical Director or designee prior to any absence from work.

9.0 Contractor’s Fellow Qualification & Evaluation Factors:

9.1 Experience. Fellows shall have a minimum of twenty‐four (24) months of experience within their specialty, including residency.

9.2 License. Fellows shall possess a current, valid, active, unrestricted license to practice medicine in a state, the District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States, throughout the term of this contract.

9.3 Fellows shall be Board certified or Board eligible by their medical specialty.

9.4 Fellows shall be concurrently working on a Master in Public Health degree through an academic fellowship program.

9.5 Fellows shall be a member of a Global Health fellowship, receiving training through an academic global health fellowship program.

9.6 J‐1 Visa candidates are not acceptable for this program/agreement.

10.0 Proposal Evaluation Criteria:

10.1 Past Performance:

a) Contractor shall provide past experience in recruitment of suitable candidates for a Global health fellowship program for the past 3 years.

b) Contractor shall provide past experience in training fellow’s in Global Health.

10.2 Technical Evaluation Criteria:

a) Contractor shall provide their selection criteria and plan for identifying available interested fellows for the fellowship program.

11.0 Billing of Professional and Facility Fees:

11.1 NAIHS/Service Unit(s) will bill for and collect all applicable reimbursement monies associated with the contracted service. Contractor shall provide NAIHS/Service Unit(s) with the National Practitioner Identification (NPI) number of the contracted medical provider.

12.0 Conduct:

12.1 The Contractor shall meet standards as listed in the Federal Code of Conduct. The Government reserves the right to remove from the facility any Contractor/Fellow(s) failing to abide with the Federal Code of Conduct.

13.0 Performance Evaluation:

13.1 The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and BOA Performance‐based Matrix.

14.0 Identification of Contractor:

14.1 The Contractor shall wear a government issued contractor identification badge during performance of duty.

15.0 Management of Medical Information:

15.1 The Contractor shall manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols, including the following:

15.1.1 Medical Records and Other Required Documentation: 100% percent of all medical records and other required documentation shall meet established IHS Medical Facility, The Joint Commission (TJC), and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature, and designated profession. (Note: payment will be withheld for inaccurate or incomplete medical records.)

15.2 The Contractor shall adhere to DHHS IT system security policies and procedures. The IT policies and procedures will be made available to the Contractor.

15.3 The Contractor shall immediately report to the Contracting Officer or HR any information or circumstances that may violate any statute, policy, or procedure.

16.0 IHS Information Technology Systems.

16.1 In performance of this contract, the Contractor shall adapt to and successfully utilize IHS information technology systems that are deemed by the Supervisor as necessary for acceptable contractor performance, including use of the Electronic Health Record (EHR).

16.2 The Contractor shall ensure that IHS information technology system security policies and procedures are adhered to. The IT policies and procedures will be made available to the Contractor at each IHS facility.

16.3 The Contractor shall comply with Homeland Security Presidential Directive 12 (HSPD12) Personal Identity Verification (PIV) badge requirements and IHS Information Technology Access Control (ITAC) requirements.

17.0 Health Requirements/Conditions of Employment:

17.1 Immunization. The Contractor shall also provide the following documentation:

Immunity to Rubella, Mumps, Measles Immunity to Hepatitis B series History of chicken pox (varicella) disease or positive titer Tdap vaccine required Documentation of receiving a TB Mantoux skin test (PPD) within the past 12 months with documentation of follow‐up for a positive test.

A signed declination of the Hepatitis B vaccination series will be accepted.

Current Influenza vaccination

18.0 Language Requirements and Cultural Awareness.

18.1 The Contractor shall read, understand, speak, and write English to effectively communicate with patients and other health care workers, and shall be respectful of the local, American Indian and Alaska Native culture. Many of the patients receiving health care services under this contract only speak a Native language and/or reside on an Indian reservation.

18.2 The Contractor shall be capable of demonstrating sensitivity to cross‐cultural and language differences. The contractor shall be able to work through interpreters as necessary for non‐English speaking patients, be cognizant of surrounding and adjacent communities, and be able to work with a diverse work force that is predominantly BI‐lingual and Native American staffed.

19.0 Information Technology Skills. The Contractor shall possess basic knowledge, skills, and abilities to use a computer.

20.0 Orientation. All providers providing service under this contract shall attend mandatory orientations and training specified by the government.

21.0 Background Checks: As directed by the Contracting Officer, the Contractor shall provide all requested information necessary to perform background checks. The Contractor shall comply with the requirement to obtain security investigations. The Contractor shall work with the IHS to ensure that the pre‐employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms will be reviewed by the Contractor and forwarded to the Government Personnel. The Contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

22.0 Challenges to Conflicts: All Fellows shall maintain an appropriate professional demeanor in the presence of patients and with each other. Harmony and good communication between the staff is necessary to maintain the best patient care environment and all staff members are expected to contribute to a positive milieu. Violent language, profanity, and any threatening behaviors are specifically prohibited. Performance is characterized by continual cultural awareness and focus on customer service. 100% adherence to the Federal Code of Conduct is expected.

23.0 52.224‐1 Privacy Act Notification (Apr 1984) The Contractor shall be required to design, develop, or operate a system of records on individuals, to accomplish an agency function subject to the Privacy Act of 1974, Public Law 93‐579, December 31, 1974 (5 U.S.C. 552a) and applicable agency regulations.

Violation of the Act may involve the imposition of criminal penalties.

24.0 PEFORMANCE‐BASED MATRIX

Performance‐based Task

Indicator Standard Quality Assurance Incentives

Contractor shall provide medical physician services in the delivery of patient care to the Navajo Area Indian Health Service, Gallup Indian Medical Center

Competency, Compliance and Patient Outcomes

Medical Records

100% compliance with IHS Service Units and/or Health Centers published Policies;

Procedures; Standards of Care;

and hospital protocols.

100% percent of all documentation meets established IHS Medical Facility, TJC, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

Surveillance systems will include periodic inspections and customer complaints.

No reports of breached patient safety, infection control, and other procedures that might adversely affect patient outcome.

Successful completion of FPPE after 3 months of work.

Subsequent evaluation (OPPE) at time of completion of 6 months of work.

Payment of contract price for satisfactory service.

Contractor performance will be evaluated using the Contractor Performance Assessment Reporting System (CPARS). The evaluation will be considered when future IHS contract selections are made.

25.0 Fee Schedule:

SPECIALTY HOURLY RATE

A. Psychiatry $

B. General Surgery $

C. Neurology $

D. Internal Medicine $

D1. Pulmonary $

D2. Endocrinology $

D3. Gastroenterology $

D4. Cardiology $

E. Family Medicine $

F. Anesthesiology $

G. Pediatrics $

H. OB/GYN $

I. Emergency Medicine $

J. Orthopedic Surgery $

K. Other – Hourly Rate to be determined for the medical specialty not listed herein prior to issuance of a Task Order

26.0 Period of Performance:

26.1 Performance of this contract shall begin on Date of Award through June 30, 2016, unless the period is changed by written modification of the BOA. This BOA will be effective for one (1) base contract year and one (1) year option period.

26.2 If the Government exercises its option to extend the BOA, the period of performance will be extended in accordance with the following schedule:

Year Option Period

BASE YEAR

FIRST YEAR OPTION

Date of Award through June 30, 2016

July 01, 2016 through June 30, 2017

27.0 Orders: Individual Task Orders on government forms SF‐1449 (Solicitation/Contract/Order for Commercial Items); OF‐347 (Order for Supplies and Services); and/or IHS‐843‐1A (Order for Health Services) shall be utilized and issued for services rendered and authorized by NAIHS.

27.1 Ordering Officials

27.1.1 The authorized officials, as listed below, shall represent the Government for the purpose of issuing and signing individual Task Orders under this BOA.

27.1.2 The authority to obligate the Government shall be in accordance with the acquisition delegation of his/her authority.

Medical Facility Name Limitation Chinle Comprehensive Health Care Facility Chinle, Arizona 86503 Phone: 928/674‐7635 Fax: 928/674‐7705

Tanya Begay, Contract Specialist

Edith Denny, Purchasing Agent

$500,000

$150,000

Pinon Health Center Pinon, Arizona 86510 Phone: 928/725‐9801 Fax: 928/725‐9556

See CCHCF above

Tsaile Health Center Tsaile, Arizona 86556 Phone: 928/674‐7635 Fax: 928/674‐7705

See CCHCF above

Crownpoint Health Care Facility Crownpoint, New Mexico 87313 Phone: 505/786‐6217 Fax: 505/786‐5840

Priscilla Duncan, Contract Specialist

Unlimited

Pueblo Pintado Health Center Cuba, NM 87103 Phone: 505/655‐3301 Fax: 505/655‐3510

Thoreau Health Clinic Thoreau, NM 87323 Phone: 505/862‐8250 Fax: 505/862‐8909

Gallup Indian Medical Center Gallup, New Mexico 87301 Phone: 505/722‐1546 Fax: 505/722‐1554

Tohatchi Health Center Tohatchi, New Mexico 87325 Phone: 505/733‐8100 Fax: 505/733‐8239

See Crownpoint above

See Crownpoint above

Natasha Chee, Contract

See GIMC above

$500,000

Kayenta Health Center Kayenta, Arizona 86033 Phone: 928/697‐4293 Fax: 928/697‐4078

Kerri Gilmore, Contract Specialist $500,000

Inscription House Health Center Shonto, AZ 86054 Phone: 928/672‐3000 Fax: 928/672‐2611

See Kayenta above

Northern Navajo Medical Center Shiprock, New Mexico 87420 Phone: 505/368‐6089 Fax: 505/368‐6362

Dzilth‐Na‐O‐Dithle Health Center Bloomfield, NM 87413 Phone: 505/368‐8001 Fax:

Linda Conn, Contract Specialist

Philoma Singer, Contract

See NNMC above

$150,000

$500,000

Four Corners Regional Health Center Teec Nos Pos, Arizona 86514 Phone: 928/656‐5000 Fax:

See NNMC above

27.1.3 The authorized individuals listed under NAIHS shall issue Task Order:

Division of Acquisition Management & Contracts

(NAIHS)

St. Michaels, Arizona 86511 Phone: 928/871‐5890 Fax: 928/871‐1447

Margaret Shirley, Contract Specialist

Priscilla Duncan, Contract Specialist

Maxine Dineyazhe, Contract

Thomasina Willie, Business Specialist

Unlimited

Unlimited

$500,000

$150,000

$150,000

27.2 The Government is obligated under this contract or BOA only to the extent of orders placed by authorized individuals. The Contractor shall only accept Task Orders from listed authorized individuals. The contractor is cautioned that acceptance of orders form personnel other than those authorized herein could be considered as an authorized procurement and jeopardize payment.

28.0 Program Managers for Each Medical Facility:

Medical Facility Name Chinle Comprehensive Health Care Facility, Chinle, AZ

Dr. Kevin Rand, Clinical Director

Crownpoint Health Care Facility Crownpoint, NM

Dr. Charlene Avery, Clinical Director

Gallup Indian Medical Center Gallup, NM

Dr. Loretta Christensen, Clinical Director

Kayenta Health Center Kayenta, AZ

Dr. Allison Clough, Clinical Director

Northern Navajo Medical Center Shiprock, NM

Dr. Ira Salom, Clinical Director

29.0 Contractor’s Representative: Designate a person whom we may contract for prompt Contract Administration in the event your firm receives a contract as a result of this solicitation.

NAME:____________________________ TITLE:_______________________________

ADDRESS:________________________________________________________________

TELEPHONE:__________________________________________

E‐MAIL ADDRESS:______________________________________

30.0 52.237‐7 Indemnification And Medical Liability Insurance (JAN 1997)

(a) It is expressly agreed and understood that this is a nonpersonal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor. The government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of services rendered, including by example, the contractor’s professional judgment. The Contractor shall be solely liable and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The contractor shall maintain during the term of this contract liability insurance issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrences: $1,000,000.

(b) An apparently successful Offeror, upon request by the Contracting Officer, shall furnish prior to contract award evidence of its insurability concerning the medical liability insurance required by paragraph (a) of this clause.

(c) Liability insurance may be on either an occurrences basis or on a claims‐made basis. If the policy is on a claims‐made basis, an extended reporting endorsement (tail) for a period of not less than 3 years after the end of the contract term must also be provided.

(d) Evidence of insurance documenting the required coverage for each provider who will perform under this contract shall be provided to the Contracting Officer prior to the commencement of service under this contract. If the insurance is on a claims‐made basis and evidence of an extended reporting endorsement is not provided prior to the commencement of services, evidence of such endorsement shall be provided to the Contracting Officer prior to the expiration of this contract. Final payment under this contract shall be withheld until evidence of the extended reporting endorsement is provided to the Contracting Officer.

(e) This policy evidencing required insurance shall also contain an endorsement to the effect that any cancellation or material change adversely affecting the Government’s interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer. If, during the performance period of the contract the Contractor changes insurance providers, the Contractor must provide evidence that the Government will be indemnified to the limits specified in paragraph (a) of this clause, for the entire period of the contract, either under the new policy, or a combination of old and new policies.

(f) The Contractor shall insert the substance of this clause, including this paragraph (f), in all subcontracts under this contract for services and shall require such subcontractors to provide evidence of and maintain insurance in accordance with paragraph (a) of this clause. At least 5 days before the commencement of work by any subcontractor, the Contractor shall furnish to the Contracting Officer evidence of such insurance.

31.0 52.204‐9 Personal Identity Verification Of Contractor Personnel (Jan 2011)

(a) The Contractor shall comply with agency personal identity verification procedures identified in the contract that implement Homeland Security Presidential Directive‐12 (HSPD‐12), Office of Management and Budget (OMB) guidance M‐05‐24 and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

(b) The Contractor shall account for all forms of Government‐provided identification issued to the Contractor employees in connection with performance under this contract. The Contractor shall return such identification to the issuing agency at the earliest of any of the following, unless otherwise determined by the Government:

(1) When no longer needed for contract performance.

(2) Upon completion of the Contractor employee’s employment.

(3) Upon contract completion or termination.

(c) The Contracting Officer may delay final payment under a contract if the Contractor fails to comply with these requirements.

(d) The Contractor shall insert the substance of this clause, including this paragraph (d), in all subcontracts when the subcontractor’s employees are required to have routine physical access to a Federally‐controlled facility and/or routine access to a Federally‐controlled information system. It shall be the responsibility of the prime Contractor to return such identification to the issuing agency in accordance with the terms set forth in paragraph (b) of this section, unless otherwise approved in writing by the Contracting Officer.

32.0 Privacy Act Notification

A. This contract requires the Contractor, on behalf of the Indian Health Service (IHS), to provide health care to American Indians and Alaskan Natives and report selected medical record as required. The Snyder Act (25 U.S.C. 2001) authorizes the collection of this information.

B. Disclosure of this information may be made by IHS to: other providers of health care for treatment of health maintenance of American Indian or Alaskan Native people; the Office of Worker’s Compensation Programs, Department of Labor; the Department of Justice or their representation of the United State; and for Congressional inquiry assessment; medical audit; or utilization review;

analytical and evaluation studies; to Federal or State agencies as required by law; research purposes supports by IHS; and identification of handicapped children under 10 U.S.C. 1401 et, seq.

C. Disclosure of the appropriate medical record information without prior consent of the subject patient may be made by you to; another provider of health care treating he same patient; a Federal or State agency as required by law such as the reporting of communicable disease, births, deaths, or commission of crimes (i.e. gunshot wounds, rape, child abuse or neglect, and alcohol or drug abuse).

33.0 Termination

BOA can be terminated by either party, with or without case, upon receipt of a written thirty (30) day notice. Neither party shall have any further obligations hereafter, except for action relative to Task Orders issued prior to the effective date of termination.

34.0 Non‐Exclusive

This BOA is not an exclusive referral arrangement between NAIHS and the Contractor.

35.0 52.232‐18 Availability of Funds (APR 1984) Funds are not presently available for this contract. The Government’s obligation under this contract is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for this contract and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer.

36.0 52.212‐4 Contract Terms and Conditions—Commercial Items (DEC 2014)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post‐acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727).

However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR 52.233‐1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202‐1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(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—System for Award Management, or 52.232‐34, Payment by Electronic Funds Transfer—Other Than System for Award Management), 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.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt

Payment Act (31 U.S.C. 3903) and prompt payment regulations at 5 CFR Part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212‐5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice.