FY_2018_URBAN_PROGRAM_3.doc

285-18-RFP-0017

05/31/2018

DHHS/Indian Health Service

Nashville Area

711 Stewarts Ferry Pike

Nashville, TN 37214

Donna S. Harjo donna.harjo@ihs .gov

467-1522

Table of Contents Page

PART I - THE SCHEDULE

A-1

SECTION A - SOLICITATION/CONTRACT FORM

A-1

SF 33 SOLICITATION, OFFER AND AWARD

A-1

PART I - THE SCHEDULE

B-2

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

B-2

SECTION C - DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

C-1-8

SECTION D - PACKAGING AND MARKING

D-1

[FOR THIS SOLICITATION, THERE ARE NO CLAUSES IN THIS SECTION]

D-1

SECTION E - INSPECTION AND ACCEPTANCE

E-1

E.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

E-1

SECTION F - DELIVERIES OR PERFORMANCE

F-1-3

SECTION G - CONTRACT ADMINISTRATION DATA

G-1-5

SECTION H - SPECIAL CONTRACT REQUIREMENTS

H-1-7

PART II - CONTRACT CLAUSES

I-1

SECTION I - CONTRACT CLAUSES

I-1

I.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

I-1-10

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS

J-1

SECTION J - LIST OF ATTACHMENTS

J-1

PART IV - REPRESENTATIONS AND INSTRUCTIONS

K-1

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND

OTHER STATEMENTS OF OFFERORS

K-1

K.1 NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED

BY REFERENCE

K-1-6

SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS

L-1-4 SECTION M – EVALUATION FACTORS AND AWARD.........................................................................................M-1

M.1

NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE………………………………………………………………………………………….M-1-3

PART I - THE SCHEDULE

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

B.1

SERVICES

The Contractor shall provide community-based substance abuse prevention, intervention, and care-coordination services, as set forth below in Section C, to all eligible Urban Indians, as defined in Section C.1.2 (see also below), within a location served by the Nashville Area Indian Health Service, inclusive of the following states: Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, New York, New Jersey, Delaware, Maryland, Pennsylvania, Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Virginia, West Virginia, Indiana, Illinois, and Ohio. The period of performance shall be August 1, 2018 to September 30, 2019 with four (4) option years, in accordance with the Indian Health Care Improvement Act(IHCIA), P.L. 94-437, as amended, codified at 25 U.S.C. §§ 1651-1660h.

B.2

COST

A. Estimated Cost: The estimated cost of the contract is $______________, subject to the Limitation of Costs Clause found in Section G.2(B)(3).

B. Option to Extend the Term of the Contract:

1. If the Government exercises its options pursuant to Section I.3, Option to Extend the Term of the Contract, the estimated cost will be increased as follows:

August 1, 2018 – September 30, 2019 Base Year

Estimated Option Year

Estimated Cost October 1, 2019 - September 30, 2020 Option Year One

October 1, 2019 - September 30, 2021 Option Year Two

October 1, 2020 - September 30, 2021 Option Year Three

October 1, 2021 - September 30, 2022 Option Year Four

2. Before any extension of the term goes into effect, the Contractor and the Indian Health Service (IHS), including the Director of the Office of Urban Indian Health Programs and the Contracting Officer must bilaterally agree and amend the existing contract to that effect.

PART 1 – THE SCHEDULE

SECTION C - DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

C.1

SCOPE OF WORK

The purpose of this contract is to provide a community-based outpatient substance abuse program for eligible Indians, through a continuum of care, treatment, and services, as clinically indicated and appropriate. Said services shall be directed at penetrating addictions and improving the overall health of the client-population served – mentally, physically, socially, and spiritually.

C.1.1 Provision of Services A. The provision of care shall consist of the following core elements: screening and assessment, mental health and substance abuse prevention, treatment and case management services, recovery support, health promotion and disease prevention education and activities and services, community outreach and referrals as well as transportation services( as needed).

B. The Contractor shall provide these services, in the geographic area stated herein (see Section B.1) either:

1. On-site; and/or

2. Through a formal referral system to local community provider(s) with whom the Contractor has a written agreement. The agreements shall identify, for example, services, fees, response time, performance standards, and other requirements.

C. The Contractor shall maintain any minimum productivity standards stated in this contract.

D. The Contractor is committed and shall provide quality services which will at all times meet applicable standards of care and practice applicable to each service and, where appropriate, to guidance of the Indian Health Service. Services provided by the Contractor or through its sub-contractors shall be guided by the standards of care and practice applicable to those services, current State law, and, to the extent applicable, other guidance such as IHS Standards, the Joint Commission Standards, and the Accreditation Association for Ambulatory Health Care (AAAHC) Standards.

C.1.2 Urban Indian Beneficiaries Pursuant to the IHCIA, 25 U.S.C. § 1603(13), (27), (28), the beneficiaries of the services to be provided under this contract are “Urban Indians,” defined as any individual who:

A. Resides in an urban center, which is any community that has sufficient urban Indian population with unmet health needs to warrant assistance under the IHCIA, as determined by the Secretary of the Department of Health and Human Services (“HHS”); and who

B. Meets one or more of the following criteria:

1. Irrespective of whether he or she lives on or near a reservation, is a member of a tribe, band, or other organized group of Indians, including: (a) those tribes, bands, or groups terminated since 1940, and (b) those recognized now or in the future by the State in which they reside; or

2. Is a descendant, in the first or second degree, of any such member described in (1); or

3. Is an Eskimo or Aleut or other Alaska Native; or

4. Is a California Indian;¹ or

5. Is considered by the Secretary of the Department of the Interior to be an Indian for any purpose; or

6. Is determined to be an Indian under regulations pertaining to the Urban Indian Health Program that are promulgated by the Secretary of HHS.

C.1.3 Behavioral Health – Alcohol/Substance Abuse Services C.1.3.1 Outpatient Alcohol/Substance Abuse Services

A. The Contractor shall provide an alcohol/substance abuse program and provide professional services that are culturally appropriate and enable beneficiaries to prevent and/or recover from alcohol/substance abuse.

B. The program shall meet the standards of care and practice and, if applicable, relevant IHS guidance.

C. The Contractor shall provide outpatient services to beneficiaries and provide for a comprehensive evaluation that includes, but is not limited to: substance abuse history and social history. This may include a standardized assessment tool such as the Addiction Severity Index (ASI). The outpatient services to be provided by the Contractor shall include, but are not limited to:

1. Screening for depression (and suicide risk), alcohol and other drug use/abuse (including tobacco), and domestic violence. The Contractor shall use IHS-recommended assessment tools, such as the PHQ-2/9.

2. Urine screening and drug testing.

3. A comprehensive biopsychosocial assessment on all admitted clients.

4. A diagnosis using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

5. A treatment plan appropriate to each admitted client’s individual needs (including aftercare), strengths, and limitations

6. Individual, group and family counseling/therapy, psychoeducation, health education, recovery and support groups, and recreational and cultural groups, according to individual clients’ need. The Contractor shall utilize a variety of clinically accepted/preferred and culturally appropriate behavioral health methods and techniques Emphasis shall be placed on the use of evidence-based and/or practice-based strategies and programs.

7. Referral of clients for medical and dental care, pharmacologic abstinence support, detoxification services, and emergency psychiatric or medical evaluation.

8. Transportation of clients to and from agency appointments and community referrals as scheduled, if clients cannot find means of transportation on their own.

9. Coordination of services with local substance abuse, mental health, and medical and social service providers to ensure clients are accessing available resources.

D. The Contractor shall develop Preventive Services and follow a written community prevention plan with goals and objectives. This plan shall identify and target groups at risk for substance abuse.

1. The program shall provide a minimum of 10 hour- annually of education sessions to elementary, middle and/or high school students.

2. The program shall offer at least 4 educational sessions annually to the community, which shall include any high risk groups identified. A minimum of one session each shall be education on Fetal Alcohol Spectrum Disorders and HIV/AIDS/STIs.

3. The program shall educate clients about the consequences of addiction on physical health, psychological, social and vocational functioning.

4. The program shall teach clients healthy coping skills, effective decision-making skills, and ways to reduce self-medicating incidences

5. The program shall provide parenting skills training as an integral part of client education and skill development.

6. The program shall provide a variety of activities appropriate to and in support of clients’ social, recreational, and cultural needs, at least monthly.

E. The Contractor shall Plan Care and Treatment and provide Case Management for all beneficiaries.

1. The treatment plan shall include measurable goals and objectives, and address the client’s discharge/aftercare needs.

2. Every treatment plan shall be developed in consultation with and fully explained to the client. Each client will sign the plan to formalize his/her approval.

3. A treatment planning conference shall occur at least monthly and shall include all of the clinical staff.

4. Treatment plans for each client shall be reviewed and updated at least once every 3- months.

5. The clinician shall provide clients with the necessary case management support to engage in the appropriate mix of care and services available in their communities of residence.

6. The Contractor shall develop a Referral Resource Network, including written referral agreements, to provide a mechanism for maximizing client access to all local, state, federal and private health care and substance abuse resources for which the client-population served is eligible.

7. The Contractor shall have a written policy and tracking system in place for missed appointments; abnormal laboratory values, x-ray, and other test results; and referrals to other providers/hospitals.

8. The clinician shall coordinate with community partners to provide workshops and trainings on topics related /designed to improve the care and services provided to urban Indians.

F. Administration of the Behavioral Health Program

1. Administrative management shall document and implement a business plan that identifies the goals and mission of the program, and a marketing plan that explains how the program will achieve, if not exceed, the program’s stated goals.

2. Administrative management shall develop and operate under comprehensive policies and procedures that will cover; patient eligibility, program management, care and treatment services, preventive services, outreach services, case management, personnel, patient rights and responsibilities, and clinic safety (including procedures for handling agitated patients).

3. The Contractor shall have an organizational chart that clearly delineates lines of authority within the program and the program’s relationship with the health program.

4. The program coordinator will meet at least monthly with the executive director, other executive staff, and the Board as requested, regarding the mission and operation of the program.

5. The program will have, at least, monthly staff meetings to discuss program operations.

6. The program will utilize a budget formulation process that takes into account patient and community needs as well as available funds.

G. The Contractor shall develop a clinical record-keeping program and shall document, assess and monitor all client care services provided for outcome, appropriateness, and effectiveness.

1. All services provided to the client shall be documented in the client’s record which will include, at minimum, screening results for depression, alcohol/drug abuse, and domestic violence, a comprehensive biopsychosocial assessment, a treatment plan (with revisions as indicted every 90-days), progress notes for each client encounter (or missed appointment) and associated follow-up activities, discharge/aftercare plans, referrals for services, and any other information pertinent to the client’s health and/or social well-being.

2. The program shall utilize the IHS RPMS Behavioral Health System Module for clinical documentation.

3. The Contractor shall ensure that entries in a client’s record for each visit shall follow the SOAP (Subjective, Objective, Assessment, Plan) format.

4. The program shall utilize the RPMS Suicide Reporting Form (included in the Behavioral Health System Module) for each serious suicidal ideation, suicide attempt, and suicide.

5. Records shall be filed in a manner that maintains utmost confidentiality for behavioral health and alcohol/substance abuse records and abides by the following: HIPAA, 42 CFR Part 2, and applicable state regulations. All files shall be kept in a locking file cabinet that is kept in a record room that is secured at all times.

6. The Contractor shall ensure that all staff members who have access to client records shall have completed a HIPAA training within the last year, and CFR 42, Chapter 1, Part 2 training within the last 3-years.

H. The Contractor shall employ qualified staff and have at least one half of their alcohol/substance abuse counselors certified by the State. Uncertified counselors operating under this contract should receive at least one hour of clinical supervision per week from a licensed counselor. All uncertified counselors operating under this contract must become certified within two years of beginning employment to continue providing services pursuant to this contract.

1. The Contractor shall raise the quality of alcohol and substance abuse services with the additional funds provided for that purpose.

2. The Contractor shall provide services as required by the Sevens Bill.

3. The Contractor shall ensure that its alcohol/substance counselors and other behavioral health staff adhere to State laws and rules and, to the extent not inconsistent, to ethical guidelines established by IHS.

C.2 Patient Bill of Rights A. The Contractor shall maintain patient relationships, in part by providing information to each patient including, but not limited to:

1. A patient Bill of Rights and Responsibility, which shall be posted in the waiting areas and to be visible to patients;

2. A grievance policy and procedures for recommending changes to policies and services to the clinic staff and Board, which shall be available to the patients upon request;

3. A description of types and scheduling of services in the clinic, which shall be provided to all patients;

4. A list of staff with their professional titles, which shall be available to the patients upon request;

5. The policies and procedures covering eligibility, referral and consultation services, billing, and other client care services, which shall be provided to the client at the time of registration;

6. Where and how to obtain care during non-clinic hours and for urgent problems, as well as emergencies.

B. The client shall be given an opportunity to privacy to be a partner in his/her evaluation, treatment, and diagnosis.

C. At least annually the Contractor shall conduct surveys of beneficiary satisfaction.

C.3 Quality Management The Contractor shall provide an environment to promote and to strive toward improved quality of care.

A. Operating License: The Contractor shall maintain a valid program operating license from the State (and apply for licensure from the State during Year 1 of the contract).

B. Health Care Professionals: The Contractor shall employ health care professionals with current, unrestricted licenses, and shall, among other things:

1. Provide training for all employees to perform their jobs adequately, including training in: alcohol and substance abuse topics (annually), managing medical and other emergencies, and emergency preparedness;

2. Ensure adequate supervision of all employees;

3. Support a peer review program with written by-laws in which all of the health care professionals participate; and

4. Maintain current cardiopulmonary resuscitation (CPR) certifications for all clinic staff.

C. Accreditation: The Contractor shall prepare for AAAHC survey and accreditation during the first contract year.

D. Quality Assurance/Continuous Quality Improvement Plan: The Contractor shall:

1. Develop and implement a written Quality Assurance/Continuous Quality Improvement (QA/CI) plan that describes the objectives, organization, scope, and mechanisms for overseeing the effectiveness of the monitoring, evaluation, and problem-solving activities, consistent with the confidentiality requirements of 25 U.S.C. § 1675. To ensure completeness and avoid unnecessary work, the plan should model a nationally recognized group such as the Joint Commission.

2. Create a QA/CI committee that is responsible for the implementation of the plan and reporting information to the Board. The committee shall be representative of the various program functions and shall not be limited to the clinical disciplines. The Committee shall hold regular meetings and shall document the attendance and activities.

3. Hold performance improvement meetings with all staff at least quarterly.

4. Continuously monitor at least one clinically-related and one administratively-related outcome measure.

5. Develop written documentation of these activities and evaluate any interventions implemented.

6. Risk Management Program: The Contractor shall develop and implement a Risk Management program, including periodic review of clinical records.

C.4

DISASTER PLANNING

The Contractor shall establish an emergency preparedness plan for the organization and participate in emergency preparedness planning for the community.

C.5

FACILITIES

The Contractor shall provide a safe and sanitary environment for the delivery of health care services, including compliance with Federal and State laws.

C.6

INCORPORATION BY REFERENCE OF THE CONTRACTOR’S TECHNICAL PROPOSAL

The Contractor shall perform the work and services required in this contract in accordance with the Contractor’s technical proposal, submitted to the Nashville Area Office, IHS on________________ [date proposal received], provided, however, that this contract is controlling and shall supersede the proposal in the event of any conflict.

PART 1 - SCHEDULE

SECTION D - PACKAGING AND MARKING

N/A

PART 1 – THE SCHEDULE

SECTION E - INSPECTION AND ACCEPTANCE

E.1 52.246-5 Inspection of Services—Cost-Reimbursement (Apr 1984)

(a) Definition. “Services,” as used in this clause, includes services performed, workmanship, and material furnished or used in performing services.

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

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

(d) If any of the services performed do not conform with contract requirements, the Government may require the Contractor to perform the services again in conformity with contract requirements, for no additional fee. When the defects in services cannot be corrected by reperformance, the Government may—

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

(2) Reduce any fee payable under the contract to reflect the reduced value of the services performed.

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

(1) By contract or otherwise, perform the services and reduce any fee payable by an amount that is equitable under the circumstances; or

(2) Terminate the contract for default.

PART 1 – THE SCHEDULE

SECTION F - DELIVERIES OR PERFORMANCE

F.1 PERIOD OF PERFORMANCE

The period of performance of this contract shall be from August 1, 2018 and shall not extend beyond the completion date of September 30, 2019, unless the period is changed by written modification of the contract.

F.2 REPORTING REQUIREMENTS

The Contractor shall submit to the Contracting Officer the following reports.

F.2.1 Financial Reports F.3

REPORTING REQUIREMENTS

The Contractor shall submit to the Contracting Officer the following reports.

F.3.1 Financial Reports

A. The Contractor shall complete and submit monthly financial reports, including vouchers (Government Standard Form (SF) 1034, “Public Voucher for Purchase and Services Other Than Personal,” and SF 1035, “Continuation Sheet, Public Voucher for Purchase and Services Other Than Personal”), by the 15th of each month, beginning with the first full calendar month following the effective date on the contract.

B. A monthly summary statement of program income/revenues and expenditures that relate to the contract should be included with the SF 1034 and SF 1035 required by paragraph A of this subsection.

C. The Contractor shall maintain records of the receipt and disposition of program income in the same manner as that required for the contract funds that gave rise to program income, showing the source of the income, the purposes for which it was expended, and any other information required by the Contracting Officer. This report shall be included with the SF 1034 and SF 1035 required by paragraph A of this subsection.

D. If the final payment of this contract is to be made on the basis of a desk audit, the Contracting Officer may require the Contractor to submit detailed support for costs contained in one or more interim financial reports.

F.3.2 Audit Reports A. The Contractor shall complete and submit an annual audit report that complies with the requirements of the Single Audit Act of 1984, P.L. 98-502, as amended, and OMB Circular A-133, “Audits of States, Local Governments, and Non-Profit Organizations,” within the earlier of 30 days after receipt of the auditor’s report or nine months after the end of the Contractor’s fiscal year.

B. The Contractor shall submit the audit reports to:

1. Federal Audit Clearinghouse

1201 East 10th Street

Jeffersonville, Indiana 47132

(800) 253-0696

2.

Department of Health and Human Services

Office of Inspector General

Office of Audit Services

National External Audit Review Center

1100 Walnut Street, Suite 850

Kansas City, Missouri 64106-2197

(800) 732-0679

(816) 426-7725

3. Division of Grants Operations

Indian Health Service

801 Thompson Avenue, TMP 360

Rockville, Maryland 20852

(301) 443-5204

4.

The Contracting Officer

F.3.3 Report on Expenditure of Funds

A. The Contractor shall submit quarterly a report on the amounts and purposes for which funding under the contract is expended, including:

1. The number of eligible Urban Indians to whom services were provided; and

2. The number and type of services provided to those eligible Urban Indians.

B. In determining whether to include a particular individual on the report, the Contractor may consider documents including, but not limited to: Certificate of Degree of Indian Blood (CDIB); Bureau of Indian Affairs Form 4432; Tribal membership card; Tribal correspondence; official birth certificate(s) that establish first or second degree descendancy; family documents (e.g. family bible); and self-certification.

F.3.4 Report of Accountable Personal Property (HHS Form 565)

As further described in Section G. 4, Property, the Contractor shall complete an updated listing, which should be submitted annual on September 1.

F.3.5 Program Reports

The Contractor shall complete and submit the following at the specified time(s), if applicable based on the scope of work set out in section C:

A. The IHS Immunization Report for children ages 3-35 months, within 15 days of the end of each quarter (April 15, July 15, October 15, January 15).

B. The PCC of RPMS, by the final business day of each month.

C. Uniform Data Set (UDS), by December 15.

D. GPRA Reporting

1. The GPRA reporting period is from July 1 through June 30 of each year.

2. All GPRA data shall be submitted electronically to the Nashville Area Office, IHS, GPRA Coordinator using GPRA Plus software.

3. All non-RPMS GPRA data shall be reported electronically in a format identical to and compatible with the “GPRAEX” format, as described in the GPRA Instruction Worksheet sent out to each non-RPMS site.

4. All GPRA data submitted shall be verifiable and based upon criteria set forth for each GPRA performance standard.

5. GPRA data shall be completed and submitted on a quarterly basis, five weeks after the end of each GPRA quarter (September 30, December 31, March 31), with the final report due no later than August 15.

E. A summary listing of public and private health services/resources, within 15 days of the end of the contract term.

F. A narrative and documentation of how access was accomplished, within 15 days of the end of the contract term.

G. A Patient Satisfaction Survey Report, within 15 days of the end of the contract term.

H. An assessment of current alcohol and substance abuse problems in their community, within 15 days of the end of the contract term.

I. An Urban Indian Unmet Health Needs Report, per 25 U.S.C. § 1653(a), within 15 days of the end of the contract term.

J. Recommendations to improve access to health services for Urban Indians, within 15 days of the end of the contract term.

F.4

QUARTERLY PROGRAM REPORTS

Contractor shall submit a quarterly narrative program report along with the voucher for the third month of each

Calendar to the Contracting Office.

1. Reports to be submitted as to

a. Program Utilization (client census)

b. Program Activities (Prevention & Intervention)

c. Evidence-Based Practices, Special Activities

d. Meetings, Training, Challenges

e. Incidents, Staffing Issues

f. Future Plans.

F.5

NONCOMPLIANCE OR UNSATISFACTORY PERFORMANCE

If, at any time during the effective period of this contract, the Contracting Office, along with the Director of the Office of Urban Indian Health Programs, determines that the Contractor has not complied with the requirements of the contract or of the IHCIA, Pub/ :/ 94-437, as amended, or other applicable Federal law, the Contracting Officer shall attempt to resolve any areas of noncompliance or unsatisfactory performance and modify the contract to prevent future occurrences of such noncompliance or unsatisfactory performance.

If the Contracting Officer determines that such noncompliance or unsatisfactory performance cannot be resolved or prevented in the future, after consultation with the Director of the Office of Urban Indian Health Programs (OUIHP), the Contracting Officer shall not renew the contract and may, also after consultation with the Director of the Office of Urban Indian Health Programs, terminate the contract before the end of the contract term if deemed necessary.

PART 1 – THE SCHEDULE

SECTION G - CONTRACT ADMINISTRATION DATA

G.1

FINANCIAL PROVISIONS

A. The Nashville Area Finance Office shall reimburse cost under this contract.

B. Payment will be made by the:

Nashville Area Indian Health Service

711 Stewarts Ferry Pike

Nashville, TN 37214 G.2

COMPENSATION

A.

Estimated Cost: The estimated total cost of this contract is __________.

B.

Allowable Costs: The allowable costs under this contract include those costs incurred by the Contractor in connection with the services covered by this contract during the effective period of this contract.

1.

Payment:

a.

Consistent with the schedule referenced in Section G.1(A), the Contractor shall request payment by submitting SF 1034 to the Contracting Officer or his/her authorized representative. The request shall itemize expenditures on forms “Computation of Amount Requested” and “Major Elements of Cost,” or comparable computerized forms, and explain how the claimed allowable costs qualify as performance under this contract. The Contractor will certify the vouchers with the following statement:

“I certify that all payments requested are for appropriate purposes and in accordance with the contract.”

b.

Upon receipt, the Contracting Officer shall determine the amounts to be allowable, in accordance with Subpart 31.2 of the Federal Acquisition Regulation; FAR Contract Clause 52.216-7, “Allowable Cost and Payment;” HHSAR Contract Clause 352.216-72, “Additional Cost Principles;” and the provisions of this contract. The Government shall make payments to the Contractor for the allowable amounts requested, but such payments shall not be made more often than once every two weeks (except for small business concerns).

Reimbursing Costs:

a.

For the purpose of reimbursing allowable costs (except as provided in subparagraph (B)(2)(b) of this subsection), the term “costs” includes only:

i.

Recorded costs for items or services purchased directly for the contract and for which, at the time of the request for reimbursement, the Contractor has paid by cash, check or other forms of actual payment;

ii.

Costs incurred in the ordinary course of business, but for which the Contractor has not necessarily paid, but only if the Contractor is not delinquent in paying costs of contract performance in the ordinary course of business, including:

A. Materials issued from the Contractor’s inventory and placed in the production process for use on the contract;

B. Direct labor;

C. Direct travel;

D. Other direct in-house costs; and

E. Properly allocable and allowable indirect costs, as shown in the records maintained by the Contractor for purposes of obtaining reimbursement under Government contracts.

iii.

Progress payments that the Contractor has paid under similar cost standards to its subcontractors.

b.

For the purpose of reimbursing allowable costs, the term “costs” includes contributions to pension, profit sharing, or employee stock ownership plan funds only as follows;

i.

For plans paid quarterly or more often, and the Contractor pays the contribution to the fund within 30 days after the close of the period covered. The Contractor may include such contributions as indirect costs for payment purposes.

ii.

For plans paid quarterly or more often, and the Contractor pays the contribution to the fund 30 days or more after the close of a period. For payment purposes, the Contractor shall exclude such contributions from the indirect costs until the Contractor actually makes the payment.

iii.

For plans paid less often than quarterly. For payment purposes, the Contractor shall exclude such contributions from the indirect costs until the Contractor actually makes the payment.

3.

Limitation of Cost: Subject to the provisions of the FAR Contract Clause 52.232-20, “Limitation of Cost,” the total cost to the Government, including all direct costs and indirect costs, for the performance of this contract shall not exceed the estimated amount stated in Section G.2(A), unless and until the Contracting Officer notifies the Contractor in writing that this ceiling amount has been increased.

4.

Direct Costs: The Contractor will be reimbursed for the following costs that the Contractor claims, and the Contracting Officer accepts, as having been incurred directly and specifically in the performance of this contract. As provided in Section G.2(B)(5), some direct costs may require prior, written approval by the Contracting Officer.

a.

Salaries and wages, including fringe benefits but excluding employees’ Federal Income Tax Withholdings, of the Contractor’s employees who are directly employed in performing the work required by this contract. Fringe benefits shall be reimbursed at actual cost.

b.

Materials and services required in the performance of this contract, after deducting all discounts for purchase of such materials and services.

c.

Consultant fees or other payments to consultants required in the performance of this contract, provided that such fees or payments shall not exceed the daily rate, excluding travel costs, without prior written approval of the Contract Officer.

d.

Travel and subsistence expenses incurred by the Contractor exclusively in direct performance of this contract, or other travel approved by the Contracting Officer. Reimbursements for travel shall not exceed the rate established for Civil Service employees by the Federal Travel Regulations in effect at the time travel is performed.

e.

Communication expenses, including telegraph, telephone and internet connectivity.

f.

Office space rental, including the expense of janitorial service.

g.

Board of Directors and Board Committee Meetings.

h.

Expense of meeting facilities.

i.

Expense of training workshops and seminars, as authorized in the contract budget.

j.

Insurance expenses. The Contractor must obtain prior written approval of the Contracting Officer before purchasing any insurance plan or policy for whatever purpose.

k.

Periodicals, publications, and brochures.

l.

Printing and duplication.

m.

Vehicle rental/leasing and maintenance.

n.

Office supplies.

o.

Payroll processing.

p.

Advertising/recruitment.

q.

Such other costs not expressly excluded by this contract may be reimbursed as an allowable cost only upon written approval by the Contracting Officer.

5.

Prior Authorization of Certain Direct Costs a.

As may be indicated herein, purchase orders and subcontracts are governed by FAR Contract Clause 52.244-02.

Notwithstanding the provisions FAR Contract Clause 52.244-02, “Subcontracts,” the Contractor shall obtain prior written approval from the Contracting Officer for the following costs:

i.

Purchase, lease, or rental of any interest in real property;

ii.

Alteration or renovation of facilities;

iii.

Purchase of non-expendable property having an acquisition cost of $5,000 per item;

iv.

Purchase of the following, regardless of cost: audiovisual equipment; telecommunications equipment; motor vehicles; automatic data processing equipment; used equipment; copying equipment; office furniture and furnishings; and equipment to be obtained through lease/rental rather than purchase.

v.

Travel outside of the State.

c.

If the Contractor intends to claim reimbursement for such costs under this contract, the Contractor does so at its own risk if it incurs the costs without obtaining prior written authorization from the Contracting Officer.

6.

Unallowable Direct Costs: Unless otherwise expressly provided elsewhere in this contract, in any contract amendment, or by specific written authorization from the Contracting Officer, any items identified as unallowable in OMB Circular A-122, “Cost Principles for Nonprofit Organizations,” shall not be allowable costs under this contract.

7.

Indirect Costs: Indirect costs are not applicable to this contract. All costs shall be billed as direct costs.

G.3

PROGRAM INCOME

The Contractor shall use program income to provide additional services or benefits within the scope of the current contract G.4

ADMINISTRATION OF GOVERNMENT PROPERTY

A.

The Property Administrator is the authorized representative of the Contracting Officer for the purpose of administrating the contract requirements and obligations relative to Government property (Government furnished and/or contractor acquired). The Contracting Officer shall designate the Property Administrator in writing and shall provide a copy of the designation to the Contractor.

B.

In accordance with the FAR Contract Clause 52.245-1, “Government Property,” the Contractor shall establish and maintain written procedures for the maintenance, repair, protection and preservation, control of, and accountability for Government property, consistent with the provisions of DHHS Publication (OS) 686, entitled “Contractor’s Guide for Control of Government Property (1990).” The Property Administrator will provide a copy of the Guide to the Contractor. Chapter 3, “Contract Start-up,” of the Guide may be used as a guide in preparing the written procedures, which shall be furnished to the Property Administrator within sixty days after the effective date of this contract.

C.

The Contractor’s procedures shall specifically address the following requirements relative to said Government property:

Provision for adequate identification, markings, recording and maintenance.

Performance of an annual physical inventory.

3.

Safeguarding of all Government property and assuring that the property is used solely for authorized purposes.

4.

Submission of Form HHS-565, “Report of Accountable Personal Property,” with each public voucher submitted for payment under which reimbursement for acquisition of authorized Capitalized Nonexpendable Equipment is requested.

D.

When the Contract is completed, a final inventory shall be taken by the Contractor and submitted to the Property Administrator. The following certificate signed by the authorized official of the Contractor shall be provided with each copy of the final inventory:

“I do hereby certify as [title of authorized official] of [name of Contractor] that the attached inventory reports are complete and correctly list and describe all items of materials, supplies, and equipment furnished to the Contractor, or for which the Contractor has been or will be reimbursed by the Government for use in the performance of Contract No. [contract number], which as of this date have not been consumed in performance of this contract; and that I will immediately notify the Contracting Officer of any change affecting these inventory reports at any time prior to final disposition of the inventory.”

E.

All Government property, either Government furnished and/or Contractor acquired, that is listed under Contract No. [contract number] is hereby transferred and made a part of this contract.

F.

The Contractor agrees to provide storage facilities, including proper identification and protection, for all Government-owned property (Government furnished and/or Contractor acquired) upon completion of the contract, without cost to the Government, until disposition instructions are provided. The Government shall provide disposition instructions after the Contractor’s submission of the final inventory.

G.5

CONTRACTING OFFICER AND CONTRACTING OFFICER REPRESENTATIVE

A. The below named is hereby designated to act as the Contracting Officer’s Technical Representative under the contract:

Edwin Taylor

IHS/Nashville Area

711 Stewarts Ferry Pike

Nashville, TN 37214

Telephone (828) 507-1115

B.

The Contracting Officer is responsible for negotiating and issuing changes in the terms, conditions, or amounts cited in this contract and is the only party authorized to bind the Government to the Contract.

C.

The Project Officer, who the Contracting Officer shall designate in writing, is responsible for ensuring that the Contractor meets the Government’s technical objectives. To this end, the Project Officer will provide necessary information, direction, and coordination within the contractual work description.

D.

Office of Urban Indian Health Programs

E.

Area Urban Coordinator.

PART 1 – THE SCHEDULE

SECTION H - SPECIAL CONTRACT REQUIREMENTS

H.1

KEY PERSONNEL

A.

In accordance with HHSAR Clause 352.270-05, “Key Personnel,” the following positions are considered key personnel:

Executive Director .

Chief Financial Officer

3.

Clinical Director

The Contractor will identify in writing to the Contracting Officer the names of the personnel occupying these positions, as well as any subsequent changes in those positions.

B.

The key personnel specified in this contract are considered to be essential to work performance. At least 30 days prior to diverting any of the specified individuals to other programs or contracts (or as soon as possible, if an individual must be replaced, for example, as a result of leaving the employ of the Contractor), the Contractor shall notify the Contracting Officer and shall submit comprehensive justification for the diversion or replacement request (including proposed substitutions for key personnel) to permit evaluation by the Government of the impact on performance under this contract. The Contractor shall not divert or otherwise replace any key personnel without the written consent of the Contracting Officer. The Government may modify the contract to add or delete key personnel at the request of the contractor or Government.

H.2 352.270-2 Indian Preference (APR 1984)

(a) The Contractor agrees to give preference in employment opportunities under this contract to Indians who can perform required work, regardless of age (subject to existing laws and regulations), sex, religion, or tribal affiliation. To the extent feasible and consistent with the efficient performance of this contract, the Contractor further agrees to give preference in employment and training opportunities under this contract to Indians who are not fully qualified to perform regardless of age (subject to existing laws and regulations), sex, religion, or tribal affiliation. The Contractor also agrees to give preference to Indian organizations and Indian-owned economic enterprises in the awarding of any subcontracts to the extent feasible and consistent with the efficient performance of this contract. The Contractor shall maintain statistical records as are necessary to indicate compliance with this paragraph.

(b) In connection with the Indian employment preference requirements of this clause, the Contractor shall provide opportunities for training incident to such employment. Such training shall include on-the-job, classroom or apprenticeship training which is designed to increase the vocational effectiveness of an Indian employee.

(c) If the Contractor is unable to fill its employment and training opportunities after giving full consideration to Indians as required by this clause, those needs may be satisfied by selection of persons other than Indians in accordance with the clause of this contract entitled ``Equal Opportunity.''

(d) If no Indian organizations or Indian-owned economic enterprises are available under reasonable terms and conditions, including price, for awarding of subcontracts in connection with the work performed under this contract, the Contractor agrees to comply with the provisions of this contract involving utilization of small business concerns, small disadvantaged business concerns, and women-owned small business concerns.

(e) As used in this clause:

(1) ``Indian'' means a person who is a member of an Indian Tribe. If the Contractor has reason to doubt that a person seeking employment preference is an Indian, the Contractor shall grant the preference but shall require the individual to provide evidence within thirty (30) days from the Tribe concerned that the person is a member of the Tribe.

(2) ``Indian Tribe'' means an Indian Tribe, pueblo, band, nation, or other organized group or community, including Alaska Native village or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (85 Stat. 688; 43 U.S.C. 1601) which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.

(3) ``Indian organization'' means the governing body of any Indian Tribe or entity established or recognized by such governing body in accordance with the Indian Financing Act of 1974 (88 Stat. 77; 25 U.S.C. 1451); and

(4) ``Indian-owned economic enterprise'' means any Indian-owned commercial, industrial, or business activity established or organized for the purpose of profit, provided that such Indian ownership shall constitute not less than 51 percent of the enterprise, and that ownership shall encompass active operation and control of the enterprise.

(f) The Contractor agrees to include the provisions of this clause, including this paragraph (f) of this clause, in each subcontract awarded at any tier under this contract.

(g) In the event of noncompliance with this clause, the Contracting Officer may terminate the contract in whole or in part or may impose any other sanctions authorized by law or by other provisions of the contract.

H.3 352.270-3 Indian Preference Program a.

In addition to the requirements of the clause of this contract entitled “Indian Preference”, the Contractor agrees to establish and conduct an Indian Preference Program which will expand opportunities for Indians to receive preference for employment and training in connection with the work to be performed under this contract, and which will expand the opportunities for Indian organizations and Indian-owned economic enterprises to receive a preference in the awarding of subcontracts. In this connection, the Contractor shall:

(1) Designate a Liaison Officer who will (i) maintain liaison with the Government and the Tribe(s) on Indian preference matters; (ii) Supervise compliance with the Provisions of this clause; and (iii) Administer the Contractor’s Indian Preference Program.

(2) Advise its recruitment sources in writing and include a statement in all advertisements for employment that Indian applicants will be given preference in employment and training incident to such employment.

(3) Not more than twenty (20) calendar days after award of the contract, post a written notice in the Tribal Office of any reservations on which or near where the work under this contract is to be performed that sets forth the Contractor’s employment needs and related training opportunities. The employees needed; the approximate dates of employment; the experience or special skills required for employment, if any; training opportunities available and other pertinent information necessary to advise prospective employee of any other employment requirements. The Contractor shall also request the Tribe(s) on or near whose reservation(s) the work is to be performed to provide assistance to the Contractor in filling its employment needs and training opportunities.

The Contracting Officer will advise the Contractor of the name, location and phone number of the Tribal Officials to contract in regard to the posting of notice and requests for Tribal assistance.

(4) Establish and conduct a subcontracting program which gives preference to Indian organizations and Indian-owned economic enterprises as subcontractors and suppliers under this contract. The Contractor shall give public notice of existing subcontracting opportunities and, to the extent feasible and consistent with the efficient performance of this contract, shall solicit bids or proposals only form Indian organizations or India-owned economic enterprises. The Contractor shall request assistance and information on Indian firms qualified as suppliers or subcontractors form the Tribe(s) on or near whose reservation(s) the work under the contract is to be performed. The Contracting Officer will advise the Contractor of the name, location, and phone number of the Tribal Officials to be contacted in regard to the request for assistance and information. Public notices and solicitations for existing subcontracting opportunities shall provide an equitable opportunity for Indian firms to submit bids or proposals by including: (i) A clear description of the supplies or services required, including quantities, specifica6tions, and delivery schedules which facilitate the participation of Indian firms; (ii) A statement indicating that preference will be given to Indian organizations and Indian-owned economic enterprises in accordance with Section 7(b) of the Public Law 93-638 (88 Stat.2205; 25 U.S.C. 450e (b)); (iii) Definitions for the terms “Indian organization” and “Indian-owned economic enterprises” as prescribed under the “Indian Preference” clause of this contract; (iv) A representation to be completed by the bidder or offeror that it is an Indian organization or Indian-owned economic enterprise; and (v) A closing date for receipt of bids or proposals which provides sufficient time for preparation and submission of a bid or proposal If after soliciting bids or proposals from Indian organizations and Indian-owned economic enterprises, no responsive bid or acceptable proposal is received, the Contractor shall comply with requirements of paragraph (d) of the “Indian Preference” clause of this contract.

If one or more responsive bids or acceptable proposals are received, award shall be made to the low responsible bidder or acceptable offeror if the price is determined to be reasonable. If the low responsive bid or acceptable proposal is determined to be unreasonable as to price, the Contractor shall attempt to negotiate a reasonable price and award a subcontract.

If a reasonable price cannot be agreed upon the Contractor shall comply with the requirements of paragraph (d) of the “Indian Preference” clause of this contract.

(5) Maintain written records under this contract which indicate:

(a) The numbers of Indians seeking employment for each employment position available under this contract;

(b) The number and types of positions filled by Indians and non-Indians, and the total number of Indians employed under this contract;

(c) For those positions where there are both Indian…