Amendment 0001 - Request for Proposal (RFP) 75H70421R00002 (11-10-2020).pdf

INDIAN HEALTH SERVICE (IHS)

AMENDMENT 0001 – REQUEST FOR PROPOSAL (RFP) 75H70421R00002

The purpose of Amendment 0001 to the Indian Health Service/Headquarters (IHS/HQ) Request for Proposal (RFP) 75H70421R00002 for National COVID-19 Critical Care Response Teams (CCRTs) IDIQ Contracts is to provide government responses to offerors’ questions received in response to this solicitation. Amendment 0001 changes the RFP Submission closing date. All proposals are due no later than 12:00 PM (Eastern Time), Monday, November 23, 2020. A hard copy of Amendment 0001, containing the Q&As are attached herein this solicitation.

Amendment 0001 further clarifies or corrects the following:

1. Corrects the agency’s name as “Indian Health Service (IHS).”

2. Adds Section B.1: Purpose that since the RFP was originally posted, a CCRT completed a deployment to Rosebud IHS Hospital (Rosebud, SD).

3. Revises RFP, Section B.4. Contract Price, Schedule of Charges pricing tables. For price evaluation purposes only (using the onsite burdened labor rates specified in Section B.4), please provide your total price and breakout, excluding travel, based on the following scenario: Ten (10) consecutive day onsite deployment, with one 24-hour rest period, to Cass Lake, MN. The four-person CCRT team needed for this location would include the following labor categories: 1 physician, 2 Critical Care RNs and 1 Registered Respiratory Therapist.

4. Clarifies Section C – Statement of Objective (SOO) - Task 2.3.4 Nurse Practitioner (NP) labor category as a billable CLIN when individuals with a NP are being used as NPs. A NP or Family Nurse Practitioner (FNP) may perform services as a CCRN on a CCRT, but will be billed at the CCRN labor rate.

5. Clarifies Section C – Statement of Objectives- Task 2.5.2 to read as follows: “A minimum 24-hour rest period is required if the CCRT member is working 10 or more 12-hour consecutive shifts, or if deemed necessary by the facility.”

6. Adds Deliverable Item Reference Number and Date of Deliverable Submission to Section D.2: Marking

7. Changes the identified COR- To Be Determined and changes Section G.1.3.2 Technical Monitoring – Technical Point of Contact – To Be Determined.

8. Clarifies Section G.2 invoice submission. The government replaces the sentence that read: “The Contractor shall send one email per monthly.” The revised requirement reads as follows: “Invoicing and Payments shall be done no less often than monthly. If more frequent invoicing and payments apply, that information will be contained in individual Task Orders.”

9. Corrects Section H.4.2. Department of Health and Human Services, Homeland Security Program Directive -12 Implementation Policy (HHS HSPD-12 Implementation Policy) to read “HSPD-12 stands for Homeland Security Presidential Directive.”

10. Clarifies Section H.7 Key Personnel that the individual responsible for Physician and Nursing Oversight may also be known as the Contractor’s “Medical Director.”

11. Revises Section H8: Non-Personal Services to clarify the contractor and the government’s roles regarding CCRT members work schedules when on deployment.

12. The government clarifies the statement for Section L - Sub-Factor 4: CCRT Deployment Scenarios as follows: “Resumes/CVs and supporting documentation must demonstrate that at least 2 physicians, 2 CCRNs, and 2 RRTs meet Appendix B: CCRT Qualification Requirements and Appendix C: Critical Care Response Team General Requirements (Non-Personal Services) (Factor 3: CCRT Member Qualifications). The government requires resumes/CVs and supporting documentation for individuals proposed who will be providing onsite services. Resumes/CVs and supporting documentation are not needed at time of proposal submission for telehealth providers.

13. Clarifies Section L: Subfactor 4: CCRT Deployment Scenarios.

14. Clarifies Section L: Factor 3: Qualifications of CCRT Members. Offerors do not need to submit resumes/CVs for proposed backups or telehealth providers, if telehealth providers are proposed on Appendix L, with technical proposal due November 23, 2020 at 12:00N (Eastern Time).

15. Revises RFP, Section L.6. Electronic Transmission of Proposals to update the RFP submission closing date to 11/23/2020 at 12:00pm (EST).

16. Revises RFP, Section M: Evaluation Factors for Award, Factor 5: Price Evaluation (b).

17. Includes revised Appendix L: CCRT Deployment Scenario Staffing Roster.

PAGE # SECTION # SECTION

TITLE

QUESTIONS GOVERNMENT RESPONSES

Page 19 C.4

Task Area 1: CCRT Management and Task 2.6

Performance Evaluation

Can Telecritical Care be substituted for deployment of onsite CCRTs?

No. At a minimum, offerors must be able to provide qualified medical professionals for onsite critical care patient care and clinical education services, when a need arises.

Telehealth critical care medicine /nursing services may be proposed to augment support but cannot be substituted if there is a need for onsite team (s). Offeror must be capable of also providing onsite CCRTs for all required labor categories.

Page 59 Factor 3 Qualifications of CCRT Members

If Telecritical Care is acceptable, can contractor submit professionals’ Curriculum Vitaes after or at the time of the emergency response.

IHS is not seeking just a telehealth solution. However, if offeror proposes telehealth services as part of an overall approach in addition to augmenting onsite services, resumes/CVs for telehealth providers are required as part of the Medical Staff credentialing and privileging application process, but do not need to be submitted with the technical proposal due 11/23/2020 at 12N ET.

Page 57 Sub-factor 2 1.2.3 Knowledge of practicum-based clinical education methods and techniques

Can you please provide an estimate for the number of individuals – “existing IHS or tribal staff, comprised of permanent employees and locums/contractors” – who will have access to the education in 1.2.3

The estimated number of staff at each facility will vary. The number of staff at each location where a CCRT performed onsite and/or virtual clinical education services during June 16, 2020 – November 8, 2020, ranged between 50-150 unique learners at each location.

Page 57 Sub-factor 2 1.2.1 Sub-factor 2: Clinical and Clinical Education Services (Tasks 2 and 3)

Do you require a focus on the adult population, pediatric population, or both?

What about any special populations?

CCRT members need to be able to provide care for all age populations.

The majority of IHS patients testing positive for COVID-19 are adults.

Offerors should discuss experience managing critically ill patients with comorbidities. Some locations identified in Attachment A have reported seeing critically ill pediatric COVID-19 cases, but were able to transfer critically ill pediatric cases to other hospitals. Due to the nature of the COVID-19 pandemic, pediatric clinical expertise may be required in the future, and if needed, will be specified on a request for task order proposal.

N/A N/A N/A Is there already an incumbent on this contract? If so, would it be possible to get the name of the company currently performing on this contract?

IHS previously awarded two separate orders/contracts:

75H70420P00027 Contractor: Fire Creek Services Company

75H70421P00002 Contractor: Tribal EM, PLLC

N/A N/A N/A Will IHS will consider nurses with flight nurse certification in lieu of CCRN-Adult?

No.

Note: It appears in Appendix A

B.1 SECTION B –

PRODUCTS

OR SERVICES

AND

PRICES/COSTS

Approximately how many IHS/tribal staff clinicians who care for critically ill patients, or may care for them in times of surge capacity, are in the IHS agency?

One of the primary purposes of this contract is to train staff across a variety of disciplines, many of whom do not typically treat critically ill patients. The estimated number of staff who will treat critically ill COVID-19 patients will vary by facility.

1 2.2.2 C.2. Program Objectives and Requirements

General clarifications needed on the transition period and plan – how long to credential staff after award?

If offeror is awarded an IDIQ contract and subsequent task order, at onset of contract or task order performance period, the COR will work with the contractor and designated IHS facility points of contact to begin the onboarding process for all qualified and acceptable candidates. Offeror must complete Appendix L: CCRT Deployment Scenario Staffing Roster to clearly identify a timeline for when proposed CCRT members would be available to start at the first location(s).

1 2.2.2 C.2. Program Objectives and Requirements

Award to deploy within 24 hours doesn’t seem realistic or is no credentialing needed to start training staff?

Per task 2.7, all Licensed Independent Practitioners are required to apply for Medical Staff membership and be granted privileges in order to perform services under the IDIQ contract and subsequent task order(s). The timeline for the first onsite deployment(s) will be specified on the request for task order proposal, with the required deployment start date(s). The government estimates that if the hospital will grant disaster privileges, the credentialing and privileging process can be expedited, but the credentialing timeframe is dependent on many factors, including the contactor and contract health care provider to submit timely and complete documentation and for peer references to be verified by IHS.

1 2.2.2 C.2. Program

Requirements

Who is setting the training schedule for all facilities to have availability?

The contract vehicle will be an IDIQ contract, with services, if needed, ordered via a task order, on an as needed basis. Therefore, if training is needed, training and locations that require training will be specified on a request for task order proposal.

16 3.3 C.2. Program

Requirements

What is the highest number of concurrent expected deployments that are anticipated and when is the peak need?

The contract vehicle will be an IDIQ contract, with services to be ordered via a task order, on an as needed basis. Due to the nature of the COVID-19 pandemic, the government cannot predict a peak period. At onset of award of the IDIQ contract, IHS anticipates an immediate need for contractors to establish 1-2 teams to deploy or be ready to deploy to locations on Attachment A.

16 3.3 C.2. Program Objectives and Requirements

SOW expresses 1 team to train as many facilities as possible. Would this best achieved with distance learning while other teams are deployed and dedicated to patient care?

The government clarifies that Task 3: Clinical Education will primarily be practicum-based at the bedside or in-services for staff during onsite deployments. If virtual training is anticipated, services will be requested on the request for task order proposal.

16 3.3 C.2. Program Objectives and Requirements

3.3 talks to virtual training – How often would this likely be scheduled?

The government clarifies that Task 3: Clinical Education will primarily be practicum-based at the bedside or in-services for staff during onsite deployments. If virtual training is anticipated, services will be requested on the request for task order proposal.

14 2.7.2 IHS

Credentialing and Privileging Process & Requirements

Is there a possibility for a central credentialing process that can approve a package that would be accepted at all facilities? Credentialing packages for all 44 locations will be heavily burdensome on all parties involved.

At this time, IHS federal locations on Attachment A do not have a centralized Medical Staff credentialing and privileging process (C&P process). Each CCRT member who is a Licensed Independent Practitioner (LIP) will be required to be credentialed at each location where the individual will perform services under the IDIQ or subsequent task order(s).

Because of the governance autonomy for each facility there is not a standard Credentialing and Privileging application. Each facility may ask for different types of verification documents to complete their C&P process.

IHS federal facilities use a centralized credentialing system to credential LIPs, which facilitates sharing of some credentialing and privileging documents. If awarded an IDIQ contract and subsequent task order, the facility will provide a point of contact and the required C&P process/forms necessary.

Refer also to Appendix D:

Schedule of Deliverables, Item 6.

14 2.7.2 IHS

Credentialing and Privileging Process & Requirements

How long are the facilities turn around times on this and are disaster credentials guaranteed in lieu of an otherwise completed package?

Facility turnaround time to complete credentialing and privileging process will vary from one facility to another depending on their process, policies, and governance requirements. Most facilities complete the C&P process within an average of 30 days. If the facility determines that the CCRT deployment purpose is for urgent patient care in the event of a Disaster or Emergencies that meets national accreditation standards, C&P can be expedited. The government reiterates that the timeframe to complete C&P process is also dependent on the timely response and correct submission of requested information from the CCRT candidate.

Refer to Appendix D: Schedule of Deliverables, Item #6.

14 2.7.2 IHS

Credentialing and Privileging Process & Requirements

How long are all facilities privileges valid upon approval

If the facility grants privileges the CCRT member, each facility will determine how long privileges are valid. The government reiterates that CCRT members granted privileges under this contract must maintain these privileges in order to continue to perform services under the contract. In general, most medical staff bylaws assign a new medical staff member who has completed the full C&P process, to a provisional status, which is typically a 1-year appointment. If the medical staff member is performing well and wishes to continue membership at the facility where privileges were granted, typically they are then moved into an active status. Even through a provider may get a 1-year appointment at one facility, the provisional appointment only applies to that facility, and does not apply to any other facility.

If the facility grants disaster privileges, disaster privileges generally expire once the provider is not working any longer.

13 2.5.2 Deployment Length & CCRT Work Schedule

The numbers on a CCRT does not support 24/7 coverage. Does this mean the individual members of the CCRT should be prepared to work on shifts that cover 24/7?

No. The government clarifies for onsite deployment that most facilities schedule in 12-hour blocks, such as 7am-7pm. CCRT members deployed onsite may be scheduled for day, night, overnight or split shifts based on the facility’s needs.

Offeror’s PWS and technical response should also explain approach to ensure after-hours offsite coverage, if a need arises.

13 2.5.2 Deployment Length & CCRT Work Schedule

Not every designated hospital has an ICU;

can we expect that the CCRTs will not be used to provide direct patient care in those facilities?

CCRT services may be needed at any of the locations on Attachment A. Many facilities are seeing critically ill COVID-19 patients in the Emergency Department or in-patient units that are converted to treat severely ill patients who cannot be transferred to other medical locations. CCRT members may be scheduled for shifts in any department that the facility is supporting the treatment and management of critically ill COVID-19 patients.

14 RFP Section 2.7.2 IHS Credentialing and Privileging Process & Requirements

How many of the designated hospitals will use the disaster credentialing and privileging process, in lieu of full credentialing/privileging process? This is critical in ensuring our physicians can be responsive to Task Orders more quickly after award.

Each facility will determine the appropriate Medical Staff credentialing and privileging process for LIPs, in accordance with national accreditation and Centers for Medicare and Medicaid Services (CMS) requirements.

17 3.2 Critical Care Clinical Education

Will a task order be issued requesting the development of new training?

The government will follow the task order process for all services needed under the scope of the IDIQ contract, which may include the need for one or more tasks in the SOO. This may include the need for new training.

17 3.2 Critical Care Clinical Education

Will this be reimbursed on the same T&M method as other tasks?

All tasks under this IDIQ contract and subsequent task orders will be billable based on acceptable Time and Materials delivered to the government.

4 Schedule of Charges

Schedule of Charges

Can the Government please clarify the minimum number of candidates for each position that are required to be submitted with the proposal?

Refer to Section L: Factor 3, of the RFP (page 59).

Factor 3: Qualifications of CCRT Members Offeror shall provide current resumes/cvs and supporting licenses and certifications for all proposed CCRT members identified on Appendix L: CCRT Deployment Scenario Staffing

Roster. Resumes/cvs and supporting documentation must demonstrate that at least 2 physicians, 2 CCRNs, and 2 RRTs meet Appendix B: CCRT Qualification Requirements and Appendix C: Critical Care Response Team General Requirements (Non-Personal Services). Current resumes/cvs are limited to 3-5 pages for each member. All employment gaps must be explained.

4 Schedule of Charges

Schedule of Charges

Can the Government please clarify what offerors are required to put in the “Estimated Total Hours of Labor” column in the pricing section? In order for the Government to compare apples to apples, it was seem that all offerors would need to be using the same number of labor hours and per the evaluation criteria, the pricing will be evaluated based on the total cost of each base/option year and the total costs of all base & options years combined.

The government clarifies Section B.4: Contract Price, Schedule of Charges; and Section M:

Evaluation Factors for Award. See also attached revised Appendix L:

CCRT Deployment Scenario Staffing Roster.

The government clarifies Section M as follows. “For price evaluation purposes only (using the onsite burdened labor rates specified in Section B.4), please provide your total price and breakout, excluding travel, based on the following scenario: Ten

(10) consecutive day onsite deployment, with one 24-hour rest period, to Cass Lake, MN. The four-person CCRT team needed for this location would be the following labor categories: 1 physician, 2 Critical Care RNs and 1 Registered Respiratory Therapist.”

3 B.4 Contract Price

Would the federal government consider having a daily stipend amount for travel based on labor category for the contractor to cover logistical expenses as a fixed rate?

No. The contractor must be able to substantiate that all travel costs comply with GSA Federal Travel Regulation when seeking reimbursement.

3 B.4 Contract Price

Would the government consider including a Medical Director labor category on a per deployment basis director to oversee the contract and clinical deployment teams?

Yes. Section B: Pricing table is updated to add offsite and onsite rates for Medical Director oversight. If the IHS determines that this labor category is necessary, this labor category will be specified in the request for task order proposal.

3 B.2 Type of Contract

If a contractor demonstrates proof that it can successfully meet the requirements outlines in the SOO, would the government consider a single source award?

The government intends to award multiple IDIQ(s) as a result of this solicitation assuming the government has a continuing need for CCRT services and based on the number of quality proposals received.

10 C.1 Scope Would the government consider using CCRT or CFRN in place of CCRN? No.