Amendment 1 to 75H70621R00003.pdf

(x)

75H70621R00003 x x copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted ; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT TO BE

RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR

OFFER. If by virtue of this amendment you desire to change an offer already submitted , such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

x

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

05/04/20210001

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

12. ACCOUNTING AND APPROPRIATION DATA (If required) is not extended.is extended, Items 8 and 15, and returning

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended , by one of the following methods: (a) By completing

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

FACILITY CODE CODE

10B. DATED (SEE ITEM 13)

10A. MODIFICATION OF CONTRACT/ORDER NO.

9B. DATED (SEE ITEM 11)

9A. AMENDMENT OF SOLICITATION NO.

CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

7. ADMINISTERED BY (If other than Item 6)CODE 6. ISSUED BY

PAGE OF PAGES

4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO. (If applicable)

1. CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

04/21/2021

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority) appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

E. IMPORTANT: Contractor is not is required to sign this document and return __________________ copies to the issuing office.

ORDER NO. IN ITEM 10A.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Firm Fixed-Price, Indefinite Delivery/Requirements, Non-Personal Services contract for

Physician Assistant/Nurse Practitioner/Certified Nurse Midwife Services for the Rosebud IHS

Hospital, Rosebud, SD 57570.

Services shall be performed in accordance with the Section C. Statement of Work.

This amendment hereby changes the solicitation as follows:

A. Extend the due date for proposals from May 5, 2021 to May 12, 2021 @10:00am CDT/CST.

B. Delete the current Statement of Work in its entirety and incorporate the revised

Continued ...

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)15A. NAME AND TITLE OF SIGNER (Type or print)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 15B. CONTRACTOR/OFFEROR 16C. DATE SIGNED

(Signature of person authorized to sign) (Signature of Contracting Officer)

CRAIG J. WELLS

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

Previous edition unusable

Except as provided herein, all terms and conditions of the document referenced in Item 9 A or 10A, as heretofore changed, remains unchanged and in full force and effect .

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 18

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70621R00003/0001

Statement of Work in its entirety.

C. Delete the current Section M in its entirety and incorporate the revised Section M in its entirety.

D. Incorporate the questions received and the responses provided regarding this solicitation.

There are no other changes authorized by this amendment.

Period of Performance: 06/01/2021 to 05/31/2022

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

C - Description/specifications/statement of work

STATEMENT OF WORK

PHYSICIAN ASSISTANT/NURSE PRACTITIONER/CERTIFIED NURSE MIDWIFE

FOR THE

ROSEBUD IHS OUTPATIENT DEPARTMENTS

Rosebud Service Unit, Great Plains Area Indian Health Service

A. PURPOSE OF CONTRACT:

The mission of the Rosebud Comprehensive Healthcare Facility [Rosebud Indian Health Service (IHS) Hospital] is to provide the best possible health care services to the Native American population of the Rosebud Reservation in South Dakota. To meet this mission this requires contractor support to provide primary care Physician Assistant (PA), Nurse Practitioner (NP) and Certified Nurse Midwife (CNMW) services on a short-term temporary basis.

Many of the IHS patients receiving services may only speak a native language and/or reside on a Native American Reservation, therefore, the Contractor must demonstrate sensitivity to cross-cultural and language differences.

The Rosebud IHS requires assistance in the recruitment and placement of primary care physician assistant, nurse practitioner and/or certified nurse midwife on the medical staff for a temporary duty assignment. The purpose of the contract is for the recruitment, credentialing and placement of primary care primary care physician assistant/nurse practitioner and certified nurse midwife for Rosebud.

B. SPECIFICATIONS OF SERVICES:

The contract is a non-personal health care services contract, as defined at Federal Acquisition Regulation (FAR) Part 37.01 under which the contractor is an independent contractor and shall allow the Government to evaluate the quality of professional and administrative services provided, but retains no control over the medical, professionals aspects of the services rendered (e.g., professional judgments, diagnosis for specific medical treatment). A Non-Personal Service Contract is established to provide primary care PA/NP and/or CNMW services. The contract provider will generally work 5 days of clinic per week from 8:00 am - 5:00 pm, Monday through Friday in Rosebud, South Dakota. Some evening or weekend shifts may be needed;

should this be needed, the Contractor would be notified and time allowed for the Contractor to provide contract providers able to work evenings or weekends. The contract provider may be required to provide direct patient care, attend meetings, or may not be required to work depending on current service unit needs.

The contractor will perform all duties according to this Statement of Work and according to the Rosebud Health Care Facility Medical Staff Bylaws, Policy and Procedures as well as all of the accreditations it upholds.

The Contractor shall indemnify the Government for any liability producing act or omission by the contractor its employee and agents occurring during contract performance. The Contractor shall maintain medical liability insurance in the coverage amount acceptable to the Contracting Officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned.

The contractor shall furnish one or more primary care PA/NPs or CNMW as needed for primary care assignments for Rosebud. Contract provider care shall cover the range of primary care services, or if needed a more specialized NP such as Women's Health typically provided in a similar rural practice. The Contractor shall provide one or more skilled clinicians to perform the necessary medical services, including but not limited to examination, diagnosis, prognosis, treatment plan, follow up and consultation of all patients presenting for care.

Upon the receipt of contract, the contractor shall locate, credential, and have available sufficient staffing to provide "seamless" coverage on a regular work schedule. Failure to provide "seamless" coverage will result in the contract going into default.

The standards of medical practice and duties of the contractor, through its providers, shall be determined pursuant to the governing body bylaws, medical staff bylaws, rules and regulations of the Indian Health Service (IHS), applicable provisions of law including but not limited to Centers for Medicare, Medicaid Services (CMS) compliance, rules and regulations of any and all governmental authorities related to licensure and regulations of PAs, NPs, and CNMWs in health care and standards and recommendations of the Accreditation Association for Ambulatory Health Care ('AAAHC').

In accordance with the Indian Health Service credentialing policy, the contractor shall complete primary source verification for the contract provider performing services under the contract. Upon the placement of a PA, NP, and/or CNMW at Rosebud IHS, the provider shall complete a credentials packet and be credentialed by the Rosebud Governing Body. Compliance with IHS privileging requirements is essential in the performance of the contract.

The contractor shall provide one or more PAs, NPs, and/or CNMWs for the professional management of patients being treated at the Rosebud IHS Hospital. The contract providers shall provide medical support for the outpatient departments.

The Contractor health care providers shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity. The Contractor shall ensure strict compliance to the release of Protected Health Information in accordance with the Coder of Federal Regulation, Title 45, Public Welfare, Subtitle A, Department of Health and Human Services, Part 164, Security and Privacy (45 CFR 164) and AFI 41-210, "Patient Administration Functions" paragraph 2.2.3, "Health Insurance Portability and Accountability Act (HIPPA)" and paragraph 2.3, "General Guidelines on Releasing Medical Information".

The Contractor shall ensure contract providers maintain open and professional communication with members of the Medical Staff. Complaints validated by the Quality Assurance Personnel (QAP) and Clinical Director shall be reported in writing to the Contracting Officer (CO) and the Contractor for action.

Contract providers shall perform procedures compatible with the medical facility's operating capacity and equipment. New medical procedures/services shall not be introduced without prior recommendation to, and approval of, the Rosebud I.H.S Clinical Director or authorized representative.

The contractor shall generate and maintain proper medical record information on patients in accordance with Indian Health Service, AAAHC and CMS regulations. The contractor shall prepare all medical record documentation exclusively on the Electronic Health Record (EHR) to meet or exceed the established standards of the IHS facility to include but not limited to: timeliness, legibility, accuracy, content and signature. An orientation to the EHR will be given by the Clinical Applications Coordinator (CAC) prior to initiation of patient care. All medical records information and documentation generated in the performance of this contract must be completed prior to the time of departure and will remain the property of and subject to the exclusive control of IHS. All medical records remain the property of the IHS service unit.

Rosebud IHS will provide support personnel to assist with clinic to equivalent of a licensed practical nurse;

the provider may have to perform some administrative duties in support of patient care.

The contractor shall document all patient encounters legibly on all medical records, such as downtime forms and in the EHR. All documentation shall be signed, timed and dated. Verbal orders are to be used in an emergency basis only and should not be routinely used. All Medical records are to be completed by the end of the provider?s scheduled shift. All documentation shall meet the current CMS/JC guidelines.

Final payment will be withheld until all medical records are completed by the contractor. The contract provider will be required to create a time work record by utilizing a timecard demonstrating hours worked.

Any hours beyond the 9 hours scheduled on any given day must have pre-authorization by administrative staff. Upon arriving for each shift the contract provider shall document time of arrival, time away for lunch, and the end time. All providers must have a documented lunch time. On a weekly basis, or per the contractor policy, timesheets will be turned in to the Clinical Director or designee for verification and signature prior to submitting to the contractor's timekeeper. No invoices shall be processed for payment until a complete, signed, and verified work record is submitted along with the medical records documentation completion is verified.

**All patient health record documentation initiated by the contract providers for patient encounters SHALL BE completed to the satisfaction of the supervisor or designee of the HIM (Health Information Management) Department and Business office supervisor or designee. The approving authority of the contract provider's time sheets will NOT sign off on the final time sheets unless the provider has successfully completed all required patient medical encounter documentation (medical records). Further, if the provider has delinquent medical records as determined by the supervisor or designee of the HIM department, the approving authority will NOT sign off on any time sheets or process any invoices generated from "unauthorized" time sheet signatures. This is a condition of the Statement of Work (SOW). The contractor is to meet with the HIM department and finalize all records prior to leaving the Service Unit. Generally the last afternoon of duty is reserved for completion of all medical records and administrative tasks. All assigned patients and patient notifications must be transferred to another provider at the service unit prior to the contract provider's final separation.

The contract will provide one or more PAs, NPs, and/or CNMWs; additional staff may be requested and supplied as needed for coverage to staff the described Outpatient duty shift(s) for the entire contract period providing "seamless coverage" AKA "continuous coverage". It is ABSOLUTELY IMPERATIVE the contracting company ensures a qualified and credentialed PAs, NPs, or CNMWs as determined necessary, and will be physically present in the Rosebud OPD every day throughout the entirety of this contract.

Skills and knowledge of established concepts, principles, and practices related to health care assignments requiring training equivalent to a Physician Assistant/Nurse Practitioner or Certified Nurse Midwife licensure and additional training and experience in assessing the conditions of patients, in providing medical care and in advising on health care needs, all with full consideration of mental, emotional, and physical factors. Extensive knowledge of routine disease entities are required to serve the population.

Knowledge of diagnostic, preventive and therapeutic procedures related to a variety of medical and health care fields provides for well-rounded patient care.

Ability to collect, organize, record and communicate, in a meaningful way, data relevant to primary health assessments including detailed family and medical history, physical examinations and selective laboratory tests. Provides recommendations for treatments and therapies based on those findings.

Skill in making diagnoses and in choosing, initiating, and modifying selected therapies, and ability to provide emergency treatments for acute walk-in patients. Skill in simple laceration repair, casting/ splinting, and in other ER or urgent care- related procedures. Skill in the management of simple fractures.

Ability to assess the physical-psychosocial health status of patients and family based upon the knowledge of growth and development patterns and health conditions that require medical management. Knowledge of human behavior during stressful situations in order to exercise emotional control, tact, patience and reliability in providing emergency/ urgent patient care.

Knowledge of pharmaceuticals in order to recognize the desired effects, side effects and complications of their use.

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

The contract providers' medical documentation will undergo peer review to ensure acceptable medical care is being provided. The Contractor shall secure a thorough health history from the patient or patient's parent and record findings. Physical examination shall be performed which is consist with the patient's presenting complaints and/or presenting signs and symptoms. Appropriate diagnostic testing shall be ordered, reviewed, interpreted, and acted upon to address and treat the patients' complaints, signs, symptoms, and in the patient's best medical interests. The Contractor will discriminate between normal and abnormal findings to recognize early stages of serious physical, emotional, or mental problems. The Contactor will consult available in-house medical services when indicated and available. If consulting services are not available in-house the Contractor will consult with the shift OPD physician about appropriate referrals.

Provides direct medical care in the presence of illness or disability in order to maintain life, provide comfort, reduce distress and enhance coping ability.

Provides surveillance over medical practices applied to stabilize chronically ill persons; adjusts treatment within established standing orders, recognizing when to refer the patient to a physician or other health team members.

Works collaboratively with physicians in management of selected complex medical problems. When clinically engaged with a medically complex patient the contract provider will present the case to the physician clinic consultant for the day for proper follow up and disposition.

C. GOVERNMENT FURNISHED EQUIPMENT, FACILITIES AND PROPERTY:

The Hospital shall provide a patient examination area and all medical and non-medical equipment and supplies used in the Indian Health Service facility for the care and management of patients. The contract provider will be authorized to use all areas of the medical treatment facility available to civil service and commission personnel in similar positions. The same restrictions apply to the contract provider as any other Indian Health Service personnel to use these areas for official business activities only.

The contract provider will be authorized to use all administrative and professional support available to Indian Health Service personnel. This will include but not limited to copy machines, fax machines, medical library, and telephone services. The same restrictions to use these items for official Indian Health Service business apply.

The facility shall provide all medical and non-medical equipment and supplies used in Rosebud IHS Hospital for the care and management of patients.

The facility shall provide all government forms applicable to the Indian Health Service. The facility personnel will provide an appropriate orientation to the necessity of such forms.

The facility shall provide an ongoing method of monitoring and evaluation of the quality and appropriateness of patient care and identifying deficiencies in the quality service performed before the level of performance becomes acceptable.

The facility shall provide the contractor provider with orientation to the facility, which must be completed in a timely manner.

D. CONTRACTOR FURNISHED EQUIPMENT, FACILITIES, AND PROPERTY:

Rosebud IHS does not anticipate a need for contractor-furnished equipment beyond a stethoscope.

The contract provider and support staff shall provide his or her own uniforms.

E. WORK SCHEDULE/PAYMENT SCHEDULE:

The PA, NP, or CNMWs will work schedule is as follows. Each work day typically consists of one 8-1/2 to 9 hour tour of duty in the Rosebud IHS hospital Outpatient Department (OPD), weekdays, Monday through Friday. Some days may be designated for evening or weekend clinic. The provider will normally start their work shift at 8:00 am. Provider will begin seeing patients in the OPD at 8:30 am and work until 4:30 or 5:00 pm CST with a minimum of a 30 minute lunch break required. The contract provider may need to work for short periods of time beyond their respective shift hours when extra time is necessary to complete patient visits.

The contract provider will adhere to work duties and schedule for shifts in accordance with the SOW with no more than one unplanned absence per quarter. Any changes more than that on the side of the contractor, resulting in any open shifts on the schedule, may result in the contract going into default. Providers are needed to ensure shift coverage and patient care, so consistent attendance is imperative. The provider shall adhere to work duties and schedule for shifts in accordance with SOW with no more than one (1) unplanned absence per quarter.

F. QUALITY ASSURANCE:

Is under the administrative supervision of the Clinical Director of the Rosebud Service Unit or his/her designee. Will participate with the Rosebud Hospital medical staff Chart Review Processes for the facility and/or department as well as participate in Corrective Actions, if needed. Incumbent performs assignments under general supervision, and will work directly under the Clinical Director. In addition, the Supervisor will monitor the contractors work and provide feedback to the contractor.

Performance objectives will include a written summary provided to the Contract Provider as well as the Contractor summarizing the provider's performance while on duty at the Rosebud IHS. Criteria for evaluation will be as follows:

Medical practice must be within the standards of their credentialed specialty Documents medical assessments, History and Physicals, observations, discharge summaries and daily progress notes, all consistent with current standards and billing requirements.

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

Complies with safety policies.

Complies with all required trainings within the scheduled timeline.

Consults with other specialty practitioners when needed.

Maintains patient privacy/confidentiality and meets all HIPPA compliance standards.

Adheres to work duties and scheduled shifts consistently without tardiness or absences.

Understands that we have an FPPE and OPPE process and process improvement needs will be reviewed with the provider. Failure to improve may result in removal of the provider.

Complaints on quality of care and/or conduct will be not more than 4 per quarter. There is zero tolerance for negligence or incompetence resulting in morbidity or mortality. Zero tolerance for violence or sexual harassment in the work place.

Rosebud Hospital's Clinical Director or designee will conduct an exit interview with the provider to obtain any feedback from the contract provider regarding the work conducted. If the contract provider is unable to meet with the Clinical Director in person, the Rosebud Hospital requests feedback to be provided in writing within 2 days prior to departure from the Rosebud facility.

G. REPORTING REQUIREMENTS:

The Contractor shall ensure that all new contract providers participate in the Rosebud IHS Facility Orientation, some of which can be completed prior to arrival, with an overlap of services to include one additional day to ensure new provider has completed orientation. Providers must arrive on a Monday ?

Friday excluding holiday and participate in the orientation prior to providing services at the Rosebud IHS Hospital. Ideally the providers arrive on the pre-scheduled every-other week Monday orientation. Prior to arrival the provider must have completed credentialing and privileging, provide proof of all required immunizations and TB testing, background clearance completed, and completed all of the required steps for provider enrollment. Failure to have all steps completed prior to arrival could result in delay of arrival and initiation of orientation and work.

H. PROFESSIONAL QUALIFICATIONS CRITERIA:

The contract provider must hold an active, current, and unrestricted state license as a nurse practitioner, physician's assistant, or certified nurse midwife from any of the 50 United States or the Commonwealth of Puerto Rico. It is the contractor and provider's responsibility to provide evidence of any change in licensure when it is done, including a renewing, retiring, or adding any additional state licensure or DEA numbers.

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

If the provider does have any resultant exclusions or sanctions after starting at the facility, they will immediately cease seeing patients and report this to the Clinical Director and the Credentialing Specialist.

The contract provider must have a degree as a nurse practitioner, physician's assistant, or certified nurse midwife from an accredited college or university in the specialty area required to provide medical services. It is important that all providers maintain certification in their respective fields.

The provider must fulfill all the requirements for appointment to the Rosebud IHS Medical Staff for the granting of privileges, in accordance with IHS policies and with the Service Unit Medical Staff Bylaws.

The contract provider must have current BLS at a minimum when working in the clinic. ACLS is also required for those working with adults and PALS for those working with children. NALS or NRP is also recommended for those working with neonates including CNMWs.

The provider shall have basic core privileges granted upon verification of all credentialing processes. The provider shall have the onus of supplying documentation supporting any requested privilege that is deemed outside the normal basic scope of practice. Requested privileges shall be denied by the medical director if the provider is unable to prove sufficient training, and State law citing specific allowance to perform requested privileges.

Required credential and appointment documents needed to allow initial provisional and subsequent active privileges and appointment shall include but not limited to the following items.

1) Unrestricted active State license photocopied, primary source verification will be completed at the service unit.

2) Photo of the individual that is recognizable, such as a driver's license or passport.

3) Evidence of a two-step PPD skin test with annual TB testing evidence that followed or Interferon Gold with results not less than one-(1) year old:

*If TB positive then chest radiograph reading results must be submitted.

*If TB positive then record of treatment must be submitted.

*If TB skin test is positive secondary to BCG shots, do IFG blood test.

4) Immunizations required prior to arrival:

1. 2 documented MMR vaccines OR positive antibody titers on each Measles, Mumps, and Rubella.

2. 2 documented varicella vaccines OR a positive antibody titer

3. TDAP documented in past history AND at least a tetanus vaccine within the past 10 years.

4. 3 documented hepatitis B vaccines OR a positive hepatitis B antibody titer OR a signed declination of refusal.

5. 2 negative TB skin tests within the last 12 months OR a negative IGRA within the last 12 months.

a. If history of a positive reaction to either TB skin testing (secondary to BCG then do IGRA, if exposure need CXR and dates treated) or to an IGRA we will need the last chest x-ray, and dates of treatment (if treated).

All providers must receive a seasonal influenza vaccination by October 31 of each year or have on file a valid medical exemption for vaccination signed by a licensed independent practitioner *Individuals with a valid medical exemption for vaccination will be required to wear a mask provided by IHS during the influenza season (November 1 through March 31) and during other periods of increased influenza activity as defined by the Centers for Disease Control and Prevention and/or State public health authorities.

5) Complete Curriculum Vitae with complete and current medical provider work history listing months and years. All gaps of medical employment eight weeks or greater must include an explanation by the applicant to the reason of this prolonged period of unemployment.

6) Current and active BLS, ACLS, and PALS as listed above with recommendation of NALS, NRP or any other certifications which will remain active throughout the provider's tour while seeing patients in Rosebud Hospital.

7) Three letters of professional reference from supervisors or professional peers not less than 3-months old.

8) Active DEA license including prescription privileges of Schedule 2 & 2N.

9) Current Liability Insurance of not less than $300,000/$1,000,000.

10) Record of recent (2 years) continuing education units (CEUs) or CMEs. Must possess CME/CEUs that satisfies state licensing requirements if credentialing is to be beyond a 120-day Temporary medical staff appointment.

Providers must furnish adequate number of CMEs. New graduates are exempt from 30 hours CME/CEUs as they have just successfully completed their training. However; fully-credentialed new graduates with active medical staff membership will be required to provide an adequate number of CME/CEUs before they can be re-credentialed in two years with active medical staff membership.

I. CHARACTER INVESTIGATION FOR CONTRACTORS WHO WILL HAVE CONTACT WITH

INDIAN CHILDREN:

The contractor is prohibited from having any unsupervised contact with Indian Children in the performance of this contract unless:

1. They act under the direct supervision and within the sight of a Government employee who has obtained a satisfactory "Criminal History Check" in accordance with the "Indian Child Protection and Family Violence Prevention" P.L. 101-630 and "Crime Control Act" P.L. 101-647.

Prospective contractors whose duties and responsibilities involve regular contact or control over children are subject to a character investigation as required by P.L. 101-630, the Indian Child Protection and Family Violence Prevention Act. IHS personnel offices will conduct these investigations following award of a contract. The character investigations may be waived if, in judgment of the Contracting Officer, in consultation with the Personnel Officer, and investigation has already been conducted and is on file. Until the character investigation has been completed and the Contracting Officer notified or the results, the Contractor must not have unsupervised contact with Indian Children.

2. The provider has obtained a satisfactory "Criminal History Check" which satisfies the requirements for the "Indian Child Protection and Family Violence and Prevention Act" P.L. 101-630 an "Crime Control Act" P. L. 101-647.

J. REQUIRED MALPRACTICE INSURANCE:

Current Liability Insurance of not less than $300,000/$1,000,000 covering the duration of the contract.

A Certificate of Insurance evidencing the required coverage shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on a claims-made basis, evidence of an extended reporting 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 endorsement is provided to the Contracting Officer.

K. COMPLIANCE WITH IHS RULES AND REGULATIONS:

Medical practices must be within the medical standards of their established credentialed specialty and maintains continuing medical education, licensing, registration and certifications 100% of the time.

Complies with all policies, By-laws, Safety, Infection Control, and rules and regulations of HHS/IHS/Rosebud

Hospital with zero (0) violations.

Maintains patient privacy/confidentiality/HIPAA with zero breaches of privacy.

The contractor shall follow IHS Purchase Referred Care (PRC) regulations and policies when arranging for a referral or consult. The contractor shall consult with specialty practitioners for consultative opinions and continuation of care. The provider shall inform patients of the required referral or consult by indicating the specialty involved. The contractor may be required to facilitate transportation arrangements for patients referred to facilities for a higher level of care.

The contract provider shall use and follow the Rosebud IHS formulary list which is approved and maintained by the Rosebud IHS Pharmacy and Therapeutics Committee. Any drug not listed on the formulary must be approved by the Pharmacy and Therapeutics Committee.

Timely documentation must be completed 100% of the time, PRIOR to the end of the daily shift and PRIOR to signing an invoice for payment.

Complaints on quality of care and/or conduct should be minimal and no more than three (3) per quarter (all issues will be addressed in writing to the contractor so that action can be taken).

The standards of medical practice and duties of the Contractor shall be determined pursuant to the bylaws of the Service Unit. The regulations of the hospital, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of practitioners and hospitals must be followed. Also the standards and recommendations of Centers for Medicare and Medicaid Services (CMS) or the Accreditation Organization must be adhered to. The contract providers shall be required to participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

L. ANY SPECIAL REQUIREMENTS:

Must be able to use EHR to access information, document and place orders. Provider must be able to type fluently to document in the EHR. No dictation systems are used and all documentation, other than downtime forms, must be documented in the EHR.

FAR 52-237-7 - IDENTIFICATION AND MEDICAL LIABILITY INSURANCE:

A. It is expressly agreed and understood that this is a Non-Personal Service Contract, as defined in Federal Acquisition Regulations (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 retain no control over professional medical judgment diagnoses, or specific medical treatments.

The Contractor shall be solely liable for 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 liability insurance issued by a responsible insurance carrier in the amount of not less than the minimum requirements established by the state in which the contract is performed during the term of the contract.

B. An apparently successful offer, upon request by the Contracting Officer shall furnish, prior to the contract award, evidence if its insurability concerning the medical liability insurance required by paragraph (1.) of this clause.

C. Liability insurance may be either on occurrence basis or a claims-made basis. If the policy is on 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. A Certificate of Insurance evidencing the required coverage shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on a claims-made basis, evidence of an extended reporting 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 endorsement is provided to the Contracting Officer.

E. The policies 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 in all subcontracts under this contract or health care 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.

G. The contract terminates when the performance period expires or the Hospital no longer requires services (e.g., lack of funding, workload, etc.)

M. CONTRACTING OFFICER REPRESENTATIVE (COR):

For the purpose of this contract, the Clinical Director or designee will act as the COR and serve as the contractor's supervisor.

N. PERFORMANCE SURVEILLANCE PLAN for PHYSICIAN ASSISTANT/NURSE PRACTITIONER, NP(CNMW/NP(PSYCH)

Performance surveillance monitors will be established to comply with regulatory guidelines and to monitor contract performance. The performance surveillance plan has been developed to describe the Indian Health Service's general plan in providing effective and systematic surveillance and reporting of all aspects of contract performance. This plan recognizes the responsibility of the contractor to carry out its own quality control obligations in the performance of this contract.

Surveillance will be accomplished via insight into the contractor's performance against requirements listed in the work statement and performance standards listed in this plan. Performance-based incentives are consistent with the intent and purpose of the contract and are outlined on the following grid:

Upon completion of the contract, the Government will complete and keep on record the Contractor's performance evaluation form, see (Section J).

OBJECTIVE/TASK PERFORMANCE

STANDARD

ACCEPTABLE

QUALITY LEVEL

(AQL)

SURVEILLANCE

METHOD/MEASURES

CONTRACTOR

INCENTIVE

PERFORMANCE

OBJECTIVE 1

THE CONTRACTOR

SHALL ESTABLISH

A TECHNICAL

APPROACH AND

MANAGEMENT

PLAN FOR THE

PLACEMENT OF

PHYSICAN

ASSISTANT/NURSE

PRACTITIONER

AND/OR

CERTIFIED NURSE

MIDWIFE

INTO TEMPORARY

ASSIGNMENTS IN

AAIHS FACILITIES

ONCE A

CALL/REQUEST IS

RECEIVED:

CONTRACTOR

SHALL LOCATE A

BOARD ELIGIBLE,

BOARD

CERTIFIED,

PA/NP/CNMW

WITHIN 21 DAYS

COMPLETE IHS

CREDENTALING

PACKET

INFORMATION &

RETURN TO

LOCAL IHS CD

WITHIN 5 DAYS

PLACEMENT OF

STAFF 100% OF

THE TIME

CV's SHALL

INCLUDE

LOCATION OF

PREVIOUS LOCUM

TENENS

ASSIGNMENT

REFERENCES

FROM

INDIVIDUALS

THAT HAVE

WORKED WITH

APPLICANT

WITHIN LAST 12

MONTHS OR

DOCUMENT WHY

THIS IS NOT

POSSIBLE

CD'S SHALL SUBMIT

MONTHLY SPREADSHEET OF

PLACEMENT DATES TO THE

CONTRACTING OFFICER'S

TECHNICAL

REPRESENTATIVE (COTR) TO

MONITOR THE 21 DAY

PLACEMENT REQUIREMENT

SPREADSHEET TO COTR

MONTHLY

AAIHS WILL

PROVIDE A

POSITIVE

PERFORMANCE

REPORT ON PA/NP

AND/OR CNMW

PLACEMENT

CAPABILITIES

OBJECTIVE/TASK PERFORMANCE

STANDARD

ACCEPTABLE

QUALITY LEVEL

(AQL)

SURVEILLANCE

METHOD/MEASURES

CONTRACTOR

INCENTIVE

PERFORMANCE

OBJECTIVE 2

PROVIDERS

CAPABLE AND

KNOWLEDGABLE

OF EFFECTIVE

COMMUNICATION

PROVIDERS

SHALL BE

RESPECTFUL,

COURTEOUS, AND

CULTURALLY

SENSITIVE TO IHS

PATIENTS AND

STAFF

THREE (3)

ANNUAL

COMPLAINTS PER

PROVIDER ARE

ACCEPTABLE

THE CONTRACTOR SHALL

RESPOND TO THE

CONTRACTING OFFICER'S

TECHNICAL

REPRESENTATIVE (COTR) IN

WRITING. WHENEVER, THEY

RECEIVE NOTICE OF MORE

THAN THREE COMPLAINTS

AGAINST A PROVIDER WITH

AN EXPLANATION OF WHAT

WAS DONE TO ADDRESS THE

MATTER

THE INVOICE FOR

THE PROVIDER IN

QUESTION WILL

BE PUT ON HOLD

UNTIL THE

COMPLAINT IS

INVESTIGATED

AND RESOLVED

IN 7 WORKING

DAYS.

PERFORMANCE

OBJECTIVE 3

COMPLETION OF

MEDICAL RECORD

DOCUMENTATION

COMPLETES

MEDICAL RECORD

DOCUMENTATION

PRIOR TO LAST

WORKDAY &

NOTIFIES

MEDICAL

RECORDS

DEPARTMENT OF

LAST WORKDAY

DOCUMENTATION

COMPLETED 100%

OF THE TIME

CLINICAL DIRECTOR

REVIEWS CHECKLIST FROM

MEDICAL RECORDS PRIOR

TO PHYSICIAN LEAVING

FACILITY

THE INVOICE FOR

THE PROVIDER IN

QUESTION WILL

BE PUT ON HOLD

UNTIL PROPER

DOCUMENTATION

OF THE CHART IS

COMPLETED

M - Evaluation factors for award

Provisions

52.217-5 Evaluation of Options. (JUL 1990)

52.212-2 Evaluation - Commercial Items. (OCT 2014)

(a) The Government will award a contract or contracts resulting from this solicitation to the responsible offeror or offerors whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

The following are the technical criteria that will be used to evaluate the proposals for this contract effort, along with their relative weight of importance. The individual members of the evaluation team will determine an overall rating based on completeness of information, qualifications, experience, and education.

1. PROBLEM AND APPROACH

2. PAST PERFORMANCE

3. KEY PERSONNEL

4. MANAGEMENT

Technical Factor Rating Definitions

ADJECTIVAL RATINGS DESCRIPTION

Outstanding Greatly exceeds all minimum requirements of the criteria; has a high probability of success; contains no weaknesses or deficiencies.

Good Exceeds all the minimum requirements of the criteria; has an above average probability of success; contains no significant weaknesses and only minor correctable weaknesses exist.

Marginal Fails to meet one or more of the minimum requirements of the criteria; low probability of success; major weaknesses and/or significant number of deficiencies exists.

**In categorizing positive and negative aspects of the information submitted for the component elements of each technical factor, the evaluator shall consider the degree to which the response to the element, or lack of response, contributes to the overall risk of performance. Missing information for a single element may not materially affect the risk of performance when considered together with the responses to the other elements. In that case the omission would be categorized as a weakness and not as a deficiency.

These evaluation factors are of prime importance. An unsatisfactory rating in any of these factors shall be considered sufficient grounds for declaring the entire proposal unacceptable.

Factor #1: PROBLEM and APPROACH Proposals, which merely offer a statement to conduct/provide services in accordance with the requirements in the Government's Statement of Work will not be eligible for award.

The offeror must submit an explanation of their understanding of the proposed technical approach in completing all tasks in the Statement of Work including, but not limited to, all elements in the description of services. The plan must include how the requirements in the character investigation shall be accomplished to ensure compliance prior to candidate placement.

The detailed work plan must indicate how each aspect of the Statement of Work is to be accomplished. The technical approach should be detailed to fully explain the proposed technical requirements in the Statement of Work, and reflect a clear understanding of the nature of the work being undertaken.

Factor #2: PAST PERFORMANCE The technical proposal must include a listing of similar Physician Assistant/ Nurse Practitioner service contracts, similar contracts with IHS, Government and/or commercial, awarded to the offeror. The similar contracts must contain the same type of Physician Assistant/ Nurse Practitioner requirements outlined in the Statement of Work. The offeror must demonstrate its record of successful performance in past contracts by including the following information for each contract:

a. Identify the one contract, which you consider to be the most successful, and the reasons for this determination.

b. Identify other similar contracts and indicate your record of performance.

c. In the event your firm did not have contracts, which meet the Statement of Work requirements of this solicitation, list up to five other contracts, which you deem similar.

d. For each of the above contracts, furnish the name, address and telephone number of the contracting organization, a point of contact in the organization, the contract number, dollar value, and dates of contract performance.

Factor #3: KEY PERSONNEL The technical proposal must include a list of professional personnel that will be assigned to this project and at least one contract Physician Assistant/ Nurse Practitioner candidate who is qualified to perform the duties listed as defined in the contract provider responsibilities in the SOW. Curriculum vitae/resume must be submitted.

Factor #4: MANAGEMENT The technical proposal, at a minimum, must include the following information in sufficient detail to allow a complete analysis of the offeror's management capabilities and responsibility.

a. Evidence of capability to organize, staff and manage the contract.

b. Financial capability statement completed by a qualified personnel, including: core competencies, differentiators, corporate data, contact information, etc. to meet the needs outlined in the Scope of Work.

c. Capability to meet delivery or performance schedules to provide seamless coverage.

d. Possession of necessary experience and technical skills to perform the work, or the ability to obtain them.

Technical and past performance, when combined, are significantly more important than cost or price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced.

Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

Attachment to Amendment #1 for Solicitation 75H70621R00003

Questions/Responses regarding the solicitation:

STATEMENT OF WORK - Questions

I wanted to clarify the RFQ-75H70621R00003 posted on beta.Sam is for a NP/PA? In the SOW it references CNMW/PSYCH: The contractor shall provide a PA/NP [PA/NP (CNMW/PSYCH)]

Is this solicitation for Primary Care NP/PA’s and/or Certified Nurse Midwives and/or Psychiatric Nurse Practitioners?

Instruction to Offerors #7 requests copies of physical exams and immunizations? HIPPA? This is usually requested by the credentialing body not as part of a proposal.

In the SOL, it references them having a MD license, do you need them to have a MD license?

What specialty are you looking for?

Are you needing 2 candidates ? You have provided 4500 hours per year

Do you need a primary care provider?

Does the provider need to have experience in CNMW and PSYCH or are these separate needs?

Do you need 2 FTE?

What will the schedule look like?

IS BLS, ACLS, PALS and NRP required for all providers?

Response: The Contractor must ensure that contract providers have documentation of all required immunizations and TB testing.

This solicitation is for one or more providers, including NP/PAs and/or certified nurse midwife.

The number of providers needed depends on staffing needs of the facility.

Refer to the revised Statement of Work.

HOUSING – Questions

Will onsite lodging be provided by the site?

Does Rosebud have on-site housing for contractors?

Response: Rosebud will prioritize availability of on-site, affordable housing for contract providers. In the event of high demand and potential housing shortage, information will be provided to the Contractor on hotels and other housing options in nearby town.

OTHER - Questions

All are different specialties that will require different pay and bill rates. Can we submit multiple rates?

Response: Yes.

Will proposals be accepted electronically (email)?

I know the due date for the above solicitation (75H70621R00003) is May 5, but I was wondering, does the bid need to be mailed in or can it be sent electronically?

Response: Yes. Offers may be submitted electronically.

Can you please provide the following forms:

• Licensure Requirement form

• Agreement to a Temporary Waiver of Character Investigation form

Response: The forms are attached.

(PLEASE COMPLETE AND RETURN)

LICENSURE REQUIREMENT

PERSONAL AND NONPERSONAL SERVICES CONTRACTORS SHALL BE SUBJECT TO THE SAME

QUALITY ASSURANCE, CREDENTIALS, LICENSURE, AND OTHER QUALIFICATION STANDARDS

AS THOSE REQUIRED OF IHS PERSONNEL. IN ADDITION, HEALTH CARE PROVIDERS, OTHER

THAN PROFESSIONALS, MUST BE LICENSED IN A STATE, THE DISTRICT OF COLUMBIA, PUERTO

RICO, OR A TERRITORY OF THE UNITED STATES TO PERFORM THE CONTRACT SERVICES

WITHIN IHS FACILITIES. THE CONTRACTING OFFICER WILL INSERT THE FOLLOWING

CERTIFICATION STATEMENT IN ALL PURCHASE ORDERS AND CONTRACTS FOR

PROFESSIONAL MEDICAL SERVICES:

MY LICENSE TO PRACTICE O HAS O HAS NOT BEEN TERMINATED, SUSPENDED, OR

REVOKED IN ANY STATE, THE DISTRICT OF COLUMBIA, PUERTO RICO, OR A TERRITORY OF

THE U.S ..

I CURRENTLY HOLD AN ACTIVE MEDICAL LICENSE IN THE FOLLOWING STATE(S):

STATE I ,I CENSURE NO. ISSUE DATE

I HA VE AN INACTIVE MEDICAL LICENSE IN THE FOLLOWING STATE{S):

STATE LICENSURE NO. ISSUE DATE

I HEREBY CERTIFY THAT THE PURPOSES OF APPLICATION OF THE FALSE STATEMENTS

PROVISIONS OF…