75H70625Q00061 SOL PKG 07.30.2025.pdf

A. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice, FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994) (Public Law 103-355). This announcement constitutes the only solicitation; quotes are being requested, and a written solicitation will not be issued.

B. The Great Plains Area Indian Health Service (IHS) intends to award a Firm-Fixed Price, Non-

Personal Medical Service, Purchase Order with a Base Period and Nine (9) Option Periods in response to Request for Quote (RFQ) 75H70625Q00061.

C. This solicitation document and incorporated provisions and clauses are those in effect through

Federal Acquisition Circular 2025-04 on June 11, 2025.

D. This RFQ is issued as 100% Indian Small Business Economic Enterprises (ISBEE) Set-Aside, and the associated NAICS Code is #621399, which has a small business standard size $20.5. Quoter is required to fill out the attached INDIAN FIRM REPRESENTATION FORM.

E. The quoted unit pricing must be all inclusive (including, but not be limited to, travel, lodging, per diem, fringe benefits, federal, state and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.

Complete the attached Request for Quote #75H70625Q00061 SF18 for Pharmacist Services along with the Business Associate Agreement. The Business Associate Agreement must be acknowledged by the quoter.

F. Firm Fixed Price, Non-Personal Medical Services to be provided for the Woodrow Wilson Keeble

Memorial Health Care Center-Sisseton Indian Health Service, 100 Lake Traverse Drive, Sisseton, South Dakota 57262. See Statement of Work (SOW) attached. The period of performance will be a Base Period with Nine (9) Option Periods. Base period will be Six (6) Months, and each option period will be six (6) months.

G. FAR 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services (SEP

2023).

Quotes shall be submitted on company letterhead stationery, signed, dated and it shall include:

1. Solicitation number: 75H70625Q00061

2. Closing Date: August 14, 2025 at 12:00 pm CST.

3. Name, address and telephone number of company and email address of contact person.

4. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements of the solicitation. This may include product literature, or other documents, if necessary.

5. Terms of any express warranty.

6. Price and any discount terms.

7. “Remit to” address, if different than mailing address.

8. A completed copy of the representations and certifications at FAR 52.212-3 (see

FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically).

9. Acknowledgment of Solicitation Amendments (if any issued)

10. Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references

(including contract numbers, points of contact with telephone numbers and other relevant information).

11. A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offerors that fail to furnish required representations or information or reject the terms and conditions of the solicitation may be excluded from consideration.

H. The Government will evaluate quotations utilizing the procedures of FAR 13.106-2 Evaluation of quotations or offers. Offers will be evaluated for acceptability but not ranked using the non-price factors/sub-factors. All non-price factors and sub-factors will be rated as either

“acceptable” or “unacceptable”. The Government intends to evaluate and make an award without discussion with the offerors other than minor clarifications, unless discussions are determined to be necessary. A decision on the technical acceptability of each offeror’s quotations will be made. For those offerors which are determined to be technically acceptable, award will be made to that vendor with the lowest overall prices.

The LPTA evaluation process will be accomplished as follows - Technical Acceptability will be comprised of three subfactors:

1. Meeting all areas under the Statement of Work (SOW) which are consistent in the scope and complexity with Outpatient Registered Nurse Services.

2. Price: The Pricing Schedule must be completed for all the line items and will be evaluated as to completeness and reasonableness. The offeror with the lowest technically acceptable prices represents the best value to the Government.

3. Past Performance: The offeror’s performance on contracts completed during the past three (3) years and all contracts are currently in progress for Outpatient Registered

Nurse Services. The offeror’s technical proposal shall include a listing of previous

Outpatient Registered Nurse Services awarded to the offeror for services provided to rural locations.

I. FAR 52.212-3 Offer Representations and Certifications-Commercial Products and Commercial

Services (MAY 2024). See attachment for full text. The Offeror shall complete only paragraphs

(b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) website accessed through http://www.acquisition.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (p) of this provision.

J. FAR 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services

(NOV 2023). Applied to this acquisition and it’s by reference.

K. FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive

OrdersCommercial Products and Commercial Services (JAN 2025). See attachment for full text.

L. FAR 52.214-16 Minimum Bid Acceptance Period (April 1984). See attachment for full text.

M. Attached are the Federal Acquisition Regulations (FAR) & Health & Human Services Acquisition

Regulation (HHSAR) clauses that are applicable, including below.

N. SECURITY CLEARANCE

http://www.acquisition.gov/

A security pre-clearance must be provided for any employees referred to IHS through this contract.

Fingerprints must be completed and adjudicated prior to services being performed under this contract.

No contract award shall be made to any vendor or provider listed on the OIG Exclusion List http://exclusions.oig.hhs.gov throughout the duration of the contract. It shall be the responsibility of the contractor to notify the acquisition official if there is a change in provider.

Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S. facilities or systems, each person must complete an FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System.

Contractors shall allow five (5) business days for I.H.S. processing of fingerprints taken electronically at an I.H.S. site and thirty (30) business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities

(LEIE), http://exclusions.oig.hhs.gov. As soon as practicable prior to the start of work, the performance of the work the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

The Contractor is responsible for conducting security pre-clearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the

LEIE and can obtain a favorable fingerprint clearance. Each security preclearance should be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access. If this is a Time and Materials, Labor-Hour or Cost Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access, or the excess time required to resolve and clear unfavorable security clearance findings. If this is a Fixed Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

The Government will pay the cost to process the contractor's suitability clearances. However, multiple investigations for the same position may, at the Contracting Officers discretion, lead to reduction(s) in the contract price of no more than the cost of the extra investigation(s).

Employees that DO NOT have access to LMS, contractors, volunteers, or IHS employees with

IPA's or MOAs to tribal organizations please, click here IHS Sexual Abuse Prevention website.

http://exclusions.oig.hhs.gov/ http://exclusions.oig.hhs.gov/

When the contractors have completed and passed the training, please have them send a copy of the last page of the training with Name, Date, and Time to their Supervisor, COR, and Kimmen

LeBeau, e-mail: Kimmen.LeBeau@ihs.gov.

"Contract Personnel will arrive on a Business Day ONLY to complete all Orientation and

Background procedures. The Clinical Director or Designee will ensure all Orientation and

Background procedures have been completed and an email will be sent to the Contracting department to state as such. The Contract Personnel will NOT see patients until

Background/Fingerprints have been cleared."

"The standards of medical practice and duties of the Contractor through its Contract Personnel 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 Contract Personnel 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 Personnel 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."

O. Offers will be accepted electronically, Submit via e-mail to the following:

Great Plains Area Indian Health Service Division of Acquisition Management

Attn: William Kohl, Contract Specialist

Email: William.Kohl@ihs.gov

Any questions, please submit by email to: William.Kohl@ihs.gov; before August 11, 2025 by

12:00 pm CST. Contractors will need a Unique Entity ID (UEI) number, TIN number, and be registered with www.sam.gov.

Invoice Processing Platform (IPP)

The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system. In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum “Improving

Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing” directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and Processing of Payment Requests”.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the

Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL).

Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register-however, we encourage you to make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

mailto:Kimmen.LeBeau@ihs.gov mailto:William.Kohl@ihs.gov mailto:William.Kohl@ihs.gov https://www.ipp.gov/

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-

3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer.

ATTACHMENTS:

1. Notice to Quoters

2. SF18 Request for Quotes

3. Statement of Work

4. Provisions and Clauses

5. Indian Firm Representative Form

6. Business Associate Agreement

7. Wage Determination Number 2015-5377 mailto:IPPCustomerSupport@fiscal.treasury.gov

75H70625Q00061

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

07/30/2025 IHS1505797

1 83

INDIAN HEALTH SERVICE

Division of Financial Management 115 4th Ave SE Federal Building

Great Plains Area

Aberdeen SD 57401

Multiple

WILLIAM KOHL

08/14/2025 1200 CT

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

***THIS IS AN INDIAN SMALL BUSINESS ECONOMIC

ENTERPRISE (ISBEE) SET-ASIDE***

Firm Fixed Price, Non-Personal Medical Service Purchase Order for PHARMACISTS.

Base Period with Nine (9) Option Periods. Base period will be Six (6) Months, and each option period will be six (6) months as well.

WORK SCHEDULE: Work shifts will typically be eight (8) hours and will be worked between the hours of 8:00am and 8:00pm with a one-half hour lunch break. The work shift may include holidays and occasionally additional hours may be required. The typical work week will be 40 hours Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 83

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70625Q00061 per week and the Contract Pharmacist will typically be scheduled to cover the weekday

(Monday through Friday) shift of 9:30am to

6:00pm, depending on staffing. Work shifts on the weekends will be 5 hours each day 12:00pm to

5:00pm. When the Contract Pharmacist is scheduled to work on a holiday or weekend, additional time may be scheduled off during the work week, depending on staffing. Work hours will be scheduled by the Pharmacy Supervisor or designee to correspond to the needs of the facility and are subject to change. Up to thirty

(30) minutes may be allowed at the end of the scheduled shift to accommodate unexpected patient care. Any work that is performed beyond this will need approval from the Pharmacy Supervisor or designee.

The quoted unit price is an all-inclusive cost.

All-inclusive is defined to include travel, lodging, per diem, fringe benefits, Federal/State/Local taxes, plus any other costs pertinent to the performance of this contract.

Period of Performance: 09/01/2025 to 08/31/2030

1 BASE PERIOD: 09/01/2025-02/28/2026

TWO (2) PHARMACISTS

ESTMATED 2,080 HOURS

$_________________ PER HOUR

$_________________ TOTAL

Delivery: 02/28/2026

Delivery Location Code: IHSSISSETON

SISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 09/01/2025 to 02/28/2026

2 OPTION PERIOD ONE (1) PERIOD:

03/01/2026-08/31/2026

TWO (2) PHARMACISTS

ESTMATED 2,080 HOURS

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Continued ...

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

3 83

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70625Q00061

02/27/2026

Delivery: 08/31/2026

Delivery Location Code: IHSSISSETON

IHSSISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 03/01/2026 to 08/31/2026

3 OPTION PERIOD TWO (2) PERIOD:

09/01/2026-02/28/2027

TWO (2) PHARMACISTS

ESTMATED 2,080 HOURS

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

08/31/2026

Delivery: 02/28/2027

Delivery Location Code: IHSSISSETON

IHSSISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 09/01/2026 to 02/28/2027

4 OPTION PERIOD THREE (3) PERIOD:

03/01/2027-08/31/2027

TWO (2) PHARMACISTS

ESTMATED 2,080 HOURS

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

02/26/2027

Delivery: 08/31/2027

Delivery Location Code: IHSSISSETON

IHSSISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 03/01/2027 to 08/31/2027

5 OPTION PERIOD FOUR (4) PERIOD:

09/01/2027-02/29/2028

TWO (2) PHARMACISTS

ESTMATED 2,080 HOURS

$_________________ PER HOUR

4 83

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70625Q00061

$_________________ TOTAL

(Option Line Item)

08/31/2027

Delivery: 02/29/2028

Delivery Location Code: IHSSISSETON

IHSSISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 09/01/2027 to 02/29/2028

6 OPTION PERIOD FIVE (5) PERIOD:

03/01/2028-08/31/2028

TWO (2) PHARMACISTS

ESTMATED 2,080 HOURS

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

02/29/2028

Delivery: 08/31/2028

Delivery Location Code: IHSSISSETON

IHSSISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 03/01/2028 to 08/31/2028

7 OPTION PERIOD SIX (6) PERIOD:

09/01/2028-02/28/2029

TWO (2) PHARMACISTS

ESTMATED 2,080 HOURS

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

08/31/2028

Delivery: 02/28/2029

Delivery Location Code: IHSSISSETON

IHSSISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 09/01/2028 to 02/28/2029

8 OPTION PERIOD SEVEN (7) PERIOD:

03/01/2029-08/31/2029

TWO (2) PHARMACISTS

5 83

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70625Q00061

ESTMATED 2,080 HOURS

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

02/28/2029

Delivery: 08/31/2029

Delivery Location Code: IHSSISSETON

IHSSISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 03/01/2029 to 08/31/2029

9 OPTION PERIOD EIGHT (8) PERIOD:

09/01/2029-02/28/2030

TWO (2) PHARMACISTS

ESTMATED 2,080 HOURS

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

08/31/2029

Delivery: 02/28/2030

Delivery Location Code: IHSSISSETON

IHSSISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 09/01/2029 to 02/28/2030

10 OPTION PERIOD NINE (9) PERIOD:

03/01/2030-08/31/2030

TWO (2) PHARMACISTS

ESTMATED 2,080 HOURS

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

02/28/2030

Delivery: 08/31/2030

Delivery Location Code: IHSSISSETON

IHSSISSETON

100 LAKE TRAVERSE DRIVE

SISSETON SD 57262 US

Period of Performance: 03/01/2030 to 08/31/2030

ATTACHMENTS:

6 83

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70625Q00061

1. Notice to Quoters

2. SF18 Request for Quotes

3. Statement of Work

4. Business Associate Agreement

5. Provisions and Clauses

Invoice Processing Platform (IPP)

The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system in compliance with the Office of Management and

Budget (OMB) M-15-19 memorandum Improving

Government Efficiency and Saving Taxpayer Dollars

Through Electronic Invoicing directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors.

Invoices submitted under any award resulting from this solicitation will be required to utilize the

Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and

Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the

Treasury?s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St.

Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register- however, we encourage you make sure your organization, and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or

IPPCustomerSupport@fiscal.treasury.gov.

Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer.

Statement of Work: Pharmacist Page 1 of 12

WOODROW WILSON KEEBLE MEMORIAL HEALTH CARE CENTER

INDIAN HEALTH SERVICE

PERFORMANCE STATEMENT OF WORK

PHARMACIST SERVICES

GENERAL

The Mission of the Sisseton Indian Health Service (IHS)/Woodrow Wilson Keeble Memorial Health Care Center (WWKMHCC) is to provide the best possible healthcare services to the patients on the Lake Traverse Reservation in South Dakota. To meet this mission, the WWKMHCC is requesting an all-inclusive, non-personal service contract for up to two Pharmacists.

BACKGROUND

The IHS is an agency within the Department of Health & Human Services and is responsible for providing federal health services to American Indians and Alaska Natives. The Indian Health Service provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 567 federally recognized tribes, in 35 states. The Indian Health Service Headquarters is located in Rockville, MD and then divided into twelve (12) physical areas: Alaska, Albuquerque, Bemidji, Billings, California, Great Plains, Nashville, Navajo, Oklahoma, Phoenix, Portland, and Tucson.

The Great Plains Area Office (GPAO) works in conjunction with 19 Indian Health Service Units and Tribal Managed Service Units to provide health care to approximately 130,000 Native American located in North Dakota, South Dakota, Nebraska, and Iowa. The Area Office’s service units include seven hospitals, eight health centers, and several smaller health stations and satellite clinics.

Our facility, the WWKMHCC, falls under the GPAO. WWKMHCC provides medical care for approximately 7,000 tribal members living on the Lake Traverse Reservation. Serving a rural area, many of our patients travel 100 miles round trip to receive care. The WWKMHCC was built in 2007 to provide an expanded level of outpatient health care services specifically designed to meet the needs of the WWKMHCC population.

Services include Behavioral Health, Community Health, Dental, Laboratory, Nutrition Services, Optometry, Pharmacy, Physical Therapy, Public Health Nursing, Purchased & Referred Care Services, and Radiology Services.

OBJECTIVES

To provide uninterrupted pharmacist services in the delivery of patient care for the WWKMHCC. The Contract Pharmacist(s) shall perform pharmaceutical services compatible with the IHS medical facility’s operating capacity and equipment, on the Lake Traverse Reservation. The care shall cover the care typically provided in a rural civilian practice of similar size.

Statement of Work: Pharmacist Page 2 of 12

PERIOD OF PERFORMANCE

Date of the award for one year of service, with four (4) option years.

PLACE OF PERFORMANCE

Woodrow Wilson Keeble Memorial Health Care Center Indian Health Service 100 Lake Traverse Drive Sisseton, SD 57262

DESCRIPTION OF SERVICES

Upon the receipt of an IHS purchase order, the Contractor shall locate and have available sufficient staffing to provide coverage for up to two pharmacists at the WWKMHCC IHS in Sisseton, SD during periods of permanent staffing absences. The Contractor(s) shall provide a full orientation of this scope of work to the Contract Pharmacist(s) prior to submitting the confirmation service agreement.

The contract resulting from this solicitation shall:

1. Be a non-personal health care services contract under which the Contractor is an independent contractor.

2. Allow the Government to evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of the services rendered.

3. Require the Contractor to indemnify the Government for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance.

4. Require the Contractor to 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.

5. Require the Contractor to assume sole and exclusive responsibility for employee federal taxes, social security, unemployment insurance, and workman’s compensation.

6. Require the Contractor to provide daily compensation and travel reimbursements to each Contract Pharmacist as appropriate.

CANDIDATE PRESENTATION. The Contractor shall present a candidate to the WWKMHCC Contracting Officer’s Representative (COR) for review by the Pharmacy Supervisor within five (5) business days of the purchase order and will include the following documentation for the Contract Pharmacist:

1. Full name

2. Date of birth

3. Social security number

4. Phone number

5. E-mail address

6. Current curriculum vitae with listing of all work experience, and explanations for any employment

Statement of Work: Pharmacist Page 3 of 12 gaps

7. Signed Release of information

8. Minimum of three (3) letters of reference (preferably within the past 6 months); must have (1) clinical supervisor and (2) peers from the same discipline

In the event the Pharmacy Supervisor does not accept the Contract Pharmacist, the documentation will be sent to the COR for review/comments and the Contractor will have three (3) business days to present a new Contract Pharmacist.

Upon acceptance of a Contract Pharmacist, a full background investigation shall be sent to the contractor.

The Contractor is responsible for ensuring that proposed Contract Pharmacist possess the requisite credentials to allow for performance of all objectives identified. The contractor shall send a fully completed background investigation back within seven (7) days. The entire candidate presentation and paperwork completion shall be accomplished within thirty (30) days.

Once a Contract Pharmacist has been cleared for suitability with a completed background check and has been granted privileges, the Contractor shall submit a confirmation service agreement and include the following information:

1. Contract Pharmacist name and phone number

2. Dates of service

3. Confirmation of Contractor’s completion of Contract Pharmacist’s orientation to this scope of work

4. Point of contact and phone number

Prior to the assumption of duty on any scheduled work shift, the Contract Pharmacist may be briefed by the service unit Pharmacy Supervisor or his/her designee concerning any matter relevant to the Contract Pharmacist’s responsibilities under the terms of this contract. The Contractor shall advise the COR, or his/her designee of any problem encountered in connection with meeting the needs of patients treated by the Contract Pharmacist.

CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of Health and Human Services (HHS) unless such a person seeks and receives approval in accordance with the Department of HHS.

CONTINUITY OF SERVICES. The Contract Pharmacist’s services are considered vital to the Government and must be continued with minimal interruption. In order to minimize interrupted services, the Contractor shall exercise best efforts and cooperation to provide coverage during periods of permanent staff absences.

In the event the Contractor is unable to fulfill the purchase order requirements for whatever reason; the government reserves the right to fulfill its need outside of this contract. A written confirmation from the contractor indicating the inability to fulfill the purchase order is immediately required. The government’s right to fulfill its need outside this contract(s) does not waive its right to the issuance of a cure notice nor does it waive its right to terminate.

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TECHNICAL REQUIREMENTS

The Contractor shall possess the following:

1. Ability to provide pharmacist(s) in a timely manner who provides on-site pharmaceutical services to beneficiary patients of all ages that present for care to the WWKMHCC.

2. Ability to assist with completion of background investigation paperwork for the Contract Pharmacist(s) in a timely manner prior to assignment.

3. Ability to provide Contract Pharmacist(s) who can interact with patients and clinical staff in a customer friendly and culturally sensitive manner.

4. Ability to provide Contract Pharmacist(s) who possess Electronic Health Record experience.

CONTRACT PHARMACIST REQUIREMENTS

COMPUTER SKILLS. Computer efficiency and Electronic Health Record experience is required.

ENGLISH LANGUAGE REQUIREMENT. The Contract Pharmacist(s) shall read, understand, speak and write English fluently, and communicate with sufficient clarity to be understood by WWKMHCC personnel and patients.

HEALTH REQUIREMENTS. The Contract Pharmacist(s) shall not have any work or health restrictions which interfere with the performance of their services. The Contract Pharmacist(s) shall provide proof of current immunizations (Hep B, MMR, Varicella, Tdap, Flu) status and a current PPD within the past year.

QUALIFICATIONS. Contract Pharmacists shall

1. Have a degree from a school of pharmacy approved by a state-accrediting agency.

2. Possess a current, active, unrestricted license from any of the 50 Unites States, the Commonwealth of Puerto Rico, or the District of Columbia.

3. Maintain continuing education/certification, and have a current Basic Life Support (BLS) certification.

4. Have a minimum of 2 years of experience as a pharmacist within the past 36 months, and must meet all credentialing and background investigation requirements.

CONTRACT PHARMACIST RESPONSIBILITIES

APPEARANCE. Contract Pharmacists are expected to comply with reasonable dress, grooming and hygiene standards based on comfort, productivity, health and type of position occupied as compatible with the expectations of the WWKMHCC IHS and the Native American community. Contract Pharmacists’ attire will be professional and in compliance with the expectations of the WWKMHCC Policy and Procedures, including displaying their identification badge on their outer clothing at all times.

CLINICAL DUTIES. The Contract Pharmacist(s)’s primary duties will be processing prescriptions in the Electronic Health Record (EHR), verifying prescriptions for accuracy before dispensing them to the patient, counseling the patients, and documenting counseling and other pertinent patient information in the Electronic Health Record. The contract pharmacist must also be knowledgeable in the following pharmacy functions:

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1. Check for completeness, appropriateness, allergies, and any drug-drug, drug-disease, or drug-food interactions when processing prescriptions. Any prescription order that is inappropriate for dispensing must be clarified with the ordering prescriber prior to processing the prescription.

2. Assure that all medications prescribed are on the WWKMHCC formulary or are prescribed in accordance with the local non-formulary policy.

3. Provide instructions to all prescribing practitioners as to substitutions of medications as applicable and answer any medical questions pertaining to medications and patient care.

4. Keep accurate records of controlled medications.

5. Participate in Patient Centered Medical Home (PCMH) model and encourage patient engagement.

6. Utilize EHR computer software/program.

7. Document complete and timely consultations in the patient’s health care record.

8. Establish interpersonal, intra-departmental relationships, and social sensitivity such that he/she can relate constructively to patients from Native American communities to enhance optimal patient care.

9. Exhibit professional conduct among staff and patients, and respect and maintain the basic rights of patients, to include but not be limited to, personal dignity, cultural sensitivity, privacy, and confidentiality. Violations of these policies may lead to the immediate removal of the Contract Pharmacist from this contract and the facility.

10. Maintain familiarity and comply with Federal, State, Indian Health Service, accreditation standards, Centers for Medicare & Medicaid Service (CMS) regulations, and departmental regulation and requirements.

11. Participate in committees as assigned (Quality Assurance, Pain Management, Pharmacy & Therapeutics, etc.).

12. Work independently and may also be required to work as the sole pharmacist on certain occasions when the permanent staff is attending meetings or completing administration assignments.

COMMUNICATIONS. Contract Pharmacists shall maintain open and professional communication with members of the Pharmacy Staff and other clinical departments. Complaints validated by the Performance Improvement Coordinator and Pharmacy Supervisor shall be reported in writing to the COR and the Contractor for action.

When the Pharmacy Supervisor is absent the Contract Pharmacist shall follow the delegation of authority and perform duties as assigned by the Pharmacy Supervisor’s designee.

ORIENTATION. All new Contract Pharmacists shall be provided with an orientation to the WWKMHCC. The Pharmacy Supervisor or a designated representative shall provide the initial orientation and continuing orientation prior to the contract pharmacist performing his/her assignments.

PRIVACY OF INDIVIDUALLY IDENTIFABLE HEALTH INFORMATION. The Contract Pharmacist shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity. The Contract Pharmacist shall ensure strict compliance with the release of Protected Health Information in accordance with the Code 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, Statement of Work: Pharmacist Page 6 of 12

Patient Administration Functions, Health Insurance Portability and Accountability Act (HIPAA), and General Guidelines on Releasing Medical Information.

RECORDS. The Contractor Pharmacist shall generate and maintain proper medical record information on beneficiaries to whom treatment is provided in accordance with Indian Health Service regulations and policies set forth by the Health Information Management (HIM) Department. The Contract Pharmacist shall prepare all medical record documentation to meet or exceed the established standards of the IHS facility including, but not be limited to, timeliness, accuracy, content, and signature.

All deadlines as determined by the facility shall be met including:

1. All chart documentation is completed within 72 hours.

2. Notifications received in the Electronic Health Record (EHR) shall be completed within one (1) day.

3. Any deficiencies (documentation that is found incomplete by the HIM department) are completed within one (1) day after notification.

All medical record information generated in the performance of this contract will remain the property of and subject to the exclusive control of the Indian Health Service.

QUALITY IMPROVEMENT. All Contract Pharmacists shall be required to participate in a quality improvement program, which is consistent with current accreditation standards and Medicaid Services (CMS) Conditions of Participation (CoP) requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

CHARACTER INVESTIGATION

CRIMINAL BACKGROUND CHECK REQUIREMENT. The Government will conduct, at the government expense, a Tier 2 with Subject Interview (T2S) and state criminal history checks on individuals providing direct, unsupervised childcare services under this contract. This investigation will be conducted at the expense of the Government and will be based upon the Federal Bureau of Investigation (FBI), state and local criminal history repositories.

The Contract Pharmacist is subject to Public Law 101-630, The Indian Child Protection and Family Violence Prevention Act. The Indian Health Service Personnel Office will conduct the criminal background investigations and obtain fingerprints on each Contract Pharmacist provided by the Contractor. Until the character investigation has been completed and the Contracting Officer notified of the results, the Contract Pharmacist must not have unsupervised contact with Indian children or access to Federal Information System that contain Personally Identifiable Information (PII) or Protected Health Information (PHI). The investigation may take several months to complete. Contract Pharmacists receiving unfavorable background investigations shall not be employed. If at any time the Contractor fails to meet or maintain suitability or eligibility for Federal employment, the Contractor will be removed from providing services at the WWKMHCC.

The Contractor shall submit completed personnel background check applications within seven (7) working days after candidate acceptance. Any corrections needed to the background investigation process must be completed and resubmitted within seven (7) days.

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Individuals shall have the right to obtain a copy of any background check pertaining to themselves and to challenge the accuracy and completeness of the information contained in the report.

SCHEDULING

TIMESHEETS. The Contract Pharmacist(s) will be responsible for reporting to work at the scheduled time.

All contract pharmacists will utilize the time clock to ensure accurate documentation of hours worked. All submitted timesheets will be verified with the invoices before payment is processed. Only the hours authorized by the Pharmacy Supervisor or designee will be authorized for payment.

WORK SCHEDULE: Work shifts will typically be eight (8) hours and will be worked between the hours of 8:00am and 8:00pm with a one-half hour lunch break. The work shift may include holidays, and occasionally additional hours may be required. The typical work week will be 40 hours per week, and the Contract Pharmacist will typically be scheduled to cover the weekday (Monday through Friday) shift of 9:30am to 6:00pm, depending on staffing. Work shifts on the weekends will be 5 hours each day from 12:00pm to 5:00pm. When the Contract Pharmacist is scheduled to work on a holiday or weekend, additional time may be scheduled off during the work week, depending on staffing. Work hours will be scheduled by the Pharmacy Supervisor or designee to correspond to the needs of the facility and are subject to change. Up to thirty (30) minutes may be allowed at the end of the scheduled shift to accommodate unexpected patient care. Any work that is performed beyond this will need approval from the Pharmacy Supervisor or designee.

EVALUATION AND PERFORMANCE REQUIREMENTS

The Contractor shall allow the Government to evaluate the quality of professional and administrative services provided with the technical requirements of this contract. This assessment will include observations of the work system, methods and execution. Examples of monitoring methods include but are not limited to:

appropriateness of candidate placement (e.g. number or removals, number of early termination of assignments due to personality conflict, poor work habits, inadequate skills for the assignment, unprofessional or discourteous behavior). An assessment spreadsheet with these methods will be monitored by the Pharmacy Supervisor and the Contracting Officers’ Representative (COR). The Contract Pharmacist’s performance will be monitored through peer review/competency, identifying deficiencies in the quality of services performed before the level of performance becomes unacceptable. These evaluations may be used as a record of contract performance history for the purpose of evaluation in other competitive or non-competitive acquisitions.

It shall be understood that eligible patients under treatment will be rendered services that provide the best medical care within the Contract Pharmacist’s professional training and experience. All services rendered shall be in accordance with current standard medical practices to ensure quality care. The Contractor must perform at a level that is satisfactory and in accordance with all applicable laws, policies, rules, regulations, and within the Statement of Work.

NEGLIGENT BEHAVIOR. Any negligent behavior or any behavior jeopardizing patient safety will not be tolerated. Professional Review Action may be taken if activity, demeanor or conduct of the member is

Statement of Work: Pharmacist Page 8 of 12 detrimental to patient care, disruptive to the service unit operation, or in violation of IHS policy or is unethical.

Each incident will be evaluated and documented, and the Pharmacy Supervisor will notify the COR, and provide copies of pertinent documentation as soon as possible when the necessity to exercise such authority becomes apparent. These incidents may be grounds for immediate removal.

PERFORMANCE SURVEILLANCE PLAN. Performance surveillance monitors will be established to comply with regulatory guidelines and to monitor contract performance. The performance surveillance plan has been developed to outline 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 through review of 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.

Upon completion of the contract, the Government will complete and keep on record the Contractor’s performance evaluation form based on the following objectives.

OBJECTIVE PERFORMANCE

STANDARD

ACCEPTABL

E QUALITY

LEVEL (AQL)

SURVEILLANCE

METHOD/

MEASURES

CONTRACTOR

INCENTIVE

DISINCENTIVE/

DEDUCT

PERFORMANCE

OBJECTIVE 1

The Contractor shall establish a technical approach and management plan for the placement of Pharmacist into temporary assignments at

WWKMHCC

providing coverage when requested

Once a purchase order/request is received:

Contractor shall locate a Pharmacist and complete all paperwork within established time frames

Present candidate within five (5) days of purchase order and if found unacceptable locate a replacement within three

(3) days.

Complete IHS background investigation information and return to WWKMHCC within 7 days.

Placement of staff 100% of the time

Pharmacy Supervisor shall submit monthly spreadsheet of placement dates to the COR to monitor the placement requirement of coverage when requested

Favorable Contractor performance evaluation

Unfavorable

OBJECTIVE 2

All Contract Pharmacist (s) shall perform in accordance with clinical standards

Care provided is within clinical standards of care

100%

Pharmacy peer reviews and / or competencies will be completed and will review the following elements:

-Appropriateness of new prescription(s), including appropriate dose, allergy review, formulary process followed, and performance evaluation, removal from contract until such time the Contract Pharmacist(s) meet qualification standards

Statement of Work: Pharmacist Page 9 of 12 counseling literature documented.

-Accurate verification and dispensing of medication, including allergy review and counseling documentation.

OBJECTIVE 3

Contract Pharmacist(s) are capable and knowledgeable of effective communication

Contract Pharmacists shall be respectful, courteous, and culturally sensitive to IHS patients and staff

No more than two (2) valid complaints per Contract Pharmacist

The Contractor shall respond to the COR in writing whenever they receive notice of more than two complaints against a Contract Pharmacist with an explanation of what was done to address the matter

The invoice will be put on hold until the complaint is investigated and resolved in 7 working days, removal from contract until such time the Contract Pharmacist(s) meet qualification standards

OBJECTIVE 4

Contract Pharmacist(s) shall complete all required trainings on time

All required training is completed on time

95% completion, no deviations

Periodic sampling contract performance evaluation, suspension or termination of all physical and/or electronic access privileges and removal from contract until training is completed

OBJECTIVE 6

Contract Pharmacist is aware of all laws, regulations and policies related to Privacy, Confidentiality and HIPAA, and complies with all standards of privacy

All Contract Pharmacist(s) comply with all laws, regulations and policies relating to Privacy, Confidentiality and HIPAA

100% compliance, no deviation

Contract Pharmacist shall provide copies of all required trainings to the Pharmacy Supervisor, HIM will report any violation to the Pharmacy Supervisor for review

Favorable Contractor performance evaluation

Immediate removal of Contract Pharmacist from contract

SECURITY

PHYSICAL ACCESS. The Contract Pharmacist(s) shall return identification badges to the Pharmacy

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Supervisor upon completion/termination of the contract.

PHYSICAL SECURITY. The Contractor Pharmacist(s) shall safeguard all government property, including controlled forms provided for use. All PHI shall be secured at all times and not left unattended in unsecure areas. At the close of each work period, government equipment, facilities, and other valuable materials shall be secured, and all PHI shall be returned to the HIM department.

REPORTING REQUIREMENTS. The Contract Pharmacist shall report to an appropriate authority any information or circumstances of which they are aware that may pose a threat to the security of IHS personnel or patients.

WEAPONS, FIREARMS, AND AMMUNITION. Contract Pharmacists are prohibited from possessing weapons, firearms, or ammunition, on themselves or within their contractor-owned vehicle or privately-owned vehicle while on the WWKMHCC grounds.

GOVERNMENT FURNISHED PROPERTY AND SERVICES

The WWKMHCC shall provide work space including a desk, computer, printer, and office supplies. The Contract Pharmacist will be authorized to use all areas of the facility available to civil service and commissioned personnel in similar positions. The same restrictions apply to Contract Pharmacists as any other IHS personnel to use these areas for official business activities only.

The Contract Pharmacist will be authorized to use all administrative and professional support available to IHS personnel. This will include, but not be limited to, copy machines, telefax machines, and telephone service. The same restrictions to use these items for official Indian Health Service business apply.

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

CONTRACTOR FURNISHED ITEMS AND SERVICES

Except for those items or services specifically stated to be Government furnished, the Contractor shall furnish everything required to perform this contract in accordance with all of its terms. The WWKMHCC does not anticipate a need for Contractor furnished equipment.

HOUSING. The Contractor shall be responsible for all applicable Federal, State, and Local Taxes, Meals, Travel/Transportation, lodging, and per diem.

COMMUNICATION BETWEEN ALL PARTIES

POINT OF CONTACT. The Contractor shall provide a point of contact who shall be responsible for the performance of the work.