75H70627R00007-Solicitation..pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

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OFFEROR

159CODE 16. ADMINISTERED BYCODE

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621999

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR159

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

12/08/2026 1200 CS

11/09/2026

FARRAH AZURE

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70627R00007

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 37 IHS1532498OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Aberdeen SD 57401

115 Fourth Ave, SE

Federal Building

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$20.5

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Aberdeen Area Indian Health Servic WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

Multiple Destinations

Aberdeen SD 57401

115 Fourth Ave, SE

Federal Building

Aberdeen Area Indian Health Servic

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

100% Indian Small Business Economic Enterprise

(ISBEE)

Firm Fixed-Price, non-personal, commercial service contract for Tele-Emergency (Tele-ED) high-acuity emergency support and Telemedicine Sexual Assault Medical Forensic Evaluation (TeleSAMFE/TeleSANE) support services for five

(5) rural hospitals ("Spoke Sites") within the Great Plains Area (GPA) Indian Health Service

(IHS).

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

X

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

The contractor's terms and conditions shall be incorporated into the contract by reference.

Where conflicts arise, the Federal Acquisition

Regulations, and other Federal Regulations, Laws and Rules shall take precedence.

Period of Performance (Ordering Period) will be date of award through five (5) years or sixty

(60) months.

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.

Delivery: 07/31/2032

1 eCritical Care 3,475 Consults & eSANE 695

Consults Services for the Pine Ridge Indian

Health Service, Pine Ridge, SD.

Plus or minus fifteen percent (+/-15%) quantity variance for the applicable CLIN to account for fluctuations in actual eCritical and eSANE requirements.

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 37

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70627R00007

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 08/01/2027 to 07/31/2032

2 eCritical Care 2,040 Consults & eSANE 410

Consults Services for the Rosebud Comprehensive

Health Care Facility, Rosebud, SD.

Plus or minus fifteen percent (+/-15%) quantity variance for the applicable CLIN to account for fluctuations in actual eCritical and eSANE requirements.

Delivery Location Code: IHSROSEBUD

IHSROSEBUD

800 HOSPITAL DR

ROSEBUD SD 57570 US

Period of Performance: 08/01/2027 to 07/31/2032

3 eCritical Care 1,770 Consults & eSANE 355

Consults Services for the Cheyenne River Indian

Health Service, Eagle Butte Service Unit, Eagle

Butte, SD.

Plus or minus fifteen percent (+/-15%) quantity variance for the applicable CLIN to account for fluctuations in actual eCritical and eSANE requirements.

Delivery Location Code: IHSEAGLEBUTTE

IHSEAGLEBUTTE

24276 166th Street

Airport Road

EAGLE BUTTE SD 57625 US

Period of Performance: 08/01/2027 to 07/31/2032

4 eCritical Care 1,595 Consults & eSANE 320

Consults Services for the Standing Rock Service

Unit, Fort Yates, ND.

Continued ...

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

Sponsored by GSA

FAR (48 CFR) 53.110

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CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70627R00007

Plus or minus fifteen percent (+/-15%) quantity variance for the applicable CLIN to account for fluctuations in actual eCritical and eSANE requirements.

Delivery Location Code: IHSFTYATES

IHSFTYATES

10 Standing Rock Ave

FT YATES ND 58538 US

Period of Performance: 08/01/2027 to 07/31/2032

5 eCritical Care 950 Consults & eSANE 190 Consults

Services for the Quentin N Burdick Memorial

Health Care Facility in Belcourt, ND.

Plus or minus fifteen percent (+/-15%) quantity variance for the applicable CLIN to account for fluctuations in actual eCritical and eSANE requirements.

Delivery Location Code: IHSBELCOURT

IHSBELCOURT

Q.N.B.M.H.C.F

1300 Hospital Road

PO Box 160

Belcourt ND 58316 US

Period of Performance: 08/01/2027 to 07/31/2032

Contract Minimum/Maximum Quantity and Contract

Value: The minimum quantity and contract value for all orders issued against this contract shall not be less than the minimum quantity and contract value stated in the following table.

Minimum Amount: $1,000,000.00

Maximum Amount: $7,500,000.00

CLIN Delivery/Task Order Minimum/Maximum Quantity and CLIN Order Value: The minimum quantity and contract order value for the given Delivery/Task

Order issued for this CLIN shall not be less than the minimum quantity and order value stated in the following table. The maximum quantity and order value for the given Delivery/Task Order issued for this CLIN shall not exceed the maximum

Continued ...

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

5 37

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70627R00007 quantity and order value stated in the following table.

Minimum Amount: $1,000.00

Maximum Amount: $1,700,000.00

INVOICE PROCESSING PLATFORM (IPP)

The Indian Health Service (IHS) has implemented 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 Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St.

Louis (FRSTL). 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.

Attachments:

1. SF1449 Request for Proposal

Continued ...

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

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CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70627R00007

2. Performance Work Statement/QASP

3. Task Order Procedures

4. Clauses

5. Indian Firm Representation Form

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

SECTION C — PERFORMANCE WORK STATEMENT (PWS)

IDIQ — Telemedicine Emergency and Sexual Assault Forensic Support Services Support for Five Rural Hospitals

C.1 Purpose This Performance Work Statement (PWS) describes requirements under an Indefinite- Delivery/Indefinite-Quantity (IDIQ) contract for 24/7/365 telemedicine clinical support services for five (5) rural hospitals (“Spoke Sites”). The Contractor shall provide (1) Tele-Emergency (Tele- ED) high-acuity emergency support and (2) Telemedicine Sexual Assault Medical Forensic Evaluation (TeleSAMFE/TeleSANE) support, as ordered by task order.

C.2 Background

• Rural hospitals often have limited on-site specialty and critical care coverage and variable access to emergency-trained clinicians.

• Many rural hospitals lack consistent Sexual Assault Nurse Examiner (SANE) coverage, creating delays and inconsistency in forensic evaluations.

• Telemedicine-enabled specialty support improves access to expertise, stabilization, documentation quality, evidence collection consistency, and patient-centered trauma-informed care.

C.3 Scope of Work The Contractor shall provide synchronous audio-video telemedicine support using a hub-and-spoke model for the following service lines, as ordered by task order. The work will support five

(5) rural hospitals in South Dakota and North Dakota (each a “Spoke Site”). Each Spoke Site is associated with an applicable Service Unit. Approximate ED volumes are as follows:

Facility Location Annual ED Volume Pine Ridge Hospital Pine Ridge, SD 27,794 Rosebud Hospital Rosebud, SD 16,324 Eagle Butte Hospital Eagle Butte, SD 14,141 Quentin Burdick Hospital Belcourt, ND 12,762 Fort Yates Hospital Fort Yates, ND 7,591

C.3.1 Tele-Emergency (Tele-ED) Support Real-time consultative support for emergent and time-sensitive clinical events in the ED and other authorized settings, including but not limited to:

• Cardiac/respiratory arrest (ACLS/PALS guidance) and post-ROSC support

• Trauma resuscitation support and stabilization

• Airway emergencies and ventilatory support guidance

• Sepsis and septic shock stabilization

• Pediatric emergency stabilization

• Stroke and neurologic emergencies (triage/transfer support)

• Toxicology/overdose stabilization

• Obstetric emergencies (stabilization support within scope/privileges)

• Surge/mass casualty events upon request

Tele-ED Clinicians provide consultative guidance. On-site clinicians retain responsibility for direct patient care and local clinical decisions.

C.3.2 TeleSAMFE / TeleSANE Support On-demand telemedicine support to enable timely, high-quality Sexual Assault Medical Forensic Evaluations (SAMFE), consistent with applicable standards of care and trauma-informed practices, including:

• Trauma-informed patient engagement, consent guidance, and patient autonomy support

• Medical and assault history guidance using non-leading techniques

• Physical assessment and injury identification guidance

• Forensic evidence collection and documentation support

• STI and pregnancy prophylaxis guidance per site protocol

• Safety planning and referral coordination

• De-identified case review and quality improvement support

C.4 IDIQ Structure and Ordering C.4.1 Contract Type: IDIQ. Services will be ordered via task orders issued by the Contracting

Officer (CO) or authorized Ordering Official.

C.4.2 Task orders may specify: covered Spoke Sites (up to five), service line(s) (Tele-ED, TeleSAMFE, or both), coverage model, staffing, response time standards, escalation, telehealth workflow integration, reporting requirements, and performance metrics (PRS).

C.4.3 The Government may provide anticipated event types and estimated count volumes by site for planning purposes. Estimated workloads provided by the Government are planning estimates only and do not guarantee volumes.

C.4.4 Service Unit Ordering Points of Contact

The Government will designate an Ordering Point of Contact (Ordering POC) for each applicable Service Unit/Spoke Site supported under this contract. The Ordering POC will serve as the primary Service Unit representative for coordinating requirements under this contract and applicable task orders.

Ordering POCs may identify Service Unit requirements, coordinate anticipated service needs, provide site-specific operational information, coordinate scheduling and implementation activities, and communicate Service Unit requirements to the Contracting

Officer (CO), Contracting Officer’s Representative (COR), and/or authorized Ordering Official, as applicable.

An Ordering POC does not, solely by virtue of the designation, have authority to:

• Obligate Government funds;

• Issue or modify task orders;

• Change contract or task order requirements, pricing, scope, or terms and conditions;

• Direct the Contractor to perform work outside an issued task order; or

• Otherwise bind the Government.

Only the Contracting Officer or other duly authorized official may exercise such authority.

The Government will provide the Contractor with the name and contact information of the designated Ordering POC for each applicable Service Unit/Spoke Site and may change an Ordering POC by written notification without requiring modification of this PWS.

C.5 Period and Place of Performance C.5.1 Period of Performance: Base Period of 12 months with four (4) additional 12-month option periods (if exercised).

C.5.2 Place of Performance:

• Remote: Contractor telemedicine operations within the United States (unless otherwise authorized).

• On-site: Five rural Spoke Sites identified by the Government:

1. Pine Ridge Hospital, Pine Ridge, SD

2. Rosebud Hospital, Rosebud, SD

3. Eagle Butte Hospital, Eagle Butte, SD

4. Fort Yates Hospital, Fort Yates, ND

5. Quentin Burdick Hospital, Belcourt, ND

C.6 General Requirements

C.6.1 Coverage and Availability

• Provide 24/7/365 coverage, including weekends and federal holidays, unless otherwise specified by task order.

• Maintain staffing sufficient to meet response times and continuous coverage, including handling concurrent events consistent with task order requirements.

C.6.2 Activation, Escalation, and Workflow Integration

• Provide a rapid activation process (dedicated call number and/or one-touch platform activation).

• Define on-site roles (e.g., telepresenter RN) and provide a documented escalation pathway if the primary remote clinician is unavailable.

• Provide real-time consultative guidance to the on-site care team, including differential diagnosis support and prioritization; resuscitation leadership support and closed-loop communication coaching; medication guidance (including weight-based dosing as applicable); procedural guidance within scope and privileges; transfer decision support; and post-event debrief support when requested. (On-site clinicians retain responsibility for direct patient care and local clinical decisions.)

• Support multi-party participation when needed and maintain a backup modality (audio-only) during outages when clinically appropriate and permitted.

• Remain connected for the duration of the emergency event/evaluation as clinically indicated.

• Support stabilization priorities before transfer, documentation of transfer rationale and recommendations, and communication support with receiving facilities when authorized by site process.

C.7 Technology and Telehealth Operations

• Use a secure, encrypted telehealth platform compatible with Spoke Site operations, supporting rapid audio-video connection and multi-party participation. System must be FedRAMP approved and approved by the Facility at which services will be performed.

• Provide technical support and troubleshooting during covered hours, including downtime procedures and a redundancy plan.

• Provide monthly platform uptime reporting when Contractor-managed.

C.8 Staffing, Qualifications, and Credentialing/Privileging

C.8.1 Tele-ED Clinician Qualifications

• Board-certified/board-eligible Emergency Medicine physicians or task-order approved equivalent qualified clinician model.

• Demonstrated experience in high-acuity emergency stabilization/resuscitation.

• Maintain current ACLS, PALS/NRP.

• Complete telehealth competency training prior to go-live.

• Hold active unrestricted licensure and meet site credentialing/privileging requirements.

Proxy credentialing is authorized as per CMS and local medical staff bylaws.

C.8.2 TeleSANE / TeleSAMFE Clinician Qualifications

• Current SANE-A certification or equivalent documented SANE training and competency.

• Minimum two (2) years recent SAMFE/SANE experience.

• Training in trauma-informed care.

• Appropriate licensure for telehealth practice and meet site credentialing/privileging requirements.

C.8.3 Credentialing/Privileging Contractor personnel shall be credentialed/privileged as required by each Spoke Site. Proxy credentialing may be used where permitted by policy and applicable regulations.

C.8.4 Key Personnel

• Program Manager

• Clinical Lead/Medical Director

• Tele-ED Clinicians

• TeleSANE Clinicians

• Technical Support Lead

C.9 Documentation Requirements The Contractor shall document consult notes in the Government-designated EHR or approved workflow. Unless otherwise specified by task order, documentation shall be completed within 24 hours.

C.9.1 Tele-ED Minimum Documentation Elements

• Reason for consult/event type

• Key findings and clinical context

• Recommendations with rationale

• Medications/procedures discussed (as applicable)

• Transfer/escalation recommendations (as applicable)

• Time connected and response time markers (as available)

C.9.2 TeleSAMFE Minimum Documentation Elements

• Support provided for consent, trauma-informed approach, and patient autonomy

• History-taking guidance (non-leading) and key considerations

• Exam and injury identification guidance

• Evidence collection guidance and chain-of-custody considerations per site process

• Prophylaxis guidance per site protocol

• Safety planning/referral coordination guidance

C.10 Quality Assurance / Performance Improvement

• Maintain a Quality Control Plan (QCP) describing staffing assurance and escalation, response time monitoring, clinical peer review/chart audit process, training/competency monitoring, and corrective action tracking.

• Participate in periodic (e.g., quarterly) de-identified case reviews focused on quality improvement and system learning, covering both Tele-ED and TeleSAMFE service lines as applicable.

C.11 Deliverables (Unless Modified by Task Order)

C.11.1 Monthly Report (Default due by 10th business day)

• Number of consults/events supported by site and service line

• Response time performance (initial and escalated)

• Consult duration aggregates and peak demand

• Technology issues and resolution; uptime summary (if Contractor-managed)

• Staffing coverage summary and any surge/concurrency impacts

• De-identified quality themes and training recommendations

C.11.2 Quarterly Quality Summary

• Chart audit/peer review themes (de-identified)

• Case review outcomes and system improvement recommendations

• Training delivered/planned and corrective action status

C.11.3 Annual Report

• Year-end performance summary and trend analysis

• Program improvement plan and recommendations

C.11.4 Incident Reports Report critical incidents per site policy and task order requirements.

C.12 Government Surveillance and Performance Standards (PRS) The Government may monitor performance through response-time logs and consult records, EHR/chart audits, validation of monthly/quarterly reports, stakeholder feedback from Spoke Sites, and periodic QCP review meetings.

Minimum PRS elements (task orders may add/modify):

• Tele-ED initial connection response time: default ≤ 10 minutes; AQL ≥ 95% monthly (per site and aggregate).

• TeleSAMFE initial response time: ≤ 15 minutes; AQL ≥ 95% monthly.

• Escalated response time: task-order defined (e.g., ≤ 15–25 minutes); AQL typically ≥ 99% monthly.

• Continuous coverage: 0 unplanned lapses.

• Documentation timeliness: ≤ 24 hours; AQL ≥ 95% monthly.

• Technology availability: ≥ 99.5% uptime monthly (excluding scheduled maintenance).

• Corrective Action Plan (CAP): required when AQL is not met (task-order specific remedies apply).

C.13 Privacy, Security, and Compliance

• Comply with applicable federal and state privacy and security requirements for PHI, including encrypted communications and role-based access.

• Ensure required training for all Contractor personnel with access to PHI.

• Execute required agreements (e.g., Business Associate Agreement) as applicable.

C.14 Transition Requirements

C.14.1 Transition-In

• Kickoff meeting and onboarding for all five sites.

• Connectivity testing and workflow mapping; activation training for on-site teams.

• Go-live readiness review and operational readiness within 60 days of award (unless modified by task order).

C.14.2 Transition-Out

• Support knowledge transfer, final reporting, and secure disposition/transfer of Government data per Government direction.

C.15 Non-Personal Services This is a non-personal services requirement. Contractor employees shall not be supervised or controlled by Government personnel.

C.16 Contact Information

C.16.1 COR Information Cara Bohling Cara.Bohling@ihs.gov

C.16.2 Point of Contact (POC) Information per Service Unit (SU) Cheyenne River IHS:

Tele-ED – Yeisabeth Jimenez (Yeissa.ChabrierRosello@fda.hhs.gov) Tele-eSANE – Keri Fischer (Keri.Fischer@ihs.gov)

Rosebud IHS:

Teresa Tobin (Teresa.Tobin@ihs.gov), ED Nurse Supervisor

Pine Ridge IHS:

Heather Brehmer (Heather.Brehmer@ihs.gov), ED Nurse Supervisor

Standing Rock IHS:

Karen Emison (Karen.Emison@ihs.gov), ED Nurse Supervisor

Quentin Burdick IHS:

Shylene Hall (Shylene.Hall@ihs.gov), Acting Clinical Director mailto:Cara.Bohling@ihs.gov mailto:Yeissa.ChabrierRosello@fda.hhs.gov mailto:Keri.Fischer@ihs.gov mailto:Teresa.Tobin@ihs.gov mailto:Heather.Brehmer@ihs.gov mailto:Karen.Emison@ihs.gov mailto:Shylene.Hall@ihs.gov

Attachment 1 Quality Assurance Surveillance Plan (QASP) Tele-Critical Care (Tele-ED) and TeleSANE Services IDIQ Contract – Five Rural Hospitals

1. Purpose This QASP defines how the Government will monitor Contractor performance to ensure compliance with the PWS and delivery of timely, high-quality telehealth services.

2. Scope Applies to Tele-ED, TeleSANE, technology, documentation, reporting, and staffing.

3. Roles and Responsibilities CO: Contract authority. COR: Monitors performance. SMEs: Conduct clinical reviews.

4. Surveillance Methods Includes automated monitoring, random sampling, periodic reviews, and stakeholder feedback.

5. Performance Standards Tele-ED Response ≤10 min (95%) TeleSANE Response ≤15 min (95%) Escalation ≤25 min (99%) Coverage: 24/7/365 Documentation ≤24 hrs (95%) Uptime ≥99.5%

6. AQLs Failure to meet AQL triggers corrective action.

7. Corrective Actions

CAP required within 5 days (or 24–48 hrs for critical issues).

8. Remedies May include increased oversight, payment adjustments, or CPARS impact.

9. Reviews Monthly, quarterly, and annual performance reviews.

10. Continuous Improvement Contractor participates in quality improvement and training.

11. Documentation All surveillance records maintained by COR.

12. Summary Ensures services meet mission and clinical standards.

Tele-ED & TeleSAMFE/TeleSANE Task Order Procedures

1. Task Order Procedures

When the Government requires work under the contract; in accordance with the Performance Work Statement (PWS), a Request for Proposal (RFP) will be issued as appropriate. The proposal due date in response to an RFP will generally be 30 days. However, the Contracting Officer may require a proposal due date of less than 30 days depending on the need for the requirement.

The Government will not be obligated to reimburse the Contractor for work performed or any costs incurred, nor shall the Contractor be obligated to perform or otherwise incur costs except as authorized by executed task orders.

Each Task Order shall include as a minimum:

• Date of order

• Contract number and order number

• Contract item number and description, quantity, and unit price or estimated cost

• Delivery or performance schedule

• Place of performance

• Any packaging, packing, and shipping instructions

• Accounting and appropriate data

• Wage Determination – if applicable

• Method of payment and payment office

• Invoicing instructions

Task Orders may be modified by the Contracting Officer. Modifications to task orders will be issued on a Standard Form (SF) 30 and cite the Task Order Number.

In the event the Contractor is unable to submit a proposal on a particular RFP, the Contractor is required to notify, in writing, the Contracting Officer who issued the RFP within five (5) working days from receipt of the RFP. More than two notifications per year MAY result in the Government choosing not to solicit/award subsequent task orders.

Task orders may range from $1,000.00 to $1,000,000.00 per order. Projects over $1,000,000.00 may be issued if the Contractor agrees.

When a request for proposal includes Brand name or equal purchase descriptions the task order must include, in addition to the brand name, a general description of those salient physical, functional, or performance characteristics of the brand name item that an “equal” item must meet to be acceptable for award as described in FAR Provision 52.211-6 Brand Name or Equal. The use of brand name or equal descriptions is necessary when the salient characteristics are firm requirements.

Authority

No person other than the Contracting Officer has authority to bind the Government with respect to this contract.

No action or omission of any government employee or representative other than the Contracting Officer shall increase or decrease the scope of this contract or shall otherwise modify the terms and conditions of this contract.

In no event shall any of the following be effective or binding on the Government or imputed to the Contracting Officer with respect to this contract:

An understanding or agreement between the Contractor and anyone other than the Contracting Officer;

A purported modification or change order issued by anyone other than the Contracting Officer;

A promise by anyone other than the Contracting Officer to provide additional funding or make payments; or An order, direction, consent, or permission from anyone other than the Contracting Officer to:

Incur costs in excess of a specified estimated cost, allotment of funds, or other ceiling;

or

Expend hours in excess of a specified level of effort.

2. Additional Task Order Information

Task Orders will be firm fixed price with a specific completion date or performance period and clearly define the specific statement of work to be performed or the performance desired. Each task order will contain applicable clauses and provisions and may include those already included or referenced in the basic contract. All Task Orders are subject to the terms and conditions of this contract. The Government reserves the right to incorporate additional clauses, as appropriate, into individual Task Order RFPs and awards.

Most Task Orders issued will be definitive (a defined price based on predetermined tasks and quantities). However, under emergency conditions, in accordance with FAR parts 16.603 and 18.112, the Contracting Officer may issue an undefinitized (lacking definitive tasks or quantities) Task Order which directs the Contractor upon issuance of the order to proceed with the work immediately. These unilateral orders will specify the work and will contain a maximum (not-to-exceed) dollar amount, against which the Contractor can submit invoices, during contract performance. The final price will be determined through negotiations to identify pre-priced and non-pre-priced tasks and quantities.

3. Task Order Scope Types Under This Contract:

a. Performance Scopes of Work

Task Orders may be issued with scopes of work and PWS. For those task orders issued with negotiated scopes of work or PWS, the following requirements apply:

Unless the issued Task Order directs otherwise, the Contractor shall submit Task Order post-award submittals within the specified times following the issuance of the Task Order:

Post Award Conference. Within ten (10) days after Task Order issuance, the Contractor shall schedule a Post Award Conference with the Contracting Officer or Contracting Officer’s designated representative.

Before any of the work is initiated under an individual Task Order, the Contractor shall furnish all submittals necessary for the completion of work. The Contractor shall confer with the Contracting Officer and/or Contracting Officer’s designated representative and agree on the sequence of procedure; means of access to premises and building; space for storage of materials and equipment; delivery of materials and use of approaches; use of corridors, stairways, elevators, means of communications, the location of partitions, and restrooms for Contractor’s employees.

Performance Scopes of Work Requirements:

Contractor Furnished Items

Except for items identified as Government Furnished, the Contractor shall provide all equipment, materials, parts, supplies, components, and facilities to perform the requirements of this contract.

The Contracting Officer or designated Government representative may inspect Contractor-furnished items for adequacy and compliance with contract requirements. Inadequate or unsafe items shall be removed and replaced by the Contractor at no cost to the Government. Materials containing asbestos, lead, and PCBs shall not be brought on-site. The Contracting Officer may at any time require Samples, Safety Data Sheets (SDS), or Manufacturer’s Data Cut Sheets of Materials used in this contract.

Management

The Contractor shall manage the total work effort associated with the services required herein to meet the performance objectives and standards. Such management includes but is not limited to planning, scheduling, cost accounting, report preparation, establishing and maintaining records, and quality control. The Contractor shall provide staff with the necessary management expertise to ensure performance objectives and standards are met.

Technical Personnel

The Contractor shall provide adequate technical expertise on staff sufficient to successfully complete joint scoping when requested by the contracting officer. The contractor shall not consult outside their organization, nor procure Architect and Engineering (A&E) services unless approved by the Contracting Officer. Technical staff may hold other positions in the organization but shall be adequate to cover a wide array of experience, and expertise, as required by the breadth and complexity of projects scoped.

Protection of Government Property

During execution of the work, the Contractor shall protect Government property. In the event that damage to Government Property is incurred due to Contractor responsibility under this contract (to include but not limited to negligence, willful intent, Contractor accident, etc.), the Contractor shall return areas damaged to their original condition at no cost to the Government.

Operation of Station Utilities

The Contractor shall not operate or disturb the setting of control devices in the station utilities system, including water, sewer, electrical, and steam services. The Government will operate the control devices as required for normal conduct of the work. The Contractor shall notify the Contracting Officer giving reasonable advance notice when such operation is required. The amount of notice required will be identified in task order RFPs.

Security Requirements

Contract Clause "FAR 52.204-2, Security Requirements” applies to all work under this contract.

IHS Requirement, Special Working Conditions and Entry to Work Area, may also apply to individual task orders, as may other special security requirements. Any extraordinary security requirements that are unique to a specific project (for example, badging requirements for restricted areas) will be included in the requirements of the Task Order RFP as applicable.

Emergency Point of Contact Information

At the Task Order level, furnish the Contractor's point of contact information to the Contracting Officer. Include addresses and telephone numbers for use in the event of an emergency at which the representative may be reached 24 hours daily. The Contractor shall notify the Contracting Officer in writing of the telephone number within three calendar days after the award of the Task Order and immediately thereafter in the event of change.

Installation Access Badges

At the Task Order level, identification badges, if required, will be furnished based on the individual installation security procedures. The contractor is responsible for all costs, if any, associated with obtaining proper credentials. The Contractor must immediately report instances of lost or stolen badges to the Contracting Officer. Failure of contractor personnel to obtain entry approval will not affect the contract price or time of completion. All Contractor personnel shall become familiar with and obey all Government regulations including fire, traffic, and security regulations. Refer to individual Task Order requirements provided at the post-award conference.

Contractor personnel will not be admitted to the work site without approval. Access requirements will be as identified in the policy for each location. Some facilities, or areas within some facilities, restrict access to U.S. Citizens only. A minimum of five (5) working days is required for the processing of each– individual or group. The contractor is not entitled to any equitable adjustment for delays (time or money) incurred as a result of the Access process.

Emergency Medical Treatment

Contractors will arrange for their own emergency medical treatment. The Government has no responsibility to provide emergency medical treatment. When on-site emergency response is required to be provided by the Government, the Contractor may be required to reimburse the Government.

Quality Control

The Contractor shall establish and maintain an inspection system in accordance with the FAR Clause 52.246-2, INSPECTION OF SUPPLIES- FIXED PRICE and/or FAR Clause 52.246-4, INSPECTION OF SERVICE-FIXED PRICE, to ensure that the work performed conforms to the contract requirements.

The Contractor shall maintain a file of all scheduled and performed QC inspections, inspection results, and dates and details of corrective and preventive actions. The file shall be the property of the Government and made available during the Government’s regular working hours. Submittal requirements for this deliverable are posted in Section Deliverables.

Temporary Facilities and Controls

a. Contractor Work Site

Limit use of the premises for work and for storage of material and equipment associated with the contract. Unless otherwise specified or separately agreed to, Government-owned material handling equipment, transportation equipment, or general tools will not be available for the Contractor’s use. Clean the work area daily and after completion of the work.

b. Contractor Furnished Equipment

Equipment is subject to the inspection and approval of the Administrative Contracting Officer, prior to and during the life of the contract. All equipment and vehicles shall display readily visible Contractor identification markings. Upon request, the Contractor shall relocate stored Contractor-furnished equipment which may interfere with operations of the Government or with others on-site.

c. Contractor Furnished Material

Protect and secure Contractor-furnished material stored at each applicable project work site.

All replacement units, parts, components, and materials to be used in the maintenance, repair, and alteration of facilities and equipment shall be new and compatible with the existing equipment on which it is to be used, and shall comply with applicable Government, commercial, or industrial standards such as Underwriters Laboratories, Inc., and National Electrical Manufacturers Association.

d. Government Installation Operation Effect On Contractor Operations

The project Task Order will identify any known Government Installation operations that may affect the Contractor's work.

Solicitation Clauses 1

PROVISIONS AND CLAUSES INCORPORATED BY REFERENCE

52.252-1 Solicitation Provisions Incorporated by Reference.

As prescribed in 52.107(a), insert the following provision:

Solicitation Provisions Incorporated by Reference (Feb 1998)

This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es):

https://www.acquisition.gov/browse/index/far

(End of provision)

52.252-2 Clauses Incorporated by Reference.

As prescribed in 52.107(b), insert the following clause:

Clauses Incorporated By Reference (Feb 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

https://www.acquisition.gov/browse/index/far

(End of clause)

I. Federal Acquisition Regulations (FAR)(48 CFR Chapter 1) Provisions and Clauses Incorporated by Reference.

FAR

CITATION

PROVISION/CLAUSE TITLE PROVISION

/ CLAUSE

DATE

52.202-1 Definitions Jun-20 52.203-3 Gratuities Apr-84 52.203-5 Covenant Against Contingent Fees May-14 52.203-6 Restrictions on Subcontractor Sales to the Government Jun-20 52.203-7 Anti-Kickback Procedures Jun-20 52.203-12 Limitation on Payments to Influence Certain Federal Transactions Jun-20 52.203-17 Contractor Employee Whistleblower Rights Nov-23 52.204-2 Security Requirements Mar-21 52.204-7 System for Award Management Nov-24 https://www.acquisition.gov/far/52.107#FAR_52_107 https://www.acquisition.gov/far/52.107#FAR_52_107

Solicitation Clauses 2

52.204-9 Personal Identity Verification of Contractor Personnel Jan-11 52.204-10 Reporting Executive Compensation and First-Tier Subcontract

Awards Jun-20

52.204-12 Unique Entity Identifier Maintenance Oct-16 52.204-13 System for Award Management Maintenance Oct-18 52.204-15 Service Contract Reporting Requirements for Indefinite-Delivery

Contracts Oct-16

52.204-19 Incorporation by Reference of Representations and Certifications Dec-14 52.204-21 Basic Safeguarding of Covered Contractor Information Systems Nov-21 52.204-25 Prohibition on Contracting for Certain Telecommunications and

Video Surveillance Services or Equipment Nov-21

52.209-5 Certification Regarding Responsibility Matters Aug-20 52.209-10 Prohibition on Contracting with Inverted Domestic Corporations Nov-15 52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law Feb-16

52.212-4 Terms and Conditions – Commercial Products and Commercial Services

RFO Nov-25

52.216-24 Limitation of Government Liability Apr-84 52.216-25 Contract Definitions Oct-10 52.217-9 Option to Extend the Term of the Contract Mar-00 52.219-33 Nonmanufacturer Rule Sep-21 52.222-50 Combating Trafficking in Persons Oct-25 52.222-90 Addressing DEI Discrimination by Federal Contractors RFO Jan-26 52.224-1 Privacy Act Notification Apr-84 52.224-2 Privacy Act Apr-84 52.232-1 Payments Apr-84 52.232-39 Unenforceability of Unauthorized Obligations Jun-13 52.232-40 Providing Accelerated Payments to Small Business Subcontractors Mar-23 52.233-3 Protest After Award Aug-96 52.233-4 Applicable Law of Breach of Contract Claim Oct-24 52.237-3 Continuity of Services Jan-91 52.242-5 Payments to Small Business Subcontractors Jun-17 52.242-15 Stop-Work Order Aug-89 52.244-6 Subcontracts for Commercial Products and Commercial Services Jan-25 52.246-4 Inspection of Services-Fixed-Price Aug-96 52.246-20 Warranty of Services May-01 52.246-25 Limitation of Liability-Services Feb-97 52.249-8 Default (Fixed-Price Supply and Services) Apr-84 52.252-6 Authorization Deviations in Clauses Nov-20 52.253-1 Computer Generated Forms Jan-91

Solicitation Clauses 3

PROVISIONS AND CLAUSES IN FULL TEXT

II. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Provisions and Clauses in Full Text

52.216-18 Ordering.

As prescribed in 16.506(a), insert the following clause:

Ordering (Aug 2020)

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued from August 1, 2027, through July 31, 2032.

(b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control.

(c) A delivery order or task order is considered "issued" when—

(1) If sent by mail (includes transmittal by U.S. mail or private delivery service), the Government deposits the order in the mail;

(2) If sent by fax, the Government transmits the order to the Contractor's fax number; or

(3) If sent electronically, the Government either—

(i) Posts a copy of the delivery order or task order to a Government document access system, and notice is sent to the Contractor; or

(ii) Distributes the delivery order or task order via email to the Contractor's email address.

(d) Orders may be issued by methods other than those enumerated in this clause only if authorized in the contract.

(End of clause)

52.216-19 Order Limitations.

As prescribed in 16.506(b), insert a clause substantially the same as follows:

Order Limitations (Oct 1995)

(a) Minimum order. When the Government requires services covered by this contract in an amount of less than $1,000, the Government is not obligated to purchase, nor is the Contractor obligated to furnish those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor-

(1) Any order for a single item in excess of $1,700,000;

https://www.acquisition.gov/far/16.506#FAR_16_506

Solicitation Clauses 4

(2) Any order for a combination of items in excess of $1,700,000; or

(3) A series of orders from the same ordering office within thirty (30) calendar days that together call for quantities exceeding the limitation in paragraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within five (5) calendar days after issuance, with written notice stating the Contractor’s intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

(End of clause)

52.216-22 Indefinite Quantity.

As prescribed in 16.506(e), insert the following clause:

Indefinite Quantity (Oct 1995)

(a) This is an indefinite-quantity contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies and services specified in the Schedule are estimates only and are not purchased by this contract.

(b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. The Contractor shall furnish to the Government, when and if ordered, the supplies or services specified in the Schedule up to and including the quantity designated in the Schedule as the "maximum." The Government shall order at least the quantity of supplies or services designated in the Schedule as the "minimum."

(c) Except for any limitations on quantities in the Order Limitations clause or in the Schedule, there is no limit on the number of orders that may be issued. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations.

(d) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor’s and Government’s rights and obligations with respect to that order to the same extent as if the order were completed during the contract’s effective period;

provided, that the Contractor shall not be required to make any deliveries under this contract after July 31, 2032.

https://www.acquisition.gov/far/52.216-21#FAR_52_216_21

Solicitation Clauses 5

(End of clause)

52.217-8 Option to Extend Services.

As prescribed in 17.203(f), insert a clause substantially the same as the following:

Option to Extend Services (Nov 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercising more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 1 day.

(End of clause)

52.222-90 Addressing DEI Discrimination by Federal Contractors.

As prescribed in 22.2203, insert the following clause:

Addressing DEI Discrimination by Federal Contractors

(a) Definitions. As used in this clause—

Program participation means membership or participation in, or access or admission to:

training, mentoring, or leadership development programs; educational opportunities; clubs;

associations; or similar opportunities that are sponsored or established by the contractor or subcontractor.

Racially discriminatory diversity, equity, and inclusion (DEI) activities means disparate treatment based on race or ethnicity in the recruitment, employment (e.g., hiring, promotions), contracting (e.g., vendor agreements), program participation, or allocation or deployment of an entity's resources.

(b) In connection with the performance of work under this contract, the Contractor agrees as follows:

(1) The Contractor will not engage in any racially discriminatory DEI activities;

(2) The Contractor will furnish all information and reports, including providing access to books, records, and accounts, as required by the Contracting Officer, for purposes of ascertaining compliance with this clause;

Solicitation Clauses 6

(3) In the event of the Contractor's or a subcontractor's noncompliance with this clause, this contract may be canceled, terminated, or suspended in whole or in part, and the Contractor or subcontractor may be declared ineligible for further Government contracts;

(4) The Contractor will report any subcontractor's known or reasonably knowable conduct that may violate this clause to the Contracting Officer and take any appropriate remedial actions directed by the Contracting Officer; and

(5) The Contractor will inform the Contracting Officer if a subcontractor sues the Contractor and the suit puts at issue, in any way, the validity of this clause.

(6) The Contractor recognizes that compliance with the requirements of this clause are material to the Government's payment decisions for purposes of 31 U.S.C. 3729(b)(4).

(c) The Contractor must include the substance of this clause, including this paragraph (c), in subcontracts at any tier, including those for commercial products and commercial services, except those where the place of delivery or performance is outside the United States.

(End of clause)

52.232-18 Availability of Funds.

As…