OCAO Providers Questions and Answers.pdf

Department of Health and Human Services

Indian Health Service

Oklahoma City Area Healthcare Providers IDIQ

75H1125R00001

Note: An amendment is forthcoming to address the following:

The discrepancies in references to tabs and other sections mentioned later in the questions including but not limited to: Tab C/D/E, three years in past performance, and subcontractor experience.

An update to the task order procedures I.101 to clarify that the task orders will be negotiated

Clarify four copies of Volume 1 for Phase 1 hard copy submittal

Question 1:

Pricing Sheet - We noticed that the fringe benefits, overhead (O/H), and general and administrative (G&A) costs in the pricing sheet. These vary based on the specialty and direct rate. For instance, a lower direct rate of $100 for a provider versus $300 per provider results in a higher fringe benefit percentage for the lower rate provider. Our question is, will the government evaluate the total price or the direct rate plus other costs? If the government is evaluating the direct rate along with fringe benefits, O/H, and G&A, we kindly request that the government consider changing the percentages and allowing the offeror to provide a dollar value in those fields. This adjustment would help us present a more accurate and competitive proposal.

Answer 1:

Please refer to page 105, M.2.6, Phase II Criteria 6 – Price, “Price will be evaluated by taking the total price of one hour for each labor category ceiling price for the base and each option period to determine the best overall pricing of offerors.”

The Government intends for the contractor to fill out the Attachment B – Pricing Breakdown in such a way that the Government has insight into the contractor’s pricing structure for the negotiation of potential task orders. As long as the Contractor uses the Government provided form, the separate categories may have different rates and can be fixed dollar values.

Question 2:

Page 95 - Section L.9 - Tab A - Criterion 1 reads "Provide a list of current prime locums contracts and subcontractor locums contracts with a list of staff provided that meet the requirements of the statement of work to provide all the listed professions on a short- or long-term basis. Provide detailed information regarding the prime’s capability to provide healthcare providers or the number of subcontracted locums partners who can provide healthcare providers. The offeror shall provide a list of prime contractor active locums staff and subcontracted locums staff with a ratio of prime locums to subcontracted locums."

Question 2a: What does list of staff refer to? Are you asking the names of providers?

Answer 2a: Please refer to page 95, L.9, Tab A: Criteria 1 – Prime or Subcontracted Locums Capabilities. The list of staff refers to the list by job categories of providers being provided on other current contracts by the prime contractor and their subcontractors, broken out by prime and sub to allow for the ratio between the two. The Government does not need the names of providers.

Question 2b:

If you are asking the names of the providers, this is confidential information and under Privacy Act of 1974 "No Disclosure without Consent" Rule, businesses cannot disclose records about an individual, including their name, without that individual's written consent unless a specific exception applies (no exception here). It is common to provide a list of few providers / their resumes for proposals as we obtain consent from them. However, in this situation, we have to provide several hundreds of providers' names, which is difficult for us to reach out to each of them. None of the teaming partners would disclose this information (all providers list) for privacy and more importantly business reasons. Hence, We request government to change the requirement to provide the size of the ATS (applicant tracking system) database or the number of providers employed / contracted based on each labor categories requested in solicitation etc rather than the names.

If IHS still requests the names of all providers in proposal, we request IHS to increase the Technical proposal page requirements from 20 pages to 30 pages as names will take more pages depending on the size of the list.

Answer 2b: The Government does not need the names of providers, see above, and the Government is requesting the number of providers employed / contracted based on each labor category refer to page 103, M.2.1, Phase I - Criteria 1: Prime or Subcontracted Locums Capabilities. The Government will not change the page limit as listed on page 94, L.7 Page Size and Format.

Question 2c: "Subcontractor Locums contracts" Does this refer to the {prime offerors contracts performed as a Subcontractor} OR {Subcontractors / Teaming Partners prime contracts}.

Answer 2c: The Government’s intent is to distinguish between capabilities the Prime contractor currently has with direct staff versus capabilities the Prime has through a subcontractor. Any active staff the Prime company provides should be on the list of current prime locums contracts.

If the staff does not belong to the Prime and belong to a subcontractor, the number of staff should be on the list of current subcontractor locums contracts. These lists should be by labor category.

Question 3: Labor categories have Respiratory Therapist who is not a privileged provider / direct patient care provider. Can you please confirm if this position is still valid in this IDIQ?

Answer 3: The Respiratory Therapist job category is valid in the IDIQ.

Question 4: We have a joint venture with an Indian Small Business Economic Enterprise. Are we eligible for an award?

Answer 4: The Contractor should meet the SBA guidelines for joint ventures to be able to compete.

Question 5: Is there a possibility for a multiple award contract for this solicitation?

Answer 5: The Government is awarding this as a single-award IDIQ.

Question 6: Can you list your major pain points of the current work you are experiencing?

Answer 6: This is a new requirement and there is no historical data.

Question 7: Is it preference that the prime has more locum tenens FTE past and current performance than its subcontractor?

Answer 7: There is no preference.

Question 8: Which labor category do you anticipate having the most amount of work?

Answer 8: This is a new requirement and there is no historical data.

Question 9: Why is IHS releasing a competitive solicitation for this work?

Answer 9: The Government anticipates the best result resulting from a competitive solicitation.

Question 10: Has the current incumbent performed to IHS satisfaction?

Answer 10: This is a new requirement.

Question 11: Can you clarify that travel and lodging and food expenses will not be covered for people we place?

Answer 11: The rates are all inclusive ceilings. If travel, lodging, and food expenses are required, they should be included in the ceiling rate.

Question 12: If they are covered, can you clarify where we put it in the bill rate sheet?

Answer 12: The Contractor can place the expenses in any section they deem appropriate and consistent as long as there is a single all-inclusive ceiling rate.

Question 13: What specifics would you like to see on the oral slide presentation?

Answer 13: Please refer to page 98, L.11, Phase II Criteria 5 – Oral Presentation, “The Offeror's oral presentation shall provide the Government an understanding of the Offeror's proposed solution, plans and resources necessary to satisfy all SOW objectives. The oral presentation shall address the proposed solution, plans and resources necessary to satisfy all SOW requirements and which will result in a successful outcome.”

Question 14: Can the proposal volumes be submitted electronically, or is a hard copy submission required? Alternatively, would the government consider accepting electronic submissions? (Reference: Pg. 92, Section L.5)

Answer 14: Please refer to page 92, L.5, Proposal Due Date and Submission. The only acceptable method is hard copy.

Question 15: If physical mail is the only method for submission, could the Contracting Officer confirm receipt via email? (Reference: Pg. 92, Section L.5)

Answer 15: If the Contractor requires confirmation, the submission should be submitted with tracking or certified mail.

Question 16: The North American Industry Classification System (NAICS) for this opportunity is 561320 "Temporary Help Services". Can the government please confirm that the required Healthcare Providers Services personnel will not be defined as temporary employees?

Answer 16: The definition of locums is a physician, nurse practitioner, or physician assistant who temporarily fills in for another provider at a healthcare facility. The Government is requesting personnel on a temporary basis to supplement Federal staff.

Question 17: Can the government please clarify if this is new requirement or existing incumbent personnel are currently performing? If existing, please also provide the contract #.

Answer 17: This is a new requirement.

Question 18: Section 2.3 refers to "external training will be at the contractor's expense". Can the government please detail per position the external training that will be required by contractor?

Answer 18: External training is expected to be any training outside the Government’s requirement or training that would have been required to be qualified at the onset and or to maintain a position.

Question 19: Section 3.4 details "time worked in excess of 80 hours in a two-week period..." that would be defined as overtime. Will the government be providing an associated Contract Line Item for government approved overtime invoicing purposes?

Answer 19: Please refer to page 105, M.2.6, Phase II Criteria 6 – Price, “Pricing for other rates, such as on-call, call back, etc. will be determined and negotiated on a task order basis.” The CLIN and pricing will be established with task orders.

Question 20: This Section details the clearance process can take up to 45 days. Can the government please clarify if contractor personnel can perform prior to the clearance process being completed?

Answer 20: The Contractor cannot perform until a preliminary clearance has been granted.

Question 21: This Section includes for the contractor to furnish all materials, supplies, and equipment required to perform to the work. Can the government please detail the contractor furnished materials, supplies, and equipment that will be required?

Answer 21: The Government will provide all materials, supplies, and equipment for daily duties.

Question 22: Section L.5 Phase I submission states, "must be mailed USPS or through private carrier and delivered to the mail room at the noted address by the date/time listed, while stating no other methods of submission will be accepted". Will the government please confirm that USPS mail is required for the Phase I submission? Additionally, is there a required number of volumes to be mailed to the government?

Answer 22: Please refer to page 92, L.5, Proposal Due Date and Submission. USPS, FedEx, UPS, or any other private carrier are required for the submission of the hard copy proposal.

Please refer to page 93 and 94, L.5, L.6, and L.7, there should be four copies of Phase 1, Volume 1, Tabs A-D.

Question 23: Please clarify if personnel must be located in the rural area or have the ability to commute to the area?

Answer 23: Yes, the Contractor will have to have the ability to get to the work site.

Question 24: Will the government be providing Labor Category descriptions for both the key positions of the Project and Program Manager?

Answer 24: The Government does not want to limit personnel. The Contractor can propose key personnel that can complete SOW 5.5.

Question 25: Can the government please clarify if the contractor key personnel of the Project and Program Manager will be billable positions and thus the Attachment B - Pricing Breakdown will be updated to include pricing for these two (2) positions?

Answer 25: The Contractor will incorporate the expenses for key personnel into the all-inclusive rates for the providers.

Question 26: To afford the government adequate time to respond to industry questions, would the government grant a 7-day time extension to the proposal due date?

Answer 26: No.

Question 27: Can you please clarify if the naming convention for Volume I “Native and Rural Provider Capabilities” is Tab C as in L.8 or Tab D as in L.9?

Answer 27: Please refer to page 94, L.8, Proposal Content (Phase I and Phase II). Tab C is the appropriate nomenclature for “Native and Rural Provider Capabilities”.

Question 28: Can you please clarify if the naming convention for Volume I “Past Performance” is Tab D as in L.8 or Tab E as in L.9?

Answer 28: Please refer to page 94, L.8, Proposal Content (Phase I and Phase II). Tab D is the appropriate nomenclature for “Past Performance”.

Question 29: The RFP states: “The Key Personnel and their associated requirements are identified in the Statement of Work, paragraph 6.5 and 6.6.” However, paragraphs 6.5 and 6.6 are not included in the Statement of Work. Can the government provide paragraphs 6.5 and 6.6 of the Statement of Work?

Answer 29: Please refer to page 12, Section C, 5.5 and 5.6. The reference should be to 5.5 and

5.6 on page 12. The Government will clarify in an amendment.

Question 30: How many hard copies of the proposal does the Government require?

Answer 30: The Government requires four copies of Phase 1, Volume 1, Tabs A-D. The Government will clarify in an amendment.

Question 31: Can the Government please clarify the percentages (0.00%) entered in the tables on rows 3, 22, 41, 60, 79, and 98? Are these "averages" to be calculated by the contractor? If so, what is the intention for the percentage listed below "Direct Rate" in column D?

Answer 31: Please refer back to Question 1. The Government intends for the contractor to fill out the Attachment B – Pricing Breakdown in such a way that the Government has insight into the contractor’s pricing structure for the negotiation of potential task orders. As long as the Contractor uses the Government provided form, the separate categories may have different rates and can be fixed dollar values.

Question 32: Referencing the table "Orders Past Option Period 4…" beginning on row 96, will the Government allow escalation of rates for this extension period or must they match that of Option Period 4?

Answer 32: Please refer to page 85, Orders Past Option Period 4 - May 1, 2030 through October 30, 2030. The Government will allow escalation of rates for this extension period. This option period is to allow the use of 52.217-8 Option to Extend Services as the Government’s discretion.

Question 33: For each labor category where such may be applicable, will the Government consider CLIN additions to include: Holiday, Weekday Day Shift, Weekday Night Shift, Weekend Day Shift, Weekend Night Shift, On-Call, Call Back, and Overtime hours?

Answer 33: Please refer to page 105, M.2.6, Phase II Criteria 6 – Price, “Pricing for other rates, such as on-call, call back, etc. will be determined and negotiated on a task order basis.” The CLIN and pricing will be established with task orders.

Question 34: Will the Government consider the addition of separate CLINS for each location?

Answer 34: The rates are all inclusive ceilings. They should include all locations.

Question 35: Referencing 2.1, the Government identifies specialized fields of provider support that matches the CLIN schedule, however, the Government also suggests that the list is not all inclusive. What other labor categories can be ordered under this vehicle? Will the Government add associated CLINS for other healthcare provider services?

Answer 35: The Government does not anticipate adding additional categories at this time, but if additional categories were added, the CLINs would expand.

Question 36: Referencing 2.3, the Government cites possible applicability of the Service Contract Act. Can the Government please include relevant wage determinations for incorporation and condition in the offerors' proposal response and pricing?

Answer 36: Relevant wage determinations would be incorporated into a task order.

Question 37: Referencing 3.4, does any facility require work outside of core hours for any services (i.e. nights and weekends)? If so which labor categories are involved and at which locations?

Answer 37: The need will be determined on a task order basis. There is no historical data to determine which categories will establish this potential need.

Question 38: Referencing 5.2.1.2, how frequently does the Medical Executive Committee and Government Board meet?

Answer 38: The board meets as credentialing candidates are presented by the facilities’ credentialing specialists.

Question 39: Referencing 5.2.1.5, what is the average length of time it takes for a provider to be processed once all documentation is submitted?

Answer 39: Please refer to page 12 and 13, 5.2.1.5 and 6.1.1. The two processes to be accounted for are estimated at up to 90 days for credentialing and up to 45 days for clearances after submission of a complete package.

Question 40: Referencing 6.1.1, what is the average length of time it takes for a provider to be processed once all documentation is submitted?

Answer 40: Please refer to page 12 and 13, 5.2.1.5 and 6.1.1. The two processes to be accounted for are estimated at up to 90 days for credentialing and up to 45 days for clearances after submission of a complete package.

Question 41: Referencing H.03, paragraph c, can the Government list the agency specific training that is reimbursable? Please confirm such training is reimbursable at the bill rates awarded at the task order level?

Answer 41: The Contract provider must pay for their own licenses and training to be qualified and maintain their position.

Question 42: Referencing H.11, paragraph b, may key personnel be provided by a subcontractor or must they be employees of the prime?

Answer 42: The Contractor may decide as long as the Prime meets the limitations on subcontracting.

Question 43: Referencing L.5, will the Government please consider electronic delivery in lieu of hard copy?

Answer 43: Please refer to page 92, L.5, Proposal Due Date and Submission. The only acceptable method is hard copy.

Question 44: Referencing L.9, Tab A, can the Government define "locums contracts" and what is considered as "short-" vs "long-" term.

Answer 44: Refer to Question 16. The Government uses the dictionary definition, “a physician, nurse practitioner, or physician assistant who temporarily fills in for another provider at a healthcare facility.”. Short term is 120 days or less and long term is anything longer than short term.

Question 45: Referencing L.9, Tab A, can the Government define "locums contracts" and what is considered as "short-" vs "long-" term.

Answer 45: Refer to Question 16. The Government uses the dictionary definition, “a physician, nurse practitioner, or physician assistant who temporarily fills in for another provider at a healthcare facility.”. Short term is 120 days or less and long term is anything longer than short term.

Question 46: Referencing L.9, Tab A, can the Government clarify the "list" that is being requested and what the ratio of prime to subcontract locums is in reference to? Is a low ratio or high ratio evaluated more favorably?

Answer 46: Please refer to Question 2. The Government’s intent is to distinguish between capabilities the Prime contractor currently has with direct staff versus capabilities the Prime has through a subcontractor. Any active staff the Prime company provides should be on the list of current prime locums contracts. If the staff does not belong to the Prime and belong to a subcontractor, the number of staff should be on the list of current subcontractor locums contracts. These lists should be by labor category.

Question 47: Referencing L.9, Tab E, and in consideration that this is an IDIQ contract, can the Government clarify relevant size?

Answer 47: The Government defines relevant size as within the same magnitude of the contemplated IDIQ.

Question 48: Referencing L.9, Tab E, is there a limit to the number of references that may be submitted?

Answer 48: No, but any in excess of the twenty page limit will not be evaluated.

Question 49: "Referencing L.9, Tab E, the Government states "The Offeror shall list the last healthcare provider contracts and subcontracts completed during the past three years and all contracts and subcontracts currently in process." Is this a separate component in addition to the list of ""at least 3 previous or current contracts that are most similar in size, scope and complexity...""?"

Answer 49: Yes, these are separate components.

Question 50: Referencing L.9, Tab E, the Government states requests "a list of subcontractors used". Is the Government looking for the number of subcontractors and the amount of work performed by the prime as compared to the subcontractors? Or is the Government looking for the names of the subcontractor companies who supported performance on the reference submitted even if they are not involved in subject RFP response?

Answer 50: The Government is looking subcontractor companies who supported performance on the reference submitted even if they are not involved in the current RFP.

Question 51: Referencing paragraph "offeror participants", and in consideration of contingent hires and other variables, recommend that the Government allows offeror to select any 3 participants from the prime or subcontractors to attend the oral presentation.

Answer 51: No, the Government maintains the requirement.

Question 52: Referencing M.1, can the Government please order criteria 1 through 6 in descending importance?

Answer 52: Please refer to page 103, M.1, Basis for Award. All criteria are already in order of importance with Criteria 1 being the most important and Criteria 6 being the least important in descending order.

Question 53: Referencing M.2.6, can the Government please clarify if the submitted ceiling rates should be able to accommodate call back rates?

Answer 53: Refer to Question 19. Please refer to page 105, M.2.6, Phase II Criteria 6 – Price, “Pricing for other rates, such as on-call, call back, etc. will be determined and negotiated on a task order basis.” The CLIN and pricing will be established with task orders.

Question 53: Referencing M.2.6, can the Government please clarify if the submitted ceiling rates should be able to accommodate call back rates?

Answer 53: Refer to Question 19. Please refer to page 105, M.2.6, Phase II Criteria 6 – Price, “Pricing for other rates, such as on-call, call back, etc. will be determined and negotiated on a task order basis.” The CLIN and pricing will be established with task orders.

Question 54: Referencing M.2.6, will the Government please consider the inclusion of a price realism analysis?

Answer 54: No, please refer to page 105, M.2.6, Phase II Criteria 6 – Price.

Question 55: Context: The document specifies the base year and multiple optional ordering periods extending through April 30, 2030. Can you clarify whether task orders extending beyond these periods are guaranteed or contingent on additional approvals?

Answer 55: Please refer to page 85, Orders Past Option Period 4 - May 1, 2030 through October 30, 2030. The Government will allow escalation of rates for this extension period. This option period is to allow the use of 52.217-8 Option to Extend Services as the Government’s discretion at pre-priced ceilings.

Question 56: Context: The document includes a list of 11 facilities for service delivery. Can you confirm whether additional facilities could be added during the contract period?"

Answer 56: The Government intends to cover the facilities in the Oklahoma City Area Indian Health Service. Any changes in facilities would be incorporated.

Question 57: "Context: In Section 3.2.1, eleven locations are listed, and the White Cloud Health Station is no longer included (as opposed to its inclusion as a twelfth healthcare facility in the Draft RFP). Question: Will the Government please confirm that the White Cloud Health Station in White Cloud, KS is no longer a healthcare facility under the Scope of Work of this IDIQ solicitation."

Answer 57: White Cloud is no longer within the Scope of Work of this IDIQ.

Question 58: "Context: The solicitation outlines mandatory compliance with HIPAA and IHS cybersecurity protocols for contractor personnel, particularly for remote work or telecommuting scenarios. Question: Could the government provide additional details on the specific IT security measures or certifications required for contractor systems to ensure compliance? "

Answer 58: The Contractor personnel on-site will follow regulations and rules. Task orders will have more information at the time of award.

Question 59: "Context: In Section 5.1, ""All candidates must be Board Certified or Board Eligible within 3 years of finishing residency (If more than 3 years from finishing residency, must provide proof of working toward certification.)"" However, residency does not apply to all labor categories identified in Attachment A Labor Categories and/or in the PWS (specifically Program Manager and Project Manager). Do the requirements of PWS Section 5.1 apply to all candidates as written, even if not applicable to the labor category?"

Answer 59: The requirements only apply if applicable to the profession. Task orders will specify the requirements per position.

Question 60: "Context: The evaluation criteria for Criteria 4: Past Performance stipulates that the Offeror must provide ""demonstrated experience from three contracts performed within the past five (5) years from the date of this RFP release."" According to Section L, page 96 of 105, ""The Offeror shall list the last healthcare provider contract and subcontracts completed during the past three years and all contracts and subcontracts currently in process."" Will the Government please correct the references in Section L for Criteria 4: Past Performance to align the instructions reference (three years) with the evaluation criteria for Past Performance performed within the past five (5) years as cited in Section M.2.4 Phase I, Criteria 4: Past Performance. "

Answer 60: The Government will clarify the requirement as three years in an amendment.

Question 61: "Context: In Section L, there is a discrepancy between the Table identifying Tabs and the Tabs further down in Section L. Will the Government please confirm Tab C is Native and Rural Provider Capabilities and Tab D is Past Performance? "

Answer 61: Please refer to page 94, L.8, Proposal Content (Phase I and Phase II). Tab C is the appropriate nomenclature for “Native and Rural Provider Capabilities” and Tab D for “Past Performance.”

Question 62 "Context: In the Instructions for Criteria 4--Past Performance (identified as Tab E on page 96, but incorrectly referenced per the question above, should be identified as Tab D) the Government instructs the Offeror to ""identify at least three (3) previous or current contracts that are most similar in size, scope, and complexity to the work of this acquisition to demonstrate its experience to perform this work. This should be the Offeror's own experience as a prime or subcontractor; experience from a proposed subcontractor may also be submitted. The Offeror shall describe how each contract is similar to this work, and shall provide sufficient information related to past efforts associated with the requirements of Statement of Work. The Offeror shall also demonstrate that it has successfully completed similar work to the scope and complexity of this requirement."" However, in the next paragraph, the Government instructs that ""The Offeror shall list the last healthcare provider contracts and subcontracts completed during the past three years and all contract and subcontracts currently in process."" The Government further instructs the specific information required to be provided for each contract and subcontract (detailed information items #1.-#11). Is the Government instructing the Offeror to provide two separate lists of previous and current contracts, one list (of at least three previous or current contracts) that provides narrative describing how each contract is similar to the solicited work, and one list (the last healthcare provider contracts and subcontracts completed during the past three years and all contract and subcontract currently in process) that provides the requested, detailed information (#1.-#11.)? Or does the Government want a single list, of at least three previous or current contracts that are most similar in size, scope and complexity to the work of this acquisition to demonstrate its experience to perform this work, that also contacts the detailed information for each contract (#1.-#11.)? "

Answer 62: Please refer to Question 49. These are separate requirements.

Question 63: "Context: The offerors shall submit the proposal volumes associated with Phase I via hard copy to Oklahoma City Area Indian Health Service, c/o Shelton Bruce, 701 Market Dr, Oklahoma City, OK 73114, no later than 2:00 pm CST on January 30, 2025. The proposals must be mailed USPS or through private carrier and delivered to the mail room at the above address by the date and time listed in the solicitation. Will the Government accept hand delivered proposal submissions to the Oklahoma City Area Indian Health Service Area Office referenced in the solicitation (701 Market Dr., Oklahoma City, OK 73114)?"

Answer 63: Please refer to page 92, L.5, Proposal Due Date and Submission. The only acceptable method is hard copy by USPS or a private carrier.

Question 64: "Context: ""The Offeror shall identify at least three (3) previous or current contracts that are most similar in size, scope, and complexity to the work of this acquisition to demonstrate its experience to perform this work. This should be the Offeror’s own experience as a prime or subcontractor; experience from a proposed subcontractor may also be submitted."" Can the three (3) previous or current contracts required by the Instructions be a mix of the Prime Offeror and major subcontractors (teammates) as indicated: ""experience from a proposed subcontractor may also be submitted."“? Will the Government modify the Evaluation Criteria to reflect evaluation of the relevant Past Performance references provided from a major subcontractor teammate?"

Answer 64: The Government will clarify the discrepancies between L.9 and M.2.4 for Past Performance.

Question 65: At OCAO, how many of the healthcare providers are contracted employees for a certain period of time?

Answer 65: This is a new requirement and there is no historical data.

Question 66: At OCAO, how many of the healthcare providers are direct hire placements?

Answer 66: This is a new requirement and there is no historical data.

Question 67: At OCAO, how many and type of healthcare provider positions are currently open?

Answer 67: This is a new requirement and there is no historical data.

Question 68: Joint Commission/Accreditation Association for Ambulatory Health Care: ART I, SECTION C – DESCRIPTIONS /SPECIFICATIONS/STATEMENT OF WORK section 2.6 – Pg.

8 states - The Indian Health Service facilities in the Oklahoma City Area Office require compliance through The Joint Commission (TJC) or Accreditation Association for Ambulatory Health Care (AAAHC) depending on the facility: a. Must all prime vendors and subcontractors/vendors be joint commission certified in order to participate?

b. Does the Joint Commission (TJC) or Accreditation Association requirement refer to Medical professionals supplied under this contract?

Answer 68a: Please refer to page 8, Schedule C 2.6. No, the certifications are for the facilities, but the Government’s intent is that providers will participate in certification activities or responses to findings with the facility.

Answer 68b: See 68a. Government’s intent is that providers will participate in certification activities or responses to findings with the facility.

Question 69: General Liability Insurance: a. If the prime contractor is a JV of small business that is unpopulated, can the Native American company with the largest percentage ownership of the JV provide the general liability insurance? b. Or, is the unpopulated Prime contractor JV of small business required to provide the general liability insurance?

Answer 69: Please refer to page 28, H.01 Insurance – Liability. The JV should propose a division of responsibilities to show the responsible party for insurance and prevent a lapse. The insurance should cover whatever providers are proposed and can be reviewed per H.01 (d).

Question 70: Medical Liability Insurance: a. If the subcontractor large company is going to assist the Prime JV small businesses in this requirement, is the Prime JV required to have medical liability insurance at the time of award to participate in the IDIQ? Or, may the Prime JV obtain the medical liability insurance upon taking over the healthcare professionals. b. Similar to question 5, is the unpopulated Prime JV of small businesses required to obtain medical liability insurance, or may be Native American small business with the largest percentage ownership of the JV obtain the medical liability insurance to act as the Prime Contractor?

Answer 70: Please refer to page 54, I.59 FAR 52.237-7 IDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (JAN 1997). The JV should propose a division of responsibilities to show the responsible party for insurance and prevent a lapse. The insurance should cover whatever providers are proposed.

Question 71: Homeland Security Requirements: Section F.04 Pg 21 states “In accordance with Homeland Security requirements all contractor employees who will perform the services shall submit to electronic fingerprints and obtain security clearance before services can be performed under this contract.” a. Does this refer to only medical staff employed under this contract, and employees that may be sent on site including any contractor staff that perform work under this contract (i.e. Project Manager, Program Manager) b. Please expand on the requirements for a security clearance? Is this at the secret level or top-secret level security clearance?

Answer 71: This refers providers covered under task orders or if the key personnel are required to come on site regularly. Security clearances are determined on a task order level. IHS uses Tiers depending on access to information or if the provider may come into contact with Indian children.

Question 72: Criminal Background Checks: The criminal background checks are referenced in 352.237-72 Crime Control Act 1990 – Requirements for a Background Checks. (i.e. state and federal background). a. Are the criminal background checks limited to Homeland security background checks referenced in Question 5 above? b. Please identify what is required for criminal background checks for this requirement other than the criminal record history of an individual?

Answer 72: The level of background check and requirements depends on the task order and the tier level required.

Question 73: Will the facilities need full hospitalist oversight?

Answer 73: The task order will specify if a hospitalist is required.

Question 74: Will integration with data systems be required?

Answer 74: The Government does not anticipate any data systems. The task order will specify there is any data systems required.

Question 75: Are the ER services outsourced? If so, what specific tasks or responsibilities are being handled externally?

Answer 75: This is a new requirement. The task order will specify if an ED Physician is required.

Question 76: Do you anticipate adding any additional support staff like RN’s, CNA’s, etc throughout the contract?

Answer 76: Refer to Question 35. The Government does not anticipate adding additional categories at this time, but if additional categories were added, they would be providers and not support staff.

Question 77: Could you please provide the estimated number of hours required for each position, along with the respective locations where services will be needed?

Answer 77: This is a new requirement and there is no historical data.

Question 78: The solicitation lists multiple locations under Section F (Principal Places of Performance). Will contractors be required to cover multiple locations simultaneously?

Answer 78: This will depend on the task order requirements, but the Contractor should be able to provide to any location.

Question 79: Will the incumbent contractor’s staff or assets (if applicable) be available to facilitate a smoother transition?

Answer 79: This is a new requirement.

Question 80: The solicitation references telemedicine as a possibility. If telemedicine is allowed, will the contractor need to provide IT infrastructure, or will the government support this?

Answer 80: The Government does not anticipate telemedicine, but will support on a task order basis.

Question 81: Is TDY housing provided at all locations? If not, please provide the list of locations that offer housing.

Answer 81: Please refer to Question 11. Housing costs would be born by the Contractor and should be included in all-inclusive ceiling rates.

Question 82: What is the average timeframe for IHS onboarding for new staff at these locations?

Answer 82: Refer to Question 39. Please refer to page 12 and 13, 5.2.1.5 and 6.1.1. The two processes to be accounted for are estimated at up to 90 days for credentialing and up to 45 days for clearances after submission of a complete package.

Question 83: Will there be 1 credentialing specialist for all the facilities or is it multiple credentialing specialists?

Answer 83: Each facility has their own credentialing staff.

Question 84: Please clarify the expectations regarding the provision of backup personnel to cover staff absences or emergencies. What is the specified minimum response time?

Answer 84: This will depend on the task order requirements.

Question 85: Will staff be expected to work in multiple departments or units within the same facility? If so please list.

Answer 85: This will depend on the task order requirements.

Question 86: After reviewing the pricing sheet, it lists "1" under hours throughout the entire sheet. Could you please confirm if this is correct and whether only 1 hour is needed for each position?

Answer 86: Refer to Question 1. Please refer to page 105, M.2.6, Phase II Criteria 6 – Price, “Price will be evaluated by taking the total price of one hour for each labor category ceiling price for the base and each option period to determine the best overall pricing of offerors.”

The Government intends for the contractor to fill out the Attachment B – Pricing Breakdown in such a way that the Government has insight into the contractor’s pricing structure for the negotiation of potential task orders. As long as the Contractor uses the Government provided form, the separate categories may have different rates and can be fixed dollar values.

Question 87: Could you please clarify the government's distinction between a project manager and a program manager, including their respective requirements? Additionally, are these two positions considered the same or separate roles?

Answer 87: The Contractor can propose key personnel that can complete SOW 5.5. They have separate duties. The Government does not want to limit potentially exceptional personnel.

These are two separate roles.

Question 88: What are the pain points in the current contract?

Answer 88: This is a new requirement.

Question 89: Could you please confirm the anticipated shifts for each position and their respective locations?

Answer 89: This will depend on the task order requirements.

Question 90: Could you provide examples of Key Performance Indicators (KPIs) or quality metrics that providers are expected to meet?

Answer 90: Please refer to page 14, Section C 11.1 Performance Measures. The contractor will also propose a quality control plan in accordance with page 21, F.04 Quality Control.

Question 91: What is the estimated contract ceiling, and how will task orders be issued under the IDIQ structure?

Answer 91: Please refer to page 26, G.06 OCAO IHS – MAXIMUM CONTRACT AMOUNT. The total combined value of all orders placed during the period of this contract, to include all option periods, shall not exceed $102,000,000.00. Please refer to page 67, Task Order Procedures.

The contracts specialist will transmit a request for task order proposal to the contractor with the statement of work to initiate a task.

Question 92: Current Contract: Is this a re-compete of an existing contract or contracts? If so, what are the current Contract (or Purchase Order(PO)) #s? If so, who are the current Incumbents?

Answer 92: This is a new requirement.

Question 93: PO/Task Order Quantities—Hours: Will the individual or specific service requirements be Full Time (40 hour work week) for a longer term employment? Or with the service requirements be Part employment/as needed?

Answer 93: This will depend on the task order requirements.

Question 94: L.9 Instructions – Phase I Volume I – Technical and Management Volume (Phase I) Tab A: Criteria 1 – Prime or Subcontracted Locums Capabilities Page 95 Candidates - What documents or information are you looking for when we ‘provide..a list of staff provided that meet the requirements of the statement of work’?

Answer 94: Please refer to Question 2. The Government’s intent is to distinguish between capabilities the Prime contractor currently has with direct staff versus capabilities the Prime has through a subcontractor. Any active staff the Prime company provides should be on the list of current prime locums contracts. If the staff does not belong to the Prime and belong to a subcontractor, the number of staff should be on the list of current subcontractor locums contracts. These lists should be by labor category.

Question 95: For Hospitalist: will the IHS ask for Internal Medicine trained hospitalists or will Family Medicine trained doctors with Hospitalist experience be accepted?

Answer 95: Please refer to page 74, Attachment A Labor Category Matrix – Hospitalist. The contractor can propose any candidate as long as they meet the qualifications and experience requirement in the Labor Category Matrix.

Question 96: Will the Agency allow Area-wide credentialing and per-sec clearances for these Contractors, considering it is an Area-wide solicitation?

Answer 96: Please refer to Question 83. Each facility has their own credentialing staff and there is a single, Area-wide clearance contact for contractors.

Question 97: Can the Agency accept multiple proposals from the same company, for instance as a prime with teaming partners and a separate proposal as single offeror?

Answer 97: Yes, the same contractor can propose as a team, individually, or in any other combination that meets the Indian Small Business Economic Enterprise rules.In best practice, please mark each proposal clearly. Clearly marked proposals will allow the Government to process them separately.

Question 98: Can the Agency accept multiple proposals from the same company, for instance as a prime with teaming partners and a separate proposal as single offeror?

Answer 98: Yes, the same contractor can propose as a team, individually, or in any other combination that meets the Indian Small Business Economic Enterprise rules.In best practice, please mark each proposal clearly. Clearly marked proposals will allow the Government to process them separately.

Question 99: Clarification Needed – Native and Rural Provider Capabilities: On Page 94, Section L.8 under Volume 1 Tech and Mgmt. (Phase 1) provides a table in which Tab C is shown as “Native and Rural Provider Capabilities". However, on page 96, the text under L.9 instructions does not reference Tab C. Rather, Tab D indicates "Native and Rural Provider Capabilities". a. Please provide guidance if "Native and Rural Provider Capabilities" should be identified as “Tab C” or “Tab D”.

Answer 99: Please refer to Question 61. Please refer to page 94, L.8, Proposal Content (Phase I and Phase II). Tab C is the appropriate nomenclature for “Native and Rural Provider Capabilities” and Tab D for “Past Performance.”

Question 100: Clarification Needed – Past Performance: Similar to question 7 above, on p.94, the Tab D, in the table, indicates "Past Performance". However, on page 96, under L.9, Past Performance is referenced as “Tab E” -- "Tab E: Criteria 4- Past Performance ". a. Please provide guidance if “Past Performance” should be referenced as “Tab D” or “Tab E”.

Answer 100: Please refer to Question 61. Please refer to page 94, L.8, Proposal Content (Phase I and Phase II). Tab C is the appropriate nomenclature for “Native and Rural Provider Capabilities” and Tab D for “Past Performance.”

Question 101: Clarification Needed – Quality Control Plan Section F.05 Pg 21 describes "The Contractor shall prepare and maintain an effective Quality Control Plan (QCP) that includes a description of the inspection system to cover the services listed in Section C 11.2" Section C

11.2 is not present.

Answer 101: The table should be labeled as 11.2. The Government will issue an amendment to fix discrepancies.

Question 102: Clarification Needed – Requirements for Key Personnel L.9 Pg 96. "Tab B" "The Key Personnel and their associated requirements are identified in the Statement of Work, paragraph 6.5 and 6.6. ". It appears as though paragraphs 6.5 and 6.6 were not included in the proposal. Please provide clarification.

Answer 102: The paragraph references should be labeled as 5.5 and 5.6. The Government will issue an amendment to fix discrepancies.

Question 103: Health care or other benefits to contracted employee: In the event that the prime contractor or subcontractor changes benefits for their company, which would flow to the contracted employees, can the cost or changes of these benefits be revised during the base year (year 1) or 4 option year periods of the IDIQ? Example: Health Insurance provider is changed or types of options under a health insurance provider changes.

Answer 103: The Contractor can place the benefits in any section they deem appropriate and consistent as long as there is a single all-inclusive ceiling rate. The ceiling should be sufficient to account for these changes between years.

Question 104: Health care or other benefits to contracted employee: In the event that the prime contractor or subcontractor changes benefits for their company, which would flow to the contracted employees, can the cost or changes of these benefits be revised during the base year (year 1) or 4 option year periods of the IDIQ? Example: Health Insurance provider is changed or types of options under a health insurance provider changes.

Answer 104: The Contractor can place the benefits in any section they deem appropriate and consistent as long as there is a single all-inclusive ceiling rate. The ceiling should be sufficient to account for these changes between years.

Question 105: Indemnity Clause: There is an indemnity clause in the solicitation. Section I.59 Pg. 54-55. a. Can you provide some examples of how this would impact a contractor? b. Does the Indemnity reference in Section I.59 only apply to the medical malpractice insurance? c. Is there an indemnity clause related to the general liability insurance?

Answer 105: The Government will not provide any specific examples. Providers are non-personal and professional services and the Government does not have control over the Contractor’s professional medical judgment, diagnosis, or specific medical treatments. If there is no specific reference to indemnity, Federal law would take precedence to address b. and c.

Question 106: Due Date for Proposals: The due date for Volume 1 of this proposal is noted as January 30. Will you consider extensions to this January 30th deadline date? If so, may we please request a two week extension?

Answer 106: No.

Question 107: Opportunity for Future Questions: If selected for Advisory Down Select (the next phase of the process), would the vendors have an opportunity to ask additional questions?

Answer 107: Please refer to page 100, Phase 2 Volume 3 Tab D Assumptions, Exceptions and Dependencies. The Government does not anticipate having a defined questions period. The Contractor may request clarifications before submission of Phase 2 proposals.

Question 108: Electronic Submission of Proposal: Do you anticipate the ability to submit this proposal thought an electronic portal or via email?

Answer 108: Please refer to page 92, L.5, Proposal Due Date and Submission. The only acceptable method is hard copy by USPS or a private carrier.

Question 108: Mailing Requirements of Proposal: On Page 93, under L.5 Proposal Due Date and Submission it States, “ “The proposals must be mailed USPS or through private carrier and delivered to the mail room at the above address by the date and time listed in the solicitation”

a. Are Fed-Ex or UPS considered acceptable private carriers?

b. Should the proposal be bound or should the proposal be submitted in such a way the documents are ready to be scanned?

c. How many copies of the proposal should be submitted?

Answer 108: Please refer to page 92, L.5, Proposal Due Date and Submission. USPS, FedEx, UPS, or any other private carrier are required for the submission of the hard copy proposal.

Please refer to page 94, L.7, there is no further requirements for the way the documentation shall be submitted and the Contractor may submit the Volume 1 at their discretion. Please refer to page 93 and 94, L.5, L.6, and L.7, there should be four copies of Phase 1, Volume 1, Tabs A- D.