75H71422C00005.pdf

IHSALBUQUERQUE

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

IHSALBUQUERQUE

520-8847131

127957

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

Tucson AZ 85746 7900 S. J Stock Road Tucson Area Office

IHSTUCSON CODE 16. ADMINISTERED BYCODE

X

621999

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR39

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

520-295-2445MICHAEL THORNE

07/05/2022 (No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION 5. SOLICITATION NUMBER

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

1 40 IHS1455575OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

TUCSON AZ 857011502

160 N STONE AVE

AMERICAN INDIAN ASSOCIATION OF TUCS

Attn: JACOB BERNAL

AMERICAN INDIAN ASSOCIATION OF TUCSON 127957

17a. CONTRACTOR/

TUCSON AZ 85746

7900 S. J STOCK ROAD

TUCSON AREA OFFICE

15. DELIVER TO

Tucson AZ 85746 7900 S. J Stock Road

9. ISSUED BY

7.

75H71422C00005

2. CONTRACT NO.

EFFECTIVE DATE

$16.50

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

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Tucson Area Office

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

1. The American Indian Association of Tucson dba Tucson Indian Center is allocated $196,899.00 for necessary expenses to establish, expand, and sustain a public health workforce to prevent, prepare for, and respond to COVID-19, other public health workforce related activities, and for the purposes described in section 11001(a)(1)(E) and (F), and for other related activities.

2. Payments have been authorized for this (Use Reverse and/or Attach Additional Sheets as Necessary)

$196,899.00

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED

SUSAN M. PROTHO

. 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 FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

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

2022.J421AWU.25837

29. AWARD OF CONTRACT:

REF.

Jacob Bernal/Executive Director 7/12/22

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. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

firm-fixed-price contract. Payment in the amount of $196,899.00 shall be paid by the Albuquerque

Area Finance Office upon receipt of payment request from the contractor.

3. The total amount of this award is $196,899.00.

COR: Loretta Billie-Encinas, Loretta.Billie-Encinas@ihs.gov, 520-295-2421.

All other terms and conditions shall remain unchanged.

Delivery: 09/30/2025

Appr. Yr.: 2022 CAN: J421AWU Object Class: 25837

1 Obligate and disburse funds for Tucson Indian 196,899.00

Center to support COVID-19 Public Health

Workforce authorized by American Rescue Plan Act

Obligated Amount: $196,899.00

This Award transfers $196,899.00 in funding that was appropriated under the American Rescue Plan

Act (ARPA), Pub. L. No. 117-2, Title XI, Sec.

11001 Indian Health Service. The parties agree to the following conditions regarding these funds: 1.) the funds are transferred to the

American Indian Association of Tucson dba Tucson

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

40 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 40

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

AMERICAN INDIAN ASSOCIATION OF TUCSON 127957

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

75H71422C00005

Indian Center on a one-time basis and shall not recur in any subsequent year; 2.) the funds may be used only for the purposes identified in Pub.

L. No. 117-2, Title XI, Sec. 11001 Indian Health

Service, including costs incurred for those purposes to prevent, prepare for, and respond to

COVID-19 from January 31, 2020 to March 11, 2021;

3.) the funding is inclusive of all costs for such activities, is consistent with the scope of work and budget submitted by the American Indian

Association of Tucson dba Tucson Indian Center, and no additional amounts incurred by American

Indian Association of Tucson dba Tucson Indian

Center will be reimbursed by HHS or IHS; and 4.)

in the event the American Indian Association of

Tucson dba Tucson Indian Center does not use the funds consistent with all conditions outlined above, it agrees it must return the funds to IHS.

The American Indian Association of Tucson dba

Tucson Indian Center is allocated $196,899.00 for necessary expenses to establish, expand, and sustain a public health workforce to prevent, prepare for, and respond to COVID-19, other public health work force-related activities, and other related activities and shall use such funds in accordance with ARPA Section 11001(a)(1)(G), which may include using funds for the purposes set forth in ARPA Sections 11001(a)(1)(E) & (F).

The total amount of award: $196,899.00. The obligation for this award is shown in box 26.

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

Sponsored by GSA

FAR (48 CFR) 53.110

PART I – THE SCHEDULE

SECTION C – DESCRIPTION/SPECS./SCOPE OF WORK STATEMENT

C.1 SCOPE OF WORK

C.1.1 Provision of Services

A. The overall goal of this contract is to fund the Urban Indian Organization (UIO) for the provision of health care and referral services for Urban Indian beneficiaries residing within the urban center, which services meet the requirements of the Indian Health Care Improvement Act (IHCIA) and will continue to elevate the health status of eligible Urban Indians to the highest level possible.

B. To ensure the availability of the services and procedures stated herein in the

State of Arizona, the Contractor shall provide the services either:

1. On-site, pursuant to written policies and procedures that conform to the standards of care and practice applicable to each service and, where appropriate; or

2. Through a subcontractor(s) with whom the Contractor has a written agreement. The agreements shall identify, for example, services, fees, response time, performance standards, and other requirements.

C. Medical and other health services provided by the Contractor or through its subcontractors shall identify and be guided by the standards of care and practice applicable to those services, current Arizona State law, and, to the extent applicable, other guidance such Centers for Medicare & Medicaid Services standards, the Accreditation Association for Ambulatory Health Care (AAAHC) standards, the Commission on Accreditation of Rehabilitation Facilities (CARF) standards, Healthcare Facilities Accreditation Program (HFAP) standards, Federally Qualified Health Center (FQHC), and Federally Qualified Health Center Look-Alikes.

D. If carrying out a program to provide comprehensive public health oriented services, the Contractor shall utilize standards of care and practice regarding electronic data collection and documentation of beneficiary use, including current Arizona State law, and shall use a health information technology (HIT) system that maintains Electronic Health Records (EHR), e.g., the Resource and Patient Management System (RPMS) or Commercial Off the Shelf systems (COTS).

E. The UIO shall utilize a HIT software for collection and data entry of IHS requirements for the following information, if applicable: patient demographics, clinical data, behavioral health data, diabetes data, public and radiology data, and shall submit data to the IHS data center on a monthly basis.

F. The Contractor shall ensure the fair and uniform provision to Urban Indians of services and assistance under this contract. (See Section H.2)

C.1.2 Urban Indian Beneficiaries

Pursuant to the IHCIA, 25 U.S.C. § 1603(13), (27), (28), the beneficiaries of the services to be provided under this contract are “Urban Indians,” defined as any individual who:

A. Resides in an urban center, which is any community that has a sufficient

Urban Indian population with unmet health needs to warrant assistance under the IHCIA, as determined by the Secretary of the Department of Health and Human Services (“HHS”); and

B. Meets one or more of the following criteria:

1. Irrespective of whether he or she lives on or near a reservation, is a member of a tribe, band, or other organized group of Indians, including: (a) those tribes, bands, or groups terminated since 1940;

and (b) those recognized now or in the future by the State in which the tribe is located; or

2. Is a descendant, in the first or second degree, of any such member described in (B)(1); or

3. Is an Eskimo or Aleut or other Alaska Native; or

4. Is a California Indian;1 or

5. Is considered by the Secretary of the Department of the Interior to be an Indian for any purpose; or

6. Is determined to be an Indian under regulations pertaining to the

Urban Indian Health Program that are promulgated by the Secretary of HHS.

1 Eligibility of California Indians may be demonstrated by documentation that the individual:

(1) Is the descendant of an Indian who was residing in California on June 1, 1852;

(2) Holds trust interests in public domain, national forest, or Indian reservation allotments in

California; or

(3) Is listed on the plans for distribution of assets of California Rancherias and reservations under the Act of August 18, 1958 (72 Stat. 619), or is the descendant of such an individual.

25 U.S.C. § 1697(a)(2).

C.1.3 Services

The UIO is allocated $196,899.00 for the provision of additional health care services, services provided through the Purchased Referred Care Program, and other related activities and shall use such funds in accordance with ARPA Section 11001(a)(1)(B). These funds are not limited to COVID-19 activities, unless they are used to restore amounts for obligations incurred from January 31, 2020 to March 11, 2021.

The UIO will provide the following under this ARPA funding contract

1. The Tucson Indian Center will provide COVID-19 healthcare services via direct services and/or contracts, referrals and coordination with local providers. Direct COVID-19 healthcare services, such as COVID-19 clinical preventative services (e.g., vaccines, health literacy, screening-diagnosis-treatment of chronic medical conditions1, behavioral health integration); COVID-19 detection; COVID-19 treatment; COVID-19 mitigation; and/or COVID-19 chronic care healthcare services, will be provided.

2. The Tucson Indian Center will provide outreach and education encounters related to COVID-19 and high-risk groups such as those with compromised immune and chronic conditions through in-person, virtual, social media, and community events following county health department guidelines.

3. The Tucson Indian Center will identify high-risk patients for severe illness from COVID-19, and provide targeted health care services, case management and/or referrals to specialty care when needed.

C.2 HEALTH RECORDS

A. Health records are the physical property of the Contractor, and not the IHS. The contractor is responsible for all health records as required by Federal and State law.

B. Health Record. The health record is a chronological documentation of health care and medical treatment given to a patient by professional members of the health care team and includes all paper and electronic documentation also known as the legal health record. It is an accurate, prompt recording of their observations including relevant information about the patient, the patient’s progress, the results of the treatment and education. The health record may be composed of three divisions:

a. Administrative Health Record. The administrative record is an official record pertaining to the administrative aspects involved in the care of a patient, including demographics, eligibility, billing, correspondence, and other business-related aspects. It includes individually identifiable health information, in any medium collected and directly used in and/or in the provision of health care.

b. Clinical Health Record. Documentation of all types of health care services provided to an individual, in any aspect of health care delivery. It includes individually identifiable health information, in any medium collected and directly used in and/or for documenting health care. The term includes records of care in any health-related setting used by health care professionals while providing patient care service, and to review patient data or to document their own observations, actions, and instructions.

c. Electronic Health Records. Electronic capture and storage of patient health information enhances access to patient data by professional members of the health care team. If applicable, VistA Imaging (VI) provides the multi-media component for the RPMS EHR. The VI Imaging system integrates clinical images, scanned documents, and other non-textual data into the patient's electronic medical record.

C. The Contractor maintains the clinical records as required by Federal and State law governing such records, in the normal course of business as a provider of health care and/or referral services. Such records are not developed or maintained for IHS or to accomplish an IHS function.

D. Consistent with the requirements of applicable Federal and State law, the Contractor shall provide a clinical records system for collecting, processing, maintaining, promptly retrieving, releasing, and safeguarding of patient records according to established policies and procedures.

E. The Contractor shall ensure the confidentiality, security, and safety of clinical records, and shall comply with the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and implementing regulations at 42 C.F.R.

Parts 160-164. To the extent it is a Program as defined by 42 C.F.R. § 2.11, the Contractor shall maintain substance use disorder patient records in accordance with 42 C.F.R. Part 2 and applicable State laws and regulations.

F. The Contractor shall assign a person qualified by education, training, and/or experience to be in charge of clinical records, whose responsibilities are consistent with the Federal and State law requirements.

G. Consistent with Federal and State law requirements, the Contractor shall maintain adequate space, facilities, and equipment for the clinical records, including:

1. Properly maintaining work and storage space that is adequate in layout and size.

2. Securing the records in a satisfactory manner, such as in a locking cabinet or a room that can be locked or otherwise secured, and limiting physical access to the records.

3. Following adequate equipment and supplies procedure.

H. Consistent with Federal and State law, the Contractor shall establish and implement a Policies and Procedures Manual concerning the clinical records department.

1. The Policies and Procedures Manual shall include and address issues such as, but not limited to, the following:

a. Retention of active records;

b. Retirement of inactive records;

c. Content of records;

d. Obtaining records from other providers who have treated a patient;

e. Timely entry of data in the records;

g. Release of information contained in the records;

h. Destruction and/or disposal of records; and

i. Disposition of clinical records when a facility or service closes, consistent with applicable federal and state laws and regulations.

2. The Policy and Procedures Manual shall be reviewed, updated, and signed annually.

I. The Contractor shall have the responsibility for the proper transfer and/or destruction of clinical records, consistent with applicable Federal and State law, should the Contractor cease its health care operations.

C.3 PATIENT BILL OF RIGHTS

A. The Contractor shall maintain patient relationships, in part by providing information to each patient including any information that may be required by Federal or State law, such as:

1. Patient rights are communicated to patients and provided in writing when requested;

2. A grievance policy and procedure for recommending changes in policies and services at the UIO and governing body, which shall be available to patients upon request;

3. A defined process for managing complaints that includes providing timely feedback to patients about their concerns and resolutions;

4. A description of types and scheduling of services available in the UIO, which shall be provided to all patients;

5. A list of staff with their professional titles, which shall be available to the patients upon request;

6. A policy on informed consent that identifies the specific care, treatment, or services that require informed consent;

7. The policies and procedures covering eligibility, referral and consultation services, billing, and other patient care services, which shall be provided to the patient at the time of registration; and

8. Where and how to obtain care during non-service hours and for urgent problems, as well as emergencies.

B. The patient shall be given an opportunity in private to be a partner in his/her evaluation, treatment, and diagnosis.

C.4 QUALITY MANAGEMENT

The Contractor shall provide an environment to promote and to strive toward improved quality of care.

A. The Contractor shall ensure all providers, whether employed by the Contractor or by a subcontractor, are appropriately credentialed and privileged. Contractor shall:

1. Provide education and training for all employees to perform their jobs adequately in care, treatment and services, managing medical and other emergencies, and emergency preparedness;

2. Ensure adequate supervision of all employees;

3. Ensure orientation and training on policies, procedures, and practices;

4. Support a peer review program with written by-laws in which all of the health care professionals participate; and

5. Maintain current Basic Life Support (BLS) and Automated External

Defibrillator (AED) certifications for all staff. Health care providers must complete courses specifically for health care providers.

B. Operating License. The Contractor shall meet generally applicable State or other requirements for operating as a provider of health care or referral services in the

State of Arizona. The Contractor shall meet all the applicable standards for State licensure or recognition, regardless of whether the Contractor obtains a license or other documentation under such State or local law.

C. Accreditation. The Contractor shall inform IHS if it intends to seek accreditation.

D. Federal Tort Claims Act

1. Generally. For purposes of Federal Tort Claims Act (FTCA) coverage, the

UIO is deemed to be part of the Public Health Service in the Department of Health and Human Services and its employees are deemed to be employees of the Federal government while performing work under this contract.

2. Case-by-Case Determination. The IHS does not determine the scope of coverage under the FTCA. The UIO understands that whether the FTCA applies in any particular case is decided on an individual case-by-case basis by the United States Department of Justice (DOJ) and subsequently by the Federal Courts.

3. Records. Should the FTCA apply to a claim against or in litigation involving the UIO or its employees, the UIO will promptly provide all documents necessary for the defense of such case. All such documents, and any related documents, shall be preserved throughout the pendency of the claim, case, and all appeals. The UIO shall designate one individual to be its FTCA point of contact to assist with these requests, and shall inform IHS of any changes to that contact.

E. Malpractice Insurance. The Contractor shall obtain professional liability insurance that provides coverage for all independent contractors, volunteers, and other individuals not otherwise covered by the FTCA. Such coverage must be consistent with the minimum levels of professional liability insurance mandated by the laws of the State of Arizona and reflects the specific Scope of Work and other circumstances at the UIO.

1. The Contractor must provide documentary proof of the insurance coverage to the Contracting Officer prior to executing this contract.

2. The Contractor shall notify the Contracting Officer immediately of any material changes in coverage that could negatively impact the Contractor’s ability to carry out the scope of work of this contract.

F. Quality Assessment and Performance Improvement Plan. Consistent with Federal and State law, as well as any other applicable standards, the Contractor shall develop and implement a written Quality Assessment and Performance Improvement (QAPI) plan to:

1. Describe the objectives, organization, scope, and mechanisms for overseeing the effectiveness of the monitoring, evaluation, and problem-solving activities.

2. Identify QAPI activities based on priorities, and specify assignments, responsibilities, data collection processes, and methods organized in a Plan- Do-Study-Act or other QAPI model.

3. Create a QAPI committee that is responsible for the implementation of the plan and reporting information to the Governing Body.

4. Appoint an appropriate individual as responsible for planning and completing those QAPI activities as assigned.

5. Hold regular performance improvement meetings with staff.

6. Develop written documentation of QAPI activities and evaluate any interventions implemented.

7. Maintain confidentiality of medical and clinical quality assurance records and testimony, consistent with 25 U.S.C. § 1675 and any implementing regulations.

G. Risk Management Plan. The Contractor shall develop and implement a Risk

Management plan, including:

1. A description of the objectives, organization, scope, and mechanisms to minimize, monitor and control the probability and impact of losses.

2. Periodic review of clinical records, consistent with Federal and State law requirements.

3. Roles and responsibilities for the Risk Management Team including reporting information to the Governing Body.

C.5 DISASTER PLANNING

The Contractor shall establish an emergency preparedness plan for the organization and participate in emergency preparedness planning for the community, consistent with Federal and State law requirements.

C.6 FACILITIES

The Contractor shall provide a safe and sanitary environment for the delivery of health care services, including compliance with Federal and State laws.

The Contractor shall maintain a lease and/or ownership of the facility. Policies and procedures shall address facility needs when a facility or service closes and shall be consistent with Federal and State laws and regulations.

Per 25 U.S.C. § 1659, the Secretary may make funds available under this contract for renovations to facilities or construction or expansion of facilities, including leased facilities.

A. The contractor shall ensure that any activities and costs pursuant to this authority are:

1. For carrying out this contract. If the activity under this authority is only partially attributable to carrying out this contract, then only that portion will be funded; and

2. In compliance with the cost principles at 45 C.F.R. Part 75, Subpart E, which are expressly incorporated by the FAR into this contract.

B. The federal government is not a party to the Urban Indian Organization’s renovation, construction, or expansion subcontract(s).

C. Any construction, renovation, or expansion of UIO facilities must comply with FAR Part 36, “Construction and Architect-Engineer Contracts” when applicable, including for subcontractors. This determination will be made by the Contract Officer based upon review of the proposed project.

D. All contracts made by the contractor must be consistent with 45 C.F.R. Part 75, Appendix II.

C.7 INCORPORATION BY REFERENCE OF THE CONTRACTOR’S

TECHNICAL PROPOSAL

The Contractor shall perform the work and services required in this contract in accordance with the Contractor’s technical proposal, submitted to the Tucson Area Office, IHS on May 10, 2022, provided, however, that this contract is controlling and shall supersede the proposal in the event of any conflict.

C.8 Additional Standard Requirements

As required by 25 U.S.C. § 1653(a)(1)-(12), the Urban Indian Organization shall successfully undertake to:

(1) estimate the population of Urban Indians residing in the urban center in which such organization is situated who are or could be recipients of health care or referral services;

(2) estimate the current health status of Urban Indians residing in the urban center;

(3) estimate the current health care needs of Urban Indians residing in the urban center;

(4) identify all public and private health services resources within such urban center which are or may be available to Urban Indians;

(5) determine the use of public and private health services resources by the Urban Indians residing in such urban center;

(6) assist such health services resources in providing services to Urban Indians;

(7) assist Urban Indians in becoming familiar with and utilizing such health services resources;

(8) provide basic health education, including health promotion and disease prevention education, to Urban Indians;

(9) establish and implement training programs to accomplish the referral and education tasks set forth in paragraphs (6) through (8);

(10) identify gaps between unmet health needs of Urban Indians and the resources available to meet such needs;

(11) make recommendations to the Secretary and Federal, State, local, and other resource agencies on methods of improving health service programs to meet the needs of Urban Indians; and

(12) where necessary, provide, or enter into contracts for the provision of, health care services for Urban Indians.

END OF SECTION C

SECTION D – PACKAGING AND MARKING

FOR THIS CONTRACT, THERE ARE NO SPECIFIC PACKAGING AND MARKING REQUIREMENTS

SECTION E – INSPECTION AND ACCEPTANCE

E.1 Inspection of Services -- Fixed-Price (Aug. 1996)

(a) Definition: “Services,” as used in this clause, includes services performed, workmanship, and material furnished or utilized in the performance of services.

(b) The Contractor shall provide and maintain an inspection system acceptable to the Government covering the services under this contract. Complete records of all inspection work performed by the Contractor shall be maintained and made available to the Government during contract performance and for as long afterwards as the contract requires.

(c) The Government has the right to inspect and test all services called for by the contract, to the extent practicable at all times and places during the term of the contract. The Government shall perform inspections and tests in a manner that will not unduly delay the work.

(d) If the Government performs inspections or tests on the premises of the Contractor or a subcontractor, the Contractor shall furnish, and shall require subcontractors to furnish, at no increase in contract price, all reasonable facilities and assistance for the safe and convenient performance of these duties.

(e) If any of the services do not conform with contract requirements, the Government may require the Contractor to perform the services again in conformity with contract requirements, at no increase in contract amount. When the defects in services cannot be corrected by re-performance, the Government may --

(1) Require the Contractor to take necessary action to ensure that future performance conforms to contract requirements; and

(2) Reduce the contract price to reflect the reduced value of the services performed.

(f) If the Contractor fails to promptly perform the services again or to take the necessary action to ensure future performance in conformity with contract requirements, the Government may --

(1) By contract or otherwise, perform the services and charge to the Contractor any cost incurred by the Government that is directly related to the performance of such service; or

(2) Terminate the contract for default.

END OF SECTION E

SECTION F – DELIVERIES OR PERFORMANCE

F.1 PERIOD OF PERFORMANCE

The contract period of performance is until all funds are expended.

F.2 REPORTING REQUIREMENTS

The Contractor shall submit to the Contracting Officer the following reports.

F.2.1 Financial Reports

A. The Contractor shall complete and submit monthly financial reports, including vouchers (Government Standard Form (SF) 1034, “Public Voucher for Purchase and Services Other Than Personal,” and SF 1035, “Continuation Sheet, Public Voucher for Purchase and Services Other Than Personal”), by the 15th of each month, beginning with the first full calendar month following the effective date on the contract.

B. A monthly summary statement of program income/revenues and expenditures that relate to the contract should be included with the SF 1034 and SF 1035 required by paragraph A of this subsection.

C. The Contractor shall maintain records of the receipt and disposition of program income in the same manner as that required for the contract funds that gave rise to program income, showing the source of the income, the purposes for which it was expended, and any other information required by the Contracting Officer. This report shall be included with the SF 1034 and SF 1035 required by paragraph A of this subsection.

D. If the final payment of this contract is to be made on the basis of a desk audit, the

Contracting Officer may require the Contractor to submit detailed support for costs contained in one or more interim financial reports.

F.2.2 Audit Reports

A. The Contractor shall complete and submit an annual audit report that complies with the requirements of the Single Audit Act of 1984, P.L. 98-502, as amended, and Federal regulations at 45 C.F.R. Part 45, within the earlier of 30 days after receipt of the auditor’s report or nine months after the end of the Contractor’s fiscal year.

B. The Contractor shall submit the audit reports to:

1. Federal Audit Clearinghouse 1201 East 10th Street Jeffersonville, Indiana 47132

(800) 253-0696

2. Department of Health and Human Services Office of Inspector General Office of Audit Services National External Audit Review Center 1100 Walnut Street, Suite 850 Kansas City, Missouri 64106-2197

(800) 732-0679

(816) 426-7725

3. Division of Acquisition Policy

Indian Health Service 5600 Fishers Lane, Mail Stop: 09E45 Rockville, Maryland 20857

(301) 443-4872 or (240) 994-0732

4. The Tucson Area Contracting Officer Susan M. Protho. 520-295-

2462, Susan.Protho@ihs.gov.

C. Cost of Annual Private Audit

The cost of an annual private audit conducted by a certified public accountant, as required under this section, is an allowable cost of the contract. 25 U.S.C. § 1657(c).

F.2.3 Report on Expenditure of Funds

A. The contractor shall submit quarterly a report on the amounts and purposes for which funding under the contract is expended, including:

1. The number of eligible Urban Indians to whom services were provided; and

2. The number and type of services provided to those eligible Urban

Indians.

B. In determining whether to include a particular individual on the report, the Contractor may consider documents including, but not limited to: Certificate of Degree of Indian Blood (CDIB); Bureau of Indian Affairs Form 4432; Tribal membership card; Tribal correspondence; official birth certificate(s) that establish first or second degree descendancy; family documents (e.g., family bible); and self-certification.

F.2.4 Report of Accountable Personal Property

Government-owned contractor-held property is defined as property that is required for the performance of work and acquired or provided by the contractor while under contract to the IHS. Alternately, the property may be government furnished equipment, property is acquired by the IHS and subsequently made available for use by the contractor.

The Tucson Area Property Management Office must maintain effective controls and accountability for all personal property furnished by the IHS or acquired with IHS funds in accordance with FAR Part 45. For further guidance regarding Contractor- Held Property, refer to the HHS LMM Appendix Q, HHS Contracting Guide.

The accountable property (assets with bar code tag) is to be recorded on the IHS property system and inventoried annually. For any property transactions, the use of the Request for Property Action form (HHS-22) is to be used. This form can also be used to document transactions of personal property that is considered “non-accountable” such as furniture items, etc.

For facility and service closures, work closely with the respective Area Property Management Officer to close out the inventory and make arrangements for return of property.

F.2.5 Program Reports

A. Quarterly Program Report

The Contractor shall, consistent with 25 U.S.C. §§ 1655 and 1657, submit quarterly reports demonstrating compliance with the contract, including an explanation of activities conducted pursuant to the contract, information gathered, an accounting for the amounts and purposes for which Federal funds were expended, and such other information as the Government may request.

B. Quarterly Unmet Needs Report

The Contractor shall, consistent with 25 U.S.C. §§ 1653(a), 1655, and 1657(a), submit an unmet needs report quarterly. The report includes information gathered by the contractor to: (1) identify gaps between unmet health needs of Urban Indians and the resources available to meet such needs; and (2) make recommendations to the Secretary and Federal, State, local, and other resource agencies on methods of improving health services to meet the needs of Urban Indians.

C. Annual On-Site Review of the Program

The Contractor shall, consistent with 25 U.S.C. § 1655(b), cooperate with the IHS’s annual on-site review, to be conducted in accordance with the IHS Urban Indian Organization On-Site Review Manual.

D. Scope of Work

The Contractor shall complete and submit the following at the specified time(s), if applicable based on the scope of work set out in Section C.

E. Data Reporting

The Contractor shall follow the reporting guidelines and timelines for Government Reporting and Results Act (GPRA) and the Uniform Data System (UDS).

A. GPRA Reporting

1. GPRA data shall be submitted electronically to the National Data Warehouse.

2. All GPRA data submitted shall be verifiable and based upon criteria set forth for each GPRA performance standard.

3. The GPRA data period shall be the federal fiscal year of October 1 through September 30.

4. Monthly registration and workload data shall be exported to the National Data Warehouse (NDW). All data for the entire fiscal year shall be exported by the cutoff date for that fiscal year.

5. A GPRA Developmental Report shall be run at the end of the 2nd and 4th quarters and sent to the National GPRA Support Team by the required due dates.

6. Quarterly Immunization Reports shall be submitted three weeks following the end of each quarter to the online National Immunization Reporting System (NIRS).

B. UDS Reporting

1. UDS reporting period shall be by calendar year.

2. UDS reports shall be due in January for the previous calendar year.

F.3 NONCOMPLIANCE OR UNSATISFACTORY PERFORMANCE

A. If, at any time during the effective period of this contract, the Contracting Officer and Office of Urban Indian Health Programs (OUIHP) Director, determines the Contractor has not complied with the requirements of the contract or the IHCIA, as amended, or other applicable Federal law, the Contracting Officer shall attempt to resolve any areas of noncompliance or unsatisfactory performance.

If the Contracting Officer determines such noncompliance or unsatisfactory performance cannot be resolved or prevented in the future, after consultation with the OUIHP Director, the Contracting Officer shall not renew the contract and may also, after consultation with the OUIHP Director, terminate the contract before the end of the contract term if deemed necessary.

B. Evaluation Procedures

1. The Contracting Officer shall develop procedures to evaluate compliance with, and performance of this contract. Such procedures shall include provisions for carrying out the contract requirements.

2. In determining whether to renew the contract, the Contracting Officer shall review the records of the Contractor, the reports submitted under the Contractor, and the results of the on-site reviews.

C. Annual On-site Review

The Tucson Area Office shall conduct an annual on-site review of the Contractor for purposes of determining the compliance with and performance under the contract.

END OF SECTION F

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SECTION G – CONTRACT ADMINISTRATION DATA

G.1 FINANCIAL PROVISIONS

A. Payment will be made by the:

Tucson Area Indian Health Service 7900 South J Stock Road Tucson, Arizona 85746

B. The source of funds and estimated amounts are as follows:

Source of Funds Amount

J421AWU $196,899.00

G.2 COMPENSATION

N/A

G.3 PROGRAM INCOME

A. Use of Program Income

1. The Government waives FAR Contract Clause 52.216-7(h)(2) with respect to program income, which includes any amounts received by or accruing to the Contractor for costs incurred under this contract. All program income under this contract shall be governed by the following provisions of this subsection.

2. In accordance with 25 U.S.C. § 1621f, the Contractor shall use program income to provide additional services or benefits within the scope of the current contract.

B. Identifying and Billing Third Party Payers

1. The Contractor shall develop a written policy and operative procedure to:

a. Screening all patients to identify third party payers, including Medicaid and Medicare, private insurance, and other alternate resources that are authorized or under a legal obligation to pay all or a portion of charges for the health services provided under this contract;

b. Enrolling patients in Medicaid, Medicare, and other third party payment programs, where applicable;

c. Collecting payment from all such third party payers and alternate resources; and

d. Recording, controlling, and otherwise accounting for all program income.

2. The Contractor shall promptly bill and make every effort to collect payment from all third party payers or alternate resources for services provided under this contract. 25 U.S.C. § 1623(b).

3. If the Contractor is not currently billing for billable services, the Contractor shall develop a plan to begin third party billing to maximize collections.

C. Internal Controls: The Contractor shall establish specific internal controls to safeguard and properly account for revenue and related assets and to define the authorities for collecting debts owed to the Contractor by third party payers and non-beneficiary patients. The Contractor’s financial operations must comply with all applicable laws, regulations, and industry-wide financial management requirements and standards, as they relate to revenues from third party payers and other resources.

D. Recording Program Income: The Contractor shall maintain records of the receipt and disposition of program income in the same manner required for the contract funds that gave rise to the program income and shall report this information as required in Section F.2.1.

G.4 ADMINISTRATION OF GOVERNMENT PROPERTY

A. The Property Administrator is the authorized representative of the Contracting Officer for the purpose of administrating the contract requirements and obligations relative to Government property (Government furnished and/or contractor acquired). The Contracting Officer shall designate the Property Administrator in writing and shall provide a copy of the designation to the Contractor.

B. In accordance with the FAR Contract Clause 52.245-1, “Government Property,” the

Contractor shall establish and maintain written procedures for the maintenance, repair, protection and preservation, control of, and accountability for Government property, consistent with the provisions of DHHS Publication (OS) 686, entitled “Contractor’s Guide for Control of Government Property (1990).” The Property Administrator will provide a copy of the Manual to the Contractor, upon request.

Chapter 3, “Contract Start-up,” of the Manual may be used as a guide in preparing the written procedures, which shall be furnished to the Property Administrator within sixty days after the effective date of this contract.

C. The Contractor’s procedures shall specifically address the following requirements relative to said Government property:

1. Provision for adequate identification, markings, recording and maintenance.

2. Disposition of equipment when a facility or service closes, in accordance with applicable federal and state laws and regulations.

3. Performance of an annual physical inventory.

4. Safeguarding of all Government property and assuring that the property is used solely for authorized purposes.

5. Submission of Form HHS-565, “Report of Accountable Personal Property,” with each public voucher submitted for payment under which reimbursement for acquisition of authorized Capitalized Nonexpendable Equipment is requested.

D. When the Contract is completed, a final inventory shall be taken by the Contractor and submitted to the Property Administrator. The following certificate signed by the authorized official of the Contractor shall be provided with each copy of the final inventory:

“I do hereby certify as Director of American Indian Association of Tucson dba Tucson Indian Center that the attached inventory reports are complete and correctly list and describe all items of materials, supplies, and equipment furnished to the Contractor, or for which the Contractor has been or will be reimbursed by the Government for use in the performance of Contract No.

75H71422C00005, which as of this date have not been consumed in performance of this contract; and that I will immediately notify the Contracting Officer of any change affecting these inventory reports at any time prior to final disposition of the inventory.”

E. All Government property, either Government furnished and/or Contractor acquired, that is listed under Contract No. 75H71422C00005 is hereby transferred and made a part of this contract.

F. The Contractor agrees to provide storage facilities, including proper identification and protection, for all Government-owned property (Government furnished and/or Contractor acquired) upon completion of the contract, without cost to the Government, until disposition instructions are provided. The Government shall provide disposition instructions after the Contractor’s submission of the final inventory.

G.5 CONTRACTING OFFICER AND CONTRACTING OFFICER

REPRESENTATIVE

A. The Contracting Officer assigned to this contract for the Tucson Area Office is Susan M. Protho, 520-295-2462, Susan.Protho@ihs.gov.

mailto:Susan.Protho@ihs.gov

B. The Contracting Officer is the only party authorized to bind the Government to a contract. As such, the Contracting Officer is the only one with the authority to change contract requirements.

C. The Tucson Area is responsible for nominating a Contracting Officer Representative

(COR) to the Contracting Officer.

D. The COR, who the Contracting Officer shall designate in writing, is responsible for working with the Contracting Officer in insuring that the Contractor complies with contract requirements. However, the COR is not authorized to make any changes to the contract. The COR’s duties are specifically identified in the COR Appointment Letter issued by the Contracting Officer.

G.6 OTHER PROVISIONS

A. The Parties expressly agree that this written contract represents the entire understanding between the Parties and supersedes any prior agreements or understanding with respect to the subject matter herein.

B. Any changes or modifications to this contract must be in writing and be signed by both

Parties.

C. Nothing in this contract, expressed or implied, is intended to confer any rights, remedies, claim or interests upon an individual or entity not a party hereto. Neither party shall have the right to assign or transfer its rights to any third party under this contract without the prior written consent of the non-transferring party.

D. The Parties acknowledge that this contract is not a contract or any other form of agreement entered into under the Indian Self-Determination and Education Assistance Act, 25 U.S.C. §§ 5301-5423, and is not subject to the dispute procedures identified therein.

END OF SECTION G

SECTION H – SPECIAL CONTRACT REQUIREMENTS

H.1 KEY PERSONNEL

In accordance with HHSAR Clause 352.237-75, Key Personnel, the following positions are considered key personnel:

1. Chief Executive Officer or Executive Director

2. Chief Financial Officer

3. Clinical Director

4. All Professional Health Care Providers, including physicians, nurses, and mental health or substance abuse counselors

H.2 FAIR AND EQUAL TREATMENT OF URBAN INDIANS

The Contractor agrees to make no discriminatory distinctions among Urban Indian patients or beneficiaries of this contract. See 25 U.S.C. § 1656(e); 42 U.S.C. § 2000d; 45 C.F.R. § 80.3.

For the purpose of this contract, discriminatory distinctions include, but are not limited to, the following:

A. Denying any service or benefit to a patient that is provided to other patients under this contract.

B. Providing any service or benefit in a different manner or at a different time from that provided to other patients under this contract.

C. Subjecting a patient to segregation or separate treatment in any manner.

D. Restricting a patient in any way as a result of the determination of whether he/she satisfies any admission, enrollment quota, eligibility, membership, or other requirements or conditions which individuals must meet in order to be provided any service or benefit.

E. Assigning times or places for the provision of services on the basis of discriminatory distinctions that may be made of the patients to be served.

H.3 GOVERNANCE

A. The Contractor shall be a nonprofit corporate body situated in an urban center and governed by an Urban-Indian controlled Board of Directors (BOD). The BOD must have the expertise to establish policy for and oversee the operations of the organization, provide for the maximum participation of all interested Indian groups and individuals, and be capable of cooperating with other public and private health care entities. To be Urban-Indian controlled, the BOD must be comprised of a minimum of 51% of eligible Urban Indians, as defined in Section C.1.2, who reside in the Pima County, Tucson, Arizona

To confirm the Contractor meets the definition of an UIO, the Contractor shall provide to the Contracting Officer the following information for every member of the BOD:

1. Name;

2. Verification of status as an Urban Indian, if applicable; and

3. Verification of residence in the Pima County, Tucson, Arizona area.

B. Consistent with applicable Federal and State law, as well as other applicable guidelines, the BOD shall establish written policies and procedures governing the following:

1. Organizational bylaws.

2. Roles and responsibilities of the BOD.

3. Training for members of the BOD, including new-member training and annual training requirements.

4. Roles and responsibilities of the Chief Executive Officer or Executive Director (CEO/ED), as well as other key positions in the organization.

5. Business ethics and conduct.

6. Internal controls.

7. Personnel files.

8. Employee performance and evaluation.

9. Equal opportunity employment, sexual harassment, and employee grievances.

This list is not exhaustive, and the BOD should adopt any other policies and procedures required by Federal or State law, as well as other applicable guidelines or standards. All policies and procedures should be made available to the Contracting Officer.

H.4 PROGRAM ADMINISTRATION

A. Program Administrator: The Contractor shall appoint a program administrator, whose responsibilities include, but are not limited to:

1. Implement and enforce the policies, procedures, and internal controls of the organization, as developed by the BOD;

2. Guide the organization’s mission, goals, and objectives, as developed by the

BOD;

3. Employ and manage personnel;

4. Manage assets and establish fiscal controls;

5. Communicate with external entities;

6. Establish a system for official documents; and

7. Conduct an annual Patient Satisfaction Survey. A Patient Satisfaction Survey

Report, within 15 days of the end of the contract term.

B. Positions Involving Regular Contact With or Control Over…