75H71526Q00024.pdf

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

139CODE 16. ADMINISTERED BYCODE

X

X

621399

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR139

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

07/16/2026 1700 ET

06/24/2026

ANDREW RHOADES

(No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H71526Q00024

5. SOLICITATION NUMBER

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

1 33 IHS1526637OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Nashville TN 37214

711 Stewarts Ferry Pike

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$10

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

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Nashville Area Office WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

Charles City VA 23030-2302

2401 Roxbury Road

IHS Mid-Atlantic Service Unit

Nashville TN 37214

711 Stewarts Ferry Pike

Nashville Area Office

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

1 78 HR

Non-personal PRN services for a Dentist, and Pharmacist in support of the Mid-Atlantic Tribal Health Center Delivery: 04/07/2026

CIT - PRN

Continued ...

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

HEREIN, IS ACCEPTED AS TO ITEMS:

XX

DATED

ANDREW A. RHOADES

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

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

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

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

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

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

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

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

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

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

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

2 CITED - PRN 7 HR

3 PIT - PRN 25 HR

4 RIT - PRN 8 HR

5 CIT - PRN Dentist 130 HR

6 CITED - PRN Dentist 11 HR

7 PIT - PRN Dentist 42 HR

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 33

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H71526Q00024

8 RIT -PRN Dentist 14 HR

9 CIT - PRN Pharmacist 130 HR

10 CITED - PRN Pharmacist 11 HR

11 PIT - PRN Pharmacist 42 HR

12 RIT -PRN Pharmacist 14 HR

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

Sponsored by GSA

FAR (48 CFR) 53.110

Statement of Work (SOW) for

Non-Personal Dentist and Pharmacist Services for the Mid-Atlantic Health Center

A. Background:

1) The Mid-Atlantic Tribal Health Center’s (MATHC) mission is to elevate the physical, mental, and spiritual health of the Native American population residing within its geographic service area.

This mission is carried out through the development and delivery of Direct Care Services and the administration of the Purchased/Referred Care (PRC) Program.

MATHC is transitioning toward expanded direct care services through the establishment of a comprehensive healthcare clinic to serve newly federally recognized Tribes in Virginia. To ensure continuity of clinical operations and uninterrupted patient care during this transition, supplemental clinical coverage is required.

This acquisition is for non-personal, as-needed (PRN) dental, and pharmacy services. These services are necessary to maintain continuity of operations during periods of provider absence, including but not limited to leave, vacancy, illness, training, or other unforeseen circumstances.

B. Statement of Objectives:

1) The primary objective of this acquisition is to obtain non-personal PRN services for a Dentist, and Pharmacist in support of the Mid-Atlantic Tribal Health Center.

The contract will consist of a one (1) year base period of performance with four (4) 12-month option periods.

The providers shall complete all required Indian Health Service (IHS) security clearance requirements prior to the commencement of services. All contracted providers must meet applicable federal, state, licensure, credentialing, and privileging requirements before performing services under the contract.

C. Scope of Work:

1) The Mid-Atlantic Health Tribal Health Center is in need of a PRN Non-Personal Service Contract for a Dentist, and Pharmacist to support the mission of the Indian Health Service (IHS). The contractor shall provide:

i. Urgent and chronic pharmacy needs for patients using automation and manual fill techniques

ii. Comprehensive dental care for patients of all ages

2) Period of Performance

i. Base Year: Services under this contract shall commence on a PRN basis.

ii. Option Period One

iii. Option Period Two

iv. Option Period Three

v. Option Period Four

3) Place of Performance:

i. Hours of Operation: Scheduled PRN work to occur Monday-Friday between the hours of

8:00AM and 4:30PM. The services will be provided at:

1. Indian Health Service

Mid-Atlantic Tribal Health Center 2401 Roxbury Rd.

Charles City, VA 23030

4) Reporting Requirements:

i. The Contractor shall be required to provide individual monthly invoices via IPP System for approval prior to payment.

5) Hours of Operation:

i. Hours of Operation: Work to be completed Monday-Friday between the hours of 8:00AM and 4:30PM, excluding Federal Holidays.

6) Federal Holidays:

i. New Year's Day

ii. Martin Luther King's Birthday

iii. Washington’s Birthday

iv. Memorial Day

v. Juneteenth

vi. Independence Day

vii. Labor Day

viii. Columbus Day

ix. Veteran's Day

x. Thanksgiving Day

xi. Christmas Day

xii. *Any other day specifically declared by the President of the United States to be a national holiday.

D. Supplies or Services and Prices/Costs

1) Price or Cost

i. This solicitation is to be issued for the quantities set forth in the bid schedule.

2) General Contract Information

i. This is a non-personal health care service contract, as defined in Federal Acquisition Regulation (FAR) 37.401, under which the contractor is an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment). The contractor indemnifies the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance.

ii. As an independent Contractor; billing and collecting for the federal, state and other local city/county taxes is the burden of the Contractor, this includes any Virginia Business, Professional and Occupational License (BPOL) tax for services provided in any county of the State of Virginia.

iii. The Contractor's price/cost for services under this contract should include all applicable taxes for Internal Revenue Service (IRS), Virginia Department of Taxation and/or other revenue agencies. The Indian Health Service will not withhold taxes nor will it issue a W- 2 to the contractor.

iv. Fingerprinting Requirements for Security and Suitability- "Prior to start of services specified by the contract scope of work, the Contractor must contact Tiffany Niles, PSR, Nashville Area Office (615) 467-1573, to schedule an appointment to complete the fingerprinting process required by the IHS regulations pertinent to security and character background investigations."

3) Contract Price

i. The Contractor shall be paid upon submission of an invoice and completion and acceptance (if deliverable) or verification (if service) by the Contracting Officer's Representative (COR), of the deliverables and/or services indicated below. Submit invoices in accordance with the instructions contained in FAR clause 52.232-25, Prompt Payment, and HHSAR 352.232-71 of this solicitation. Minimum for this contract for one year is $3,000.00

4) Option Prices

i. Unless the Government exercises its option, pursuant to the option clause referenced in the Contract Clauses section, this contract consists only of the Base Period specified in this contract.

ii. Pursuant to either the FAR Clause 52.217-8, Option to Extend Services or the FAR Clause 52.217-9, Option to Extend the Term of the Contract, set forth in Section I, Contract Clauses, of this contract, the Government may, a unilateral contract modification, require the Contractor to perform the Option Period(s) as defined in the SOW of this contract. A notice that the Government intends to exercise any of the options will happen prior to the contract’s expiration date. Specific information regarding the timeframe for this notice is set forth in the OPTION PROVISION of this order. When exercising an option period, the fixed price rate of this contract is set forth below.

iii. Upon the delivery and acceptance of the Option Services described in the Statement of Work, the Government shall pay the Contractor the rate(s) set.

iv. If the Government exercises its option pursuant to the OPTION PROVISION of this contract, the Government's total estimated contract amount, represented by the sum of the price of base plus option periods and the period of performance will be as follows:

1. Note: Unit price shall be an all-inclusive rate of all other fees including travel expenses, per diem, lodging all cities, state, federal, local taxes and miscellaneous cost associated with the above services. It is preferred the contract personnel reside in driving distance from the facility.

2. Lunch break of 30 minutes is permitted (as non-paid) under the contract; the contractor cannot invoice time as worked if its’ employee chooses not to take a lunch break. The Contractor also cannot invoice travel times to/from the facility site as time worked.

E. Definitions

1) Acceptance: As stated in FAR, subpart 46.5, Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements and subject to other terms and conditions of the contract.

2) Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements. Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

3) Area: A defined geographical region for Indian Health Service administrative purposes. Each Area Office may administer several Service Units.

4) Blanket Purchase Agreement (BPA): is a simplified method of filling anticipated repetitive needs for supplies or services.

5) Business Associate (BA): Any company or person that shown to, handles, or works with the data or medical records of the medical entity.

6) Business Associate Agreement (BAA): A BAA is a contract between a HIPAA-covered entity and a HIPAA BA. The contract protects personal health information (PHI) in accordance with HIPAA guidelines.

7) Code of Ethics: The Revised American Nurses Association Code of Ethics and Standards of Practice and Care, published in 1996 by the American Nurses Association, which makes explicit primary goals, values and obligations of the nursing profession.

8) Contract: This is a legal binding document between the Government and the Contractor.

9) Contractor: The individual award a legal binding contract to provide supplies and services.

10) Contracting Officer (CO): A Government employee with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

11) Contracting Officer's Representative (COR): A federal employee who assists the CO in the administration of this contract. The COR is primarily responsible for the technical assistance and day-to-day program management.

12) Customer: Patients, staff and visitors of an IHS service unit and health center.

13) Customer Evaluation/Input: Written comments made to the COR regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor's performance.

14) Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal

Executive agencies in their acquisition of supplies and services with appropriated funds.

15) Health Clinics/Center: A facility physically separated from a hospital, with a full range of ambulatory services including at least primary care providers, nursing, laboratory, and dietary services, as well as pharmacy, and dentistry which are available at least 40 hours a week for outpatient care.

16) Indefinite Delivery/Indefinite Quantity: No set delivery time and no set quantity amount (used for recurring purchases with no set delivery time or quantity).

17) Non-Personal Health Care Services: A contract under which the personnel rendering the health care services are not subject, either by the contract's terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees, as defined in

FAR 37.401

18) Ordering Activity: An authorized user of IHS that may issue a purchase order to obtain required services under this contract.

19) Orientation: An activity designed to provide basic familiarization of the facility and transition into the IHS Service Unit and/or Health Center.

20) Past Performance Information: Relevant information regarding a contractor's actions under previously awarded contracts.

21) Patient Outcome: End result of nursing care.

22) Performance Based Matrix: Lists the services and the standards to determine quality of performance.

23) Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

24) Point of Contact: Person other than the COR or the Alternate COR

25) Quality Assurance Surveillance Plan (QASP): A written document prepared and used by the government for Quality Assurance surveillance of the contractor's performance.

26) Service Unit: The local administrative unit of IHS.

27) Standards of Practice and Standards of Care: Authoritative statements by which it describes the responsibilities for which its practitioners are accountable.

28) Technical Direction: A directive to the Contractor that approves approaches, solutions, designs, or refinements; fills in details or otherwise completes the general description of work or documentation items; shifts emphasis among work areas or tasks; or furnishes similar instruction to the Contractor.

29) Valid Patient Complaint: Justifiable accusation made by a patient and supported by investigation.

30) Verifiable Emergency: An unexpected/unplanned absence by the contractor requiring valid documentation to confirm the occurrence.

F. Government Furnished Property and Services

1) The Government will provide the following item(s) of Government property to the Contractor for use in the performance of this contract. This property used and maintained by the Contractor in accordance with provisions of FAR Clause 52.245-1, Government Property (found in Section 4).

Item No

Property Description Property Value Qty. Date Available

1 Computer 1 Upon Arrival 2 Telephone 1 Upon Arrival 3 Desk/Chair 1 Upon Arrival 4 PIV Card 1 Upon Arrival 5 PPE Equipment Upon Arrival

2) Government Furnished Information/ Property and Services

i. Information: Government unique information related to this requirement, which is necessary for Contractor performance, made available to the Contractor. The COR will be the point of contact for identification of any required information to be supplied by the Government.

ii. Joint Use by the Government and the Contractor: Except for the property and service listed, the Government will provide, for joint use by the Government and the Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

iii. Contractor Exclusive Use:

1. Personal Protective Equipment (PPE): The Government will furnish the

Contractor with appropriate PPE other than specified in the contract. The Government will be responsible for any repair, cleaning, and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

2. The Government will provide facility specific contractor identification badges/keys for each contractor. For lost or destroyed badges/keys, there is a minimum charge of $20.00.

3. Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures. Training provided ONLY if the subject matter is necessary to improve or enhance the quality of services or includes mandates made by the IHS Service Units/Health Centers while the providers are working under this contract. Training not provided for the purpose of continuing education, career development or individual development.

iv. Contractor Furnished Property

1. Except for the property specified as government furnished, the Contractor shall provide all uniforms and other personal medical instruments subject to the following:

a. Uniforms and Lab Coats: Uniforms and Lab Coats must conform to the requirements of the Indian Health Service Manual, Part 3, and Chapter 4 and meet the approval of the COR.

b. Other personal medical instruments: "Other personal medical instruments" defined, as Contractor owned items include but not limited to stethoscope, scissors, as appropriate to the work unit. The Contractor must not use unsafe equipment or supplies at any time during performance of this contract. All Contractor furnished equipment and supplies shall be subject to inspection by the Government and must be approved by the COR prior to use by the Contractor. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

G. Statement of Work

1) Provider Duties and Requirements

i. Pharmacist

1. Primary Duties

a. Shall provide prescription medication order entry, dispensing, when the pharmacy opens.

b. Maintain a medication profile for all patients and assist providers with prescription renewals and medication management therapy (MTM).

c. Shall investigate and complete medication error reports, assign, prioritize and evaluate work, and follow medication policies and procedures including appropriate documentation within an electronic record.

d. Requires knowledge of current state requirements, and other Federal or State regulatory agency requirements specific to medication order processing.

e. Shall provide pertinent drug information and education to providers, patients, and staff

f. Maintains patient records in the Electronic Health Record.

g. Attends dental, medical staff, or clinic meetings as requested.

h. Observes and abides by all the policies of Mid-Atlantic Tribal Health

Center including rules and regulations of the medical staff.

i. May participate in Service Unit meetings and in-services.

j. Performs other related duties as assigned.

k. Observes and complies with all policies, procedures, and regulations of the Mid-Atlantic Tribal Health Center, including medical and dental staff bylaws and infection control standards

l. The Contractor must have a minimum of twelve (12) months of recent outpatient pharmacy experience within the last five (5) years.

ii. Dentist

1. Primary Duties

a. Provides comprehensive dental care within the scope of licensure, including but not limited to patient history review, oral examinations, diagnosis of dental and oral conditions, treatment planning, and delivery of preventive, restorative, and emergency dental services.

b. Performs dental procedures as appropriate, including examinations, extractions, restorations, endodontic procedures, periodontal care, and urgent/emergent same-day dental services.

c. Orders, reviews, and interprets appropriate diagnostic studies, including dental radiographs and laboratory tests when indicated, and integrates findings into clinical decision-making.

d. Develops and implements individualized treatment plans; explains diagnoses, treatment options, risks, benefits, and alternatives to patients and their families; and provides patient education and counseling on oral health maintenance.

e. Prescribes medications within the scope of dental practice, including antibiotics, analgesics, and other medications as clinically indicated, in accordance with federal, state, and organizational policies.

f. Determines when referral to dental specialists or medical providers is necessary and coordinates appropriate referrals for complex or unusual cases.

g. Provides care for scheduled and walk-in/same-day patients to meet clinic access and urgent care needs.

h. Maintains timely, accurate, and complete documentation of all patient encounters, procedures, prescriptions, and treatment plans in the Electronic Health Record (EHR).

i. Attends dental, medical staff, or clinic meetings as requested.

j. Performs other related duties as assigned.

k. Observes and complies with all policies, procedures, and regulations of the Mid-Atlantic Tribal Health Center, including medical and dental staff bylaws and infection control standards

l. The Contractor must have a minimum of twelve (12) months of recent dental practice within the last five (5) years.

iii. All providers under the contract must be a board certified who have permanent, full, and unrestricted license to practice medicine in the Commonwealth of Virginia. Providers must also have a BLS certification.

iv. All Contract providers will be held to the same Standards of Conduct as federal employees "Standards of Conduct" as outlined in the IHS Indian Health Manual, Chapter 23- Ethical and Professional Condict of Health Care Providers https://www.ihs.gov/ihm/pc/part-3/p3c23/ and Indian Health Service Anti-Harassment Policy Statement https://www.ihs.gov/ihm/sgm/2024/indian-health-service-anti-harassment-policy-statement/

Violations of these policies may lead to contract termination.

v. Any negligent behavior or any behavior jeopardizing patient safety will not be tolerated.

Professional Review Action may be taken regarding any member of the Medical staff if activity, demeanor or conduct of the member is detrimental to patient care, disruptive to service unit operation, or in violation of the local Bylaws, Medical Staff Rules and Regulation, IHS policy or ethical. Each incident will be evaluated and documented.

Documentation will be submitted to the contractor. These incidents may be grounds for immediate removal. Credentialing actions giving rise to a hearing or appeals will be in accordance with the appropriate by-laws. No costs for travel, attorney fees, phone, mail, or other expenses associated with the candidates hearing or appeal will be provided by the IHS, or the local service unit.

vi. Observes and complies with all policies, procedures, and regulations of the Mid-Atlantic Tribal Health Center, including medical and dental staff bylaws and infection control standards.

vii. The Contractor shall perform all services in accordance with applicable federal laws, regulations, and policies governing the Indian Health Service (IHS) and the U.S.

Department of Health and Human Services (HHS), including compliance with all applicable oversight and regulatory authorities

viii. May participate in service unit meetings, in-services, and interdisciplinary care coordination activities.

ix. Performs other related duties as assigned to support clinic operations and patient care needs

x. Work assignments will be defined by the Clinical Director/CEO (or designee) to include shifts within the hours of operation of the facility. The work hours/shifts cannot be changed/traded/switched without prior approval from the Clinical Director/CEO (or designee).

https://www.ihs.gov/ihm/pc/part-3/p3c23/ https://www.ihs.gov/ihm/sgm/2024/indian-health-service-anti-harassment-policy-statement/ https://www.ihs.gov/ihm/sgm/2024/indian-health-service-anti-harassment-policy-statement/

xi. Contract providers shall generate and maintain proper medical record information on beneficiaries to whom treatment is provided in accordance with Indian Health Service, Accrediting Body. The Contractor provider shall prepare all electronic medical record documentation to meet or exceed the established standards of the IHS facility to include but not be limited to: timeliness, accuracy, content, and signature. Contract providers shall complete all third party reimbursement and referral forms. All medical record information and documentation generated in the performance of this contract must be completed at the time of departure and will remain the property of and subject to the exclusive control of the Indian Health Service. The Medical Records Department shall be notified in advance of the contract provider's last workday. The Clinical Director/CEO (or designee) will not sign off on the contract provider's timesheet unless the contract provider is cleared by Health Information Management Systems (HIMS) utilizing the HIMS Clearance Form. Failure to complete medical records before leaving may result in a delay of the processing of all invoices from the contract.

xii. To ensure that contract providers are in compliance with all facility regulations, MATHC shall provide contract providers an orientation on Cultural Sensitivity, Customer Service, Resource & Patient Management System (RPMS), Purchased and Referred Care (PRC) and Electronic Health Record (EHR) systems. Each contract provider shall be granted access to RPMS and EHR systems for electronic documentation of patient care services. In addition, dentists will be granted access to Dentrix. This orientation will be paid at the regular rate.

xiii. The contractor's conformance with the technical requirements of this contract will be monitored for the period of performance. This assessment will include observations of the work system, methods and execution. Examples of monitoring methods include, but are not limited to: compliance with the Indian Health Service credentialing and privileging requirements, appropriateness of candidate placement (e.g., number of removals, number of early termination of assignments due to personality conflict, poor work habits, and inadequate skills for the assignment, unprofessional or discourteous behavior). An assessment spreadsheet with these methods will be monitored by the Clinical Director/ CEO and the Contracting Officer's Representative (COR) and/or designee.

xiv. Conditions for Removal/Replacement of Contractor’s Employee/Staff:

1. As mutually agreed upon between the Contracting Officer and the Contractor, there may be grounds for removal and/or replacement of contractor personnel.

a. Contractor staff will be removed from the facility if services are not performed in accordance with the terms and conditions of the contract.

b. It is the accountability and responsibility of the Contractor to have replacement provider(s) on-board at the MATHC facility as expeditiously as possible; by immediately informing the provider staff to complete and have ready, their background investigation requirements upon notice of placement.

c. The Contactor is responsible for having a replacement provider in place no more than three (3) to four (4) weeks or sooner, if possible, of notification for a replacement of a provider.

xv. Certification forms and required documents must be completed in their entirety and returned demonstrating the minimum qualifications have been met, as follows:

1. Provider Liability Insurance: Provide proof of current medical liability insurance carried in the minimum amount of One (1) million dollars per occurrence and Three (3) million-dollar aggregate.

xvi. License:

1. Pharmacist, as minimum basic eligibility requirements, must be A Doctor of

Pharmacy (Pharm.D.) degree from a program accredited by the Accreditation

Council for Pharmacy Education (ACPE) or an accrediting body recognized by the U.S. Department of Education. Evidence of completion must be provided.

a. Must have at least 12-months of pharmacy outpatient experience specialization in the last five (5) years.

b. Hold a full unrestricted and current active pharmacy license in a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States (US) during the term of the term of this order.

c. BLS Certification: Current Basic Cardiac Life Support (BLS) Certification.

2. Dentist, as minimum basic eligibility requirements, must possess and maintain a current, unrestricted license to practice dentistry in the state where services are provided. The Contractor must be a graduate of a Commission on Dental Accreditation (CODA)–accredited dental program, resulting in a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. Evidence of successful completion of the dental program and current licensure must be provided

a. The Contractor must have a minimum of twelve (12) months of recent clinical dental practice experience within the last five (5) years, demonstrating competence in general dentistry and outpatient clinical care, including urgent or same-day dental services.

b. BLS Certification: Current Basic Cardiac Life Support (BLS) Certification.

xvii. All providers placed at the Mid-Atlantic Tribal Health Center MUST comply with Federal

Vaccine/Immunization requirements. Under no circumstance will a provider by allowed to provide patient care services without the mandated vaccination and booster requirements of all federal agencies.

xviii. Credentialing: The Contractor's employees shall apply and be approved for clinical privileges prior to providing patient care. Contractor's employees shall submit the following to the service unit medical staff office: pre-application, if approved; then they shall submit a complete medical staff application with request for clinical privileges, copies of active, unrestricted professional licensure, professional degree, residency and board certification in specialty, current curriculum vitae, proof of professional liability coverage, DEA certificate and any supporting documentation that may be requested by the medical staff office.

1. NOTE: The credentialing/privileging process takes a minimum of 4 to 6 weeks to complete.

2) Work Schedule

i. The contract provider(s) shall provide services at the Mid-Atlantic Tribal Health Center between the hours of 8:00AM and 04:30PM from Monday through Friday with the exception of federal holidays. By the Department of Labor Regulations, all contractor providers will be allowed to take a 30-minute meal/rest break. If the contract provider chooses to forego their meal/rest break, they cannot bill as hours worked.

ii. Hours of services during the contract period of performance is not expected to exceed 80 hours. This contract would be inclusive of singular days and 40 hours week schedules. Contract providers under this contract shall be scheduled and required to perform services at the request of the Clinical Director or his/her designee.

iii. The POC at the Mid-Atlantic Tribal Health Center must determine specific tour of duty.

The contractor’s employee must work 100% of the contracted hours.

iv. The Contractor will perform duties on a PRN basis.

v. The Government reserves the right to examine and or re-examine any Contractor who meets the criteria.

vi. Discipline specific training: Not provided to Contractor employees. The only training provided to the Contractor employees will be in-house software specific at the Service Unit.

3) Performance Evaluation

i. The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract.

ii. Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome constitutes a breach of contract.

4) Conduct

i. The Contractor must perform standards as listed in the Federal Code of Conduct.

5) Conditions of Contract Services:

i. All contractors providing service under this contract must attend mandatory orientations specified by the Service Unit.

1. The contractor must be subject to character investigation as required by Public Law 101-360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance of a contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eQIP) system and this shall include all fingerprinting procedures and clearances.

The contractor must provide all requested information necessary to perform Level I and Level II background checks. The contractor must comply with the requirement to obtain security investigations. The contractor must work with the IHS to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. The contractor will review all completed forms and forward onto the Government personnel. The contractor will be immediately removed from the position (at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

2. Identification of Contractor: The Contractor must wear a government issued contractor identification badge during performance of duty.

3. Management of Medical Information: The Contractor must manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols. The Contractor must immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

a. The Contractor shall ensure adherence to DHHS IT system security policies and procedures. The IT policies and procedures will be made available to the Contractor.

b. The Contractor shall immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

4. IHS Information Technology Systems: In performance of this contract, the Contractor must adapt to and successfully utilize IHS information technology systems such as Electronic Health Records (EHR) or RPMS, which the IHS has deemed necessary for acceptable contractor performance. The IT policies and procedures are available to the Contractor at the Service Unit and the Contractor will adhere to the IHS Information Technology System Security Policies and procedures. The Contractor must follow all appropriate federal required information Technology security requirements and will be operating under Health Insurance Portability and Accountability (HIPAA) and Privacy Act regulations.

6) Contractor Qualification Requirements

i. Motor Vehicle Operator's License: If required by the position, the Contractor shall possess a valid state driver’s license throughout the term of this contract. Contractors will not operate any Government-Owned vehicles. If required to provide health care services, they are allowed only as passengers in the Government-Owned Vehicle driven by a Federal employee.

ii. Health Requirements of Contracted Healthcare Providers: Furnish documentation that reflects immunity for the indicated vaccine preventable diseases through documented disease, vaccination history, serology results, and/or any documented episodes of adverse events after vaccination. Any contractor’s employee who is allergic to a component of a vaccine and/or have a history of a severe reaction to a vaccine is not required to receive that vaccine with documented proof of contraindication to the vaccination. The following are additional requirements for specific vaccine preventable diseases.

1. Measles:

a. Vaccinations with 2 doses of live measles or MMR vaccines administered at least 28 days apart,

b. Laboratory evidence of immunity,

c. Laboratory confirmation of disease, or

d. Birth before 1957.

2. Mumps:

a. Vaccinations with 2 doses of live mumps or MMR vaccines administered at least 28 days apart,

b. Laboratory evidence of immunity,

c. Laboratory confirmation of disease, or

d. Birth before 1957.

3. Rubella:

a. Vaccinations with 1 dose of live rubella or MMR vaccines administered at least 28 days apart,

b. Laboratory evidence of immunity,

c. Laboratory confirmation of disease, or

d. Birth before 1957

4. Hepatitis B:

a. Vaccinations with three doses of Hepatitis B vaccines, or

b. signed declination of Hepatitis B vaccination series.

5. Varicella:

a. Vaccinations with two doses of varicella at least 4 weeks apart,

b. Laboratory evidence of immunity or confirmation of disease,

c. Diagnosis or verification of history of varicella disease by a health care provider, or

d. Diagnosis or verification of a history of herpes zoster by a health care provider.

e. signed declination of Varicella vaccination series.

6. Influenza:

a. Vaccination with one dose of current annual influenza season vaccine.

b. Documented proof of the contraindication to the influenza vaccination as outlined by Advisory Committee on Immunization Practices recommendations, or

c. Written statement justifying religious exemption from influenza vaccination.

7. Pertussis:

a. Vaccination with one dose of Tdap vaccine.

b. Signed declination of Tdap vaccine

8. Any additional immunization in accordance with IHS Immunization Policy that is available upon request.

9. Tuberculosis:

a. The contract staff must have written documentation of TB test (TST or

IGRA) within the last 12 months.

b. If documented Positive TB test: Provide chest x-ray report of “No active

TB disease” following positive TB test.

c. Annual sign and symptoms screen:

i. If negative sign and symptom screen, follow up chest x-ray not indicated.

ii. If signs and symptoms screen positive, contract staff must have written documentation of chest x-ray and health care provider evaluation.

10. Credentialed provider contract staff must have documentation from the provider’s physician or chief of staff that confirms they do not have any health problems (including disability, emotional stability, drug, or alcohol dependency) that might impair his/her ability to care for patient at time of application.

11. Annual N95 Fit Testing

12. Note: Unvaccinated contract staff with an approved medical or religious exemption must wear an IHS-provided surgical or similar mask when working in patient care areas or other areas frequented by patients in an IHS facility during the influenza season.

iii. Criminal History Background Check:

1. Contractor’s employees whose duties and responsibilities involve regular contact or control over children are subject to a character investigation as required by Public Law 101-630, The Indian Child Protection and Family Violence Act. The minimum standards of character shall ensure that none of the individuals described in this order have been found guilty of, or entered a plea of nolo contendere or guilty to, any felonious offense, or any of two or more misdemeanor offenses, under federal, state, or tribal law involving crimes of violence; sexual assault, molestation, exploitation, contact or prostitution; crimes against persons; or offenses committed against children. These crimes do not hold a time statue and will be evaluated the same under any Child Care “CNACI” investigation with IHS. IHS will conduct these investigations following award of a contract. Until the character investigation has been completed and the Contracting Officer notified of the results, the Contractor’s employees must not have unsupervised contact with Indian children. Contractor’s employees are not able to work a scheduled shift until the security check is performed and clearance has been obtained by the appropriate agency. At a minimum, fingerprints are required, and upon clearance of this stage, a contractor’s employee may work a scheduled shift. However, Contractor’s employees are required to complete the detailed background application and the application is to be completed within 30 days once the contractor’s employee has been given physical and logical access.

All Contractors’ employees are subject to criminal background check prior to performing services in accordance with the contract terms and conditions. The contractor shall ensure that each of their employees complete the Certification of Criminal History and Background Check Packet.

iv. Required Training: As stated in IHM Circular 19-05; Contractor Training Plan for Implementation of Indian Health Manual Part 3, Chapter 20:

1. Protecting Children from Sexual Abuse by Health Care Providers

2. HHS Annual Emergency Preparedness Training

3. HHS Records Management

4. I-STAR training

5. Annual Ethics Training

6. ISSA Training

7. Cybersecurity Awareness Training

8. IHS Patient Safety

9. Trauma Informed Care and Historical Trauma

10. HIPAA/Privacy Training

11. IHS Unauthorized Commitments

12. IHS Reversing Opioid Overdose/Naloxone Training

13. Each provider must take this training within 30 days from their start date at the service unit. Certificate(s) should be provided to the COR. * This list may change as requirements change.

v. Subpoenas/Testimonies: Contractors are mandated to cooperate with the appropriate IHS managers when the contractors' employees are subpoenaed or requested by Tribal, State or Federal Parties to provide testimony as stated in Section 5-27.3(B)(9) of the Indian Health Manual.

vi. Challenges to Conflicts: For any inconsistency between COR and Contractor's employee, the employee should contact their agency. If this situation needs further remedies, then the Contractor will contact the COR

vii. When the Contractor demonstrates impaired judgement, they cannot continue working under the contract. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

H. Technical Monitoring

1) Performance of work under this contract must be subject to the technical direction of the COR identified above, or an Alternate COR designated in writing. The term "technical direction" includes, without limitation, direction to the Contractor that directs or redirects the labor effort.

Shifts the work between work areas or locations, fills in details and otherwise serves to ensure that task areas outlined in the SOW accomplished satisfactorily.

2) Technical direction must be within the scope of the specification(s)/work statement. The COR does not have authority to issue technical direction that

i. Constitutes a change of assignment or additional work outside the specification(s)/ statement of work;

ii. Constitutes a change as defined in the clause entitled "Changes;"

iii. In any manner causes an increase or decrease in the contract price, or the time required for contract performance;

iv. Changes any of the terms, conditions, or specification(s)/work statement of the contract;

v. Interferes with the Contractor's right to perform under the terms and conditions of the contract; or

vi. Directs, supervises or otherwise controls the actions of the Contractor's employees.

3) Technical direction may be oral or in writing. The COR shall confirm oral direction in writing within five workdays, with a copy to the Contracting Officer.

4) The Contractor shall proceed promptly with performance resulting from the technical direction issued by the COR. If, in the opinion of the Contractor, any direction of the COR, or his designee, falls within the limitations in (b), above, the Contractor shall immediately notify the CO no later than the beginning of the next Government work day.

5) Failure of the Contractor and the CO to agree that technical direction is within the scope of the contract shall be subject to the terms of the clause entitled "Disputes" (FAR 52.233-1, Disputes).

I. Meetings:

Initial meeting with COR I, Contracting Department, Safety Officer and Mashpee Service Unit Administration staff to review expectations, communication methods and future timelines.

1) Post-award Kickoff Meeting

i. Within 10 business days of contract award, the Government will conduct a post-award kickoff meeting via Microsoft Teams at the convenience of all parties.

2) Intermittent Project Status Reviews:

i. At the sole discretion of the Government, intermittent project status reviews may be conducted on an informal basis (by telephone or teleconference) or in person at Mashpee Service Unit on two weeks’ notice as approved by the Contracting Officer.

J. Contracting – General:

1) NAICS:

i. 621399 – Offices of All Other Health Practitioners

2) PSC:

i. Q503 – Medical - Dentistry

ii. Q517 – Medical – Pharmacy Services

3) Type of Solicitation:

i. Set Aside

1. 100% Indian Small Business Economic Enterprise / Indian Economic Enterprise

(ISBEE / IEE)

4) Type of Contract:

i. The government intends to award a firm fixed-price contract for PRN dental and pharmacist services on a base year contract with four option periods

5) List of Attachments:

i. IHS IEE Representation Form

6) Evaluation Basis:

i. Trade Off

7) Evaluation Factors:

i. See 52.212-2 in the section below

8) Insurance:

i. Minimum of $1,000,000.00 per person, per occurrence, and property damage respectively with $3,000,000.00 aggregate

CLAUSES INCORPORATED BY FULL TEXT:

Federal Acquisition Regulation (FAR):

52.212-2 Evaluation—Commercial Products and Commercial Services (OCT 2025).

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

1. Price

a. Includes hourly rates and any other fees by line item

2. Past Performance

a. Relevant performance of equivalent services provided within the last five years

3. Technical Capability

a. Based on the ability to meet the requirements in Section G above along with evidence of certifications required.

4. Subcontracting

a. If you plan on subcontracting portions of this requirement you will need to identify the subcontractor and amount of planned work to be subcontracted.

5. Proposal Factors

(b) Options (if applicable). The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. The evaluation of options does not obligate the Government to exercise the option(s).

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

52.217-8 Option to Extend Services (NOV 1999).

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 30 days.

52.217-9 Option to Extend the Term of the Contract (MAR 2000).

(a) The Government may extend the term of this contract by written notice to the Contractor within 30 days;

provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 30 days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed five years.

52.252-2 Clauses Incorporated by Reference (FEB 1998).

This contract incorporates one or more clauses by reference, with the same force and effect…