ATTACHMENT 1 - Statement of Work - Yakama Service Unit.pdf

Yakama Service Unit 24 Hour Nurse Advice Line Support Services

Statement of Work

I. Purpose of Contract:

This is a request for toll free telephone Nurse Advice line for patients who live on or near the Yakama Indian Reservation located in Central Washington. The contract is to exercise 1-year Base Year and four (4) 1-year Option Years.

II. Objective:

The objective is to decrease emergency room visits by all patients to help prioritize emergency services and providers time on critical patients that are brought in by ambulatory and/or family members. The patient toll free access to a Nurse Advice line and the Medical Library line has proven to decrease unnecessary ER visits. It directs patients to the appropriate care at the Yakama Indian Health Center (YIHC) (known as YIHC hereafter), or to emergent care if indicated.

Toll free access to both Nurse Advice line and Medical Library line has been well received by patients here and at other IHS facilities.

III. Period of Performance and Location:

Period of Performance will be as followed:

Base Year: September 01, 2025 – August 31, 2026 Option Year 1: September 01, 2026 – August 31, 2027 Option Year 2: September 01, 2027 – August 31, 2028 Option Year 3: September 01, 2028 – August 31, 2029 Option Year 4: September 01, 2029 – August 31, 2030

Yakama Indian Health Center 401 Buster Road Toppenish, WA 98948-9727

IV. Statement of Work

A. The Contractor shall provide toll free telephone access for Nurse Advice and Medical Library, on 24-hour /7-days per week to the Yakama Service Unit. All YIHC active beneficiaries will have access to the Contractor’s Service.

B. The Contractor has defined the term “Member”, as used in this agreement as, those members and their immediate family that are beneficiaries of the YIHC active user population.

C. The Contractor shall fax an encounter form within 24-hours to the YIHC staff, this fax to include all encounters. The fax shall include the caller’s name, date of birth, purpose of call and the advice provided to the patient from the Nurse Advice line.

D. The Contractor shall hold all information provided by YIHC and its members as confidential, and any and all information will not be distributed to any third party, especially medical information of the members. The Contractor will take all reasonable steps necessary to safeguard the privacy of member information.

E. The Contractor is not responsible for Acts of God, acts or omissions of YIHC or other actions beyond the control of the Contractor while performing services under this agreement.

F. The Contractor Nurse Triage process shall utilize specialized Nurse Triage process and shall utilize specialized Microsoft based software and interactive voice response technology to support the Schmitt/Thompson protocols in use at the Contractor’s call centers.

G. The Contractor shall utilize readily available, comprehensive protocols that reflect and extensive, high-quality physician written, reviewed, and updated medical knowledge base.

The guidelines shall provide consistent, accurate triage information, as well as home care and health education information, and they shall be updated continuously.

H. The Contractor shall utilize appropriated software to run established guidelines that the

Contractor utilizes so the call centers have access to state-of-the art triage supported software platform.

I. When patients in need of medical assistance call the designated Contractor’s Medical Call

Center, they will first hear a disclaimer stating that if they are experiencing an emergency, they should hang up and call 911 or their appropriate emergency number. Caller’s will then have the option of being connected to the audio health library, or speaking immediately with a Registered Nurse. If a caller chooses to speak with a nurse, the nurse will document and discuss the patient’s symptoms and recommend an appropriate course of action. These courses of action (dispositions) range from “home care procedures to seek emergency care”. Depending on the disposition, the Contractor’s nurses will place a follow-up phone call to assure that the caller’s condition has improved. The Contractor shall ensure that the Caller will never get a busy signal.

J. Indemnity – The Contractor shall indemnify and hold YICH harmless from any claim, demand, loss, lawsuit, settlement, judgment or other liability, and all related expenses, which may arise from a negligent act or omission of the Contractor, its agents or employees.

YIHC shall indemnify and hold the Contractor harmless for any claim, demand, loss, lawsuit, settlement, judgment or other liability, and all related expenses which may arise from or in connection with a claim of a third party arising from a negligent act or omission of YIHC, its agents or employees. Indemnity shall include damages, reasonable costs, reasonable expense, and reasonable attorney’s fees as incurred by the party indemnified. The forgoing indemnification provision shall survive the expiration or termination of this Agreement.

K. Contractor to ensure staff coverage is provided so no interruption in services happens when unexpected leave, scheduled leave, and/or vacations.

V. Indian Health Service Responsibilities:

A. To monitor the Contractor’s technical progress including surveillance and assessment of performance and the day-to-day contract administration, however, does not have authority to change orders or other otherwise authorize changes, which would affect the contract price, conditions, or period of performance.

B. Interpreting the Scope of Work.

C. Technical inspection and acceptance required by this contract.

D. Assisting the Contractor in the resolution of technical and administrative problems encountered during the performance.

VI. Qualifications:

− The Contractor shall be responsible for ensuring that all the nurses answering the advice line are licensed in accordance with regulations in the State or principal practice.

− The contractor will demonstrate culturally sensitive interactions appropriate to the care and interactions with our American Indian/Alaska Native population.

− The Contractor shall utilize U.S. State Licensed Registered Nurses during the performance of this contract.

VII. Project Officer/Contracting Officer Representative:

The following individual or their designee shall serve as the Project Office/Contracting Officer Representative/Supervisor Government Representative under this contract:

Ryan Pett, Pharm D MPH

Commander, United States Public Health Service

Program Management Officer (QI/RM/Credentialing)

Yakama Indian Health Center

401 Buster Road

Toppenish, WA 98948-9727

The Project Officer/Contracting Officer Representation/Supervisor’s responsibilities will be to coordinate wit the provider the technical aspects of this service and the review of performance hereunder. The Project Officer does not have the authority to change or alter the order amount, terms or conditions of the contract.

VIII. Payment Schedule:

A. The Contractor shall be paid a fixed monthly amount based on the current active user population** (as of 07/01/2023, the active YIHC user population is approximately 10,000).

This is an all-inclusive price that covers all related costs to provide services off-site. The contract price includes full compensation for providing all services off-site. For example, the contractor is responsible for applicable federal/state/local/sales and all other applicable taxes, etc.

B. Payment shall be made by Electronic Funds Transfer (EFT) method under this contract. The Electronic Payment Information is Mandatory.

C. The Government is obligated only to the extent of authorized purchases actually made and received under this agreement.

Invoicing:

Invoices shall be submitted to:

Portland Area Indian Health Service Division of Financial Management 1414 NW Northrup Street Suite 800 Portland, OR 97209-2790

POR_AODFMPayables@ihs.gov

Payment shall be made only for completed invoice submission. Payment will be made by Electronic Funds Transfer.

IX. Additional Terms & Conditions:

Federal Tort Claims Act.

Federal Tort Claims Act coverage for medical claims is extended to personal service contractors only when and incident or negligence is alleged to have occurred during delivery of services as provided by the contract in a facility, owned, operated, or constructed under the jurisdiction of the Indian Health Service, by the contract health care provider. Such tort claims coverage is extended to services provided within the scope of this contract.

Credentialing/Clinical Privileges

Contractor is to ensure all available staff providing services meet or maintain required qualifications, licensure, credentialing requirements or clinical privileges. If the Contractor fails to meet or maintain the contract required qualifications, licensure, credentialing requirements or clinical privileges for Yakama Service Unit. All stakeholders will communicate and provide necessary contracting actions.

mailto:POR_AODFMPayables@ihs.gov

Contractor Government Furnished Equipment and Facilities

The Yakama Indian Health Center does not anticipate a need for contactor furnished equipment.

HIPAA Requirement

Pursuant to the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and its implementing regulation, the Standards of Privacy of Individual Identifiable Health Information at 45 C.F.R. Part 160 and 164, Subpart A and E (“Privacy Rule”), the Indian Health Service is required to enter into an agreement with the Business Associate, pursuant to which the Business Associate shall comply with and appropriately safeguard Protected Health Information (“PHI”) that it will use and disclose when performing functions, activities or services (“Services”) for Indian Health Service. The Business Associate by signing the contract shall comply with the following terms in addition to other applicable contract terms and conditions relating to the safekeeping, use and disclosure of PHI. (See attachment G for related HIPAA material and Business Associate Agreement Clause).