Attachment 2 - Performance Work Statement.docx

PERFORMANCE WORK STATEMENT

24/7 Nurse Advice Line Services Indian Health Service - Portland Area Office - Western Oregon Service Unit RFQ No. 75H71326Q00035

1.0 GENERAL INFORMATION

The Indian Health Service, Western Oregon Service Unit, requires non-personal 24 hours per day, 7 days per week nurse advice line services for eligible beneficiaries and eligible immediate family members. Services shall be performed remotely using contractor-furnished staff, systems, telephony, clinical protocols, documentation tools, reporting tools, quality controls, and management oversight.

This is a performance-based acquisition. The Contractor is responsible for determining the methods, staffing model, systems, and internal quality controls necessary to meet the outcomes and performance standards stated in this Performance Work Statement.

1.1 BACKGROUND

Western Oregon Service Unit serves American Indian and Alaska Native beneficiaries. The required service must provide timely access to U.S. state-licensed Registered Nurses who use evidence-based triage protocols and clinical decision-support tools to assess caller concerns, provide nurse advice, and direct callers to the appropriate level of care. Services must be culturally respectful, beneficiary-centered, and compliant with applicable healthcare privacy and security requirements.

1.2 OBJECTIVE

The objective is to maintain uninterrupted access to a dedicated nurse advice line that supports timely clinical triage, appropriate care-seeking decisions, HIPAA-compliant encounter documentation, and monthly utilization reporting for program oversight.

1.3 PERIOD OF PERFORMANCE

Base Period: June 1, 2026 through May 31, 2027.

Option Period 1: June 1, 2027 through May 31, 2028.

Option Period 2: June 1, 2028 through May 31, 2029.

Option Period 3: June 1, 2029 through May 31, 2030.

Option Period 4: June 1, 2030 through May 31, 2031.

Exercise of any option period is at the Government discretion and is subject to the terms of the contract.

1.4 PLACE OF PERFORMANCE AND HOURS

Services shall be performed at contractor-controlled location(s). The Contractor shall provide coverage 24 hours per day, 7 days per week, 365 days per year, including weekends and Federal holidays. The service shall operate on Pacific Time for WOSU beneficiary support and reporting purposes.

1.5 ESTIMATED CALL VOLUME

The estimated call volume is 30 to 40 calls per month. This estimate is provided for planning, staffing, and pricing purposes only. It is not a representation, warranty, or guarantee of actual call volume. The Contractor shall maintain the capacity required to meet the performance standards in this PWS regardless of ordinary fluctuations in call volume.

1.6 NON-PERSONAL SERVICES

The services are non-personal services. Contractor personnel are not Government employees and shall not be subject to continuous Government supervision or control. The Contractor is solely responsible for personnel management, supervision, training, credential verification, scheduling, compensation, benefits, discipline, and quality control.

2.0 CONTRACTOR PERFORMANCE REQUIREMENTS

2.1 Dedicated Toll-Free Access

The Contractor shall establish, maintain, and operate a dedicated toll-free number for exclusive WOSU beneficiary use. The number shall be active, tested, and ready for beneficiary use by the service start date. The Contractor shall not change the dedicated number without prior written Government approval.

2.2 Continuous Nurse Advice Line Operations

The Contractor shall operate the nurse advice line continuously, including after hours, weekends, and Federal holidays. Calls shall be handled by qualified Registered Nurses using evidence-based clinical protocols. The Contractor shall maintain staffing, scheduling, backup coverage, and supervisory oversight sufficient to prevent service gaps, busy signals, or unreasonable delays.

2.3 Registered Nurse Staffing, Licensure, and Competency

All personnel providing clinical triage or nurse advice shall be Registered Nurses licensed in a U.S. state and in good standing. The Contractor shall verify and maintain documentation of licensure, disciplinary status, training, and competency. The Contractor shall provide licensure or credentialing documentation to the Government upon request and shall promptly remove from performance any personnel who do not meet applicable requirements.

2.4 Clinical Triage Protocols and Decision Support

The Contractor shall use current, evidence-based clinical triage protocols and clinical decision-support tools appropriate for telephone nurse advice line operations. Protocols shall support safe assessment, disposition, and referral for medical, dental, and behavioral health concerns. The Contractor shall maintain protocol version control and shall ensure clinical personnel are trained on protocol use and updates.

2.5 Medical, Dental, and Behavioral Health Call Support

The Contractor shall support calls involving medical, dental, and behavioral health concerns. The Contractor shall provide nurse triage, self-care guidance within RN scope of practice, referral guidance, follow-up guidance, and escalation when clinically indicated. For suspected emergencies or threats to life or safety, the Contractor shall direct callers to call 911 or emergency medical services and shall follow approved escalation procedures.

2.6 Encounter Documentation

The Contractor shall create an encounter record for each beneficiary call or interaction. Encounter documentation shall be complete, accurate, clinically appropriate, and transmitted to WOSU using a secure, HIPAA-compliant method within 24 hours after the encounter. The Contractor shall not transmit protected health information through unencrypted or unauthorized channels.

At a minimum, encounter documentation shall include date and time of call, caller or patient identifier if provided and authorized, contact information if available, chief concern, relevant symptoms or history, protocol or decision-support tool used, advice or disposition, recommended level of care, escalation actions, follow-up instructions, RN identifier, and call outcome.

2.7 Monthly Reporting

The Contractor shall provide monthly utilization and performance reports by the tenth calendar day after the end of each reporting month unless otherwise directed by the Contracting Officer. Reports shall be sufficiently detailed to allow WOSU to understand demand, caller needs, dispositions, trends, quality issues, complaints, incidents, service interruptions, and corrective actions. Reports shall not include unnecessary protected health information.

Monthly reports shall include, as applicable, total call volume, encounter count, call categories, medical/dental/behavioral health categories, disposition categories, average speed to answer if tracked, abandoned calls if tracked, service interruptions, documentation timeliness, complaints, incidents, quality issues, trends, and corrective actions.

2.8 Culturally Sensitive Service

The Contractor shall provide services in a respectful, culturally sensitive, and trauma-informed manner appropriate for American Indian and Alaska Native beneficiaries. Contractor personnel shall communicate clearly, avoid stigmatizing language, and tailor instructions to the caller understanding. The Contractor shall address complaints related to communication, disrespect, or cultural insensitivity and shall report corrective action information to the Government when requested.

2.9 Privacy, Security, and Business Associate Requirements

The Contractor shall protect protected health information and personally identifiable information in accordance with HIPAA, the Privacy Act, applicable contract clauses, any Business Associate Agreement required by the Government, and all other applicable privacy and security requirements. The Contractor shall use administrative, physical, and technical safeguards appropriate for the services. The Contractor shall ensure workforce members and subcontractors with access to protected health information are trained and bound by confidentiality obligations.

The Contractor shall notify the Contracting Officer and the Government contract administration points of contact immediately upon discovery of any actual or suspected privacy, security, patient-safety, or service-disruption incident affecting the services or Government data. Initial notice for urgent incidents shall occur as soon as practicable and no later than 1 hour after discovery. A written incident report shall be provided within 24 hours unless the contract, Business Associate Agreement, or Contracting Officer establishes a different timeframe.

2.10 Continuity of Operations

The Contractor shall maintain contingency procedures to sustain nurse advice line operations during staffing shortages, technology failures, telephony interruptions, natural disasters, cyber incidents, and other reasonably foreseeable disruptions. The Contractor shall notify the Government of any interruption or degradation affecting WOSU callers and shall provide status updates and corrective action information until normal service is restored.

2.11 Transition-In and Transition-Out

The Contractor shall coordinate transition-in activities so that the dedicated toll-free number, reporting process, escalation procedures, secure documentation transmission process, staffing plan, and quality controls are operational by the service start date. At contract end, termination, or transition to another provider, the Contractor shall cooperate with the Government to avoid service interruption, provide final reports, and return or securely dispose of Government data as directed.

3.0 DELIVERABLES

The Contractor shall provide the following deliverables:

- Implementation and Transition-In Plan. Due within 10 business days after award unless otherwise directed. The plan shall identify the project manager, toll-free number setup, go-live activities, reporting format, secure transmission method, escalation workflows, staffing approach, quality controls, privacy and security safeguards, and schedule.

- Dedicated Toll-Free Number Activation Confirmation. Due before the service start date. Confirmation shall show that the WOSU-exclusive toll-free number is active, tested, and ready for beneficiary use.

- RN Licensure and Staffing Certification. Due before service start and upon Government request thereafter. Certification shall confirm that RNs performing services hold current U.S. state licenses in good standing and are trained to perform the required services.

- Encounter Documentation. Due within 24 hours after each encounter, transmitted using a secure Government-approved method.

- Monthly Utilization and Performance Report. Due by the tenth calendar day after each reporting month unless otherwise directed.

- Incident Reports. Initial notification due as soon as practicable and no later than 1 hour after discovery for urgent incidents. Written report due within 24 hours unless otherwise directed.

- Transition-Out Support and Final Report. Due as directed before contract end or transition to another provider.

4.0 PERFORMANCE REQUIREMENTS SUMMARY

The Government may use the following standards for surveillance and acceptance:

- Dedicated toll-free access: Number active by service start date and available continuously. Acceptable performance is no unauthorized change to the number and no avoidable service interruption.

- 24/7/365 operations: Nurse advice line available continuously, including weekends and Federal holidays. Acceptable performance is no avoidable gap in coverage.

- RN staffing: All clinical advice provided by U.S. state-licensed RNs in good standing. Acceptable performance is 100 percent compliance for clinical calls.

- Clinical triage: Evidence-based protocols used for each applicable call. Acceptable performance is clinically appropriate documentation and disposition consistent with protocol and RN scope of practice.

- Encounter documentation: Secure documentation transmitted within 24 hours after each encounter. Acceptable performance is at least 95 percent timely submission and 100 percent secure transmission.

- Monthly reporting: Complete monthly report submitted by due date. Acceptable performance is report received on time and containing required utilization and performance information.

- Privacy and security: Protected information safeguarded at all times. Acceptable performance is no unauthorized use or disclosure and timely incident reporting if an incident occurs.

- Continuity of operations: Contingency procedures maintained and used when needed. Acceptable performance is prompt notification and corrective action for any service degradation or interruption.

5.0 QUALITY ASSURANCE SURVEILLANCE

The Government will monitor performance through review of deliverables, monthly utilization and performance reports, encounter documentation timeliness, complaints, incident reports, service availability information, and other reasonable surveillance methods. Government surveillance may include review of documentation for completeness and timeliness, verification of 24/7 availability, and review of corrective actions.

Government review, surveillance, inspection, or acceptance does not relieve the Contractor of responsibility for meeting contract requirements. The Contractor shall correct deficiencies at no additional cost to the Government when the deficiency is attributable to contractor performance.

6.0 GOVERNMENT RESPONSIBILITIES

The Government will provide information reasonably necessary for performance, subject to applicable privacy and security requirements. Government-furnished information may include points of contact, escalation contacts, approved referral or escalation procedures, secure transmission instructions, program-specific reporting requirements, and contract administration instructions after award.

The Government will not furnish contractor workspace, routine equipment, telephony infrastructure, nurse staffing, or contractor quality-control systems unless expressly stated in the contract.

7.0 INVOICING

The Contractor shall submit all invoices electronically through the U.S. Department of the Treasury Invoice Processing Platform (IPP) or successor system unless the Contracting Officer authorizes alternate procedures in writing. Invoices shall be submitted no more frequently than monthly unless otherwise stated in the contract. Invoices shall identify the contract number, period of performance covered, line item, amount billed, and any supporting information required by the contract or IPP.

Payment is subject to Government acceptance of services and compliance with applicable invoicing and payment clauses. Submission of an invoice through IPP does not constitute Government acceptance of nonconforming services.

8.0 CONTRACTOR PERSONNEL AND SUBCONTRACTORS

The Contractor shall remain fully responsible for performance by its employees, subcontractors, agents, and teaming partners. The Contractor shall ensure all subcontractors comply with applicable privacy, security, HIPAA, Business Associate Agreement, Buy Indian Act, and subcontracting limitation requirements. The Contractor shall not use a subcontractor in a manner that impairs compliance with the PWS, the contract, or applicable law.

9.0 ACCEPTANCE

Services and deliverables will be accepted when they conform to the PWS, contract terms, and applicable standards. The Government may reject nonconforming services or require correction, reperformance, or other appropriate contractual remedy.