Combined_Synopsis_RSU_CNM_Final.pdf

RFP: 75H70627R00005

Combined Synopsis 1

COMBINED SYNOPSIS/SOLICITATION

Request for Proposal (RFP) No. 75H70627R00005

Firm-Fixed-Price (FFP), Non-Personal Healthcare Services acquisition for Certified Nurse-Midwife (CNM) services equivalent to two (2) full-time CNMs supporting the Rosebud IHS Hospital Outpatient Department

Clinic and Emergency Department obstetric on-call requirement in Rosebud, South Dakota. The requirement consists of a three (3)-month base period and three (3) three-month option periods, for a total potential period of performance of twelve (12) months.

A. NOTICE TYPE

This combined synopsis/solicitation for commercial services is prepared using the format prescribed by FAR Subpart 12.6, as supplemented by the information contained herein.

This announcement constitutes the solicitation. Proposals are being requested, and a separate written solicitation will not be issued unless otherwise determined by the Contracting Officer.

B. CONTRACT AWARD

The Great Plains Area Indian Health Service (IHS) intends to award a Firm-Fixed-Price (FFP), Non-Personal Healthcare Services contract for Certified Nurse-Midwife (CNM) services equivalent to two (2) full-time CNMs to support the Rosebud IHS Hospital Outpatient Department (OPD) Clinic and Emergency Department (ED) obstetric on-call requirement in Rosebud, South Dakota.

This acquisition is being conducted in accordance with FAR Part 12, Acquisition of Commercial Products and Commercial Services.

The anticipated contract award will be made in response to Request for Proposal (RFP) No. 75H70627R00005.

The Contractor shall furnish all qualified CNM personnel, management, supervision, credentialing and privileging support, licensure and certification maintenance, professional liability insurance, and other Contractor-furnished resources necessary to perform the services described in the Performance Work Statement (PWS).

The Contractor shall perform as an independent contractor and shall retain responsibility for the supervision, direction, compensation, and management of Contractor personnel. Contractor personnel shall not be considered employees, agents, or representatives of IHS or the Federal Government.

C. SOLICITATION PROVISIONS AND CLAUSES

This solicitation incorporates applicable Federal Acquisition Regulation (FAR) and Health and Human Services Acquisition Regulation (HHSAR) provisions and clauses in effect as of the date of issuance.

Federal Acquisition Circular (FAC): 2026-01, effective March 13, 2026.

Acquisition-specific provisions and clauses shall be reviewed and incorporated by the Contracting Officer prior to release.

D. SET-ASIDE INFORMATION

This requirement is issued as an:

Indian Small Business Economic Enterprise (ISBEE) Set-Aside NAICS Code: 561320 - Temporary Help Services Size Standard: $34.0 million The Offeror shall meet all applicable ISBEE eligibility requirements at the time of proposal submission and award.

E. CONTRACT TYPE AND PRICING REQUIREMENTS

The anticipated contract type is:

Firm-Fixed-Price (FFP), Non-Personal Healthcare Services, priced by Month of Service (MOS).

Combined Synopsis 2

One (1) MOS represents complete performance of the required CNM services for one contract month, including qualified CNM staffing sufficient to support two (2) full-time CNM positions, scheduled outpatient clinic services, required obstetric emergency on-call availability, ED response/callback services when required, clinical documentation, care coordination, and all other PWS requirements.

The Contractor's firm-fixed monthly MOS price shall include all costs necessary to satisfy the contract requirements, including, but not limited to:

• CNM compensation and benefits;

• Recruitment and retention;

• Licensure, certification, credentialing, and privileging;

• Professional liability insurance;

• Administrative and management support;

• Mandatory training and quality-improvement participation;

• Travel, lodging, meals, and other contractor expenses not expressly Government-furnished;

• Overhead and profit; and

• Any other costs necessary to perform the PWS requirements.

The Government will not provide separate reimbursement for costs incurred by the Contractor in performing this requirement unless specifically authorized by the Contracting Officer.

The Contractor shall be responsible for managing staffing resources necessary to satisfy the Government's requirements, including recruitment, scheduling, continuity of coverage, and replacement of Contractor personnel when necessary.

The Government is acquiring complete monthly CNM healthcare services measured in Months of Service (MOS), rather than individual labor hours. Clinic activity, on-call coverage, ED responses, and related workload information may be tracked for scheduling, workload analysis, quality assurance, performance surveillance, and contract administration, but shall not serve as the basis for invoice payment.

F. PRICE SCHEDULE

Offerors shall propose a Firm-Fixed-Price (FFP) for each Month of Service (MOS) for the base period and each option period. The proposed monthly price shall include all personnel, management, supervision, credentialing, licensing, professional liability insurance, administrative support, and other resources necessary to satisfy the

PWS.

Unit of Issue: MOS - Month of Service

CLIN Description Unit Quantity Unit Price Extended Price

0001 Base Period - Certified Nurse-Midwife (CNM) Services equivalent to two (2) full-time CNMs MOS 3 $________ $________

1001 Option Period 1 - Certified Nurse-Midwife (CNM) Services equivalent to two (2) full-time CNMs MOS 3 $________ $________

2001 Option Period 2 - Certified Nurse-Midwife (CNM) Services equivalent to two (2) full-time CNMs MOS 3 $________ $________

3001 Option Period 3 - Certified Nurse-Midwife (CNM) Services equivalent to two (2) full-time CNMs MOS 3 $________ $________

Totals MOS 12 $________ $________

Total Evaluated Price (Base Period + All Option Periods): $____________________ Price Evaluation The Government will evaluate proposed pricing based on the Total Evaluated Price for the entire potential period of performance.

The Total Evaluated Price will be the sum of the extended FFP MOS amounts for the base period and all option periods. Each extended price will be calculated by multiplying the proposed firm-fixed monthly MOS price by the quantity of MOS for the applicable CLIN.

The Government will evaluate price fairness and reasonableness using one or more appropriate price-analysis techniques, which may include:

Combined Synopsis 3

• Comparison of proposed prices received from Offerors;

• Comparison with the Independent Government Cost Estimate (IGCE);

• Comparison with historical pricing information for similar healthcare staffing requirements; and/or

• Other appropriate price-analysis techniques in accordance with applicable FAR requirements.

The Government will consider the relationship between price and the technical benefits offered in determining the proposal that represents the best value to the Government.

Prices that appear unrealistically low may be evaluated to determine whether the Offeror understands the requirements and possesses the capability to successfully perform the contract.

G. DESCRIPTION OF REQUIREMENT

The purpose of this acquisition is to obtain Certified Nurse-Midwife (CNM) services equivalent to two (2) full-time CNMs to provide outpatient obstetric, gynecological, postpartum, family planning, and women's primary care services and to participate in obstetric emergency on-call coverage for the Rosebud IHS Hospital Emergency Department.

Services shall be performed primarily at Rosebud IHS Hospital, 800 Hospital Drive, Rosebud, South Dakota 57570.

Required CNM services include prenatal care; intrapartum care, as applicable to facility capabilities; postpartum care; gynecological and women's primary care; obstetric emergency evaluation and stabilization; clinical documentation; care coordination; communication; and quality-improvement activities, all within approved scope and privileges.

The Contractor shall furnish personnel who satisfy all PWS requirements for education, national certification, licensure, prescriptive authority, credentialing and privileging, background investigation, health requirements, and required life-support and neonatal-resuscitation certifications.

The Contractor shall provide appropriate staffing resources to maintain continuity of CNM healthcare services and shall be responsible for recruitment, scheduling, supervision, and management of Contractor personnel.

The Government is purchasing professional healthcare support services measured in Months of Service (MOS).

The Government is not purchasing individual labor hours or individual personnel.

H. PLACE OF PERFORMANCE AND PERIOD OF PERFORMANCE

Place of Performance Rosebud IHS Hospital, Outpatient Department Clinic and Emergency Department, 800 Hospital Drive, Rosebud, South Dakota 57570.

Period of Performance The anticipated period of performance is as follows:

• Base Period: Three (3) months

• Option Period 1: Three (3) months

• Option Period 2: Three (3) months

• Option Period 3: Three (3) months

• Maximum Potential Period of Performance: Twelve (12) months

Standard outpatient clinic hours are generally Monday through Friday, 8:00 a.m. to 5:00 p.m. The PWS also requires shared 24-hour-per-day, 7-day-per-week CNM on-call availability for obstetric emergencies during non-clinic hours. At least one CNM shall be designated as the primary on-call provider at all times. On-call coverage, ED responses, and service interruptions shall be tracked for workload and performance-surveillance purposes and shall not establish an hourly basis for payment.

I. INSTRUCTIONS TO OFFERORS

FAR 52.212-1, Instructions to Offerors - Commercial Products and Commercial Services, applies to this acquisition.

Offerors shall submit a complete proposal addressing all requirements contained within this solicitation and the Performance Work Statement (PWS). Proposals shall be submitted on company letterhead, signed and dated by an authorized representative, and shall include the following:

Combined Synopsis 4

Solicitation Information

• Solicitation number: 75H70627R00005.

• Offeror legal business name, address, telephone number, and email address of the point of contact.

• Unique Entity Identifier (UEI) and applicable SAM registration information.

Price Proposal

• Completed Government FFP Month-of-Service (MOS) Price Schedule for the base period and all option periods.

• Proposed pricing shall include all costs necessary to satisfy the applicable PWS requirements.

Technical Capability Information Offerors shall provide information demonstrating the ability to furnish qualified CNM personnel sufficient to support two (2) full-time CNM positions and satisfy the outpatient clinic and shared 24/7 obstetric on-call requirements, including:

• Ability to provide CNMs meeting applicable education, national certification, licensure, credentialing, privileging, and required certification requirements;

• CNM qualifications, education, training, certifications, and relevant clinical experience;

• Credentialing and privileging process and ability to support timely onboarding;

• Experience providing prenatal, postpartum, gynecological, women's health, and obstetric emergency services;

• Ability to support rural or underserved healthcare environments;

• Ability to maintain continuity of clinical services and provide qualified replacement personnel when necessary; and

• Experience supporting similar healthcare service requirements.

Management Approach Information Offerors shall provide a management approach addressing:

• Recruitment and retention capability;

• Availability of qualified CNM resources;

• Scheduling and shared on-call coverage procedures;

• Credentialing, privileging, and licensing management;

• Quality assurance procedures;

• Contractor oversight and supervision;

• Communication procedures with Government personnel;

• Continuity of operations planning; and

• Contingency plans for staffing interruptions.

Past Performance Information Offerors shall provide recent and relevant past performance information for CNM, OB/GYN, women's health, healthcare staffing, or comparable non-personal healthcare services, if available. Past performance information should include:

• Contract number;

• Customer/agency name;

• Description of services performed;

• Period of performance;

• Contract type and dollar value, if available;

• Point of contact information; and

• Any other relevant information demonstrating successful contract performance.

Required Representations and Certifications

• Completed representations and certifications from SAM.gov;

• Acknowledgment of solicitation amendments, if issued;

• A statement specifying the extent of agreement with all solicitation terms, conditions, and requirements; and

• Any additional information requested within this solicitation.

Failure to provide required information may result in the proposal being determined incomplete or excluded from consideration.

BASIS FOR AWARD

FAR 52.212-2, Evaluation - Commercial Products and Commercial Services

Combined Synopsis 5

The Government will evaluate proposals in accordance with FAR 52.212-2, Evaluation - Commercial Products and Commercial Services.

Award will be made to the responsible Offeror whose proposal conforms to the solicitation requirements and is determined to provide the best value to the Government, price and other factors considered.

The Government intends to evaluate proposals and make award without discussions. Offerors should therefore submit their best technical and price proposals initially. The Government reserves the right to conduct discussions, request clarifications, or seek additional information if determined necessary by the Contracting Officer.

The Government may reject any proposal that does not demonstrate an acceptable level of technical capability, compliance with solicitation requirements, or ability to successfully perform the required services.

Evaluation Factors The Government will evaluate proposals using the following factors:

• Technical Capability

• Past Performance

• Management Approach

• Price

Technical Capability, Past Performance, and Management Approach are non-price factors. When combined, the non-price factors are significantly more important than Price. The Government will consider the overall merits, strengths, weaknesses, deficiencies, and performance risks associated with each proposal in determining best value.

Technical Factor Rating Definitions

Rating Definition Outstanding Proposal greatly exceeds all minimum requirements of the criteria; demonstrates exceptional capability; has a high probability of successful performance; and contains no significant weaknesses or deficiencies.

Good Proposal exceeds all minimum requirements of the criteria; demonstrates above-average capability; has a strong probability of successful performance; and contains no significant weaknesses.

Acceptable Proposal meets all minimum requirements of the criteria; demonstrates adequate capability; has an acceptable probability of successful performance; and contains no significant weaknesses or deficiencies.

Marginal Proposal fails to adequately meet one or more requirements of the criteria; demonstrates limited capability;

has an uncertain probability of successful performance; and contains significant weaknesses or deficiencies.

Unacceptable Proposal fails to meet minimum requirements of the criteria; demonstrates inadequate capability; has a low probability of successful performance; and requires major revisions.

Factor 1 - Technical Capability The Government will evaluate the Offeror's ability and approach to furnish qualified CNM personnel and perform the services identified in the PWS. The Offeror shall demonstrate:

• Ability to provide qualified CNMs sufficient to support two (2) full-time CNM positions;

• Ability to meet applicable credentialing and privileging requirements;

• Ability to provide CNMs with appropriate education, training, licensure, national certification, experience, and required clinical qualifications;

• Experience providing prenatal, postpartum, gynecological, women's health, and obstetric emergency services;

• Ability to satisfy outpatient clinic and shared 24/7 obstetric on-call requirements;

• Ability to maintain continuity of services and provide qualified replacement personnel when necessary;

• Understanding of rural healthcare environments and/or Indian Health Service healthcare operations; and

• Ability to successfully perform all requirements identified in the PWS.

The Government will evaluate the Offeror's demonstrated capability, qualifications, proposed approach, and overall likelihood of successfully meeting contract requirements.

Factor 2 - Past Performance The Government will evaluate the Offeror's recent and relevant past performance. Relevant past performance may include CNM services, OB/GYN services, women's healthcare services, healthcare staffing, hospital-based clinical support services, non-personal healthcare service contracts, and/or similar healthcare staffing requirements.

Recent past performance is defined as contracts performed within three (3) years from the solicitation closing date.

Combined Synopsis 6

The Government may consider information obtained from CPARS, Government databases, references provided by the Offeror, Federal procurement records, and other available sources.

Offerors without recent and relevant past performance, or where past performance information is unavailable, may receive a neutral evaluation. A neutral evaluation will not be considered either favorable or unfavorable.

Factor 3 - Management Approach The Government will evaluate the Offeror's ability to manage contract performance and provide reliable CNM coverage. The Offeror shall address:

• Recruitment and retention capability;

• Availability of qualified CNM resources;

• Clinic and on-call scheduling and coverage management;

• Credentialing, privileging, and licensing management procedures;

• Quality assurance procedures;

• Contractor oversight and performance monitoring;

• Communication processes with Government personnel;

• Contractor management and supervision procedures; and

• Contingency plans for staffing shortages, provider availability issues, or unexpected service interruptions.

The Government will evaluate the Offeror's ability to provide effective management, maintain continuity of services, and reduce performance risk.

Factor 4 - Price The Government will evaluate the Total Evaluated Price for the entire potential period of performance, including the base period and all option periods.

The Government will evaluate price fairness and reasonableness using appropriate price-analysis techniques, which may include comparison of proposed prices received from Offerors, comparison with the IGCE, comparison with historical pricing information, market research information, and/or other appropriate price-analysis techniques in accordance with FAR requirements.

The Government will consider the relationship between price and technical capability in determining the proposal that represents the best value.

J. CONTRACT TERMS AND CONDITIONS

FAR 52.212-4, Contract Terms and Conditions - Commercial Products and Commercial Services, and other applicable FAR and HHSAR terms and conditions apply to this acquisition.

The Contractor shall comply with all applicable Federal, HHS, IHS, Rosebud IHS Hospital, medical staff, credentialing and privileging, privacy, security, patient-safety, and professional-practice requirements identified in the solicitation, PWS, and resulting contract.

K. ADDITIONAL FAR/HHSAR REQUIREMENTS

Applicable FAR and HHSAR provisions and clauses shall be selected and incorporated by the Contracting Officer based on the acquisition strategy, contract type, dollar value, period of performance, and nature of the healthcare services.

The PWS references, among other authorities, FAR 37.101 and 37.103, FAR 52.217-9, HIPAA requirements at 45 CFR Parts 160 and 164, the Indian Child Protection and Family Violence Prevention Act, and the Emergency Medical Treatment and Labor Act (EMTALA).

L. PROPOSAL SUBMISSION INFORMATION

Submit proposals electronically to:

Great Plains Area Indian Health Service Attn: CONTRACT SPECIALIST – David Jones Email: David.Jones@ihs.gov Questions Due: October 21, 2026 Proposals Due: November 6, 2026 12:00 pm

CT

Offerors must have:

Combined Synopsis 7

• A valid Unique Entity Identifier (UEI);

• A Taxpayer Identification Number (TIN); and

• An active registration in the System for Award Management (SAM.gov).

The proposal must provide complete, accurate, and current information required by this solicitation. Failure to submit required information may result in the proposal being determined incomplete or ineligible for award.

No contract award shall be made to any vendor listed on the HHS Office of Inspector General Exclusions List at the time of award.

Acceptance Period The Offeror agrees to hold its proposal, including all proposed prices, firm for acceptance by the Government through December 30, 2026.

Invoice Processing Platform (IPP) The Indian Health Service utilizes the Department of the Treasury's Invoice Processing Platform (IPP) for electronic submission and processing of payment requests.

Invoices submitted under any resulting contract shall be submitted electronically through IPP in accordance with applicable HHSAR requirements.

Contractors are encouraged to register for IPP prior to contract award if they have not already established an account.

If the Contractor believes use of IPP would be unduly burdensome, the Contractor shall include an explanation with its proposal for consideration by the Contracting Officer.

PWS | Page 1

PERFORMANCE WORK STATEMENT

Certified Nurse-Midwife (CNM) Services

Outpatient Department Clinic and Emergency Department OB Call

Issuing Agency: U.S. Department of Health and Human Services, Indian Health Service (IHS)

Area Office: Great Plains Area Indian Health Service

Facility: Rosebud IHS Hospital, Rosebud, South Dakota

Service Required: Certified Nurse-Midwife (CNM) - Two (2) Full-Time Equivalent Positions

OPM Series/Grade: GS-0610-11/12 (Nurse Midwife)

Contract Type: Firm-Fixed-Price (FFP), Month-of-Service (MOS), Non- Personal Services Contract (FAR 37.101)

Period of Performance: Twelve (12) months total: three (3)-month base period plus three (3) three-month option periods

Place of Performance: Rosebud IHS Hospital OPD Clinic and Emergency Department, Rosebud, South Dakota 57570

COR: Andrea Garrigan Date Prepared: March 2026

1. BACKGROUND AND PURPOSE

The Indian Health Service (IHS), an agency within the U.S. Department of Health and Human Services, provides Federal healthcare services to American Indians and Alaska Natives (AI/AN). Rosebud IHS Hospital is a 35-bed comprehensive medical and surgical facility located on the Rosebud Sioux Indian Reservation in Rosebud, South Dakota, and serves members of the Rosebud Sioux Tribe (Sicangu Oyate) and surrounding communities.

This PWS establishes the requirements for two (2) full-time Certified Nurse-Midwives (CNMs) to provide outpatient obstetric and gynecological services and to respond to obstetric emergencies in the Emergency Department on an on-call basis. The requirement is intended to support continuity of maternal and women’s healthcare services for the Rosebud service population.

2. PERIOD OF PERFORMANCE

The total potential period of performance is twelve (12) months, consisting of the following:

Base Period: Three (3) months

Option Period 1: Three (3) months

Option Period 2: Three (3) months

Option Period 3: Three (3) months

The Government may exercise each option period by written notice to the Contractor in accordance with FAR 52.217-9. Exercise of an option is contingent upon continued Government need, satisfactory Contractor performance, availability of funds, and Contracting Officer approval.

3. SCOPE OF WORK

The Contractor shall provide professional Certified Nurse-Midwife services consistent with the American College of Nurse-Midwives (ACNM) Core Competencies, IHS clinical policies, applicable South Dakota licensure requirements, and Rosebud IHS Hospital medical staff bylaws and credentialing standards. This is a non-personal services contract. The Contractor shall independently manage and supervise its personnel, while the

PWS | Page 2

Government retains the right to evaluate the quality, timeliness, and completeness of services against the performance standards established in this PWS.

Services shall be provided in the following primary settings:

Outpatient Department (OPD) Clinic - scheduled clinic sessions for prenatal, postpartum, gynecologic, and women's primary care services.

Emergency Department (ED) - on-call coverage for OB emergencies outside of scheduled clinic hours.

The Contractor's CNM personnel shall adhere to the clinical protocols, credentialing requirements, and collaborative practice framework established by the Rosebud IHS Hospital medical staff bylaws and credentialing committee. Such adherence reflects the professional standard of care and facility access requirements, and does not constitute employer-employee supervision by the Government.

4. SPECIFIC TASKS AND DELIVERABLES

4.1 Outpatient Clinic Services

Each assigned CNM shall provide the following services during scheduled OPD clinic hours, generally Monday through Friday consistent with facility operating hours and as otherwise required by the PWS:

4.1.1 Prenatal Care

Conduct initial prenatal intake examinations, including comprehensive health history and physical assessment.

Develop individualized prenatal care plans in accordance with ACOG and ACNM evidence-based guidelines.

Perform all routine prenatal visits: assessment of fetal growth, fundal height, fetal heart tones, blood pressure monitoring, and symptom review.

Order and interpret prenatal laboratory studies, including but not limited to: complete blood count (CBC), blood type and Rh factor, rubella titer, hepatitis B surface antigen, HIV, syphilis (RPR/VDRL), gonorrhea/chlamydia culture, Group B Streptococcus (GBS) screening, and gestational diabetes screening (one-hour glucose challenge/three-hour GTT as indicated).

Perform or coordinate obstetric ultrasound as clinically indicated (dating, anatomy survey, growth, biophysical profile).

Assess and manage common pregnancy complications including hyperemesis gravidarum, anemia, gestational hypertension, and preterm labor risk, with timely physician consultation or referral for conditions exceeding CNM scope of practice.

Screen for intimate partner violence (IPV), substance use, and perinatal mood and anxiety disorders (PMADs) utilizing validated screening tools; initiate appropriate referrals to behavioral health and social services.

Provide patient education on nutrition, exercise, fetal movement monitoring, labor preparation, breastfeeding, and postpartum expectations.

Facilitate and document referrals to maternal-fetal medicine (MFM) specialists, genetic counseling, or other specialty services as clinically indicated.

4.1.2 Intrapartum Care (as applicable to facility capabilities) Provide labor support, assessment, and management within the scope of CNM practice and within facility capabilities.

Assess maternal and fetal status, including interpretation of electronic fetal monitoring (EFM) strips.

Manage normal labor progress, including amniotomy, oxytocin augmentation per protocol, and pain management options.

Attend and manage normal vaginal deliveries, including repair of first- and second-degree lacerations and episiotomies per facility policy.

Perform immediate newborn assessment and resuscitation (NRP-certified) pending pediatric provider response.

Recognize and respond to obstetric emergencies (e.g., shoulder dystocia, postpartum hemorrhage, cord prolapse) and initiate physician consultation/transfer protocols immediately.

4.1.3 Postpartum Care

Conduct postpartum visits at approximately 2 weeks and 6 weeks following delivery (or per facility protocol).

Assess uterine involution, wound healing, breastfeeding status, and emotional well-being.

Screen for postpartum depression and anxiety using the Edinburgh Postnatal Depression Scale (EPDS) or equivalent validated tool; initiate referral as indicated.

PWS | Page 3

Counsel on contraception options and initiate family planning services during the postpartum period.

4.1.4 Gynecological and Women's Primary Care

Perform annual well-woman examinations including comprehensive physical assessment, clinical breast examination, and pelvic examination.

Collect cervical cytology specimens (Pap smears/liquid-based cytology) and manage results per current ASCCP guidelines.

Diagnose and treat common gynecological conditions including vaginitis, pelvic inflammatory disease (PID), sexually transmitted infections (STIs), dysmenorrhea, and abnormal uterine bleeding.

Provide full-scope family planning services including: oral contraceptive pills, injectable contraceptives (Depo- Provera), transdermal patch, vaginal ring, subdermal implant insertion/removal (Nexplanon), and intrauterine device (IUD) insertion/removal (hormonal and copper).

Perform preconception counseling, including folic acid supplementation, medication reconciliation, and management of chronic conditions prior to conception.

Provide health maintenance services including immunizations per ACIP guidelines, cancer screening coordination, and lifestyle counseling.

Manage menopause-related symptoms including hormone therapy counseling where clinically appropriate.

4.2 Emergency Department (ED) OB On-Call Services

Each assigned CNM shall participate in an on-call rotation to provide obstetric emergency coverage in the Rosebud IHS Hospital Emergency Department when the OPD clinic is not operational. On-call responsibilities shall be shared equitably between the two Contractor CNMs and any other credentialed CNM providers available at the facility.

While on call, the CNM shall:

Respond to the ED within a timeframe established by the facility, not to exceed 60 minutes from notification.

Evaluate and stabilize OB emergencies including but not limited to: antepartum hemorrhage, eclampsia/pre-eclampsia with severe features, preterm labor, premature rupture of membranes (PROM/PPROM), fetal distress, ectopic pregnancy, hyperemesis requiring IV management, and miscarriage (threatened, inevitable, incomplete, or complete).

Initiate emergency protocols, order laboratory and imaging studies, establish IV access, and administer medications within CNM scope of practice and applicable standing orders.

Immediately notify and collaborate with the on-call physician for any patient whose condition exceeds CNM scope of practice, requires operative intervention, or who meets criteria for emergent transfer.

Facilitate timely transfer to a higher level of care (e.g., Sioux Falls or Rapid City Monument Health Hospital) in accordance with EMTALA requirements and IHS transfer protocols.

Complete all required documentation in the electronic health record (EHR) in a timely manner.

4.3 Documentation and Health Records

Document all patient encounters, assessments, diagnoses, orders, and care plans in the Rosebud IHS Hospital electronic health record (EHR) system (Resource and Patient Management System [RPMS]/Electronic Health Record [EHR] module, or successor system) on the day of service.

Complete required IHS performance measure documentation, including Government Performance and Results Act (GPRA) clinical measures for maternal and child health.

Maintain accurate and legible medical records in compliance with IHS medical records standards, Joint Commission standards (if applicable), and applicable federal regulations.

Utilize CPT and ICD-10-CM coding accurately for all encounters to support billing and reporting requirements.

4.4 Coordination and Communication

Participate in scheduled multidisciplinary team meetings, case conferences, and departmental huddles.

Communicate effectively with supervising physicians, nursing staff, social workers, behavioral health providers, and other members of the patient care team.

Maintain collaborative practice relationships consistent with ACNM and ACOG joint practice guidelines.

Attend and complete all required IHS mandatory training (e.g., HIPAA, infection control, fire safety, workplace violence prevention) within established timelines.

PWS | Page 4

4.5 Quality Improvement

Participate in facility quality improvement (QI) initiatives, peer review, and morbidity and mortality (M&M) review processes related to obstetric and gynecological care.

Contribute to development and review of clinical protocols and standing orders relevant to CNM practice areas.

Monitor and support achievement of IHS GPRA clinical performance metrics pertaining to prenatal care, postpartum visit rates, family planning, STI screening, and cervical cancer screening.

5. MINIMUM QUALIFICATIONS AND PERSONNEL REQUIREMENTS

All CNM personnel assigned to perform services under this contract shall satisfy the following minimum qualification requirements throughout the period of performance:

5.1 Education

Graduation from a graduate-level nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME).

Possession of a Master of Science in Nursing (MSN) with a nurse-midwifery specialty, Master of Midwifery (MM), Doctor of Nursing Practice (DNP), or equivalent graduate or higher-level degree from an accredited institution, consistent with OPM GS-0610 qualification standards.

5.2 Certification

Current, valid national certification as a Certified Nurse-Midwife (CNM) issued by the American Midwifery Certification Board (AMCB). Certification must remain active and unencumbered throughout the period of performance.

5.3 Licensure

Current, valid, unrestricted licensure as a Registered Nurse (RN) and Advanced Practice Registered Nurse (APRN) in the State of South Dakota, or eligibility to obtain such licensure prior to commencement of services.

South Dakota APRN authorization to practice in the midwifery role.

Prescriptive authority consistent with South Dakota law; DEA registration (Schedule II-V) required.

5.4 Required Certifications and Competencies

Current Basic Life Support (BLS) certification - American Heart Association (AHA) or equivalent.

Current Neonatal Resuscitation Program (NRP) provider certification - American Academy of Pediatrics (AAP).

Current Advanced Cardiac Life Support (ACLS) certification - AHA (preferred; may be required by facility credentialing).

Completion of or willingness to complete training in: fetal heart rate monitoring interpretation (NICHD terminology), shoulder dystocia management, eclampsia management, postpartum hemorrhage (PPH) protocols, and maternal early warning systems (MEWS).

5.5 Experience

Consistent with OPM GS-0610 Nurse Midwife grade-level criteria:

GS-12 equivalent: At least one (1) year of professional nurse-midwifery clinical experience equivalent to the GS- 11 level, demonstrating progressive responsibility in prenatal, intrapartum, and postpartum care.

GS-13 equivalent: At least one (1) year of professional nurse-midwifery clinical experience equivalent to the GS- 12 level, including demonstrated competence in complex obstetric and gynecological case management, family planning procedures (IUD/implant insertion), and independent clinical decision-making.

Experience in federally qualified health centers (FQHCs), Indian Health Service facilities, or other rural or underserved community settings is strongly preferred.

Demonstrated familiarity with AI/AN health disparities, cultural competency in care delivery to Native American populations, and commitment to patient-centered, culturally respectful care.

5.6 IHS Credentialing and Privileging

All CNM Contractors shall complete and maintain IHS credentialing and privileging requirements prior to providing patient care, in accordance with IHS credentialing policy (IHS Manual Chapter 3-1.3).

Contractor shall cooperate fully with the Rosebud IHS Hospital credentials committee and provide all required documentation, including but not limited to: proof of education, AMCB certification, state licensure, malpractice insurance certificate, DEA registration, BLS/NRP/ACLS cards, and professional references.

PWS | Page 5

5.7 Background Investigation

Each CNM Contractor shall undergo a suitability/background investigation as required for federal healthcare workers providing direct patient care in IHS facilities, consistent with 45 CFR Part 5 and IHS policy.

Contractor shall not begin patient care services until a favorable preliminary background determination has been received.

5.8 Health Requirements

1. MMR (Measles, Mumps, Rubella):

EITHER: 2 documented MMR vaccines OR: Positive antibody titers for each (Measles, Mumps, and Rubella) OR: 2 separate live vaccines for Measles and Mumps, plus 1 Rubella vaccine

2. Varicella (Chickenpox):

EITHER: 2 documented varicella vaccines OR: A positive varicella antibody titer OR: Physician-documented diagnosis of previous infection

3. Tetanus, Diphtheria, and Pertussis (Tdap):

Documentation of a Tdap vaccine at some point in the past AND a tetanus-containing vaccine (Td or Tdap) within the last 10 years

4. Hepatitis B:

EITHER: 3 documented Hepatitis B vaccinations OR: A positive Hepatitis B surface antibody titer OR: A signed declination form if you choose not to receive the vaccine

5. Tuberculosis (TB):

EITHER: 2 negative TB skin tests (done within the last 12 months) OR: 1 negative IGRA blood test (done within the last 12 months) If you have a history of a positive TB test or IGRA:

Provide a chest X-ray report dated within the last 5 years Include dates of TB treatment, if applicable

6. Influenza (Flu) Vaccine:

Required annually If your start date is before October 31, the vaccine will be administered on site If your start date is after October 31, provide written proof of vaccination

7. COVID-19 Vaccination:

Documentation of COVID-19 vaccination is required

6. PLACE AND HOURS OF PERFORMANCE

6.1 Clinic Hours

Services shall be performed at the Rosebud IHS Hospital Outpatient Department Clinic, located at 800 Hospital Drive , Rosebud, SD 57570. Standard clinic hours are Monday through Friday, 8:00 AM - 5:00 PM, excluding federal holidays. The CD or designee shall establish specific daily clinic schedules in coordination with the Outpatient Clinic Director. Schedules may be adjusted by mutual written agreement to meet operational needs.

6.2 On-Call Coverage

CNM Contractors shall share on-call responsibility for OB emergency coverage in the Emergency Department during non-clinic hours. An on-call rotation schedule shall be developed collaboratively between the two CNM Contractors and the supervising CD or designee prior to the commencement of services and updated at least monthly. The on-call schedule shall ensure:

24/7 CNM on-call availability for OB emergencies, shared equitably between the two Contractors.

At minimum, one CNM Contractor shall be designated as the primary on-call provider at all times.

On-call coverage, ED responses, and service interruptions shall be tracked and reported to the COR monthly for workload and performance-surveillance purposes. Such reporting shall not establish an hourly basis for payment.

PWS | Page 6

6.3 Federal Holidays

CNM Contractors may be required to provide scheduled clinic services on federal holidays. On-call OB emergency coverage shall be maintained on all federal holidays as part of the on-call rotation.

7. GOVERNMENT-FURNISHED PROPERTY AND INFORMATION

The Government shall furnish the following property, information, and support at no additional cost to the Contractor:

Clinical workspace, examination rooms, and equipment within the OPD clinic adequate for CNM practice.

Access to the IHS electronic health record system (RPMS/EHR or successor) and related clinical information systems, including necessary training.

Laboratory services, diagnostic imaging, and pharmacy support consistent with Rosebud IHS Hospital capabilities.

Medical supplies, medications, and equipment available in the OPD clinic and ED for performance of patient care duties.

Access to IHS clinical policies, standing orders, clinical protocols, and applicable Indian Health Manual (IHM) chapters.

Office space, telephone, and secure computer access necessary to perform administrative and documentation functions.

Required IHS mandatory training materials and computer-based training (CBT) modules.

8. CONTRACTOR RESPONSIBILITIES

Provide CNM services in accordance with applicable professional standards of nurse-midwifery practice and the requirements of this PWS.

Maintain all required licenses, certifications, and AMCB certification in good standing throughout the period of performance and notify the COR immediately of any change, lapse, investigation, restriction, or adverse action affecting licensure or certification.

Maintain professional malpractice liability insurance at levels consistent with IHS policy and South Dakota requirements; provide certificate of insurance to the COR prior to commencement of services and upon renewal.

Adhere to all IHS policies, Rosebud IHS Hospital medical staff bylaws, clinical protocols, patient safety standards, HIPAA privacy and security requirements, and applicable federal regulations.

Maintain patient confidentiality at all times and comply with 45 CFR Parts 160 and 164 (HIPAA).

Report all adverse patient events, near-misses, and sentinel events through the IHS ISTAR Reporting System in accordance with facility policy.

Comply with the Indian Child Protection and Family Violence Prevention Act (25 U.S.C. § 3201 et seq.)

requirements, including mandatory reporting of child abuse and neglect.

Complete all required IHS mandatory training within timeframes specified by IHS.

9. CONTRACTOR MANAGEMENT AND NON-PERSONAL SERVICES

This is a non-personal services contract in accordance with FAR 37.101. The Contractor shall be solely responsible for managing, supervising, and directing its personnel. Government personnel shall not supervise or control Contractor personnel with respect to the manner of performance, work methods, or other employer-employee functions.

To preserve the non-personal nature of the services, the following requirements apply:

Government personnel shall communicate requirements and evaluate results through the Contracting Officer's Representative (COR), not through direct supervision of individual CNM personnel.

The Contractor shall designate a point of contact responsible for day-to-day coordination with the COR.

Scheduling of clinic sessions and on-call rotation shall be proposed by the Contractor and agreed upon in writing with the Clinical Director/Designee and COR in advance of each performance period.

Government employees shall not assign additional tasks to Contractor personnel outside the scope of this PWS.

Clinical consultation and collaboration with IHS physicians and other clinical staff, when required by clinical protocols, credentialing bylaws, or accepted standards of care, constitute professional practice requirements and do not create a personal-services relationship for purposes of FAR 37.104.

PWS | Page 7

10. MONTH-OF-SERVICE AND INVOICING REQUIREMENTS

10.1 Month-of-Service Standard

One (1) Month of Service (MOS) consists of complete performance for the applicable contract month, including provision of two (2) qualified and credentialed CNMs; scheduled outpatient clinic services; required obstetric emergency on-call availability; ED response/callback services when required; clinical documentation; care coordination; and all other PWS requirements. The Contractor shall manage staffing and other resources necessary to satisfy these requirements for the firm-fixed monthly price. Clinic, on-call, and ED response activity may be tracked for scheduling, workload analysis, quality assurance, and performance surveillance, but shall not serve as the basis for invoice payment.

10.2 Invoicing Requirements

Invoices shall be submitted monthly and shall identify the contract number, applicable CLIN, month of service, and firm-fixed monthly MOS amount billed. Unless otherwise specified in the resulting contract, invoices shall be submitted no later than the 10th calendar day following the billing month. Invoices may be submitted only for services satisfactorily performed and accepted by the Government. The Contractor shall not invoice based on actual labor hours, on-call hours, or ED callback hours unless specifically authorized by a written contract modification signed by the Contracting Officer. Payment shall be made in accordance with the applicable payment clauses and the Prompt Payment Act.

11. PERFORMANCE STANDARDS

Performance Objective Performance Standard Acceptable Quality Level (AQL)

Clinical Quality of Care CNM services provided in accordance with ACNM Core Competencies, evidence-based guidelines, and IHS clinical protocols.

Zero substantiated patient safety events attributable to CNM negligence or scope violation per quarter.

On-Call Response Time CNM responds to ED OB emergency calls within the timeframe established by facility policy.

95% of on-call responses meet established response time standard.

Documentation Timeliness All patient encounters documented in RPMS/EHR on the day of service.

98% of encounter notes completed within 24 hours of patient visit.

Licensure/Certification Currency All licenses, AMCB certification, BLS, NRP, and ACLS current and unencumbered.

100% compliance at all times. Immediate notification to COR upon any change.

Mandatory Training Compliance Completion of all required IHS mandatory training.

100% of assigned mandatory training completed within required timeframes.

GPRA Measures CNM services contribute to achievement of applicable IHS GPRA prenatal and women's health clinical measures.

Performance consistent with or exceeding IHS national GPRA targets.

Patient Satisfaction Patient satisfaction data (where collected) reflects professional, culturally respectful, and effective care delivery.

No sustained pattern of negative patient feedback attributable to CNM conduct.

12. CONTRACT VALUE AND UTILIZATION MONITORING

12.1 Monthly Contract Utilization Report

The Contractor shall submit a Monthly Contract Utilization Report to the Contracting Officer's Representative (COR) no later than the tenth (10th) calendar day following the close of each contract month. The report shall provide the Government with current information regarding contract utilization, invoicing status, remaining authorized contract value, and overall performance-period status.

Because this contract is structured as a Firm-Fixed-Price (FFP), Month-of-Service (MOS) acquisition, payment shall not be based on actual labor hours worked. Any clinic-hour, on-call, Emergency Department (ED) callback, or other labor-hour information maintained or reported by the Contractor shall be used solely for workload monitoring, performance surveillance, quality assurance, and contract administration and shall not serve as the basis for invoice payment.

The Monthly Contract Utilization Report shall include, at a minimum, the following information:

• Contract number and applicable Contract Line Item Number (CLIN).

• Applicable period of performance and Month of Service covered by the report.

• Firm-fixed monthly price for the applicable CLIN.

• Total authorized value for the applicable performance period.

• Amount invoiced for the current month.

PWS | Page 8

• Cumulative amount invoiced for the applicable performance period.

• Percentage of the authorized performance-period value invoiced to date.

• Remaining authorized contract value for the applicable performance period.

• Number of Months of Service completed and number of Months of Service remaining in the applicable performance period.

• Status of any pending, unpaid, rejected, or unsubmitted invoices.

• Any anticipated staffing, scheduling, credentialing, privileging, or performance issue that may affect continued performance.

• Any known or anticipated circumstance that may require Contracting Officer action.

Submission of the Monthly Contract Utilization Report does not authorize the Contractor to exceed the scope, value, or period of performance established by the contract. Only the Contracting Officer has authority to modify the contract or authorize changes affecting contract price, scope, or period of performance.

12.2 Sixty Percent (60%) Contract Value Threshold Notification The Contractor shall provide written notification to the COR and Contracting Officer when cumulative invoiced amounts for the applicable performance period reach, or are reasonably projected to reach, sixty percent (60%) of the authorized value for that performance period. The notification shall be submitted within five (5) calendar days after the Contractor determines that the threshold has been reached or is projected to be reached.

The sixty percent (60%) threshold notification shall include, at a minimum:

• Applicable contract number, CLIN, and performance period.

• Total authorized value of the applicable performance period.

• Cumulative amount invoiced and the percentage of authorized value invoiced.

• Remaining authorized contract value.

• Number of Months of Service completed and remaining.

• Status of pending or unpaid invoices.

• Any known circumstances that may affect completion of the remaining performance period.

• Any anticipated need for Government or Contracting Officer action.

Receipt of a threshold notification does not authorize additional work, an increase in contract value, an extension of the period of performance, or performance beyond the terms of the contract. The Contractor shall not perform services outside the scope or period of performance of the contract without a duly executed contract modification signed by the Contracting Officer.

12.3 Additional Contract Value Threshold Notifications

In addition to the sixty percent (60%) notification required by Section 12.2, the Contractor shall provide written notification to the COR and Contracting Officer when cumulative invoiced amounts reach, or are reasonably…