Consolidated_Performance_Work_Statement_Nurse_Triage.pdf

INDIAN HEALTH SERVICE | PERFORMANCE WORK STATEMENT

Nurse Telephone Triage Services | Page 1

PERFORMANCE WORK STATEMENT

NURSE TELEPHONE TRIAGE / NURSE ADVICE LINE SERVICES

Colorado River Service Unit (CRSU) | Elko Southern Band Health Center (ELKO) | Fort Yuma Service Unit (FYSU) | Fort Duchesne (U&O)

Consolidated Draft for Acquisition Review

1. INTRODUCTION AND BACKGROUND

The Indian Health Service (IHS) requires contractor-operated nurse telephone triage and advice line services to support eligible American Indian and Alaska Native beneficiaries served by CRSU, ELKO, FYSU, and U&O. The services support the facilities’ missions to promote physical, mental, social, and spiritual wellness and to provide beneficiaries timely access to clinical guidance when facility staff may not be immediately available.

The contractor shall provide Registered Nurse (RN) access using evidence-based, nationally recognized, physician-approved triage protocols. Based on clinical assessment, advice may range from home/self-care instructions and education regarding non-emergent appointments or prescription-renewal processes to direction to urgent or emergency care. The FYSU/U&O and CRSU/ELKO source documents also identify medical, dental, and behavioral health questions as within the advice-line context.

1.1 Service Locations and Estimated Call Volume

Location Estimated Volume / Source Planning Figure

CRSU 150-200 calls/month

ELKO 20 calls/month

FYSU No more than 25 calls/month; approximately 300 annually

U&O Approximately 1-10 calls/month

Estimated call volumes are planning estimates and do not guarantee a minimum quantity of calls unless established elsewhere in the solicitation/contract.

2. OBJECTIVE

The objective is to provide a continuously available, clinically sound, secure, culturally responsive, and measurable nurse triage service that directs beneficiaries to an appropriate level of care, supports patient safety, protects health information, and provides IHS with timely encounter documentation and management information.

3. SCOPE OF WORK

The contractor shall furnish all personnel, supervision, management, labor, materials, equipment, facilities, telecommunications, software, and services necessary to operate the Nurse Triage System (NTS), except for Government-furnished information specifically identified in this PWS. Service shall be available Monday through Sunday, 24 hours per day, 7 days per week, including weekends and federally recognized holidays.

• Provide a dedicated toll-free nurse advice line for the applicable IHS service locations.

• Provide toll-free access to a health information/audio medical library addressing common medical conditions and diseases, with RN assistance to access appropriate topics.

• Provide clinical assessment and disposition to an appropriate level of care for patients using the service.

• Provide technical, operational, administrative, and management support for contract performance.

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• Maintain call summaries and provide feedback to practices/providers, program management, and medical management as requested.

• Ensure callers do not receive a busy signal.

4. PERFORMANCE REQUIREMENTS

4.1 Call Intake and Clinical Triage

1. At call initiation, play an emergency disclaimer instructing callers experiencing an emergency to hang up and call 911 or the appropriate emergency number.

2. Provide callers the option to access the health information/audio library or speak with an RN.

3. When a caller elects RN assistance, document and discuss symptoms and recommend an appropriate course of action using nationally recognized, physician-approved, evidence-based clinical protocols and guidelines.

4. Use comprehensive, physician-written, reviewed, and updated medical knowledge-base guidance that supports consistent triage, home care, and health education information and is updated continuously.

5. Use specialized nurse triage processes and technology supporting Schmitt-Thompson protocols, as specified in the source requirements.

6. Collect applicable patient details, including name, date of birth, usual IHS facility, chart number, primary care physician, insurance, and tribal enrollment information. If the caller is not a member of a federally recognized tribe, advise that the service is limited to enrolled beneficiaries, consistent with the source requirements.

7. Place follow-up calls when indicated by the beneficiary’s disposition to determine or assure improvement in the caller’s condition.

4.2 Call Responsiveness

Performance Requirement Standard Initial call answering Average of 30 seconds, consistent with the URAC standard stated in the source documents.

Urgent calls Use protocols to determine urgency and transfer urgent calls directly to an RN.

Non-urgent RN response Preferably within an average of 30 minutes.

Call access No busy signal to callers.

4.3 Emergency and Urgent Care

• When the patient meets URAC criteria for emergency or urgent care referral, direct the patient to the closest appropriate emergency room or urgent care facility.

• When information is available, document the facility the patient plans to use.

• In a medical emergency, remain on the line until relieved by EMS or until a responsible individual assumes responsibility for the caller; alternatively, obtain pertinent information and notify EMS if the caller wishes the contractor to do so.

4.4 Privacy Message and IHS Disclaimer

Provide a 15-second pre-recorded message advising callers of privacy rights and including a disclaimer regarding IHS payment responsibility for health care advice. The applicable IHS facility will provide the script.

5. ACCOUNTABILITY, PRIVACY, SECURITY, AND RECORDS

5.1 Encounter Documentation

Within 24 hours of an encounter, provide the designated IHS recipients the caller name, date of birth, purpose of call, and advice provided. The contractor shall also capture personal data, assessment, documented resolution, and any further action needed from a Primary Care Provider in a database or spreadsheet application.

For CRSU, the 17 February 2026 source requires an encounter form to be faxed within 24 hours and daily call summaries to be faxed or emailed to CRSU Medical Records by the next business day. It identifies encrypted fax 1-928-669-3232. For FYSU/U&O and CRSU/ELKO, the later-formatted source requirements allow secure

Nurse Telephone Triage Services | Page 3 data transfer/SFTP or another Government-approved secure method, with encrypted fax as an alternate where specified. The Contracting Officer/COR shall identify the approved location-specific transmission method at award.

5.2 Privacy and Confidentiality

• Protect all beneficiary and IHS information as confidential and do not distribute it to unauthorized third parties.

• Comply with applicable privacy requirements and safeguard Protected Health Information (PHI). The source documents use the term “HIPPA”; this consolidated draft uses the standard acronym “HIPAA” without changing the intended privacy requirement.

• Use secure/encrypted transmission methods for PHI and limit recipients to authorized IHS personnel for the applicable location.

• Include the applicable confidentiality notice on fax cover sheets and/or secure email notifications, consistent with the source documents and Government direction.

• Ensure documented patient encounters conform to applicable HHS/OCIO records-management requirements.

5.3 Secure Electronic Transfer

Where electronic access or transfer is used, the method shall meet applicable IHS and Federal requirements identified in the source documents, including FedRAMP and “BPISA” requirements as written in the source. The Government shall approve the secure transfer method. If direct access cannot be provided, the contractor shall use an alternate secure method approved by the Contracting Officer or designee.

6. DELIVERABLES

Deliverable Content / Requirement Due / Frequency Recipient / Acceptance

Encounter record / call summary

Caller identification, purpose, assessment/advice, disposition, resolution/follow-up as applicable.

Within 24 hours;

daily summary/access as specified by location.

Designated IHS clinical/medical records personnel; secure method approved by Government.

Monthly status report

Comprehensive triage activity analysis including day of week, call time, response time, triage nurse identification, chief complaint, disposition, unusual circumstances, and trend/planning information.

No later than the 10th business day of each month.

Applicable IHS POC/COR.

Quality Control Plan Contractor QC program addressing clinical/peer review, protocol adherence, timeliness, documentation, disposition, caller satisfaction, and compliance with contract/URAC requirements.

Within 30 days after contract start.

Applicable IHS POC/COR for review/approval.

POC designation Primary and alternate contractor POC; identify times alternate serves as primary.

30 days prior to contract start, where practicable under award timing.

Contracting Office.

Credentials / licensing evidence

Current RN licenses, registrations, certifications, and required qualifications.

Prior to work performance and as renewed.

Government upon request / contract file.

Accessibility conformance documentation

VPAT/ACR or applicable HHS Section 508 checklist for ICT deliverables.

With applicable ICT deliverable / as required by solicitation.

Contracting Officer/COR.

7. QUALITY CONTROL AND PERFORMANCE STANDARDS

The contractor shall maintain a quality control program based on clinical and peer review. The program shall verify appropriate protocol use, timely response, complete documentation, appropriate disposition, documentation of intended compliance with advice, and customer satisfaction. New services shall not be introduced without prior recommendation to and approval by the Contracting Officer.

Measure Performance Requirement Standard Acceptable Quality Level

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Measure Performance Requirement Standard Acceptable Quality Level

1 - Key Personnel Provide required care services with qualified personnel available as needed.

Qualified personnel are available and properly positioned to perform required tasks.

100%

2 - Patient Safety Timely reporting of potential or actual patient risk-management incidents. All incidents reported within 24 hours. 100%

3 - Licensing / Registration / Certification

Provide updated licensing, registration, and certifications as renewed.

Licensing and registration information kept current.

99% of contractor provider records up to date

4 - Privacy / Confidentiality /

HIPAA

Comply with applicable privacy, confidentiality, policies, procedures, and standards.

Zero breaches of privacy or confidentiality. 100%

5 - Call Answering Answer calls promptly. Average answer time of 30 seconds. Measured monthly 6 - Non-Urgent RN Response Provide RN response to non-urgent calls. Preferably within an average of 30 minutes. Measured monthly 7 - Monthly Reporting Submit complete monthly status report. By 10th business day of each month. 100% on time

7.1 Complaints

Forward complaints to the applicable IHS Point of Contact for action and/or rectification.

8. CONTRACTOR PERSONNEL AND QUALIFICATIONS

• Minimum education: Associate degree-prepared Registered Nurse.

• Use U.S. state-licensed Registered Nurses during contract performance.

• RNs shall be licensed in the state in which the nurse triage service is physically located and otherwise licensed in accordance with regulations governing the state of principal practice.

• Maintain copies of credentials before work performance and keep licensing/registration information current.

• Personnel shall have a minimum of three years of nurse triage experience.

• Maintain URAC accreditation by the American Accreditation Healthcare Commission during contract performance, as required by the source documents.

• Provide cultural sensitivity training specific to American Indian/Alaska Native people using training/information provided by the applicable IHS POC.

• Provide a primary and alternate contractor POC. The POC shall be available by telephone and/or email/pager, as applicable, 24 hours per day, 7 days per week.

9. GOVERNMENT-FURNISHED INFORMATION / RESPONSIBILITIES

• Provide the applicable privacy/payment-responsibility prerecorded message script.

• Provide lists of local urgent care facilities and emergency rooms, including telephone numbers and hours of operation, for use in referrals.

• Provide cultural sensitivity training content or direction specific to American Indian/Alaska Native people.

• Provide at least 30 days’ notice, when practicable, of planned health center closures during normal business hours.

• Designate authorized recipients and approve secure transmission/access methods for encounter data and

PHI.

10. SECTION 508 / ICT ACCESSIBILITY

All Information and Communication Technology (ICT) deliverables under the contract, including websites, applications, electronic documents, and multimedia, shall comply with the Revised Section 508 Standards (36 CFR Part 1194) and WCAG 2.1 Level AA, as stated in the CRSU/ELKO source document. The contractor shall provide conformance documentation using a VPAT/Accessibility Conformance Report (ACR) or applicable HHS Section 508 Accessibility Checklists and shall remediate identified accessibility issues at no additional cost. The source document identifies HHSAR 352.239-73 and 352.239-74 for inclusion by the Contracting Officer.

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11. PERFORMANCE CONDITIONS

• This is a non-personal services requirement as defined in FAR 37.101; the contractor is an independent contractor.

• The contractor shall perform independently of Government supervision except for administrative guidance and contract oversight.

• No employer-employee relationship exists between Government personnel and contractor personnel.

• The Government may evaluate the quality of services but does not control the manner in which contractor personnel render the services.

• No services under this PWS may be subcontracted or transferred to another contractor or organization without prior written approval of the Contracting Officer.

12. PRICING / PAYMENT BASIS

The FYSU/U&O and CRSU/ELKO source documents specify a fixed per-call rate and state that the unit price is payment in full for services, inclusive of holiday, weeknight, weekend, taxes, and associated service costs, with initial fees clearly identified in the rate schedule. They also prohibit billing or collection from IHS patients or alternate resources unless directed by IHS. The CRSU 17 February 2026 source does not state this pricing structure. The Contracting Officer should confirm whether the fixed per-call structure applies to the consolidated acquisition.

13. PERIOD OF PERFORMANCE

Location Period of Performance Preserved from Source Acquisition Review Note

CRSU 10 March 2026 through 9 September 2026 (six months).

Later CRSU-specific document dated 17 February 2026 conflicts with the earlier 14 January 2026 CRSU/ELKO base-plus-options term; later CRSU-specific term used in this draft.

ELKO

One 12-month base period plus four 12-month option periods, commencing from award.

Options subject to written exercise/approval, continuing need, satisfactory performance, and availability of funds.

FYSU

One 12-month base period plus four 12-month option periods, commencing from award.

Same option conditions stated in source.

U&O One 12-month base period plus four 12-month option periods, commencing from award.

Same option conditions stated in source.

14. SOURCE TERMS REQUIRING CONTRACTING OFFICER / LEGAL REVIEW

The source documents contain indemnification language and force-majeure/“Acts of God” language. Because these provisions concern contract risk allocation rather than performance outcomes, they are not rewritten as performance standards in this PWS. The Contracting Officer and legal counsel should determine whether and how those provisions are included in the solicitation/contract.

15. ACCEPTANCE AND SURVEILLANCE

The Government will assess contractor performance using deliverable timeliness/completeness, monthly call statistics, quality-control results, incident reporting, licensing/credential currency, privacy/confidentiality performance, call responsiveness, and other measures in Section 7. Government review does not constitute direct supervision of contractor personnel.

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16. Contracting Officer Authority I. No person other than the Contracting Officer has authority to bind the Government with respect to this contract.

II. No action or omission of any government employee or representative other than the Contracting Officer shall increase or decrease the scope of this contract or shall otherwise modify the terms and conditions of this contract.

III. In no event shall any of the following be effective or binding on the Government or imputed to the Contracting Officer with respect to this contract:

a. An understanding or agreement between the Contractor and anyone other than the Contracting Officer;

b. A purported modification or change order issued by anyone other than the Contracting Officer;

c. A promise by anyone other than Contracting Officer to provide additional funding or make payments; or

d. An order, direction, consent, or permission from anyone other than the Contracting Officer to:

i. Incur cost in excess of a specified estimated cost, allotment of funds, or other ceiling; or

ii. Expend hours in excess of a specified level of effort.

APPENDIX A - CONSOLIDATION / TRACEABILITY SUMMARY

Requirement Area CRSU 17 Feb 2026 FYSU/U&O 27 Jan 2026 CRSU/ELKO 14 Jan 2026 24/7 toll-free RN triage Yes Yes Yes Health information library Yes Yes Yes 30-sec average answer Yes Yes Yes Non-urgent RN response ~30 min Yes Yes Yes Monthly report by 10th business day Yes Yes Yes QC plan within 30 days Yes Yes Yes URAC accreditation Yes Yes Yes

Secure encounter transfer Encrypted fax emphasized

Secure transfer/SFTP; fax alternate

Secure transfer;

Government-approved alternate

QASP table No Yes Yes Section 508 / WCAG 2.1 AA No No Yes Pricing fixed per call Not stated Yes Yes POP 6 months Base + 4 options Base + 4 options