CRHC-24-032 SOLICITATION.pdf

A. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice, FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994) (Public Law 103-355) & FAR 37.4, Non- Personal Health Care Services Contract (10 U.S.C. 2304 and 41 U.S.C 253). This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued.

B. The Indian Health Service/Cheyenne River Health Center intends to award a Firm Fixed-Price, Non-Personal Service Contract to provide ENT (Ears, Nose, & Throat) Services for the Medical Department at the Cheyenne River Health Center located in Eagle Butte, South Dakota. All orders may be submitted via email to Danielle.chasinghawk@ihs.gov This solicitation is being issued under solicitation number CRHC-24-032.

C. The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2024-03 dated 02/23/24.

D. This is an Unrestricted Set-Aside and the associated NAICS code is 621111 Offices of Physicians (except Mental Health Specialist), with a Small Business Size Standard of $16.0 Million, Product Service Code is Q514 Otolaryngology Services.

E. The unit pricing must be all inclusive (to include but not limited to travel, lodging, per diem, fringe benefits, federal, state, and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.

See Attached Pricing/Cost Schedule.

F. Description of Services: Include, continuous ENT Services, required by the attached Performance Work Statement, for the Cheyenne River Health Center, Eagle Butte, South Dakota.

The period of performance will include one base year, plus the option to exercise four-1 year option years. Delivery and acceptance terms for this order are with the PWS. POP:

Base Year: 05/01/2024 – 04/30/2025, OY1: 05/01/2025 – 04/30/2026, OY2: 05/01/2026 –04/30/2027, OY3: 05/01/2027 – 04/30/2028, and OY4: 05/01/2028 – 04/30/2029.

G. The provision at 52.212-1, Instructions to Offerors – Commercial Products and

Commercial Services (Sept 2023), applies to this acquisition. Quotes shall be submitted on company letterhead stationery, signed and dated; it shall include, at a minimum;

a. Solicitation number CRHC-24-032

b. Closing Date: April 15, 2024 at 1:00pm MST

c. Name, address, telephone number of the offeror and email address of the contact person

d. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements in the solicitation.

e. Terms of any express warranty

f. Price and any discount terms

g. “Remit to” address, if different than mailing address mailto:Danielle.chasinghawk@ihs.gov http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm#P1579_222340

h. A completed copy of the representations and certifications at FAR 52.212-3

i. Acknowledgement of Solicitation Amendments, if issued

j. A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offers that fail to furnish required representation or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

Quotes shall also include the following to be considered acceptable.

1. Price/Cost Schedule.

2. Proof of Malpractice Insurance Coverage.

3. Certify they understand and can meet all requirements listed in this Solicitation, Performance Work Statement and Attachments.

4. Candidate information, to include: Resume, current/up-to-date licenses & certifications as requested in the PWS, completed Background clearance forms attached to this solicitation, proof of Mandatory Employee Health Records Requirements as spelled out in the PWS, and guarantee report date.

“Basis of award is Lowest Price, Technically Acceptable “LPTA” bid package. All of the above is required in order to be considered technically acceptable.”

The clause at 52.212-2, Evaluation-Commercial Products and Commercial Services (Nov 2021) applies to this acquisition. See attachment for Full Text

H. Offerors must include a completed copy of the provision at 52.212-3, Offeror Representations and Certifications – Commercial Products and Commercial Services (Feb 2024), with its offer. The offeror shall complete only paragraphs (b) of the provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site located at http://www.sam.gov

I. The clause at 52.212-4, Contract Terms and Conditions—Commercial

Products and Commercial Services (Nov 2023), applies to this acquisition. See attachment for Full Text.

J. The clause at 52.212-5, Contract Terms and Conditions Required To Implement Statutes or Executive Orders (Feb 2024) – See attachment for Full Text.

K. Attached are the Federal Acquisition Regulations (FAR) & Health and Human Services Acquisition Regulation (HHSAR) clauses that are applicable.

L. Submit proposal to:

Cheyenne River Health Center Attn: Danielle Chasing Hawk, Supervisory Contract Specialist 24276 166th Street, Airport Road, PO Box 1012 Eagle Butte, S.D. 57625 Email: Danielle.chasinghawk@ihs.gov https://www.acquisition.gov/content/part-52-solicitation-provisions-and-contract-clauses#i1060530 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm#P1657_236576 http://www.sam.gov/ http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm#P1974_281919 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm#P2174_322700 mailto:Danielle.chasinghawk@ihs.gov

Questions in reference to this solicitation shall be submitted to the email address listed above. The last day to submit questions is March 29, 2024 at 1:00pm MST. No questions will be answered after this date/time. Please be advised that the Government reserves the right to transmit those questions and answers of a common interest to all prospective vendors through a solicitation amendment.

SECURITY CLEARANCE

A security pre-clearance must be performed for any employees referred to IHS through this contract.

Fingerprints must be completed and adjudicated prior to services being performed under this contract.

No contract award shall be made to any vendor or provider listed on the OIG Exclusion List http://exclusions.oig.hhs.gov throughout the duration of the contract. It shall be the responsibility of the contractor to notify the acquisition official if there is a change in provider.

Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S. facilities or systems each person must complete a FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System. Contractors shall allow five business days for I.H.S. processing of fingerprints taken electronically at an I.H.S. site and thirty business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE), http://exclusions.oig.hhs.gov. As soon as practicable prior to the start of work, the performance of the work the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

The Contractor is responsible for conducting security preclearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the LEIE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access. If this is a Time and Materials, Labor-Hour or Cost Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access or the excess time required to resolve and clear unfavorable security clearance findings. If this is a Fixed Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

Government will pay for the cost to process the contractors suitability clearances. However, multiple investigations for the same position may, at the Contracting Officers discretion, lead to reduction(s) in the contract price of no more than the cost of the extra investigation(s).

Employees that DO NOT have access to LMS, contractors, volunteers, or IHS employees with IPA’s or MOA’s to tribal organizations please, click here IHS Sexual Abuse Prevention website. When the http://exclusions.oig.hhs.gov/ http://exclusions.oig.hhs.gov/ https://www.ihs.gov/sexualabuseprevention/training/ contractors have completed and passed the training, please have them send a copy of the last page of the training with Name, Date, and Time to their Supervisor, COR, and Kimmen LeBeau, e-mail:

Kimmen.LeBeau@ihs.govInvoice Processing Platform (IPP) The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system

In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum “Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing” directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award resulting from this solicitation will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232- 71, Electronic Submission and Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL).

Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register-however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

Invoice Processing Platform (IPP) The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system.

In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum “Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing” directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award resulting from this solicitation will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL).

Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register-however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973- 3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov

“Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer”.

mailto:Kimmen.LeBeau@ihs.gov https://obamawhitehouse.archives.gov/sites/default/files/omb/memoranda/2015/m-15-19.pdf https://www.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasury.gov

Request for Proposals CRHC-24-032 ENT Services

SERVICES AND PRICES/COSTS

(Fixed-Price, Services, Commercial Items)

Firm Fixed Price, Non-Personal Services contract, to provide ENT Services, for the Cheyenne River Health Center, located in Eagle Butte, South Dakota. The Period of Performance will be from Date of Award through One(1) Year, with Four-One(1)Year option periods.

1. BASE YEAR: 05/01/2024 – 05/30/2025

Item No

Descript of Service Estimated Qty

Unit Unit Price Total Amount

1. ENT Specialty Clinic Services

192 HRS $ $

TOTAL Base Year: $

1. OPTION YEAR ONE (1): 05/01/2025 – 04/30/2026

Descript of Service Estimated Qty

Unit Unit Price Total Amount

1. ENT Specialty Clinic Services

1. OPTION YEAR TWO (2): 05/01/2026 – 04/30/2027

Descript of Service Estimated Qty

Unit Unit Price Total Amount

1. ENT Specialty Clinic Services

2. OPTION YEAR THREE (3): 05/01/2027 – 04/30/2028

Descript of Service Estimated Qty

Unit Unit Price Total Amount

1. ENT Specialty Clinic Services

192 HRS $ $

1. OPTION YEAR FOUR (4): 05/01/2028 – 04/30/2029

Descript of Service Estimated Qty

Unit Unit Price Total Amount

1. ENT Specialty Clinic Services

Request for Proposals CRHC-24-032 ENT Services

2. AGGREGRATED TOTALS

TOTALS

1. Base Year (05/01/2024 – 04/30/2025) $

2. Option Year One (05/01/2025 – 04/30/2026) $

3. Option Year Two (05/01/2026 – 04/30/2027) $

4. Option Year Three (05/01/2027 – 04/30/2028) $

5. Option Year Four (05/01/2028 – 04/30/2029) $

AGGREGRATED TOTAL FOR ALL FIVE

YEARS:

PERFORMANCE WORK STATEMENT

Cheyenne River Health Center (CRHC)

Ear, Nose, and Throat (ENT) Physician

General

This performance based work statement describes the requirements for non-personal services for ENT to support the mission of the Indian Health Service (IHS)/Cheyenne River Health Center (CRHC).

The mission of the Cheyenne River Indian Health Service Hospital in Eagle Butte, South Dakota is to provide the best possible health care services to Cheyenne River Reservation in South Dakota.

Background

The Indian Health Service (IHS) an agency within the Department of Health & Human Services is responsible for providing federal health services to American Indians and Alaska Natives. The Indian Health Service provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 567 federally recognized tribes, in 35 states. The Indian Health Service Headquarters is located in Rockville, MD and then divided into twelve physical areas: Alaska, Albuquerque, Bemidji, Billings, California, Great Plains, Nashville, Navajo, Oklahoma, Phoenix, Portland and Tucson.

The Great Plains Area Office (GPAO) works in conjunction with its 19 Indian Health Service Units and Tribal Managed Service Units to provide health care to approximately 122,000 Native American located in North Dakota, South Dakota, Nebraska, and Iowa. The Area Office’s service units include seven hospitals, eight health centers, and several smaller health stations and satellite clinics.

Our facility, the Cheyenne River Health Center (CRHC), falls under the GPAO. Cheyenne River Health Center (CRHC) provides medical care for approximately 9,000 tribal members living on the CRST Reservation. Serving a rural area, many of our patients travel 100 miles’ round trip to receive care. The CRHC was built in 2011 to provide an expanded level of health care services specifically designed to meet the needs of the CRHC population. Services include: Emergency Room Department, Pharmacy, Physical Therapy, Public Health Nursing, Radiology Services, Inpatient Care, Laboratory, MRI, Dental, Community Health, Contract Health Services, Dietitians, Audiology, Eye Care, Inpatient, and Specialist Clinics: OB/GYN, ENT, and Podiatry. The Cheyenne River Sioux Tribe through a 638 contract with IHS, operates four satellite health stations which offer basic ambulatory services at Cherry Creek, Red Scaffold, Swiftbird, and Whitehorse communities.

Objective

To provide ENT services 2 days per month as needed in support of the monthly ENT clinics during the term of the contract.

Period of Performance

May 1, 2024 through April 30, 2029. Base year, to include 4 option years.

Base Year: May 1, 2024 through April 30, 2025 Option Year One: May 1, 2025 through April 30, 2026 Option Year Two: May 1, 2026 through April 30, 2027 Option Year Three: May 1, 2027 through April 30, 2028 Option Year Four: May 1, 2028 through April 30, 2029

Work Schedule

Provide 2 days of ENT consultation per month, scheduling of which will be determined by the Clinical Director.

Place of Performance

ENT Department 24276 166th Street Airport Road Eagle Butte, South Dakota 57625

DESCRIPTION OF SERVICES: The contractor shall provide ENT services required for the Cheyenne River Indian Health Service Hospital.

This contract is a non-personal health care services contract, as defined at Far Part 37.101 under which the Contractor is an independent contractor and which shall allow the Government to evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of the services rendered, (e.g., professional judgements, diagnosis for specific medical treatment). The Contractor shall indemnify the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance. The Contractor shall maintain medical liability insurance, in the coverage amount acceptable to the Contracting Officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned.

Upon the receipt of an IHS purchase order, the Contractor shall locate, credential, and have available sufficient staffing to provide ENT coverage for the ENT Department.

The standards of medical practice and duties of the Contractor through its physicians shall be determined pursuant to Governing Body bylaws, medial staff bylaws, rules and regulations of the appropriated IHS hospital, applicable provisions of law including but not limited to rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals, and standards and recommendations of CMS (Centers for Medicare and Medicaid Services) compliance. The Contract ENT Physician shall be required to participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

CONTRACTOR RESPONSIBILITY

Perform individual ENT examinations using the operating microscope nashopharyngeal and laryngeal mirrors, nasal speculum, head mirror, fiber-optic flexible endoscope, curettes, alligator forceps, suction.

Utilizes audiometric and tympanometric data performed by the contract ENT Physician.

Provide Allergy Testing and follow up.

Provide examination, diagnosis, and follow-up and recommend treatment plans as part of the patient assessment.

Perform routine clinical procedures as part of the clinical examination, such as the following listed below:

• Cautery and paper patch of small tympanic membrane perforations;

• Microscopic ear examinations

• Removal of cerumen

• Removal of foreign bodies of ear and nose

• Microscopic cleaning of mastoid cavities

• Flexible nasophyngoscopy-laryngoscopy

Instruct and counsel patients, parents, and/or family members regarding the diagnosis, treatment, and surgical management of ENT disorders.

Provides ENT coverage in the event of any post-op complications.

The provision of comprehensive direct patient care services and serves as a referral source non-surgical management of patients with ENT disorders.

The ENT Physician consultant provides phone consultation services to assure proper management of patients presenting at Cheyenne River Service Unit ENT with complications and emergencies.

Improve the coordination of care between ENT and ENT patients. Improve the quality of care for ENT patients.

As requested, meet with Family and/or Pediatric providers who provide medical care.

Regular and routine consultation with CRSU and Family Practitioner.

Review of care provided to ENT patients.

Establishes inter-personal and intra-departmental relationships to enhance optimal patient care.

Ensures a safe work environment and employee safe work habits.

Demonstrates competent and effective oral and written communication.

Computer efficiency required. Preferred 5 years of Electronic Health Record experience.

Maintain certification in Basic Life Support (BLS) or CPR.

Quarterly meetings with the CRSU Clinical Director if needed.

The ENT Physician shall locate, credential, and have available sufficient staffing to provide professional ENT services on a regular schedule to the Cheyenne River Health Center. Will also provide credentialing information of nursing staff that he/she provides to assist them.

The ENT consultant physician will be responsible for all travel and other personal expenses.

The ENT Physician must abide by the Cheyenne River Health Center Bylaws, Rules, and Regulations and Clinical Duties.

REFERRALS AND CONSUSLTS. The ENT Physician shall follow IHS Purchased Referred Care regulations and policies when arranging for a referral or consult. The ENT Physician shall be required to consult with other specialty practitioners for consultative opinions and continuation of care. The ENT Physician shall inform patients of the required referral or consult by indicating the specialty involved.

CONTRACTOR TIMESHEETS. The ENT Physician will be responsible for obtaining Medical Records (HIM) signature prior to Clinical Director or representative signature for the completion of their timesheet. Invoices submitted without the signed timesheet including Medical Records (HIM) and Clinical Director signatures will not be paid.

PROCEDURE GUIDANCE. Contractor ENT Physician shall perform procedures compatible with the medical facility’s operating capacity and equipment.

PRIVACY OF INDIVIDUALLY IDENTIFABLE HEALTH INFORMATION. The Contract health care providers shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity. The Contractor shall ensure strict compliance to the release of Protected Health Information in accordance with the Code of Federal Regulation, Title 45, Public Welfare, Subtitle A, Department of Health and Human Services, Part 164, Security and Privacy (45 CFR 164) and AFI 41-210, “Patient Administration Functions” paragraph 2.2.3, “Health Insurance Portability and Accountability Act (HIPAA)” and paragraph 2.3, “General Guidelines on Releasing Medical Information”.

COMMUNICATIONS. The Contractor shall ensure contract ENT Physicians maintain open and professional communication with members of the Medical Staff. Complaints validated by the Hospital Accreditation Specialist and Clinical Director or shall be reported in writing to the Contracting Officer (CO) and the Contractor for action.

ENGLISH LANGUAGE REQUIREMENT. The Contract ENT Physician shall read, understand, speak and write English fluently.

DOCUMENTATIONS. Contractor personnel shall prepare all documentation to meet or exceed established CMS standards and Cheyenne River IHS Medical Staff Bylaws.

AVAILABILITY:

HOURS OF OPERATION: 2 days per month (8 hours per day).

CONTINUITY OF SERVICES/REPLACEMENT STAFF. The Contractor point of contact shall ensure qualified personnel are available to provide coverage at all times.

PERFORMANCE OF SERVICES DURING CRISIS DECLARED BY THE NATIONAL COMMAND AUTHORITY. On occasion, services may be required to support an activation or exercise of contingency plan outside the normal duty hours. Emergency situations (i.e. accident and rescue operations, civil disturbances, natural disasters) may necessitate the contractor provide increased or reduced with the contractor for the cost of these emergency requirements.

RECORDS. The contractor shall document all patient encounters legibly in the patient medical record. All documentation shall be timed and dated. Verbal orders are to be used as infrequently as possible. In the event of a major disaster or code all verbal orders are to be signed off immediately following the code or disaster. All Medical Records must be signed by the ENT Physician and charge ticket completed at the end of the visit. All Medical Records are to be completed within 24 hours of the ENT Physicians scheduled shift. All documentation shall meet the current CMS guidelines.

Final payment will be withheld until all medical records are completed by the contract ENT Physician.

PERSONNEL REQUIREMENTS

CONTINUING MEDICAL EDUCATION (CME) / CERTIFIED EDUCATION UNITS (CEU) REQUIREMENTS.

Maintain CME and review pertinent journals, books and publications. Health care providers registered or certified by the national/medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentials office for tracking by the Clinical Director.

LICENSURE/REGISTRATION. Contractor must maintain a current active and unrestricted license in at least one of the 50 United States or US territories.

CERTIFICATION. Board certified in field of specialty is favorable.

FORMAL EDUCATION. The ENT Physician must possess an ASHA accredited graduate degree from an accredited American College or University.

EXPERIENCE. The ENT Physician must have a minimum of 5 years of experience within ENT to include fellow and residency time within the past 36 months prior to ENT Physician beginning performance at Cheyenne River Health Center.

PERFORMANCE-BASED SERVICE DELIVERY SUMMARY. The contractor’s performance will be measured based on the following Performance Requirements. The Performance Requirements will be measured against

Government Performance Standards and monitored in accordance with the following Methods of Government Surveillance or what is known as a Quality Assurance Surveillance Plan (QASP) to determine compliance. A 5% deduction will be assigned to each Performance Requirements not met. Deductions shall be assessed against individual invoices when services are not performed or do not meet contract requirements. Deductions will be done by the category that was deficient.

Performance Standards

Performance Task/Requirement

Indicator Standard/(AQL) Acceptable Quality

Level

Surveillance (QA) Quality Assurance

Incentive

Completion of documentation of patient record

All patient records must be documented accurately, correctly, and completely within 24 hours of patient visit

100% Random observation and HIM Report

5% deduction from weekly invoice.

Deductions will increase by 1% in subsequent months.

Prompt and continuous coverage

Agency must provide a competent Mid- Level to ensure no gaps in coverage.

100% Provider Schedule For every shift not covered by Agency, the shift rate will be deducted from next submitted invoice

Credentialing Agency is allowed 3 business to submit required credentialing documentation

100% Credential Report 5% deduction from weekly invoice.

Deductions will increase by 1% in subsequent months.

Performance Evaluation. If the contractor fails to perform required services at the acceptable quality level, payment may be withheld until the contractor makes corrections. In the event that the contractor fails to perform any required services, the COR will provide written notice of such to the Contracting Specialist and CCO and the contractor. The Contracting Office will issue the contractor a Contract Discrepancy Report (CDR). The contractor shall have seven

(7) calendar days to provide the Contracting Office with their response to the CDR. Upon evaluation of the contractor’s response to the CDR for tasks surveilled, the contractor’s payment for the month in which the performance is question occurred will be calculated as outlined above.

Contractor Payment. If the contractor fails to perform required services at the acceptable quality level, payment may be withheld until contractor makes corrections.

Contracting Officer’s Representative Designation

The Contracting Officer Representative (COR) designated for this Project is:

COR: Stephanie Red Elk 24276 166th Street, Airport Road

Eagle Butte, SD 57625 Office: 605-964-7724 Fax: 605-964-0522

The COR is responsible for:

a. Monitoring the Contractor’s technical progress;

b. Interpreting the statement of work;

c. Technical evaluation as required;

d. Technical inspections and acceptance required by this contract; and,

e. Assisting the Contractor in the resolution of technical problems encountered during performance of this contract.

The contractor shall be paid a fixed flat rate of per hour. No differential pay for government holidays, compensation time, and night differential. Holidays and weekends shall be included as part of the work period and considered regular hours.

Quality Assurance Surveillance Plan (QASP). The purpose of the QASP is to provide a government developed system to assure the use of quality assurance methods in the administration of the performance based acquisition standards. The intent is to ensure that the Contractor performs services for the Cheyenne River Health Center that are provided in accordance with performance requirements set forth in the contract documents, that the government receives the quality of services called for in the contract and that the government only pays for the acceptable level of services received.

The plan provides the basis for the COR to evaluate the quality of the contractor’s performance. The oversight provided for in the contract and in this plan will help ensure that service levels reach and maintain the required levels throughout the contract term. Further, this plan provides the COR with a proactive way to avoid unacceptable or deficient performance and provides verifiable input for the required past performance evaluations.

GOVERNMENT FURNISHED PROPERTY AND SERVICES.

EQUIPMENT. Contract providers shall have joint use of all available equipment for performing services required by this contract.

PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish the contract provider(s) with appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE.

This does not include any type of uniform or laboratory coat.

IDENTIFICAITON CREDENTIALS. The Cheyenne River Health Center will provide each contract provider with the required identification card.

FORMS. The Cheyenne River Health Center will provide required Government forms used in the performance of services.

SUPPLIES. The Cheyenne River Health Center will provide medical and non-medical supplies commonly used in the facility for the care and management of patients and the performance of the requirements of this contract.

HOUSING. Contractor shall be responsible for all applicable Federal, State, and Local Taxes, Meals, Travel/Transportation, lodging, and per diem.

Government Housing: Lodging is available in government housing at prevailing rates, if available, and must be paid by the contractor. There are limited furnished units available for contract employees and prevailing rates range from Single -$34.72 daily, Shared $16.58 daily and Trailer Pads - $8.00 daily (Rates are subject to change).

Local Hotel: Cheyenne River Motel (605) 964-8888.

SERVICES

ORIENTATION. The Contractor shall ensure that all new contract providers participate in the Cheyenne River Health Center Facility Orientation with an overlap of services to include one additional day. Providers must arrive on a Monday-Friday excluding holiday and participate in the orientation, which must be completed in the Monday- Friday timeframe, prior to providing services at the hospital.

Administrative Support. Cheyenne River Health Center will provide normal office administrative support services, to include telephone and utilities.

Patient Scheduling. Facility personnel will assist in patient scheduling. Complete administrative control of the patient shall remain with the facility.

CONTRACTOR FURNISHED ITEMS AND SERVICES

GENERAL. Except for those items or services specifically stated above to be Government furnished, the Contractor shall furnish everything required to perform this contract in accordance with all of its terms.

CONTRACTOR OWNED EQUIPMENT. The provider will provide his/her own stethoscope.

INITIAL INSPECTION. Contractor owned equipment will be inspected and approved by the biomedical equipment maintenance section prior to use in the facility.

Staff: Contractor must provide appropriately licensed/trained nursing staff to assist with patient care.

GENERAL INFORMATION

PERSONNEL.

POINT OF CONTACT. The Contractor shall provide a point of contact who shall be responsible for the performance of the work. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The Contractor shall designate this individual, in writing, to the Contracting Officer before the contract start date. An alternate may be designated, but the Contract shall identify those times when the alternate shall be the primary point of contact.

CRIMINAL BACKGROUND INVESTIGATION. The Government will conduct at government expense, a state criminal history check on individuals providing direct, unsupervised child care services under this contract. As a minimum, the Contractor shall contact the Cheyenne River Health Center Contracting Officer for obtaining all necessary forms and directions for filing background check information in writing and electronically on personnel hired at the beginning of the contract. This action shall take place no later than five (5) working days from contract award date. Contractor shall submit completed personnel background check applications within Five (5) business days after award date to the Contracting Officers for processing. Contractor personnel will be required to be fingerprinted. Requests for personnel hired subsequent to the contact start date shall be submitted to the Government no later than five (5) working days from the employee’s first duty day. Contractor shall provide a list of substitute contract personnel fulfilling contingency situations (i.e. absences of certificated contact personnel). Names of substitutes and credentials shall be provided 15 calendar days in advance to accomplish background checks.

Contractor personnel receiving an unfavorable background check shall not be employed. Cheyenne River Health Center may employ an individual pending completion of successful background checks.

Background checks will be based on fingerprints of individual obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureau of Investigation (FBI) and state criminal history repositories.

Individuals shall have the right to obtain a copy of any background check pertaining to themselves and to challenge the accuracy and completeness of the information contained in the report.

CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of HHS (Health and Human Services), unless such a person seeks and receives approval in accordance with the Department of HHS.

APPEARANCE. Employees are expected to comply with reasonable dress, grooming and hygiene standards based on comfort, productivity, health and type of position occupied. Employee attire will be in good repair, and should not be considered offensive, disruptive or unsafe.

Contract providers shall display their identification badge on their outer clothing.

PROTECTIVE CLOTHING. When required and supplied by the Government, the provider shall wear special protective clothing and shoe covers. When duties will be performed in specified areas, a disposable protective hood shall be worn to ensure infection control standards are met. The Government will provide this hood. These items shall remain the property of the Government and shall not be removed from the facility. After use, protective clothing shall be turned in or destroyed as directed by the Infection Control Policy.

PRIVILEGING REQUIREMENTS. The contract providers’ credentials shall be reviewed by the Credentialing Specialist and the Credentialing Committee. The Contractor is responsible for ensuring that proposed providers possess the requisite credentials to enable granting of privileges by the Cheyenne River Health Center Medical Staff sufficient to allow for performance of al tasks identified. Medical Services cannot be performed by a contract ENT Physician until professional staff membership and the Great Plains Indian Health Service Governing Body has granted clinical privileges in writing.

Initial applications for clinical privileges, to include credentials action history, malpractice history, and certified true copies of the documents listed below, shall be submitted to the Cheyenne River Health Center Credentialing Committee, through the Credentialing Specialist, no later than 3 calendar days after receipt of notice of contract award.

a. Copy of valid, current unrestricted state license and applicable Board Certification. (Submission of required with proposal).

b. Possess a ASHA accredited graduate degree from an accredited American College or University.

c. Documentation of continuing education and training.

d. Current Basic Life Support (BLS) or CPR. (Submission required with proposal).

e. A signed consent for release of information.

f. A list of all states in which contract ENT Physician currently holds or has held a license to practice related services.

g. A current copy of the proposed contract ENT Physician professional resume.

h. Certification of current physical examination. The certification shall have a statement signed by the examining physician stating that the employee is free of any contagious diseases. The physical examination shall be current as of 12 months prior to application for privileges.

Applications for privileges will be screened through the National Practitioners Data Bank.

Re-appointment shall occur no less than every two years, in accordance with Cheyenne River Health Center Medical Bylaws.

DENIAL/TERMINATION OF PRIVILEGES. Actions to limit, suspend, or revoke clinical privileges will be in accordance with the procedures outlined in the Medical Staff Bylaws. The Clinical Director, will notify the Contracting Officer, and provide copies of pertinent documentation, as soon as possible when the necessity to exercise such authority becomes apparent. The Contracting Officer will notify the Contractor of the initiation of the revocation process if such action becomes apparent.

REVIEW OF CREDENTIALS PACKAGES. The Government reserves the right to limit the number of credentialing packages it will evaluate.

HEALTH REQUIREMENTS

The contract ENT Physician shall provide proof of current immunizations (Hep B, MMR, Varicella, Tdap, Flu) status and a current TST within the past year.

EMERGENCY HEALTH CARE. Cheyenne River Health Center will provide emergency health care for the contract ENT Physician for injuries incurred while on duty in the facility. These services will be billed to the Contractor at the current full reimbursement rate.

MEDICAL QUALITY IMPROVEMENT/RISK MANAGMENET (QI/RM).

The contract ENT Physician (s) shall participate in QI/RM activities to the extent required by Section 2C, AFI 44-119 and the individual Cheyenne River Health Center QI/RM plan or regulation.

The Government will evaluate the ENT Physician’s professional, as differentiated from administrative, performance under this contract using Quality Improvement standards specified in paragraphs 2.1 and 2.2. Nothing in this paragraph precludes the Government from also conducting inspections under the Inspection/Acceptance requirement of FAR clause 52.212-4.

PERFORMACE EVALUATION

The Cheyenne River Health Center will evaluate the contractors’ performance under this contract. Evaluations will be provided to the contactor, in writing. These evaluations may be used by as a record of contract performance history for the purpose of evaluation in other competitive or non-competitive acquisitions.

FREEDOM OF INFORMATION ACT (FOIA) PROGRAM. All FOIA request shall be delivered immediately to the Medical Records Supervisor.

PHYSICAL ACCESS. The Contractor shall return identification badge to the IT Department and house keys to the Housing Officer, upon completion/termination of the contract.

Physical Security. The contractor shall safeguard all government property, including controlled forms provided for contractor use. At the close of each work period, government equipment, facilities, and other valuable materials shall be secured.

Weapons, Firearms, And Ammunition. Contractor employees are prohibited from possessing weapons, firearms, or ammunition, on themselves or within their contractor-owned vehicle or privately-owned vehicle while on the Cheyenne River IHS compound.

Reporting Requirements. Contractor personnel shall report to an appropriate authority any information or circumstances of which they are aware may pose a threat to the security of IHS personnel, contractor personnel or patients.

The contractor shall prohibit their use of keys, issued by the government, by any persons other than the contractor’s employees and the opening of locked areas by contractor employees to permit entrance of person other than contractor employees engaged in performed of contract work requirement in those areas.

Contract Clauses (Fixed-Price, Non-Personal Healthcare Services, Commercial Items)

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

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

https://www.acquisition.gov/browse/index/far

(End of clause)

FAR Citation Clause Title Clause Date

NO. FAR

CITATION

FAR CLAUSE CLAUSE

DATE

01 52.202-1 Definitions June 2020 02 52.203-3 Gratuities April 1984 03 52.203-12 Limitations on Payments to Influence Certain Federal

Transactions June 2020

04 52.203-17 Contractor Employee Whistleblower Rights and Requirements to Inform Employees of Whistleblower Rights

November 2023

05 52.204-7 System for Award Management October 2018 06 52.204-9 Personal Identity Verification of Contractor Personnel January 2011 07 52.204-13 System for Award Management October 2018 08 52.204-16 Commercial & Government Entity Code Reporting August 2020 09 52.204-17 Ownership or Control of Offeror August 2020 10 52.204-18 Commercial & Government Entity Code Maintenance August 2020 11 52.204-19 Incorporation by Reference of Representations and

Certifications December 2014

12 52.212-1 Instructions to Offerors, Commercial Products and Commercial Services

September 2023

13 52.212-4 Contract Terms & Conditions-Commercial Products & Commercial Services

November 2023

14 52.217-5 Evaluation of Options July 1990 15 52.217-8 Option to Extend Services November 1999 16 52.219-1 Small Business Program Representations February 2024 17 52.222-54 Employment Eligibility Verification May 2022 18 52.224-1 Privacy Act Notification April 1984 19 52.224-2 Privacy Act April 1984 20 52.225-25 Prohibition on Contracting With Entities Engaging in Certain

Activities or Transactions Relating to Iran—Representation & Certifications.

June 2020

21 52.232-39 Unenforceability of Unauthorized Obligations June 2013 22 52.232-40 Providing Accelerated Payments to Small Business

Subcontractors March 2023

23 52.233-2 Service of Protest September 2006 24 52.237-1 Site Visit April 1984 25 52.237-2 Protection of Government Buildings, Equipment, &

Vegetation April 1984 https://www.acquisition.gov/browse/index/far

26 52.237-7 Indemnification and Medical Liability Insurance January 1997 27 52.242-13 Bankruptcy July 1995 28 52.253-1 Computer Generated Forms January 1991

II. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses in Full Text

FAR Citation Clause Title Clause Date

NO. FAR

CITATION

CLAUSE TITLE CLAUSE

DATE

52.204-24

Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment

November 2021

02 52.209-5 Certification Regarding Responsibility Matters August 2020 03 52.209-7 Information Regarding Responsibility Matters August 2020 04 52.212-2 Evaluation – Commercial Products & Commercial Services November 2021 05 52.212-3 Offeror Representation & Certifications – Commercial

Products and Commercial Services February 2024

06 52.212-5 Contract Terms & Conditions Required to Implement Statues or Executive Orders – Commercial Products and Commercial Services

February 2024

07 52.217-9 Option to Extend the Term of the Contract March 2020 08 52.232-19 Availability of Funds for the Next Fiscal Year April 1984

52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO

SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

As prescribed in 4.2105(a), insert the following provision:

REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR

EQUIPMENT (NOV 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212- 3, Offeror Representations and Certifications-Commercial Products or Commercial Services. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204- 26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

https://www.acquisition.gov/far/part-4#FAR_4_2105 https://www.acquisition.gov/far/52.204-26#FAR_52_204_26 https://www.acquisition.gov/far/52.212-3#FAR_52_212_3 https://www.acquisition.gov/far/52.212-3#FAR_52_212_3 https://www.acquisition.gov/far/52.204-26#FAR_52_204_26 https://www.acquisition.gov/far/52.204-26#FAR_52_204_26 https://www.acquisition.gov/far/52.212-3#FAR_52_212_3

(a) Definitions. As used in this provision—

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition.

(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) ( https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".

https://www.acquisition.gov/far/52.204-25#FAR_52_204_25 https://www.sam.gov/

(d)…