ED Solicitation 75H71124R00001.pdf

75H71124R00001

SOLICITATION, OFFER AND AWARD

4. TYPE OF SOLICITATION2. CONTRACT NUMBER 3. SOLICITATION NUMBER

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than Item 7)

ORDER UNDER DPAS (15 CFR 700)

6. REQUISITION/PURCHASE NUMBER

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

NEGOTIATED (RFP)

SEALED BID (IFB)

5. DATE ISSUED

1. THIS CONTRACT IS A RATED RATING PAGE OF PAGES

1 78

C. E-MAIL ADDRESS

EXT.NUMBERAREA CODE

B. TELEPHONE (NO COLLECT CALLS)A. NAME

10. FOR

INFORMATION

CALL:

CAUTION: LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

(Date)(Hour) local timeuntildepository located in copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the

SOLICITATION

9. Sealed offers in original and

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

EVALUATION FACTORS FOR AWARD

INSTRS., CONDS., AND NOTICES TO OFFERORS

REPRESENTATIONS, CERTIFICATIONS AND

LIST OF ATTACHMENTS

CONTRACT CLAUSES

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

I

J

K

L

M SPECIAL CONTRACT REQUIREMENTS

CONTRACT ADMINISTRATION DATA

DELIVERIES OR PERFORMANCE

INSPECTION AND ACCEPTANCE

PACKAGING AND MARKING

DESCRIPTION/SPECS./WORK STATEMENT

SUPPLIES OR SERVICES AND PRICES/COSTS

SOLICITATION/CONTRACT FORM

PART II - CONTRACT CLAUSESPART I - THE SCHEDULE

H

G

F

E

D

C

B

A

SEC. DESCRIPTION PAGE(S) (X) DESCRIPTION SEC. (X)

11. TABLE OF CONTENTS

18. OFFER DATE17. SIGNATURE

SUCH ADDRESS IN SCHEDULE.

IS DIFFERENT FROM ABOVE - ENTER

15C. CHECK IF REMITTANCE ADDRESS

EXT.NUMBERAREA CODE

15B. TELEPHONE NUMBER

(Type or print)AND

ADDRESS

OF

OFFEROR

CODE FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER15A. NAME

DATEAMENDMENT NO.DATEAMENDMENT NO.

and related documents numbered and dated):

amendments to the SOLICITATION for offerors

(The offeror acknowledges receipt of

14. ACKNOWLEDGEMENT OF AMENDMENTS

CALENDAR DAYS (%)30 CALENDAR DAYS (%)20 CALENDAR DAYS (%)10 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

13. DISCOUNT FOR PROMPT PAYMENT

designated point(s), within the time specified in the schedule.

by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

OFFER (Must be fully completed by offeror)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

28. AWARD DATE

(Signature of Contracting Officer)

27. UNITED STATES OF AMERICA

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

CODE 24. ADMINISTERED BY (If other than Item 7)

ITEM

(4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

41 U.S.C. 3304 (a) ( 10 U.S.C. 2304 (c) (

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

21. ACCOUNTING AND APPROPRIATION20. AMOUNT19. ACCEPTED AS TO ITEMS NUMBERED

AWARD (To be completed by government)

CODE

10/03/2023 X

Claremore Indian Hospital West Will Rogers & Moore 101 South Moore Avenue Claremore OK 74017

1530 CS 11/10/2023

SHELTON BRUCE 918

SHELTON.BRUCE@IHS.GOV

342-6424

X

X

X

X

X

X

X

X

X

X

X

X

X

PAGE(S)

SEAN L. LONG

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (REV. 6/2014)

Prescribed by GSA - FAR (48 CFR) 53.214(c)

1-3

5-12 13-14 15-20 21-25 26-33

34-62

64-67

68-74

75-78

12. In compliance with the above, the undersigned agrees, if this offer is accepted within _____90_________ calendar days (60 calendar days unless a different period is inserted

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 78

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

75H71124R00001

(A) (B) (C) (D) (E) (F)

PROVIDE NON-PERSONAL ED SUPPORT SERVICES IN

ACCORDANCE WITH SECTION C FOR THE CLAREMORE

INDIAN HOSPITAL

Delivery Location Code: IHSCLAREMORE

IHSCLAREMORE

101 SOUTH MOORE AVENUE

CLAREMORE OK 74017 US

Period of Performance: 04/01/2024 to 03/31/2029

1 Base Year - Emergency/Urgent Care Department 13000 HR

Physician Services: April 1, 2024 - March, 31, Delivery: 03/31/2025

Period of Performance: 04/01/2024 to 03/31/2025

2 Option Year 1 - Emergency/Urgent Care Department 13000 HR

Physician Services: April 1, 2025 - March, 31, (Option Line Item)

02/01/2025

Delivery: 03/31/2026

Period of Performance: 04/01/2025 to 03/31/2026

3 Option Year 2 - Emergency/Urgent Care Department 13000 HR

Physician Services: April 1, 2026 - March, 31, (Option Line Item)

02/01/2026

Delivery: 03/31/2027

Period of Performance: 04/01/2026 to 03/31/2027

4 Option Year 3 - Emergency/Urgent Care Department 13000 HR

Physician Services: April 1, 2027 - March, 31, (Option Line Item)

02/01/2027

Delivery: 03/31/2028

Period of Performance: 04/01/2027 to 03/31/2028

5 Option Year 4 - Emergency/Urgent Care Department 13000 HR

Physician Services: April 1, 2028 - March, 31, (Option Line Item)

02/01/2028

Continued ...

OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

NSN 7540-01-152-8067

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 78

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

75H71124R00001

(A) (B) (C) (D) (E) (F)

Delivery: 03/31/2029

Period of Performance: 04/01/2028 to 03/31/2029

This contract may be incrementally funded due to

IHS's apportionment of funds.

Oversight and monitoring: Dr. Gary Lang, Clinical

Director

Contract Administration: Judy Eaves, Contract

Specialist, 405-951-3856

OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

NSN 7540-01-152-8067

SECTION B – PRICE SCHEDULE

Item Schedule Hours Per

Year

ALL-INCLUSIVE

HOURLY RATE

1 Base Year - Emergency/Urgent Care Department Physician Services: April 1, 2024 - March, 31, 2025

13,000

2 Option Year 1 - Emergency/Urgent Care Department Physician Services: April 1, 2025 - March, 31, 2026

3 Option Year 2 - Emergency/Urgent Care Department Physician Services: April 1, 2026 - March, 31, 2027

4 Option Year 3 - Emergency/Urgent Care Department Physician Services: April 1, 2027 - March, 31, 2028

5 Option Year 4 - Emergency/Urgent Care Department Physician Services: April 1, 2028 - March, 31, 2029

The hourly rate is all-inclusive for all shifts, holidays, weekends, weekdays, day, night 24/7 x 365

SECTION C – STATEMENT OF WORK

ED PHYSICIANS

1. PURPOSE:

The Claremore Indian Hospital (CIH), Indian Health Services (IHS) has a requirement for contractor support of Emergency Medicine physician(s) in the CIH. The care provided by the physicians shall be as comprehensive as the Indian Health Service supplied facilities, equipment, and support services permit. The contractor shall provide qualified physicians to provide medical services for patients as required by this statement of work (SOW) and in accordance with the terms and conditions of this contract. Contractor physicians shall provide services to eligible beneficiaries of the Indian Health Service who present themselves for treatment. Contracted services encompass the provision of medical services that are emergent and non-emergent.

The Indian Health Service, an agency within the Department of Health and Human Services (HHS), is responsible for providing federal health services to American Indians and Alaska Natives. The mission of IHS is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level and assure that comprehensive, culturally acceptable personal and public health services are available and accessible to members of the 566 federally recognized Tribes across the United States.

The purpose of this contract is to obtain contracted Emergency Department/Urgent Care non-personal services for the Indian Health Service (IHS) Claremore Indian Hospital.

Contracted services encompass the provision of medical services that are emergent and non-emergent.

The emergent category of patients is defined as:

A patient that has presented to an emergency department when: an unforeseen condition of a pathophysiological or psychological nature develops which a prudent layperson, possessing an average knowledge of health and medicine, would judge to require urgent and unscheduled medical attention after consideration of possible alternatives. This would include, but limited to:

1. Any condition resulting in admission of the patient to a hospital within 24 hours.

2. Evaluation or repair of acute (less than 72 hours) trauma.

3. Relief of acute or severe pain.

4. Investigation or relief of acute infection.

5. Protection of public health.

6. Obstetrical crisis and/or labor.

7. Hemorrhage or threat of hemorrhage.

8. Shock or impending shock.

9. Investigation and management of suspected abuse or neglect of person which, if not interrupted, could result in temporary or permanent physical or psychological harm.

10. Congenital defects or abnormalities in a newborn infant, best managed by prompt intervention.

11. Decompensation or threat of decompensation of vital functions such as sensorium, respiration, circulation, excretion, mobility or sensory organs.

12. Management of a patient suspected to be suffering from a mental illness and posing an apparent danger to the safety of himself/herself or others.

13. Any sudden and/or serious symptom(s) which might indicate a condition which constitutes a threat to the patient’s physical or psychological well-being requiring immediate medical attention to prevent possible deterioration, disability or death.

14. In addition, any patient presenting to the emergency department must be evaluated with at least a medical screening exam in compliance with all EMTALA regulations.

15. Non-emergent patients will be evaluated and treated consistent with the urgent care needs of the facility and our patients.

2. DESCRIPTION OF THE REQUIREMENTS

The contractor shall provide emergency/urgent care physician services to evaluate and treat eligible patients who present themselves to the Emergency Department.

The contractor shall furnish services to include but not limited to the following:

1. Maintain a continuous vigil within the immediate confines of the Emergency Department in order that services are readily and immediately available.

2. Obtain a medical history, performing a physical exam as appropriate to the presenting problem, and formulate a diagnosis of the patient’s problem, and secondary diagnosis, as required, to treat the patient.

3. Render immediate medical services to those patients determined as emergent.

4. Request and interpret laboratory and radiologic tests, as necessary, for diagnosis.

5. Provide and order medically indicated treatment.

6. Prescribe medication.

7. Interpret x-rays and electrocardiograms.

8. Suture minor lacerations.

9. Treat uncomplicated fractures.

10. Refer patients as appropriate to routinely scheduled clinics of the Outpatient

Department.

11. Render initial assessments of which Emergency Department/Urgent Care patients will require transfer to a tertiary care center and consult the appropriate Indian Health Service physician on-call who in turn will render the final decision concerning transfer and arrange transfer, if indicated.

12. Render the initial assessment of which emergency/urgent care patients may require admission to the on-site Hospital and consulting the Indian Health Service physician on-call who in turn will render the final decision concerning admissions.

13. Chart, record and document complete medical care in the Electronic Health Record system provided by the facility or on any paper forms approved by the facility in case of EHR outage. Medical records shall be completed in a timely manner as determined by the service unit. The physician shall be proficient in electronically documenting services utilizing the appropriate electronic medical record system for patient encounters; complete all required administrative paperwork day of the patient encounter to include electronic consults, referrals, co-signatures, completion of chart or Risk Management Reviews.

14. Consult with appropriate IHS specialist on back up call for all complex cases, which, while not requiring admission to the hospital or transfer to another facility, do require further evaluation by the specialty physician, or more than routine follow up.

15. Provide medical advice to patients by telephone when the nurse requests a physician to do so.

16. Respond to in-hospital emergencies while on duty.

17. Provide basic life support in a first responder status for patients requiring resuscitation outside of the hospital on hospital grounds.

18. The emergency department physician shall evaluate emergency medical service (EMS) calls, i.e. patients enroute to the Emergency Department. If the physician is able to determine that the patient will need a higher level of care, then he/she may divert the ambulance to another facility.

19. Contractor shall participate in quality assurance activities that ensure quality patient care as well as efficient use of hospital resources. These activities may include, but not limited to, chart review and discussion with the Clinical Director or his designee.

20. The contractor shall advise the Clinical Director or designated representative of any problem encountered, in connection with meeting the patient care needs as required in the statement of work.

The contractor shall perform to a minimum of published National Standard Averages in their delivery of medical care in the Emergency Department.

Monthly Measured Total Time in the Emergency Department for discharged patients (“Turn Around Time”) : Less than mean time of 123 minutes (2013 National Rural Emergency Department Study, Establishing Rural Relevant Benchmarks, Ivantage Health Analytics, July 25, 2013.)

Monthly left without being seen (Left before Treatment completed) rate of less than 2% (Welch SJ, Volume Related Differences in Emergency Department Performance. Joint Commission Journal of Quality and Patient Safety, September 2012; Vol 38:9)

Monthly average arrival to provider (Door to Physician) time of less than 32 minutes. (Welch SJ, Volume Related Differences in Emergency Department Performance. Joint Commission Journal of Quality and Patient Safety, September 2012; Vol 38:9)

Whenever these thresholds are not met, analysis will be made to determine if variances are due to contractor performance or due to a need of facility process improvements. The Contractor agrees to participate in this analysis and if internal facility processes are responsible, contractor shall participate in identifying and improving departmental processes for the betterment of patient care. Claremore Indian Hospital retains the right of determining the final decision regarding whether variances are due to contractor performance or a need for internal improvement of departmental processes.

Normal shifts for the Emergency Department consist of 12 hour shifts, including 7am to 7pm and 7pm to 7am, but other shift times may be added to best suite patient care. Double coverage may be required to allow for increased patient care. The work schedule will be determined by the Emergency Department Director. All shifts assigned to the contractor is the responsibility of the contractor to cover.

Any changes to the proceeding shall require mutual agreement of the Contractor and the Contracting Officer.

3. PERIOD OF PERFORMANCE

The base year Period of Performance will be 12 months from date of award with four (4) twelve (12) month option years.

4. LEVEL OF EFFORT

4.1. The contractor shall ensure all providers furnished by the contractor complete orientation sessions conducted by the on-site Health Records Department and the Human Resource Department.

4.2. The contractor’s professional services shall be subject to evaluation on quality by the

Government via routine staff members review of emergency department/urgent care charts on a quarterly basis or more often as appropriate, however, the government retains no control over the medical professional aspects of services rendered (e.g.

professional judgements, diagnosis for specific medical treatment).

4.3. The contractor shall be required to be familiar with and comply with the “Emergency

Assurance ER Plan” already established by the Emergency Room Director. Reference publications are available on-site.

4.4. The contractor shall be required to develop familiarity and abide by current policies, procedures, by-laws and regulations of the on-site clinical and medical staff.

4.5. The contractor shall perform services in compliance with applicable standards of The Joint Commission (TJC), which is available to the general public and the Professional Services Policies of the IHS Manual, which is available from the IHS.

5. SPECIAL REQUIREMENTS

5.1. The US PHS Claremore Indian Hospital is a tobacco/smoke free environment (buildings and grounds). No tobacco/smoking use will be tolerated during service.

5.2. Security Requirements: All contractors shall undergo a fingerprint check and shall be cleared prior to hire. Contractor’s continued employment is contingent upon the outcome of a complete and favorable background investigation as determined by the sensitivity level of the position. If contractors are found not suitable, they will be removed.

5.2.1. This is a designated position covered by Public Law 101-647, 101-630, Crime

Control Act of 1990, and the Indian Child Protection and Family Violence Prevention Act, requiring contact or control over Indian children. Contractors shall be required to complete, sign, and submit the Addendum to OF-306, Child Care & Indian Child Care Worker Position form. Due to this requirement, the agency shall ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes. Failure to comply with these statutes shall result in immediate removal.

5.3. The contractor shall provide during the term of the contract documentation of provider’s immunization record to reflect CDC’s Recommended Vaccines for Healthcare Workers (specifically MMR, Tdap, varicella, Hep B immunity, current (within the past year) influenza vaccination) and current annual tuberculosis screening. Documentation shall be provided with the completed Application for Appointment to Medical Staff and continual updates to the immunization record supplied to the Employee Health Nurse.

5.4. The contractor shall not disclose or cause to disseminate any information concerning operations of Claremore Indian Hospital. Such action(s) could result in violation of the contract and possible legal actions.

5.4.1. All inquiries, comments, or complaints arising from any matter observed, experienced or learned of as a result of or in connection with the performance of the contract, the resolution of which may require the dissemination of official information, shall be directed to the government’s designated representative.

6. DELIVERABLES AND REPORTING REQUIREMENTS

6.1. The contractor shall perform quality assurance activities that are acceptable for The

Joint Commission (TJC) certification regarding the monitoring of emergency/urgent care services and shall provide a quarterly quality assurance letter to the Emergency Department Director. This letter shall identify the kind of studies performed, results, and recommendations.

6.2. Contractor Point of Contact: The contractor shall furnish one designated point of contact (POC) to the government’s designated representative for coordination of supplies, delivery, and/or maintenance. The POC will be empowered to make daily decisions to ensure that the contract implementation and day-to-day maintenance meets the terms and conditions of this contract.

6.3. Contractor’s Phone Numbers: The contractor shall provide a toll-free telephone number for service calls, which must be answered during at least eight working hours, between 8:00 am and 4:30 pm, Monday through Friday.

6.4. Personnel Qualifications:

Emergency department physicians shall have a permanent, current, full and unrestricted license to practice emergency medicine in a state, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

Physicians shall comply with the policies, procedures and by-laws of the hospital/clinic. The physician shall also be required to perform this service in compliance with applicable standards of The Joint Commission and Quality Improvement.

6.4.1. Physicians shall meet the following minimum qualifications and requirements:

6.4.1.1. Permanent, current, full and unrestricted license to practice medicine in the United States, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

6.4.1.2. Physicians shall be Board Certified in or Board Eligible in emergency medicine.

6.4.1.3. Physicians shall apply and be accepted as clinic/hospital associate member.

6.4.1.4. Shall provide a copy of documentation of physician’s current Basic Life Support (BLS).

6.4.1.5. Documentation of Advanced Cardiac Life Support (ACLS), Advanced Trauma Life Support (ATLS) and Pediatric Advance Life Support (PALS) certification.

6.4.1.6. Shall speak, understand, read and write English fluently and communicate with sufficient clarity to be understood by IHS personnel and patients.

6.4.1.7. Shall be a United States Citizen.

6.4.1.8. Shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to patients of the Native American/Alaska Native communities.

6.4.1.9. Shall maintain standards of personal hygiene and grooming such that his/her image as a physician is compatible with the expectations of the on-site Clinical Director.

6.4.1.10. Shall have a current DEA license.

6.4.1.11. Shall provide a complete IHS Medical Staff Application to include documentation of work history since graduation from professional school to present day in chronological order. Any time period of gaps greater than 30 days since graduation from professional school, shall be explained in writing along with contact information of an individual who can verify the gaps.

6.4.1.12. Shall provide a copy of documentation of current and past insurance carriers and contact information during the past 10 years.

6.4.1.13. Shall provide documentation of and maintain current professional liability insurance coverage in the amount of $1 million per occurrence and $3 million aggregate per provider and tail coverage.

6.4.1.14. Physicians who spend 50 percent or more of their clinical time under contract with the Federal Government, and prescribe controlled substances shall obtain IHS Opioid Prescriber Training and provide Certification within six months of appointment and every 3 years after.

6.4.2. Credentials:

6.4.2.1. Physicians shall be credentialed and have privileges as active members of the medical staff. The physician shall be required to provide completed applications for Medical Staff appointments and privileges, as specified in the By-laws, for all providers to the Clinical Director and at least 30 (thirty) days prior to assignment for periods of coverage.

6.4.2.2. Credentialing activities shall require a minimum of thirty (30) calendar days to insure (1) that written or printed information is received at the on-site Hospital Quality Assurance Department from the National Physicians Data Bank, (2) that three letters of reference for each sub-contractor are received in the Credentials Office and are recent within the last year, and

(3) the credentialing package (application for appointment and request for privileges) is completed and received by the Medical Executive Committee and OCA IHS Governing Board.

6.4.3. Verification of Credentials

To ensure that physicians providing services under this contract are properly licensed, and that the IHS is made aware of all disciplinary actions taken against each physician, the Contractor shall:

6.4.4. Verify in writing to the IHS through the Federation of State Medical Boards database, all active, inactive, and lapsed licenses that are held or have been held by physicians who provide services in IHS hospitals and clinics under this blanket purchase agreement.

6.4.5. Inform the IHS of the status of all licenses for each physician including all reasons for each inactive or lapsed license.

6.4.6. Obtain at least three (3) letters of reference from health care providers whom have knowledge of the applicant’s clinical practice skills. One letter shall be from the Chief of Staff, or Service at the hospital where the physician holds or last held staff privileges. If the physician has just completed a residency, one letter shall be from the residency program director or serve chief.

6.4.7. Provide all information regarding performance and disciplinary actions that are collected on physicians who would be placed under this contract to the receiving IHS facility Clinical Director. This includes all information that is collected and compiled on such physicians at the time of initial hire by the Contractor, and/or information that is reported during periods that the Contractor is an agent of such physicians for a placement under this contract.

6.4.8. Certify that all information obtained on physicians whom they would assign to IHS hospital and clinics have been reviewed, verified and recommended by the Contractor. The Certification shall include a statement that the physician is competently and adequately trained and experienced to provide the Services contemplated pursuant to the assignment in accordance with all applicable federal, state, and local laws, rules and regulations, all applicable standards of the Joint Commission and any other relevant accrediting organizations; and the Contractor has found no reason to reject the physician’s application. The names of the contacts, their titles, telephone numbers, date of contacts and the name(s) of the Contractor’s representative(s) collecting and reviewing such information shall be recorded in writing and made available to the IHS by the contractor.

7. GOVERNMENT FURNISHED PROPERTY, FACILITIES AND SERVICES

7.1. The Government will provide the facilities, supplies and the equipment of the

Emergency Department and all hospital and Emergency specialty/support staff. The on-call specialty staff consists of staff in obstetrics/gynecology, pediatrics, internal medicine, family practice and general surgery as well as a person to provide orientation to contract physicians. Use of government furnished facility space, equipment, supplies, and personnel are for the provision of care and services set forth in this contract only.

7.2. A written Orientation Manual of Policies and Procedures for the Emergency Department, and on-call room, and application forms for appointment and privileging as associate staff members and will also be provided by the Government.

8. CONTRACTOR FURNISHED PROPERTY, FACILITIES AND SERVICES

8.1. Required personnel. The contractor shall furnish all personnel required to perform work under the contract, to include but not limited to: personnel, credentials, oversight, and project management.

9. CHANGES TO THE STATEMENT OF WORK (SOW)

Any changes to this SOW shall be authorized and approved only through written correspondence from the Contracting Officer. Costs incurred by the contractor through the actions of parties other than the Contracting Officer shall be borne by the contractor.

10. DELIVERABLES/PERFORMANCE MATRIX

10.1. Provided physicians: Yes No

10.2. Physicians were credentialed: Yes No

10.3. Physicians met professional qualifications: Yes No

10.4. Met the terms of the SOW: Yes No

10.5. Physicians were on time and in proper attire: Yes No

10.6. Any issues were addressed in a timely manner: Yes No

SECTION D – PACKAGING AND MARKING

NOT APPLICABLE – BLANK

SECTION E – INSPECTION AND ACCEPTANCE

E.01 FAR 52.246-4 INSPECTION OF SERVICES - FIXED PRICE (AUG 1996)

(a) Definition: “Services,” as used in this clause, includes services performed, workmanship, and material furnished or utilized in the performance of services.

(b) The Contractor shall provide and maintain an inspection system acceptable to the Government covering the services under this contract. Complete records of all inspection work performed by the Contractor shall be maintained and made available to the Government during contract performance and for as long afterwards as the contract requires.

(c) The Government has the right to inspect and test all services called for by the contract, to the extent practicable at all times and places during the term of the contract. The Government shall perform inspections and tests in a manner that will not unduly delay the work.

(d) If the Government performs inspections or tests on the premises of the Contractor or a subcontractor, the Contractor shall furnish, and shall require subcontractors to furnish, at no increase in contract price, all reasonable facilities and assistance for the safe and convenient performance of these duties.

(e) If any of the services do not conform with contract requirements, the Government may require the Contractor to perform the services again in conformity with contract requirements, at no increase in contract amount.

When the defects in services cannot be corrected by reperformance, the Government may --

(1) Require the Contractor to take necessary action to ensure that future performance conforms to contract requirements; and

(2) Reduce the contract price to reflect the reduced value of the services performed.

(f) If the Contractor fails to promptly perform the services again or to take the necessary action to ensure future performance in conformity with contract requirements, the Government may --

(1) By contract or otherwise, perform the services and charge to the Contractor any cost incurred by the Government that is directly related to the performance of such service; or

(2) Terminate the contract for default.

(End of Clause)

E.02 FAR 52.246-20 WARRANTY OF SERVICES (MAY 2001)

(a) Definitions.

“Acceptance,” as used in this clause, means the act of an authorized representative of the Government by which the Government assumes for itself, or as an agent of another, ownership of existing and identified supplies, or approves specific services, as partial or complete performance of the contract.

(b) Notwithstanding inspection and acceptance by the Government or any provision concerning the conclusiveness thereof, the Contractor warrants that all services performed under this contract will, at the time of acceptance, be free from defects in workmanship and conform to the requirements of this contract. The Contracting Officer shall give written notice of any defect or nonconformance to the Contractor “within 30 days from the date of acceptance by the Government,”; This notice shall state either –

(1) That the Contractor shall correct or reperform any defective or nonconforming services; or

(2) That the Government does not require correction or reperformance.

(c) If the Contractor is required to correct or reperform, it shall be at no cost to the Government, and any services corrected or reperformed by the Contractor shall be subject to this clause to the same extent as work initially performed. If the Contractor fails or refuses to correct or reperform, the Contracting Officer may, by contract or otherwise, correct or replace with similar services and charge to the Contractor the cost occasioned to the Government thereby, or make an equitable adjustment in the contract price.

(d) If the Government does not require correction or reperformance, the Contracting Officer shall make an equitable adjustment in the contract price.

(End of Clause)

END OF SECTION E

SECTION F – DELIVERIES AND PERFORMANCE

CLAUSE NO. TITLE OF CLAUSE

F.01 FAR 52.242-15 STOP-WORK ORDER (AUG 1989)

F.02 PERIOD OF PERFORMANCE

F.03 PRINCIPLE PLACES OF PERFORMANCE

F.04 ACCESS TO BUILDING

F.05 SECURITY REQUIREMENTS/BACKGROUND CHECKS

F.06 QUALITY CONTROL PLAN

F.07 HHSAR 352.224-70 PRIVACY ACT (DEC 2015)

F.08 HHSAR 352.237-70 PRO-CHILDREN ACT OF 1994 (DEC 2015)

F.09 HHSAR 352.237-71 CRIME CONTROL ACT OF 1990 – REPORTING

OF CHILD ABUSE (DEC 2015)

F.10 HHSAR 352.237-72 CRIME CONTROL ACT OF 1990 –

REQUIREMENT FOR A BACKGROUND CHECKS (DEC 2015)

F.11 HHSAR 352.237-73 INDIAN CHILD PROTECTION AND FAMILY

VIOLENCE ACT (DEC 2015)

F.12 HHSAR 352.242-71 TOBACCO-FREE FACILITIES (JANUARY 2006)

SECTION F – DELIVERIES AND PERFORMANCE

F.01 FAR 52.242-15 STOP-WORK ORDER (AUG 1989)

(a) The Contracting Officer (CO) may, at any time, by written order to the Contractor, require the Contractor to stop all, or any part, of the work called for by this contract for a period of 90 days after the order is delivered to the Contractor, and for any further period to which the parties may agree. The order shall be specifically identified as a stop-work order issued under this clause. Upon receipt of the order, the Contractor shall immediately comply with its terms and take all reasonable steps to minimize the incurrence of costs allocable to the work covered by the order during the period of work stoppage. Within a period of 90 days after a stop-work order is delivered to the Contractor, or within any extension of that period to which the parties shall have agreed, the CO shall either -

(1) Cancel the stop-work order; or

(2) Terminate the work covered by the order as provided in the Default, or the Termination for Convenience of the Government, clause of this contract.

(b) If a stop-work order issued under this clause is canceled or the period of the order or any extension thereof expires, the Contractor shall resume work. The CO shall make an equitable adjustment in the delivery schedule or contract price, or both, and the contract shall be modified, in writing, accordingly, if -

(1) The stop-work order results in an increase in the time required for, or in the Contractor's cost properly allocable to, the performance of any part of this contract; and

(2) The Contractor asserts its right to the adjustment within 30 days after the end of the period of work stoppage; provided that, if the CO decides the facts justify the action, the CO may receive and act upon a proposal submitted at any time before final payment under this contract.

(c) If a stop-work order is not canceled and the work covered by the order is terminated for the convenience of the Government, the CO shall allow reasonable costs resulting from the stop-work order in arriving at the termination settlement.

(d) If a stop-work order is not canceled and the work covered by the order is terminated for default, the CO shall allow, by equitable adjustment or otherwise, reasonable costs resulting from the stop-work order.

F.02 PERIOD OF PERFORMANCE

The contract base performance period will be one (1) year with four (4) option years beginning on April 1, 2024, through March 31, 2025.

F.03 PRINCIPAL PLACES OF PERFORMANCE

Claremore Indian Hospital 101 S Moore Ave, Claremore, OK 74017

F.04 ACCESS TO BUILDING

The Contractor will have access to the hospital facilities after office hours within the guidelines of Indian Health Services security plan and as permitted by the Security Officer through the coordination of the Contracting Officers Representative (COR).

F.05 SECURITY REQUIREMENTS / BACKGROUND CHECKS

In accordance with Homeland Security requirements all contractor employees who will perform the services shall submit to electronic fingerprints and obtain security clearance before services can be performed under this contract.

F.06 QUALITY CONTROL

The Contractor shall develop and maintain a quality control plan to ensure services are performed in accordance with commonly accepted commercial practices, including the development and implementation of procedures to identify, prevent, and ensure non- recurrence of defective deliverables and unacceptable services. This plan shall be submitted with the proposal and will be made a part of the contract. Changes to the Quality Control Plan may be necessary and must be reviewed and agreed to by Claremore Indian Hospital before the changes are incorporated.

F.07 HHSAR 352.224-70 PRIVACY ACT (DEC 2015)

This contract requires the Contractor to perform one or more of the following: (a) design; (b) develop; or (c) operate a Federal agency system of records to accomplish an agency function in accordance with the Privacy Act of 1974 (Act) (5 U.S.C. 552a(m)(1)) and applicable agency regulations.

The term system of records means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual. Violations of the Act by the Contractor and/or its employees may result in the imposition of criminal penalties (5 U.S.C. 552a(i)).

The Contractor shall ensure that each of its employees knows the prescribed rules of conduct in 45 CFR part 5b and that each employee is aware that he/she is subject to criminal penalties for violation of the Act to the same extent as Department of Health and Human Services employees. These provisions also apply to all subcontracts the Contractor awards under this contract which require the design, development or operation of the designated system(s) of records (5 U.S.C. 552a(m)(1)). The contract work statement:

(a) Identifies the system(s) of records and the design, development, or operation work the Contractor is to perform; and

(b) Specifies the disposition to be made of such records upon completion of contract performance.

F.08 HHSAR 352.237-70 PRO-CHILDREN ACT OF 1994 (DEC 2015)

(a) Public Law 103-227, Title X, Part C, also known as the Pro-Children Act of 1994 (Act), 20 U.S.C. 7183, imposes restrictions on smoking in facilities where certain federally funded children's services are provided. The Act prohibits smoking within any indoor facility (or portion thereof), whether owned, leased, or contracted for, that is used for the routine or regular provision of: (i) kindergarten, elementary, or secondary education or library services or (ii) health or day care services that are provided to children under the age of 18. The statutory prohibition also applies to indoor facilities that are constructed, operated, or maintained with Federal funds.

(b) By acceptance of this contract or order, the Contractor agrees to comply with the requirements of the Act. The Act also applies to all subcontracts awarded under this contract for the specified children's services. Accordingly, the Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understands, and complies with the provisions of the Act. Failure to comply with the Act may result in the imposition of a civil monetary penalty in an amount not to exceed $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. Each day a violation continues constitutes a separate violation.

F.09 HHSAR 352.237-71 CRIME CONTROL ACT OF 1990—REPORTING OF CHILD

ABUSE (DEC 2015)

(a) Public Law 101-647, also known as the Crime Control Act of 1990 (Act), imposes responsibilities on certain individuals who, while engaged in a professional capacity or activity, as defined in the Act, on Federal land or in a federally-operated (or contracted) facility, learn of facts that give the individual reason to suspect that a child has suffered an incident of child abuse.

(b) The Act designates “covered professionals” as those persons engaged in professions and activities in eight different categories including, but not limited to, teachers, social workers, physicians, dentists, medical residents or interns, hospital personnel and administrators, nurses, health care practitioners, chiropractors, osteopaths, pharmacists, optometrists, podiatrists, emergency medical technicians, ambulance drivers, alcohol or drug treatment personnel, psychologists, psychiatrists, mental health professionals, child care workers and administrators, and commercial film and photo processors.

The Act defines the term “child abuse” as the physical or mental injury, sexual abuse or exploitation, or negligent treatment of a child.

(c) Accordingly, any person engaged in a covered profession or activity under an HHS contract or subcontract, regardless of the purpose of the contract or subcontract, shall immediately report a suspected child abuse incident in accordance with the provisions of the Act. If a child is suspected of being harmed, the appropriate State Child Abuse Hotline, local child protective services (CPS), or law enforcement agency shall be contacted. For more information about where and how to file a report, the Childhelp USA, National Child Abuse Hotline (1-800- 4-A-CHILD) shall be called. Any covered professional failing to make a timely report of such incident shall be guilty of a Class B misdemeanor.

(d) By acceptance of this contract or order, the Contractor agrees to comply with the requirements of the Act. The Act also applies to all applicable subcontracts awarded under this contract. Accordingly, the Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understands, and complies with the provisions of the Act.

F.10 HHSAR 352.237-72 CRIME CONTROL ACT OF 1990—REQUIREMENT FOR

BACKGROUND CHECKS (DEC 2015)

(a) Public Law 101-647, also known as the Crime Control Act of 1990 (Act), requires that all individuals involved with the provision of child care services to children under the age of 18 undergo a criminal background check. “Child care services” include, but are not limited to, social services, health and mental health care, child (day) care, education (whether or not directly involved in teaching), and rehabilitative programs. Any conviction for a sex crime, an offense involving a child victim, or a drug felony, may be grounds for denying employment or for dismissal of an employee providing any of the services listed above.

(b) The Contracting Officer will provide the necessary information to the Contractor regarding the process for obtaining the background check. The Contractor may hire a staff person provisionally prior to the completion of a background check, if at all times prior to the receipt of the background check during which children are in the care of the newly-hired person, the person is within the sight and under the supervision of a previously investigated staff person.

(c) By acceptance of this contract or order, the Contractor agrees to comply with the requirements of the Act. The Act also applies to all applicable subcontracts awarded under this contract. Accordingly, the Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understands, and complies with the provisions of the Act.

F.11 HHSAR 352.237-73 INDIAN CHILD PROTECTION AND FAMILY VIOLENCE

ACT (DEC 2015)

(a) This contract is subject to the Indian Child Protection and Family Violence Act, Pub. L. 101-630 (25 U.S.C. 3201 et seq.) The duties and responsibilities required by this contract may involve regular contact with or control over Indian children.

Pub. L. 101-630 prohibits employment, including Personal Service Contracts, with anyone who has been convicted of any crime of violence. Any such conviction should immediately be brought to the attention of the Contracting Officer. The contractor will be subject to a character investigation, conducted by the Indian Health Service, Office of Human Resources. Until such time as the contractor has been notified of completion of the investigation, the contractor shall have no unsupervised contact with Indian children. In order to initiate this background investigation, the contractor must provide information as required in this contract or as directed by the Contracting Officer.

(b) As a prerequisite to providing services under this contract, the Contractor is required to complete and sign the declaration found in Section J of this contract.

F.12 HHSAR 352.242-71 TOBACCO-FREE FACILITIES (JANUARY 2006)

In accordance with Department of Health and Human Services (HHS) policy, the Contractor and its staff are prohibited from using tobacco products of any kind (e.g., cigarettes, cigars, pipes, and smokeless tobacco) while on any HHS property, including use in personal or company vehicles operated by Contractor employees while on an HHS property. This policy also applies to all subcontracts awarded under the contract or order. The term “HHS properties” includes all properties owned, controlled and/or leased by HHS when totally occupied by HHS, including all indoor and outdoor areas of such properties. Where HHS only partially occupies such properties, it includes all HHS-occupied interior space.

Where HHS leases space in a multi-occupant building or complex, the tobacco-free HHS policy will apply to the maximum area permitted by both law and current lease agreements. The Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understand, and comply with this policy.

END OF SECTION F

SECTION G – CONTRACT ADMINISTRATION DATA

TABLE OF CONTENTS

G.01 INVOICING INSTRUCTIONS AND PAYMENT INFORMATION

G.02 CONTRACT PAYMENT METHOD

G.03 CONTRACTING OFFICER'S REPRESENTATIVE (COR)

G.04 GOVERNMENT CONTACT FOR POST AWARD ADMINISTRATION

G.05 TECHNICAL DIRECTION

SECTION G – CONTRACT ADMINISTRATION DATA

G.01 INVOICING INSTRUCTIONS AND PAYMENT INFORMATION

(a) The Contractor shall submit a proper invoice for payment on a monthly basis as the work proceeds in accordance with the prices specified in Section B, Price Schedule.

(b) Payment will be made in accordance with Contract Clause FAR 52.232-25, Prompt Payment (Jan 2017).

(c) A proper invoice shall reflect the following information:

Contractor Name, Address, Phone Number, billing contact name and e-mail address

Invoice Date Unique invoice number Tax Identification Number (TIN) Contract Number as shown on the award document Modification Number (if applicable) Discount Terms, if applicable Banking information: Bank Routing Transit Number (nine digits) and last 4 digits of bank account number (for verification) Specific description of Work relating to invoice, including service period dates (if applicable) Invoice Amount

(d) Invoice will only be accepted if received in the following manner

Faxed to: 405-951-3873, Attn: Accounts Payable

Mailed to: Indian Health Services Oklahoma City Area Office 701 Market Drive Oklahoma City, OK 73114

(e) Prompt payment clock will begin on the date finance receives a proper invoice.

(f) Authorized Training, travel, and background costs shall be billed as a separate line item and identified as to which functional area required the training or travel (Administrative and Professional). A copy of the authorized Training or Travel Request (see Section J for request forms) shall accompany the invoice. The contractor shall invoice for reimbursement for authorized travel and training expenses no later than 30 days after occurrence. If there is a delay in invoicing for the expense(s), the Contractor shall provide the CO, in writing, details of the expenditure(s) and the reasons why a claim for reimbursement was not made no later than 30 days after occurrence.

G.02 CONTRACT PAYMENT METHOD

Payments will be made by electronic funds transfer using the Automated Clearing House (ACH) in accordance with Contract Clause FAR 52.232-33 Payment by Electronic Funds Transfer – System for Award Management (OCT 2018).

G.03 CONTRACTING OFFICER'S REPRESENTATIVE (COR)

(a) The Contracting Officers Representatives are as follows:

Contracting Officer’s Representative Kim Hale Phone: 918-342-6201 Email: Kimberly.Hale@ihs.gov

Contracting Officer’s Representative - Administrative Doctor Gary Lang Clinical Director Phone: 918-342-6430 Email: gary.lang@ihs.gov

The COR appointment letter will be provided at the time of award of the contract.

(b) The Contractor shall use the COR as the point of contact on technical matters, subject to the restrictions in Clause G.05, Technical Direction, of this section of the

G.04 GOVERNMENT CONTACT FOR POST AWARD ADMINISTRATION

To promote timely and effective contract administration, correspondence shall include the contract number and title, and shall be subject to the following procedures:

(a) Technical Correspondence. Technical correspondence (as used herein, this term excludes technical correspondence where patent or technical data issues are involved and correspondence which proposes or otherwise involves waivers, deviations, or modifications to the requirements, terms, or conditions of this contract) shall be addressed to the Contracting Officer's Representative (COR).

(b) Other Correspondence. All correspondence, other than technical correspondence, shall be addressed to the Contract Specialist/ Contracting Officer (CO) as shown in paragraph (c). The Contract Specialist/CO is the focal point for all matters regarding this contract except for technical matters.

(c) The Contract Specialist/CO is as follows:

Ms. Judy Eaves – Contract Specialist

Indian Health Services Oklahoma City Area Office

701 Market Drive Oklahoma City, OK 73114 Email: Judy.eaves@ihs.gov 405-951-3856

G.05 TECHNICAL DIRECTION

(a) Performance of the work is subject to the technical direction of Claremore’s COR.

(1) The term "technical direction" includes:

(i) Directions to the Contractor which redirect the contract effort, shift work emphasis between work areas or tasks, require pursuit of certain lines of inquiry, fill in details, or otherwise serve to accomplish items in the Statement of Work (Section C of the contract)

(ii) Written information to the Contractor which assists in the interpretation of drawings, specifications, or technical portions of the statement of work.

(iii) Review and, where required by the contract, approval of technical reports, drawings, specifications, and technical information delivered by the Contractor.

(b) Technical direction must be within the Contract's performance work statement.

The COR may not issue any technical direction which:

(1)…