SECTION C — PERFORMANCE WORK STATEMENT (PWS)

IDIQ Contract: 24/7 Telebehavioral Health Emergency Department Support Services

1.0 Purpose

This Performance Work Statement (PWS) describes the requirements for an Indefinite-Delivery/Indefinite-Quantity (IDIQ) firm fixed price contract to provide 24/7/365 synchronous audio-video telebehavioral health services supporting Emergency Department (ED) operations for facilities identified in this PWS and/or in individual task orders.

2.0 Background

Patients present to EDs with suicidal ideation, suicide attempts, acute psychiatric crises, substance-related emergencies, and co-occurring disorders. Timely behavioral health assessment and intervention are critical to patient safety, regulatory compliance, and appropriate disposition.

3.0 Objectives

The Contractor shall provide qualified licensed independent behavioral health clinicians (psychologists, psychiatrics, LCSW, LPC-MH, or equivalent) to deliver real-time telebehavioral health services, including suicide risk assessment, CSSRS with SAFE-T assessments, crisis stabilization, Stanley-Brown Safety Planning, culturally responsive care, interpreter access coordination, and placement assistance for patients requiring higher levels of care.

For patients presenting with acute psychiatric crises, qualified prescribing providers (psychiatrists, psychiatric nurse practitioners, or psychologists with prescribing privileges) will be available to provide consultation on appropriate medication stabilization.

4.0 IDIQ Structure, Ordering, and Place of Performance

4.1 Contract Type and Ordering

This contract is an IDIQ. Services will be ordered via written task orders issued by the Contracting Officer (CO) or authorized Ordering Official. Each task order will identify: ordering period of performance (POP) and deliverable schedule; locations/facilities covered; required hours of coverage and staffing/surge expectations; reporting cadence and site-specific workflows; and applicable performance metrics.

4.2 Ordering Period and Task Order Period of Performance

IDIQ ordering period and task order POP will be as specified in the solicitation/contract and the individual task order.

4.3 Place of Performance (Initial Facilities)

Initial scope supports the following EDs:

• Pine Ridge Hospital, Pine Ridge, SD

• Rosebud Hospital, Rosebud, SD

• Eagle Butte Hospital, Eagle Butte, SD

• Fort Yates Hospital, Fort Yates, ND

• Belcourt Hospital, Belcourt, ND

4.4 Estimated Workload (Not a Guarantee)

Approximate monthly consult volume by facility (for planning only): Pine Ridge (50), Rosebud (50), Eagle Butte (30), Fort Yates (15), Belcourt (20). The Government does not guarantee volumes; actual quantities will be based on clinical demand and task order scope.

5.0 General Requirements (Applies to All Task Orders)

5.1 Service Delivery Modality and Coverage

The Contractor shall provide synchronous audio-video telebehavioral health services 24 hours/day, 7 days/week, including weekends and federal holidays, unless otherwise specified in a task order utilizing Webex or another platform identified by the Indian Health Service

5.2 Required Clinical Services

The Contractor shall provide the following services when clinically indicated and/or required by facility workflows:

• Suicide risk assessment and completion of CSSRS with SAFE‑T for patients presenting with suicidal ideation or attempt.

• Crisis intervention, de-escalation guidance, and reassessment as indicated.

• Individualized Stanley-Brown safety planning, including lethal means counseling when appropriate.

• Placement coordination for higher levels of care (e.g., inpatient psych, crisis stabilization, detox), including documentation of placement attempts.

• Language access coordination: interpreter services (telephonic/VRI/ASL) available within 15 minutes of request and documented in the EHR.

• Culturally responsive and trauma-informed care, with annual training for clinicians (e.g., cultural competency, implicit bias, trauma-informed care).

For patients presenting with acute psychiatric crises, qualified prescribing providers (psychiatrists, psychiatric nurse practitioners, or psychologists with prescribing privileges) will be available to provide consultation to ED provider on appropriate medication stabilization.

Prior to initiating the consult, the Contractor will receive a report from the referring provider or designee and the telebehavioral health provider will provide a report back to the referring provider at the conclusion of the patient evaluation.

6.0 Staffing and Credentialing (Applies to All Task Orders)

6.1 Minimum Qualifications

Personnel shall hold active, unrestricted licensure in any U.S. state or territory and have at least two (2) years of emergency or crisis behavioral health experience.

6.2 Coverage and Surge

The Contractor shall ensure no lapse in required coverage and maintain surge staffing capability as needed.

6.3 Facility Credentialing

Personnel must meet the credentialing requirements of the facility(ies) served. Proxy credentialing is permissible consistent with CMS regulations and facility policy.

6.4 Security Clearance

A security pre-clearance must be carried out by 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 throughout the duration of this contract. It shall be the responsibility of the contractor to notify the acquisition official if there is a change in provider.

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).

7.0 Documentation Requirements

All CSSRS assessments, SAFE‑T evaluations, safety plans, interpreter usage, and disposition decisions shall be documented in the EHR prior to discharge or transfer, consistent with facility policy and workflow.

8.0 Government Surveillance

The Government may monitor performance through chart audits, ED log reviews, validation of monthly reports, and periodic quality reviews.

9.0 Deliverables (Applies Unless Modified by Task Order)

Unless otherwise specified in a task order, the Contractor shall provide:

• Monthly performance reports (metrics, volumes, response times, interpreter timeliness, SAFE‑T completion, Safety Plan completion, etc.).

• Staffing coverage plan (including surge approach).

• Quarterly quality improvement summaries.

• Incident reports within 24 hours of critical events, when applicable and consistent with facility reporting procedures.

10.0 Transition Requirements

Task orders may include transition-in activities to validate connectivity, workflows, escalation pathways, documentation standards, and site-specific processes. At task order completion, the Contractor shall support orderly transition-out, including final reporting and transfer/disposition of Government data as directed.

11.0 Non-Personal Services

Services under this contract are non-personal services. Contractor personnel shall not be supervised or controlled by Government personnel.

12.0 Indemnification and Medical Liability Insurance

FAR 52.237-7 Indemnification and Medical Liability Insurance (JAN 1997)

(a) The Contractor shall indemnify the Government and its employees from liability resulting from performance of this contract. The Contractor shall maintain such insurance as is necessary to protect the Contractor from claims arising out of the performance of this contract.

(b) The Contractor shall provide and maintain during the entire period of performance of this contract medical liability insurance covering damages due to death or injury to persons arising from the Contractor’s performance of this contract.

(c) The Contractor shall ensure that all healthcare providers furnishing services under this contract maintain current and valid professional liability insurance with minimum coverage of $1,000,000 per occurrence and $3,000,000 aggregate, or higher if required by state law or facility policy, and acceptable to the Contracting Officer.

(d) The Contractor shall provide proof of such insurance to the Contracting Officer upon request.

13.0 Additional Regulatory and Compliance Requirements

FAR 52.224-1 Privacy Act Notification (APR 1984) FAR 52.224-2 Privacy Act (APR 1984)

The Contractor shall comply with all applicable provisions of the Privacy Act and ensure protection of patient information.

HIPAA Compliance:

The Contractor shall comply with the Health Insurance Portability and Accountability Act (HIPAA) and all applicable HHS/IHS privacy and security requirements, including safeguarding Protected Health Information (PHI).

Professional Standards:

All providers shall adhere to applicable clinical standards of care, licensure requirements, and IHS-specific policies governing telehealth and behavioral health services.

ATTACHMENT 1 — PERFORMANCE REQUIREMENTS SUMMARY (PRS)

This PRS establishes minimum performance standards for task orders issued under the IDIQ. Task orders may add, remove, or modify PRS elements consistent with site-specific workflows and requirements.

Note: Remedies above describe minimum corrective actions. The Government reserves the right to apply additional remedies consistent with the contract, task order terms, and applicable acquisition regulations.