Solicitation IHS5421107 Q and A_dated 10-30-20.pdf

Solicitation IHS5421107 – Question and Answers Dated 10/30/2020

1) PWS 1.1. Is the Rapid Triage Screening Model coded in software the Government furnishes to contractor personnel? No. The contractor must furnish its own computer software and hardware associated with telephone triage.

2) PWS 1.2.2. Please confirm whether contractor RNs need to be on site at CCHCF or whether the contractor may provide services remotely. Please also confirm whether IHS expects the contractor to provide the toll‐free number and bear associated charges. Contract RN’s do not provide services on site. Service is exclusively remote.

Contractor is expected to furnish its own toll‐free number and bear associated charges.

3) PWS 3.1. Please confirm that the RN is expected to chart encounters in HIE. Please also clarify whether the

Government will provide HIE training to contract RNs. Contract RN is not expected to document in HIE. Triage encounter forms uploaded into the Chinle EHR are automatically transferred to the HIE. Contractor is expected to have view only access to the HIE for the purposes of reviewing a specific patient’s medical information, if indicated to complete an accurate triage.

4) PWS 3.3. What is the method and frequency of inspection by Dr. Ritchie? Dr. Ritchie receives and signs off on all triage encounter documents. These are reviewed randomly for quality assurance. Dr. Ritchie also investigates complaints or issues raised by patients or medical staff related to the nurse phone triage service.

5) PWS 4.1. Is the contractor responsible for maintaining its own call center software and associated hardware? Is

HIE a web‐based system? If not, what software/connectivity will contract personnel require to access HIE? Yes, the contractor is responsible for maintaining its own call center and associated hardware. HIE is a web‐based portal.

6) PWS 5.1.4. Does the Government have any data on how many calls per year have required Navajo to English translation? Also the pricing volume includes a line for “other language”, but that is not mentioned in the PWS.

What other languages does the Government expect the contractor to be able to translate? We cannot furnish data on the frequency of Navajo translation service usage, however, approximately 25% of the Chine Service Unit patient population lists Navajo as a preferred first language. Translation services into other languages is not anticipated but most contractors use a third party interpreter service capable of translation into many languages.

7) PWS 5.1.5. Specifically, which TJC standards shall apply to contract services? Is the contractor required to be certified by TJC in Healthcare Staffing Services? The contractor shall adhere to TJC standards with regard to 24/7 access to care for organizations certified as a Primary Care Medical Home by TJC. Yes, the contractor is required to be certified for healthcare staffing purposes but not as a separate healthcare facility.

8) PWS 5.3. Please confirm this subsection refers to mandatory reporting requirements. Refer to solicitation as stated and the cited programs.

9) PWS 6.1. Can the government please confirm that licensure is permitted in any state? Our understanding of non‐ personal services contract is that the contract RN does NOT stand in the shoes of IHS legally and must be licensed in the state in which the pt is in. Accordingly, please provide the list of states from which patients may be calling the triage RN line and confirm that the RN must be licensed in the states from which pts are calling. RN may be licensed in any state. IHS’s authority here derives from the Snyder Act, which authorizes IHS to "expend such moneys as Congress may from time to time appropriate for the benefit, care, and assistance of the Indians," including for the "relief of distress and conservation of health." 25 U.S.C. § 13. Pursuant to the doctrine of intergovernmental immunity recognized by the Supreme Court, a state cannot apply its licensing laws to an employee or contractor carrying out work for the federal government.

10) PWS 6.1.3. Based on our experience, we would recommend changing “the Federal Government or other large entities” to “healthcare systems”, which is more likely to capture the type of experience telephonic triage RNs will have and will benefit the Government and its beneficiaries. Will remain as is.

11) PWS 6.2. Please add “certification” to this section. For example, we are TJC certified because we are a healthcare services firm but not “accredited” because we are not a healthcare facility. Here, the Government is purchasing services, so “certification”, at least with respect to TJC in PWS 6.2.1 is also an appropriate credential. The contractor shall adhere to TJC standards with regard to 24/7 access to care for organizations certified as a Primary

Care Medical Home by TJC. Yes, the contractor is required to be certified for healthcare staffing purposes but not as a separate healthcare facility.

12) PWS 6.5. Will orientation be in person or virtual? Virtual.

13) Please provide inbound call volume data, including call arrival patterns (i.e. allowing industry to understand which days and times are heavy, which are lighter) and average handle times for the last year. Similarly, please provide outbound call volumes (e.g. PWS 5.1.3). Estimated average of 15 calls per day. 52% were actual nurse triage, 48% were for general information about COVID‐19

14) The pricing schedule has line items not described in the PWS, e.g. 2) Nurse Triage Call with RX Refill, 4) Physician

Referral, 5) General Information and Messaging Calls, and 7) On‐Call Schedule Maintenance. What are each of these services? Is a bidder required to price each line separately, or can it simplify pricing in its proposal? Simplified pricing is acceptable. Our experience thus far has been that rx refills and physician referral are not services that are utilized. General information and messaging can be included as a line item. This service has been utilized heavily in 2020 to provide general information about the novel coronavirus. On‐call schedule maintenance merely refers to ensuring the contractor has up to date information about physicians on call at the facility for consultation, if needed. This service can be billed as a line‐item or just included in the per‐call rate.

15) Is there a page limit to the “Qualifications” and “Technical Capabilities” submissions? Refer to solicitation size limitation.

16) Past Performance: may bidders provide CPARs or PPQs completed by customers (this is the norm for most Q‐ coded services bids, and CORs typically do not write letters). Refer to solicitation as stated. You may provide this at your discretion.