MSU Endocrinology SOW.docx

Mescalero Service Unit

PURPOSE

The contractor shall provide Endocrinology Medical Doctor outpatient treatment non personal services agreement to the following Albuquerque Area Indian Health Service Facility:

Mescalero Service Unit Outpatient and Urgent Care Department 318 Abalone Loop Rd Mescalero, New Mexico 88340

Acquisition will be for 52 weeks working 16 hours a month (one full day and one half day) for one year.

DESCRIPTION OF SERVICES/SUPPLIES

The contractor shall be in accordance with all Federal, State, Local, Tribal and IHS regulations and shall be made with minimal divergence from the schedule established and with minimum disturbance and maximum protection of government personnel, property and general public.

The contract shall provide Endocrinology Medical Outpatient treatment non-personnel services with the following specifications:

· Contractor will participate directly in the medical care of the patients, performing functions to the extent delineated by the medical staff privileging process and individual licensure.

· Contractor will adhere to the scope of work and accept work assignment from the Clinical Director as necessary.

· Contractor will analyze patient’s medical history, medication allergies, physical conditions, examination, and test results to determine appropriate medical treatment plan for course of treatment.

· Contractor will conduct exams and tests to determine likelihood of endocrine gland related issues

· Contractor will examine patients to obtain information on medical conditions, need for surgery and surgical risks as necessary

· Contractor will follow up with patients to monitor conditions and provide patient education

· Contractor will provide lifesaving and support measures in emergency situations as necessary

· Contractor will work with appropriate staff, outer agencies and accepting facilities to medically stabilize and coordinate appropriate surgical services or urgent and emergent transfers to acute inpatient hospital facilities.

· Contract shall provide thorough and concise written documentation of evaluations, treatment, active orders, medications and referrals through the Electronic Health Record in a timely manner in accordance to the MSU HIM Internal Control policy. Record keeping, release of information and patient confidentiality are in compliance with HIPPA Guidelines.

· Contractor shall participates in Quality Assurance/Risk Management activities of the hospital and peer review functions as necessary

· Contractor shall have knowledge of Personal Protective Equipment (PPE) technique, usage and disposal for infectious control purposes.

· Contractor will adhere to guidelines as outlined in the Medical Staff Bylaws.

· Contractor must maintain credentialing and privileges at MSU.

· Contractor shall only be compensated at the agreed contract amount based on invoices submitted and only for services in direct performance of this contract.

· Training and training expenses are not covered by this contract, unless it is included as; training required by IHS for new Technology or as requirement of the IHS and IHS itself has not had the required training to carry out its mission.

· The contract terms and conditions does not allow for accrual of annual or sick leave or other fringe benefits.

· Overtime compensation is not authorized in this contract.

· QUALIFICATIONS

· Contractor will maintain active license as a Medical Doctor in this state or any other state of the United States of America throughout the duration of this contract.

· Contractor will poses and Maintain Board Certification throughout the duration of this contract.

· Contractor must maintain credentialing and privileges at Mescalero Service Unit

· Certified for ACLS, BLS, and PALS; current and must maintain throughout duration of contract.

· Able to provide 3 professional references of the same degree or discipline (ex. MD to MD)

· Contractor must have a valid driver’s license

· Provide documents to complete security procedures to include fingerprint cards

· Maintain confidentiality of patient care records

· Poses, maintain and able to provide proof of Medical Professional Liability Insurance in the amounts of $1,000,000/$3,000,000.

· HEALTH REQUIREMENTS

· Contractor shall meet the following health requirements prior to assignment:

· Provide prior to entering on duty evidence of current immunization for:

· Immunity to Rubella, Mumps, Measles

· Immunity to Hepatitis B

· History of chicken pox disease or positive titer

· Tetanus Diphtheria (Td) within the last 5 years

· Documentation of receiving a TB skin test (PPD) within the past 12 months with documentation of follow-up for a positive test.

· Current influenza immunization or documentation by a provider that the contractor has an allergy to egg

· COVID-19 Immunization

· Provide prior to entering on duty evidence of negative PPD or chest X-ray if history of positive PPD completed within the last 12 months.

· Contractor must provide evidence of physical examination conducted within the preceding twelve (12) months. A copy of a physical examination must be provided prior to the first day of assignment.

· Guidelines applicable in the performance of the contract are established hospital policy and procedure, laboratory policy and procedure, doctor’s orders and memoranda.

· Contract shall be responsible for maintaining satisfactory standards of competence, conduct, appearance and integrity. The quality of work performance of the contractor’s employee shall be subject to review.

· Contractor’s employee shall abide by the IHS facility standards of conduct and the policies and procedures of the service unit and assigned department/unit. Guidelines applicable in the performance of the contract are established doctor's orders, hospital policy, local directives, and standing orders.

· The Contractor shall complete the required documents for the character investigation in compliance with Public Law) (P.L) 101-630 "Indian Child Protection and Family Violence Act of 1990". The contractor’s employee will answer and sign the attached document entitled; "Care and Certification of Addendum to Declaration to Federal Employment, Indian Health Service, and Indian Child Care Worker Positions".

· SCHEDULE

· Services are required at one 8 hours day and one 4 hour day per month for 12 months (with an hour NON-PAID lunch break). Scheduled shift do not include weekends and holidays. Hours of Operation are:

· Saturday and Sunday afternoons 1230 – 1700 (4.5 hours)

· Mondays 0800-1900

· Tuesdays 0800-1900

· Wednesdays 0800-1900

· Thursday 0800-1900

· Friday 0800-1900

· HOLIDAY 1230 - 1700

· Contractor's Employee work hours will be arranged accordingly by the Clinical Director or designee, and/or depending on the need of the Mescalero Service Unit. Travel to/from the facility site is not included in the schedule hours and contractor's employee cannot invoice that as part of the scheduled shift.

· The Contractor's Employee shall be responsible for notifying the designated Contracting Officer's Representative in advance of any situation that would prevent them from their scheduled shift.

· The unit price paid to the Contractor shall be considered as payment in full for services provided under this contract and shall be inclusive of all travel, taxes, and associated fees. It is the sole responsibility of the contractor to collect and pay for any New Mexico State Gross Receipt Taxes for work performed in the State of New Mexico, regardless of county the work was performed. In no way shall the contractor bill or collect from any IHS patient, or from any alternate resource for which the patient may be eligible, any monies for services provided under this contract.

· CONTRACTOR PERFORMANCE CONDITIONS AND RESPONSIBILITIES

· Contractor is responsible for maintaining satisfactory standards of competence, conduct, appearance and integrity. The quality of work performance of the contractor shall be subject to review.

· Contractor shall abide by the facility standards of conduct and the policies and procedures of the service unit and the assigned unit.

· Contractor is responsible for notifying the Clinical Director Personnel on duty if he/she will be late, or is ill and/or is unable to work for other reasons.

· Contractor is compensated only for hours actually worked at the agreed compensator rate.

· Cooperative Attitude: Behavior that is positive and displays a willingness to perform assigned patient care tasks and to be a team player.

· Cultural Awareness: Realization and respect for American Indian and Alaska Native practices.

· Contractor shall possess basic knowledge, skills, and abilities to use a computer.

· Contractor shall read, understand, speak, and write English to effectively communicate with patients and other health care workers, and shall be respectful of the local, American Indian and Alaska Native culture.

· Evaluation CRITERIA

The proposal shall be evaluated to determine the Offeror's ability to complete all requirements necessary for successful performance under the contract. A proposal which merely paraphrases the requirements stated in Performance Objectives will be ineligible for award. In addition, a proposal that addresses only a part of the requirements will be considered unresponsive to this solicitation and unacceptable for award. The proposal should show that the requirements stated in Performance Objectives of this solicitation are understood and offer a logical approach for their achievement.

(1) FACTORS FOR AWARD

The Government will award a Fixed-Price contract resulting from this solicitation to the responsible Offeror whose offer, conforming to this solicitation; will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

1. Contractor Candidate Qualification

2. Past Performance with Indian Health Services

3. Price An award will be made on a best value basis; both price and other factors considered. Offeror's proposal is found to be technically acceptable, based upon the evaluation criteria, and the Offeror is determined responsive and responsible in accordance with the terms and conditions of this solicitation.

(2) RELATIVE IMPORTANCE OF EVALUATION CRITERIA

All evaluation factors other than price, when combined, are significantly more important than price. Factor 1 is more important than Factor 2. Factors 1 and 2, when combined, are more important than price. Selection of the firm to perform this Contract will be based on IHS’ assessment of the best value to the Government.

· CRIMINAL HISTORY BACKGROUND CHECK:

· The contractor is subject to character investigation in the performance of the contract in accordance with P.L. 101-0630, "Indian Child Protection and Family Violence Act of 1990".

· Contractor’s employees whose duties and responsibilities involve regular contact or control over children are subject to a character investigation as required by Public Law 101-630, The Indian Child Protection and Family Violence Act. The minimum standards of character shall ensure that none of the individuals described in subsection have been found guilty of, or entered a plea of nolo contendere or guilty to, any felonious offense, or any of two or more misdemeanor offenses, under federal, state, or tribal law involving any crimes of violence; sexual assault, molestation, exploitation, contact or prostitution; crimes against persons; or offenses committed against children. These crimes do not hold a time statue and will be evaluated the same under any Child Care “CNACI” investigation with IHS. IHS will conduct these investigations following award of a contract. Until the character investigation has been completed and the Contracting Officer notified of the results, the Contractor‘s employees must not have unsupervised contact with Indian children. Contractor’s employees are not able to work a scheduled shift until the security check is performed and clearance has been obtained by the appropriate agency. At a minimum, fingerprints are required and upon clearance of this stage a contractor’s employee may work a scheduled shift. However, Contractor’s employees are required to complete the detail background application and application is to be completed within 30 days once the contractor’s employee has been given access. All Contractors’ employees are subject to criminal background check prior to performing services in accordance with Task Order terms and conditions. The contractor shall ensure that each of their employees complete the Certification of Criminal History and Background Check Packet. The completed forms are to be returned to the COR. Additional Background Check packets can be obtained through the COR.

· Complete and return the form "Addendum to Declaration for Federal Employment.

· Completed document shall be returned to the Contracting Officer.

· Failure to respond may be cause for termination.

· The Contractor shall possess all licenses and certifications required by Federal, State, and local laws prior to performance of this contract and shall be maintained current during the term of the contract. Contractor employees shall be courteous, professional, present a neat appearance and be easily recognized. This includes wearing distinctive clothing bearing the name of the company or by wearing appropriate badges that contain the company name and employee name.

NON-PERSONAL SERVICES

The services provided under this order are non-personal in nature as defined by FAR 37.101, Non-Personal Healthcare Service, under which the contractor is an independent contractor and shall perform the work described herein independently of government supervision and that the provision of services are in accordance with FAR 52.237-7.

FINGERPRINTING REQUIREMENTS FOR SECURITY AND SUITABILITY:

Prior to start of services specified by the contract scope of work, the Contractor must contact the General Service Office at the designated IHS facility to schedule an appointment to complete the fingerprinting process required by the IHS regulations pertinent to security and character background investigations.

“Please note in Title 25 - Chapter 34 – Sec. 3207 – Character Investigations of Public law 101-630 , Criminal records – The minimum standards of character that are to be prescribed under this section shall ensure that none of the individuals appointed to positions described in subsection (a) of this section have been found guilty of, or entered a plea of nolo contendere or guilty to, any felonious offense, or any of two or more misdemeanor offenses, under federal, state, or tribal law involving crimes of violence; sexual assault, molestation, exploitation, contact or prostitution; crimes against persons; or offenses committed against children. These crimes do not hold a time statute and will be evaluated the same under any Child Care “CNACI” investigation with IHS”.

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

CONTRACTOR RESPONSIBILITIES

Pursuant to the Public Law (PL) 101-630, Indian Child Protection and Family Violence Prevention Act and Public Law (PL) 101-647, Crime Control Act, the Contractor shall be responsible for completion of all applications and forms required for the purpose of a background character investigation. If the Contractor is a group practice, all professionals scheduled to provide services at the designated IHS facility are required to complete the appropriate forms. The Contractor shall be required to schedule an appointment with the General Service Office representative for completing the forms and for fingerprinting.

The Contractor shall be responsible for notifying the designated IHS representative in case of an emergency or inclement weather that would prevent him/her from providing medical services.

The Contractor shall designate in writing, a Contractor’s Representative, who has authority to act for the Contractor and be responsible for contract performance. The Contractor shall provide the name, telephone/facsimile number and e-mail address of the Representative in writing to the Contracting Officer Representative (COR) within 5 days after contract award. An alternate name and telephone number shall be provided when the primary person will be absent for more than three days.

The Contractor shall possess all licenses and certifications required by Federal, State, and local laws prior to performance of this contract and shall be maintained current during the term of the contract. Contractor employees shall be courteous, professional, present a neat appearance and be easily recognized. This includes wearing distinctive clothing bearing the name of the company or by wearing appropriate badges that contain the company name and employee name. The Contractor shall furnish to the Contracting Officer, prior to commencement of performance, evidence of insurance coverage described herein:

CLIENT BACKGROUND

Some of the IHS patients receiving services under this contract may only speak a native language or may have limited comprehension of the English language, and/or may reside on a Native American Indian Reservation. The Contractor is expected to demonstrate sensitivity to cross-cultural and language difference and have the ability to work through interpreters.

REVIEW, APPROVAL AND EVALUATION

The Contracting Officer or his duly authorized representative shall review and approve services provided under the terms and conditions of the contract.

The Contracting Officer, the designated Government Project Officer and the Contractor shall evaluate the services during the term of contract and the report of the evaluation will be made a part of the official contract file. The evaluation will be objective and directed toward the progress made in meeting the contract objectives and statement of work, resolve problems encountered, clarify issues that may arise unexpectedly and to evaluate the accomplishments. The evaluation will be conducted on dates mutually agreed to by all parties.

a. Quality Assurance Review

a. Overall evaluation of the Contractor's performance in meeting the terms of the contract will be reviewed and monitored according to the applicable Service Unit Quality Assurance Standards. Reviews shall consist of patient chart audits, peer review, and patient satisfaction surveys.

b. The Contractor will be informed if any quality of service problems are identified by the IHS Project Officer and the Contractor shall take appropriate corrective action within appropriate timeframes specified by the Government. Failure to do so may result in Termination for Default.

COMPENSATION

The Contractor shall be compensated at the agreed contract amount based on monthly invoices submitted and only for services in direct performance of this contract. The Contract does not allow for annual or sick leave or other fringe benefits. Per mandate by the U. S. Department of Treasury and effective July 1996, payments by Electronic Funds Transfer System will be made to the Contractor's designated financial institute.

PRICING

Offers will be accepted in the following format:

SHIFTS ARE ESTIMATES ONLY

EVALUATION CRITERIA

The proposal shall be evaluated to determine the Offeror's ability to complete all requirements necessary for successful performance under the contract. A proposal which merely paraphrases the requirements stated in Performance Objectives will be ineligible for award. In addition, a proposal that addresses only a part of the requirements will be considered unresponsive to this solicitation and unacceptable for award. The proposal should show that the requirements stated in Performance Objectives of this solicitation are understood and offer a logical approach for their achievement.

(3) FACTORS FOR AWARD

The Government will award a Fixed-Price contract resulting from this solicitation to the responsible Offeror whose offer, conforming to this solicitation; will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

4. Admitting/Surgical privileges at a Hospital or Surgical Center within 50 mile radius of MSU

5. Qualifications

6. Past Performance

7. Price An award will be made on a best value basis; both price and other factors considered. Offeror's proposal is found to be technically acceptable, based upon the evaluation criteria, and the Offeror is determined responsive and responsible in accordance with the terms and conditions of this solicitation.

(4) RELATIVE IMPORTANCE OF EVALUATION CRITERIA

All evaluation factors other than price, when combined, are significantly more important than price. Factor 1 is more important than Factor 2 and 3. Factors 1 and 2, when combined, are more important than price. Selection of the firm to perform this Contract will be based on IHS’ assessment of the best value to the Government.

DELIVERY LOCATION

The contractor shall provide Board Certified Physician services, non-personal services agreement to the following Albuquerque Area Indian Health Service Facility:

Mescalero Service Unit Outpatient and Urgent Care Department 318 Abalone Loop Mescalero, New Mexico 88340.

PERIOD OF PERFORMANCE

Supplies/Services under this contract shall commence NLT 10 days after award:

Performance shall be for the period TBD through TBD unless the period is changed by written modification to the purchase order in accordance with FAR 52.217-9, Option to Extend the Term of the Contract.

Total contract award shall not exceed this timeframe.

GOVERNMENT FURNISHED MATERIALS AND SUPPLIES/OFFICE FACILITIES/EQUIPMENT

The Government may provide the use of medical and office equipment/space, minimum use of office supplies & materials, computer use, if available, routine office/medical equipment i.e. fax machine, copy machine, etc.

CONTRACT OFFICER REPRESENTATIVE (COR)

Deena Evans, 575-464-3808, is hereby designated as Contract Officer’s Representative for this service. The Contract Officer Representative responsibilities will be to coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The Contract Officer’s Representative does not have the authority to change or alter the order amount, terms and conditions.

The Contract Officer’s Representative responsibilities include ensuring contractor accountability, monitoring the contractor's technical progress- including the surveillance and assessment of performance and recommending to the Contracting Officer changes in requirements, interpreting the statement of work, performing technical evaluations as required, performing technical inspection and acceptance required, assisting the contractor in the resolution of technical problems encountered during performance and receiving and processing invoices for payment.

ISBEE CASCADING SET-ASIDE:

Offers will be solicited from Indian Small Business Economic Enterprise (ISBEE) concerns. If we do not receive enough competition and/or reasonably priced offers from the ISBEE set-aside, we will then evaluate quotes and consider for award to other small business concerns. Any acquisition resulting from this cascading set-aside will be from such a concern as follows: First Tier: ISBEE Second Tier: all other Small Business Concerns. Offers received from enterprises that are not one of these small business concerns will not be considered.

SUBCONTRACTS:

None of the services furnished under this agreement shall be subcontracted or transferred to another contractor, or organization, without the specific prior written approval of the Contracting Officer.

IHS CONTRACTING OFFICER:

The authority to negotiate a change in terms, conditions, or amounts cited is reserved for the IHS contracting Officer. The COR designated holds no such authority.

GENERAL CONTRACT INFORMATION:

Contractor Requirements Mandated by the Federal Acquisition Regulation (FAR) to comply with the mandate, the contractor must obtain a Data Universal Numbering System (DUNS) Number. The DUNS No. is a 9-digit number assigned by Dun and Bradstreet Inc., to identify unique business entities. If the offeror (Contractor) does not have a DUNS Number, it should contact Dun and Bradstreet directly to obtain one by calling 1-866-705-5711 or via the internet at http://www.dnb.com. Refer to FAR Clause No. 52.204-6, Data Universal Numbering System (DUNS) Number (Dec 2012).

Effective on July 31, 2012, the System for Award Management (SAM) replaced the Central Contractor Registration (CCR). During the term of the contract, the Contractor's DUNS number shall be in active status in accordance to FAR 52.204-6, Data Universal Numbering Systems (DUNS) and updated annually in the System Award Management (SAM) pursuant to 52.204-7, Central Contractor Registration (Dec 2012). You June access SAM at www.sam.gov.

Contractors/Vendors wanting to do business with the government are required to register in CCR and revalidate annually. This provides payment information, validates Small Business Administration certifications as small, disadvantaged, 8(a), or HUB-Zone businesses, calculates business size, and validates taxpayer IDs with IRS.

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.

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.

CONTRACT ADMINISTRATION DATA

Accounting and Appropriation Data The accounting data must be in cited on invoice for reimbursement.

CONTRACTING OFFICER RESPONSIBILITY:

The authorities to negotiate changes in the terms and conditions or the amounts cited in the contract are reserved to the Contracting Officer.

INVOICE SUBMISSION:

The Contractor shall submit invoices directly to the following address:

4101 Indian School Road NE, Suite 225 2nd Floor P.O Box 210

The following information must be cited on each invoice submitted for payment.

- Contract No.

- Contractors Name and Address

- DUNS No.

- Date of Invoice period

- Hours of services provide during the invoiced period.

- Invoice No.

- Invoice signed and dated, and to include the following certification:

"I hereby certify that all services provided and invoiced are for appropriate purposes and in accordance with the terms and conditions of the cited contract."

Per mandate by the U. S. Department of Treasury and effective July 1996, all contractor payments will be by Electronic Funds Transfer System (EFT).

Payment Office The payment office is:

1. Albuquerque Indian Health Service Division of Accounting Services 4101 Indian School Road NE, Suite 225 2nd Floor Albuquerque, NM 87110

Electronic Funds Transfer (EFT) Disbursed by:

1. U S Department of Treasury Office of Disbursements Austin, TX 73301

SPECIAL CONTRACT REQUIREMENTS

a. Privacy Act Notification

(a) This contract requires the Contractor, on behalf of the IHS to provide health care to American Indians and Alaskan Natives and report selected medical record and financial information to IHS. The Synder Act (25 U.C.S. 3) and Public Law 83-5658 (42 U.S.C. 2001) authorizes the collection of this information.

(b) To be reimbursed by IHS, you must provide the information required by the purchase-delivery orders issued under this contract. IHS will use the information for financial, legal, research and health care purposes. Disclosure of this information may be made by IHS to: other providers of health care for treatment or health maintenance of American Indian or Alaskan Native people; the Officer Worker's Compensation, Department of Labor; the Department of Justice for their representation of the United States; and for Congressional inquiry; quality assessment, medical audit, or utilization review; billing third parties for the payment of care, analytical and evaluation studies; to Federal or State agencies as required by law. Disclosure of the appropriate medical information without prior consent of the subject patient may be made by you: to another provider of health care treating the same patient, a Federal or State agency as required by law such as the reporting of communicable diseases, births, deaths, or the commission of crimes (i.e. gunshot wounds, rape, child abuse or neglect, alcohol or drug abuse, etc.); and billing third parties for payment of care not reimbursed by IHS.

(c) You must forward all other requests for information contained on this form to the applicable IHS Ordering Official.

b. Privacy Act Violation Notification

(a) Pursuant to the section of the Privacy Act entitled, "Civil Remedies", a Federal employee or contractor can be required to pay up to $5,000 if,

i. A Federal employee or Contractor, who knows that certain types of releases of information about a patient are prohibited, willfully discloses the information to a person not entitled to receive it.

ii. A Federal employee or contractor keeps information about individual people and does not make public notice of it as required by the Privacy Act of 1997, or;

iii. Any person or organization asks for or gets a copy of an individual's record under false pretense.

(b) The Privacy Act of 1974 was designed to establish and protect certain rights of people served by the employees of the Federal Government or their contractors. The Contractor shall ensure that each Contract employee is aware that he/she can be subject to criminal penalties for violations of the Act to the same extent as a Federal employee. Questions concerning the Privacy Act Procedures may be directed to:

Joel McIntosh, Area Privacy Act Coordinator Albuquerque Area Indian Health Services 4101 Indian School Road NE Albuquerque, New Mexico 87110 Telephone (505) 256-6817