Neuropsych SOW.pdf

Attachment D: Statement of Work Indian Health Service Early Childhood Neuropsychological Evaluation PAO

STATEMENT OF WORK

GENERAL SCOPE:

The Contractors shall provide all personnel, equipment, supplies, and travel resources for personnel required in order to provide culturally sensitive in-person neuropsychologic assessments and evaluations of referred American Indian/Alaskan Natives that reside within the Phoenix Area (PAO) of the Indian Health Service (IHS). The PAIHS covers the states of Arizona, Nevada, Utah, and parts of California. PAO Integrated Behavioral Health (IBH) will only be paying for the evaluations. Specific locations for service are Ft. Yuma Service Unit, Ft. Yuma, Arizona; Elko Service Unit, Elko, Nevada; Uintah and Ouray (U&O) Service Unit, Ft. Duchesne, Utah; and Colorado River Service Unit (CRSU) with focus on Chemehuevi Reservation, California; Havasupai, Arizona and Moapa, Nevada locations. The preferred place of performance would be within these four (4) listed states. Referrals will originate from IHS/Tribal/Urban programs, hospitals, and health clinics, which are to be considered “customers.”

The reservation areas in these states are remote and have limited behavioral health services. Specifically, assessment for various cognitive and learning impairments is severely lacking or non-existent. PAIHS recognizes that State, Federal, Tribal, and private sector resources for these specific areas of need are minimal to none, and gaps exist. This Statement of Work (SOW) seeks to address these gaps in service.

Assessments provided by the Contractors are required to be submitted in a timely manner, and quick access to these assessment services will be a priority for these referrals. The level of need and environment or home setting for these referred patients suggests that there is a high demand and need for behavioral health services that include alcohol/substance abuse, mental health, and inpatient/residential treatment services.

Evaluations will be performed by contractors with experience providing such services to American Indian/Alaskan Natives and/or tribal communities.

The contractor will utilize data from applied assessments to compose an integrated written report to inform relevant parties. Contractor support for needed clinical and supportive resources related to newly identified diagnoses or disorders will be an included service sought as part of the assessment.

The contractor will have five (5) business days to respond to evaluation requests; 10 business days to schedule evaluations from the time response is given; 20 business days to provide an evaluation of the referral; 15 business days from completion of the evaluation to provide a written report to the requesting provider and IBH via secure email. The maximum allowable time for the entire process is 50 business days, based on availability and/or scheduling of contractor to provide such evaluations. The contractor is to provide an evaluation invoice to PAO IBH within 10 business days of evaluation completion.

The PAIHS anticipates an estimated 50 referrals per annual year. Minimum referrals will be between one

(1) and 50 per year.

PROGRAM IDENTIFICATION:

The behavioral health service treatment components for this target population shall include the following for child and adolescent neuropsychologic evaluations.

A. Comprehensive evaluations for referred children and adults with suspected neurodevelopmental disorders (e.g., learning disorders, autism, ADHD) or other psychological/behavioral health concerns.

TARGET POPULATION:

The target population is federally recognized tribal members, from participating Phoenix Area tribes, referred from eligible federally recognized tribal programs, IHS programs, or IHS Urban Programs within the Phoenix Area as described in the aforementioned general scope. These referrals will be approved by PAO before a commitment to pay for services will be provided to the referring program by the PAO.

This referred target population consists of children and young adults in need of formalized neuropsychological evaluation and diagnoses.

PROGRAM DESCRIPTION:

The Contractor shall provide all the necessary evaluation services for the identified target population. The following service components that are included are not all-inclusive, but serve as the minimum requirements that are necessary for the delivery of these services:

A. Comprehensive evaluations for referred children and adults with suspected neurodevelopmental disorders (e.g., learning disorders, autism, ADHD, FASD, intellectual ability, and adaptive behavior) or other psychological/behavioral health concerns.

1. Based on the results of evaluations, make impactful and actionable recommendations to individuals and/or caregivers for support to improve educational, employment, and personal outcomes. As part of the comprehensive evaluation process, components of the evaluation will consist of:

Conduct intake interview and review of past records, to assess for relevant historic psychosocial information and current functioning.

Administer relevant cognitive, achievement, and personality measures to provide diagnostic clarity in addressing the cause for referral.

Utilize data from applied assessments to compose an integrated written report to inform relevant parties.

Provide actionable, relevant, and helpful recommendations to assist the client in obtaining needed academic, vocational, or behavioral health resources.

Provide feedback to clients in both verbal and written format to provide an understanding of the results.

Maintain continuance of Client care through consultation, referral, and follow-up with recommended agencies.

B. The contractor(s) behavioral health services will occur in person.

C. The contractor will schedule Behavioral Health Services during normal business hours and will not schedule appointments during major US or tribal holidays.

D. The contractor shall be available for consultations with the Behavior Health Director and/or staff, either by telephone or in person.

E. The contractor will maintain industry standards of ethical and professional competence in the effort to integrate personal and group identities to provide informed and culturally sensitive assessment practices and recommendations that account for potential psychological and educational differences by:

o Consulting with relevant cultural and community leaders and incorporating feedback sourced to inform accommodations during assessment administration and information of culturally congruent recommendations for treatment and services o Providing culturally informed training and supervision to staff grounded in extant literature and feedback from consultant agencies.

o When no local cultural informant is appropriate for consultation, the clinic will consult with IHS to identify a contact within the community.

EXPECTED ASSESSMENT PERIOD:

The contractor will have five (5) business days to respond to evaluation requests; schedule the evaluation within ten (10) business days to schedule evaluations from the time response is given; 20 business days to then provide an evaluation within twenty (20) business days of the referral; and 15 business days from completion of the evaluation to provide a written report to the requesting provider and IBH via secure email. within fifteen (15) business days after evaluation completion. The maximum allowable time for the entire process is 50 business days, based on the contractor's availability and/or scheduling to provide such evaluations. The contractor is to provide an evaluation invoice to PAO IBH within 10 business days of evaluation completion.

ANNUAL ESTIMATED NUMBER OF PATIENT REFERRALS

Individuals estimated to be referred annually for this Statement of Work will be as follows: minimum referrals will be one (1) per year, with a maximum of 50 per year. The need for the referring programs may increase or decrease depending on the needs of the overall PAIHS community of referring programs, but the maximum referral allotment shall not exceed50 individuals in a single year.

CONTRACTOR PERSONNEL EDUCATION AND LICENSURE:

The Contractor represents and warrants that the Contractor has and shall continue to have the ability, expertise, qualifications, licensure, and capacity to render the requested services. Contractor’s clinical providers shall meet or exceed educational and licensure requirements for their particular profession/discipline in accordance with State of location, Federal, and/or another appropriate regulatory licensure authority.

CONTRACTOR ACCREDITATION:

State licensure and accreditation of the contracted entity by a national accrediting body is required for contract consideration and approval. The preferred national accrediting bodies include The Joint Commission (TJC), Accreditation Association for Ambulatory Healthcare, and Commission on Accreditation of Rehabilitation Facilities, or The Center for Improvement of Healthcare Quality.

Individuals will be licensed/accredited based on their specific discipline and applicable state board(s) and oversight of their background and maintenance of licensure during the contract period will be conducted by their employer/organization.

CONTRACTOR CULTURAL COMPETENCY:

Cultural competency is the ability to respond to the needs of populations with different cultures.

Contractors with experience serving American Indian and Alaskan Native patients and /or Tribal communities are highly desired for this requirement.

REFERRAL PROCESS AND PRIOR AUTHORIZATIONS:

Eligible tribal and IHS behavioral health programs under this contract will obtain initial financial approval from the Phoenix Area Behavioral Health (PAO BH) program and then the requesting provider, referred to as “Customer,” will contact the Contractor either by telephone, secure email or fax to initiate the referral process for completing the necessary documentation for evaluations.

The contractor will respond in five (5) business days to evaluation requests, schedule the evaluation within 10 business days, then provide evaluation within 20 business days of referral and provide a written report to requesting provider and IBH via secure email within 15 business days after evaluation completion. This process may total fifty (50) business days, based on the availability and/or scheduling of the contractor to provide such evaluations. The contractor is to provide an evaluation invoice to PAO IBH within 10 business days of evaluation completion.

The Phoenix Area Indian Health Service will pay for the approved evaluation via a formalized reimbursement process in the Invoice Processing Payment (IPP) system. Once the requesting provider “Customer” and IBH have confirmed receipt of the evaluation and PAO IBH receives the invoice in IPP, payment for completed evaluations will be sent to the Contractor.

PAO IBH is not financially responsible for the payment of invoices for evaluations exceeding the allotted time period for receipt of referral, scheduling, and evaluation, in this case 60 days, nor is IBH responsible for the payment for evaluations that did not receive authorization prior to evaluation.

PROGRAM EVALUATION/REVIEW:

The Contractor shall have program files available to IHS evaluators on request for purposes of an on-site program inspection/review. The program evaluation may include a review of policy and procedures and related program documents such as intake forms, assessment tools, and licenses. Additionally, all administrative and clinical records pertaining to the patients.

PLACE OF PERFORMANCE:

The contractor shall provide services at their facilities . States to be considered are AZ, NV, UT, and parts of CA.

PERIOD OF PERFORMANCE:

Performance under this contract shall consist of a base year with 12 months of service followed by two (2) option years for consecutive 12-month periods. The contract shall also include a month-by-month option not to exceed a total of six months of service exercisable at any point in the period of performance.

Base Year 1 ___________ 2025 through 2028

No. Description Date:

01 Base Year TBD 02 Option Year TBD 03 Option Year TBD 04 6-Month Option TBD

OPTION PERIOD OF PERFORMANCE:

All options shall be exercised under the authorities of FAR 52.217-8, Option to Extend the Services of the Contract and FAR 52.217-9 Option to Extend the Terms of the Contract.

SCHEDULE OF DELIVERABLES/REPORTING REQUIREMENTS:

1. Unless otherwise agreed to by the contracting officer per HHSAR 352.232-71(c), the use of IPP shall take precedence over previously established invoicing procedures.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at

(866) 973-3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov The Contractor shall invoice separately for each client/patient. The invoice shall contain the following terms:

- Name and address of Contractor

- Taxpayer Identification Number (TIN)

- Invoice date and invoice number

- Contract number

- Description of services (no identifying patient information), i.e., Neuropsychiatric Evaluation provided at ____________________________.

- Dates of service (no patient information)

- Number of evaluations multiplied by unit price

Send a copy of the completed evaluation via secure email to IPP.

PHOENIX AREA INDIAN HEALTH SERVICE

OFFICE OF HEALTH PROGRAMS

INTEGRATED BEHAVIORAL HEALTH

ATTN: CDR SCOTT PEAKE

II RENAISSANCE SQUARE

40 N. CENTRAL AVE. STE. 606

PHOENIX, AZ 85004

INVOICE AND EVALUATION :

Contractor to provide invoice indicating evaluation completion to PAO IBH within 10 business days.

Contractor to provide requesting provider and PAO IBH evaluation report within 10 business days of completion. These two documents will be required before payment will be processed. Copies of invoices shall be sent to: PHXAreaAP-team@ihs.gov.

Key Personnel:

Any changes to the Key Personnel shall be requested in writing and submitted to the Contracting Officer for approval.

Key Personnel:

(a) Board of Directors

(b) CEO

(c) Chief Operating Officer and/or Chief Financial Officer

(d) Vice Presidents (if applicable)

Property Inventory:

DUE DATE Annually

* No person other than the Contracting Officer may bind the government in any way.