P - Teleradiology Sections B-M.docx

75H71124R00002

75H71124R00002

PART I, SECTION B – SUPPLIES OR SERVICES AND PRICES

BASE YEAR

Price Per

Total Base

Pricing

OPTION YEAR 1

Price Per

Total OY1

Pricing

OPTION YEAR 2

Price Per

Total OY2

Pricing

OPTION YEAR 3

Price Per

Total OY3

Pricing

OPTION YEAR 4

Price Per

Total OY4

Pricing

TOTAL PRICING

5 YEARS

END OF SECTION B

PART I, SECTION C – DESCRIPTIONS /SPECIFICATIONS/STATEMENT OF WORK

Statement of Work

1. General: This Statement of Work describes the requirement for the provision of diagnostic radiology services for the Oklahoma Area Indian Health Services (IHS) and Albuquerque Area Indian Health Services (IHS) and the Pine Ridge Hospital; and radiology transcription services for all mentioned areas.

1.1 Background: The Oklahoma and Albuquerque Areas are Joint Commission accredited but do not have a staff radiologist within their direct patient care programs at this time.

A physician has been designated Medical Director of Radiology Services by the Claremore medical staff and is not qualified as a radiologist. Contracted radiology services are therefore required to supplement and complement the hospital and health center direct care programs so that adequate radiology services are available to the medical staff to meet the requirements for patient care needs.

IHS is an agency within the U.S. Department of Health and Human Services and is responsible for providing federal health services to American Indians and Alaska natives. The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes. The IHS is the principle federal health care provider and health advocate for Indian people. The goal is to assure that comprehensive culturally acceptable personal and public health services are available and accessible to American Indians and Alaska Native people. The IHS currently provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 34 states.

1.2 Scope: Provide diagnostic radiology services, professional consultation and radiologic transcription services to comply with The Joint Commission (TJC) and the American College of Radiology (ACR). Services shall be fully coordinated and integrated with the direct patient care program with respect to services provided, professional relationships, Quality Assurance requirements and maintenance of standards of patient care. Accountability requires that all services be under professional direction, therefore, the Contractor shall be fully responsible for any subcontracts, professionally, administratively and financially.

1.3 Applicable Documents

· The Joint Commission (TJC) http://www.jointcommission.org

· Centers for Medicare and Medicaid Services (CMS) Standards http://cms.gov

· Accreditation Association for Ambulatory Health Care (AAAHC). http://aaahc.org

· Health Insurance Portability and Accountability Act (HIPAA) of 1996. http://www.ihs.gov/AdminMngrResources/HIPAA/index.cfm?module=elec_reading_room

· IHS Information Technology and Records Security and Safeguard Policies. http://www.ihs.gov/generalweb/helpcenter/webmaster/standards/information%20system.htm

· IHS Computer Security Directives http://www.ihs.gov/cio/securityawareness/index.cfm

· IHS Director’s initiatives http://www.ihs.gov

· DICOM. http://medical.nema/org

· American Cardiology of Radiology. http://www.acr.org/s_acr/index.asp

· Section 231 of Public Law 101-647, Crime Control Act of 1990

· System for Award Management (SAM) http://www.sam.gov

· American Association for Radiology Transcriptions (AAMT) website: http://www.aamt.org/ScriptContent/Index.cfm

· American Health Information Management Association (AAMT) website: http://www.ahima.org

· Business Partner Interconnection Security Agreement DIS-TEMPLATE-09-01 [Word-347k]

· Health Information Technology for Economic and Clinical Health Act (HITECH) Act ARRA Components—January 6, 2009 http://www.hipaasurvivalguide.com/hitech-act-text.php

· BPISA Checklist [Word-192k]

· BPISA Rules of Behavior [Word-205k

1. Definitions

2.1 Acceptance- Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart 46.5 and subject to other terms and conditions of the contract.

issue contracts and to make subsequent modification(s). The CO has full authority to make determination on all changes and disputes regarding the contract.

2.27 Contracting Officer’s Representative (COR) - A Government employee who assists the CO in the administration of task orders issued under the contract. The COR is primarily responsible for the day to day program management of ordering activity’s task orders.

2.6 Contractor – The individual awarded a legal binding contract to provide diagnostic radiology services and professional consultation services.

2.7 Credentialing – The process of verifying provider Licensure training and education.

2.8 Customer- Staff at an IHS facility.

2.9 Customer Evaluation – Written comments made to the CO regarding the contractor’s performance. This is one of the criteria used to monitor the contractor’s performance.

2.10 Delivery- Contractor successfully delivered data files.

2.11 Delivery Order- An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activity’s written order to obtain services, at a minimum shall include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number and the ordering activities order number.

2.12 DICOM – Diagnostic Imaging communication in Medicine.

2.13 Dictation- Verbal report recorded onto radiologist’s digital dictation system.

2.14 Electronic Health Record (EHR)- is a longitudinal collection of patient-centric healthcare information available across providers, care settings, and time.

2.15 Error- Incorrect terminology; omitted terminology; punctuation or spelling that changes the meaning of the sentence; entering material that is not dictated; entering material that is not part of the report such as dictator’s directions to transcribers; transposed letters; unauthorized abbreviations; misspelled words that would have been caught by a spell-check program; incorrect use of blank line(s); entering information in the wrong format, and entering symbols (such as “@@@” or “(inaudible)”) for dictation that is clearly understood.

2.16 Federal Acquisition Regulations (FAR) – The FAR is the primary regulation for use by all Federal Executive agencies in their acquisition of supplies and services with appropriated funds.

2.17 File Transfer Program (FTP)- Software used to transfer data files from a host computer to a remote computer.

2.18 HIPAA- The Health Insurance Portability and Accountability Act.

2.21 Line- A line is equal to 65 characters or key strokes. Each letter, symbol, spacebar, tab, and enter key will be counted as one key stroke each.

2.22 Log File- A read-only text file which shall record a time stamp when a voice file is retrieved by the contractor and the time a text file was delivered by the contractor.

2.23 Lost reports- Reports dictated by CIH facility employees and verified as received by the contractor but not returned to CIH facility.

2.24 Ordering Activity- An authorized user of OCAO IHS that may issue a task order to obtain required services under this contract.

2.25 Ordering Activity Contracting Officer- A Government employee of CIH IHS authorized and warranted to issue task orders and to make subsequent task order modification(s) under this contract. The Ordering Activity CO has the authority to make initial determinations on all matters of dispute regarding task orders.

2.31 Referring Facility Physician - An IHS medical professional who orders the radiographic and medical images or his/her designee.

2.32 Resource Patient Management System (RPMS) - Facility software modules developed in the MUMPS programming language.

2.33 Routine/Standard Interpretations of Radiographic/Medical Images - Interpretations of standard radiographic and other medical images (i.e. Ultrasound, MRI, mammography) of a non-emergent nature. Written interpretations required within 24 hrs.

2.34 Service Unit – The local administrative unit of IHS Area Offices.

2.35 Stat (includes emergent and or critical) Interpretations of Radiographic/Medical Images - Interpretations of radiographic and other medical images done as stat or on emergency basis. Telephonic interpretations to the referring facility physician or designee required within 20 minutes, with written interpretation to follow.

2.35 Task Order – An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activity's written order to obtain services, at a minimum shall include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number and the ordering activities task order number.

2.36 Turn-around-Time (TAT) - Elapsed time beginning when a voice file is available on the host server to the contractor and ending when the transcribed report is delivered back to CIH host server.

2.37 Valid Complaint- Justifiable accusation made by the customer and supported by investigation.

2.38 Written- defined as either electronic or telefax or transcribed transmission.

1. Government Furnished Information, Property, and Services

3.1 All digital medical imaging files provided to the Contractor for interpretation shall remain the property of the government. Contractor shall not publish and /or share outside Contractor’s organization any IHS digital or analog image or imaging study report without the express written consent of the sending IHS facility. Any publication or sharing outside of Contractor's organization of any digital or analog images or imaging study reports undertaken with the express written consent of the sending IHS facility shall be done in a manner allowed by HIPAA and all other IHS rules and regulations.

3.2 Joint use by the Government and the Contractor- All digital images and x-ray films shall be provided to the Contractor for interpretation service only. As clinically indicated, sending IHS facilities will forward available copies of prior radiology studies requested by the Contractor in order to assure comparison interpretations. Contractor shall securely retain digital images and x-ray films in a HIPAA-compliant manner consistent with best practices for future clinical questions that may occur from the sending IHS facilities.

3.4 Electronic Voice and Data Files- All .WAV and data files provided to or generated by the Contractor for transcription shall remain government property, secured, and stored pursuant to the terms of this contract. After expiration of the contract data storage requirements, all protected health information shall be destroyed and/or returned to the Contracting facility.

3.5 File Storage and Host Server Information:

3.6 CIH will provide to the Contractor the path and directory names of the folder where the transcribed text files will be stored by the application software after transcription. CIH will provide the Contractor the appropriate level of permission (write only) for the application program to connect to the designated folder.

1. Contractor Furnished Information, Property, and Service

Contractor shall provide DICOM compatible formatted equipment. Shall provide all material, supplies, and maintenance necessary to provide the interpretation service described herein.

Work orders shall be received and Interpretive Reports returned to IHS facilities electronically via HL 7 format for all participating facilities capable of transmitting study information /receiving study reports in HL7 format.

Except for information and property as specified as government furnished, the contractor shall provide all equipment, facilities, material, supplies, software application and maintenance necessary to provide the transcription service described herein.

1. Specific Requirements: The Contractor shall provide the necessary personnel, supplies, material s and equipment to provide for the interpretation of digital exams for the Oklahoma Area, Albuquerque Area Indian Health Services (IHS), and Pine Ridge; and professional consultation services at the Oklahoma Area Claremore Indian Hospital.

5.1 Routine and Emergency Study Interpretation

All radiology study interpretations are to be performed by licensed; Board certified/eligible radiologists.

The Contractor shall provide interpretations on a routine and emergency basis. Final interpretations for studies sent as routine are to be returned to the sending IHS facility by 12:00 PM Central time of the next business day. Final interpretations for studies sent as emergency/stat are to be returned to the sending IHS facility within 20 minutes of study receipt by the Contractor.

The Contractor may provide preliminary interpretations (so-called "wet readings") for radiology studies sent after-hours), as long as final interpretations are still to be returned as outlined above.

5.2 Critical Results

The Contractor shall immediately notify the sending site clinician via the telephone concerning any results where the interpretation may be deemed critical to patient care. This includes significant abnormal findings on routine and emergency studies that may affect a patient's care or treatment. The Contractor shall also immediately notify the sending site clinician via the telephone concerning any and all discrepancies between preliminary interpretations and final interpretations (should the Contractor provide preliminary interpretations for after-hour emergency studies).

5.3 Radiologist Availability for Telephone Consultation

Contractor radiologists shall be available 24 hours/day and 7 days/week for telephone consultation so that ordering clinicians from IHS facilities may discuss radiology examinations and interpretations with them.

5.4 Estimated Workload

The estimated workload identified in Appendix A is an estimate of the radiology study workload by type and IHS Area. While these numbers should not be understood as definitive, they represent a reasonable guide to workload for the base period of the contract. Additional workload from within the IHS Areas listed in this SOW may be requested during the course of the contract. The Contractor should have sufficient radiologist staffing to receive increased workload.

5.5 Reporting Requirements

The Contractor shall provide interpretation reports in HL7 format, for all participating IHS facilities capable of transmitting study information /receiving study interpretation reports. All contractor reports shall be compatible with the HL7 software package used by the Indian Health Service (the VA HL7 software package). Reports shall also be available via secure facsimile or secure internet/server-based interpretation service, for facilities unable to receive study interpretations in HL7 format (either because of inability to do so or because of temporary difficulty in doing so).

Final interpretations are preferred. Should the Contractor provide preliminary ("wet") interpretations for critical results and or stat or emergency studies, both the preliminary and the final interpretations shall be provided for the sending facility. For facilities whose information systems are unable to receive both the preliminary and final interpretations in electronic format (i.e. two reports cannot be electronically accepted for a single radiology study accession number), the contactor shall provide the final interpretation in electronic format and the preliminary interpretation via facsimile or secure internet/server-based interpretation service.

5.6 Billing

The Contractor shall provide information concerning Contractor radiologists such that billing for radiology interpretation services can be successfully conducted by the sending IHS facilities. This information may include, but is not limited to, radiologist NPI and other Medicare / Medicaid billing identification numbers and identifiers. The Contractor shall work with the IHS facilities to facilitate billing for services by IHS facilities. At the time of award, billing addresses will be determined for each facility.

5.7 Quality Control

The Contractor shall perform quarterly Quality Control peer review on interpretations from electronic images specific to each facility location covered under this contract. This Quality Control (QC) peer review shall occur as part of the Contractor's Joint Commission-Compliance Quality Control program. Discordant interpretations shall be graded as to their clinical significance (agree, disagree-insignificant, disagree-significant).

In addition, a log quantifying discrepancy rates between preliminary vs. final interpretations shall be maintained and reported as part of the quarterly quality control report. This log should likewise assess discordant interpretations as to their clinical significance (agree, disagree-insignificant, disagree-significant).

The Contractor shall also provide a mechanism for independent review of studies identified by either the IHS sending facilities and/or the Contractor as inaccurate or of concern; this information shall include all adverse events that result from the telemedicine services provided by the distant site physician or practitioner to the hospital's patients and all complaints the hospital has received about the distant site physician or practitioner. IHS reserves the right to request a more focused peer review.

Quarterly reports, via either hard copy or electronic mail, should be forwarded to the applicable Credentialing Specialist. The contractor shall notify the appropriate Credentialing Specialist of their quarterly review dates and shall have 10 working days to submit report. These reports shall express peer review discordance rates and any additional information that is pertinent to the Contractor's performance of quality assurance for the tele-radiology services provided.

Quarterly discordant interpretation rates greater than 3% for "disagree-significant" category discordant interpretations require that the Contractor submit to the IHS a detailed plan for quality improvement. Persistent discordant rates greater than 3% for "dis agree-significant" category may lead to discontinuation of the contract.

5.8 Communication/Network Infrastructure

The Contractor shall interface with Government furnished Image Archive and PACS (Picture Archiving and Communication System) communications platform(s) at participating IHS facility sites. Many sites use the VA Vista Imaging software suite for Image Archive and PACS services while other facilities use commercial systems. The Contractor shall utilize Image Storage, Tele-radiology PACS Reading System and Reporting System that are compliant and compatible with industry standards by the American College of Radiology (ACR), HIPAA and the Food and Drug Administration (FDA). The Contractor shall specify an acceptable compression ratio for a given study before the contract is awarded. The Contractor shall be capable of receiving a 14x17 high resolution (20MB) radiology study within one (1) minute of study transmission (once the study has been successfully sent to the Contractor from the sending IHS facility). Computer monitors utilized by the Contractor for purposes of radiology study interpretation shall be calibrated in a timely fashion consistent with proper quality control procedures at the reading site. This calibration shall be in compliance with ACR and FDA recommendations for monitor calibration. The Contractor shall provide the IHS with documentation of equipment quality control policies and certifications, upon request.

5.9 TRANSCRIPTION SPECIFIC REQUIREMENTS

The Contractor shall receive voice files (radiology dictation) from CIH via radiologist’s digital dictation system, transcribe the voice recordings, and return transcribed reports to CIH host server ensuring that the performance standards of the contract are met. These transcribed reports shall be entered into the RPMS system. The contractor shall provide the required service on a 24-hour, 7-day-a-week basis. The Contractor shall protect all data files and all Contractor hardware and software in accordance with IHS Manual Part 8, Chapter 12, Privacy Act of 1974 and HIPAA privacy rule. The Contractor shall have the facility security and IT security necessary to safeguard all Government records in accordance with Government requirements.

5.10 Management of Electronic Voice Files

5.12 The system shall be accessible 24 hours a day, 7 days a week.

5.13 A back-up system shall be provided in the event the primary system fails.

5.14 The dictation system shall be accessed by digital voice recorder via Radiology Information System.

5.15 The dictation system shall record, store and provide reporting and query capabilities for the following information: dictator’s name, dictator’s identification number, chart number, type of report, date and time recorded, date and time transcribed, length of dictation and job number.

5.16 The Contracting facility shall have access to the dictation system database 24 hours a day, 7 days a week via Internet or Network access.

5.17 The Contractor shall update the log file real-time when files are received and notify the COR immediately when they are unable to receive voice files. An alternative method shall be agreed to by both parties.

5.18 Transcription of Electronic Voice Files:

5.19 The Contractor shall transcribe voice files to meet the performance standards of this contract.

5.20 The Contractor shall ensure full compliance with HIPAA requirements at all times during the transcription process.

5.21 The Contractor shall transcribe all electronic voice files into English.

5.22 The Contractor shall adapt to variations in accents, speech patterns, tone, voice volume, note and style delivery, pronunciations, enunciations, and regional dialect for each voice file.

5.23 Format:

5.24 The Contractor shall provide Radiology Transcriptions in the proper format. See Exhibit 1

5.25 Left, right and bottom margins shall be one-half (1/2) inch. The top margin shall be one (1) inch.

5.26 Date and time dictated, date and time transcribed, job number, dictator’s initials and transcriber’s initials shall be typed at end of every report.

5.27 Patient’s name, chart number, headers and footers shall appear on every page.

5.28 A minimum of 1-1/2 to 2 full lines of text (excluding signature line) shall be carried over to an additional page preventing orphan/widow lines.

5.29 The Contractor shall use these symbols “@@@” for inaudible words or phrases that cannot be understood or heard.

5.30 The Contractor shall recognize obvious inconsistencies, discrepancies, and inaccuracies and appropriately revise, edit, or clarify, without altering the meaning of the dictation or changing the dictator’s style, flag for review, or bring to the attention of the CIH Medical Record Personnel. The Report will be marked with these symbols “@@@” and a deficiency report explaining the problem shall accompany the report. Example: dictation of “@@@ left leg” with subsequent dictation of “@@@ right leg”.

5.31 The Contractor shall prepare all transcribed reports in an MS Word file format ensuring that the text is Times New Roman Font, size 12, single spaced between lines and double spaced between paragraphs.

5.32 The Contractor shall spell out all abbreviations in full that are on the hospitals’ “Unacceptable Abbreviation List” See Exhibit 2.

5.33 Abbreviations shall not be used in the admission diagnoses, impressions, discharge diagnoses, preoperative and postoperative diagnoses, or in the names of operations and procedures.

5.34 The Contractor shall adhere to official transcription formatting standards as published by the AAMT unless otherwise specified in this contract.

5.35 The Contractor shall accurately transcribe the spelling of the patient’s name, the attending, dictating, and operating provider’s names and titles as verified by patient census lists and staff rosters which shall be provided to the Contractor.

5.36 Delivery of Transcribed Reports:

5.37 The Contractor shall deliver transcribed reports, in an MS Word file format, electronically using a minimum of TLS 1.2 with an AES 128-bit cipher suite that meets FIPS 140-2 encryption requirements.

5.38 The Contractor shall ensure that all transcribed files are delivered virus, ad-ware, spy-ware FREE and in MS Word file format.

5.39 Turn-Around-Time (TAT): The Contractor shall deliver transcribed reports to achieve the following turn-around-time:

5.44 Customer Service

The Contractor shall identify a lead point-of-contact for questions and issues related to clinical service delivery. The Contractor shall also identify a customer service representative to assist IHS staff with billing and /or administrative questions during regular business hours 8:00 A.M. to 5:00 P.M. Monday through Friday (CST). The Contractor shall maintain a toll-free telephone number or equivalent telephone service 24 hours per day with an answering service or recording machine.

The COR for the Albuquerque Clinical Lead is Dr. Juliana Reese, 505-256-6734 and Oklahoma is Dr. Greg Woitte, 405-951-3776 and Patty Cummings is at Pine Ridge, 605-867-3084

5.45 Deliverables: Roles and Responsibilities

The contractor shall provide a monthly report of service volume of all modalities and over-read activities. These reports shall be provided to the COR.

The COR reserves the right to call for additional reports on an as needed basis.

Key Personnel Changes: All changes that affect the contract shall be communicated to the Contracting Officer, as soon as possible. The contractor shall submit additions to staffing to the appropriate Credentialing Specialist PRIOR to the radiologist reading, who will then notify the contractor once the radiologist has been privileged to perform radiology services. The contractor shall also submit deletions from staffing to the appropriate Credentialing Specialist, as soon as possible.

Contractor shall provide semi-annually calibration of equipment compliance with the DICOM part 14 standards.

The contractor shall have the capability to receive and send study report information in an HL7 format. If the contractor can does not have this capability to interface with the software we are working with, then it is their responsibility to develop that interface.

Credentialing and Privileging: The contractor shall submit a list of radiologist(s) credentialed and privileged to provide service under this contract along with their respective documentation of credentialing and privileging approval to the appropriate Credentialing Specialist. Once the radiologist has been approved, the Credentialing Specialist will notify the contractor the radiologist has been approved to begin providing radiology services outlined in this contract. The contractor is responsible for providing the applicable Credentialing Specialist with updated information regarding the status of each radiologist(s) credentialing and privileging expiration dates and renewal status.

5.46 Training

The Contractor shall provide training and support to participating IHS facilities for any secure internet/server-based platform or software used to transmit work orders and teleradiology images from IHS facilities to Contractor and interpretations from Contractor back to IHS facilities, within 14 days of the contract award date.

In addition, the Contractor shall provide, upon request, as needed training and support based on the needs of the IHS facility, for example, when staff turnover occurs. Training and support shall be provided within 7 days of the request.

The Contractor shall visit each facility participating under this contract bi-annually and as required by Radiology or Medical staff to meet the needs of the facility.

Also, the Contractor shall make an initial site visit to each facility participating under this contract within 45 days of the service start date.

5.47 Security

The Contractor shall obtain completed IHS ISSO Security Clearance prior to the start of this contract. This clearance will establish that the Contractor has provided sufficient local telecommunication network firewalls and procedures to ensure patient confidentiality and security consistent with HIPPA (Health Insurance Portability and Accountability Act of 1996) regulations, FlPS, and ACR (American College of Radiology) Guidelines.

5.48 Interconnection Security Agreement (ISA)

Contractor shall provide and complete an ISA with the IHS, prior to the performance of any actions related to the contract.

5.49 Business Associate Agreement (BAA)

The Contractor shall complete an approved copy of a BAA to IHS, prior to performance of any actions related to the contract. This BAA will be attached to solicitation.

5.50 Patient data security plan

The Contractor shall describe the security plan for patient data. This includes location of physical servers and reading centers in support of contractor services. The plan should include any encrypted wireless systems used by reading providers. All wireless systems shall be FIPS-140 compliant.

5.51 Encryption Protocols

Contractor will provide the ability to comply with l PSec VPN standards for encrypting communications. All communications between participating facilities and contractor that are transmitted outside the IHS Wide Area Network must be encrypted.

5.52 Section 508 Compliance

Contractor shall conform to Federal 508 requirements which address accessibility for personnel with disabilities. Contractor shall procure a waiver if Section 508 applicability does not exist or relates to the contract. Please refer to http://www.sectio n508.gov for more information.

5.53 Contractor Qualifications and Relevant Experience Requirements.

Contractor shall possess a minimum 2 years of experience in the practice of teleradiology. References shall be made available upon request.

All radiologists providing interpretations under this contract shall be English speaking.

License: All radiologist(s) shall possess a current, valid unrestricted license in a state, the District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States, throughout the term of this contract.

Board Eligibility: All radiologists shall be Board Eligible or Certified by the American College of Radiology (ACR) throughout the term of this contract. All radiologists shall be eligible to participate in the Medicare or Medicaid programs.

Credentialing and Privileging: The contractor shall be independently accredited by The Joint Commission or employ radiologists who are credentialed and privileged by The Joint Commission or equivalent institution to perform teleradiological interpretations.

All radiologists shall meet the "Qualifications and Responsibilities of Personnel" in the American College of Radiology Technical Specification for Teleradiology Section III, A, Physician.

6.0 ADMINISTRATIVE:

6.3 Equipment Failure: Any delays or downtime due to Contractor equipment failure shall be communicated to the COR or their designee within ten (10) minutes via telephone. The Contractor shall not be penalized for transcription delays due to equipment failure beyond the Contractor’s control (e.g., CIH or OCAOIHS server downtime).

7.0 REPORTS:

7.3 Monthly summary: The Contractor shall provide a monthly report summarizing all data transcribed the previous month to the COR, by the tenth (10) calendar day of the following month, via computer, fax, or as determined by the COR.

8.0 PERIOD OF PERFORMANCE

Performance of this contract shall be for 12 months with four 12-month options. If the Government exercises the options pursuant to Federal Acquisition Regulation (FAR) 52.217-9, Option to Extend the Term of the Contract (MAR 2025), the period of performance shall be extended in accordance with the following schedule:

Option Period

9.0 CONTRACTING OFFICER AUTHORITY

Authority to negotiate changes in terms, conditions, or amounts cited in this contract is reserved to the Contracting Officer.

10.0 CONTRACTING OFFICER REPRESENTATIVE (COR) DESIGNATION

The COR shall be responsible for:

1. Monitoring the contractors technical progress, including surveillance and assessment of performance and recommending technical changes;

1. Technical evaluation as required;

1. Technical inspections and acceptance; and

1. Assisting the Contractor in the resolution of technical problems encountered during performance of this contract.

Albuquerque Area Indian Health Services, 5300 Homestead RD., N.E., Albuquerque, NM 87110

Oklahoma City Area Indian Health Service, Division of Financial Management, 701 Market Drive, Oklahoma City, OK 73114

Great Plains Area, Pine Ridge Indian Hospital Administration.

P.O. Box 1201 East U.S. 18, Pine Ridge, SD 57770 with a courtesy copy to the Contracting Officer’s Representative (COR).

b. The Contractor agrees to include the following information on each invoice:

1. Contractor’s name, address, and telephone number;

1. Contract number and task order number;

1. Invoice number and date;

1. Cost or price;

1. Dates of service including the number of hours worked;

Payment shall be made by the:

Albuquerque Area Indian Health Service, Division of Accounting Management/Budget, 5300 Homestead RD., NE., Albuquerque, NM 87110 a

Oklahoma City Area Indian Health Service, Division of Financial Management, 701 Market Drive, Oklahoma City, OK 73114.

Pine Ridge Hospital P.O. Box 1201 East Highway 18 Pine Ridge, South Dakota 57770

END OF SECTION C

75H71124R00004 Page 3 of 51

PART I, SECTION D – PACKAGING AND MARKING

NOT APPLICABLE – BLANK

PART I, SECTION E – INSPECTION AND ACCEPTANCE

PART I, 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)

END OF SECTION E

PART I SECTION F – DELIVERIES AND PERFORMANCE

PART I, SECTION F – DELIVERIES OR 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)

T I, 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.

(End of Clause)

F.02 PERIOD OF PERFORMANCE

The contract base performance period will be one (1) year with four (4) option years beginning approximately July 1, 2025, through June 30, 2030. Total contract year shall last 5 years.

F.03 PRINCIPAL PLACES OF PERFORMANCE

Contractor and sub-contractor locations shall be the primary place of performance for all referred patients.

F.04 ACCESS TO BUILDING

Contractor shall not need access to any Federal Facility within the Oklahoma Area Indian Health Service.

F.05 SECURITY REQUIREMENTS / BACKGROUND CHECKS

In accordance with Homeland Security requirements, all contractor employees who will perform the services on-site 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 Clinton Service Unit before the changes are incorporated.

F.07 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. (End of clause)

F.08 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.