PackageCRHC23-58.pdf

(i) a. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulations (FAR) Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; bids are being requested and a written solicitation will not be issued.

b. The Indian Health Service/Cheyenne River Health Center intends to award multiply Firm Fixed-Price, Non-Personal Services, Indefinite Delivery/Indefinite Quality (IDIQ) contract, to provide EMT-

Paramedic and EMT-Basic Services for the Ambulance Department at the Cheyenne River Health

Center located in Eagle Butte, South Dakota. The contract resulting from this solicitation will not obligate funds; funds must be obligated prior to ordering through the issuance of a task order. All orders may be submitted electronically, facsimile, or hard copy.

(ii) This solicitation is being issued under solicitation number CRHC23-58.

(iii) The solicitation document and incorporated provisions and clauses are those in effect through

Federal Acquisition Circular 2023-01, dated 12/30/2022.

(iv) This is a 100% Indian Small Business Economic Enterprise (ISBEE) Set-Aside and the associated

NAICS code is 561320 Temporary Help Services, with a Small business Size Standard of $34.0 Million, Product Service Code is Q999 Medical -Other .

(v) Services purchased through this contract will be EMT-Paramedic and EMT-Basic Services for patient care. A list of line items, quantities/units of measure at attached. The “Unit Price” is an all-inclusive cost. All “inclusive cost” is defined to include, but not limited to travel, lodging, per diem, benefits, fuel, freight etc., plus all other costs pertinent to the performance of this contract. The period of performance will be a base year, plus the option to exercise, Four-One(1) year option terms.

See Attached Pricing/Cost Schedule.

(vi) Description of Services: Include, but not limited to, continuous EMT-Paramedic and EMT-Basic

Services, required by the attached Performance Work Statement, for the Cheyenne River Health Center, Eagle Butte, South Dakota.

(vii) The period of performance will include one base year, plus the option to exercise four-1 year option years. Delivery and acceptance terms for this order are with the PWS. POP: Base Yr: 9/1/2023 –

8/31/2024, OY1: 9/1/2024 – 8/31/2025, OY2: 9/1/2025 – 8/31/2026, OY3: 9/1/2026 – 8/31/2027 &

OY4: 9/1/2027 – 8/31/2028.

(viii) The provision at 52.212-1, Instructions to Offerors – Commercial Products and Commercial

Services (Nov 2021), applies to this acquisition. Quotes shall be submitted on company letterhead stationary, signed and dated; it shall include, at a minimum;

1. Solicitation number CRHC23-58

2. Closing Date: July 3, 2023 at 1:00pm MST

3. Name, address, telephone number of the offeror and email address of the contact person

4. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements in the solicitation.

5. Terms of any express warranty

6. Price and any discount terms

7. “Remit to” address, if different than mailing address http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm#P1579_222340

8. A completed copy of the representations and certifications at FAR 52.212-3

9. Acknowledgement of Solicitation Amendments, if issued

10. A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offers that fail to furnish required representation or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

Quotes shall also include the following to be considered acceptable.

1. Signed SF1449.

2. Price/Cost Scheduled.

3. At least 2 Past Performance Questionnaire’s filled out and submitted.

4. Proof of Malpractice Insurance Coverage.

5. Buy Indian Representation Form

6. Certify they understand and can meet all requirements listed in this Solicitation, Performance Work

Statement and Attachments.

7. Candidate information, to include: Resume, current/up-to-date licenses & certifications as requested in the PWS. Encouraged to complete Background clearance forms attached to this solicitation and proof of Mandatory Employee Health Records Requirements as spelled out in the PWS, and guarantee report date.

(ix) The clause at 52.212-2, Evaluation-Commercial Products and Commercial Services (Nov 2021) applies to this acquisition. (a) The Government will award a contract resulting from this solicitation to the responsible offerors whose offer conforming to the solicitation will be most advantageous to the

Government, price and other factors considered.

The basis for award will be based on “Lowest Price Technically Acceptable” along with credential able candidates. Past performance is always an evaluation factor and will be considered.

Technical and past performance, when combined are equal to costs or price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the

Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the

Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

IHS reserves the right to make multiple awards, which is most advantages to the Government. This is a competitive solicitation and the offer your firm submits will be used by IHS to determine, which of the quantities listed within are, “estimate only” and it is not the intent of IHS to be obligated to order the

“quantities”

(x) Offerors must include a completed copy of the provision at 52.212-3, Offeror Representations and

Certifications – Commercial Products and Commercial Services (Dec 2020), with its offer. The offeror https://www.acquisition.gov/content/part-52-solicitation-provisions-and-contract-clauses#i1060530 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm#P1657_236576 shall complete only paragraphs (b) of the provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site located at http://www.sam.gov

(xi) The clause at 52.212-4, Contract Terms and Conditions -- Commercial Items (Oct 2018), applies to this acquisition.

(xii) The clause at 52.212-5, Contract Terms and Conditions Required To Implement Statutes or Executive

Orders -- Commercial Items (Aug 2019) – See attachment for full text.

(xiii) Any additional contract requirement(s) or terms and conditions are determined by the contracting officer to be necessary for this acquisition and consistent with customary commercial practices (i.e.

warranty requirements, HHSAR, etc..) are attached.

(xiv) N/A

(xv) Offerors are due on July 3, 2023 by 1:00 PM MST, and can be mailed, e-mailed or fax to:

Cheyenne River Health Center

Attn: Stephanie Red Elk, COR

24276 166th Street

PO Box 1012

Eagle Butte, South Dakota 57625

Fax: 605/964-7737

Email: Stephanie.RedElk@ihs.gov

Questions in reference to this solicitation shall be submitted to the email address listed above. The last day to submit questions is June 20, 2023 at 1:00pm MST. No questions will be answered after this date/time.

Please be advised that the Government reserves the right to transmit those questions and answers of a common interest to all prospective vendors through a solicitation amendment.

(xvi) Points Of Contacts: Danielle Chasing Hawk, Supervisory Contract Specialist, Danielle.ChasingHawk@ihg.gov, 605/964-0605 or Stephanie Red Elk, Contracting Officer Representative, Stephanie.RedElk@ihs.gov, 605/964-0507,

(xvii) Contractor will need a UIE number, TIN number, and be active & registered in SAM at www.sam.gov.

http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm#P1974_281919 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm#P2174_322700 mailto:Stephanie.RedElk@ihs.gov mailto:Danielle.ChasingHawk@ihg.gov mailto:Stephanie.RedElk@ihs.gov http://www.sam.gov/

DEPARTMENT OF HEALTH & HUMAN SERVICES

INDIAN HEALTH SERVICE

BUY INDIAN ACT

Indian Health Service

Division of Acquisition Policy (DAP) 5600 Fishers Lane

Rockville, MD 20857

INDIAN FIRM REPRESENTATION FORM

SOLICIATION NUMBER: CRHC23-58

PROJECT TITLE: Paramedic & Basic EMT Services

DATE: 06/02/2023

In accordance with 25 U.S.C. 47 the Buy Indian Act, the signature below constitutes self-certification that the Offeror meets the definition of an “Indian Firm” (HHSAR 326.602) with “Indian Ownership” (HHSAR 326.603), in response to this solicitation and resultant contract.

The enterprise must meet the definition of “Indian Firm” throughout the following time periods:

(1) At the time an offer is made in response to this solicitation;

(2) At the time of contract award; and

(3) During the full term of the contract performance period. At any point during these periods, if the Contractor no longer meets the eligibility requirements, the contractor must provide immediate written notification to the Contracting

Officer.

Individual Contracting Officers may require documentation of eligibility before awarding a set-aside or sole source contracts under the Buy Indian Act and awards may be subject to protest if the eligibility of the successful Offeror is in question. In addition to the self-certification requirements, successful Offerors must also be registered with DUN and

Bradstreet (D&B) and the System of Award Management (SAM).

Any false or misleading information submitted by an enterprise when submitting an offer in consideration of an award set-aside under the authority of the Buy Indian Act is a violation of the law and punishable under 18 U.S.C. 1001.

False claims submitted as part of contract performance are subject to the penalties enumerated in 31 U.S.C. 3729 to

3731 and 18 U.S.C. 287.

REPRESENTATION

The Offeror represents as part of its offer that it does , does not meet the definition of an “Indian Firm” with “Indian Ownership” under the authority of the Buy Indian Act.

Business Name Certifying Signature

DUNS Number Print Name

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER

N/A

PAGE 1 OF

1 of

2. CONTRACT NO.

7. FOR SOLICITATION

INFORMATION CALL:

3. AWARD/EFFECTIVE

DATE

a. NAME

4. ORDER NUMBER 5. SOLICITATION NUMBER

CRHC23-58

b. TELEPHONE NUMBER (No collect calls)

6. SOLICITATION ISSUE

DATE

06/02/2023

8. OFFER DUE DATE/

LOCAL TIME

07/03/2023 Stephanie Red Elk, COR 605/964-0507 1:00 PM MST

9. ISSUED BY CODE 173 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: 100 % FOR:

IHS/Cheyenne River Health Center SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

24276 166th St. Airport Rd.

Eagle Butte, SD 57625

11. DELIVERY FOR FOB DESTINA-

12. DISCOUNT TERMS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

SMALL BUSINESS PROGRAM

EDWOSB

8 (A)

13b. RATING

NAICS:

561320

SIZE STANDARD:

$35.0M

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO

IHS/Cheyenne River Health Center

24276 166th St. Airport Rd.

Eagle Butte, SD 57625

CODE 173 16. ADMINISTERED BY CODE

IHS/Cheyenne River Health Center

24276 166th St. Airport Rd.

Eagle Butte, SD 57625

17a. CONTRACTOR/

OFFEROR

CODE FACILITY

CODE

18a. PAYMENT WILL BE MADE BY CODE

IPP.GOV

US Treasuery

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

OFFER BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

100% Buy Indian Set Aside/Small Business

Firm Fixed-Price, Non-Personal Healthcare Service, Commercial Item, Indefinite Delivery/Indefinite Quantity

Contract, for EMT-Paramedic & EMT-Basic Services, for the Ambulance Department, at the Cheyenne River

Health Center(CRHC), Eagle Butte, South Dakota.

The Period of Performance will be a one(1) year base period, with four(4) - one(1) year option periods.

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE

ARE NOT ATTACHED

ARE NOT ATTACHED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF. OFFER

DATED . . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

Craig Wells, CCO, IHS/GPA

31c. DATE SIGNED

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Base Year: 09/1/2023 - 08/31/2024

Option Year 1: 09/1/2024 - 08/31/2025

Option Year 2: 09/1/2025 - 08/31/2026

Option Year 3: 09/1/2026 - 08/31/2027

Option Year 4: 09/1/2027 - 08/31/2028

Fill Out Attached Price/Cost Schedule to submit pricing.

This IDIQ contract does not obligate any funds

Funds will be obligated on an individual basis as

Task Orders and will be issued electronically, sent by email. For details, please refer to the attached clauses FAR 52.216-18 Ordering, FAR 52.216-19 Ordering Limitations and

FAR 52.216-22 Indefinite Quantity.

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

36. PAYMENT

COMPLETE PARTIAL FINAL

37. CHECK NUMBER

PARTIAL FINAL

38. S/R ACCOUNT NO. 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Request for Proposal: CRHC 23-58

EMS Services –PWS

PERFORMANCE WORK STATEMENT (PWS)

EMT-PARAMEDIC & EMT-BASIC SERVICES

CHEYENNE RIVER HEALTH CENTER

Eagle Butte, South Dakota

General

This performance based work statement describes the requirements for non-personal services for the recruitment, credentialing and placement for up to Four (4) EMT-Paramedics and up to Four

(4) EMT-Basic, to support the mission of the Indian Health Service (IHS)/Cheyenne River Health

Center (CRHC).

Agency: The Indian Health Service (IHS), an agency within the Department of Health and Human

Services, is responsible for providing federal health services to American Indians and Alaska

Natives. The mission of IHS is to raise the physical, mental, social, and spiritual health of

American Indians and Alaska Natives to the highest level and assure that comprehensive, culturally acceptable personal and public health services are available and accessible to members of the 567 federally recognized Tribes across the United States.

The Great Plains Area: The Great Plains Area Office (GPAO) in Aberdeen, South Dakota, works in conjunction with its 19 IHS Service Units and Tribal Managed Service Units to provide health care to approximately 130,000 Native Americans located in North Dakota, South Dakota, Nebraska, and Iowa. The GPAO's Service Units include seven hospitals, eight health centers, and several smaller health stations and satellite clinics. Each facility incorporates a comprehensive health care delivery system. The hospitals, health centers, and satellite clinics provide inpatient and outpatient care and conduct preventive and curative clinics.

Background

The Indian Health Service (IHS) an agency within the Department of Health & Human Services is responsible for providing federal health services to American Indians and Alaska Natives. The

Indian Health Service provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 567 federally recognized tribes, in 35 states. The Indian Health Service Headquarters is located in Rockville, MD and then divided into twelve physical areas: Alaska, Albuquerque, Bemidji, Billings, California, Great Plains, Nashville, Navajo, Oklahoma, Phoenix, Portland and Tucson.

Our facility, the Cheyenne River Health Center (CRHC), falls under the Great Plains Area Office

(GPAO). Cheyenne River Health Center (CRHC) provides medical care for approximately

9,000 tribal members living on the CRST Reservation. Serving a rural area, many of our patients travel 100 miles round trip to receive care. The CRHC was built in 2011 to provide an expanded level of health care services specifically designed to meet the needs of the CRHC population.

The Cheyenne River Sioux Tribe through a 638 contract with IHS, operates four satellite health stations which offer basic ambulatory services at Cherry Creek, Red Scaffold, Swiftbird, and

Whitehorse communities. Services include: Emergency Room Department, Pharmacy, Physical

Therapy, Public Health Nursing, Radiology Services, Inpatient Care, Laboratory, MRI, Dental, Community Health, Contract Health Services, Dietitians, Audiology, Eye Care, Inpatient, Pain

Management, and Specialist Clinics: OB/GYN, ENT, Podiatry & Neurology.

Objective

The Contractor shall provide uninterrupted Paramedic Staffing Services in support of the Cheyenne River Health Center at Eagle Butte, South Dakota.

Period of Performance

Base Year: 09/1/2023 – 08/31/2024

Option Year One (1): 09/1/2024 – 08/31/2025

Option Year Two (2): 09/1/2025 – 08/31/2026

Option Year Three (3): 09/1/2026 – 08/31/2027

Option Year Four (4): 09/1/2027 – 08/31/2028

Work Schedule

Hours of Operation: The shifts will be 0700 to 1930 for the day and 1900 to 0730 for the evening. There will be on-call/standby shifts.

Assignments shall require shifts of no more than twelve (12) hours in a 24 hour period. Shifts shall rotate any time during the twenty-four (24) hour period for a total of 80 hours in a two-week period. Holidays and weekends shall be included as part of the 80 hour work period and considered regular hours. Regular, and/or Overtime shall be determined by the EMS Department

Supervisor.

Regular Hours: Working rotating 8-12 hours shifts, during a two week period and equal 80 hours in a two week period.

Overtime Hours: Any hours worked over 80 hours in a two week period.

On-Call: The contractor is off duty, but remains available by telephone for the purpose of being contacted when unanticipated situations arise, and remains within a reasonable call-back radius, and reports for duty within 45 minutes of contact, or if live on campus, within 30 minutes of contact.

Work Flexibility: Because we are a health facility and there are compliance issues where coverage is mandatory, work schedules shall occasionally change. As directed by the departmental supervisor, the contractor shall rotate into other duty sections as needed to support patient care.

A 30 minute unpaid meal break will be included with each shift. Lunch breaks will be taken at the approximate midpoint of the shift, and will not be saved in order to leave 60 minutes early.

rest periods, not to exceed 15 minutes every four hours of scheduled duty, if not on a call at that time. Rest periods will not be used for a continuation of lunch/dinner period or taken at the beginning or end of the workday.

Hours worked do not include travel time to reach the CRHS or other place of performance.

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

Place of Performance

Cheyenne River Health Center

EMS Department

24376 166th Street Airport Road

Eagle Butte, South Dakota 57625

Scope

The Contactor shall provide Services to include staffing for up to four (4) EMT-Paramedic and up to four (4) EMT-Basic.

The Emergency Medical Services (EMS) Department operation hours are 24 hours per day, 7 days per week.

The EMS Services include, but are not limited to: advanced life support ambulance service, transportation of remains, administrative transfers, transports to and from aero-medical evacuation sites, patient transports, and field ambulance services as defined in Indian Health

Manual Part 3 Chapter 17 - Emergency Medical Services and by the state of South Dakota The

Contractor shall provide personnel who are competent, qualified, and adequately trained to perform the assigned duties.

This is a non-personal service requirement to provide support to the Cheyenne River Health

Center. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the contractor who, in turn is responsible to the Government. The contractor shall provide all personnel with supervision and other items as defined in this Performance Work

Statement except for those items specified as government furnished property. The contractor shall perform and shall adhere to the standards in this contract.

Performance Measurements Requirement Summary. The following performance objectives and measures will be used to evaluate Contractor performance and compliance under the contract.

This information will be used to prepare annual past performance evaluations. See Exhibit 1, Quality Assurance Surveillance Plan (QASP), for additional detail

The inspection and acceptance point for all services rendered under this contract will be by the

Cheyenne River Health Center. The performance by the HCP, the quality of services rendered, and any documentation or written material in support of same, shall be subject to continuous inspection, surveillance and review for acceptance by the Contracting Officer Representative

(COR) or designated representative. Any services rendered by the HCP(s) to patients or interaction with personnel deemed unprofessional/threatening/dangerous by the EMS Director will be considered as grounds for immediate removal of the HCP and termination under the clause 52.212-4 (m) Termination for Cause. Quality Assurance procedures established by the

EMS Director shall be used for continuous monitoring. Other performance evaluation factors will be monitored that are not quantified by numerical measurements, which include:

administering medications as provided by the; Contractor providing personnel not meeting the minimum qualification standards; administering inappropriate medications; patient customer service comments; HCP and Contractor relationship with clinic staff/government contracting personnel; compliance with clinic policy and procedures. Services provided by the HCP shall be reviewed and rated in accordance with the Indian Health Service policies, CRHC policies and

Joint Commission (JC) standards. A poor rating shall be grounds for immediate removal of the

HCP(s).

HCP’s will comply and meet all patients and customer service, HCP’s will meet and maintain a high level of patient and customer satisfaction and all times. No more than two substantiated complaints per year will be permitted.

Requirements and Qualifications

The Contractor shall ensure that all Contractor personnel providing services meet the following requirements:

The Contractor shall not employ any individual to provide direct healthcare services who is listed on the Health and Human Services (HHS) list of providers excluded from federally funded healthcare programs. The list may be found at http://oig.hhs.gov/fraud/exclusions.asp.

The HCP shall have sufficient skills, knowledge, and experience to perform the specific tasks see

Paragraph 5. of this Performance Work Statement.

The Contractor will be required to enter into an electronic health system record.

The Contractor and the Contractor personnel shall abide by all clinical standards, rules, and procedures including requirements for licensure, credentialing and quality assurance programs.

The Contractor shall ensure its Contractor personnel perform and maintain required training indicative towards working in a rural setting and Service Unit requirements.

The Contractor shall sit with SI patients, under certain situations, as directed by the EMS

Supervisor.

The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to GPA patient referrals. While performing services for the GPA, the Contractor shall not knowingly employ, http://oig.hhs.gov/fraud/exclusions.asp contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all

“E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent

Amendments, as well as applicable Federal Acquisition Regulations

Contractor personnel shall not have been convicted of a felony.

Contractor personnel shall successfully complete a criminal history background check.

Contractor personnel shall be able to read, write, and speak English well enough and enunciate with sufficient clarity to effectively communicate with patients and various HCPs.

Possess sufficient initiative, interpersonal relationship skills, and social sensitivity such that the

HCP can relate to a variety of patients from diverse backgrounds.

Able to operate a personal computer utilizing Microsoft applications, such as Word, Excel, and efficiently utilize an Electronic Medical Record.

Contractor personnel shall be required to meet Continuing Education (CE) requirements as determined by the Emergency Medical Technicians (EMT) State of licensure, whichever is more stringent. The Government will not reimburse for these costs

EMT Paramedics: Must be National EMT license or a State license. With the ability to obtain a

South Dakota State paramedic license

Required certifications: ACLS, PALS, BLS

EMT basis: Must be National EMT license or a State license. With the ability to obtain a South

Dakota State EMT license.

Required certificate: BLS

Face Masks/Badges: The contractor personnel will be required to obtain and wear badges and masks, in the performance of this service at all times.

Lodging: The Contractor shall be responsible for arranging lodging for their employees that work under this contract. Government Housing is available on a limited basis. Please check with the Cheyenne River Housing Manager for availability and rates at least two weeks before arrival is expected. The CRHC does offer furnished units for contract employees. Depending on the needs of the CRHC and the contract employee, there are unfurnished units available for extended periods of employment. The contract employee is responsible for executing the rental agreement and prompt payment. The Government does not guarantee government housing availability and will be on a first come first serve basis.

Data Rights: The Government has unlimited rights to all documents/material produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government.

These documents and materials may not be used or sold by the contractor without written permission from the Contracting Officer. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

Emergency Health Care: IHS/Cheyenne River Health Center will provide emergency healthcare of the contract providers for injuries incurred while on duty at the facility. These services will be billed to the Contractor at the current full reimbursement rate.

Performance-Based Service Delivery Summary

The contractor’s performance will be measured based on the following Performance

Requirements. The Performance Requirements will be measured against Government

Performance Standards and monitored in accordance with the following Methods of Government

Surveillance or what is known as a Quality Assurance Surveillance Plan (QASP) to determine compliance. A 5% deduction will be assigned to each Performance Requirements. Deductions shall be assessed against individual invoices when services are not performed or do not meet contract requirements. Deductions will be done by the category that was deficient.

Performance Standards/Requirements

PERFORMAN

CE

REQUIREME

NT

PERFORMAN

CE

STANDARD

PERFORMA

NC E LEVEL

SURVEILLANCE METHOD

Staffing for

Department.

Fill all shifts. Fill Rate – 95

% minimum

Review requested and filled shift data. EMS

Director/Supervisory Program Manager monitors and provides feedback to

COR.

Patient and

Customer satisfaction.

Maintain a high level of patient and customer satisfaction.

Max of two substantiated complaints per staff member per year.

Review assessment of customer complaints. EMS Director and provides feedback to COR.

Qualifications of Personnel

All staff shall be certified.

Max of two uncertified staff prior to orientation

Review and obtain appropriate certifications. EMS Director and provides feedback to COR.

Provide patient care per the policies and procedures.

Complete an accurate assessment of patients.

Meets – 100 % Patient complaints, review records to ensure properly completed. EMS Director

Monitors and provides feedback to COR.

Documentatio n of patient treatment using electronic health record system

Document charts completely and accurately.

All required documentatio n completed

100% of the time.

EMS Director/Supervisory

Program Manager monitors and provides feedback to

COR

Run Reports The contractor shall document each individual

EMS/ambula nce response in a timely, legible and accurate manner.

90% compliance for each incident

/response;

documentatio n completed/del ivered to

COR within hours of recording

Reported to EMS

Supervisor/Director per incident and monthly reports to COR.

Turnover rate Complete

Contractor

Manpower Report and notify COR.

Turnover rate – less than 30% per year.

Vendor provides monthly and yearly turnover rates.

EMS

Director/Supervisory

Program Manager monitors and provides feedback to COR.

Patient Safety All patient safety incidents are reporting using

Patient Safety

Report within 24 hours

All patient safety incidents are reporting using Patient Safety Report within 24 hours

– No acceptable deviation

EMS

Director/Supervisory

Program Manager monitors and provides feedback to COR.

Mandatory

Training

Contractor shall complete all required training on time

All (95%) of required training is complete on time by staff.

EMS

Director/Supervisory

Program Manager monitors and provides feedback to COR

Ambulance

Response

Times

Monthly evaluation review of 100% inspection logs

Performance Evaluation: If the contractor fails to perform required services at the acceptable quality level, payment may be withheld until the contractor makes corrections. In the event that the contractor is failing to perform any required services, the COR will provide written notice of such to the Contracting Specialist and CCO and the contractor. The Contracting Office will issue the contractor a Contract Discrepancy Report (CDR). The contractor shall have seven (7) calendar days to provide the Contracting Office with their response to the CDR. Upon evaluation of the contractor’s response to the CDR for tasks surveilled, the contractor’s payment for the month in which the performance is question occurred will be calculated as outlined below.

Contractor Payment: If the contractor fails to perform required services at the acceptable quality level, payment may be withheld until contractor makes corrections.

Contracting Officer’s Representative Designation

The Contracting Officer Representative (COR) designated for this Project is:

Stephanie Red Elk

605-964-0507

Cheyenne River Health Center

24276 166th Street, Airport Road

Eagle Butte, SD 57625

The COR is responsible for:

a. Monitoring the Contractor’s technical progress;

b. Interpreting the statement of work;

c. Technical evaluation as required;

d. Technical inspections and acceptance required by this contract; and,

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

Compensation

The contractor shall be paid a fixed flat rate of per hour. No differential pay for government holidays, compensation time, and night differential. Holidays and weekends shall be included as part of the 80 hour work period and considered regular hours. Regular, and/or Overtime shall be determined by the EMS Department Supervisor.

Quality Assurance Surveillance Plan (QASP)

The purpose of this QASP is to provide a government developed system to assure the use of quality assurance methods in the administration of the performance based acquisition standards.

The intent is to ensure that the Contractor perform services for the Cheyenne River Health

Center that are provided in accordance with performance requirements set forth in the contract documents, that the government receives the quality of services called for in the contract and that the government only pays for the acceptable level of services received.

The plan provides the basis for the COR to evaluate the quality of the contractor’s performance.

The oversight provided for in the contract and in this plan will help ensure that service levels reach and maintain the required levels throughout the contract term. Further, this plan provides the COR with a proactive way to avoid unacceptable or deficient performance and provides verifiable input for the required past performance evaluations.

Contractor Performance Evaluation Report

During the life of this contract, contractor performance will be evaluated on a quarterly basis and final basis pursuant to FAR requirements. These evaluations shall become a part of the contract file and shall be used as past performance information in evaluating the contractor’s, and any subcontractor’s, or affiliates, past performance on future contracts. Contractor Performance

Assessment Report System (CPARS) is an on-line reporting system https:://www.cpars.gov/.

The Contractor Performance Report is completed by the COR electronically and sent to the

Contractor for review and approval at the end of each performance period, as an interim report, and at the end of the contract performance as a final report.

Security/Background Investigation

To perform the work specified herein, contractor personnel will require access to sensitive data, regular access to HHS-controlled facilities, and/or access to HHS information systems. The

Government has determined the position sensitivity under this effort to be Level I.

To gain access to the sensitive data, HHS-controlled facilities, and/or HHS information systems, the Contractor shall comply with Homeland Security Presidential Directive 12, Policy for a

Common Identification Standard for Federal Employees and Contractors, and with the personal identity verification and investigation procedures obtained in:

-HHS Information Security Program Policy, http://www.hhs.gov/ocio/securityprivacy/

-HHS Office of Security and Drug Testing, personnel Security Suitability Handbook, http:://www.hs.gov/ocio/policy/hhs-ocio-2011-0003.html

-HHS HSPD-12 Implementation Policy (draft)

The minimum Government investigation for a non-critical sensitive position is a National

Agency Check and Inquiries (with fingerprinting), which consists of searches of records covering specific areas of a person’s background during the past five years. Those inquiries are sent to current and past employers, schools attended, references, and local law enforcement authorities. More restricted positions, above non-sensitive, require more extensive documentation and investigation.

This security applies to all sub-contracts and/or sub-contractors associated and/or created from this contract.

Required Security Clearance Forms for credentialing and security clearance will be provided to the contractor after award.

References

Statutes, Acts, Laws, and/or Regulations generally applicable to IHS security and functions, include, but are not limited to:

http://www.hhs.gov/ocio/securityprivacy/

• Health Information Technology for Economic and Clinical Health Act

• Federal Information Security Management Act (FISMA), part of the E-Government Act of 2002 (Public Law 107-347, Title II)

• OMB Circular A-130 and Appendix III, Security of Federal Automated Information

Resources

• OMB Circular A-11, Preparing, Submitting, and Executing the Budget

• Presidential Decision Directive 63 (PDD 63)

• NIST Special Publications – 800 Series

• Health Insurance Portability and Accountability Act (HIPAA)

• Indian Healthcare Improvement Act (HCIA) – Public Law 94-437

• Crime Control Act 1990 – Public Law 101-647

• Indian Child Protection and Family Violence Prevention Ace Public Law 101-630

• Privacy Act of 1974

• Section 508 of the Rehabilitation Act of 1973

• Courtesy and Respect in the Workplace Policy

Business Agreement

Pursuant to 45 C.F.R. 164.502(e), the Indian Health Service, as a covered entity, is required to enter into an agreement with a “business associate”, as defined in 45 C.F.R. 160.103, under which the business associate must agree to appropriately safeguard Protected Health Information

(PHI) that is will use and disclose when performing function, activities or services pursuant to its contract with IHS. Therefore, a business associate agreement shall be attached to this contract and executed upon award of this contract. See attached Business Associate Agreement.

Invoice Submission:

Invoices shall be submitted through Invoice Processing Platform (IPP).

The IPP website address is: https://www.ipp.gov

In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum

“Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing” directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award will be required to utilize the Invoice

Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and

Processing of Payment Requests” IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL).

Contractors are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register-however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date. It will be the responsibility of the contractor to keep active and maintain https://www.ipp.gov/ there SAM.gov account, in order to keep there IPP account active. Payment is sent via E.F.T., through the account registered in SAM.gov.

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 or ihse-invoicingteam@ihs.gov

Should the contractor feel that use of the IPP would be unduly burdensome, their response to the solicitation should include an explanation of this position, for a determination by the contracting officer to allow non-IPP invoicing.

The contractor shall submit a signed and approved invoice to request payment through IPP, at least bi-weekly. If services are billed at an hourly rate, invoices will include timesheets, signed off by the department supervisor.

The Contractor shall include the following information on each invoice in accordance with the

Prompt Payment Act (5 CFR Part 1315.9(b):

1. Contractor's name;

2. Invoice number and date;

3. Entire award number/Contract number or other authorization number for delivery of goods or services;

4. Description (including dates of service), price, and quantity of goods and services rendered;

5. Shipping and payment terms;

6. UEI number and Taxpayer Identifying Number (TIN); and

7. Contact name (where practicable), title and telephone number.

Only actual hours worked must be invoiced for, at the Fixed Rate referenced in the award document(s). The government reserves the right to not use all hours enacted under each task order and will de-obligated excess hours at close-out of the task order.

Mandatory Background/Security Clearance Requirements:

The employees of the Contractor or its subcontractors, are subject to a background investigation and shall comply with Section 231 of the Crime Control Act of 1990, P.L. 101-647; and the

Indian Child Protection and Family Violence Prevention Act, P.L. 101-630. In addition, each person shall also comply with the Privacy Act of 1974 and the HIPPA Act of 1996. Failure to comply with these statutes will result in immediate removal.

Contractor personnel performing work under this contract, which involve regular contact with, or control over, Indian children, are subject to a character investigation in accordance with the

“Indian Child Protection and Family Violence Prevention Act” P.L. 101-630. The Indian Health

Service Personnel Office will conduct these investigations following award of a contract unless in the judgment of the Contracting Officer, in consultation with the Personnel Officer, investigation may be waived based on prior investigations on file. Until the character investigation has been completed and the Contracting Officer notified, such individual shall not mailto:IPPCustomerSupport@fiscal.treasury.gov mailto:ihse-invoicingteam@ihs.gov mailto:ihse-invoicingteam@ihs.gov have unsupervised contact with Indian children. This level of security is required, and must be maintained for the life of the contract.

Before starting work requiring routine access to I.H.S. facilities or systems each person must complete a FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S.

employee using the Office of Personnel Management Personnel Investigations Processing

System.

Fingerprint cards need to be mailed by USPS, UPS, or Fed Ex, to:

Cheyenne River Health Center

Attn: Chelsie Veit, Background Clearance

24276 166th Street

Eagle Butte, South Dakota, 57625

The only acceptable format for official fingerprints is federal document FD-258 (Rev. 5-15-

17) 1110-0046. The fingerprints must be ORIGINAL in ink. The document must be completed in its entirety. The fingerprint form when completed can be sent using USPS, Fed-Ex or any commercial carrier but must be sent to the address and person named above.

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.

The Contractor is responsible for conducting security preclearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the

LEIE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access. If this is a Time and Materials, Labor-Hour or Cost Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access or the excess time required to resolve and clear unfavorable security clearance findings. If this is a Fixed Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

Government will pay for the cost to process the contractors suitability clearances. However, multiple investigations for the same position may, at the Contracting Officers discretion, lead to reduction(s) in the contract price of no more than the cost of the extra investigation(s).

Employees that DO NOT have access to LMS, contractors, volunteers, or IHS employees with

IPA’s or MOA’s to tribal organizations please, click here IHS Sexual Abuse Prevention https://www.ihs.gov/sexualabuseprevention/training/ website. When the contractors have completed and passed the training, please have them send a copy of the last page of the training with Name, Date, and Time to their respective Department

Supervisor, COR, and Kimmen LeBeau, e-mail: Kimmen.LeBeau@ihs.gov

Request Background documents from the contractor, to complete the clearance process, should be mailed/FedEx to the designated background coordinator with 5-7 days.

Since the background clearance process may take up to 2 weeks to be processed and cleared, candidates coming on board should have their complete background documents properly filled out, Employee Health Records, and fingerprint cards, sent to the background coordinator 10 days before there scheduled start date. Failure for delay of getting the required background documents into the Background coordinator, will be reflect on contractors rating performance and entered into CPARS.

Mandatory Employee Health Records Requirements:

Clearance from the Employee Health Coordinator (EHC) needs to be obtained prior to the contractor arriving to the facility, this means all records have been collected and reviewed by the

EHC. The EHC will mark the contractor as “Yes” in the Cleared Column of the database when they have been cleared by the EHC in the Onboarding Database.

The required records are:

• Two (2) documented vaccinations of MMR or a titer showing immunity to Mumps, Measles (Rubeola), Rubella

• Three (3) documented vaccinations of hepatitis b or a titer showing immunity to hepatitis B

• Two (2) documented vaccinations of varicella or a titer showing immunity to varicella

• COVID-19: Completed primary series along with most recent bivalent booster vaccine o Medical and Religious Exemptions may be submitted – will need to be reviewed and approved / disapproved by EHC o Appeals process not valid for contractors, only Federal Employees

• Tdap within the last 10 years

• PPD (purified protein derivative) or QuantiFERON- TB Gold within the last year or chest x-ray within last five (5) years to rule out Tuberculosis o Neither item can expire within contracted time o If contractor were to extend and the PPD/Gold/X-ray were to expire during the extension time frame, the expiring items must be completed and submitted to CRHC prior to extension being signed by CRHC

• Flu vaccine for current Flu Season if contracted between Oct 1 and March 31

• Fit Test within the last year to a mask that CRHC carries.

o Fit test cannot expire within contracted time https://www.ihs.gov/sexualabuseprevention/training/ mailto:Kimmen.LeBeau@ihs.gov o If contractor were to extend and the fit test were to expire during the extension time frame, a new fit test must be completed and submitted to

CRHC prior to extension being signed by CRHC

Contactors are required to follow any Employee Health or Infection Control mandates given by Indian Health Services (IHS) Headquarters, IHS Great Plain Areas, IHS Cheyenne River

Health Center, or the Infection Control Preventionist of CRHC. Listed are examples of mandates that would need to be follow as of 1.24.2023, these mandates are fluid and always changing:

• Mandatory Self Screening for COVID before each shift

• Mandatory masking for all areas of the facility

• Mandatory COVID Bivalent Booster Vaccination

EMS Services

SERVICES AND PRICES/COSTS

(Fixed-Price, Services, Commercial Items)

Firm Fixed Price, Non-Personal Services, contract, to provide EMT-Paramedic & EMT-Basic Services, for the Cheyenne River Health Center, located in Eagle Butte, South Dakota. The Period of Performance will be a base year and four 1-year option years.

Base Year: 09/1/2023 – 08/31/2024.

CLIN001. EMT/Paramedic Regular Hours

Item

No Descript of Service Estimated

Qty

Unit No. of

Candidates submitted

(up to 4)

Unit Price Total

Amount

1. EMT-Paramedic

Regular Hours

8,320 HRS

(x)

_____ (x)

Total: $

CLIN002. EMT/Paramedic Overtime Hours

Item

No Descript of Service Estimated

Qty

U…