75H70624R00001-Amendment5_.pdf

DEPARTMENT OF HEALTH & HUMAN SERVICES

Great Plains Area Indian Health Service Federal Building, Room 309 115 4th Ave. SE Aberdeen, SD 57401

OUR REFERENCE: AO-AS/DAM

Amendment No. ) Solicitation Number:

To Whom It May Concern:

Attached is the executed SF-30 document(s) signed and dated by the Contracting Officer in reference to solicitation number RF . Please retain for your own records.

Should you have any questions or need information, please contact Wenda Wright, Contract Specialist at .

Sincerely, Craig J. Wells Contracting Officer Great Plains Area Indian Health Service

Attachment

- SF 30

Questions & Answers: RFP‐75H70624R00001 ‐ Great Plains Area ‐ Emergency Room Dept. & Mgmt. Services

1. Is it Mandatory to bid for all of the labor categories provided, or are we allowed to select specific ones?

Answer: Yes. Section B.4 specifies the required labor categories for the medical facilities under each Schedule. It is mandatory to propose all labor categories for each medical facility under the Schedule for which the offeror is submitting a proposal.

2. Solicitation Page 4/Page 97, Section B/Section L, Schedule of Prices/Instructions, Conditions – Does Schedule B have to provide an Emergency Department Director? Answer: No. See Section B.4 for the required labor categories for the medical facilities under each Schedule.

3. Solicitation Page 11, Section C, Description, Specifications, Performance Work Statement – Does Schedule B have to provide management and oversight of ED Directors, ED Physicians, ED APPs, ED Nurse Leads, ED RNs, and MSAs? Answer: See Section B.4 for the required labor categories for the medical facilities under Schedule B.

As stated in the solicitation, the contractor shall provide the required qualified personnel “to provide comprehensive medical and related services for patients as required by the PWS and in accordance with the terms and conditions in [the] agreement.”

4. Solicitation Page 97, Section L, Instructions, Conditions – How many CV’s do we have to submit with our proposal? Answer: Offerors must submit a resume for the ED Director and/or ED Nurse Lead (if the position(s) is required under the Schedule) and a representative sample of 10 personnel for each CLIN for the Base Ordering Period only.

5. Solicitation Page 102, Section M (M1.1), General Information – What documents need to be provided to show financial stability? Answer: Please, provide a detailed financial statement of your firm’s or company’s financial ability within the Price/Business Proposal

6. Solicitation Page 4, Section B, Schedule of Prices – Do we have to provide all labor categories listed under each facility? (ex, do we have to provide MSAs). Is this an all or nothing bid? Answer: Yes. Section B.4 specifies the required labor categories for the medical facilities under each Schedule. It is mandatory to propose all labor categories for each medical facility under the Schedule for which the offeror is submitting a proposal.

7. Solicitation Page 4, Section B, Schedule of Prices – Are the estimated hours correct? Answer: Yes

8. Who is the current vendor for these services? Answer: Tribal Health, LLC (Rosebud and Pine Ridge) and Worldwide Medical Services, LLC (Fort Yates).

9. What is the anticipated start date of this contract/jobs? Answer: Anticipated award is April 2024. Anticipated start of performance is June/July 2024.

10. Will the existing Clinicians be transitioning to the newly awarded company? Answer: If a new firm(s) is selected for award, it is up to the individual clinicians and the new firm(s) to determine whether the clinicians transition to a new contractor.

11. What is the estimated number of Clinicians that will transition? How many per labor category? Answer: See response to question 10.

12. Will the newly awarded company have to supply support staff, or will those be already at the facility?

Answer: Section B.4 specifies the required labor categories for the medical facilities under each Schedule. The awarded company will need to provide all staff required by the performance work statement (PWS) and as specified in issued task orders.

13. Would you kindly confirm if this is an entirely new effort or is there an incumbent currently providing these services? If so, would you please provide the incumbent contract details? Answer: See response to question 8.

14. Solicitation Page 114, Section L.1.2, Subfactor 2, Qualifications of Clinical Personnel ‐ “The offeror must provide information in table format by CLIN that demonstrates the qualifications of personnel to meet the requirements to include:

1.1.1. A listing of all professional staff who will be assigned to fill each CLIN

1.1.2. Current expiration of degrees; licenses; accreditations, certifications as required by the PWS per category.

1.1.3. Information regarding candidates’ specialized training and expertise, i.e., any education, internships, licenses, certifications, or professional accomplishments or awards shall be included in a comments section in the table.

1.1.4. The NPI for the contractor organization and each individual HCP.”

We respectfully request that the requirement for Section 1.1.4. be amended to as follows:

“1.1.4. The NPI for each individual HCP.”

This request is due to the fact that as the provision is currently written is unnecessarily restrictive to prospective offerors. Contractors do not generally have an NPI unless they sign up for Medicare billing, which is generally not a requirement of Government Solicitations regarding the provision of healthcare staff.

This provision would limit otherwise fully qualified businesses from submitting proposals.

Answer: The Government intends to amend the solicitation to remove the requirement to submit the “NPI for the contractor organization.”

15. Who is the current incumbent contractor for this service? Answer: See response to question 8.

16. What is the Contract number for the incumbent Contract? Answer: 75H70623D00023 and

HHSI236201800003I

17. What is the Contract value for the incumbent Contract? Answer: Contract 75H70623D00023 is valued at $36,496,525.76. Contract HHSI236201800003I is valued at $143,561,655.12.

18. What is the period of performance of the incumbent Contract? Answer: 75H70623D00023 7/1/2023 – 6/30/2024 and HHSI236201800003I 4/26/2018 – 10/25/2023 of which a Task Order is in place to cover through 3/31/2024

19. Solicitation Page 96, Section L, Instructions, Conditions, and Notice to Offerors – Is there a subcontracting plan required by offerors proposing under the Unrestricted Schedule? If so, what are the required percentages?

Answer: Offerors proposing under Schedule A (Unrestricted) are not required to submit a small business subcontracting plan.

20. Solicitation Page 96, Section L.1 – Content of the Technical Proposal, L.1.1 Factor 1: Technical Excellence –

On page 97 of the Solicitation, the Government states as follows regarding the page limit for Factor 2:

Qualifications of Clinical Personnel: "The Qualifications of Personnel Section of the Technical Proposal, excluding resumes, is limited to 30 pages." Additionally, on page 98 the Government states as follows regarding the page limit for Factor 3: Management Approach: "The Management Approach Section of the Technical Proposal is limited to 30 pages."

We respectfully note that the Government does not include a page limit for Factor 1: Technical Excellence.

Is the page limit for Factor 1: Technical Excellence 30 pages, like the other two Factors? Answer: Yes. The Government intends to amend the solicitation to specify a page limit of 30 pages for Factor 1.

21. Solicitation Page 98, Section L.1.2, Subfactor 2, Qualifications of Clinical Personnel – The Government states that the 30 page limit of this section excludes resumes. Are pages containing the licensure and certifications also excluded from the 30 page limit? Answer: Yes. The Government intends to amend the solicitation to specify that licensures and certifications are also excluded from the page limitation.

22. Solicitation Page 98, Section L.1.3, Factor 3: Management Approach – On page 98 of the Solicitation, the following is stated as a component of Subfactor 3: “The offeror shall describe its plan to provide enhanced support to IHS in transitioning the Emergency Department Management functions to federal management.” Can the Government confirm which Emergency Department Management functions they anticipate to be transitioned to federal management? Answer: Functions related to daily operations, including scheduling and medical quality oversight.

23. Solicitation Page 102, Section M.1.1, FAR 52.212‐2 Evaluation – Commercial Products and Commercial Services (NOV 2021) – Will any past Medical Liability and Malpractice Judgments or tort claims against the contractor or any of its proposed providers be evaluated less favorably than a contractor or any of its proposed providers with no past Medical Liability and Malpractice Judgments or tort claims? Answer: The evaluation of Factor 4 ‐ Relevant Past Performance will take into consideration past or pending medical liability and medical malpractice judgments, among other things. See RFP Section M. (The Government notes that, during performance, consideration of malpractice judgments is factored into credentialing and privileging decisions by the cognizant agency offices.)

24. Solicitation Page 105, Appendix A, Deliverables, Deliverables – We respectfully note that Appendix A on page 105 of the Solicitation currently reads, concerning any documents that would be submitted at the proposal stage.

"Copies of any and all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff."

Currently, the submission requirement noted states as follows regarding these items:

"Upon proposal and upon renewal of licenses and upon renewal of option periods or change of key personnel."

We respectfully note that the requirement as it is written is unnecessarily restrictive, if it applies at the proposal stage. We would respectfully submit that copies of any and all licenses and board certifications, or primary source verification of such licenses and certifications, and NPI would suffice to document the qualifications of the submitted candidates. Insisting on both copies of licenses and board certifications, and primary source verifications of licenses and board certifications, at the proposal stage for this activity, unnecessarily favors incumbents already furnishing the service as they would have all possible information for current credentialed candidates at the facility. Additionally, having both forms of documentation for these credentials at the proposal stage does not serve to validate the qualifications of the Contractor to staff the service once awarded. Also, a number of states are not providing license copies any longer. As an example, Alabama is not providing copies of nursing licenses, but only making prime source verifications available online. Similarly, California does not provide copies of nursing licenses, but only prime source verifications online. This provides a very important further reason why requiring both a copy of the license and the prime source verification is not appropriate for evaluating proposals to determine qualifications of each offeror. We respectfully submit that either a copy of the license or board certification or a primary source verification of the license or board certification documents that the Physician, Advanced Practice Provider, or RN is appropriately licensed and certified, and meets the reasonable needs of the Government at the proposal stage.

We would respectfully ask that the Solicitation be modified in Appendix A, Deliverables to read as follows for the "Upon proposal" phase of this requirement:

"Upon proposal, copies of any and all licenses, board certifications, NPI, to include either copies of physical documents or primary source verifications of those licenses and board certifications." Answer: Appendix A outlines anticipated post‐award deliverables. Offerors must review Section L of the RFP for all proposal submission requirements.

25. Solicitation Page 105, Appendix A, Deliverables, Deliverables – Appendix A of the Solicitation requires the submission of Proof of Indemnification and Medical Liability Insurance. Which Volume does Proof of Indemnification and Medical Liability Insurance go in the proposal? Answer: Appendix A outlines anticipated post‐award deliverables. Offerors must review Section L of the RFP for all proposal submission requirements.

26. Solicitation Page 105, Appendix A, Deliverables, Deliverables – Appendix A of the Solicitation requires the submission of Proof of Indemnification and Medical Liability Insurance. Does Proof of Indemnification and Medical Liability Insurance count against any applicable page limits? Answer: No. Appendix A outlines anticipated post‐award deliverables. Offerors must review Section L of the RFP for all proposal submission requirements.

27. Solicitation Page 105, Appendix A, Deliverables, Deliverables – Appendix A of the Solicitation requires the submission of a Contingency Plan. Which Volume does the Contingency Plan go in the proposal? Answer:

Appendix A outlines anticipated post‐award deliverables. Offerors must review Section L of the RFP for all proposal submission requirements. Volume I: Technical Proposal as part of the ED Management and Staffing Plan

28. Solicitation Page 105, Appendix A, Deliverables, Deliverables – Appendix A of the Solicitation requires the submission of a Contingency Plan. Does the Contingency Plan count against any applicable page limits? Answer:

Yes

29. Solicitation Page 105, Appendix A, Deliverables, Deliverables – Appendix A of the Solicitation requires the submission of Copies of any and all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff. Which Volume does this information go in the proposal? Answer: Appendix A outlines anticipated post‐award deliverables. Offerors must review Section L of the RFP for all proposal submission requirements.

30. Solicitation Page 105, Appendix A, Deliverables, Deliverables – Appendix A of the Solicitation requires the submission of Copies of any and all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff. Does this information count against any applicable page limits? Answer: Appendix A outlines anticipated post‐award deliverables. Offerors must review Section L of the RFP for all proposal submission requirements.

31. Can you please provide the full text of the solicitation provisions incorporated by reference? Answer: Only the Provisions that include blanks or blocks that must be completed by the offeror and submitted with its offer will be provided.

52.203‐2 Certificate of Independent Price Determination.

As prescribed in 3.103‐1 , insert the following provision. If the solicitation is a Request for Quotations, the terms "Quotation" and "Quoter" may be substituted for "Offer" and "Offeror."

CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APR 1985)

(a) The offeror certifies that‐

(1) The prices in this offer have been arrived at independently, without, for the purpose of restricting competition, any consultation, communication, or agreement with any other offeror or competitor relating to‐

(i) Those prices;

(ii) The intention to submit an offer; or

(iii) The methods or factors used to calculate the prices offered.

(2) The prices in this offer have not been and will not be knowingly disclosed by the offeror, directly or indirectly, to any other offeror or competitor before bid opening (in the case of a sealed bid solicitation) or contract award (in the case of a negotiated solicitation) unless otherwise required by law; and

(3) No attempt has been made or will be made by the offeror to induce any other concern to submit or not to submit an offer for the purpose of restricting competition.

(b) Each signature on the offer is considered to be a certification by the signatory that the signatory‐

(1) Is the person in the offeror’s organization responsible for determining the prices being offered in this bid or proposal, and that the signatory has not participated and will not participate in any action contrary to paragraphs (a)(1) through (a)(3) of this provision; or (2)

(i) Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have not participated, and will not participate in any action contrary to paragraphs (a)(1) through (a)(3) of this provision ____________ [insert full name of person(s) in the offeror’s organization responsible for determining the prices offered in this bid or proposal, and the title of his or her position in the offeror’s organization];

(ii) As an authorized agent, does certify that the principals named in subdivision (b)(2)(i) of this provision have not participated, and will not participate, in any action contrary to paragraphs (a)(1) through (a)(3) of this provision; and

(iii) As an agent, has not personally participated, and will not participate, in any action contrary to paragraphs (a)(1) through (a)(3) of this provision.

(c) If the offeror deletes or modifies paragraph (a)(2) of this provision, the offeror must furnish with its offer a signed statement setting forth in detail the circumstances of the dis‐closure.

(End of provision)

52.204‐17 Ownership or Control of Offeror.

As prescribed in 4.1804(b), use the following provision:

OWNERSHIP OR CONTROL OF OFFEROR (AUG 2020)

(a) Definitions. As used in this provision– Commercial and Government Entity (CAGE) code means–

(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity by unique location; or

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.

Highest‐level owner means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

Immediate owner means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

(b) The Offeror represents that it □ has or □ does not have an immediate owner. If the Offeror has more than one immediate owner (such as a joint venture), then the Offeror shall respond to paragraph (c) and if applicable, paragraph (d) of this provision for each participant in the joint venture.

(c) If the Offeror indicates "has" in paragraph (b) of this provision, enter the following information:

Immediate owner CAGE code: ____________ Immediate owner legal name: ____________ (Do not use a "doing business as" name) Is the immediate owner owned or controlled by another entity?: □ Yes or □ No.

(d) If the Offeror indicates "yes" in paragraph (c) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information:

Highest‐level owner CAGE code: ____________ Highest‐level owner legal name: ____________ (Do not use a "doing business as" name)

Pages 84‐85 52.209‐5 Certification Regarding Responsibility Matters.

As prescribed in 9.104‐7(a), insert the following provision:

CERTIFICATION REGARDING RESPONSIBILITY MATTERS (AUG 2020)

(a)

(1) The Offeror certifies, to the best of its knowledge and belief, that—

(i) The Offeror and/or any of its Principals–

(A) Are □ are not □ presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(B) Have □ have not □, within a three‐year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property (if offeror checks "have", the offeror shall also see 52.209‐7, if included in this solicitation);

(C) Are □ are not □ presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph (a)(1)(i)(B) of this provision;

(D) Have □, have not □, within a three‐year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds the threshold at 9.104‐5(a)(2) for which the liability remains unsatisfied.

(1) Federal taxes are considered delinquent if both of the following criteria apply:

(i) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(ii) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(2) Examples.

(i) The taxpayer has received a statutory notice of deficiency, under I.R.C. § 6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(ii) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. § 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(iii) The taxpayer has entered into an installment agreement pursuant to I.R.C. § 6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(iv) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. 362 (the Bankruptcy Code).

(ii) The Offeror has □ has not □, within a three‐year period preceding this offer, had one or more contracts terminated for default by any Federal agency.

(2) "Principal," for the purposes of this certification, means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager;

plant manager; head of a division or business segment; and similar positions).

This Certification Concerns a Matter Within the Jurisdiction of an Agency of the United States and the Making of a False, Fictitious, or Fraudulent Certification May Render the Maker Subject to Prosecution Under Section 1001, Title 18, United States Code.

(b) The Offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, the Offeror learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(c) A certification that any of the items in paragraph (a) of this provision exists will not necessarily result in withholding of an award under this solicitation. However, the certification will be considered in connection with a determination of the Offeror’s responsibility. Failure of the Offeror to furnish a certification or provide such additional information as requested by the Contracting Officer may render the Offeror nonresponsible.

(d) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by paragraph (a) of this provision. The knowledge and information of an Offeror is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

(e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly rendered an erroneous certification, in addition to other remedies available to the Government, the Contracting Officer may terminate the contract resulting from this solicitation for default.

52.209‐7 Information Regarding Responsibility Matters.

As prescribed at 9.104‐7(b), insert the following provision:

INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

(a) Definitions. As used in this provision— Administrative proceeding means a non‐judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables.

Federal contracts and grants with total value greater than $10,000,000 means—

(1) The total value of all current, active contracts and grants, including all priced options; and

(2) The total value of all current, active orders including all priced options under indefinite‐delivery, indefinite‐ quantity, 8(a), or requirements contracts (including task and delivery and multiple‐award Schedules).

Principal means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

(b) The offeror □ has □ does not have current active Federal contracts and grants with total value greater than $10,000,000.

(c) If the offeror checked "has" in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information:

(1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions:

(i) In a criminal proceeding, a conviction.

(ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more.

(iii) In an administrative proceeding, a finding of fault and liability that results in–

(A) The payment of a monetary fine or penalty of $5,000 or more; or

(B) The payment of a reimbursement, restitution, or damages in excess of $100,000.

(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision.

(2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence.

(d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management, which can be accessed via https://www.sam.gov (see 52.204‐7).

(End of provision)

32. Did you not receive enough qualified “Buy Indian” responses to create a “set‐aside”? Answer: Based on market research, the Government determined that a “Buy Indian” set‐aside was not appropriate.

33. Is there currently an incumbent? Answer: See response to question 8.

34. Will there be a briefing regarding this opportunity? Answer: No. The Government will not provide a briefing to industry regarding this opportunity. Information concerning this procurement has been posted in the System for Award Management (SAM).

35. Solicitation Page 3, Section B.4, Schedule of Prices and Solicitation Page 28, Section 5.1.4, Key Personnel‐ While the key personnel section specifies the requirement for an ED Director, there is no mention of an ED Director for Fort Yates, Eagle Butte, and Belcourt. Please confirm whether an ED Director is needed for all five locations (including Rosebud and Pine Ridge) or just for Rosebud and Pine Ridge. Answer: See Section B.4 for the required labor categories for the medical facilities under each Schedule. An ED director is required for the Rosebud and Pine Ridge facilities only. An ED Director is not required for any other locations.

36. Solicitation Page 28, Section 5.14, Key Personnel – Is it permissible for the Point of Contact (POC) designated for one location to also be listed as the secondary POC for another location? For example, if John Smith is the POC for Rosebud, can we designate the same John Smith as the secondary POC for Pine Ridge? Answer: The Government intends to amend the solicitation to remove the identification of the Point of Contact (POC) and Alternate POC (APOC) positions as designated key personnel. Notwithstanding, during performance, the Government anticipates that it will need to contact the contractor’s representatives regarding the contract and/or issued task orders. For those purposes, the POC the contractor identifies for one location may also be identified as the POC or APOC for another location.

37. Solicitation Page 97, Section L.1.2, Subfactor 1 – Qualifications of Key Personnel ‐ Is the Government requesting resumes for all personnel, including MDs, RNs, MSAs, NP/PAs (approximately 200 in total), across all five locations? Or is the requirement limited to providing resumes for the key personnel, totaling 17 resumes? Answer: Offeror must submit a resume for the ED Director and/or ED Nurse Lead (if the position(s) is required under the Schedule) and a representative sample of 10 personnel for each CLIN for the Based Ordering Period only.

38. Solicitation Page 3, Section B.4, Schedule of Prices ‐ Can a small business submit one proposal for both Schedule A & Schedule B – i.e. Small Business & Unrestricted. Are there any specific rules to follow for the proposal in this situation? Answer: A small business that wishes to be considered under both Schedules must submit separate, responsive proposals for both Schedule A and Schedule B. See RFP Amendment 2.

39. Solicitation Page 15 & 16, Section 3.3, Current Staffing Plan/Staffing Compositions – “Current staffing plans/staffing composition for each place of performance will likely vary by time of award and during the contract performance periods based on the options described in Paragraphs 3.3 and 3.4 of the PSW. Current staffing plans/staffing composition are listed below for informational purposes only.” We do NOT see a section

3.4 in the solicitation. Answer: The reference to PWS paragraph 3.4 is an error and will be addressed as part of an amendment.

40. Solicitation Page 3, Section B.4, Schedule of Prices – Would IHS comply with the FAR 19.1307 (c) and (d) Price evaluation preference for HUBZone small business concerns. The factor of 10 percent shall be applied on a line item basis or to any group of items on which award may be made. Answer: The Government intends to evaluate proposals and make award in accordance with the terms of the solicitation and applicable statutes and regulations.

41. Solicitation Page 3, Section B.2, Contract Type – On March 3rd 2023 and March 28th 2023, similar solicitation was released under small business (both times and acknowledged that 10 small businesses responded to initial source sought) but now this new solicitation is released as a partial set aside with majority of contract set aside to unrestricted and minority portion to small business. Why is IHS setting aside this solicitation to unrestricted / partial business set‐aside when in fact 10 small businesses submitted sources sought response that are capable? Answer: The agency received responses from multiple small businesses in response to the Sources Sought Notice issued as part of its market research. However, the Government determined that the capability statements received did not support a total small business set‐aside.

42. Solicitation Page 3, Section B.2, Contract Type – Can you please explain the process on the MD/APP/RN/MSA scheduling and how task orders are split up and issued for Rosebud and Pine Ridge? Who prepares the schedule? Our understanding is that currently only one contractor is providing these services and preparing the schedule by the contractor. How does IHS handle 2 contractors at the same time providing staffing services at rosebud and pine ridge 24/7/365? Answer: If IDIQ awards result from this solicitation, the Government intends to fulfill its requirements by competing task orders among the IDIQ contract holders under each Schedule. The Government anticipates that issued task orders may cover one or more Service Units under a Schedule, but the required services will be provided by a single vendor. At no time will there be two or more contractors providing ED services in one Service Unit. The vendor will make the schedule for its contractors in accordance with the task order specifications.

43. Solicitation Page 15, Section 3.2, Staffing services and volume ‐ How many newborns are delivered in ED at each facility? Please list the numbers per year / per month at each facility. Answer: Historically, there have been less than 10 ED deliveries per year at each facility. ED deliveries are dependent upon whether there are OB Departments at the facilities. For example, Pine Ridge and Belcourt have OB Departments. Rosebud, Fort Yates, and Eagle Butte do not have OB Departments and experience deliveries in the ED Department.

44. To facilitate our thorough evaluation, We are seeking clarification regarding the bid. Specifically, we would like to inquire: Is it mandatory to bid for all the labor categories provided, or are we allowed to select specific ones? Answer: Section B.4 specifies the required labor categories for the medical facilities under each Schedule.

It is mandatory to propose all the labor categories for each medical facility under the Schedule for which the offeror is submitting a proposal.

45. Solicitation Page 14, Section C, ED Management and Staffing 2.5 – Does the Contractor designate a POC for each hospital (i.e., using corporate Operations team members and the PM) or are they located at each hospital for the review and approval of timecards? Answer: The Government intends to amend the solicitation to remove the identification of the Point of Contact (POC) and Alternate POC (APOC) positions as designated key personnel. Notwithstanding, during performance, the Government anticipates that it will need to contact the contractor’s representatives regarding the contract and/or issued task orders. For those purposes, the POC the contractor identifies for one location may also be identified as the POC or APOC for another location.

46. Solicitation Page 14, Section C, 24/7/365 ED Management and Staffing 3.1.1 – Will the government provide examples of off‐campus transport situations in which contract employees may accompany patients? i.e., mode of transport, distance, destinations(s), length of time, and who provides the service? Answer: Examples include but are not limited to: critically ill, unstable patient requiring transport via ambulance or flight; patient requiring one‐on‐one observation during transport to higher level of care. Distance varies depending on the location of the accepting facility, but usually 90‐120 miles from the IHS facility. Transport may be via federal EMS program, security, or private medical transportation company.

47. Solicitation Page 28, Section C, Key Personnel – Will the offeror identify the POC and APOC along with the Program Manager upon proposal submission ow within 5 days of contract award? Answer: Within 5 business days of award as stated in PWS Section 2.1

48. Solicitation Page 96‐97, Section L.1.2/Subfactor 1, Qualifications/Personnel – Are there file sized limits for emails and may we present Key Personnel qualification information as a separate attachment? Answer: The Government’s email system generally has a file size limitation of 100 MB. Offerors are permitted to submit the required proposal Volumes in multiple emails. However, offerors are reminded that, as stated in the proposal submission instructions, the offeror’s complete proposal must be received by the proposal deadline.

49. Solicitation Page 97, Section L, Subfactor 2, Qualifications of Clinical Personnel vs. Solicitation Page 166, Section Appendix A Deliverables, Copies of any/all licenses, board certs., NPI, PSV of all licensed and certified staff – Please conform whether the government requires CVs upon proposal submission or upon task order proposal request? Answer: See questions 4 and 37.

50. Solicitation Page 99, Section L/Factor 5, L.1.5 (b) – Please confirm offerors will fill in and return all of Section K regardless of our status in SAM? Answer: If the offeror’s reps/certs are not current in SAM, the offeror must submit the required reps/certs with the proposal. If the offeror’s reps/certs are current in SAM, see the solicitation provision at FAR 52.212‐3.

51. Solicitation Page 99 and 100, Section L.1.7, Min Acceptance Period – Please confirm whether the government will require a 90 or a 60‐calendar day acceptance period? Answer: The Government requires a minimum 90 calendar day acceptance period.

52. Misc., RE: Medical Support Assistants (MSAs) – Would the government please provide a list of task or skillsets that will be required for the Medical Support Assistants? Answer: MSAs are required to perform clerical duties, patient registration, and other duties as assigned by contractor nursing staff. The Government intends to amend the solicitation to address the PWS requirements for MSAs qualifications and duties.

53. Can we get a list of the current incumbents on this contract? Answer: See response to question 8.

54. Can we get the current bill rates the current incumbents are charging? Answer: No. The Government will not provide any information regarding an incumbent contractor’s confidential/proprietary business information.

55. What are the pain points in the current contract? Answer: Under the current Emergency Room Department Services contracts, contractors are required to provide services in accordance with the terms and conditions of the contract, which include, but are not limited to, filling all required shifts with qualified staff, allowing enough lead time for staff to get through the background clearance and credentialing/privileging, process, if applicable, and providing timely staff schedules to the government.

56. Can you explain more in depth what you are looking for in the technical proposal for Management Approach Subfactor 3? Answer: The Government is expected to recruit and fill emergency department positions during the period of performance of the contract. Therefore, the contract needs will vary. The offeror should describe how it will work with the Government to ensure that the ED schedule of staff keeps up with the changing needs of the facility.

57. For Section 5.9 – 5.9.2, is the emergency index training still required? Answer: There is an error here. It should read “emergency severity index training.” Yes, this is required. The Government intends to amend the solicitation to address this requirement.

58. Can we get an extension for the RFP due date? Answer: Yes, the proposal deadline is extended to February 29, 2024

59. The RFP states that there will likely be four winners (two large businesses, two small businesses). Does the IHS intend to award vendors by facility (i.e. one vendor will be responsible for providing all labor for a given facility)? Answer: If IDIQ awards result from this solicitation, the Government intends to fulfill its requirements by competing task orders among the IDIQ contract holders under each Schedule. The Government anticipates that issued task orders may cover one or more Service Units under a Schedule, but the required services will be provided by a single vendor.

60. When task order are released, will the task order be for an entire facility’s staff, or only select resources?

Answer: The Government’s requirements will be specified in issued task orders, which will generally include contract line items numbers (CLINs) specifying the required labor categories and the number of labor hours ordered. The Government anticipates that issued task orders may cover one or more Service Units under a Schedule.

61. Reviewing the CLINs, there are a number of positions where the estimated hours are less than one full‐time equivalent (FTE). Do these positions represent part‐time work, fill‐in resources, seasonal increases in workload, or some other factor? Answer: The estimated labor hours are based on various factors, including, but not limited to, the availability of federal personnel to meet the Government’s requirements. Notwithstanding, the number of hours are estimates only, and performance requirements will be specified in issued task orders.

62. Section 1.3.1. states “The purpose of this contract is to acquire twenty‐four hours per day, seven days per week, three hundred sixty‐five days per year (24/7/365) Emergency Department (ED) Management and Staffing Services for the Emergency Departments in GPA facilities.” Does this mean the awarded vendor(s) are responsible for providing all care provided from these facilities, or are they expected to augment existing resources? Answer: Yes, the awarded vendor(s) are responsible for providing all care provided from these facilities which may include augmenting existing federal staff. Performance requirements will be specified in issued task orders. The contractor(s) must fulfill the requirements specified in the issued task order.

63. Section 3.1.2. states “The contractor shall provide an ABEM/AOBEM certified physician to serve as the full‐ time Contractor Director of the Emergency Department and a Contractor Lead Nurse for the locations specified in the Schedule. The Contractor ED Director will be responsible for ensuring Emergency Department provider coverage on a 24/7 basis. The Contractor ED Director shall provide medical leadership for case reviews, quality of care monitors, ongoing and focused professional practice evaluation, codes, patient transfers, and patient complaint investigations. The Contractor ED Director and Contractor Lead Nurse shall maintain an effective, ongoing, data‐driven quality assessment and performance improvement program (QAPI) for Emergency Medicine and report the results through the hospital‐wide QAPI process. The Contractor ED Director and Contractor lead Nurse shall serve on medical committees as requested.” Are these resources directly billable to the IHS? Answer: All services provided by the ED Director and Lead Nurse will be billable to IHS based on the requirements specified in the Task Order(s).

64. Subfactor 3 states “The offeror shall describe its plan to provide enhanced support to IHS in transitioning the Emergency Department Management functions to federal management. The Government is continuing to recruit to fill positions for the Emergency Departments within the GPA.” Please clarify / elaborate further on what the IHS means by this subfactor? Answer: During performance, shifts from contracted personnel to federal personnel may occur as federal staff are hired. The contractor’s proposal must describe how it will work with IHS to address changing staffing and oversight requirements as federal personnel are hired.

65. In the event of healthcare resources calling in, please confirm the selected vendor is responsible for providing resources who can cover their shift. Answer: Yes, it is the vendor’s responsibility to provide the required support in the event its personnel are unable to perform for any reason (e.g., call outs, unexpected sick leave, etc.). The vendor is responsible for developing an ED Management and Staffing Plan for providing “full staffing coverage” at all times. See, e.g., PWS Sections 2.4.4 and 2.4.5.

66. Is there an incumbent vendor, and if so, how long have they held this contract? Answer: See responses to questions 8 and 18.

67. Has the scope of the opportunity changed since it was last released? Answer: No.

68. We would like to know if this is a brand new contract OR if there is (was) an incumbent performing these services. If not brand new, could you please provide the current / previous contract number? Answer: See response to question 16.

69. Solicitation Page 98, Section L.1.2 Factor 2: Subfactor 2, Qualifications of Clinical Personnel – Will full resumes be required of the clinical personnel listed in the table? Answer: The offeror must submit a resume for the ED Director and/or ED Nurse Lead (if the position(s) is required under the Schedule) and a representative sample of 10 personnel for each CLIN for the Base Ordering Period only.

70. Solicitation Page 28, Section C 5.14, Key Personnel vs. Solicitation Page 97, Section L.1.2 Factor 2: Subfactor 1, Qualifications of Key Personnel – Can you clarify, do we need to submit resumes for all Key Personnel listed in Section (ED Director, ED Nurse Lead, one POC, and on Alternate POC for each location, plus one Contractor’s Program Manager)? Or, do we only submit resumes for Key Personnel listed in Section L (ED Clinical Director and ED Nurse Lead for each location)? Answer: The Government intends to amend the solicitation to remove the identification of the Point of Contact (POC) and Alternate POC (APOC), and Contractor’s Program Manager as positions as designated key personnel. Offerors must submit resumes for the ED Physician Director and/or Nurse Lead (if the position(s) is required under the Schedule) and a representative sample of 10 personnel for each CLIN for the Base Ordering Period only.

71. Quentin Burdick: The Hours outlined in the Ordering Periods do not coincide with the Hours in the Staffing Plan. The Staffing Plan in Section 3.3 requests 2 MD/DOs per day but the Hours allow for only 1 per day. What are the correct Hours? See attached table.1 Answer: The solicitation states that the Current Staffing Plan/Staffing Composition tables listed in the PWS are for informational purposes only. The required labor categories and estimated labor hours for each performance period are specified in Section B.4. Performance requirements will be specified in issued task orders.

72. Quentin Burdick: The Hours outlined in the Ordering Periods do not coincide with the Hours in the Staffing Plan. The Staffing Plan in Section 3.3 requests for 2APPs but there are no Hours on the pricing sheets. What should it be? See attached table. Answer: The solicitation states that the Current Staffing Plan/Staffing Composition tables listed in the PWS are for informational purposes only. The required labor categories and estimated labor hours for each performance period are specified in Section B.4. Performance requirements will be specified in issued task orders.

73. Quentin Burdick: The Hours outlined in the Ordering Periods do not coincide with the Hours in the Staffing Plan. The Staffing Plan in Section 3.3 requests for 8 RNs but the Hours only allow for 2. What are the correct Hours? See attached table. Answer: The solicitation states that the Current Staffing Plan/Staffing Composition tables listed in the PWS are for informational purposes only. The required labor categories and estimated labor hours for each performance period are specified in Section B.4. Performance requirements will be specified in issued task orders.

74. Quentin Burdick: The Hours outlined in the Ordering Periods do not coincide with the Hours in the Staffing Plan. The Staffing Plan in Section 3.3 requests for 8 RNs but the Hours only allow for 2. What are the correct Hours? See attached table. Answer: The solicitation states that the Current Staffing Plan/Staffing Composition tables listed in the PWS are for informational purposes only.