RFPPackage-HospitalistCRHC23-27.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 Hospitalist

Services for the Inpatient 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. The contract established minimum and maximum quantities will be in the form of dollars. The guaranteed minimum amount is $5,000, for the first year of the contract. The maximum amount of the contract is $3M, for all 5 years of the contract

(ii) This solicitation is being issued under solicitation number CRHC23-27.

(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 (IEE) Set-Aside and the associated

NAICS code is 621111 Office of Physicians (except Mental Health Specialists), with a Small Business

Size Standard of $16.0 Million, Product Service Code is Q201 Medical – General Health Care.

(v) Services purchased through this contract will be Hospitalist 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 Hospitalist 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: 8/1/2023 –

7/31/2024, OY1: 8/1/2024 – 7/31/2025, OY2: 8/1/2025 – 7/31/2026, OY3: 8/1/2026 – 7/31/2027 &

OY4: 8/1/2027 – 7/31/2028.

(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 CRHC23-27

2. Closing Date: May 18, 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 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_000.htm#P1579_222340

6. Price and any discount terms

7. “Remit to” address, if different than mailing address

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 Proposal.

3. Technical Evaluation Proposal

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

5. Proof of Malpractice Insurance Coverage.

6. Candidate information, to include: CV or Resume, current/up-to-date licenses & certifications as requested in the PWS, complete and sign Background clearance forms attached to this solicitation, immunization record showing meet the Mandatory Employee Health Records Requirements as spelled out in the PWS.

7. Buy Indian Representation Form

8. Offeror Representations and Certifications

(ix) The clause at 52.212-2, Evaluation-Commercial Products and Commercial Services (Nov 2021) applies to this acquisition.

(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 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. See attachment for full text.

(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 May 18, 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 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 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

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 May 4, 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, COR, 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. No contract award shall be made to any vendor or provider listed on the OIG Exclusion List http://exclusions.oig.hhs.gov throughout the duration of the contract. It shall be the responsibility of the contractor to notify the acquisition official if there is a change in provider.

mailto:Stephanie.RedElk@ihs.gov mailto:Danielle.ChasingHawk@ihg.gov http://www.sam.gov/

52.212-2 Evaluation—Commercial Products and Commercial Services.

As prescribed in 12.301(c), the Contracting Officer may insert a provision substantially as follows:

EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021)

(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 following factors shall be used to evaluate offers:

(1) Problem and Approach

(2) Past Performance

(3) Key Personnel

(4) Management

Technical and past performance, when combined are significantly more important than cost 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”

AWARD WITHOUT DISCUSSIONS & COMPETITIVE RANGE DETERMINATIONS

The Government intends to evaluate proposals and award a contract without discussions with Offerors

(except for clarifications as described in FAR 15.306(a)). Therefore, the Offeror's initial proposal should contain the Offeror's best terms from a price and technical standpoint. The Government reserves the right to conduct discussions if the Contracting Officer later determines them to be necessary. In the event discussions are held, a competitive range determination will be made. If the Contracting Officer determines that the number of proposals that would otherwise be in the competitive range exceeds the number at which an efficient competition can be conducted, the Contracting Officer may limit the number of proposals in the competitive range to the greatest number that will permit an efficient competition among the most highly rated proposals.

EVALUATION FACTORS: The technical proposal will be evaluated by a team of Government personnel who shall comprise the evaluation panel. Each proposal will be rated strictly in accordance with its content and will no assume that performance will include areas not specified in the offeror’s written proposal.

1) Problem and Approach: Proposals, which merely offer a statement to conduct/provide services in accordance with the requirements in the Governments SOW, will not be eligible for award. The offeror must submit an explanation of the proposed technical approach in conjunction with the tasks outlined in https://www.acquisition.gov/far/part-12#FAR_12_301 the Statement of Work. The technical approach should reflect a clear understanding of the nature of the work being undertaken.

2) Past Performance: The proposal must include a list of similar ER Physician contracts, and contact information, Government and/or commercial, awarded to the offeror. The offeror must demonstrate its record of successful performance in past contracts.

3) Key Personnel: The proposal must include a list of professional personnel and key employees that will be assigned to this project. Curriculum vitae, resumes, license, credentials, and PWS requirements, of personnel providing services under this contract shall be included in the proposals.

4) Management: The proposal must include information in sufficient detail to allow a complete analysis of the offeror’s management capabilities and responsibilities. To include, financial capabilities, capability to meet delivery or performance, possession of necessary skills and experience.

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

CRHC23-27

b. TELEPHONE NUMBER (No collect calls)

6. SOLICITATION ISSUE

DATE

04/18/2023

8. OFFER DUE DATE/

LOCAL TIME

05/18/2023 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:

621111

SIZE STANDARD:

$16.0M

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.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

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

Contract, for Hospitalist Service, for the Cheyenne River

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

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

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

Period of Performance:

Base Year: 08/01/2023 - 07/31/2024

Option Year 1: 08/01/2024 - 07/31/2025

Option Year 2: 08/01/2025 - 07/31/2026

Option Year 3: 08/01/2026 - 07/31/2027

Option Year 4: 08/01/2027 - 07/31/2028

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.

This is a 100% Indian Small Business Economic

Enterprise set-aside. Government reserves the right to make multiply awards if advantageous to the government.

The solicitation does not commit the Governement to pay for any cost for preparation and submission of an offer. In additional, the Contracting Officer is the only individual who can legally commit the Governement to the expenditure of public funds in connection with this proposed acquisition.

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 23-27

Hospitalist Services

SERVICES AND PRICES/COSTS

(Fixed-Price, Services, Commercial Items)

Firm Fixed Price, Non-Personal Services, IDIQ contract, to provide Hospitalist Services, for the Inpatient

Department, 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: 08/01/2023 – 07/31/2024.

CLIN001. Hospitalist Regular Hours

Item

No Descript of Service Estimated

Qty

Unit Unit Price Total Amount

1. Regular Hours 2,016 HRS $

Total: $

CLIN002. Hospitalist On-Call Hours

Item

No Descript of Service Estimated

Qty

2. On-Call Hours 2,016 HRS

OPTION YEAR ONE (1): 08/01/2024 – 07/31/2025.

CLIN101. Hospitalist Regular Hours

Item

No Descript of Service Estimated

Qty

3. Regular Hours 2,016 HRS $

CLIN102. Hospitalist On-Call Hours

No Descript of Service Estimated

Qty

4. On-Call Hours 2,016 HRS $

OPTION YEAR TWO (2): 08/01/2025 – 07/31/2026.

CLIN201. Hospitalist Regular Hours

Item

No Descript of Service Estimated

Qty

5. Regular Hours 2,016 HRS $

CLIN202. Hospitalist On-Call Hours

No Descript of Service Estimated

Qty

6. On-Call Hours 2,016 HRS $

OPTION YEAR THREE (3): 08/01/2026 – 07/31/2027.

CLIN301. Hospitalist Regular Hours

Item

No Descript of Service Estimated

Qty

7. Regular Hours 2,016 HRS $

CLIN302. Hospitalist On-Call Hours

No Descript of Service Estimated

Qty

8. On-Call Hours 2,016 HRS

OPTION YEAR FOUR (4): 08/01/2027 – 07/31/2028.

CLIN401. Hospitalist Regular Hours

Item

No Descript of Service Estimated

Qty

9. Regular Hours 2,016 HRS $

CLIN402. Hospitalist On-Call Hours

No Descript of Service Estimated

Qty

10. On-Call Hours 2,016 HRS $

AGGREGRATED TOTALS

TOTALS

1. Base Year $

2. Option Year One (1) $

3. Option Year Two (2) $

4. Option Year Three (3) $

5. Option Year Four (4) $

AGGREGRATED TOTAL: $

PERFORMANCE WORK STATEMENT

Cheyenne River Health Center (CRHC)

General

This performance based work statement describes the requirements for non-personal services for

Hospitalist Physician Services for the Inpatient Department to support the mission of the Indian

Health Service (IHS)/Cheyenne River Health Center (CRHC).

The mission of the CRHC is to provide the best possible health care services to the Cheyenne

River Sioux Tribe Reservation in South Dakota.

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.

The Great Plains Area Office (GPAO) works in conjunction with its 19 Indian Health Service

Units and Tribal Managed Service Units to provide health care to approximately 122,000 Native

American located in North Dakota, South Dakota, Nebraska, and Iowa. The Area Office’s service units include seven hospitals, eight health centers, and several smaller health stations and satellite clinics.

Our facility, the CRHC, falls under the GPAO. 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. 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, and Specialist

Clinics: OB/GYN, ENT, Audiology & Podiatry. 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.

Objective

To provide uninterrupted Hospitalist services, for the Inpatient Department at the Cheyenne

River Health Center.

Period of Performance

Base Year: 08/1/2023 – 07/31/2024

Option Year One (1): 08/1/2024 – 07/31/2025

Option Year Two (2): 08/1/2025 – 07/31/2026

Option Year Three (3): 08/1/2026 – 07/31/2027

Option Year Four (4): 08/1/2027 – 07/31/2028

Tour of Duty/Schedule

The Hospitalist shall work up to 7 days a week, 12 hour shifts, on sight, 0700 – 1900 and on call

1900 -0700. Holidays included. During on-call, the Hospitalist shall be subject to call back, to evaluate an ER patient for possible admission, or to access an in-patient when needed. Shall work no more than 7 continuous days, but may be less. Required to rest one day after 7 days then can work another 7 days if needed. This schedule is subject to change by the Medical Director, depending on the need of the facility.

All-inclusive Regular Hours: All-inclusive hour, any hours worked during the period of performance of the contract.

Overtime Hours: No overtime hours, all-inclusive hours.

On-Call: The contractor is off duty, but remains available by telephone for the purpose of being contacted when an inpatient condition changes, or new admissions need to be admitted. Remains within a reasonable call-back radius, and reports for duty within 30 minutes of contact, or if live on campus, within 25 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 Clinical

Director or Deputy Clinical Director, 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 CRHC or other place of performance.

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 work period and considered regular hours. Time on call will be compensated at a lower hourly rate than regular hours. Regular, and On-call, shall be determined by the Clinical Director or Deputy Clinical Director.

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

Inpatient Department

24276 166th Street, Airport Road

Eagle Butte, South Dakota 57625

DESCRIPTION OF SERVICES: The contractor shall provide Hospitalist services, as required by the Cheyenne River Health Center and determined by the Clinical Director, CRHC.

This contract is a non-personal health care services contract, as defined at Far Part 37.101 under which the Contractor is an independent contractor and which shall allow the Government to evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of the services rendered, (e.g., professional judgements, diagnosis for specific medical treatment). The Contractor shall indemnify the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance. The Contractor shall maintain medical liability insurance, in the coverage amount acceptable to the Contracting Officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned.

Contract physician shall cover a range of medicine typically provided in a rural civilian practice of similar size. The Contractor shall provide physicians to perform the necessary medical procedures for patients in Inpatient Departments. Hospitalist experience shall include 3 years of full time Hospitalist experience within the past 5 years.

Upon the receipt of an IHS purchase order, the Contractor shall locate, credential, and have available sufficient staffing to provide physician coverage for the Inpatient Departments.

The standards of medical practice and duties of the Contractor through its physicians shall be determined pursuant to Governing Body bylaws, medial staff bylaws, rules and regulations of the appropriated IHS hospital, applicable provisions of law including but not limited to rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals, and standards and recommendations of CMS (Centers for Medicare and

Medicaid Services) compliance. The Contract Physician(s) shall be required to participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

CONTRACTOR RESPONSIBILITY

Utilizes RPMS/EHR computer software/program for entering and signing of medical orders such as laboratory studies, and directly signing and dating radiological studies, etc.

Treatment Protocol development. Assist in development of treatment order sets and protocols that may be included in EHR in collaboration with CAC, Medical Staff, Pharmacy, and Nursing.

The Physicians actual clinical duties will be in accordance with his/her credentialed privileges.

Primary duty will be to provide care to Inpatient Department. Performs triage, assesses, and re-assesses patients throughout the patient visits. Ensures documentation of medical assessments and observations are documented accurately in the patient’s health care record. Documents consultations in the patient’s health care record. Procedures for transfer of patients requiring transfer to facilities where a higher level of care must follow the “Emergency Medical Treatment and Labor Act” (EMTALA) guidelines. Obtains necessary information on patients seen in the

Inpatient Department, such as medical records, x-ray films and reports, and pathology slides and reports and documents pertinent normal and abnormal test results in the patient’s medical record.

Implements, evaluates and is consulted on Inpatient procedures and instructions.

Establishes inter-personal and intra-departmental relationships to enhance optimal patient care.

Ensures a safe work environment and employee safe work habits.

Demonstrates competent and effective oral and written communication.

Computer efficiency required. Preferred 5 years of Electronic Health Record experience.

Maintain certification in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS) and

Pediatric Advanced Life Support (PALS).

REFERRALS AND CONSUSLTS. The provider shall follow IHS Purchased Referred Care regulations and policies when arranging for a referral or consult. The Physician shall be required to consult with other specialty practitioners for consultative opinions and continuation of care.

The provider shall inform patients of the required referral or consult by indicating the specialty involved.

PRESCRIPTIONS. The provider shall use and follow the IHS formulary for prescriptions for all patients. The formulary list is approved and maintained by the Cheyenne River Health Center

Pharmacy and Therapeutics Committee. Any drug not listed on the formulary must be approved by the Pharmacy and Therapeutics Committee.

CONTRACTOR TIMESHEETS. The Physician will be responsible for signing their timesheet, obtaining Medical Records (HIM) signature, prior to presenting to the Department

Head (i.e. Clinical Director, Department Supervisor) for signature. Timesheets attached to invoices submitted for payment, without the required 3 signatures, will be rejected and sent back to the company for correction and resubmittal.

PROCEDURE GUIDANCE. Contractor providers shall perform procedures compatible with the medical facility’s operating capacity and equipment.

PRIVACY OF INDIVIDUALLY IDENTIFABLE HEALTH INFORMATION. The

Contract health care providers shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity. The Contractor shall ensure strict compliance to the release of Protected Health Information in accordance with the Code of

Federal Regulation, Title 45, Public Welfare, Subtitle A, Department of Health and Human

Services, Part 164, Security and Privacy (45 CFR 164) and AFI 41-210, “Patient Administration

Functions” paragraph 2.2.3, “Health Insurance Portability and Accountability Act (HIPAA)” and paragraph 2.3, “General Guidelines on Releasing Medical Information”.

COMMUNICATIONS. The Contractor shall ensure contract providers maintain open and professional communication with members of the Medical Staff. Complaints validated by the

Hospital Accreditation Specialist and Clinical Director shall be reported in writing to the

Contracting Officer (CO) and/or Contracting Officer Representative (COR) for action.

ENGLISH LANGUAGE REQUIREMENT. The Contractor provider(s) shall read, understand, speak and write English fluently.

DOCUMENTATIONS. Contractor personnel shall prepare all documentation to meet or exceed established CMS standards and Cheyenne River IHS Medical Staff Bylaws.

CONTINUITY OF SERVICES/REPLACEMENT STAFF. The Contractor point of contact shall ensure qualified personnel are available to provide coverage at all times even during scheduled absences of contract providers.

The Inpatient Physician services are considered vital to the Government and must be continued with the minimal interruption. In order to minimize interrupted services, the incumbent contractor shall exercise its best efforts and cooperation to effect an orderly and efficient transition to a successor.

PERFORMANCE OF SERVICES DURING CRISIS DECLARED BY THE NATIONAL

COMMAND AUTHORITY. On occasion, services may be required to support an activation or exercise of contingency plan outside the normal duty hours. Emergency situations (i.e. accident and rescue operations, civil disturbances, natural disasters) may necessitate the contractor provide increased or reduced with the contractor for the cost of these emergency requirements.

RECORDS. The contractor shall document all patient encounters legibly in the patient medical record. All documentation shall be timed and dated. Verbal orders are to be used as infrequently as possible. In the event of a major disaster or code all verbal orders are to be signed off immediately following the code or disaster. All Medical Records must be signed by the providers and charge ticket completed at the end of the visit. All Medical Records are to be completed within 24 hours of the provider’s scheduled shift. All documentation shall meet the current CMS guidelines.

Final payment will be withheld until all medical records are completed by the contract physician.

PERSONNEL REQUIREMENTS

CONTINUING MEDICAL EDUCATION (CME) / CERTIFIED EDUCATION UNITS (CEU)

REQUIREMENTS. Maintain CME and review pertinent journals, books and publications.

Health care providers registered or certified by the national/medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentials office for tracking by the CEO.

LICENSURE/REGISTRATION. Contractor must maintain a current active and unrestricted license in at least one of the 50 United States or US territories.

CERTIFICATION. Board certified in field of specialty is favorable.

FORMAL EDUCATION. The Physician must have a Medical Doctor (MD) or Doctor of

Osteopathic Medicine (DO) degree from an accredited college or university in the specialty area required to complete the FTE.

EXPERIENCE. The Physician must have a minimum of 3 years of experience within Family

Practice/Internal Medicine to include fellow and residency time within the past 36 months prior to provider beginning performance at Cheyenne River Health Center.

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 not met.

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

Performance

Task/Requirement

Indicator Standard/(AQL)

Acceptable

Quality Level

Surveillance

(QA)

Quality

Assurance

Incentive

Completion of documentation of patient record

All patient records must be documented accurately, correctly, and completely within 24 hours of patient visit

100% Random observation and

HIM Report

5% deduction from weekly invoice.

Deductions will increase by 1% in subsequent months.

Prompt and continuous coverage

Agency must provide a competent

Mid-Level to ensure no gaps in coverage.

100% Provider

Schedule

For every shift not covered by

Agency, the shift rate will be deducted from next submitted invoice

Credentialing Agency is allowed 3 business to submit required credentialing documentation

100% Credential

Report

5% deduction from weekly invoice.

Deductions will increase by 1% in subsequent months.

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 fails 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 above.

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, COR

Cheyenne River Health Center

24276 166th Street

Eagle Butte, SD 57625

Office: 605-964-7724

Fax: 605-964-0522

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.

Quality Assurance Surveillance Plan (QASP). The purpose of the 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 performs 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.

GOVERNMENT FURNISHED PROPERTY AND SERVICES.

EQUIPMENT. Contract providers shall have joint use of all available equipment for performing services required by this contract.

PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish the contract provider(s) with appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

IDENTIFICAITON CREDENTIALS. The Cheyenne River Health Center will provide each contract provider with the required identification card.

FORMS. The Cheyenne River Health Center will provide required Government forms used in the performance of services.

SUPPLIES. The Cheyenne River Health Center will provide medical and non-medical supplies commonly used in the facility for the care and management of patients and the performance of the requirements of this contract.

HOUSING. Contractor shall be responsible for all applicable Federal, State, and Local Taxes, Meals, Travel/Transportation, lodging, and per diem.

Government Housing: Lodging is available in government housing at prevailing rates, if available, and must be paid by the contractor. There are limited furnished units available for contract employees and prevailing rates range from Single -$34.72 daily, Shared

$16.58 daily and Trailer Pads - $8.00 daily (Rates are subject to change).

Local Hotel: Cheyenne River Motel (605) 964-8888.

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/housing.

These services will be billed to the Contractor at the current full reimbursement rate.

ORIENTATION. The Contractor shall ensure that all new contract providers participate in the

Cheyenne River Health Center Facility Orientation with an overlap of services to include one additional day. Providers must arrive on a Monday-Friday excluding holiday and participate in the orientation, which must be completed in the Monday-Friday timeframe, prior to providing services at the hospital.

Administrative Support. Cheyenne River Health Center will provide normal office administrative support services, to include telephone and utilities.

Patient Scheduling. Facility personnel will assist in patient scheduling. Complete administrative control of the patient shall remain with the facility.

Cheyenne River Health Center will provide all other ancillary personnel services required, including personnel to move patients or equipment.

CONTRACTOR FURNISHED ITEMS AND SERVICES

GENERAL. Except for those items or services specifically stated in Section III to be

Government furnished, the Contractor shall furnish everything required to perform this contract in accordance with all of its terms.

CONTRACTOR OWNED EQUIPMENT. The provider will provide his/her own stethoscope.

INITIAL INSPECTION. Contractor owned equipment will be inspected and approved by the biomedical equipment maintenance section prior to use in the facility.

GENERAL INFORMATION

PERSONNEL.

POINT OF CONTACT. The Contractor shall provide a point of contact who shall be responsible for the performance of the work. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The Contractor shall designate this individual, in writing, to the Contracting Officer before the contract start date. An alternate may be designated, but the Contract shall identify those times when the alternate shall be the primary point of contact.

CRIMINAL BACKGROUND INVESTIGATION. The Government will conduct at government expense, a state criminal history check on individuals providing direct, unsupervised child care services under this contract. As a minimum, the Contractor shall contact the Cheyenne River

Health Center Contracting Officer for obtaining all necessary forms and directions for filing background check information in writing and electronically on personnel hired at the beginning of the contract. This action shall take place no later than five (5) working days from contract award date. Contractor shall submit completed personnel background check applications within

Five (5) business days after award date to the Contracting Officers for processing. Contractor personnel will be required to be fingerprinted. Requests for personnel hired subsequent to the contact start date shall be submitted to the Government no later than five (5) working days from the employee’s first duty day. Contractor shall provide a list of substitute contract personnel fulfilling contingency situations (i.e. absences of certificated contact personnel). Names of substitutes and credentials shall be provided 15 calendar days in advance to accomplish background checks. Contractor personnel receiving an unfavorable background check shall not be employed. Cheyenne River Health Center may employ an individual pending completion of successful background checks.

Background checks will be based on fingerprints of individual obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureau of Investigation (FBI) and state criminal history repositories.

Individuals shall have the right to obtain a copy of any background check pertaining to themselves and to challenge the accuracy and completeness of the information contained in the report.

Individuals who have previously received a background check shall provide proof of the check to the CEO or obtain a new one.

CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of HHS (Health and

Human Services), unless such a person seeks and receives approval in accordance with the

Department of HHS.

APPEARANCE. Employees are expected to comply with reasonable dress, grooming and hygiene standards based on comfort, productivity, health and type of position occupied.

Employee attire will be in good repair, and should not be considered offensive, disruptive or unsafe.

Contract providers shall display their identification badge on their outer clothing.

PROTECTIVE CLOTHING. When required and supplied by the Government, the provider shall wear special protective clothing and shoe covers. When duties will be performed in specified areas, a disposable protective hood shall be worn to ensure infection control standards are met. The Government will provide this hood. These items shall remain the property of the

Government and shall not be removed from the facility. After use, protective clothing shall be turned in or destroyed as directed by the Infection Control Policy.

PRIVILEGING REQUIREMENTS. The contract providers’ credentials shall be reviewed by the

Credentialing Specialist and the Credentialing Committee. The Contractor is responsible for ensuring that proposed providers possess the requisite credentials to enable granting of privileges by the Cheyenne River Health Center Medical Staff sufficient to allow for performance of al tasks identified. Medical Services cannot be performed by a contract Physician until professional staff membership and the Great Plains Indian Health Service Governing Body has granted clinical privileges in writing.

Initial applications for clinical privileges, to include credentials action history, malpractice history, and certified true copies of the documents listed below, shall be submitted to the

Cheyenne River Health Center Credentialing Committee, through the Credentialing Specialist, no later than 3 calendar days after receipt of notice of contract award.

a. Copy of valid, current unrestricted state license and applicable Board Certification.

(Submission of required with proposal).

b. Documentation of continuing education and training.

c. Current Basic Life Support (BLS), Advances Cardiac Life Support (ACLS), and Pediatric

Advanced Life Support (PALS). (Submission required with proposal).

d. A signed consent for release of information.

e. Current copy of Drug Enforcement Agency (DEA) Certificate.

f. A list of all states in which contract provider currently holds or has held a license to practice related services.

g. A current copy of the proposed contract providers professional resume.

h. Certification of current physical examination. The certification shall have a statement signed by the examining physician stating that the employee is free of any contagious diseases. The physical examination shall be current as of 12 months prior to application for privileges.

Applications for privileges will be screened through the National Practitioners Data Bank.

Re-appointment shall occur no less than every two years, in accordance with Cheyenne River

Health Center Medical Bylaws.

DENIAL/TERMINATION OF PRIVILEGES. Actions to limit, suspend, or revoke clinical privileges will be in accordance with the procedures outlined in the Medical Staff Bylaws. The

CEO, will notify the Contracting Officer, and provide copies of pertinent documentation, as soon as possible when the necessity to exercise such authority becomes apparent. The Contracting

Officer will notify the Contractor of the initiation of the revocation process if such action becomes apparent.

REVIEW OF CREDENTIALS PACKAGES. The Government reserves the right to limit the number of credentialing packages it will evaluate.

HEALTH REQUIREMENTS

The contract provider shall provide proof of current immunizations (Hep B, MMR, Varicella, Tdap, Flu) status and a current TST within the past year.

MASK REQUIREMENT

See Attached Cheyenne River Health Center Interim Guidance COVID-19.

EMERGENCY HEALTH CARE. Cheyenne River Health Center will provide emergency health care for the contract providers for injuries incurred while on duty in the facility. These services will be billed to the Contractor at the current full reimbursement rate.

MEDICAL QUALITY IMPROVEMENT/RISK MANAGMENET (QI/RM).

The contract provider(s) shall participate in QI/RM activities to the extent required by Section

2C, AFI 44-119 and the individual Cheyenne River Health Center QI/RM plan or regulation.

The Government will evaluate the provider’s professional, as differentiated from administrative, performance under this contract using Quality Improvement standards specified in paragraphs

2.1 and 2.2. Nothing in this paragraph precludes the Government from also conducting inspections under the Inspection/Acceptance requirement of FAR clause 52.212-4.

PERFORMACE EVALUATION

The Cheyenne River Health Center will evaluate the contractors’ performance under this contract. Evaluations will be provided to the contactor, in writing. These evaluations may be used by as a record of contract performance history for the purpose of evaluation in other competitive or non-competitive acquisitions.

FREEDOM OF INFORMATION ACT (FOIA) PROGRAM. All FOIA request shall be delivered immediately to the Medical Records Supervisor.

PHYSICAL ACCESS. The Contractor shall return identification badge to the IT Department and house keys to the Housing Officer, upon completion/termination of the contract.

Physical Security. The contractor shall safeguard all government property, including controlled forms provided for contractor use. At the close of each work period, government equipment, facilities, and other valuable materials shall be secured.

Weapons, Firearms, And Ammunition. Contractor employees are prohibited from possessing weapons, firearms, or ammunition, on themselves or within their contractor-owned vehicle or privately-owned vehicle while on the Cheyenne River IHS compound.

Reporting Requirements. Contractor personnel shall report to an appropriate authority any information or circumstances of which they are aware may pose a threat to the security of IHS personnel, contractor personnel or patients.

The contractor shall prohibit their use of keys, issued by the government, by any persons other than the contractor’s employees and the opening of locked areas by contractor employees to permit entrance of person other than contractor employees engaged in performed of contract work requirement in those areas.

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…