RFPPackage-MidLevelOptCRHC23-21.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 Mid-Level

Services for the Outpatient 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 CRHC23-21.

(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 621399 Office of All Other Miscellaneous Health Practitioners, with a Small Business

Size Standard of $7.5 Million, Product Service Code is Q201 Medical – General Health Care.

(v) Services purchased through this contract will be Mid-Level Services for Outpatient Department. 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 Outpatient Mid-Level 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: 7/1/2023 –

6/30/2024, OY1: 7/1/2024 – 6/30/2025, OY2: 7/1/2025 – 6/30/2026, OY3: 7/1/2026 – 6/30/2027 &

OY4: 7/1/2027 – 6/30/2028.

(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 CRHC23-21

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

CRHC23-21

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:

621399

SIZE STANDARD:

$7.5M

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 Mid-Level Service, for the Outpatient

Department, Cheyenne River Health Center, 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: 07/01/2023 - 06/30/2024

Option Year 1: 07/01/2024 - 06/30/2025

Option Year 2: 07/01/2025 - 06/30/2026

Option Year 3: 07/01/2026 - 06/30/2027

Option Year 4: 07/01/2027 - 06/30/2028

Fill Out Attached Price/Cost Schedule to submit pricing.

This IDIQ contract does not obligate any funds

Funds will be obligated on an individual basis as

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

FAR 52.216-22 Indefinite Quantity.

This is a 100% Indian Small Business Economic

Enterprise set-aside. Multiply awards will be made.

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 23-21

Mid-Level Services

SERVICES AND PRICES/COSTS

(Fixed-Price, Services, Commercial Items)

Firm Fixed Price, Non-Personal Services, IDIQ contract, to provide Mid-Level Services, for the

Outpatient 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: 07/01/2023 – 06/30/2024.

CLIN001. Mid-Level Regular Hours

Item

No Descript of Service Estimated

Qty

Unit Unit Price Total Amount

1. Regular Hours 6,240 HRS

(x)

Total: $

OPTION YEAR ONE (1): 07/01/2024 – 06/30/2025.

CLIN101. Mid-Level Regular Hours

Item

No Descript of Service Estimated

Qty

Unit Unit Price Total Amount

1. Regular Hours 6,240 HRS

OPTION YEAR TWO (2): 07/01/2025 – 06/30/2026.

CLIN201. Mid-Level Regular Hours

Item

No Descript of Service Estimated

Qty

Unit Unit Price Total Amount

OPTION YEAR THREE (3): 07/01/2026 – 06/30/2027.

CLIN301. Mid-Level Regular Hours

Item

No Descript of Service Estimated

Qty

Unit Unit Price Total Amount

Request for Proposal: CRHC 23-21

Mid-Level Services

OPTION YEAR FOUR (4): 07/01/2027 – 06/30/2028.

CLIN401. Mid-Level Regular Hours

Item

No Descript of Service Estimated

Qty

Unit Unit Price Total Amount

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 Indian Health Service

Outpatient Mid-Level Provider(s)

General

This performance based work statement describes the requirements for non-personal services for up to three(3) Outpatient Mid-Level Provider(s) (i.e. Certified Nurse Practitioner or Certified

Physician Assistant) Service, to support the mission of the Indian Health Service (IHS)/

Cheyenne River Health Center (CRHC).

Cheyenne River Sioux Reservation and the Cheyenne River Health Center currently has the need for outpatient clinic Mid-Level providers.

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 Cheyenne River Health Center (CRHC), falls under the GPAO. Cheyenne River

Health Center (CRHC) provides medical care for approximately 9,000 tribal members living on the CRST Reservation. Serving a rural area, many of our patients travel 100 miles’ round trip to receive care. The CRHC was built in 2011 to provide an expanded level of health care services specifically designed to meet the needs of the CRHC population. Services include: Emergency

Room Department, Pharmacy, Physical Therapy, Public Health Nursing, Radiology Services, Inpatient Care, Laboratory, MRI, Dental, Community Health, Contract Health Services, Dietitians, Audiology, Eye Care, Inpatient, Pain Management, and Specialist Clinics: OB/GYN, ENT, Podiatry & Audiology. 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 Outpatient Mid-Level Provider Service, in the delivery of patient care, for the Outpatient Department (OPD), Cheyenne River Health Center.

Period of Performance

Base Year: 07/1/2023 – 06/30/2024

Option Year One (1): 07/1/2024 – 06/30/2025

Option Year Two (2): 07/1/2025 – 07/30/2026

Option Year Three (3): 07/1/2026 – 07/30/2027

Option Year Four (4): 07/1/2027 – 07/30/2028

Tour of Duty/Work Schedule

(8) hour shifts, Monday through Friday – 5 days per week, 8:00 a.m. – 5:00 p.m. These shifts are subject to change at the discretion of the Clinical Director.

Regular Hours: Hours worked during a one-week period and equal to 40 hours in a one-week period.

Overtime Hours: Any hours worked over 40 hours in a one-week period.

On-Call: N/A, no on-call hours.

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

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

rest periods, not to exceed 15 minutes every four hours of scheduled duty, if not on a call at that time. Rest periods will not be used for a continuation of lunch/dinner period or taken at the beginning or end of the workday. Hours worked do not include travel time to reach the 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 40 hour work period and considered regular hours. Regular, and/or

Overtime shall be determined by the Department Supervisor.

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

Outpatient Department

24276 166th Street Airport Road

Eagle Butte, South Dakota 57625

DESCRIPTION OF SERVICES: The contractor shall provide up to three (3) Outpatient Mid-

Level Provider(s) (i.e. Certified Nurse Practitioner or Certified Physician Assistant) services required for the Cheyenne River Indian Health Service Hospital.

The mission of the Cheyenne River Indian Health Service Hospital in Eagle Butte, South Dakota is to provide the best possible health care services to Cheyenne River Reservation in South

Dakota.

The Great Plains Area Indian Health Service (GPAIHS) requires contractor support to assist in the recruitment and placement of an Outpatient Midlevel Provider into temporary duty assignments in health centers and hospitals in the Great Plains Area IHS. The purpose of the contract is for the recruitment, credentialing, and placement of an Outpatient Midlevel Provider at Cheyenne River Health Center.

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.

The Contractor shall furnish an Outpatient Midlevel Provider to provide services to beneficiaries in the Outpatient Department(OPD) in IHS in Eagle Butte, South Dakota. Contract Outpatient

Midlevel Providers care shall cover the range of medicine typically provided in a rural civilian practice of similar size.

Upon the receipt of an IHS purchase order, the Contractor shall locate, credential, and have available sufficient staffing to provide an Outpatient Midlevel Provider coverage for the

Outpatient Department (8 hours shifts, Monday through Friday, 8AM-5PM). Overtime is defined as any hours worked beyond any 40-hour time period. These shifts are subject to change at the discretion of the Clinical Director.

The standards of medical practice and duties of the Contractor through its providers 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.

The contract resulting from this solicitation shall:

1. be a non-personal health care services contract under which the Contractor is an independent contractor;

2. allow the Government to evaluate the quality of professional aspects of the services rendered, (e.g. professional judgments, diagnosis for specific medical treatment);

3. require the Contractor to indemnify the government for any liability-producing act or omission by the Contractor, its employees and agents occurring during contract performance;

4. require the Contractor to 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 specific specialty; and

5. require the Contractor to ensure its subcontracts for provisions of health care service, contain the requirements of the clause at FAR 52.237-7, including the maintenance of medical liability insurance.

1.1 CONTRACTOR RESPONSIBILITY

1.1.1. Provides on-site Outpatient Midlevel medical services to beneficiary patients that present for care to the Cheyenne River IHS Outpatient Department (OPD). The Outpatient

Department sees approximately 1500 patient visits per month ranging in age from newborn to geriatric. Due to the volume of patients, Outpatient Midlevel Provider must be able to provide high quality, effective and efficient care to patients. Provider shall see up to 18 patients per day.

1.1.2. The incumbent must possess specialized knowledge of the concepts, principles and practices of Internal Medicine or General Medicine, Pediatrics or Family Practice, or

Obstetrics and Gynecology such as is obtained through the successful completion of a course of study leading to the Accredited Nurse Practitioner or Physician Assistant

Program and the successful completion of post graduate training. Completion of Board

Certification.

1.1.3. The Outpatient Midlevel Provider’s actual clinical duties shall be in accordance with his/her credentialed privileges.

1.1.4. The Outpatient Midlevel Provider shall practice within the Medical Staff Bylaws of the

Cheyenne River Indian Health Service.

1.1.5. Primary duty shall be to provide outpatient care in OPD. Examines and diagnoses the health related conditions of individuals requesting care, refers individuals for consultation when appropriate, prescribes and carries out, or directs others in carrying out, appropriate therapy in conformance with approved Clinical Privileges. Educates individuals in the nature of health related conditions, recommended therapy and in the general promotion of health and prevention of disease. Documents consultations in the patient’s health care record.

1.1.6. Implements, evaluates and is consulted on Outpatient procedures and instructions in accordance to their clinical privileges.

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

1.1.8. Demonstrates competent and effective oral and written communication.

1.1.9. 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.

1.1.10. Obtains necessary information on patients seen in the Outpatient 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.

1.1.11. Maintains familiarity and complies with hospital antiseptic policies and procedures.

Maintain familiarity and comply with all Federal, State, Indian Health Service, CMS regulations, and departmental regulation and requirements.

1.1.12. Ensures a safe work environment and employee safe work habits.

1.1.13. REFERRALS AND CONSULTS. The provider shall follow IHS Purchased Referred

Care regulations and policies when arranging for a referral or consult. The Outpatient

Midlevel Provider 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.

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

1.1.15. CONTRACTOR TIMESHEETS. The Outpatient Midlevel Provider shall be responsible for obtaining Medical Records (HIM) signature prior to Clinical Director or representative signature for the completion of their timesheet. Invoices submitted without the signed timesheet including Medical Records (HIM) and Clinical Director’s signatures shall not be paid.

1.2 PROCEDURE GUIDANCE. Contractor providers shall perform procedures compatible with the medical facility’s operating capacity and equipment. New medical procedures/services shall not be introduced without prior recommendation to, and approval of the Clinical Director or authorized representative.

1.3 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”.

1.4 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 the Contractor for action.

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

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

1.6 AVAILABILITY:

1.6.1 HOURS OF OPERATION: Contractor coverage shall be for the Outpatient Department

(8 hour shifts, Monday through Friday, 8AM-5PM) occasionally additional hours may be required. Overtime is defined as any hours worked beyond any 40-hour time period.

Work hours shall be scheduled by the Clinical Director to correspond to the needs of the facility and are subject to change. The Outpatient Midlevel Provider shall arrive for each scheduled shift in a well-rested condition and shall have had at least six hours’ rest from all other duties. Providers shall attend all meetings applicable to the position.

1.6.2 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.

1.6.3 The Outpatient Midlevel Providers 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.

1.6.4 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.

1.7 ORIENTATION. The Contractor shall ensure that all new contract providers participate in the Cheyenne River IHS 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.

1.8 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.

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

1.9 PERSONNEL REQUIREMENTS

1.9.1 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 Clinical Director.

1.9.2 LICENSURE/REGISTRATION. Non-personal services contract personnel providing care at the Cheyenne River IHS facility must maintain a current active and unrestricted license in at least one of the 50 United States or US territories.

1.9.3 CERTIFICATION. Nurse Practitioners and Physician Assistants shall be Nationally

Certified by their respective National Professional Board and State Licensed.

1.9.4 FORMAL EDUCATION. The provider must show proof of graduation from an accredited school of their profession.

1.9.5 EXPERIENCE. The Provider must have a minimum of 3 years of experience within

Family Medicine/General Medicine within the past 36 months prior to provider beginning performance at Cheyenne River IHS.

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

(ACLS), and Pediatric Advanced Life Support (PALS).

1.9.7 LIABILITY INSURANCE. The Contractor shall maintain current 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.

1.9.8 Computer efficiency required. Preferred Electronic Health Record experience.

2. PERFORMANCE-BASED SERVICE DELIVERY SUMMARY. The contractor’s performance shall be measured based on the following Performance Requirements. The

Performance Requirements shall 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. 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.

OUTPATIENT MIDLEVEL PROVIDERS

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 to be reviewed at end of POP.

2% incentive bonus for contract company.

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.

2.1 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 shall 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.

2.2 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

24276 166th Street, Airport Road

Eagle Butte, SD 57625

Office: 605-964-7724

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.

2.3 Compensation. The contractor shall be paid a fixed flat rate of per hour. No differential pay for government holidays, compensation time, and night differential. Overtime is defined as any hours worked beyond any 40-hour time period.

2.4 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 is implemented to 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.

3. GOVERNMENT FURNISHED PROPERTY AND SERVICES.

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

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

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

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

3.5 SUPPLIES. The Cheyenne River IHS 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.

3.6 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 -$39.27 daily, Shared

$22.65 daily and Trailer Pads - $11.20 daily (Rates are subject to change). There are unfurnished units available at regular employee rates.

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

3.7 SERVICES.

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.

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

3.7.2 Outpatient Clinic Scheduling. Facility personnel will assist in patient scheduling.

Complete administrative control of the patient shall remain with the facility.

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

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/transit housing. If provider has no private insurance, the services will be billed to the Contractor at the current full reimbursement rate.

3.8 CONTRACTOR FURNISHED ITEMS AND SERVICES

3.8.1 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.

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

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

4. GENERAL INFORMATION

4.1 PERSONNEL.

4.1.1 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.

4.1.2 CRIMINAL BACKGROUND CHECK REQUIREMENT/CHILD CARE NATIONAL

AGENCY CHECK WITH INQUIRIES (CNACI). The Government will conduct at government expense, a CNACI and state criminal history checks on individuals providing direct, unsupervised child care services under this contract. As a minimum, the Contractor shall contact the Cheyenne River IHS 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 twenty (20) working days after award date to the Contracting Officers for processing. Contractor personnel shall 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 30 calendar days in advance to accomplish background checks. Contractor personnel receiving unfavorable CNACIs shall not be employed. IHS may employ an individual pending completion of successful background checks.

4.1.2.1 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.

4.1.2.2 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.

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

4.1.2.4 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.

4.1.2.5 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.

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

4.1.2.7 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.

4.2 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 Medical Staff sufficient to allow for performance of al tasks identified. Medical Services cannot be performed by a contract Outpatient Midlevel Provider until professional staff membership and the Great Plains Indian Health Service Governing Body has granted clinical privileges in writing.

4.2.1 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 IHS 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) and Advances Cardiac Life Support (ACLS).

(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.

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

4.2.3 Professional staff appointments and clinical privileges actions will be based on review of documents listed in paragraph 4.2.1 above. Re-appointment shall occur no less than every two years, in accordance with Cheyenne River IHS Medical Bylaws.

4.2.4 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

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