RFQ-22-048 - OBGYN.pdf

A. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice, FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994) (Public Law 103-355) & FAR 37.4, Non-Personal Health Care Services Contract (10 U.S.C. 2304 and 41 U.S.C 253). This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued.

B. The Great Plains Area Indian Health Service (IHS) intends to award a Firm Fixed-Price, Non-Personal Healthcare

Service, in response to Request for Quote (RFQ) RFQ-22-048.

C. This solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2022-04/01/30/2022.

D. This RFQ is an “Unrestricted” solicitation and the associated NAICS Code is 621111, which has a small business standard of $12.0

E. The contract resulting from this solicitation is an Indefinite Delivery/Indefinite Quantity (ID/IQ) Contract. A ID/IQ Contract does NOT obligate any funds. Funds will be obligated on an as needed basis and placed against this contract through the issuance of Delivery/Task Orders. Orders may be submitted electronically.

F. The quoted unit pricing must be “all inclusive” (to include but not be limited to travel, lodging, per diem, fringe benefits, federal, state and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.

Complete the attached Price Schedule.

1. Base Year: July 1, 2022 thru June 30, 2023 Regular Hours - 0.15 FTE - 312 Hours/Year $_______________.

2. Option Year One (1): July 1, 2023 thru June 30, 2024

3. Option Year Two (2): July 1, 2024 thru June 30, 2025

4. Option Year Three (3): July 1, 2025 thru June 30, 2026

5. Option Year Four (4): July 1, 2026 thru June 30, 2027

Total Estimated Contract Price for the Base + Four (4) Option Years $_______________.

G. Board Certified Obstetrics/Gynecologist (OB/GYN) Physician (1) and Support Staff (Nurse (1) and Ultrasound Technician (1)) for OB/GYN Services

H. See attached Performance Work Statement. Services will be provided for the Fort Yates Indian Health Service

Facility, 10 Standing Rock Ave, Fort Yates, North Dakota and the McLaughlin Indian Health Center, 701 E. 6 th St, McLaughlin, South Dakota. The period of performance will be July 1, 2022 through June 30, 2023 with Four

(4) Option Years.

I. FAR 52.212-1 Instructions to Offerors-Commercial Items (November 2021).

Quotes shall be submitted on company letterhead stationery, signed, dated and it shall include:

1. Solicitation number RFQ-22-048;

2. Closing Date: February 18, 2022 at 12:00 pm CST;

3. Name, address and telephone number of company and email address of contact person;

4. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements of the solicitation. This may include product literature, or other documents, if necessary;

5. Price and any discount;

6. “Remit to” address, if different than mailing address;

7. A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically);

8. Acknowledgment of Solicitation Amendments (if any issued);

9. Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information);

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

In addition, Contractors shall provide the following:

Name and phone number of three (3) current professional references.

Complete and sign Child Care Position/Personnel Security Office form.

Complete and sign the Declaration for Federal Employment – Optional Form 306.

Complete and sign Addendum to Declaration for Federal Employment (OF306).

Complete and sign Licensure Requirement Form.

Copy of malpractice insurance coverage.

Shall meet the Qualifications and Knowledge Requirements in the Performance Work Statement and provide copies of the required documents (if needed).

Copy of current Board Certification Copy of active, current, full and unrestricted license to practice.

Copy of a recent Health Examination.

Copy of Diplomas/Specialty Certifications.

Copies of Continuing Education.

Current CV/resume.

J. Basis of Award is Lowest Price Technically Acceptable.

K. FAR 52.212-3 Offer Representations and Certifications-Commercial Items (November 2021). See attachment for full text. The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) website accessed through http://www.acquisition.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (p) of this provision.

L. FAR 52.212-4 Contract Terms and Conditions-Commercial Items (November 2021). Applied to this acquisition and it’s incorporated by reference.

M. FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders-

Commercial Items (January 2022). See attachment for full text.

N. Attached are the Federal Acquisition Regulations (FAR) & Health & Human Services Acquisition Regulation (HHSAR) clauses that are applicable including below.

O. Submit quote to:

Great Plains Area Indian Health Service Attn: Wenda Wright, Contract Specialist

115 4th Ave. SE, Room 309 Aberdeen, SD 57401 email wenda.wright@ihs.gov

Questions in regards to this solicitation shall be submitted in writing by either email no later than February 11, 2022, 12:00pm CST.

SECURITY CLEARANCE

A security pre-clearance must be performed for any employees referred to IHS through this contract.

Fingerprints must be completed and adjudicated prior to services being performed under this contract.

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.

Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S.

facilities or systems each person must complete a FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System.

Contractors shall allow five business days for I.H.S. processing of fingerprints taken electronically at an I.H.S. site and thirty business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE), http://exclusions.oig.hhs.gov. As soon as practicable prior to the start of work, the performance of the work the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

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

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

Employees that DO NOT have access to LMS, contractors, volunteers, or IHS employees with IPA’s or MOA’s to tribal organizations please, click here IHS Sexual Abuse Prevention website. When the contractors have completed and passed the training, please have them send a copy of the last page of the training with Name, Date, and Time to their Supervisor, COR, and Kimmen LeBeau, e-mail: Kimmen.LeBeau@ihs.gov

No contract award shall be made to any vendor listed on the OIG Exclusions List at http://exclusions.org.hhs.gov throughout the duration of the contract.

Contractor must be registered with the System for Award Management (SAM) at www.sam.gov

ACCEPTANCE PERIOD: Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. In addition, it must contain a statement to the effect that it is firm for a period of at least 30 days from the date of receipt by the Government.

“Obstetrics/Gynecologist Physician(s) (OB/GYN) and Support Staff will arrive on a Business Day ONLY to complete all Orientation and Background procedures. The Clinical Director or Designee will ensure all Orientation and Background procedures have been completed and an email will be sent to the Contracting department to state as such. The Obstetrics/Gynecologist Physician(s) (OB/GYN) and Support Staff will NOT see patients until Background/Fingerprints have been cleared.”

“The standards of medical practice and duties of the Contractor through its Obstetrics/Gynecologist Physician(s) (OB/GYN) and Support Staff shall be determined pursuant to the bylaws of the Service Unit. The regulations of the hospital, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals must be followed. Also the standards and recommendations of Centers for Medicare and Medicaid Services (CMS) or the Accreditation Organization must be adhered to. The Contract Obstetrics/Gynecologist Physician(s) (OB/GYN) and Support Staff 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.”

A CONTINUING RESOLUTION, also known as a "CR" is legislation enacted by congress that continues funding for specific ongoing activities if the fiscal year appropriation has not been enacted by the beginning of the fiscal year.

"Due to the Continuing Resolution, funds are presently available through February 18, 2022 (P.L. 117-70). The Government's obligation for performance of this contract beyond that date is contingent upon the availability of appropriated funds. No legal liability on the part of the Government for any payment may arise for performance under this contract beyond February 18, 2022. If funds are made available to the Contracting Officer for performance beyond the above cited date, the Contractor will receive notification in writing by the Contracting Officer."

FAR 52.232-18 - Availability of Funds FAR 52.232-19 - Availability of Funds for the Next Fiscal Year

PRICE SCHEDULE

FORT YATES INDIAN HEALTH SERVICE, NORTH DAKOTA

OBGYN and Support Staff Services

Firm Fixed-Price, Non-Personal Healthcare Service, ID/IQ, Contract

BASE YEAR: 7/1/2022 – 6/30/2023

ITEM # DESCRIPTION ESTIMATED

QUANTITY

UNIT OF

ISSUE

UNIT COST TOTAL COST

1. Regular Hours .015 FTE – One OBGYN Physician with Support Staff

312 Hours $ ___________ $ ___________

Sub-Total $ ___________

OPTION YEAR ONE (1): 7/1/2023 – 6/30/2024

UNIT OF

ISSUE

UNIT COST TOTAL COST

1. Regular Hours .015 FTE – One OBGYN Physician with Support Staff

OPTION YEAR TWO (2): 17/1/2024 – 6/30/2025

UNIT OF

ISSUE

UNIT COST TOTAL COST

1. Regular Hours .015 FTE – One OBGYN Physician with Support Staff

OPTION YEAR THREE (3): 7/1/2025 – 6/30/2026

UNIT OF

ISSUE

UNIT COST TOTAL COST

1. Regular Hours .015 FTE – One OBGYN Physician with Support Staff

OPTION YEAR FOUR (4): 7/1/2026 – 6/30/2027

UNIT OF

ISSUE

UNIT COST TOTAL COST

1. Regular Hours .015 FTE – One OBGYN Physician with Support Staff

GRAND TOTAL

FOR BASE + FOUR (4) OPTION YEARS: $ _______________________

Statement of Work (SOW)

Obstetrics and Gynecologic Physician Services

1. GENERAL:

1.1. Services Provided: The Contractor shall provide a Board Certified Obstetrics/Gynecologist (OB/GYN) physician (1) and support staff (Nurse (1) and Ultrasound Technician (1)) for services at the Indian Health Service (IHS) at the Standing Rock Service Unit, which includes Fort Yates IHS Hospital (FYH), Fort Yates, ND and McLaughlin Health Center (MHC), McLaughlin, SD. This physician and support staff will provide OB/GYN Services on site in accordance with the specifications contained herein to beneficiaries of the IHS. The Contract physician shall be Credentialed and Privileged at a Bismarck, ND hospital with an Operating/Labor/Delivery Room, as FYH has no Operating/Labor/Delivery Room.

The contractor providing onsite OB/GYN services will meet or exceed the American College of Obstetricians and Gynecologists (ACOG) Physician Guidelines https://www.acog.org. Contractor employees shall not be considered government employees for any purpose under this contract.

1.2. Place of Performance - Contractor shall furnish services at the SRSU:

1.2.1. N01 O River Road, Fort Yates, ND 58538.

1.2.2. 701 East 61h Street, McLaughlin SD 57642.

1.3. Period of Performance:

1.3.1. Base Year: January 1, 2022 through December 31, 2022

1.3.2. Option Year 1: January 1, 2023 through December 31, 2023

1.3.3. Option Year 2: January 1, 2024 through December 31, 2024

1.3.4. Option Year 3: January 1, 2025 through December 31, 2025

1.3.5. Option Year 4: January 1, 2026 through December 31, 2026

1.4. Policy/Handbooks: the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.4.1. - IHS Manual - "Health Care Service Standards"

1.4.2. - National Practitioner Data Bank Reports

1.4.3. - Credentialing and Privileging

1 .4.4. - Health Information Management and Health Records

1.4.5. - Privacy Act of 1974 (5 U.S.C. 552a) as amended

1.4.6. - Standing Rock Service Unit Medical Staff Bylaws

1.5. Definitions/Acronyms- Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1. ACOG: American College of Obstetricians and Gynecologists

1.5.2. BLS: Basic Life Support

1.5.3. CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

1.5.4. CDC: Centers for Disease Control and Prevention

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1.5.5. CDR: Contract Discrepancy Report

1.5.6. CEU: Certified Education Unit

1.5.7. CME: Continuing Medical Education

1.5.8. CMS: Centers for Medicare and Medicaid Services

1.5.9. Contracting Officer (CO) - The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

1.5.9.1. Contract Specialist (CS) - The person who is administering the contract on behalf of the

Contracting Officer.

1. 5.10. Contracting Officer's Representative (COR) - A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.5.11. COS: Chief of Staff

1.5.12. CPARS: Contractor Performance Assessment Reporting System

1.5.13. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.5.14. DEA: Drug Enforcement Agency

1.5.15. FSMB: Federation of State Medical Boards

1.5.16. HHS: Department of Health and Human Services

1.5.17. HIPAA: Health Insurance Portability and Accountability Act

1.5.18. HR: Human Resources

1.5.19. ISO: Information Security Officer

1.5.20. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPls in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.21. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

1.5.22. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.5.23. NP: Nurse Practitioner

1.5.24. NPPES: National Plan and Provider Enumeration System

1.5.25. PA: Physician Assistant

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1.5.26. POP: Period of Performance

1.5.27. PPD: Purified Protein Derivative

1.5.28. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual's license, based upon the individual's clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility specific and provider-specific.

1.5.29. QASP: Quality Assurance Surveillance Plan

1.5.30. SOW: Statement of Work

1.5.31. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient's medical record and with the hospital information system.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License/Certification - The contract physician and staff assigned by the Contractor to perform the services covered by this contract shall have a current license/certification to practice their specialty in any State, Territory, or Commonwealth of the United States or the District of

Columbia. SPECIAL NOTE: For procurements that require a Drug Enforcement Agency (DEA) registration, contract providers must have a medical license and be individually registered with the DEA All licenses/certifications held by the personnel working on this contract shall be full and unrestricted licenses. The Contract physician or staff who have current, full and unrestricted licenses/certifications in one or more states, but who have, or ever had, a license/certification restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification - The contract physician shall be a Board Certified OB/GYN physician. The physician must be currently certified in Basic Life Support (BLS). All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the IHS Credentialing

Coordinator on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging - Credentialing and privileging for SRSU is to be done in accordance with the provisions of IHS Credentialing and Privileging standards. The physician is also required to be Credentialed and Privileged at a Bismarck, ND hospital with an

Operating/Labor/Delivery Room. The Contractor is responsible to ensure that the proposed physician possesses the requisite credentials enabling the granting of privileges. Services shall not be provided by any contract physician prior to obtaining approval by the Great Plains Area

Credentialing and Privileging Governing Body, and the FYH Medical Executive Committee.

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2.1.7.4. COVID-19: All contract staff who work or provide direct care in a federally-operated IHS health care facility shall receive two doses of COVID-19 vaccine in a two-dose series, or one dose of COVID-19 vaccine in a single-dose. Limited exemptions apply to those who have a valid medical or religious exemption on file.

2.1. 7.5. Varicella Zoster Virus: A reliable history is a valid measure of varicella immunity. All contractors providing an uncertain or negative history of chickenpox shall provide proof of immunization with varicella vaccine.

2.1.8. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The IHS must use NPls in all Hf PAA-standard electronic transactions for individual

(health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider

Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.1.9. DEA (as required) - Contract physicians shall provide copy of current DEA.

2.1.10. Conflict of Interest: The Contractor and all contract staff are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The

Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.

2.1.11. Citizenship related Requirements:

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2.1.11.1. The Contractor certifies that the Contractor and support staff shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, as Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and

Customs Enforcement and the U.S Department of Labor as these may relate to non immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to IHS patient referrals;

2.1.11.2. While performing services for the I HS, the Contractor and support staff shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all "E-Verify" requirements consistent with "Executive Order 12989" and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.11.3. If the Contractor or support staff fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the IHS may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor's place of business that services Department of Veterans

Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.11 .4.This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.11.5.The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP.

2.1.12. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the

Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS)

Office of Inspector General (OIG) has established a list of parties and entities excluded from

Federal health care programs. Specifically, the listed parties and entities may not receive

Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.12.1. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the

HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contract staff are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP's may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.12.2. By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded

Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/Professional Direction: The qualifications of Contractor personnel are subject to review by FYH

Clinical Director, COS or his/her clinical designee and approval by the Great Plains Area Office.

Clinical/Professional direction of all clinical personnel covered by this contract will be provided by the

Clinical Director, COS and/or her designee. Only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non-Personal Healthcare Services: The parties agree that the Contractor and all contract staff shall not be considered IHS employees for any purpose.

2.4. Inherent Government Functions: Contractor and Contract staff shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of

Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

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2.5. No Employee status: The Contractor shall be responsible for protecting Contract staff furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.5.1.

2.5.2.

2.5.3.

2.5.4.

2.5.5.

Workers' compensation

Professional liability insurance

Health examinations

Income tax withholding, and

Social security payments.

2.6. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract staff. When a

Contractor or contract staff has been identified in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a

Contractor's (or contract staff) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.7. Key Personnel:

2.7.1. The IHS Full Time Equivalency (FTE) for the services required is 0.15 FTE for a total of 312 hours for 1 year. FTE is defined by IHS as a minimum of 80 hours every two weeks and does not include holidays.

2. 7 .2. The number of Board Certified OB/GYN Physician staff that are required to be on-site once a week is 0.15 FTE.

2.7.3. The number of support staff, one (1) Nurse (RN or LPN) and one (1) Ultrasound Technician that are required to be on-site once a week is 0.15 FTE.

2.7.4. It is essential that continuity of services are maintained to the maximum degree possible, hence, substitution of contractor provided Physicians shall be limited to urgenUemergent absences of approved, assigned providers. The Contractor shall be responsible for providing coverage to the IHS during periods of vacancies of the Contractor's personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event that a scheduled physician or support staff is unable to come in for or complete an assigned shift, the contractor shall provide replacement coverage within 24 hours and notify the Contracting Office Representative (COR) at the IHS immediately of schedule change.

2.8. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar days after the occurrence of any of these events and provide the information required below. After 90 days, the

Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions.

2.8.1. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the IHS Clinical Director, COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contract staff, s/he may request, without cause, immediate replacement of said contract staff.

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2.8.2. The CO and COR shall deal with issues raised concerning Contract staff conduct. The final arbiter on questions of acceptability is the CO.

2.9. Contingency Plan: Because continuity of care is an essential part of IHS SRSU medical services, The

Contractor shall have a contingency plan in place to be utilized if the contract staff leaves Contractor's employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. HOURS OF OPERATION

3.1. IHS Business Hours: Ambulatory Care Clinics are provided Monday through Friday, 0800-16:30, 52 weeks per year.

3.2. Work Schedule: Coverage for the FYH shall be for 6 hours, performed once per week, 52 weeks per year as follows:

3.2.1. FYH: Once per week for 3 weeks per month

3.2.2. MHC: Once per month

3.2.3. Patients must be seen by a contract staff on-site at SRSU in a timely manner in accordance with

IHS Rules and Regulations. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.2.4. Contract staff shall be available and present in the Ambulatory Care Clinic during hours of responsibility, at FYH, which will be established, and may be revised, as deemed appropriate for patient care by the Clinical Director.

4. CONTRACTOR RESPONSIBILITIES

4.1. Clinical Personnel Required: The Contractor shall provide a contract Physician, Nurse and Ultrasound

Technician who are competent, qualified per this statement of work and adequately trained to perform assigned duties.

4.1.1. Contract staff shall be responsible for signing in and out when in attendance. Time sheets will be used to confirm hours/day and services provided against the contractor's invoices.

4.2. Standards of Care: The contract staff's care shall cover the range of OB/GYN services as the health care treatment facility allows and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

4.2.1. American Society of OB/GYN https://www.acoq.org

4.2.2. IHS Manual https://www.ihs.gov/lHM/

4.2.3. The professional standards of The Joint Commission (T JC) http://www. jointcommission. org/emergency departmenU

4.2.4. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=1 00&type=8 and;

4.2.5. The requirements contained in this SOW

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contract physician and support staff providing healthcare services to IHS patients shall be considered as part of the Department Healthcare Activity and shall comply with the

U.S.C.551a (Privacy Act). 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552

(FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332

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(Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on

Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.3.2. Disclosure: Contract staff may have access to patient medical records: however, Contractor shall obtain permission from the IHS HIM before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to IHS's records, at IHS's place of business on request during normal business hours, to inspect and review and make copies of such records.

The penalties and liabilities for the unauthorized disclosure of IHS patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.3.3. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by

IHS Manual and all guidelines provided by the IHS.

4.3.4. Release of Information: The IHS shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the IHS authorizing the Contractor to release patient information, the Contractor in compliance with IHS regulations, and at his/her own expense, shall use IHS

Form, Request for and Consent to Release of Information from Individual's Records, to process

"Release of Information Requests". In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The IHS's Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use

IHS Form, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient's consent form.

4.4. Direct Patient Care: 90% of the time involved in direct patient care.

4.4.1. Per the qualification section of this SOW, the Contractor shall provide the following staff:

4.4.1.1. Board Certified OB/GYN physician at SRSU. The Contractor will be assigned to the IHS facility and report on-site to ensure the quality of the OB/GYN program.

4.4.1.2. Registered Ultrasound Technician at the SRSU. The Contractor will be assigned to the IHS facility and report on-site to ensure the quality of the OB/GYN program.

4.4.1.3. Nurse (RN or LPN) at the SRSU. The Contractor will be assigned to the IHS facility and report on-site to ensure the quality of the OB/GYN program.

4.4.2. Scope of Care: Contract staff (as appropriate and within scope of practice/privileging) shall be responsible for providing O8/GYN care, including, but not limited to :

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4.4.2.1. Evaluation, Treatment and Management: Employment of the principles of OB/GYN care.

4.4.2.1.1. Initial and follow-up evaluation, treatment and management for OB/GYN care encompassing, but not limited to gestation, childbirth, reproductive disorders, prenatal care, sexually transmitted diseases, paps, family planning and urinary stress incontinence.

4.4.2.2. Clinic: Contractor staff shall be present on time for any scheduled clinics as documented by physical presence in the clinic at the scheduled start time.

4.4.2.3. Consultation and Referral Responsibilities: Contractor physician shall provide consultation with and instruction to referring physicians regarding appropriate indications for procedures so that the most expeditious and clinically appropriate work-up can be done. Contractor physician shall determine the appropriate course of treatment and communicate in person or by phone with the referring clinicians.

4.4.2.4. Medications: Contractor physician shall follow all established medication policies and procedures. No sample medications shall be provided to patients.

4.4.3. ADMINISTRATIVE: 10% administrative time.

4.4.3.1. Quality Improvement Meetings: The contract physician shall participate in continuous quality improvement activities and meetings with committee participation as required by the IHS

Clinical Director, Chief of Staff, or designee.

4.4.3.2. Staff Meetings: The contract physician shall attend staff meetings as required by the IHS

Clinical Director, Chief of Staff, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.

4.4.3.3. QA/QI documentation: The contract physician shall complete the appropriate QM/Pl documentation pertaining to all procedures, complications and outcome of examinations.

4.4.3.4. Specialized EHR Documentation Procedures: Patient documentation is completed using the

Computerized Electronic Health Record (EHR).

4.4.3.4.1. Contract staff shall document care given and select appropriate Evaluation and

Management (E&M) procedure codes in EHR. Documentation must be sufficient to support both the E&M and procedure codes. Documentation and coding functions must be completed by the end of each patient care encounter.

4.4.3.5. Patient Safety Compliance and Reporting: Contract staff shall follow all established patient safety and infection control standards of care. Contract staff shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR, per IHS Safety Policy. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit to the

COR the Patient Safety Report, following up with COR as required or requested.

4.4.3.6. Customer Service: Contract staff shall refer all patient/customer service issues to the

Ambulatory Care Lead Physician and/or Ambulatory Care Nurse Manager or designee.

4.5. PERFORMANCE STANDARDS, QUALITY ASSURANCE PLAN

4.5.1. Attachment 1.

5. GOVERNMENT RESPONSIBILITIES

5.1. Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to: (enter contract administration if not already listed in another area- list the title (not name) and contact information for

COR, Clinical point of contact, and any other relevant personnel involved).

5.1.1. CO/CS RES PONS I Bl LITI ES:

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5.1.1.1. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting

Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract.

5.1.1.2. The Contracting Officer or Contract Specialist shall resolve complaints concerning

Contractor relations with the Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof.

5.1.1.3. In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services;

consultation or training for Contractor personnel to be provided by the IHS; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract.

5.1.2. COR Responsibilities:

5.1.2.1. The COR shall be the IHS official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

5.1.2.2. The COR will be responsible for monitoring the Contractor's performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected.

5.1.2.3. The COR will maintain a record-keeping system of services by timesheets. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the IHS record-keeping system and those on the invoices. Any evidence of the Contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

5.1.2.4. The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the

Government for the difference.

5.1.2.5. All contract administration functions will be retained by the IHS.

6. SPECIAL CONTRACT REQUIREMENTS

6.1. Reports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each.

Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required.

6.1.1. The following are brief descriptions of required documents that must be submitted by Contractor:

upon award; weekly; monthly; quarterly'; annually, etc. identified throughout the SOW and is provided here as a guide for Contractor convenience. If an item is within the SOW and not listed here, the Contractor remains responsible for the delivery of the item.

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What Submit as noted Submit To

Quality Control Plan: Description and reporting Upon proposal and as frequently as Contracting reflecting the contractor's plan for meeting of indicated in the performance Officer contract requirements and performance standards.

standards

Copies of any and all licenses, board Upon proposal and upon renewal of Contracting certifications, NPI, to include primary source licenses and upon renewal of Officer verification of all licensed and certified staff option periods or change of key personnel.

Certification that staff list have been compared Upon proposal and upon new hires. Contracting to OIG list Officer

Proof of Indemnification and Medical Liability Upon proposal and upon renewals. Contracting

Insurance Officer

Certificates of Completion for Cyber Security Before receiving an account on IHS Contracting and Patient Privacy Training Courses Network and annual training and Officer new hires.

BLS Certification Upon award and every two years Credentialing after award. Coordinator

Contingency plan Upon proposal and as updated COR/Clinical

Director

6.2. Billing:

6.2.1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th workday of the month. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a "proper" invoice in accordance with FAR 52.212-4 (g), all invoices must include:

6.2.1.1.

6.2.1.2.

6.2.1.3.

6.2.1.4.

6.2.1.5.

6.2.1.6.

6.2.1.7.

6.2.1.8.

Name and Address of Contractor

Invoice Date and Invoice Number

Contract Number and Purchase/Task Order Number

Date of Service

Contract physician(s)

Hourly Rate

Quantity of hours worked

Total price

6.3. Payment Adjustments/Performance Related Payment Deductions:

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6.3.1. Invoices will be prorated for partial days/hours worked. The contractor shall be paid only for actual work performed onsite. In the event that the Contract provider works a portion of an hour, the government may adjust payments by 15 minute increments. Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed.

6.3.1.1. The contract shall be adjusted at the end of the period of performance for each invoice presented in accordance with actual performance.

6.4. Performance Deductions: If the contractor fails to meet the Acceptable Quality Level on any performance measure that references a deduction as a disincentive, the following method for calculating and applying the deduction shall be employed:

6.4.1. Describe the method of calculation, application (to include method and timing) for each deduction. The COR will prepare a contract discrepancy report and will notify the CO in the event the contractor failed to meet the AQL established for any performance measure. The CO will provide the contractor with the CDR and documentation (as appropriate) supporting the performance level of the contractor and the government's intent to apply the deduction in the following manner: 25% reduction of monthly invoice in accordance with section 5.1.2.4 under the

Contract Administration/Performance Monitoring. The 25% reduction shall be applied to the next invoice billed. The contractor has thirty (30) days to respond if the contractor wishes to provide evidence that the AQL was met or to assert that the government's action or inaction prevented the Contractor from reaching performance at the AQL. The Contracting Officer shall make the final determination regarding the deduction after reviewing the contractor's response.

7. Services and Price Costs:

7.1. Base Year: 01/01/22 -12/31/2022

Item No. Description of Service

1. High Risk and Routine

Obstetrical and

Gynecological Services

7.2. Option Year One (1): 0101/23 - 12/31/23

Item No. Description of Service

1. High Risk and Routine

Obstetrical and

Gynecological Services

Estimated

Quantity

Estimated

Quantity

7.3. Option Year Two (2): 01/01/24-12/31/24

Item No. Description of Service Estimated

Quantity

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Unit Unit Price Total Amount

HRS $ $

Total Base $ Year:

Unit Unit Price Total

Amount

HRS $ $

Total Base $

Year:

Unit Unit Price Total

Amount

1. High Risk and Routine 312 HRS $ $

Obstetrical and

Gynecological Services

Total Base $

Year:

7.4. Option Year Three (3): 01/01/25 - 12/31/25

Item No. Description of Service Estimated Unit Unit Price Total

Quantity Amount

1. High Risk and Routine 312 HRS $ $

Obstetrical and

Gynecological Services

Total Base $

Year:

7.5. Option Year Four (4): 01/01/26 - 12/31/26

Item No. Description of Service Estimated Unit Unit Price Total

Quantity Amount

1. High Risk and Routine 312 HRS $ $

Obstetrical and

Gynecological Services

Total Base $

Year:

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ATTACHMENT 1

QASP

The contractor will be evaluated in accordance with the following:

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

• What will be monitored?

• How monitoring will take place.

• Who will conduct the monitoring?

• How monitoring efforts and results will be documented.

This QASP does not detail how the contractor accomplishes the work.