RFQ 24Q00006 Supporting Solicitation Docs Mid-Level Services.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

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

OFFEROR

Aberdeen SD 57401 115 Fourth Ave, SE Federal Building Aberdeen Area Indian Health Servic

161 CODE 16. ADMINISTERED BYCODE

X

X

X

621399

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR159

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

01/08/2024 1200 CT

12/28/2023

605-226-7274URSULA MASLONKA

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70624Q00006

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 3 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Fort Yates ND 58538 10 Standing Rock Ave Fort Yates IHS Hospital

15. DELIVER TO

Aberdeen SD 57401 115 Fourth Ave, SE Federal Building

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$10

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

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Aberdeen Area Indian Health Servic

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Firm Fixed-Price, Non-Personal Healthcare Service, IDIQ Contract, Single Award, for Mid-Level Certified Nurse Practitioner/Physician Assistant Provider Services and Psychiatrics Certified Nurse Practitioner Provider Services at the Ft. Yates PHS, IHS Hospital, Ft. Yates, ND.

The period of performance will be January 15, 2024 through January 14, 2025, with four (4), one

(1) year option periods.

Period of Performance: 01/15/2024 to 01/14/2029 (Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

XX

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

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

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

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

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

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

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT:

REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

1 Base Year Mid-Level Provider

4160 hours

Period of Performance: 01/15/2024 to 01/14/2025

2 Option Year One Mid-Level Provider

4160 hours

(Option Line Item)

Period of Performance: 01/15/2025 to 01/14/2026

3 Option Year Two Mid-Level Provider

4160 hours

(Option Line Item)

Period of Performance: 01/15/2026 to 01/14/2027

4 Option Year Three Mid-Level Provider

4160 hours

(Option Line Item)

Period of Performance: 01/15/2027 to 01/14/2028

5 Option Year Four Mid-Level Provider

4160 hours

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

3 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 3

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70624Q00006

(Option Line Item)

Period of Performance: 01/15/2028 to 01/14/2029

6 Base Year Psych NP

2080 hours

Period of Performance: 01/15/2024 to 01/14/2025

7 Option Year One Year Psych NP

2080 hours

(Option Line Item)

Period of Performance: 01/15/2025 to 01/14/2026

8 Option Year Two Year Psych NP

2080 hours

(Option Line Item)

Period of Performance: 01/15/2026 to 01/14/2027

9 Option Year Three Year Psych NP

2080 hours

(Option Line Item)

Period of Performance: 01/15/2027 to 01/14/2028

10 Option Year Four Year Psych NP

2080 hours

(Option Line Item)

Period of Performance: 01/15/2028 to 01/15/2029

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

Statement of Work (SOW)

Mid-Level Healthcare Services

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Certified Nurse

Practitioner/Physician Assistant services for the Indian Health Service (IHS) Standing Rock Service Unit which consists of the Fort Yates Hospital (FYH), Fort Yates, ND, McLaughlin Health Center, (MHC), McLaughlin, SD, Cannonball Health Station (CB), Cannonball, ND, Wakpala Health Station (WAK), Wakpala, SD and Bullhead Health Station (BH), Bullhead, SD. These mid-level providers will provide primary healthcare services on site in accordance with the specifications contained herein to beneficiaries of the IHS. A contractor providing onsite primary healthcare services that meet or exceed the American Academy of Nurse Practitioners Certification Board (AANPCB) or the National Commission on Certification of Physician Assistants (NCCPA). Contractor employees shall not be considered government employees for any purpose under this contract. And, the Contractor shall provide Psychiatric Certified Nurse Practitioner services for the Indian Health Service (IHS) at the McLaughlin Health Center (MHC), McLaughlin, SD and the Fort Yates Hospital (FYH), Fort Yates, ND. This mid-level provider(s) will provide primary healthcare services on site in accordance with the specifications contained herein to beneficiaries of the IHS. A contractor providing onsite primary healthcare services that meet or exceed the American Academy of Nurse Practitioners Certification Board (AANPCB). Certification by the American Nurse Credentialing Center or American Academy of Nurse Practitioners with a reflected specialist of “psychiatric-mental health.”

1.1.1. The Provider assesses plans and provides comprehensive and therapeutic psychiatric care to patients and their families. Specifically, to provide specialized psychiatric services including clinical assessments and diagnosis to individuals with mental illness and prescribing medications and treatment.

1.1.2. Takes a complete health and psychiatric history from the patient and/or family member. Reviews medical history as recorded in patient’s chart and consults with primary care physician as needed.

1.1.3. Orders and interprets findings of relevant laboratory and diagnostic tests.

Interprets test results and analyzes all collected data, discriminates between normal and abnormal findings to identify all stages of serious physical, emotional or mental problems, and to prioritize health care needs.

1.1.4. Performs mental status examinations, recognizes the major categories of psychiatric disorders, provides diagnosis, determines appropriate level of care, and documents these findings clearly in the electronic health record daily using SOAP format, and in compliance with hospital policies and procedures, and consistent with professional standards of practice.

1.1.5. Formulates and implements plan of care which may involve various treatment modalities, prescribing medications, consultation with other health care providers, and referrals. Identifies and manages both acute and chronic mental health and substance use disorders in accordance with established standards of medical care and approved clinical privileges. Provides surveillance of medical regimens for stabilized, chronically mentally ill persons, recognizing when to refer the patient to physician or other health care team member

1.1.6. 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. Fort Yates Hospital Outpatient Clinic, 10 Standing Rock Ave, Fort Yates, ND

1.2.2. McLaughlin Health Center, 701 6th Street East, McLaughlin, SD.

1.2.3. Cannonball Health Center, Weasel Street, Cannonball ND

1.2.4. Wakpala Health Center, 1st Street, Wakpala, SD

1.2.5. Bullhead Health Center, 102 Tasunka Street, Bullhead, SD

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

1.3.1. – IHS Manual – “Health Care Service Standards”

1.3.2. - National Practitioner Data Bank Reports

1.3.3. - Credentialing and Privileging

1.3.4. - Health Information Management and Health Records

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

1.4. 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.

1.4.1. BLS: Basic Life Support

1.4.2. CCNE: Commission on Collegiate Nursing Education:

www.aacn.nche.edu/accreditation

1.4.3. CDC: Centers for Disease Control and Prevention

1.4.4. CDR: Contract Discrepancy Report

1.4.5. CEU: Certified Education Unit

1.4.6. CME: Continuing Medical Education

1.4.7. CMS: Centers for Medicare and Medicaid Services

1.4.8. 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.

1.4.8.1. Contract Specialist (CS) – The person who is administering the contract on behalf of the Contracting Officer.

1.4.9. 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 http://www.aacn.nche.edu/accreditation of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.4.10. COS: Chief of Staff

1.4.11. CPARS: Contractor Performance Assessment Reporting System

1.4.12. 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.

1.4.13. DEA: Drug Enforcement Agency

1.4.14. HHS: Department of Health and Human Services

1.4.15. HIPAA: Health Insurance Portability and Accountability Act

1.4.16. HR: Human Resources

1.4.17. ISO: Information Security Officer

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

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

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

1.4.21. NP: Nurse Practitioner

1.4.22. NPPES: National Plan and Provider Enumeration System

1.4.23. PA: Physician Assistant

1.4.24. POP: Period of Performance

1.4.25. PPD: Purified Protein Derivative

1.4.26. PWS: Performance Work Statement

1.4.27. 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, http://www.nlnac.org/ health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.4.28. QASP: Quality Assurance Surveillance Plan

1.4.29. 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 - Contract midlevel provider(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine 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 held by the personnel working on this contract shall be full and unrestricted licenses. Contract midlevel provider(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license 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 - All contract midlevel provider(s) shall be Certified through the appropriate board. All midlevel provider(s) 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 is to be done in accordance with the provisions of IHS Credentialing and Privileging standards.

The Contractor is responsible to ensure that proposed midlevel provider(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract midlevel provider(s) prior to obtaining approval by the Great Plains Area Credentialing and Privileging Governing Body, and the SRSU Medical Executive Committee.

2.1.3.1. If a contract midlevel provider(s) is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.4. Technical Proficiency - Contract midlevel provider(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract midlevel provider(s) and contract midlevel provider(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations that govern medical staff behavior.

2.1.5. Continuing Medical Education (CME)/Certified Education Unit (CEU) Requirements: Contractor shall provide copies of current CMEs as required or requested by the IHS. Contract midlevel provider(s) registered or certified by national associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credentials office for tracking. These documents are required for both privileging and re-privileging.

Failure to provide shall result in loss of privileges for contract midlevel provider(s).

2.1.6. Training (BLS, EHR and IHS MANDATORY): Contractor shall meet all IHS educational requirements and mandatory course requirements defined herein; all training must be completed by the contract midlevel provider(s) as required by the IHS. BLS, EHR, IHS Privacy and Information Security Awareness and Rules of Behavior, IHS Privacy and HIPPA, and Prevention of Workplace Harassment/No Fear.

2.1.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for midlevel provider(s) within five (5) calendar days after contract award and prior to the first duty shift. Tests shall be current within the past year.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract midlevel provider(s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

2.1.7.2. RUBELLA TESTING: Contractor shall provide proof of immunization for all contract midlevel provider(s) for measles, mumps, rubella or a rubella titer of

1.8 or greater.

2.1.7.3. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contract midlevel provider(s); provide their own Hepatitis B vaccination series at no cost to the IHS if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The IHS shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control.

Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.8. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The IHS must use NPIs in all HIPAA-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) - Contractor shall provide copy of current DEA.

2.1.10. Conflict of Interest: The Contractor and all contract midlevel provider(s) 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 it’s 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:

2.1.11.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to IHS patient referrals;

2.1.11.2. While performing services for the IHS, the Contractor 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.

http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

2.1.11.3. If the Contractor 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 midlevel provider(s) is 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 midlevel provider(s) are subject to review by SRSU Clinical Director, Clinical Services Administrator (CSA), 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 http://oig.hhs.gov/exclusions/index.asp 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 midlevel provider(s) shall not be considered IHS employees for any purpose.

2.4. Inherent Government Functions: Contractor and Contract midlevel provider(s) 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.

2.5. No Employee status: The Contractor shall be responsible for protecting Contract midlevel provider(s) 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. Workers’ compensation

2.5.2. Professional liability insurance

2.5.3. Health examinations

2.5.4. Income tax withholding, and

2.5.5. Social security payments.

2.6. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract midlevel provider(s). When a Contractor or contract midlevel provider(s) have been identified as a provider 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 midlevel provider(s)) 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 NP/PA services required is 2.0 FTE for a total of 4,160 hours for 1 year. FTE is defined by IHS as a minimum of 80 hours every two weeks and does not include holidays. The IHS Full Time Equivalency (FTE) for the PNP services required is 1.0 FTE for a total of 2,080 hours for up to 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 Certified midlevel providers that are required to be on-site will be on an as needed basis to cover vacation, leave, trainings and conferences for the FYH, MHC, CB, WAK and/or BH.

2.7.3. The number of Certified Psychiatric midlevel providers that are required to be on-site will be on an as needed basis to cover increased workload, vacation, leave, trainings and/or conferences for the MCH and FYH.

2.7.4. It is essential that continuity of services is maintained to the maximum degree possible, hence, substitution of contractor provided midlevel provider(s) shall be limited to urgent/emergent 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 midlevel provider is unable to come in for or complete an assigned shift, the Contractor shall provide replacement midlevel provider 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 midlevel provider(s), s/he may request, without cause, immediate replacement of said contract midlevel provider(s).

2.8.2. The CO and COR shall deal with issues raised concerning Contract midlevel provider(s) 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 FYH, MHC, CB, WAK and BH medical services, the Contractor shall have a contingency plan in place to be utilized if the contract midlevel provider(s) 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:

3.2.1. The contractor’s works schedule will vary from work week to work week. The requirement may be for one day per week or up to 5 days per week. The variation is dependent on SRSU’s current FTE staffing pattern.

3.2.2. Patients must be seen by the contract midlevel provider(s) on-site at FYH, MHC, CB, WAK and/or BH 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.

3.2.3. Contract midlevel provider(s) shall be available and present in the Ambulatory Care Clinic during hours of responsibility, at FYH, MHC, CB, WAK and/or BH, 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 contract midlevel provider(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Contract midlevel provider(s) 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 midlevel provider(s) care shall cover the range of Ambulatory 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. IHS Manual https://www.ihs.gov/IHM/

4.2.2. The professional standards of The Joint Commission (TJC) http://www.jointcommission.org/emergency_department/

4.2.3. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

4.2.4. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contract midlevel provider(s) who provide 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 (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 midlevel provider(s) may have access to patient medical records. However, Contract midlevel provider(s) shall obtain permission from the IHS before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contract midlevel provider(s), or their https://www.ihs.gov/IHM/ http://www.jointcommission.org/emergency_department/ http://www.hpoe.org/resources?show=100&type=8 designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contract midlevel provider(s), 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 Contract midlevel provider(s).

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 Contract midlevel provider(s) to release patient information, the Contract midlevel provider(s) in compliance with IHS regulations, shall use IHS Form, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” The IHS’s Release of Information Section shall provide the Contract midlevel provider(s) with assistance in completing forms. Additionally, the Contract midlevel provider(s) 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 of 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 Midlevel provider(s) (either a PA or an NP) at FYH, MHC, CB, WAK and/or BH. The Contract midlevel provider(s) will be assigned to the IHS facility and report on-site.

4.4.2. Scope of Care: Contract midlevel provider(s) (as appropriate and within scope of practice/privileging) shall be responsible for providing Primary Healthcare Services, including, but not limited to :

4.4.2.1. Evaluation, Treatment and Management: Employment of the principles of Primary Care.

4.4.2.1.1. Initial and follow-up evaluation, treatment and management for Primary Healthcare Services.

4.4.2.2. Clinic: Contract midlevel provider(s) 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: Contract midlevel provider(s) shall provide consultation with and instruction to referring physicians regarding http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/va/pdf/VA3288.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf http://www4.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf appropriate indications for procedures so that the most expeditious and clinically appropriate work-up can be completed. Contract midlevel provider(s) shall determine the appropriate course of treatment and communicate in person or by phone with the referring clinicians.

4.4.2.4. Medications: Contract midlevel provider(s) 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 midlevel provider(s) 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 midlevel provider(s) 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 midlevel provider(s) shall complete the appropriate QM/PI 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 midlevel provider(s) 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 midlevel provider(s) shall follow all established patient safety and infection control standards of care.

Contract midlevel provider(s) 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 midlevel provider(s) shall refer all patient/customer service issues to the Ambulatory Care Supervisory Physician and/or Ambulatory Care Nurse Manager or designee.

4.5. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY

IMPROVEMENT(QI)

4.5.1. Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, proper utilization of the EHR used for patient tracking and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE).

Contract midlevel provider(s) performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.5.2. Patient Complaints: The CO will resolve complaints concerning Contract midlevel provider(s) relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that The Contract midlevel provider(s) is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

4.5.3. 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. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

4.5.4. Performance Standards:

4.5.4.1. Measure: Provider Quality Performance

Performance Requirement:

Standard: OPPE documentation for all (100%) staff providing services under the contract. All staff (100%) meets Standards.

Acceptable Quality Level: 80% meet Standards

Surveillance Method: Ongoing Provider Performance Evaluation (OPPE) data pertinent to care performed for each provider working under this contract. OPPE data will review the following elements:

A. Patient Care Performance

B. Medical/Clinical knowledge

C. Practiced Based Learning and Improvement

D. Interpersonal and Communication Skills

E. Professionalism

F. System Based Practice

Frequency: Will be completed within 3 months of beginning work at the IHS or if specified triggers occur. The following applies: POTENTIAL TRIGGERS FOR

FOCUSED REVIEW (PLEASE INDICATE IF RELEVANT)

• New Provider (generally at 3 months)

• Request for New Privileges

• Sentinel Events

• Substantiated Practitioner-Specific Complaint

• Provider-Specific Tort Settlement

• Significant Safety Violations

• Repeated/Egregious Unprofessional Behavior

• Other

Incentive: Positive Past Performance

Disincentive: Negative Past Performance, (should there be deductions for this standard)

4.5.4.2. Measure: Qualifications of Key Personnel

Performance Requirement: All Contract midlevel provider(s) shall be board certified.

Standard: All (100%) contract midlevel provider(s) are board certified.

Acceptable Quality Level: 100% No deviations accepted.

Surveillance Method: Random Inspection of qualification documents

Frequency: At the time of hire and during re-credentialing.

Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation. Removal from contract until such time the Contract midlevel provider(s) meet qualification standard:

4.5.4.3. Measure: Scope of Practice/Privileging

Performance Requirement: Contract midlevel provider(s) performs within their individual scopes of practice/privileging.

Standard: All (100%) Contract midlevel provider(s) perform within their scope of practice/privileges 100% of the time.

Acceptable Quality Level: All (100%) Contract midlevel provider(s) perform within their scope of practice/privileges 100% of the time. No deviations accepted.

Surveillance Method: Random Inspection of records during OPPE/FPPE.

Frequency: Two times a year.

Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation. Removal from contract until such time the contract physician(s) meet qualification standard.

4.5.4.4. Measure: Patient Access

Performance Requirement: The Contractor shall provide Contract midlevel provider(s) in accordance with the operating hours and IHS clinical schedule outlined in this PWS.

Standard: All (100%) Contract midlevel provider(s) are on time and available to perform services.

Acceptable Quality Level: Contract midlevel provider(s) is on-time and available to perform services 90% of the time

Surveillance Method: Periodic Sampling of Time and Attendance Sheets

Frequency: Quarterly review by Supervisor of Ambulatory Care at SRSU.

Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation.

4.5.4.5. Measure: Patient Safety

Performance Requirement: Patient safety incidents shall be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)

Standard: All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident.

Acceptable Quality Level: All (90%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident. No acceptable deviation.

Surveillance Method: Direct Observation

Frequency: As needed

Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation.

4.5.4.6. Measure: Maintains licensing, registration, and certification Performance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current.

Standard: All (100%) licensing, registration(s) and certification(s) for Contract midlevel provider(s) shall be provided as they are renewed. Licensing and registration information kept current.

Acceptable Quality Level: All (100%) licensing, registration(s) and certification(s) for Contract midlevel provider(s) shall be provided as they are renewed.

Licensing and registration information kept current. No acceptable deviation.

Surveillance Method: Periodic Sampling and Random Sampling

Frequency: Every 2 years by credentialing/privileging at SRSU IHS

Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation.

4.5.4.7. Measure: Mandatory Training

Performance Requirement: Contractor shall complete all required training on time

Standard: All (100%) of required training is complete on time by Contract midlevel provider(s).

Acceptable Quality Level: 90% completions, no deviations.

Surveillance Method: Periodic Sampling

Frequency: Annually, or as requirement is established.

Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation, Suspension or termination of all physical and/or electronic access privileges and removal from contract until such time as the training is complete.

4.5.4.8. Measure: Privacy, Confidentiality and HIPAA

Performance Requirement:

Standard: All (100%) Contract midlevel provider(s) and technicians comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA

Acceptable Quality Level: 100% compliance; no deviations.

Surveillance Method: Periodic Sampling; Contract midlevel provider(s) shall provide evidence of annual training required by IHS.

Frequency: Monthly monitoring by Information Security Officer and Privacy Officer.

Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contactor performance evaluation. Immediate removal from contract.

4.5.5. Registration with Contractor Performance Assessment Reporting System

4.5.5.1. As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the IHS evaluates Contractor past performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement IHS uses an online database, CPARS. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information.

4.5.5.2. Each Contractor whose contract award is estimated to exceed $150,000 requires a CPARS evaluation. A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations). Additional information regarding the evaluation process can be found at www.cpars.gov.

http://www.cpars.gov/

4.5.5.3. For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the Contractor’s performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the Contractor’s designated representative for comment. The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO.

4.5.5.4. Failure for the Contractor’s representative to respond to the evaluation within those sixty (60) days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond;

the Contractor’s representative will be “locked out” of the evaluation and may no longer send comments.

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 RESPONSIBILITIES:

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.