RFQ-10-17-017-REL.Attachments.doc.docx

Appendix A Site Emergency Department Description and Capabilities

Crow Hospital Top 10 ED diagnoses:

1. Acute URI NOS

2. Urinary Tract Infection

3. Cellulitis

4. Abdominal Pain

5. Viral Infection

6. Acute Pharyngitis

7. Chest Pain NOS

8. Otitis Media NOS

9. Lumbago

10. Impetigo

Emergency Department staffing includes a combination of the following:

· Medical Providers:

· M.D. (the ED Supervisor)

· NP

· Locum Tenens Permanent Nursing Staffing:

· RNs

· Locum Tenens RNs

ED Capabilities:

· 7 Bays with an average daily visit count of 31

· Can implement basic ATLS protocols in order to stabilize a patient prior an appropriate transfer to higher level trauma center

· 24-hour radiology and laboratory coverage

· ACLS, ATLS, and PALS capable

· Intraosseous lines, central lines, chest tubes, intubation in adults and pediatrics, needle decompression of tension pneumothorax, and cricothyrotomy.

· Emergency obstetric deliveries only

· Simple and Complex wound repairs/I&Ds

Blackfeet Service Unit Top 10 ED diagnoses:

1. Abdominal pain

2. Bronchitis

3. Urinary Tract Infection NOS

4. Lumbago

5. Acute Pharyngitis

6. Alcohol Abuse

7. Acute Bronchitis

8. Chest Pain NOS

9. Otitis Media NOS

10. Cellulitis

Emergency Department staffing includes a combination of the following:

· Supervisory Medical Officer (1)

· RNs

ED Capabilities:

· 8 Bays with an average daily visit count of 60

· Can implement basic ATLS protocols in order to stabilize a patient prior an appropriate transfer to higher level trauma center

· 24-hour radiology and laboratory coverage

· ACLS, ATLS, and PALS capable

· Intraosseous lines, central lines, chest tubes, intubation in adults and pediatrics, needle decompression of tension pneumothorax, and cricothyrotomy.

· Emergency obstetric deliveries only

· Simple and Complex wound repairs/I&Ds

Fort Belknap Service Unit Top 10 ED diagnoses:

1. Acute URI

2. Acute Pharyngitis

3. Lumbago

4. Acute Bronchitis

5. Abdominal Pain

6. Headache

7. Urinary Tract Infection

8. Otitis Media NOS

9. Acute Sinusitis

10. Strep Throat

Emergency Department staffing includes a combination of the following:

· Permanent Medical Providers:

· M.D. (the ED Supervisor)

· PA

· RNs

ED Capabilities:

· Four Bays with an average daily visit count of 25

· ACLS, ATLS, and PALS capable

· Intraosseous lines, central lines, chest tubes, intubation in adults and pediatrics, needle decompression of tension pneumothorax, and cricothyrotomy.

· Emergency obstetric deliveries only

· Simple and Complex wound repairs/I&Ds

Northern Cheyenne Service Unit Emergency Department staffing include a combination of the following:

· Permanent Medical Providers:

· M.D. (the ED Supervisor)

· NP

· PA

· Locum Tenens Physicians

· Permanent Nursing Staffing:

· RNs

· Intermittent RNs

ED Capabilities:

· 4 Bays with an average daily visit count of 24

· ACLS, ATLS, and PALS capable

· Intraosseous lines, central lines, chest tubes, intubation in adults and pediatrics, needle decompression of tension pneumothorax, and cricothyrotomy.

· Emergency obstetric deliveries only

· Simple and Complex wound repairs/I&Ds

Appendix B IHS System Environment

a. The table below provides information on IHS IT System Environment, within which Tele-ED services shall be provided.

· Quality of Services is provisioned on the network to prioritize voice and video traffic.

· Circuit bandwidth for the Billings Area sites accessing the MPLS network are DS3.

· Supports ISDN through 4(PRI circuits) (additional circuits can be added, if needed).

· Supports IP connections through the IHS Wide Area Network.

· Video Border Proxy hosted in the Albuquerque data center DMZ with an Internet facing interface.

· Video Gateway hosted in the Albuquerque data center DMZ with an Internet facing interface.

· Compatible video end points are available.

· Two factor authentication.

· Windows based client access.

· See URL below for additional information.

https://www.ihs.gov/citrix/

See URL below for additional information.

https://www.ihs.gov/RPMS/

Appendix C OCIO Deliverables

Deliverables mandated by HHS Office of the Chief Information Officer (OCIO):

a)

Appendix D

DEPARTMENT OF HEALTH AND HUMAN SERVICES

INDIAN HEALTH SERVICE

Past Performance Questionnaire RFQ Title: 10-17-017-REL Due Date: 02/13/2017 at 2:00 PM (Mountain Time) Email completed questionnaire to: Rita.Langager@ihs.gov

EVALUATOR INFORMATION

City

State

Zip Code

Contract Number/Order Number: __ _________________________________________

PART 1: SPECIFIC PERFORMANCE

Instructions: This part consists of an open-ended question to determine the scope, complexity, and relevance of the project to the current requirement.

PART 2: GENERAL PERFORMANCE

Instructions: Please rate each of the following areas based on the evaluation scale included in Appendix A. Other evaluation areas that are unique to the contract or that cannot be captured elsewhere should be added to the table. Lines 7-9 are in the table for this purpose, but additional lines can be added by references. Space to include comments to support ratings is provided in the ‘Evaluator Comments’ section.

EVALUATOR COMMENTS:

PAST PERFORMANCE RATINGS

The Federal Government uses the Contractor Performance Assessment Reporting System (CPARS) to document contractor performance information that is required by Federal Regulations. Past performance information entered to CPARS is available to Federal agencies through a separate system called the Past Performance Information Retrieval System (PPIRS) for source selection purposes. The ratings and definitions used in this questionnaire are identical to those used in CPARS.

Good Performance meets contractual requirements and exceeds some to the Government's benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Acceptable Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor's corrective actions appear or were ineffective.

PERFORMANCE AREA DEFINITIONS

The Federal Government uses the Contractor Performance Assessment Reporting System (CPARS) to document contractor performance information that is required by Federal Regulations. Past performance information entered to CPARS is available to Federal agencies through a separate system called the Past Performance Information Retrieval System (PPIRS) for source selection purposes. The performance areas and definitions used in this questionnaire are identical to those used in CPARS.

Quality of Product/Service: Assess the contractor’s conformance to contract/order requirements, specifications and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards). For example: Are reports/data accurate? Does the product or service provided meet the specifications of the contract/order? Does the Contractor’s work measure up to commonly accepted technical or professional standards? Assess the degree of customer (Government or Commercial) technical direction required to solve problems that arise during performance.

For Operations Support: Assess how successfully the contractor meets program quality objectives such as ability to produce, reliability, maintainability and ability to inspect. The evaluator must be flexible in how contractor success is measured; e.g., using data from field reliability and maintainability and failure reports, user comments, and acceptance rates, and scrap and rework rates. Did the contractor demonstrate continuous improvement, quality and reliability leadership that reflects progress in quality management?

Schedule: Assess the timeliness of the contractor against the competition of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or effect the schedule variance).

This evaluation of the contractor’s adherence to the required delivery schedule should include the contractor’s efforts during the evaluation period that contributes to or effects the schedule variance. This element applies to contract/order closeout activities as well as contract performance. Instances of adverse actions such as assessment of liquidated damages, or issuance of Cure Notices, Show Cause Notices, and Delinquency Notices are indicators of problems which may have resulted in variance to the contract/order schedule and should therefore be noted in the evaluation.

Cost Control: (Not required for Firm Fixed Price or Firm Fixed Price with Economic Price Adjustment) – Assess the contractor’s effectiveness in forecasting, managing, and controlling contract/order cost. For example, does the contractor keep within the total estimated cost (what is the relationship of the negotiated costs and budgeted costs to actuals)? Did the contractor do anything innovative that resulted in cost savings? Were billings current, accurate and complete? Are the contractor’s budgetary internal controls adequate?

Business Relations: Assess the integration and coordination of all activity needed to execute the contract/order, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.

Include, as applicable, information on the following:

· Is the contractor oriented toward the customer?

· Is interaction between the contractor and the customer satisfactory or does it need improvement?

· Include the adequacy of the contractor’s accounting, billing, and estimating systems and the contractor’s management of customer property if a substantial amount of property has been provided to the contractor under the contract/order.

· Address the timeliness of awards to subcontractors and management of subcontractors, including subcontract costs. Consider efforts taken to ensure early identification of subcontract problems and the timely application of corporate resources to preclude subcontract problems from impacting overall prime contractor performance.

· Assess the prime contractor’s effort devoted to managing subcontracts and whether subcontractors were an integral part of the contractor’s team.

Management of key Personnel (Applicable when the contract/order contains a Key Personnel clause): Assess the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

For example, how well did the contractor match the qualifications of the key position, as described in the contract/order, with the person who filled the key position/ Di the contractor support key personnel so they were able to work effectively? If a key person did not perform well, what action was taken by the contractor to correct this? If a replacement of a key person was necessary, did the replacement meet or exceed the qualifications of the position as described in the contract/order schedule?

Utilization of Small Business (Applicable only to Government contracts with small business clauses): FAR subpart 19.7 and 15 U.S.C. 637 contain statutory requirements for complying with the Small Business subcontracting Program. Assess whether the Contractor provided maximum practicable opportunity for Small Businesses to participate in contract/order performance consistent with efficient performance of the contract/order.Assess compliance with all terms and conditions in the contract/order relating to Small Business participation (including FAR 52.219-8, Utilization of Small businesses and FAR 52.219-9, small b=business Subcontracting Plan (when required)). Assess any Small Business participation goals, to include AbilityOne goals, which are stated separately in the contract/order. Assess achievement on each individual goal stated within the contract/order of subcontracting plan including good faith effort if the goal was not achieved.