SF-1449 - 75H70723Q00145.pdf

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CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

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

OFFEROR

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225 Albuquerque Indian Health Service

CODE 16. ADMINISTERED BYCODE

X

X

X

621399

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR203

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

09/05/2023 1730 MD

08/24/2023

505-256-6755SHANDIIN DEWOLFE

(No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70723Q00145

5. SOLICITATION NUMBER

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

1 37 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

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 FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Albuquerque Indian Health Service

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Solicitation No. 75H70723Q00145 is hereby issued for two (2) Dental Assistants to provide services at the Zia Health Center located in Zia Pueblo, NM, starting October 01, 2023 and ending September 30, 2024. The resulting award will consist of a base year with four option years.

ISBEE CASCADING SET-ASIDE:

Offers will be solicited from Indian Small Business Economic Enterprise (ISBEE) concerns. If we do not receive enough competition and/or

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED

SHANDIIN R. DEWOLFE

. 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 (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

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: REFERENCE

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. 11/2021) BACK

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SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

reasonably priced offers from the ISBEE set-aside, we will then evaluate quotes and consider for award to other small business concerns. Any acquisition resulting from this cascading set-aside will be from such a concern as follows:

First Tier: ISBEE vendors

Second Tier: All other Small Business Concerns

Offers received from enterprises that are not one of these small business concerns will not be considered.

Period of Performance: 10/01/2023 to 09/30/2024

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37 2 of

2 Dental Assistants Zia Health Clinic SOLICITATION NO. 75H70723Q00145

SECTION 1 - SUPPLIES OR SERVICES AND PRICES/COSTS

1.1 SERVICES

1.1.1 The Indian Health Service (IHS)/Albuquerque Area Office (AAO), Albuquerque Service Unit (ASU) has a requirement for two (2) Dental Assistants to provide services at the Zia Health Center located in Zia Pueblo, NM, starting October 01, 2023 and ending September 30, 2024. The resulting award will consist of a base year with four option years.

1.1.2 The Government contemplates to award at least one award resulting from this solicitation.

1.2 PRICE OR COST

This will result in one Firm-Fixed-Price (FFP) purchase order. The prices listed in the “SCHEDULE OF

CHARGES” below are expected but may not be representative of actual pricing and serve as a means of arriving at price reasonableness for award purposes. Utilization of the FFP contract has been determined to be appropriate for two (2) Dental Assistants to provide Non-Personal Healthcare Services, as the government anticipates a recurring need, but prices are subject to change.

1.3 GENERAL CONTRACT INFORMATION

1.3.1 This is a non-personal health care service contract, as defined in Federal Acquisition Regulation (FAR) 37.401, under which the contractor is an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment). The contractor indemnifies the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance.

1.3.2 As an independent Contractor; billing and collecting for the federal, state and other local city/county taxes is the burden of the Contractor, this includes the New Mexico Gross Receipt Taxes (NMGRT) for services provided in any county of the State of New Mexico.

1.3.3 The Contractor's price/cost for services under this contract should include all applicable taxes for Internal Revenue Service (IRS), State of New Mexico Taxation and Revenue agency and/or other revenue agencies. The Indian Health Service will not withhold taxes nor will it issue a W-2 to the contractor.

1.3.4 FINGERPRINTING REQUIREMENTS FOR SECURITY AND SUITABILITY:

Prior to start of services specified by the contract scope of work, the Contractor must contact

Warren Cheromiah, at Telephone No. (505) 256-6749, AAO, Division of Contracts and Grants, to schedule an appointment to complete the fingerprinting process required by the IHS regulations pertinent to security and character background investigations.

1.4 CONTRACT PRICE

1.4.1 This will result in an FFP purchase order. The total price for this contract is $TBD.

1.4.3 The Contractor shall be paid upon submission of an invoice and completion and/or verification (if service) are completed by the Contracting Officer's Representative (COR), of the services indicated below.

SCHEDULE OF CHARGES

Item # Contract Period* Pricing per Year** Total Amount

CLIN 1

Base Period:

10/01/23 – 09/30/24

2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year =

$___________/year

CLIN 2 1st Option Period:

10/01/24 – 09/30/25

2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year =

$___________/year

CLIN 3 2nd Option Period:

10/01/25 – 09/30/26

2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year =

$___________/year

CLIN 4 3rd Option Period:

10/01/26 – 09/30/27

2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year =

$___________/year

CLIN 5 4th Option Period:

10/01/27 – 09/30/28

2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year =

$___________/year

GRAND TOTAL (base year + option years):

* - Note: Hourly rate shall be an all-inclusive rate of all other fees including: travel expenses; per diem;

lodging; all city, state, federal, and local taxes; and miscellaneous cost associated with the above services.

** - There is a fillable table attached for your usage or you may use a format of your own. Thank you!

SECTION 2 – DEFINITIONS:

2.1 Acceptance: As stated in FAR, subpart 46.5, Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements and subject to other terms and conditions of the contract.

2.2 Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements. Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

2.3 Area: A defined geographical region for Indian Health Service administrative purposes. Each Area Office may administer several Service Units.

2.4 Blanket Purchase Agreement (BPA): is a simplified method of filling anticipated repetitive needs for supplies or services.

2.5 Business Associate (BA): Any company or person that shown to, handles, or works with the data or medical records of the medical entity.

2.6 Business Associate Agreement (BAA): A BAA is a contract between a HIPAA-covered entity and a HIPAA BA. The contract protects personal health information (PHI) in accordance with HIPAA guidelines.

2.7 Code of Ethics: There are five fundamental principles that form the foundation of the ADA Code: patient autonomy, non-maleficence, beneficence, justice and veracity. Principles can overlap each other as well as compete with each other for priority.

2.8 Contract: This is a legal binding document between the Government and the Contractor.

2.9 Contractor: The individual award a legal binding contract to provide supplies and services.

2.10 Contracting Officer (CO): A Government employee with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.11 Contracting Officer's Representative (COR): A federal employee who assists the CO in the administration of this contract. The COR is primarily responsible for the technical assistance and day-to-day program management.

2.12 Customer: Patients, staff and visitors of an IHS service unit and health center.

2.13 Customer Evaluation/Input: Written comments made to the COR regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor's performance.

2.14 Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal Executive agencies in their acquisition of supplies and services with appropriated funds.

2.15 Health Clinics/Center: A facility physically separated from a hospital, with a full range of ambulatory services including at least primary care providers, nursing, laboratory, and x-ray, which are available at least 40 hours a week for outpatient care.

2.16 Non-Personal Services: A contract under which the personnel rendering the services are not subject, either by the contract's terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees, as defined in FAR 37.401

2.17 Ordering Activity: An authorized user of IHS that may issue a purchase order to obtain required services under this contract.

2.18 Orientation: An activity designed to provide basic familiarization of the facility and transition into the IHS Service Unit and/or Health Center.

2.19 Past Performance Information: Relevant information regarding a contractor's actions under previously awarded contracts.

2.20 Patient Outcome: End result of pharmaceutical care.

2.21 Performance Based Matrix: Lists the services and the standards to be applied.

2.22 Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

2.23 Point of Contact: Person other than the COR or the Alternate COR

2.24 Quality Assurance Surveillance Plan (QASP): A written document prepared and used by the government for Quality Assurance surveillance of the contractor's performance.

2.25 Service Unit: The local administrative unit of IHS.

2.26 Standards of Practice and Standards of Care: Authoritative statements by which it describes the responsibilities for which its practitioners are accountable.

2.27 Technical Direction: A directive to the Contractor that approves approaches, solutions, designs, or refinements; fills in details or otherwise completes the general description of work or documentation items; shifts emphasis among work areas or tasks; or furnishes similar instruction to the Contractor.

2.28 Valid Patient Complaint: Justifiable accusation made by a patient and supported by investigation.

2.29 Verifiable Emergency: An unexpected/unplanned absence by the contractor requiring valid documentation to confirm the occurrence.

SECTION 3 – GOVERNMENT-FURNISHED PROPERTY AND SERVICES:

3.1 Information: Government unique information related to this requirement, which is necessary for Contractor performance, made available to the Contractor. The COR will be the point of contact for identification of any required information to be supplied by the Government.

3.2 Joint Use by the Government and the Contractor: Except for the property and service listed in 10.7.1, the

Government will provide, for joint use by the Government and the Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

3.3 Contractor-Exclusive Use:

3.3.1 Personal Protective Equipment (PPE): The Government will furnish the Contractor with appropriate PPE other than specified in the contract. The Government will be responsible for any repair, cleaning, and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

3.3.2 The Government will provide facility specific contractor identification badges for each contractor.

For lost or destroyed badges, there is a minimum charge of $20.00.

3.3.3 Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures.

Training provided ONLY if the subject matter is necessary to improve or enhance the quality of services or includes mandates made by the IHS Service Units/Health Centers while the providers are working under this contract. Training not provided for the purpose of continuing education, career development or individual development.

SECTION 4 – CONTRACTOR-FURNISHED ITEMS

4.1 Except for the property specified in Section 10.6.1, Contractor will supply all other items as required to carry out the services. The Contractor shall provide all uniforms and other personal medical instruments subject to the following:

4.1.1 Uniforms and Lab Coats: Uniforms and Lab Coats must conform to the requirements of the Indian

Health Service Manual, Part 3, and Chapter 4 and meet the approval of the Chief Nurse Executive at each IHS facility.

4.1.2 Other personal medical instruments: "Other personal medical instruments" defined, as Contractor-owned items include but not limited to stethoscope, scissors, as appropriate to the work unit. The Contractor must not use unsafe equipment or supplies at any time during performance of this contract. All Contractor-furnished equipment and supplies shall be subject to inspection by the Government and must be approved by the COR prior to use by the Contractor.

The Government reserves the right to prohibit the use of any materials, supplies, or equipment

SECTION 5 – SCOPE OF WORK (SOW)

5.1 SCOPE OF WORK

Dental Assistants have many tasks, such as assisting in the care of patient’s teeth, recordkeeping, appointment scheduling, taking x-rays, etc. In the capacity of an expanded-function Dental Assistant, they may be required to perform other activities as delegated by a Dentist to an unlicensed person, such as intra-oral procedures.

Duties:

Dental Assistants at this level serve as Dental Assistants at the full performance level for routine patient care and perform more complex patient procedures under the general supervision of more experienced Dental Assistants, or the Dental Supervisor.

-Compliant in customer service. Shows courtesy, respect, and positive attitude for patients, co-workers, and the public. Provides assistance to customers with questions or concerns and provides service recovery.

-All Contractors shall abide by IHS Policy and Procedures.

-Compliant in Chair-side Dental Assisting. Sets up operatory for planned Dental procedure and cleans Dental Unit for timely turnover. Passes instruments safely, accurately, and efficiently. Keeps operative field clear of debris and retracts oral tissues effectively and comfortably. Prepare dental medicaments and impression materials per manufacturer’s instructions. Accomplishes all intra-operative procedures within standard infection control protocols. Assists in routine general dental procedures. Assists in specialized dental procedures, such as oral surgery, endodontics, and prosthodontics.

-Participates in staff meeting, in-service education programs, and quality improvement studies/activities to enhance the overall delivery of patient care.

-Compliant in Dental Imaging. Images are characterized by diagnostic quality, accurately-oriented and exposed. Dental imaging safety techniques are utilized, and retakes are minimized. Imaging requests are accomplished within the desired timeframe.

-Compliant in Infection Control and Equipment Sterilization. Demonstrates proper infection control procedures in setting up and cleaning up operatories. Instruments are properly prepared for sterilization by SPD standards. Instruments are prepared in a manner that does not delay clinical care. Demonstrates proper infection control procedures in exposing images.

-Compliant in Clerical Functions. Assists patients in scheduling appointments. Assists in filling gaps in the dentist’s schedule due to late cancellations and failed appointments. Assists Dentist in charting findings, treatment plans, and treatment in patient records (including the use of Millennium, Dental Record Manager, and VISTA). Performs other clerical duties as assigned.

-Compliant in Information Management. Maintains patient confidentiality per HIPAA with written and verbal information. Follows computer safety regulations.

-Compliant in Patient Safety. Modifies care as necessitated by patient’s age and abilities (patient transfer and position). Provides accurate and understandable instructions to patients. Participates in patient identification and timeout per Joint Commission (JC) requirements. Monitors patient conditions during treatment, being alert for signs of physical distress.

-Compliant in Employee Education. Complies with Employee Education requirements. Completes mandatory annual safety training sessions. Maintains Basic Life Support (BLS) qualifications.

-Compliant in Dental Laboratory Functions. Pour impression and prepares study models. Makes final denture impression trays and prepares bite rims. Prepares cases for the Dental Laboratory and ensures timely retrieval of completed cases from the laboratory. Performs other dental laboratory functions as time and skill levels allow.

-Compliant in Direct Patient Care. Remove sutures. Impressions for diagnostic casts and preliminary impressions for prosthetic fabrication. Remove temporary crown/bridge and clean tooth preparation of debris. Re-cement and fabricate temporary crowns. Vital signs monitoring. Administers oxygen (in emergencies and routinely via transfer from patient’s oxygen tank to the same liter flow on operatory oxygen and returns to patient’s oxygen after treatment). Applies fluoride products, as ordered by Dentist.

Applies topical anesthetics, as ordered by Dentist. Applies other topical medications and medicaments, as ordered by Dentist. Administers pre-procedural mouth rinses, as ordered by the Dentist. Coronal polishing of teeth. Place rubber dams and matrix band. Provides post-operative and other appropriate patient education. Telephonically addresses patient care issues and documents for review by the Dentist.

Performs other permissible direct patient care issues as time and skill levels allow within the contractors’ scope of practice.

DESCRIPTION OF SERVICES/SUPPLIES

The contractor shall be in accordance with all Federal, State, Local, Tribal and IHS regulations and shall be made with minimal divergence from the schedule established and with minimum disturbance and maximum protection of government personnel, property and general public.

SERVICE CONTRACT WAGE DETERMINATION

Wage Determination #2015-5443 Revision 20 dated 07-21-2023 is hereby incorporated.

5.2 Work Schedule:

5.2.1 Work Shift: This is a full time position. The contractor shall be scheduled to work 40 hours per week, excluding Federal holidays, or as otherwise coordinated with the Contracting Officer Representative (COR) or his/her designee based on staffing and facility needs.

-General work days and hours at Zia Health Clinic are 8:00 am to 4:30 pm, Monday through Friday.

5.2.3 Scheduling of Shifts: The Clinical Director (or COR or POC) at the IHS facility will determine specific tour of duty. The contractor's employee must work 100% of the contracted hours for the clinics.

5.2.4 Work Flexibility: As directed by the COR, the Contractor's employee must rotate into other duty sections as needed to support patient care.

5.2.5 Work Absence: The Contractor will perform and obtain approval of the COR and Alternate COR prior to any absence from work. If the length of the absence exceeds working hours the Contractor must request from agency approval at least fifteen (15) days, (the exception is verifiable emergencies) in advance of the desired absence.

5.2.6 The Contractor must perform and maintain documentation from a qualified health care provider for absences of three (3) or more consecutive days, due to illness, stating:

5.2.6.1 The cause of the current illness or incapacitation AND

5.2.6.2 Indicating the Contractor as contagious or non-contagious.

5.2.6.3 The Government reserves the right to examine and or re-examine any Contractor who meets the criteria.

5.3 Performance Evaluation:

5.3.1 The Contractor must possess either the education or experience listed in Section 5.7.1.

5.3.2 The Contractor will be responsible for make sure Heart Association BLS as required.

5.3.3 The Contractor will be responsible for making sure all charting is update as required, if necessary.

5.4 The contractor will perform work with multicultural patients and interpreters as necessary for non-English speaking patients.

5.5 Conduct: The Contractor must perform standards as listed in the Federal Code of Conduct.

5.6 Conditions of Contract Services: All healthcare providers providing service under this contract must attend mandatory orientations specified by the IHS.

5.6.1 The contractor must be subject to character investigation as required by Public Law 101-360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance of a contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eQIP) system and this shall include all fingerprinting procedures and clearances. The contractor must provide all requested information necessary to perform Level I and Level II background checks. The contractor must comply with the requirement to obtain security investigations. The contractor will review all completed forms and forward onto the Government personnel. The contractor will be immediately removed from the position (at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

5.6.2 Identification of Contractor: The Contractor must wear a government issued contractor identification badge during performance of duty. After 120 day’s PIV cards are issued at the Service Unit.

5.6.3 Management of Medical Information: The Contractor must manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols. The Contractor must immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

5.6.4 IHS Information Technology Systems: In performance of this contract, the Contractor must adapt to and successfully utilize IHS information technology systems such as Electronic Health Records (EHR) or RPMS, which the IHS has deemed necessary for acceptable contractor performance. The IT policies and procedures are available to the Contractor at the Service Unit and the Contractor will adhere to the IHS Information Technology System Security Policies and procedures. The Contractor must follow all appropriate federal required information Technology security requirements and will be operating under Health Insurance Portability and Accountability (HIPAA) and Privacy Act regulations.

5.7. CONTRACTOR QUALIFICATION REQUIREMENTS:

5.7.1 Qualifications:

Basic Requirements:

a. Citizenship: Citizen of the United States.

b. Experience or Education (one is required):

(1) Experience. Six months’ experience that demonstrates the applicant's ability to perform the work, or provides familiarity with the work. This experience must be documented and submitted with proposal.

OR

(2) Education. Successful completion of a 1-year dental assistant program accredited by the American Dental Association's Commission on Dental Accreditation (CODA). A certificate of completion or other evidence of completion must be submitted with proposal.

5.7.4 Motor Vehicle Operator's License: Contractors can operate a Government-owned or leased vehicle and must be on official Government business. Contractors can be approved to operate a Government-owned vehicle upon record/completion of the following:

1.) Valid Driver's license 2.) Temporary Waiver (required every 90 days) 3.) Driver's Overview and Fleet Card Use (000022239) Course Completion Certificate (required every two years) available on HHS Learning Portal 4.) Valid background check clearance

5.7.5 Health Requirements of Contracted Healthcare Providers: Furnish documentation that reflects immunity for the indicated vaccine preventable diseases through documented disease, vaccination history, serology results, and/or any documented episodes of adverse events after vaccination. Any contractor’s employee who is allergic to a component of a vaccine and/or have a history of a severe reaction to a vaccine is not required to receive that vaccine with documented proof of contraindication to the vaccination. The following are additional requirements for specific vaccine preventable diseases.

• Measles:

-Vaccinations with 2 doses of live measles or MMR vaccines administered at least 28 days apart, -Laboratory evidence of immunity, -Laboratory confirmation of disease, or -Birth before 1957.

• Mumps:

-Vaccinations with 2 doses of live mumps or MMR vaccines administered at least 28 days apart, -Laboratory evidence of immunity, -Laboratory confirmation of disease, or -Birth before 1957.

• Rubella:

-Vaccinations with 1 dose of live rubella or MMR vaccines administered at least 28 days apart, -Laboratory evidence of immunity, -Laboratory confirmation of disease, or -Birth before 1957

• Hepatitis B:

-Vaccinations with three doses of Hepatitis B vaccines, or -signed declination of Hepatitis B vaccination series.

• Varicella:

-Vaccinations with two doses of varicella at least 4 weeks apart, -laboratory evidence of immunity or confirmation of disease, -diagnosis or verification of history of varicella disease by a health care provider, or -diagnosis or verification of a history of herpes zoster by a health care provider.

• Influenza:

-Vaccination with one dose of current annual influenza season vaccine.

-Documented proof of the contraindication to the influenza vaccination as outlined by Advisory

Committee on Immunization Practices recommendations, or -Written statement justifying religious exemption from influenza vaccination.

Note: unvaccinated contract staff with an approved medical or religious exemption must wear an IHS-provided surgical or similar mask when working in patient care areas or other areas frequented by patients in an IHS facility during the influenza season.

• Pertussis:

-Vaccination with one dose of Tdap vaccine.

• Any additional immunization in accordance with IHS Immunization Policy that is available upon request.

The contract staff must have written documentation of TB test (TST or IGRA) within the last 12 months. If documented Positive TB test:

-Provide chest x-ray report of “No active TB disease” following positive TB test.

-Annual sign and symptoms screen:

• If negative sign and symptom screen, follow up chest x-ray not indicated.

• If signs and symptoms screen positive, contract staff must have written documentation of chest x-ray and health care provider evaluation.

For credentialed provider, contract staff must have documentation from the provider’s physician or chief of staff that confirms they do not have any health problems (including disability, emotional stability, drug, or alcohol dependency) that might impair his/her ability to care for patient at time of application.

5.7.6 Criminal History Background Check:

Contractor’s employees whose duties and responsibilities involve regular contact or control over children are subject to a character investigation as required by Public Law 101-630, The Indian Child Protection and Family Violence Act. The minimum standards of character shall ensure that none of the individuals described in this order have been found guilty of, or entered a plea of nolo contendere or guilty to, any felonious offense, or any of two or more misdemeanor offenses, under federal, state, or tribal law involving crimes of violence; sexual assault, molestation, exploitation, contact or prostitution; crimes against persons; or offenses committed against children. These crimes do not hold a time statue and will be evaluated the same under any Child Care “CNACI” investigation with IHS. IHS will conduct these investigations following award of a contract. Until the character investigation has been completed and the Contracting Officer notified of the results, the Contractor‘s employees must not have unsupervised contact with Indian children. Contractor’s employees are not able to work a scheduled shift until the security check is performed and clearance has been obtained by the appropriate agency. At a minimum, fingerprints are required, and upon clearance of this stage, a contractor’s employee may work a scheduled shift. However, Contractor’s employees are required to complete the detailed background application and the application is to be completed within 30 days once the contractor’s employee has been given physical and logical access. All Contractors’ employees are subject to criminal background check prior to performing services in accordance with Purchase Order terms and conditions. The contractor shall ensure that each of their employees complete the Certification of Criminal History and Background Check Packet. The completed forms are to be returned to the COR. Additional Background Check packets can be obtained through the COR. See HHSAR Clauses 352.237-72 and 352.237-73

5.7.7 Required Training:

a) Protecting Children from Sexual Abuse as stated in IHM Circular 19-05: Contractor Training Plan for Implementation of Indian Health Manual Part 3, Chapter 20, Protecting Children from Sexual Abuse by Health Care Providers. Each provider must take this training within 30 days from their start date at the service unit. Certificate should be provided to the COR.

b) Overview of Trauma-Informed Care and Historical Trauma training for Non Personal Healthcare Services (i.e., MLTs, RN, Physician, etc.).

c) Information System Security Awareness (ISSA) Training: Contractors who utilize the IHS information system or accesses or connects to the IHS network must complete the ISSA training 24 hours of receiving access and annually thereafter. The online ISSA training is located at http://www.ihs.gov/issa. Contractor access will be revoked unless and until the training is completed. An exception can be made if the user has read and signed the IHS Quick Guide to Information Security, in which case the contractor will have 30 days to complete the training. Course certifications must be provided to the COR upon completion and annually thereafter.

Please also review Section 7.5.1 of the Indian Health Service General User Security Handbook which covers ISSA training to support this requirement of all contractors who access our information system network.

5.7.8 Subpoenas/Testimonies: Contractors are mandated to cooperate with the appropriate IHS managers when the contractors' employees are subpoenaed or requested by Tribal, State or Federal Parties to provide testimony as stated in Section 5-27.3(B)(9) of the Indian Health Manual.

5.8 When the Contractor demonstrates impaired judgement, they cannot continue working on the Purchase/Task Order No. 75H70723XXXXXX. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

SECTION 6 0 QUALITY ASSURANCE SURVEILLANCE PLAN (example)

Performance-Based Task Indicator Standard Quality Assurance Incentives

1. Manage patient needs for Dental visits.

All patients’ needs are being meet during each visit.

Outstanding – 100% of patient needs are being meet per visit.

Acceptable – 80 to 99% of patient needs are being meet per visit.

Satisfactory – 65 to 80% of patient needs are being meet per visit.

Monitored on a periodic basis when services occur.

Final determination will happen when job is completed.

Outstanding. Means there are no issues so payments processed promptly.

Acceptable. Means there are some issues so payment are on hold until issues cleared.

Satisfactory – Means there are too many issues and payment not processed until they are at the level of either Satisfactory or Outstanding.

2. Provide Dental Assistant duties.

Dental Assistant duties are to be used.

Outstanding – 100% of standard duties are being meet per visit.

Acceptable – 80 to 99% of standard duties are being meet per visit.

Satisfactory – 65 to 80% of standard duties are being meet per visit.

Monitored on a periodic basis when services occur.

Final determination will happen when job is completed.

Outstanding. Means there are no issues so payments processed promptly.

Acceptable. Means there are some issues so payment are on hold until issues cleared.

Satisfactory – Means there are too many issues and payment not processed until they are at the level of either Satisfactory or Outstanding.

3. Maintain the American Heart Association BLS certification.

Certifications are current.

Outstanding – 100% of certifications have been update as required.

Acceptable – 80 to 99% of certifications have been update as required.

Satisfactory – 65 to 80% of certifications have been update as required.

Monitored on a periodic basis when services occur.

Final determination will happen when job is completed.

Outstanding. Means there are no issues so payments processed promptly.

Acceptable. Means there are some issues so payment are on hold until issues cleared.

Satisfactory – Means there are too many issues and payment not processed until they are at the level of either Satisfactory or Outstanding.

4. Complete all required documentation in the EHR.

All patients record are routinely update per visit.

Outstanding – 100% of all charting completed per visit.

Acceptable – 80 to 99% of all charting completed within 3 days after patient visits.

Satisfactory – 65 to 80% of all charting completed within 5 days after patient visits.

Monitored on a periodic basis when services occur.

Final determination will happen when job is completed.

Outstanding. Means there are no issues so payments processed promptly.

Acceptable. Means there are some issues so payment are on hold until issues cleared.

Satisfactory – Means there are too many issues and payment not processed until they are at the level of either Satisfactory or Outstanding.

SECTION 7 - PACKAGING AND MARKING

N/A

SECTION 8 - INSPECTION AND ACCEPTANCE

8.1 INSPECTION AND ACCEPTANCE: All work under this contract is subject to inspection and final acceptance by the Contracting Officer or the duly authorized representative of the government. The COR, as a duly authorized representative of the Contracting Officer, shall assume the responsibilities for monitoring the Contractor's performance, evaluating the quality of services provided by the Contractor and performing final inspection and acceptance of all deliverables and services called for by the contract.

8.2 FEDERAL ACQUISITION REGULATION {48 CFR CHAPTER 1) CLAUSES

FAR Clause No. Title Date 52.246-4 Inspection of Services – Fixed Priced (Aug 1996)

SECTION 9 - DELIVERIES OR PERFORMANCE

9.1 PERIOD OF PERFORMANCE: The period of performance is a base period of one year with four one-year option periods, if extended by modification to this contract. The Government may exercise options to extend the period of performance in accordance with FAR Clause 52.217-9 - Option to Extend the Term of the Contract (Mar 2000); upon written notification by the Contracting Officer within 60 days of contract expiration.

9.1.1 The Period of Performance will be structured as follows:

Base Year: 10/01/2023 – 09/30/2024 1st Option Year: 10/01/2024 – 09/30/2025 2nd Option Year: 10/01/2025 – 09/30/2026 3rd Option Year: 10/01/2026 – 09/30/2027 4th Option Year: 10/01/2027 – 09/30/2028

9.1.2 Performance will be for the period of 10/01/2023 to 09/30/2024 unless the period changed by written modification to the purchase order in accordance with FAR 52.217-9, Option to Extend the Term of the Contract.

9.1.3 Total contract award must not exceed one year, unless extended via modification to “Exercise the Option.” Option period renewal is dependent on satisfactory services provided availability of funds for the appropriate fiscal year, and existing requirements.

9.2 PLACE OF PERFORMANCE: The contractor must provide Dental Assistant Non-Personal Healthcare Services to the following Albuquerque Service Unit Indian Health Service Facilities:

9.2.1 Albuquerque Service Unit, including:

Zia Health and Dental Clinic 155 Capitol Square Drive Zia Pueblo, NM 87053

9.3 GOVERNMENT HOLIDAYS (https://www.federalpay.org/holidays)

New Year's Day Martin Luther King's Birthday President's Day Memorial Day Juneteenth Independence Day Labor Day Columbus Day Veteran's Day Thanksgiving Day Christmas Day

*Any other day specifically declared by the President of the United States to be a national holiday (see www .opm.gov/fedhol).

SECTION 10 - CONTRACT ADMINISTRATION

10.1 AUTHORITIES OF GOVERNMENT PERSONNEL: Notwithstanding the Contractor's responsibility for total management during the performance of this Contract, the administration of the Contract will require maximum coordination between the Government and the Contractor.

The Federal Acquisition Regulation (FAR) defines an unauthorized commitment as an agreement that is not binding solely because the government representative who made it lacked the authority to enter into that agreement on behalf of the government. Only contracting officers have the authority to make purchases or award contracts. Upon receipt and/or execution of any order placed for goods or services, the vendor shall verify that the Government Agent issuing the order has necessary authority to entire into the purchase order/contract. If it is determined that the vendor failed to do so, they may be held liable for future Unauthorized Commitments.

The following individuals will be the Government's points of contact during the performance of this Contract:

10.2 CONTRACTING OFFICER

The IHS Contracting Officer (CO) is the only individual authorized to modify this Contract. The CO responsible for administrative and contractual issues concerning this purchase order is:

Shandiin DeWolfe, Contract Specialist (CS) Indian Health Service/Division of Contracts & Grants Management (DCGM) 4101 Indian School Road NE, Suite 225 Albuquerque, NM 87110 Phone: 505-256-6755 Email: Shandiin.DeWolfe@ihs.gov

HHSAR 301-602-3 Ratification of Unauthorized Commitments: The Government is not bound by agreements with, or contractual commitments made to, prospective contractors by individuals who do not have delegated contracting authority. Unauthorized commitments do not follow the appropriate process for the expenditure of Government funds. Consequently, the Government may not be able to ratify certain actions, putting a contractor at risk for taking direction from a Federal official other than the contracting officer. See FAR 1.602-1. Government employees responsible for unauthorized commitments are subject to disciplinary action. Contractors perform at their own risk when accepting direction from unauthorized officials. Failure to follow statutory and regulatory processes for the expenditure of Government funds is a very serious matter.

10.3 CONTRACTING OFFICER'S REPRESENTATIVE (COR) & ALTERNATE CONTRACTING OFFICER’S

REPRESENTATIVE (ALTERNATE COR)

10.3.1 Ernest Nakamura, (505) 248-4000, Ernest.Nakamura@ihs.gov, is hereby designated as COR for this service. The COR responsibilities will be to coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The COR does not have the authority to change or alter the order amount, terms and conditions.

10.3.2 Autumn DiValentino, (505) 248-4000, Autumn.DiValentino@ihs.gov, is hereby designated as the Alternate COR for this service. The Alternate COR responsibilities will be to help coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The Alternate COR does not have the authority to change or alter the order amount, terms and conditions.

10.3.2 The COR’s responsibilities will include ensuring contractor accountability. Monitoring the Contractor’s technical progress including the surveillance and assessment of performance and recommending to the CO changes in requirements. Interpreting the SOW. Performing technical evaluations as required. Perform technical inspection and acceptance as required. Assisting the Contractor in the resolution of technical problems encountered during performance. Perform receiving and processing invoices for payment.

10.4 TECHNICAL MONITORING

(a) Performance of work under this contract must be subject to the technical direction of the COR identified above, or designated in writing. The term "technical direction" includes, without limitation, direction to the Contractor that directs or redirects the labor effort. Shifts the work between work areas or locations, fills in details and otherwise serves to ensure that task areas outlined in the SOW accomplished satisfactorily.

(b) Technical direction must be within the scope of the specification(s)/work statement. The COR does not have authority to issue technical direction that

(1) Constitutes a change of assignment or additional work outside the specification(s)/ statement of work;

(2) Constitutes a change as defined in the clause entitled "Changes;"

(3) In any manner causes an increase or decrease in the contract price, or the time required for contract performance;

(4) Changes any of the terms, conditions, or specification(s)/work statement of the contract;

(5) Interferes with the Contractor's right to perform under the terms and conditions of the contract; or

(6) Directs, supervises or otherwise controls the actions of the Contractor's employees.

(c) Technical direction may be oral or in writing. The COR shall confirm oral direction in writing within five workdays, with a copy to the Contracting Officer.

(d) The Contractor shall proceed promptly with performance resulting from the technical direction issued by the COR. If, in the opinion of the Contractor, any direction of the COR, or his designee, falls within the limitations in (b), above, the Contractor shall immediately notify the CO no later than the beginning of the next Government work day.

(e) Failure of the Contractor and the CO to agree that technical direction is within the scope of the contract shall be subject to the terms of the clause entitled "Disputes."

10.5 INVOICE SUBMISSION

10.5.1 The Contractor shall submit invoices daily, weekly, or monthly as necessary. Advance payments will not be issued by Finance unless stated herein. Upload complete invoice with all required documentation to:

https://www.ipp.gov

* Please do not sent any copies to the CS or Finance Office for any invoices related documents such as deliverables, reports or balance statements). Failure to upload required documents directly to the website listed above will delay prompt payment of your invoice.

10.5.2 Additionally, the Contractor is required to include the Unique Entity Identifier (UEI) on each invoice.

For additional information about the UEI (hhtps://www.sam.gov).

10.5.3 Submit invoices in accordance with the contract terms, i.e. payment schedule, progress payments, partial payments, deliverables, etc.

All information set forth in FAR 32.905(b), Content of Invoices, must be included in all invoices for it to constitute a proper invoice.

FAR 32.905(b), Content of Invoices:

(b) Content of invoices.

(1) A proper invoice must include the following items (except for interim payments on cost reimbursement contracts for services):

(i) Name and address of the contractor.

(ii) Invoice date and invoice number. (Contractors should date invoices as close as possible to the date of mailing or transmission.)

(iii) Contract number or other authorization for supplies delivered or services performed (including order number and line item number).

(iv) Description, quantity, unit of measure, unit price, and extended price of supplies delivered or services performed.

(v) Shipping and payment terms (e.g., shipment number and date of shipment, discount for prompt payment terms). Bill of landing number and weight of shipment will be shown for shipments on Government bills of landing.

(vi) Name and address of contractor official to whom payment is to be sent (must be the same as that in the contract or in a proper notice of assignment).

(vii) Name (where practicable), title, phone number, and mailing address of person to notify in the event of a defective invoice.

(viii) Taxpayer Identification Number (TIN). The contractor must include its TIN on the invoice only if required by agency procedures. (See 4.9 TIN requirements.)

(ix) Electronic funds transfer (EFT) banking information.

(A) The contractor must include EFT banking information on the invoice only if required by agency procedures.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the contractor must have submitted correct EFT banking information in accordance with the applicable solicitation provision (e.g., 52.232-38, Submission of Electronic Funds Transfer Information with Offer), contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer-Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by

EFT.

(x) Any other information or documentation required by the contract (e.g., evidence of shipment).

(2) An interim payment request under a cost-reimbursement contract for services constitutes a proper invoice for purposes of this subsection if it includes all of the information required by the contract.

(3) If the invoice does not comply with these requirements, the designated billing office must return it within 7 days after receipt (3 days on contracts for meat, meat food products, or fish; 5 days on contracts for perishable agricultural commodities, dairy products, edible fats or oils, and food products prepared from edible fats or oils), with the reasons why it is not a proper invoice. If such notice is not timely, then the designated billing office must adjust the due date for the purpose of determining an interest penalty, if any.

(4) Per the Accounts Payable office, failure to submit invoices to the IPP Website can result in delayed payment of your invoice.

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as "Small Business."

Additionally, in accordance with OMB Memorandum, M-12-16, fill prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner.