SOL_75H70723Q00002 MSU Emergency Room Physician Telehealth Non Personal Healthcare 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

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

IHSMSU CODE 16. ADMINISTERED BYCODE

X

X

621111

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR203

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

10/25/2022 1200 MT

10/11/2022

505-256-6752ERIC WRIGHT

(No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70723Q00002

5. SOLICITATION NUMBER

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

1 25 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Mescalero New Mexico 88340 318 Abalone Loop Mescalero Service Unit

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$12.00

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 SCHEDULE

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)

Albuquerque Indian Health Service

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

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AMOUNT

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SCHEDULE OF SUPPLIES/SERVICES

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ITEM NO.

Solicitation #75H70723Q00002 is issued to provide Emergency Room Physican Telehealth non personal healthcare services at the Mescalero Service Unit.

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

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

ERIC K. WRIGHT

. 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

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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

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32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

25 2 of

75H70723Q00002, MSU Emergency Room Physician Telehealth Non Personal Healthcare Services

SF-1449 continued, page 3 of 25

SECTION 1 - SUPPLIES OR SERVICES AND PRICES/COSTS

1.1 SERVICES

1.1.1 The Indian Health Service (IHS)/Albuquerque Area Office, Mescalero Service Unit has a requirement for Emergency Room Physician Telehealth Non Personal healthcare services in Mescalero, New Mexico.

1.2 PRICE OR COST

This Solicitation is issued with the quantities shown in the Schedule of Charges.

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 the COR and/or Service Unit Contracting POC to schedule a fingerprinting appointment required by the IHS regulations pertinent to security and character background investigations.

1.4 CONTRACT PRICE

1.4.1 Upon delivery and acceptance of the item(s) specified in the DELIVERY Article in SECTION 7 of this contract, the Government shall pay to the Contractor resulting from the awarded contract price.

1.4.2 Upon delivery and acceptance the services described in the Statement of Work and identified in the schedule of charges below, the Government shall pay to the Contractor the total prices set forth below and will be paid from the following Contract Line Item Numbers (CLINs) accordingly:

1.4.3 The Contractor shall be paid upon submission of an invoice and completion and acceptance (if deliverable) or verification (if service) by the Contracting Officer's Representative (COR), of the deliverables and/or services indicated below. Submit invoices in accordance with the instructions contained in FAR clause 52.232-25, Prompt Payment, and Section 10 of this contract.

1.5 OPTION PRICES

1.5.1 Unless the Government exercises its option, pursuant to the option clause referenced in the Contract Clauses section, this contract consists only of the Base Period specified in this contract.

1.5.2 Pursuant to either the FAR Clause 52.217-8, Option to Extend Services or the FAR Clause 52.217-9, Option to Extend the Term of the Contract, set forth in Section 12, Contract Clauses, of this contract, the Government may, a unilateral contract modification, require the Contractor to perform the Option Period(s) as defined in the SOW of this contract. A notice that the Government intends to exercise any of the options will happen prior to the contract’s expiration date. Specific information regarding the timeframe for this notice is set forth in the OPTION PROVISION of this order. When exercising an option period, the fixed price rate of this contract is set forth below:

YEAR Description of Service MIN # of Visits

MAX # of Visits

Hourly Rate

BASE Year Emergency Room consultation services through the NM EMSC Child Ready Program 90 110 $_________

OPTION YEAR 1 Emergency Room consultation services through the NM EMSC Child Ready Program 90 110 $_________

OPTION YEAR 2 Emergency Room consultation services through the NM EMSC Child Ready Program 90 110 $__________

OPTION YEAR 3 Emergency Room consultation services through the NM EMSC Child Ready Program 90 110 $__________

OPTION YEAR 4 Emergency Room consultation services through the NM EMSC Child Ready Program 90 110 $__________

1.5.3 Upon the delivery and acceptance of the Option Services described in the Statement of Work of the contract and identified in the schedule of charges below, the Government shall pay the Contractor the rate(s) set forth below and will be paid from the following Contract Line Item Numbers (CLINs) accordingly;

1.5.4 If the Government exercises its option pursuant to the OPTION PROVISION of this contract, the Government's total estimated contract amount, represented by the sum of the price of base plus option periods and the period of performance.

1.5.5 Note: Unit price shall be an all-inclusive rate of all other fees including travel expenses, per diem, lodging all cities, state, federal, local taxes and miscellaneous cost associated with the above services.

1.5.6 Lunch break of 1 hour is permitted (as non-paid) under the contract; the contractor cannot invoice time as worked if its’ employee chooses not to take a lunch break. The Contractor also cannot invoice travel times to/from the facility site as time worked.

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.

SF-1449 continued, page 4 of 25

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: The Revised American Nurses Association Code of Ethics and Standards of Practice and Care, published in 1996 by the American Nurses Association, which makes explicit primary goals, values and obligations of the nursing profession.

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 Indefinite Delivery/Indefinite Quantity: No set delivery time and no set quantity amount (used for recurring purchases with no set delivery time or quantity).

2.17 Non-Personal Health Care Services: A contract under which the personnel rendering the health care 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

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

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

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

2.21 Patient Outcome: End result of nursing care.

2.22 Performance Based Matrix: Lists the services and the standards to determine quality of performance.

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

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

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

2.26 Service Unit: The local administrative unit of IHS.

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

2.28 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.

2.29 Solicitation: An order issued in accordance with the terms of a contract (GSA or VA, etc.) that details a specific requirement.

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

2.31 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 The Government will provide the following item(s) of Government property to the Contractor for use in the performance of this contract. This property used and maintained by the Contractor in accordance with provisions of FAR Clause 52.245-1, Government Property (found in Section 3).

Item No

Property Description Property Value Qty. Location Date Available

1 Computer 1 Upon Arrival 2 Telephone 1 Upon Arrival 3 Desk/Chair 1 Upon Arrival 4 PIV Card 1 Upon Arrival

SF-1449 continued, page 5 of 25

5 PPE Equipment Upon Arrival

3.2 Government Furnished Information / Property and Services

3.2.1 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.

3.2.2 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.

3.2.3 Contractor Exclusive Use:

3.2.3.1 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.

3.2.3.2 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.

3.2.3.3 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.

3.3 Contractor Furnished Property

3.3.1 Except for the property specified in paragraph 10.9.3 as government furnished, the Contractor shall provide all uniforms and other personal medical instruments subject to the following:

3.3.2 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.

3.3.3 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 4 - CONTRACTOR FURNISHED ITEMS

4.1 Except for the property specified in Section 10.7, Contractor will provide all other items as required to carry out the services.

SECTION 5 – STATEMENT OF WORK

5.1

Purpose: The purpose of this contract is to obtain an agreement with the University of New Mexico Center for Telehealth to maintain access to the NM EMSC Child Ready Program. Through the NM EMSC Child Ready Program, Mescalero Service Unit will provide Emergency Room consultation visit capability which will be delivered via Tele-health platform to the pediatric population of the Mescalero Indian Reservation and surrounding areas.

Background: The Mescalero Service Unit provides outpatient medical treatment, including laboratory and pharmacy services, to the local community of the Mescalero Indian reservation and surrounding areas. The Mescalero Service Unit is also the only Indian Health Service in the Southwestern part of New Mexico, which accommodates HIS beneficiaries who wish to travel to Mescalero Service Unit to receive care.

Objective: The objective of this scope of work is to establish a contract to obtain an agreement to receive Emergency Room consultation services for the IHS, MSU beneficiaries, Pediatric population.

Scope: Under the terms and conditions, the contract will:

• Furnish all necessary personnel, supplies, materials and equipment to perform under the terms of this contract.

• All services supplied by contractor under the terms of the contract shall be performed in compliance with all requirements and regulations of the AAAHC, Center for Medicare & Medicaid Services (CMS) and Health Insurance Portability and Accountability Act of 1996 and Privacy Act (HIPPA) and IHS security requirements.

• Provide under the contract only Pediatric Emergency Medicine professional services within the scope of their credentials as granted by contractor under AAAHC or CMS accredited methods.

• All Consults provided to MSU under the terms of the contract shall be performed by Emergency Medicine Physicians on staff with the vendor and located in the United States of America.

• Perform quarterly Quality Assurance and Peer Review (QA) including review of all Pediatric Emergency Medicine care.

o Contractor will report results of all QA performed as part of the Scope of Work to COR, Mescalero Service Unit.

• Contractor shall ensure that telehealth services are staffed as required by an Emergency Department providing services 24 hours per day 7 days per week.

o If Contractor cannot ensure staffing of telehealth services, contractor will notify the Mescalero Service Unit within 24 hours of learning of staff shortage

• Contractor will provide equipment to support Telehealth connectivity and capability

• The Mescalero Service Unit will bill for all third party insurance for all consults covered in the contract. The contractor will not bill insurance for services rendered. The contractor will be required to have all participating Pediatric Emergency Medicine Physician sign billing waivers.

Equipment Requirements: Telehealth equipment provided by contract will meet below requirements:

• Communication Interface: Where applicable (eg in the even a proprietary communication platform is used) Contractor shall provide equipment to support Telehealth o Provided equipment must be in compliance with IHS security requirements, AAAHC, CMS and HIPAA. All equipment and software shall be calibrated and maintained by the vendor in accordance with AAAHC, CMS and HIPPA Compliance standards.

SF-1449 continued, page 6 of 25

• Required communication and Information Systems Agreement: Contractor shall work with MSU and facility IRM Department to complete all IHS required Information System agreements

• Contractor’s network must have established firewalls and procedures to ensure patient confidentiality and security consistent with HIPAA regulations and American College of Radiology (ACR) guidelines.

• Contractor shall transmit reports to MSU facility by electronic means in format acceptable to MSU.

Consultation Visit Requirements: Consultation visits will meet below criteria:

• Consultation visit will be performed via Live over telehealth capable equipment with a Mescalero Service Unit, Licensed Medical Provider, with or without the pediatric patient presence.

• Consultation recommendations will be relayed verbally in a doctor to doctor approach

• Complete consultation report will be faxed to Mescalero Service Unit, Medical records Department or Nursing upon completion of the consultation within

2 business days.

• Contractor will keep a record of each consultation.

• TELEMEDICINE SESSIONS WILL NOT BE RECORDED BY CONTRACTOR

Technical and Customer Assistance: Contractor will provide a dedicated team member and telephone number

• Contractor will maintain an 800 number or equivalent telephone service to permit twenty-four hours per day and seven days per week immediate contract with contractor’s technical staff by clinical providers or technical support personnel at referring facility.

• Contractor shall provide a customer representative to assist the Mescalero Service Unit with business questions during regular business hours, Monday through Friday, 0800 – 1700 MT.

• Contractor will maintain an 800 number or equivalent telephone service to permit twenty-four hours per day and seven days per week immediate contract with contractor’s clinical staff by clinical providers at the Mescalero Service Unit.

Quality Assurance: Contractor will take necessary steps to assure quality assurance program is established and maintained throughout the life of this contract.

• Contractor will maintain a written or electronic list or log of all consultations performed and all consultation reports that are sent from them to the

Mescalero Service Unit. They will also keep, in the same platform, telephone and/or fax urgent or stat consult reports.

• Contractor will establish and maintain a system to complete quarterly peer reviews, at the expense of the contractors, on a quarterly basis

• Contractor will provide quarterly peer review results to the Mescalero Service Unit, COR, quarterly which will be maintained within the contract file for QA monitoring requirements.

• Performance Improvement Plans must be included for any contractor’s interpreting Pediatric Emergency Medicine Physicians with a rate of clinically significant discrepancy greater than 1%

Site Visit: An optional site visit at the Mescalero Service Unit can be arranged to meet staff physicians, imaging department personnel, and administrative representatives (e.g., Clinical Director, CEO, Business office and IT Department, etc.).

REVIEW, APPROVAL AND EVALUATION

The Contracting Officer or his duly authorized representative shall review and approve services provided under the terms and conditions of the contract.

The Contracting Officer, the designated Government Project Officer and the Contractor shall evaluate the services during the term of contract and the report of the evaluation will be made a part of the official contract file. The evaluation will be objective and directed toward the progress made in meeting the contract objectives and statement of work, resolve problems encountered, clarify issues that may arise unexpectedly and to evaluate the accomplishments. The evaluation will be conducted on dates mutually agreed to by all parties.

a. Quality Assurance Review

a. Overall evaluation of the Contractor's performance in meeting the terms of the contract will be reviewed and monitored according to the applicable Service Unit Quality Assurance Standards. Reviews shall consist of patient chart audits, peer review, and patient satisfaction surveys.

b. The Contractor will be informed if any quality of service problems are identified by the IHS Project Officer and the Contractor shall take appropriate corrective action within appropriate timeframes specified by the Government. Failure to do so may result in Termination for Default.

5.2 Work Schedule:

5.2.1 Work Shift:

• The POC at each IHS facility must determine specific tour of duty. The contractor’s employee must work 100% of the contracted hours.

• The Contractor must perform and obtain approval of the department Supervisor or designee prior to any absence from work. If the length of the absence exceeds working hours the Contractor must request from agency approval at least thirty (30) days, (the exception is verifiable emergencies) in advance of the desired absence.

• Approval of leave is contingent upon availability of a qualified replacement.

5.2.3 Scheduling of Shifts: The COR or Alternate COR at the IHS facility will determine specific tour of duty. The scheduler will determine the schedule along with the COR or the Alternate.

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 from their agency who will inform the COR and/or 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.

5.2.7 Training: Not provided to Contractor employees. The only training provided to the Contractor employees will be in-house at ACL Service Unit.

5.3 Performance Evaluation: In accordance with the standards set forth in the contract and Statement of Work Matrix (Section 6).

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 contractors providing service under this contract must attend mandatory orientations specified by the Service Unit.

SF-1449 continued, page 7 of 25

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 must work with the IHS to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. 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 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.

5.6.5 Required Training: Information System Security Awareness (ISSA) Training is required by contractors who use an IHS information system or accesses or connects to the IHS network prior to receiving or updating access and annually thereafter. System access will be revoked unless and until the training is completed within 24 hours of receiving access and then annually thereafter. An exception can be made if the user has read and signed the IHS Quick Guide to Information Security, in which case they will have 30 days to complete the training. The online ISSA training is located at http://www.ihs.gov/issa. Upon completion certificate should be provided to the COR.

5.7. CONTRACTOR QUALIFICATION REQUIREMENTS:

5.7.1 Professional Development:

• Be Board Eligible or Board Certified (BC/BE) in Pediatric Emergency Medicine or Emergency Medicine

• Possess an unrestricted license to practice medicine in the state where they will be providing professional services.

• Be credentialed by contractor under AAAHC or CMS accredited methods to provide Pediatric Emergency Medicine Services.

• Meet the “Qualifications of Personnel” as defined by the American Board of Emergency Medicine.

• Contractor will maintain, at contractor’s sole expense, Professional Liability Insurance for each of contractor’s Emergency Medicine

Physicians providing services under the contract in the amount of at least Two Million Dollars ($2,000,000) per claim and Six Million Dollars ($6,000,000) in the annual aggregate, AND General Liability Insurance in an amount at least commensurate with industry standards.

• Contractors’ providers will not be mentioned or a party on the OIG (Office of Inspector General) Exclusions List and Excluded Part List.

5.7.2 Operation of Government Owned Vehicles:

Unless otherwise authorized, contractors will not operate any Government owned or leased vehicles. If required to provide health care services, contractors are only allowed as passengers in the Government-Owned Vehicle driven by a Federal employee unless otherwise authorized.

If specified in the statement of work, 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. Drivers Overview and Fleet Card Use (000022239) course completion certificate (required every two years)

4. Valid background check clearance

5.7.3 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:

http://www.ihs.gov/issa

SF-1449 continued, page 8 of 25

- 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.

- COVID-19 Immunization

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 they 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 Solicitation 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: 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 10 days from their start date at the service unit. Certificate should be provided to the COR.

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.

5.7.9 Trauma Informed Care: The IHS acknowledges the role that trauma, resulting from violence, victimization, colonization, and systemic racism plays in the lives of American Indian and Alaska Native (AI/AN) populations. Delivering trauma-informed services requires an understanding of the profound neurological, biological, psychological, spiritual, and social effects trauma and violence can have on individuals, families, and communities. The IHS workforce must be aware of the high prevalence of trauma in AI/AN populations, and train to respond effectively to this trauma, which affects many individuals who seek services at IHS facilities as well as the AI/AN staff of IHS. It is also important to recognize, and build on the resiliency of AI/AN people, which comes, at least in part, from their culture and spirituality.

Trauma Informed Care (TIC) training is an intervention and organizational approach that focuses on how trauma may affect an individual’s life and response to the healthcare services. Overall, TIC is a system-wide change in culture that can improve patient engagement, treatment adherence, health outcomes, as well as provider and staff wellness. To support this organizational transformation to TIC, all contractors are required to complete the two-hour “Overview of Trauma-Informed Care and Historical Trauma” training course. This training meets the requirement of the IHS Indian Health Manual Part 3 Chapter 37 policy that provides guidance to IHS hospitals, health centers, clinics, and health stations in delivering trauma-informed care services.

5.7.10 Required Training: Access for Contractors who don’t have access to IHS computer network must access the mandatory training at:

https://www.ihs.gov/mentalhealth/ticmandatorytraining/. After completing the training, please provide a copy of the course completion certificate to the COR of this award and this training 10 day from their start and will be required annually thereafter.

5.8 Challenges to Conflicts: For any inconsistency between COR and Contractor's employee, the employee should contact their agency. If this situation needs further remedies, then the Contractor will contact the COR

5.9 When the Contractor demonstrates impaired judgement, they cannot continue working on the Solicitation. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

5.10 APPLICABLE DOCUMENTS:

• Business Associate Agreement

• OF 306 – Addendum to Declaration for Federal Employment – Indian Health Service Child Care & Indian Child Care Work Positions

SECTION 6 0 QUALITY ASSURANCE SURVEILLANCE PLAN

(INTENTIONALLY LEFT BLANK)

SECTION 7 - PACKAGING AND MARKING

7.1 PACKAGING

SF-1449 continued, page 9 of 25

All deliverables shall be preserved, packaged, and packed in accordance with normal commercial practices to meet the packing requirements of the carrier including which is necessary to prevent deterioration and damages due to the hazards of shipping, handling, and storing.

7.2 MARKING

Each package/container shall be clearly marked as follows:

• Name of Contractor

• Contract Number

• Description of Items Contained Therein

• Consignee's Name and Address

7.3 DELIVERY

All deliverables delivered to the following addresses:

Mescalero Service Unit 318 Abalone Loop Mescalero, New Mexico 88340

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 9.1.1 Services under this contract shall commence NLT 10 days after all clearances occur.

9.1.2 Total contract award must not exceed five years.

9.2 PLACE OF PERFORMANCE:

9.2.1 Mescalero Service Unit

318 Abalone Loop Mescalero, New Mexico 88340

9.3 Travel to and from the facility/office site are not included in the tour of duty. See Section 5.2 for shift hours.

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

New Year's Day Martin Luther King's Birthday Juneteenth President's Day Memorial Day 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 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 Contract is:

Eric Wright, Contract Specialist (CS) Indian Health Service/Division of Contracts & Grants Management (DCGM) 4101 Indian School Road NE, Suite 225 Albuquerque, NM 87110 Phone: 505-256-6752 Email: eric.wright@ihs.gov

Send all communications pertaining to contractual and/or administrative matters to the address above and to the Contract Specialist administering this Contract.

The Federal Acquisition Regulation 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.

10.3 CONTRACT ADMINISTRATOR

· All Contract administration performed by:

http://www.opm.gov/fedhol

SF-1449 continued, page 10 of 25

Eric Wright, Contract Specialist (CS) Indian Health Service/Division of Contracts & Grants Management (DCGM) 4101 Indian School Road NE, Suite 225 Albuquerque, NM 87110 Phone: 505-256-6752 Email: eric.wright@ihs.gov

10.4 CONTRACTING OFFICER'S REPRESENTATIVE (COR)

10.4.1 Deena Evans, 575-464-3808, 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.

10.4.2 The COR 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.

10.5 TECHNICAL MONITORING

(a) Performance of work under this contract must be subject to the technical direction of the COR identified above, or an Alternate COR 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" (FAR 52.233-1, Disputes).

10.6 INVOICE SUBMISSION

10.6.1 The Contractor shall submit invoices once per month. Electronically sent via e-mail complete invoice with all required documentation to:

10.6.1.1 Contracting Officer's Representative (COR): Deena Evans, deena.evans@ihs.gov

10.6.1.2 Invoice Processing Platform: https://www.ipp.gov

* Please do not sent to the CS or Finance Office any other invoice related documents such as deliverables, reports or balance statements).

Failure to submit required documents directly to the offices listed above will delay prompt payment of your invoice.

10.6.2 For invoices submitted by email, the subject line of your email invoice submission shall contain the Contractor's name, UEI and TIN numbers, contract number, and invoice. The Contractor shall send one email per contract monthly. The email may have multiple invoices for the contract. Invoices accepted in one of these formats: PDF, TIFF, or Word only (no Excel formats). The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word).

10.6.3 Additionally, the Contractor is required to include its Unique Entity ID (UEI) number on each invoice.

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

10.6.5 All information set forth in FAR Clause 52.212-4(g), Invoice, must be included in all invoices for it to constitute a proper invoice.

FAR 52.212-4(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure,…