SOLICITATION 246-23-Q-0157.pdf

SOLICITATION, OFFER AND AWARD 1. THIS CONTRACT IS A RATED ORDER RATING

UNDER DPAS (15 CFR 700)

PAGE OF PAGES

1 57

2. CONTRACT NUMBER 3. SOLICITATION NUMBER

246-23-Q-0157

4. TYPE OF SOLICITATION

SEALED BID (IFB)

X NEGOTIATED (RFP)

5. DATE ISSUED 6. REQUISITION/PURCHASE

NUMBER

876-TSD-2023-002708

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than item 7)

Indian Health Service Oklahoma Area 701 Market Drive, Oklahoma Offer may be emailed to noleen.powell@ihs.gov City, OK 73114

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

SOLICITATION

9. Sealed offers in original and 1 copy for furnishings the supplies or services in the Schedule will be received at the place specified in item 8, or if hand carried, in the depository located in Item 7 until 4:30 p.m. Local time on September 14, 2023

(Hour) (Date) CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

10. FOR

INFORMATION

CALL:

A. NAME

Noleen Powell

B. TELEPHONE (NO COLLECT CALLS) C. E-MAIL ADDRESS

Noleen.Powell@ihs.gov

AREA CODE

NUMBER

EXTENSION

11. TABLE OF CONTENTS

(X) SEC. DESCRIPTION PAGE(S) (X) SEC. DESCRIPTION PAGE(S)

PART I - THE SCHEDULE PART II - CONTRACT CLAUSES

A SOLICITATION/CONTRACT FORM A-1 X I CONTRACT CLAUSES I-9

X B SUPPLIES OR SERVICES AND PRICES/COSTS B-1 PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

X C DESCRIPTION/SPECS./WORK STATEMENT C-4 X J LIST OF ATTACHMENTS J-1

X D PACKAGING AND MARKING D-1 PART IV - REPRESENTATIONS AND INSTRUCTIONS

X E INSPECTION AND ACCEPTANCE E-1 X K REPRESENTATIONS, CERTIFICATIONS AND OTHER

STATEMENTS OF OFFERORS

K-10

X F DELIVERIES OR PERFORMANCE F-3

X G CONTRACT ADMINISTRATION DATA G-3 X L INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS L-1

X H SPECIAL CONTRACT REQUIREMENTS H-14 X M EVALUATION FACTORS FOR AWARD M-4

OFFER (Must be fully completed by offeror) NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within calendar days (60 calendar days unless adifferent period is inserted by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT

(See Section I, Clause No. 52.232-8)

10 CALENDAR DAYS (%) 20 CALENDAR DAYS (%) 30 CALENDAR DAYS (%) CALENDAR DAYS(%)

14. ACKNOWLEDGMENT OF AMENDMENTS

(The offeror acknowledges receipt of amendments to the SOLICITATION for offerors and related documents numbered and dated):

AMENDMENT NO. DATE AMENDMENT NO. DATE

15A. NAME AND

ADDRESS

OF OFFER-

OR

CODE FACILITY 16. NAME AND THE TITLE OF PERSON AUTHORIZED TO SIGN OFFER

(Type or print)

15B. TELEPHONE NUMBER 15C. CHECK IF REMITTANCE ADDRESS IS

DIFFERENT FROM ABOVE - ENTER SUCH

ADDRESS IN SCHEDULE.

17. SIGNATURE 18. OFFER DATE

AREA CODE NUMBER EXTENSION

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEMS NUMBERED

B.1

20. AMOUNT

21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL OPEN COMPETITION:

X 10 U.S.C. 2304 (c) 41 U.S.C. 3304(a) ( )

23. SUBMIT INVOICES TO ADDRESS SHOWN IN ITEM

(4 copies unless otherwise specified) G.2

24. ADMINISTERED BY (If other than Item 7) Indian Health Service Oklahoma Area 701 Market Drive Oklahoma City, OK 73114

25. PAYMENT WILL BE MADE BY CODE

Indian Health Service Oklahoma Area Attn: Finance 701 Market Drive Oklahoma City, OK 73114

26. NAME OF CONTRACTING OFFICER (Type or print)

Sean L. Long, Chief Contracting Officer

27. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

28. AWARD DATE

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (REV. 6/2014)

Prescribed by GSA - FAR (48 CFR) 53.214 (c) mailto:noleen.powell@ihs.gov mailto:Noleen.Powell@ihs.gov

PART I - THE SCHEDULE

SECTION A - SOLICITATION/CONTRACT FORM

SF 33 SOLICITATION, OFFER AND AWARD

PART I - THE SCHEDULE

Table of Contents Page A-1 A-1 A-1

B-1

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

SECTION C - DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

SECTION D - PACKAGING AND MARKING

[FOR THIS SOLICITATION, THERE ARE NO CLAUSES IN THIS SECTION]

B-1

C-1

D-1

D-1

SECTION E - INSPECTION AND ACCEPTANCE E-1

E.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE E-1

SECTION F - DELIVERIES OR PERFORMANCE F-1

F.1 REPORTING REQUIREMENTS F-1

SECTION G - CONTRACT ADMINISTRATION DATA G-1

G.1 INVOICE REQUIREMENTS G-1

G.2 INVOICE SUBMISSION G-1

G.3 METHOD OF PAYMENT G-1

G.4 CONTRACTING OFFICER'S REPRESENTATIVE G-2

G.5 CONTRACTING OFFICER'S TECHNICAL REPRESENTATIVE G-2

G.6 ACCOUNTING AND APPROPRIATION DATA

SECTION H - SPECIAL CONTRACT REQUIREMENTS

G-3

H-1

H.1 HHSAR 352.237-75 KEY PERSONNEL (DEC 2015) H-1

H.2 LEGAL HOLIDAYS H-1

H.3 DISCLOSURE OF INFORMATION H-1

H.4 ALLOWABLE COST H-2

H.5 PRECONTRACT COST H-3

H.6 OVERTIME PREMIUM H-3

H.7 TRAVEL H-3

H.8 DOMICILE TRANSPORTATION H-4

H.9 TRAVEL TIME (OTHER THAN DAILY COMMUTING) H-4

H.10 MATERIALS H-4

H.11 BUSINESS ASSOCIATES AGREEMENT CLAUSE

PART II - CONTRACT CLAUSES

H-5

I-1

SECTION I - CONTRACT CLAUSES I-1

I.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE I-1

I.2 52.204-1 APPROVAL OF CONTRACT (DEC 1989)

I.3 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

I.4 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT

(MAR 2000)

I.5 52.232-25 PROMPT PAYMENT (JULY 2013)

I.6 5 2 . 2 3 7 - 7 INDEMNIFICATION AND MEDICAL LIABILITY

INSURANCE (JAN 1997)

I.7 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

I-3

I-8 I-9

I.8 HHSAR 352.227-70 PUBLICATIONS AND PUBLICITY (DEC 2015) I-9

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS J-1

SECTION J - LIST OF ATTACHMENTS J-1

PART IV – REPRESENTATIONS AND INSTRUCTIONS K-1

SECTION K-REPRESENTATIONS, CERTIFICATIONS, & OTHER STATEMENTS OF OFFERORS K-1

K.1 NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY REFERENCE K-1

K.2 52.204-3 TAXPAYER IDENTIFICATION (OCT 1998) K-1

K.3 52.204-5 WOMEN-OWNED BUSINESS (OTHER THAN SMALL BUSINESS) (OCT 2014) K-2

K.4 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (OCT 2015) K-2

K.5 52.215-6 PLACE OF PERFORMANCE (OCT 1997) K-3

K.6 52.219-1 SMALL BUSINESS PROGRAM REPRESENTATIONS (OCT 2014) K-4

K.7 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999) K-7

K.8 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (APR 1984) K-7

K.9 52.230-1 COST ACCOUNTING STANDARDS NOTICES AND CERTIFICATION (OCT 2015) K-7

K.10 GOVERNMENT EMPLOYEE REPRESENTATION K-9

K.11 IDENTIFICATION OF SUBCONTRACTORS K-9

K.12 SUBCONTRACTOR INFORMATION K-9

K.13 SIGNATURE BLOCK

SECTION L - LIST OF ATTACHMENTS

K-9

L-1

L.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE L-1

L.2 52.215-1 INSTRUCTIONS TO OFFERORS—COMPETITIVE ACQUISITION (JAN 2004)

ALTERNATIVE I (OCT 1997) L-1

L.3 52.215-1 INSTRUCTIONS TO OFFERORS—COMPETITIVE ACQUISITION (JAN 2004)

ALTERNATIVE II (OCT 1997) L-4

L.4 52.215-20 REQUIREMENTS FOR COST OR PRICING DATA OR INFORMATION OTHER THAN

CERTIFIED COST OR PRICING DATA (OCT 2010) L-7

L.5 52.216-1 TYPE OF CONTRACT (APR 1984) L-8

L.6 52.233-2 SERVICE OF PROTEST (SEP 2006) L-8

L.7 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) L-8

L.8 GENERAL INSTRUCTIONS FOR THE PREPARATION OF PROPOSALS L-9

L.8.1 VOLUME I – TECHNICAL PROPOSAL L-9

L.8.2 VOLUME II – BUSINESS PROPOSAL L-10

L.8.3 VOLUME III – COST/PRICE PROPOSAL L-10

L.9 RETURN OF OFFERS L-11

L.10 ALTERNATE PROPOSALS L-11

L.11 ACCEPTANCE OF PROPOSALS L-11

L.12 PRE-AWARD SURVEY L-11

L.13 AMENDMENTS TO PROPOSAL L-11

L.14 CONTRACT CLAUSES L-12

SECTION M – EVALUATION FACTORS FOR AWARD M-1

M.1 NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY REFERENCE M-1

M.2 BEST OVERALL RESPONSE M-1

M.3 PRICE/COST EVALUATION M-1

M.4 UNBALANCED BIDS/OFFERS M-1

SECTION B - SUPPLIES OR SERVICES AND PRICE/COST

PART I-THE SCHEDULE

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

Vendor shall provide outpatient non-medical Behavioral Health Services for the Oklahoma Area Indian Health Service.

B.l. Base Period - Year l -October 1, 2023 - September 31, 2024

B.2. Option Period 1 - Year 2 - October 1, 2024 - September 31, 2025

B.3. Option Period 2 - Year 3 - October 1, 2025 - September 31, 2026

B.4. Option Period 3-Year 4 -October1,2026- September31,2027

B.5. Option Period 4 - Year 5 - October 1, 2027 - September 31, 2028

B.6. Total ALL YEARS:

*SUBJECT TO: FAR 52.232-19 - Availability of Funds for the Next Fiscal Year

B-1

SECTION C - DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

C-1

C.1 PURPOSE:

The basic goal of this contractual agreement will be to provide outpatient non-medical Behavioral Health Services for the urban Native Americans within the Kansas City Metropolitan Service area, including Wyandotte and Johnson counties in Kansas, Clay and Jackson counties in Missouri.

Estimated population to be served is approximately 5,200.

C.2 BACKGROUND:

According to the Indian Health Service (IHS) data, the abuse of alcohol and other drugs along with its related effects on the community, families and tribal groups is considered the major socio-economic and health problem of American Indians and Alaskan Natives. Through its initiative, the IHS intends to impact strongly on substance abuse problems by making every possible effort to bring this problem under control. Providing ongoing support to Tribes or Indian organizations is a major component of this initiative through the use of contracts and grants. Initial funds for this purpose were authorized by Congress, and came with the transfer of operating Indian substance abuse programs from the National Institute on Alcohol Abuse and Alcoholism to the IHS with the passage of P.L. 94-437. The recent enactment of P.L. 99-570 has targeted additional funds toward Indian communities to further combat substance abuse.

In the Oklahoma Area it is estimated by both IHS and State Mental Health authorities, that substance abuse rate among Native Americans is about four times that of the non-Indian population in the region.

C.3 DEFINITION FOR OUTPATIENTSERVICES:

An outpatient program is a non-medical, ambulatory treatment model designed to provide a wide range of diagnostic and treatment services for the alcohol/substance abuse client and family/community. The services need to identify and respond to the biopsychosocial antecedents, influences, and effects associated with the patient's dependence. The program provides initial comprehensive treatment planning services and responsibilities for the provision of the continuity of care to clients with established aftercare plans. Some elements having a multi-disciplined treatment approach addressing dual diagnosed problems should be incorporated in the program philosophy of care. Special treatment needs of patients by reason of age, gender, sexual orientation, or ethnic origin are evaluated.

C.4 CONTRACT TASKS TO BE PERFORMED:

The Contractor shall:

A. Have specific written program objectives and policies, including measurable results expected from program activity. Established policies related to the following issues shall include, but not withstand, the following:

1. Rights of Patients

2. Suicidal Behavior/Ideas

3. Child Abuse/Neglect

4. Domestic Violence

5. Confidentiality

C-2

6. Sexual Assault

7. Incident Reporting

8. Discharge Planning

9. Post discharge follow/up (6 & 12 months)

B. Establish formal intake and screening process. A case management system shall be established pursuant to Federal Medical Records requirements.

C. Assessment of the severity of the client’s use/abuse and the biopsychosocial stress factors.

D. Provide evidence of signed individualized treatment plans related to specific diagnostic impression(s). Preference for multi/discipline treatment planning and consultation is documented when appropriate.

1. The treatment plan shall delineate those services required for the clients, i.e.

social work, psychological, vocational, medical, legal, and psychiatric, etc.

2. The treatment plan shall be documented and evaluated periodically with specific goals and time frames with measurable outcomes.

3. Patient’s response to intervention is documented at least at the conclusion of a treatment episode or each one (1) month.

4. Follow-up on referral to another agency to determine if service was received shall be documented.

5. Consultation with other providers/services as necessary shall be documented.

6. A discharge summary with current impression, prognosis, functioning level, and aftercare plan shall be documented.

E. Provide written procedures for handling medical emergencies.

F. Provide crisis intervention services to families and individuals.

G. Provide (20) hours of counseling, education, and peer support services to individuals, groups, and families per week.

H. Therapeutic services to individuals, groups, and families (optional). Documentation of services provided is required.

I. Provide a facility with adequate space to accommodate ten (10) clients with physical characteristics for privacy, security, etc.

J. Provide appropriate staff that meets counselor certification/licensure requirements. (See IHS

Substance Abuse Standards).

I. Each counselor/clinician will provide a minimum of at least twenty (20) hours of direct patient contact per week in addition to employment (training) and prevention activities.

2. Each counselor shall have documentation of credentials with annual performance standards established.

H. Provide a process by which the client is contacted within five (5) working days following discharge from the last treatment component.

C-3

C.5 QUALITY ASSURANCE:

The contractor shall document a current QA plan and the communication to a facility QA committee. Major aspects of care are identified, monitored, and issues discovered addressed. In-service education to staff and other primary care providers is documented. Patient satisfaction surveys are conducted annually. Workload data is collected for staff and reviewed monthly.

Consultant and specialty services are monitored.

C.6 WORK SCHEDULE:

Hours of operation shall be during regularly scheduled periods, which make outpatient services accessible to clients, including those employed between 8:00 a.m. and 5:00 p.m., and the general public.

C.7 PERSONNEL QUALIFICATIONS:

The contractor shall provide substance abuse treatment personnel to perform the contracted services. Staff trained in the provision of behavioral health services with knowledge and understanding of substance abuse shall be required. Counseling staff should have a minimum of state certification/licensure in the field of expertise.

C.8 INDEMNITY ANDINSURANCE:

The Government assumes no responsibility for negligent acts of either the Contractor of his/her employees; therefore, the Contractor is responsible for obtaining that amount of professional liability insurance coverage that he/she considers appropriate. The Contractor will keep harmless and indemnify the Government against any or all loss, cost damage claims, expenses or liability whatsoever as a result from the performance of the contract.

Contractor will hold the Federal Government and its agents including the medical director and the governing body immune from civil or professional liability for all acts related to quality care management and enforcement of this contact.

C.9 PROGRAM MANAGEMENT AND CONTROL REQUIREMENTS:

Criteria for review of the contractor's performance will be through an annual program review completed by the Project Officer utilizing the Oklahoma Area Human Services Program Review document. The remainder of the performance will be based on data derived from the CDMIS system and a quarterly narrative report from the contractor.

Inspection, test, and acceptance criteria:

The Contactor shall provide a methodology to internally monitor the achievement of program objectives on a quarterly basis.

C.10 EXHIBITS AND REFERENCEMATERIAL:

Indian Health Service Manual Part III, Chapter 18, Alcoholism/Substance Abuse Program. Oklahoma City Area IHS Alcohol/Substance Abuse Assessment (attachment J-2).

D-1

SECTION D - PACKAGING AND MARKING

(THERE ARE NO CLAUSES IN THIS

SECTION)

SECTION E- INSPECTION AND ACCEPTANCE

E.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

The following contract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title and Date) in accordance with the clause at FAR "52.252-2 CLAUSES INCORPORATED BY REFERENCE" in Section I of this contract. See FAR 52.252-2 for an internet address (if specified) for electronic access to the full text of a clause.

52.246-5

TITLE

FEDERAL ACQUISITION REGULATION (48 CFR Chapter 1)

INSPECTION OF SERVICES-COST-REIMBURSEMENT

DATE

APR 1984

E-1

SECTION F- DELIVERIES OR PERFORMANCE

F-1

F.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

The following contract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title and Date) in accordance with the clause at FAR "52.252-2 CLAUSES INCORPORATED BY REFERENCE" in Section I of this contract. See FAR 52.252-2 for an internet address (if specified) for electronic access to the full text of a clause.

NUMBER TITLE DATE

52.242-15 STOP-WORK ORDER

ALTERNATE I (APR 1984)

AUG 1989

F.2 PERIOD OFPERFORMANCE

A. The period of performance of this contract shall be for a twelve-month period from 10/01/2023 through 09/31/2024 with an option to renew for four 12-month periods.

B. If the Government exercises its options pursuant to I-3. FAR Clause 52-217-9 of the contract, the period of performance will be extended in accordance with the following schedule:

YEAR OPTION PERIOD

Option Period 1 - Year 2

Option Period 2 - Year 3

Option Period 3 - Year 4

Option Period 4 - Year 5

10/01/2024 through 09/31/2025

10/01/2025 through 09/31/2026

10/01/2026 through 09/31/2027

10/01/2027 through 09/31/2028

F.3 PROGRAM REPORTING REQUIREMENTS

The contractor shall submit through the contract Project Officer, to the Contracting Officer the following report:

SECTION F- DELIVERIES OR PERFORMANCE

F-2

A. Monthly Report

The contractor shall provide monthly narrative written report will be provided by the 10th day of the month.

The report will include as a minimum a detail of the services provided and the number of patient contacts.

B. Annual Report

Within thirty (30) working days after the end of the performance period of the contract, a summarization report shall be provided which indicates the actual accomplish accomplishments as compared with the objectives outlined in this contract. Explanations must be included to indicate how these objectives were accomplished with any major variances explained.

C. Monthly Invoice

An SF1034, Public Voucher for Purchases and Services Other Than Personal. Submit a copy via email, due the 15th day of the following month. The Project officer shall be identified at the time of award.

F.4 WORK SCHEDULE

Hours of operation shall be during regularly scheduled periods , which make outpatient services accessible to clients, including those employed between 8:00 a.m. and 5:00 p.m., and the general public.

F.5 PROGRAM MANAGEMENT AND CONTROL

Criteria for review of the contractor's performance will be through an annual program review completed by the Oklahoma Area Human Services Program Review Document.

SECTION G - CONTRACT ADMINISTRATION

G-1

G.1 INVOICE REQUIREMENTS

Invoices shall be submitted in an original and one (1) copy to the Government office designated in this contract or on the delivery order to receive invoices. To constitute a proper invoice, the invoice must include the following information and/or attached documentation:

(1) Name of the business concern and invoice date.

(2) Contract Number, or other authorization for delivery of property or services.

(3) Description, price, and quantity of property and services actually delivered or rendered.

(4) Shipping and payment terms, and such other substantiating documentation or information as required by the contract.

(5) Name (where practicable), title, telephone number, and complete mailing address of responsible official to whom payment is to be sent.

G.2 INVOICE SUBMISSION

Invoices shall be submitted to the following address:

Oklahoma City Area Indian Health Service ATTN: Office of Tribal Self Determination – Debra Isham, Project Officer 701 Market Drive Oklahoma City, OK 73114

G.3 METHOD OF PAYMENT

a) Payments under this contract will be made either by check or by wire transfer through the Treasury Financial Communications System at the option of the Government.

b) The Contractor shall forward the following information in writing to the Contracting Officer not later than 7 days after receipt of notice of award:

1) Full Name (where practicable), title, telephone number, and complete mailing address of responsible official(s) :

(i) to whom check payments are to be sent, and

(ii) who may be contacted concerning the bank account information requested below.

2) The following bank account information required to accomplish wire transfers:

(i) Name, address, and telegraphic abbreviation of the receiving financial institution.

(ii) Receiving financial institution's 9-digit American Bankers Association (ABA) identifying number for routing transfer of funds. (Provide this number only if the receiving financial institution has access to the Federal Reserve Communications System.)

(iii) Recipient's name and account number at the receiving financial institution to be credited with the funds.

(iv) If the receiving financial institution does not have access to the Federal

G-2

Reserve Communications System, provide the name of the correspondent financial institution through which the receiving institution receives electronic funds transfer messages. If a correspondent financial institution is specified, also provide:

(a) Address and telegraphic abbreviation of the correspondent financial institution.

(b) The correspondent financial institution's 9-digit ABA identifying number for routing transfer of funds.

(c) Any changes to the information furnished under paragraph (b) of this clause shall be furnished to the Contracting Officer in writing at least 30 days before the effective date of the change. It is the Contractor's responsibility to furnish these changes promptly to avoid payments to erroneous addresses or bank accounts.

(d) The document furnishing the information required in paragraphs (b) and

(c) must be dated and contain the signature, title, and telephone number of the Contractor official authorized to provide it, as well as the Contractor's name and contract number

G.4 CONTRACTING OFFICER'S REPRESENTATIVE

The Contracting Officer may designate in writing one or more Government employees, by name and position title, to take action for the Contracting Officer under this contract. Each designee shall be identified as a Contracting Officer's Representative (COR). Such designation(s) shall specify the scope and limitations of the authority so delegated;

provided, that the designee shall not change the terms or conditions of the contract, unless the COR is a warranted Contracting Officer and this authority is delegated in the designation .

G.5 CONTRACTING OFFICER'S REPRESENTATIVE

a) The following person is hereby designated to act as Contracting Officer's

Representative under this contract:

Director of Behavioral Health Division of Healthcare Systems Oklahoma City Area Indian Health Service 701 Market Drive Oklahoma City, OK 73114 Telephone 405-951-3816

b) The COR is responsible for: receiving all deliverables; inspecting and accepting the supplies or services provided hereunder in accordance with the terms and conditions of this contract; providing direction to the contractor which clarifies the contract effort, fills in details or otherwise serves to accomplish the contractual Scope of Work; evaluating performance; and certifying all invoices/vouchers for acceptance of the supplies or services furnished for payment prior to forwarding the original invoice to the payment office and a conformed copy to the Contracting Officer.

G-3

c) The COR does not have the authority to alter the contractor's obligations under the contract, direct changes that fall within the purview of the General Provisions clause entitled "Changes" and/or modify any of the expressed terms, conditions, specification, or cost of the agreement. If as a result of technical discussions it is desirable to alter/change contractual obligations or the Scope of the Work, the Contracting Officer shall issue such changes in writing and signed.

G.6 ACCOUNTING AND APPROPRIATION DATA

SECTION H- SPECIAL CONTRACT REQUIREMENTS

H-1

H.1 HHSAR 352.237-75 KEY PERSONNEL (DEC 2015)

The key personnel specified in this contract are considered to be essential to work performance. At least 30 days prior to the contractor voluntarily diverting any of the specified individuals to other programs or contracts the Contractor shall notify the Contracting Officer and shall submit a justification for the diversion or replacement and a request to replace the individual. The request must identify the proposed replacement and provide an explanation of how the replacement's skills, experience, and credentials meet or exceed the requirements of the contract (including, when applicable, Human Subjects Testing requirements). If the employee of the contractor is terminated for cause or separates from the contractor voluntarily with less than thirty days’ notice, the Contractor shall provide the maximum notice practicable under the circumstances. The Contractor shall not divert, replace, or announce any such change to key personnel without the written consent of the Contracting Officer. The contract will be modified to add or delete key personnel as necessary to reflect the agreement of the parties.

H.2 LEGAL HOLIDAYS

The following Federal legal holidays are observed under this contract.

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

1 January Third Monday in January Third Monday in February Last Monday in May 4 July First Monday in September Second Monday in October November 11 Fourth Thursday in November December 25

H.3 DISCLOSURE OFINFORMATION

Any information made available to the Contractor by the Government shall be used only for the purpose of carrying out the provisions of this contract and shall not be divulged or made known in any manner to any person except as may be necessary in the performance of the contract.

In performance of this contract, the contractor assumes responsibility for protection of the confidentiality of Government records and shall ensure that all work performed by its subcontractors shall be under the supervision of the contractor or the contractor's responsible employees.

Each officer or employee of the contractor or any of its subcontractors to whom any Government record may be made available or disclosed shall be notified in writing by the contractor that information disclosed to such officer or employee can be used only for a purpose and to the extent authorized herein, and that further disclosure of any such information, by any means, for a purpose or to an extent unauthorized herein, may subject the offender to criminal sanctions imposed by 19 U.S.C. 641. That section provides, in pertinent part, that whoever knowingly converts to their use or the use of another, or without

H-2 authority, sells, conveys, or disposes of any record of the United States or whoever receives the same with intent to convert it to their use of gain, knowing it to have been converted, shall be guilty of a crime punishable by a fine of up to $10,000, or imprisoned up to ten years, or both.

H.4 ALLOWABLE COST

(a) Allowable cost. The estimated cost of the Contractor's performance is shown in Section B.

(b) Fixed Fee. In addition to the "allowable" cost the Government shall pay to the

Contractor a fixed fee as set forth in Section B. Subject to the withholding provisions of Section I clause "Fixed Fee", the contractor, at the time or reimbursement of allowable costs, will be entitled to proportionate payment of fee in an amount which reflects the ratio of total fee to total estimated cost exclusive of fee.

(c) The contractor shall, to the extent of his ability, acquire materials and services at the most advantageous prices available with due regard to securing timely delivery of satisfactory materials and take all cash and trade discounts, rebates, allowances, credits, salvage commissions and beneficiation.

(d) It is understood and agreed that subject to those Section I clauses entitled Limitation of

Costs or Limitation of Funds, and Allowable Costs and Payment, the following shall be considered as allowable items of cost under the contract when incurred or paid by the Contractor and when necessary and required and used for performance of work hereunder. This clause does not preclude the allowance of other costs allowable under the Federal Acquisition Regulation, Part 32.

(1) Indirect Costs. For the period of this contract, subject to the establishment of final annual indirect cost rate(s), the Contractor shall be reimbursed at billing rate(s) established by the Contracting Officer of by an authorized representative (the cognizant auditor), in accordance with paragraph (e) of the contract clause, Allowable Cost and Payment.,

(2) Travel and Subsistence. Reasonable subsistence shall be allowed in accordance with the Contractor's established and Government approved policy for transportation for personnel employed in the performance of this contract while in travel status; provided such travel is necessary for the performance of this contract and provided further that expenses for transportation hereunder by motor vehicle other than common carrier or rented automobile shall be reimbursed on a reasonable actual expense basis plus any toll or ferry charges. The difference in cost between first-class air accommodations and less than first-class air accommodations is unallowable except when less than first-class accommodations are not reasonably available to meet mission requirement. Reasonableness shall be ascertained by a review of all facts pertaining to the specific cost by the Contracting Officer. Should transportation ad subsistence expenses by incurred concurrently in connection with the performance of more than one contract, such expenditures shall be allocated on an equitable basis to the contracts involved.

This allocation shall be based on a review of all pertinent facts concerned with the particular trip.

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(3) Reproduction costs. "Duplicating" is defined in Printing and Binding Regulations published by the Joint Committee on Printing of the Congress of the United States, current issue. Allowable reproduction and duplicating usually includes that produced from stencils, masters, and mats used on single unit duplicating equipment not larger than 11 by 17 inches with a maximum image of 10 3/4 by 14 1/4 inches, provided that, not more than 5,000 production units shall be produced of any page and that items consisting of multiple page will not exceed 25,000 production units in the aggregate.

(4) Special Costs. Special items which have been certified in writing by the Contracting Officer as constituting part of the Contractor's undertakings hereunder.

H.5 PRECONTRACT COST

Precontract costs incurred by an offeror prior to the date of award of this contract are not allowable.

H.6 OVERTIME PREMIUM

Overtime which results in the payment of premium wages or in a direct labor charge to the contract must be approved in advance by the Contracting Officer pursuant to 52.222-2 "Payment for Overtime Premiums" in Section I.

H.7 TRAVEL

(a) Notwithstanding the provisions of FAR 52.216-7 and 52.216-8, entitled, "Allowable cost and Payment" and "Fixed Fee" respectively, the following additional provision applies to per diem and travel:

The per diem and travel rates for reimbursement purposes shall be in accordance with acceptable accounting procedures, Section 31 of the FAR, and shall not exceed those established by Volume 2 of the Joint Travel Regulation (JTR).

(b) The Contractor shall be reimbursed by the Government for travel cost required in performance of this contract provided such travel and prior approval by the Contracting Officer of his duly authorized representative.

(c) Request for travel shall be in writing and shall include the dates, locations, and estimated costs of the travel. The Government may issue invitational Travel Orders when contractor personnel must travel overseas or in military aircraft.

(d) The Contractor shall use Government contract Airfares and other Government transportation services whenever possible.

(e) The contractor shall use the Joint Travel Regulation (JTR) rates for determining the reimbursement for travel expenses such as per diem, rental cars, lodging, and other common expenses.

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(f) The contractor shall prepare travel orders and provide them to the COR in sufficient time to allow for processing, prior to beginning travel (as determined by the Government on individual delivery orders).

H.8 DOMICILE TRANSPORTATION

Transportation of employees from domicile to work places shall not be an allowable cost under this contract.

H.9 TRAVEL TIME (OTHER THAN DAILY COMMUTING)

Time required to travel from the contractor's site or sites to any other site(s) of performance and return shall be considered time spent in performance.

H.10 MATERIALS

(a) The estimated cost for all material required for the performance of the delivery order will be included in each contractor estimate. The estimated cost for this material will be calculated by multiplying the purchase price times the material handling rate proposed by the contractor in Section B.

(b) In some cases, the Government may specify certain material to be purchased by the contractor. This material will be ordered on individual delivery orders, if at all. All necessary clauses required for the purchase of the specific material involved will be incorporated into the delivery order. The Contractor and the Government must meet all statutory and regulatory prerequisites for the furnishing of such material before any delivery order can be issued. The estimated cost for material will be arrived at by applying the material handling fee proposed in Section B to the estimated purchase cost.

(c) The Contractor shall track the total cost of all material (to include the material handling rate) purchased under a delivery order and shall notify the Contracting officer when it expects to exceed the estimated cost for material. The Contractor shall not be reimbursed for any material cost in excess of the estimated material cost unless written authorization to incur such costs and new estimated material cost have been received from the Contracting Officer.

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H-11 BUSINESS ASSOCIATE AGREEMENT CLAUSE

Pursuant to 45 C.F.R. § 164.502(e), the Indian Health Service (IHS), as a covered entity, is required to enter into an agreement with a “business associate,” as defined by 45 C.F.R. § 160.103, under which the business associate must agree to appropriately safeguard Protected Health Information (PHI) that it will use and disclose when performing functions, activities or services pursuant to its contract with the IHS. By signing Contract No. TBD, TBD agrees that it is a Business Associate and will comply with the terms below, in addition to other applicable Contract terms and conditions, and applicable law, relating to the safekeeping, use, and disclosure of PHI. This Appendix comprises the Business Associate Agreement (Agreement).

II. Definitions:

The following terms shall have the same meaning as those terms in 45 C.F.R. Part 160 and Part 164, which are the federal regulations implementing the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended: Breach, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices, PHI, Required by Law, Secretary, Security Incident, Subcontractor, Unsecured PHI, and Use.

A. Business Associate. “Business Associate” shall generally have the same meaning as the term “business associate” at 45 C.F.R. § 160.103, and in reference to the party to this Agreement shall mean TBD.

B. Covered Entity. “Covered Entity” shall generally have the same meaning as the term “covered entity” at 45 C.F.R. § 160.103, and in reference to the party to this Agreement, shall mean the IHS.

C. HIPAA Rules. “HIPAA Rules” shall mean the Privacy, Security, Breach Notification, and Enforcement Rules at 45 C.F.R. Part 160 and Part 164.

D. Master Patient Index (MPI). The “Master Patient Index” or “MPI” is composed of a unique list of patients and a current list of medical centers where each patient has been seen. This enables the sharing of patient data between operationally and regionally diverse systems. Each record (or index entry) on the MPI contains a small amount of patient data used to identify individual entries.

The mission of the MPI is to uniquely identify a patient and to “link” that patient’s data throughout the IHS facilities using the Integration Control Number (ICN). The MPI is the authoritative source of a patient’s ICN, the enterprise-wide identifier for IHS facilities and the key to accessing a patient’s record. The accuracy of patient information and patient identification directly affects clinical, administrative, billing, and interdepartmental processes.

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III. Obligations and Activities of Business Associate:

A. Compliance: Business Associate agrees not use or disclose PHI other than as authorized by the Agreement or as required by law. Business Associate acknowledges that it is directly liable under the HIPAA Rules and subject to civil and, in some cases, criminal penalties for making uses and disclosures of PHI that are not authorized by the Agreement or required by law. Business Associate agrees that it will require all of its agents, employees, subsidiaries, and affiliates, to whom Business Associate provides PHI, or who create or receive PHI on behalf of Business Associate for Covered Entity, to comply with the HIPAA Rules and to enter into written agreements with Business Associate that provide the same restrictions, terms, and conditions as set forth in the Agreement.

B. Subcontractors: In accordance with 45 C.F.R. §§ 164.502(e)(1)(ii) and 164.308(b)(2), which govern relations with subcontractors, Business Associate agrees to ensure that any subcontractors that create, receive, maintain, or transmit PHI on behalf of Business Associate agree to the same restrictions, terms, and conditions that apply to Business Associate with respect to such PHI.

C. Safeguarding PHI: Business Associate shall develop and use appropriate procedural, physical, and electronic safeguards to protect against the use or disclosure of PHI in a manner not authorized by this Agreement or required by law. Business Associate will limit any use, disclosure, or request for use or disclosure of PHI to the minimum amount necessary to accomplish the intended purpose of the use, disclosure, or request.

D. Safeguarding Electronic PHI: Business Associate agrees to use appropriate safeguards, as set forth in Subpart C of 45 C.F.R. Part 164 with respect to electronic PHI, to prevent use or disclosure of electronic PHI other than as authorized by this Agreement or required by law.

E. Reporting Use or Disclosures Not Authorized By this Agreement or Required by Law:

Business Associate agrees to report to Covered Entity any use or disclosure of PHI not authorized by this Agreement or required by law within thirty (30) days of discovering the use or disclosure, or any security incident of which it becomes aware. In addition, Business Associate shall mitigate, to the extent practicable, any harmful effect that is known to Business Associate of the use, disclosure, or security incident.

F. Reporting of Breach: In accordance with the policy of the Department of Health and Human Services, Business Associate will report, within one hour of discovery, all suspected or confirmed breaches to Covered Entity.

G. Notification of Breach of Unsecured PHI: In addition to the above, Business Associate shall notify Covered Entity of a breach, as set forth in 45 C.F.R. §164.410, of the security of any unsecured PHI that Business Associate received from, or created or received on behalf of, Covered Entity within thirty (30) calendar days after the discovery of the breach by Business Associate, its employees, officers, and/or other agents, unless notification is specifically excepted by 45 C.F.R. § 164.412.

1. Requirements of Notice. Such notice shall include, to the extent possible, the identification of each individual whose unsecured PHI has been, or is reasonably

H-7 believed by Business Associate to have been, accessed, acquired, or disclosed during such breach; a brief description of the circumstances of the breach of security, including the date of the breach and the date of Business Associate’s discovery of the breach; and the type of unsecured PHI involved in the breach.

Business Associate agrees to provide any other available information that Covered Entity is required to include in notification to the individual under 45 §164.404(c).

In the event notification is delayed, evidence demonstrating the necessity of the delay shall accompany the notification.

H. Individual Access to PHI: Business Associate shall maintain a designated record set for each individual for whom it maintains PHI. In accordance with an individual’s right to access his or her PHI, Business Associate shall make available all PHI in the individual’s designated record set to the individual to whom that information pertains, or, upon the request of the individual, to that individual’s authorized representative, as necessary to satisfy Covered Entity’s obligations under 45 C.F.R. § 164.524. Availability to access PHI shall be made within five (5) calendar days of receipt of a valid request.

I. Accounting of Disclosures: Business Associate shall maintain records of PHI received from, or created or received on behalf of, Covered Entity and shall document subsequent uses and disclosures of such information by Business Associate. Business Associate shall, within five (5) calendar days after receiving a request from Covered Entity, provide to Covered Entity such information as Covered Entity may require to fulfill its obligations to account for disclosures of PHI pursuant to 45 C.F.R. § 164.528.

J. Amendment of PHI: Business Associate shall, within five (5) calendar days of a request by Covered Entity, make PHI available to Covered Entity for Covered Entity to fulfill its obligations under 45 C.F.R. § 164.526 to amend PHI and shall, as directed by Covered Entity, within five (5) calendar days of receipt of such direction, incorporate any amendments into PHI held by Business Associate. In addition, Business Associate shall ensure incorporation of any such amendments into PHI held by its agents or subcontractors within ten (10) days of such direction, and shall notify Covered Entity within five (5) calendar days of when those agents or subcontractors have completed the incorporation of the amendments. Business Associate shall forward to Covered Entity all requests to amend PHI that it receives directly from individuals within five (5) calendar days of its receipt of a request.

K. Carrying out Covered Entity’s Obligations: To the extent Business Associate is to carry out one or more of Covered Entity’s obligation(s) under Subpart E of 45 C.F.R. Part 164, Business Associate agrees to comply with the requirements of Subpart E that apply to Covered Entity in the performance of such obligation(s).

L. Disclosures for Verifying Compliance: Upon request, Business Associate shall permit access by the Secretary and Covered Entity during normal business hours to its facilities, books, records, accounts, and any other sources of information, including PHI and any agreements that it has with subcontractors, vendors, and/or other agents relating to the use and disclosure of PHI received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity, for purposes of determining both Business Associate’s and Covered Entity’s compliance with the HIPAA Rules.

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IV. Permitted Uses and Disclosures by Business Associate:

A. Business Associate shall not use or disclose PHI except to perform functions, activities, or services on behalf of Covered Entity as provided for in the Contract, this Agreement, the HIPAA Rules, or other applicable law.

B. Business Associate agrees that it may use or disclose PHI on behalf of Covered Entity only:

1. Upon obtaining the authorization of the individual to whom the PHI pertains;

2. For the purposes of treatment, payment or health care operations unless Covered Entity has agreed to a restriction pursuant to 45 C.F.R. § 164.520(b)(iv)(A) or 45 C.F.R. § 164.522; or

3. Without an authorization or consent, if in accordance with 45 C.F.R. § 164.510, 45 C.F.R. § 164.512, 45 C.F.R. § 164.514(e), 45 C.F.R. § 164.514(f), or 45 C.F.R.

§ 164.514(g).

C. Business Associate shall use and disclose PHI in compliance with each applicable requirement of 45 C.F.R. § 164.504(e), which section is fully incorporated herein.

D. Business Associate agrees to make uses, disclosures, and requests for PHI consistent with Covered Entity’s minimum necessary policies and procedures.

E. It is anticipated that Business Associate will have access to the MPI.

F. Business Associate may not use or disclose PHI in a manner that would violate Subpart E of 45 C.F.R. Part 164 if done by Covered Entity, except for the specific uses and disclosures set forth below.

1. Business Associate may disclose PHI for the proper management and administration of Business Associate or to carry out the legal responsibilities of Business Associate, provided the disclosures are required by law, or Business Associate obtains reasonable assurances from the person to whom the information is disclosed that the information will remain confidential and used or further disclosed only as required by law or for the purposes for which it was disclosed to the person, and the person notifies Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached.

V. Obligations of Covered Entity:

A. Covered Entity shall provide Business Associate with its Notice of Privacy Practices and any changes to the Notice.

B. Covered Entity shall notify Business Associate of any limitation(s) in Covered Entity’s Notice of Privacy Practices under 45 C.F.R. § 164.520, to the extent that such limitation may affect Business Associate’s use or disclosure of PHI.

C. Covered Entity shall notify Business Associate of any change in, or revocation of, the permission by an individual to use or disclose his or her PHI to the extent that such changes may affect Business Associate’s use or disclosure of PHI.

D. Covered Entity shall notify Business Associate of any restriction on the use or disclosure of PHI that Covered Entity has agreed to or is required to abide by under 45 C.F.R. § 164.522, to the extent that such restriction may affect Business Associate’s use or disclosure of PHI.

E. Covered Entity shall not request Business Associate to use or disclose PHI in any manner that would not be permissible under Subpart E of 45 C.F.R. Part 164 if done by Covered Entity, except as provided in Part IV, Subpart F, Section 1.

VI. Termination:

A. Term: The Term of this Agreement shall be effective as of the date Business Associate signs the underlying Contract and shall terminate when the Contract ends or on the date covered entity terminates for cause as authorized in paragraph (b) of this Section, whichever is sooner.

B. Termination for Cause: Business Associate authorizes termination of this Agreement by Covered Entity, if Covered Entity determines Business Associate has violated a material term of the Agreement and Business Associate has not ended the violation within the time specified by Covered Entity.

C. Obligations of Business Associate Upon Termination: Upon termination of this Agreement for any reason, Business Associate, with respect to PHI received from Covered Entity, or created, maintained, or received by Business Associate on behalf of Covered Entity, shall:

1. Retain only that PHI which is necessary for Business Associate to continue its proper management and administration or to carry out its legal responsibilities;

2. Return to Covered Entity, or, if agreed to by Covered Entity, destroy, the remaining PHI that Business Associate does not need to continue its proper management and administration or to carry out its legal responsibilities;

3. Continue to use appropriate safeguards, in compliance with Subpart C of 45 C.F.R. Part 164, with respect to electronic PHI to prevent use or disclosure of electronic PHI, other than as provided for in this Part, for as long as Business Associate retains the PHI;

4. Not use or disclose PHI retained by Business Associate other than for the purposes for which such PHI was retained and subject to the same conditions set out above, at Part IV, Subpart F, Section 1 of the Agreement which applied prior to termination;

5. Return to Covered Entity, or, if agreed to by Covered Entity, destroy, the PHI retained by Business Associate when it is no longer needed by Business Associate for its proper management and administration or to carry out its legal responsibilities; and

6. If Business Associate or its agent or subcontractor destroys any PHI, Business Associate will provide Covered Entity with documentation evidencing such destruction within thirty (30) days of completion of destruction.

D. Survival: The obligations of Business Associate under this Part shall survive the termination of this Agreement.

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VII. Indemnification:

In the event Business Associate is investigated and/or becomes a party to a civil or criminal cause of action in any forum relating to its failure to comply with…