SOLICITATION NO. 75H70724Q00048.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

CODE 16. ADMINISTERED BYCODE

X

X

X

541611

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR203

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

04/03/2024 1730 MD

03/20/2024

505-256-6755SHANDIIN DEWOLFE

(No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70724Q00048

5. SOLICITATION NUMBER

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

1 61 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$24.5

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

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Albuquerque Indian Health Service

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Solicitation No. 75H70724Q00048 is hereby issued for Remote Medical Credentialing Assistance Services to be provided for the Ute Mountain Ute Health Center (UMUHC) located in Towaoc, CO, starting May 01, 2024 through April 30, 2025. The resulting award will consist of a base year with four option years.

***THIS IS A TOTAL SMALL-BUSINESS SET-ASIDE***

Please read solicitation in its entirety. First (Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED

SHANDIIN R. DEWOLFE

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

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

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

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

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

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

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

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

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

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

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

page must be signed in Blocks 30a, 30b, and 30c, and submitted with proposal to indicate it has been read, understood, and accepted.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

61 2 of

Medical Credentialing Assistance

Solicitation No. 75H70724Q00048 -Southern Colorado Ute Service Unit-

SECTION 1 - SUPPLIES OR SERVICES AND PRICES/COSTS

1.1 SERVICES

1.1.1 The Indian Health Service (IHS)/Albuquerque Area Office (AAO), Southern Colorado Ute Service Unit (SCUSU) has a requirement for Remote Medical Credentialing Assistance Services to be provided for the Ute Mountain Ute Health Center (UMUHC) located in Towaoc, CO, starting May 01, 2024 through April 30, 2025. The resulting award will consist of a base year with four option years.

1.2 PRICE OR COST

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

CHARGES” below are expected but may not be representative of actual pricing and serve as a means of arriving at price reasonableness for award purposes. Utilization of the Requirements contract has been determined to be appropriate for Remote Medical Credentialing Assistance Services, as the government anticipates a recurring need, but cannot pre-determine the precise hours that will be worked during the contract period. Pricing proposals should be determined based on estimated shifts of two eight-hour shifts per week (about 832 hours/year).

1.3 GENERAL CONTRACT INFORMATION

1.3.1 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 Colorado Gross Receipt Taxes (COGRT) for services provided in any county of the State of Colorado.

1.3.2 The Contractor's price/cost for services under this contract should include all applicable taxes for Internal Revenue Service (IRS), State of Colorado 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.

1.3.3 FINGERPRINTING REQUIREMENTS FOR SECURITY AND SUITABILITY:

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

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

1.4 CONTRACT PRICE

1.4.1 This is a FFP purchase order. The total price for this contract is $TBD.

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

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Solicitation No. 75H70724Q00048

SCHEDULE OF CHARGES**(these dates are tentative)

Item # Contract Period Pricing per Year* Total Amount

CLIN 1

Base Year:

05/01/2024 – 04/30/2025

$______/hour x 16 hours/week x 52 weeks/year =

$__________/year

CLIN 2 1st Option Year:

05/01/2025 – 04/30/2026

$______/hour x 16 hours/week x 52 weeks/year =

$__________/year

CLIN 3 2nd Option Year:

05/01/2026 – 04/30/2027

$______/hour x 16 hours/week x 52 weeks/year =

$__________/year

CLIN 4 3rd Option Year:

05/01/2027 – 04/30/2028

$______/hour x 16 hours/week x 52 weeks/year =

$__________/year

CLIN 5 4th Option Year:

05/01/2028 – 04/30/2029

$______/hour x 16 hours/week x 52 weeks/year =

$__________/year

GRAND TOTAL (base year + option years):

$__________/year

* - Note: The hourly rate shall be an all-inclusive rate of all other fees including: all city, state, federal, and local taxes; and miscellaneous cost associated with the above services. Also, the number of hours per week will vary per year, so this pricing is only to be used as an estimate of the yearly total cost.

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

1.4.4 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 10.5 of this contract.

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.

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Solicitation No. 75H70724Q00048

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: N/A

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

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

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

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

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

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

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

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

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

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

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

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

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Solicitation No. 75H70724Q00048

2.20 Patient Outcome: End result of pharmaceutical care.

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

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

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

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

2.25 Service Unit: The local administrative unit of IHS.

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

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

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

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

SECTION 3 – GOVERNMENT-FURNISHED PROPERTY AND SERVICES: See below.

SECTION 4 – CONTRACTOR-FURNISHED ITEMS

4.1 The Contractor will supply all other items as required to carry out the services.

SECTION 5 – STATEMENT OF WORK (SOW)

5.1 Remote Medical Credentialing Assistance Services are needed at the Ute Mountain Ute Health Center

(UMUHC) located in Towaoc, CO. This is anticipated to be remote work and the Contractor will provide assistance to the UMUHC for Medical Credentialing Services. The Government contemplates to award one single award for this solicitation.

Background/Purpose: An effective, timely, and accurate credentialing service is a requirement for the

UMUHC to provide safe patient care that meets that requirements of CMS and private insurers for the appropriate and timely payment of services.

Scope: The services sought include the appropriate credentialing and privileging of Medical and

Professional Staff, which includes approximately six (6) full-time staff, eight (8) contract subspecialists, and 30 telehealth providers. Services provided must meet the requirement specified in the Clinical Staff bylaws, Accreditation Association for Ambulatory Health Care (AAAHC) accreditation standards, and all other applicable Federal, State, and other regulatory Agencies. Awardee must be familiar with credentialing and privileging requirements for Family Medicine, Pediatricians, Internal Medicine Physicians, Advanced Practice Nurses, Dentists, Psychologists, Psychiatrists, and Telehealth providers.

Hours: This assistance will typically require 10 to 16 hours per week, but this can vary. The shift will typically be Wednesday and Thursday, for 8 hours per day.

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Solicitation No. 75H70724Q00048

Applicable Documents: SCUSU/UMUHC Clinical Staff Bylaws; Governing Board Bylaws; AAAHC requirements; CMS requirements.

Tasks: The Contractor shall provide:

a. Knowledge and familiarity with electronic credentialing software programs, such as MD Staff (please include any past performance and/or certifications, etc. with such programs in proposal).

b. Clear communication on all credentialing activities with the facility Clinical Director, Albuquerque Area Credentialing Consultant, and the CEO.

c. Coordinates the application process for all credentialed providers. Initiates and accepts all applications and verifies education, training, licensure, specialty boards, National Practitioner Data Bank reports, etc.

d. Ensures the privileges requested are consistent with education and training requirements of each specific position.

e. Assembles all verified information and prepares the credentialing file for the Medical Executive Committee, within the timeframes dictated by the bylaws of the organization.

f. Monitor and track the expiration dates of professional licensure, DEA licensure, prescribing licensure, basic life support certification, and obtaining primary source verification on all initial applications, reappointment applications and upon renewal of license.

g. Notifies each credentialed staff member approximately 3 months before the expiration of the individual’s term of appointment of the need to begin and complete the reappointment process.

h. Follows the Privacy Act and Service Unit bylaws, rules, and regulations pertaining to the confidentiality and protection of the material and maintenance of the files.

Government-Furnished Equipment and Information: Because the work will be completed remotely, there will be no Government-Furnished equipment. The Government will provide access to the Credentialing Software Program. The Contractor will provide any computer workstations needed to complete the work.

Place of Performance: It is anticipated that this work will be completed from a remote location. Provide exact address, if possible.

Security: D1 access and IT Clearance will be required for access to email and the Credentialing Software program. The Contractor will need to complete a background clearance, which includes the submission of fingerprints and other required documentation, as necessary.

DESCRIPTION OF SERVICES/SUPPLIES

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

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Solicitation No. 75H70724Q00048

5.2 Work Schedule:

5.2.1 Work Shift: This assistance will typically require 10 to 16 hours per week, but this can vary. The shift will typically take place on Wednesday and Thursday, for 8 hours per day. This will be coordinated between the Clinic and the contractor.

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

5.2.4 Work Flexibility: - Contractor's Employee work hours may vary as requested by the Director, or designee, and/or depending on the need of the health center.

5.2.5 Work Absence: - N/A

5.3 Performance Evaluation:

5.3.1 This will be determined by the COR and other Service Unit staff.

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

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

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

5.6.1 The contractor must be subject to character investigation as required by Public Law 101-360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance of a contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eQIP) system and this shall include all fingerprinting procedures and clearances. The contractor must provide all requested information necessary to perform Level I and Level II background checks. The contractor must comply with the requirement to obtain security investigations. The contractor must work with the IHS to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed within 7 business day of receipt. Failure to abide by this 7 business day submission timeframe will result in termination of your contract under 52.249-1 Termination for Convenience of the Government (Fixed Price) Short Form (April 1983). The contractor will review all completed forms and forward onto the Government personnel. The contractor will be immediately removed from the position (at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

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

5.6.3 Management of Medical Information: The Contractor must manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific

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Solicitation No. 75H70724Q00048 policies and protocols. The Contractor must immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

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

5.7. CONTRACTOR QUALIFICATION REQUIREMENTS:

5.7.1 Professional Development:

Graduate: N/A

License/Registration: N/A

Certifications: Please include any certifications with medical credentialing software programs, such as MD Staff, within proposal.

Past Performance: Please include any past performance (especially within past two years) for Medical Credentialing Assistance service or other similar services, within proposal. It is preferred that the Contractor has at least two years of experience in this type of assistance services.

5.7.2 Motor Vehicle Operator's License: N/A

5.7.3 Health Requirements of Contracted Healthcare Providers: N/A

5.7.4 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

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Solicitation No. 75H70724Q00048 scheduled shift. However, Contractor’s employees are required to complete the detailed background application and the application is to be completed within 30 days once the contractor’s employee has been given physical and logical access. All Contractors’ employees are subject to criminal background check prior to performing services in accordance with Purchase Order terms and conditions. The contractor shall ensure that each of their employees complete the Certification of Criminal History and Background Check Packet. The completed forms are to be returned to the COR. Additional Background Check packets can be obtained through the COR. See HHSAR Clauses 352.237-72 and 352.237-73

5.7.5 Required Training: Protecting Children from Sexual Abuse as stated in IHM Circular 19-05:

Contracting Training Plan for Implementation of Indian Health Manual Part 3, Chapter 20, Protecting Child from Sexual Abuse by Health Care Providers. Each provider must take this training within 30 days from their start date at the service unit. Certificate should be provided to the COR.

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

Course certifications must be provided to the COR upon completion and annually thereafter.

5.7.6 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.

5.9 When the Contractor demonstrates impaired judgement, they cannot continue working on the Purchase/Task Order No. 75H70724xxxxxx. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

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Solicitation No. 75H70724Q00048

SECTION 6 0 QUALITY ASSURANCE SURVEILLANCE PLAN (example)

Performance-Based Task Indicator Standard Quality Assurance Incentives

1. Complete all required background verifications for UMUHC staff, as necessary.

All verifications are being met on time.

Outstanding – 100% of verifications are being completed.

Acceptable – 80 to 99% of verifications are being completed.

Satisfactory – 65 to 80% of verifications are being completed.

Monitored on a periodic basis when services occur.

Final determination will happen when job is completed.

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

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

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

2. Provide updates as requested.

Detailed updates are being provided to UMUHC as requested (during weekly calls, etc).

Outstanding – 100% of updates are being provided.

Acceptable – 80 to 99% of updates are being provided.

Satisfactory – 65 to 80% of updates are being provided.

Monitored on a periodic basis when services occur.

Final determination will happen when job is completed.

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

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

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

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Solicitation No. 75H70724Q00048

SECTION 7 - PACKAGING AND MARKING

7.1 PACKAGING

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 delivered to the address shown in Section G.1.3 entitled "Contracting Officers' Representative Appointment and Authority" and 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:

Ute Mountain Ute Health Center 232 Rustling Willow St, Complex D PO Box 49 Towaoc, CO 81334

SECTION 8 - INSPECTION AND ACCEPTANCE

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

8.2 FEDERAL ACQUISITION REGULATION {48 CFR CHAPTER 1) CLAUSES

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

SECTION 9 - DELIVERIES OR PERFORMANCE

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

9.1.1 Services under this contract shall typically commence as listed below:

These dates are subject to change due to background checks, etc.

Base Year: 05/01/2024 – 04/30/2025 1st Option Year: 05/01/2025 – 04/30/2026 2nd Option Year: 05/01/2026 – 04/30/2027

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Solicitation No. 75H70724Q00048

3rd Option Year: 05/01/2027 – 04/30/2028 4th Option Year: 05/01/2028 – 04/30/2029

9.1.2 Performance will be for the period of 05/01/2024 to 04/30/2025 unless the period changed by written modification to the purchase order in accordance with FAR 52.217-9, Option to Extend the Term of the Contract.

9.1.3 Total contract award must not exceed one year, unless option year is exercised. Option period renewal is dependent on satisfactory services provided availability of funds for the appropriate fiscal year, and existing requirements.

9.2 PLACE OF PERFORMANCE: N/A

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

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

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

SECTION 10 - CONTRACT ADMINISTRATION

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

10.2 CONTRACTING OFFICER

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

Shandiin DeWolfe, (CO) Indian Health Service/Division of Contracts & Grants Management (DCGM) 4101 Indian School Road NE, Suite 225 Albuquerque, NM 87110

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Solicitation No. 75H70724Q00048

Phone: 505-256-6755 Email: Shandiin.DeWolfe@ihs.gov

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

CONTRACT ADMINISTRATOR

All Contract administration performed by:

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

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

10.3 CONTRACTING OFFICER'S REPRESENTATIVE (COR)

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

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

10.4 TECHNICAL MONITORING

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

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

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

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

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

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

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

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

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

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

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

10.5 INVOICE SUBMISSION

PROPER INVOICE:

The Contractor shall submit invoice per month. Advance payments will not be issued by Finance unless stated herein. Electronically sent via email complete invoice with all required documentation to:

Invoices shall be submitted in accordance with the contract terms, i.e., payment schedule, progress payments, partial payments, deliverables, etc. All information set forth in FAR 32.905(b), Content of Invoices, must be included in all invoices for it to constitute a proper invoice.

Additionally, the Contractor is required to include its UEI number.

A complete invoice with all required back-up documentation shall be sent electronically*:

a. Albuquerque Finance: https://www.ipp.gov

*Do not send to the CS or Finance Office any other invoices related documents (i.e. deliverables, reports, and balance statements) to the Buyer or Albuquerque Finance. Failure to submit required documents directly to the website as listed above will delay prompt payment of your invoice.

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

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

FAR 32.905(b), Content of Invoices:

(b) Content of invoices.

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

(i) Name and address of the contractor.

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

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

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

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

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

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

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

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

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

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

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

EFT.

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

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

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

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

In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this contract will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution

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Credit memos will not be accepted as a form of refund. All refunds are to be submitted via a check addressed to:

Albuquerque Area Indian Health Service Division of Accounts Receivable 4101 Indian School Road NE, Suite 225 Albuquerque, NM 87110

10.6 GOVERNMENT FURNISHED PROPERTY

N/A

10.7 Government Furnished Information / Property and Services

10.7.1 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.

10.7.2 Joint Use by the Government and the Contractor: Except for the property and service listed in 10.6.1, 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.

10.7.3 Contractor Exclusive Use:

10.7.3.1 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.

10.7.3.2 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.

10.7.3.3 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.

10.8 Contractor-Furnished Property

10.8.1 The Contractor shall provide any necessary equipment and/or supplies to complete these services.

SECTION 11 - SPECIAL CONTRACT REQUIREMENTS

11.1 CONTRACTOR PERFORMANCE EVALUATION REPORT

11.1.1 During the life of this contract, the contractor's performance will be evaluated on an interim and final basis pursuant to FAR Subpart 42.15. Evaluation will become part of the contract file and will be used

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11.1.2 Contractor Performance Assessment Report System (CPARS) is an on-line reporting system https://www.cpars.gov/. The Contractor Performance Report is completed by the COR electronically and sent to the Contractor for review and approval at the end of each performance period as an interim report and at the end of the contract performance as a final report. After review by the Contracting Officer, the report becomes a permanent record of the Contractor's past performance.

11.2 SECURITY

a. To perform the work specified herein, contractor personnel will require access to sensitive data, regular access to HHS-controlled facilities, and/or access to HHS information systems. The Government has determined the position sensitivity under this effort to be Level 1.

b. To gain access to the sensitive data, HHS-controlled facilities, and/or HHS information systems, the Contractor shall comply with Homeland Security Presidential Directive 12, Policy for a Common Identification Standard for Federal Employees and Contractors, and with the personal identity verification and investigation procedures obtained in:

(i) HHS Information Security Program Policy, http://www.hhs.gov/ocio/securityprivacy/

(ii) HHS Office of Security and Drug Testing, personnel Security/Suitability Handbook, http://www.hhs.gov/ocio/policy/hhs-ocio-2011-0003.html

(iii) Reserved

(iv) HHS HSPD-12 Implementation Policy (draft)

c. The minimum Government investigation for a non-critical sensitive position is a National Agency Check and Inquiries (with fingerprinting), which consists of searches of records covering specific areas of a person's background during the past five years. Those inquiries are sent to current and past employers, schools attended, references, and local law enforcement authorities. More restricted positions, above non-sensitive, require more extensive documentation and investigation.

d. Contractors should ensure that the employees whose names they submit have a reasonable chance for access approval. Delays associated with rejections and consequent reinvestigations may not be excusable.

e. Typically, the Government investigates personnel at no cost to the Contractor, but the expense of multiple investigations for the same position is difficult to justify. Consequently, multiple investigations for the same position may, at the Contracting Officer's discretion, justify reduction(s) in the Contract price of no more than the cost of the extra investigation(s).

f. Language similar to this Security section shall be included in any Sub-Contracts which require Sub- Contractor personnel to have access to an information system, access to sensitive data, regular or prolonged access to a HHS-controlled facility, or any combination of these three.

g. Inquiries, including requests for forms and assistance, should be directed to the Contracting Officer or his/her designee, listed in the Contract.

h. Within seven (7) calendar days after final acceptance of the work specified herein, the Contractor shall return all identification badges to the Contracting Officer or his/her designee.

11.3 REFERENCES: The work performed under this contract will assist the IHS in better meeting legislative mandates and associated implementation guidance from OMS, HHS, NIST, and US Cert. Statutes and Acts generally applicable to IHS security include, but are not limited to the following:

• Health Information Technology for Economic and Clinical Health Act

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• Federal Information Security Management Act (FISMA), part of the E-Government Act of 2002

(Public Law 107-347, Title Ill).

• OMB Circular A-130 and Appendix Ill, Security of Federal Automated Information Resources

• OMB Circular A-11, Preparing, Submitting, and Executing the Budget

• Presidential Decision Directive 63 (POD 63)

• NIST Special Publications - 800 Series

11.4 IDENTIFICATION AND DISPOSITION OF DATA, REPORTS, AND OTHER DELIVERABLES

A. The Contractor not permitted to make use of any data derived from these services for any purpose not directly related to and/or authorized by the Albuquerque Area Indian Health Service. All patient data/information are subject to the Privacy Act and the Confidentiality of Information Clause (HHSAR 352.224-70)

B. Upon completion/termination of the contract, all information, statistical or analytical material or reports and other data generated by the Contractor shall become the property of the Albuquerque Area Indian Health Service.

C. The Contractor is prohibited from gathering data, statistics, or use of material for publication and/or research for its own benefits. Obtain prior approval before dissemination of information from the Government Contracting Officer for the release or dissemination of information related to this contract.

11.5 ADDITIONAL REQUIREMENTS CONCERNING DATA, DATA RIGHTS AND COMPUTER SOFTWARE

11.5.1 Notwithstanding any other clause concerning data, data rights and computer software and hardware under this Contract. All data produced, recorded, transferred or manipulated under this Contract shall remain the exclusive property of the Government irrespective or the manner or method of recording or storage and no matter what form of computer mechanism used in the processing of said information or data. The Government shall retain exclusive right and domain over any by-product produced under this Contract, or any other use of the data produced under this Contract by either plan or accident.

11.5.2 Copies of the final Reports and Deliverables under each task must officially sent to the Indian Health Service and kept on file by the Contractor. At the end of the contract, all files must be kept by the Contractor for audit purposes.

11.5.3 Works other than Software Development or Enhancements

11.5.4 No software will be developed, modified, or enhanced under this acquisition.

SECTION 12 - FEDERAL ACQUISITION REGULATIONS (FAR) 48 CFR CHAPTER CLAUSES

12.1 CLAUSES INCORPORATED BY REFERENCE - FAR 52.252-2 (FEB 1998)

This Contract incorporates FAR provisions/clauses referenced, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The full text of a clause accessed electronically at this website address: FAR - https://www.acguisition.gov/far/index.html.

FAR

Clause Title Date

52.203-3 Gratuities Apr 1984 52.203-5 Covenant against Contingent Fees May 2014

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52.203-6 Restrictions on Subcontractor Sales to the Government Sep 2006 52.203-7 Anti-Kickback Procedures May 2014 52.203-8 Cancellation, Rescission, and Recovery of Funds for Illegal or Improper

Activity May 2014

52.203-10 Price or Fee Adjustment for Illegal or Improper Activity May 2014 52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber Content Paper May 2011 52.204-9 Personal identity Verification of Contractor…