Solicitation No. 75H71021R00002 - CHCF Emergency Medicine Physician Services.pdf

Emergency Medicine Physician Services – Crownpoint Health Care Facility (CHCF) Solicitation No: 75H71021R00002

ISSUE DATE: October 19, 2020 DUE DATE: November 20, 2020

The Navajo Area Indian Health Service, Crownpoint Health Care Facility is Requesting for Proposals from interested Offerors to provide Emergency Medicine Physician Services It is requested that you review the enclosed RFP proposal instructions and provide this office with a proposal, utilizing the information contained therein. The Government contemplates award of a requirements type firm fixed price contract resulting from this solicitation.

COMPLETION OF SOLICITATION REQUIREMENTS

Offeror(s) shall submit the following documents, ensuring all forms are completed in its entirety before signing proposal:

1. Standard From 1449: Offeror(s) shall fully complete blocks 17a, 30a, 30b and 30c.

2. Section B-2, Fee Schedule

3. Section E-2, 52.212-2 Evaluation-Commercial Items (OCT 2014), Contractor’s responses to evaluation factors.

4. Active registration in the System for Award Management

5. Section E-3, 52.212-3 Offeror Representation & Certifications – Commercial Items (AUG 2020)

All proposals shall be sent to the below address by 12:00 PM (MST) on November 20, 2020

Please provide three (3) copies

Offerors’ proposal shall be prepared and submitted in accordance with Paragraph E.1 52.212-1 Instructions to Offeror Commercial Items. This paragraph shall stipulate the submission of all required documents, certifications, etc., to determine your responsibility of providing the required services. All proposals shall be received in the Department of Acquisition Management and Contracts by the due date listed above.

Crownpoint Health Care Facility Attn: Stephen Silversmith, Contract Specialist NM State Highway 371 & Navajo Route 9 PO Box 358 Crownpoint, NM 87313

MARK YOUR ENVELOPE: “RFP – Emergency Physician Services”

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

Crownpoint NM 87313 P.O. Box 358 Crownpoint Health Care Facility

CODE 16. ADMINISTERED BYCODE

X

X

621111

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR50

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

11/20/2020 1200 MS

10/19/2020

STEPHEN SILVERSMITH

(No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H71021R00002

5. SOLICITATION NUMBER

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

1 50OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Crownpoint, NM 87313 P.O. Box 358 NM State Highway 371 & Navajo Route 9 Crownpoint Health Care Facility

15. DELIVER TO

Crownpoint NM 87313 P.O. Box 358

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$12.00

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

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Crownpoint Health Care Facility

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

The Contractor Physician shall provide Emergency Medicine Physician services to the Crownpoint Health Care Facility in Crownpoint, New Mexico, in accordance with the Performance Work Statement contained herein.

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

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

MARGARET J. SHIRLEY-DAMON

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

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

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

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

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

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:

REF.

To be cited on each task order issued against this contract.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

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

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

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

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

2 2 of

Table of Contents

SECTION A - SF1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SECTION B – CONTINUATION BLOCK PAGE

B-1 Purpose of Contract 4

B-2 Fee Schedule 4

B-3 Performance Work Statement and Performance Based Matrix (Page 11) 5-15

B-4 Non-Discrimination in Services, Benefits, and Facilities 16

B-5 Period of Performance 16

B-6 Contracting Officer Responsibility 16

B-7 Contracting Officer’s Representative (COR) 16

B-8 Task Orders 16-17

B-9 Invoice Submission 17-18

B-10 Health Insurance Portability and Accountability Act (HIPAA) 18

B-11 Department Supervisory Point of Contact for Medical Facility 18

B-12 Contractor’s Representative 18

SECTION C – CONTRACT CLAUSES

C-1 52.202-1 Definitions (Jun 2020) 18-19

C-2 52.204-9 Personal Identity Verification of Contractor Personnel (Jan 2011) 19

C-3 52.209-5 Certification Regarding Responsibility Matters (Aug 2020) 19-20

C-4 52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction (Feb 2016) 20-21

C-5 52.212-4 Contract Terms and Conditions – Commercial Items (Oct 2018) 21-24

C-6 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders (Oct 2020) 24-29

C-7 52.216-8 Fixed Fee (Jun 2011) 29

C-8 52.216-18 Ordering (Aug 2020) 29

C-9 52.216-21 Requirements (Oct 1995) 29-30

C-10 52.217-8 Option to Extend Services (Nov 1999) 30-31

C-11 52.217-9 Option to Extend the Terms of Contract (MAR 2000) 31

C-12 52.232-18 Availability of Funds (APR 1984) 31

C-13 52.237-7 Indemnification and Medical Liability Insurance (JAN 1997) 31-32

C-14 52.252-2 Clauses Incorporated by Reference (Feb 1998) 32

C-15 Department of Health and Human Services Acquisition Regulation (HHSAR) (48 CFR CHAPTER 3) CLAUSES 32

SECTION D – CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D-1 Contractor’s Performance Assessment Report (CPAR) 33

SECTION E – SOLICITATION PROVISIONS

E-1 52.212-1 Instructions to Offerors – Commercial Items (JAN 2017) 33-36

E-2 52.212-2 Evaluation – Commercial Items (OCT 2014) 36-37

E-3 52.212-3 Offeror Representations and Certifications – Commercial Items (Aug 2020) 37-49

E-4 52.204-26 Covered Telecommunications Equipment or Services – Representation (Dec 2019) 49

E-5 52.225-25 Prohibition on Contracting With Entities Engaging in Certain Activities or Transactions Relating to Iran – Representation and Certifications (Jun 2020)

E-6 52.217-5 Evaluation of Options (JULY 1990) 50

E-7 52.233-2 Service of Protest (SEPT 2006) 50

B-1 PURPOSE OF CONTRACT

The Contractor Physician shall provide Emergency Medicine Physician Services, in accordance with Section B-3, performance work statement requirements.

Duties and responsibilities of the Contractor shall encompass outpatient and inpatient services to IHS patients.

The medical facilities to be serviced are:

Facilities:

1. Crownpoint Health Care Facility, Crownpoint, New Mexico

B-2 FEE SCHEDULE

This is a Firm Fixed Price (FFP) Requirements-type service contract. The FFP for each line item shall be all-inclusive of all necessary labor, materials, equipment, facility, supplies, housing, permits, licenses and Federal, State and local taxes to furnish medical services in accordance with Performance Work Statement (PWS) in Section B-3.

FEE SCHEDULE – BASE YEAR

Date of Award to December 31, 2021

ESTIMATE

QUANTITY

OF

HOURS

HOURLY

RATE

ESTIMATED

TOTAL

COST

Emergency Medicine Physician 8000 or to be determined per Date of Award

FEE SCHEDULE – FIRST YEAR OPTION

January 1, 2022 to December 31, 2022

ESTIMATE

QUANTITY

ESTIMATED

TOTAL

COST

Emergency Medicine Physician 8000 $ $

FEE SCHEDULE – SECOND YEAR OPTION

January 1, 2023 to December 31, 2023

ESTIMATE

QUANTITY

ESTIMATED

TOTAL

COST

Emergency Medicine Physician 8000 $ $

Per FAR 16.503(a)(1) this estimate is not a representation to an offeror or contractor that the estimated quantity will be required or ordered, or that conditions affecting requirements will be stable or normal. The contracting officer may obtain the estimate from records of previous requirements and consumptions, or by other means, and should base the estimate on the most current information available.

In the event the Contractor is unable to provide staff coverage due to unforeseen absences, (i.e., Illness, Leave, AWOL, Act of God), a penalty fee of the listed hourly rate plus 30% administrative cost, will be assessed per hour for loss of coverage per scheduled shift.

B-3 PERFORMANCE WORK STATEMENT (PWS)

B-3.1.0 General: This Performance Work Statement (PWS) describes the requirements for a non-personal service Contractor Physician to provide coverage for 100% of night and holiday shifts and 100% of those day shifts that our permanent emergency department providers cannot staff in the emergency department at the Crownpoint Health Care Facility (CHCF) in Crownpoint, New Mexico.

B-3.1.1 Background: The Indian Health Service (IHS) is an agency within the US Dept. of Health and Human Services and is responsible for providing federal health services to American Indians and Alaska Natives. The goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Natives. The IHS currently provides health services to approximately 1.5 million American Indians and Alaskan Natives who belong to one of the 557 federally recognized tribes in 34 states. The Navajo Area IHS administers health centers and hospitals providing health care to approximately 201,583 members of the Navajo Nation. The Navajo Nation is the largest Indian tribe in the United States and has the largest reservation, which encompasses more than 25,516 square miles in northern Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico. The NAIHS is the primary provider of inpatient, ambulatory care, preventative and community health, and environmental health services for members of the Navajo Nation.

The CHCF is a small rural hospital with a non-designated trauma level emergency department, emergency department fast track, inpatient unit, and numerous ambulatory care clinics. The CHCF emergency department operates 24 hours a day, 365 days a year. The emergency department includes the fast track which operates daily, including weekends and holidays, with limited hours.

The inpatient unit has an average of 5 patients daily with a typical maximum of 12 patients. There is no intensive care unit or surgical capabilities including no respiratory therapy and no anesthesia services. The labor and delivery unit is on long term divert and any deliveries that happen at CHCF will take place in the emergency department which has a dedicated room set up for this purpose.

There is an on call OB resource coverage provided by midwives or FP/OB when available to assist with any obstetric patients that present to the emergency department after 20 weeks gestational age.

Ground and air transport is available for patient transfers to higher-level-of-care facilities (located 1- 2 hours away by ground).

B-3.1.2 Scope: The Contractor Physician shall provide services to include: emergency care, includes fast track patients, admissions/transfers of patients (as medically indicated), and provision of care to inpatients as needed. “Provision of care to inpatients” includes admitting patients to the inpatient unit with associated documentation and orders. Specifically, the Contractor Physician shall be responsible for any admissions to the hospital and all inpatient coverage and services that occur when there is no Hospitalist on-duty. Generally there is a Hospitalist on duty from 8:00am to 6:00pm, 365 days of the year. Admission and other orders shall include anything the patient needs until approximately noon the day following admission. A well detailed ED note shall be completed prior to 8:00am when the Hospitalist comes on duty, as well as the provision of care to inpatients as needed. There is NOT an overnight Hospitalist service at the CHCF. The Hospitalist when going off duty, which is generally 6:00pm to 8:00pm, will transfer care of inpatients to the Contractor Physician at the end of his/her shift. The Contractor Physician shall cover the inpatients care and needs until the Hospitalist comes on duty. There will be provider to provider sign out with the Contractor Physician at the end of the Hospitalist shift and at the beginning of their next shift.

B-3.1.3 Place of Performance: The Contractor Physician shall be assigned to the emergency department at the CHCF. The Contractor Physician shall provide care to all departments as needed.

B-3.1.4 Point of Contact: The following supervisory staff will have full authority to act for the Government on all matters relating to the daily operation of the contract and will be responsible for the performance of the work. The point of contact(s) will follow the ordering of staff listed below:

Dr. Kim Raney, Acting Director of the Emergency Department Dr. Diane Adams, Chief of Staff Dr. Miranda Haley, Co-Chief of Staff Dr. Mary Slaughter, Clinical Director

An alternate may be designated, but the points of contact shall identify those times when the alternate shall be the primary point of contact.

B-3.1.5 Availability: The point of contact or their designee will be available via telephone 24 hours a day, seven days a week including federal holidays.

B-3.2.0 Government Furnished Information, Property and Services:

B-3.2.1 Information: All government unique information related to this requirement, which is necessary for Contractor Physician performance, will be made available to the Contractor. The Contracting Officer or designee will be the point of contact for identification of any required information to be supplied by the Government.

B-3.2.2 Joint Use by the Government and the Contractor: Except for the property and service listed in B-3.3.0 and B-3.4.0, the Government will provide, for joint use by the Government and the Contractor Physician, all necessary equipment, supplies and clinic space to perform the services under this contract.

B-3.2.3 GSA Vehicle: If required by the position, authorization will be in accordance with NAIHS Chapter 12, Section 13 Motor Vehicle Management. Contractors may ride in Government vehicles but not authorized to drive a Government vehicle.

B-3.2.4 Government Housing: One three-bedroom unfurnished government housing unit may be available for Contractor Physician use with rent and utilities charged in accordance with CHCF housing policy.

Linens, day-to-day supplies (soap, toilet paper, food, etc.) and cleaning is the sole responsibility of the Contractor Physician. Structural issues (broken windows, broken furnace, and plumbing problems) will be addressed by CHCF maintenance.

B-3.2.5 Pharmacy Tokens: All Contractor Physicians appointed to the CHCF Medical Staff shall comply with the Drug Enforcement Agency and the State of New Mexico’s two-factor authentication Electronic Prescription of Controlled Substances (EPCS) requirements. The Contractor Physician shall obtain an HID USB token to meet identity verification for prescribing controlled substances with in IHS and the HID USB token shall be compatible with CHCF’s Electronic Health Record (EHR) and the Resource Patient Management System (RPMS). The Contractor Physician or their respective staffing company shall incur all cost associated with obtaining an HID USB token.

B-3.3.0 Contractor Exclusive Use:

B-3.3.1 Personal Protective Equipment (PPE): The Government will furnish the Contractor Physician with appropriate PPE. The Government will be responsible for any repair, cleaning, and inventory required for the PPE. This does not include any type of uniform, scrubs or laboratory coat. The Government will provide facility specific contractor identification badges for each Contractor Physician. A $5.00 fee will be charged for lost or destroyed identification badges.

B-3.3.2 Training: Facility specific orientation/training necessary for the Contractor Physician to perform the required duties, e.g., NAIHS information technology (IT) systems and operational procedures.

Training will be provided ONLY if the subject matter is necessary to improve or enhance the quality of medical services or includes mandates made by the NAIHS or Crownpoint Service Unit while the Contractor Physician is working under this contract. Training will not be provided for purposes of continuing education, career development, or individual development.

B-3.3.3 Orientation. The Contractor Physician providing service under this contract shall attend mandatory orientations and training specified by the Government. New-provider orientation and training may be scheduled for 1-3 days. Orientation is generally 1 day. The Contractor Physician proposal shall include planning and compensation for orientation. Please note that new Contractor Physicians can NOT be on-boarded on weekends or holidays as the following necessary departments are not available: Information Technology (IT), Human Resources (HR), Medical Records, and Acquisition.

Orientation hours are generally Monday to Friday from 8:00am to 8:00pm. The provider shall be prepared to see patients during their orientation.

B-3.3.4 Protection of Government Buildings, Equipment, and Vegetation: The Contractor Physician shall use reasonable care to avoid damaging existing buildings, equipment, and vegetation on the Government installation. If the Contractor Physician fails to use reasonable care and causes damage to any Government property, the Contractor Physician shall replace or repair the damage at no expense to the Government as the Contracting Officer directs. If the Contractor Physician fails or refuses to make such repair or replacement, the Contractor Physician shall be liable for the cost, which may be deducted from the contract price.

B-3.4.0 Contractor Furnished Property: Except for the property specified in paragraph 3 as government furnished, the Contractor Physician shall provide all uniforms and other personal medical instruments, subject to the following: “Other personal medical instruments” are defined as Contractor Physician owned items and may include but are not limited to stethoscope, scissors, etc. as appropriate to the work unit. The Contractor Physician shall maintain and clean their equipment and shall not use unsafe equipment or supplies at any time during performance of this contract. All Contractor Physician furnished equipment and supplies shall be subject to inspection by the Government and approval by the Contracting Officer Representative (COR) prior to use by the Contractor Physician. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

B-3.5.0 Performance-based Requirements: The following are the elements of service called for under this contract. This PWS describes the desired service outcome; in their proposal, the Contractor Physician shall specify how each outcome is to be achieved, including relevant logistics, and contingency plans to achieve each element in case of unforeseen circumstances.

B-3.5.1 Staffing: The Contractor Physician shall perform the necessary medical care for patients in a variety of emergency room situations such that at least one physician is on duty at the CHCF-ED at all hours of all days (24/7/365). Since CHCF can presently staff approximately 120 shifts of non-holiday daytime shifts a year, the Contractor Physician shall coordinate coverage with the CHCF-ED director and/or CHCF clinical director. The Contractor Physician shall provide immediate medical evaluation, examination, diagnosis, treatment, and/or referral of patients who present for care in the CHCF-ED. “Present for care” includes patients referred to the emergency department by other medical providers in the CHCF system (such as outpatient clinics, outlying clinics, ED fast track, inpatient, etc.). The Contractor Physician shall provide professional advice to other CHCF providers with regard to professional management of patients being treated and/or hospitalized. The Contractor Physician shall be a resource for both permanent staff and contract providers. The Contractor Physician shall oversee and manage/co-manage all patients in the fast track portion of the emergency department as well the main emergency department. The Contractor Physician shall check the communication book at the beginning of each shift. The Contractor Physician shall attend morning medical staff meetings promptly at 7:30am Monday through Friday, non-holidays, to present all admissions and transfers since the last meeting. The Contractor Physician shall cover the range of emergency department care typically provided in a rural civilian practice of similar size. The following list is an example of the types of cases, but is not all-inclusive:

• Major trauma, including fractures of multiple extremities, stab wounds, open wounds of the chest and abdomen, head trauma, suspected spine injuries, lacerations, amputations;

• Major medical emergencies such as cardiac arrest, myocardial infarction, respiratory failure, shock;

• Obstetrical emergencies such as deliveries of single or multiple births, acute pregnancy complications, vaginal bleeding; Our Labor and Delivery Unit is on Long Term Divert.

When possible, we have an OB provider (CNM, FP/OB) on resource call.

• Pediatric emergencies, including neonatal resuscitations;

• Acute psychiatric problems, including suicide attempts;

• Lower-acuity complaints including viral illnesses, other infections, minor orthopedic problems, minor trauma, alcohol abuse (i.e., “fast track” patients);

• Other miscellaneous medical problems both acute and chronic.

B-3.5.1.a The Contractor Physician shall be responsible for any admissions to the hospital that occur when there is no Hospitalist on duty, generally from 6:00pm to 8:00am (including ED note and admission orders), as well as the provision of care to inpatients as needed. The Contractor Physician shall be responsible for attending to all patients’ needs when there is no Hospitalist on duty.

B-3.5.1.b The Contractor Physician shall be responsible to arrange transfer of all patients requiring a higher level of care or care not available at CHCF. The Contractor Physician shall be the lead provider in the facility. As such they shall be ultimately responsible for all patients until they have left the facility.

B-3.5.1.c The Contractor Physician shall be responsible for assessing, diagnosing, treating, hospitalizing (when/if indicated), and referring patients (when/if indicated) within the ED fast track when the high acuity side of the ED is not busy and when the ED fast track is not open. ED fast track is generally open at 8:30am to 9:00pm Monday through Friday with Holidays and weekends set to 10:00am to 9:00pm.

B-3.5.1.d The Contractor Physician shall be responsible for review and follow-up of lab and x-ray results received after hours, on night shifts, weekends and holidays. Labs drawn at the outlying clinics are often resulted in the evening and panic values will be called to the Contractor Physician. The Contractor Physician will conduct follow-up of positive culture results in accordance with hospital infection prevention policies. This shall include ensuring receiving facilities are notified in the case of patient transfers.

The Contractor Physician shall notify medical staff of all deaths and shall document in the medical record all in facility and out of facility deaths if they are notified by

EMS.

B-3.5.1.e The Contractor Physician shall also serve as medical control for the Navajo Nation Emergency Medical Service (EMS) stationed in Crownpoint, New Mexico (in accordance with CHCF policies and procedures) and other area EMS as needed.

B-3.6.0 Quality of care by physicians: The Contractor Physician will provide medical care according to the standards of medical practice adopted by the Crownpoint Health Care Facility as defined by, but not limited to:

• CHCF Governing Board bylaws

• CHCF Medical Staff bylaws, rules and regulations, and policies

• CHCF ED policies and procedures

• Centers for Medicare and Medicaid Services (CMS)

• The Joint Commission (TJC)

• Applicable state licensure boards

• Applicable federal authorities (Indian Health Service, DEA, etc.)

B-3.6.1 Documentation of care by physicians: Contractor Physician shall generate and maintain proper medical record information on patients to whom treatment is provided in accordance with IHS, TJC, and CMS regulations. The Contractor Physician shall prepare all medical record documentation to meet or exceed the established standards of the IHS facility to include, but not limited to: timeliness, legibility, accuracy, content, and signature. Contractor Physician shall complete all third party reimbursement forms. All medical record information and documentation generated in the performance of this contract must be completed and will remain the property of and subject to the exclusive control of the IHS. The Contractor Physician is expected to use the Electronic Health Record for all documentation.

The Contractor Physician shall complete all medical record documentation for patients seen at the facility prior to them leaving the facility. This shall include completing all required documentation prior to the patients transfer out of the facility. All other medical record documentation shall be completed within 48 hours of the visit. The department point of contact (or designee) will not be able to sign any time sheets unless the medical records department confirms there are no chart delinquencies.

Contractor Physician shall check-out with the medical records department before turning in their time sheet or leaving CHCF. Failure for Contractor Physician to complete medical record documentation before departing the facility may result in a delay of the processing of all invoices and discipline in accordance with the medical staff bylaws.

B-3.6.2 Immunizations: The Contractor Physician shall provide proof of contracted physician immunizations. This should include proof of immunity against Measles, Varicella, and Rubella.

Influenza vaccination (or an approved exemption request) is required annually by October 31.

Tetanus, Diphtheria, Pertussis, Hepatitis A, and Hepatitis B immunizations are recommended.

Results of the most recent tuberculin skin test shall be provided.

B-3.6.3 Providing Reports: The Contractor Physician shall establish a reporting system that includes significant findings, major problems encountered, and plans for their resolution, including quarterly reports of provider certifications/expiration dates for ATLS, ACLS, PALS, BLS, NRP, and ALSO

B-3.7.0 Work Flexibility STAFF COVERAGE DUE TO UNFORESEEN ABSENTEEISM:

Due to short staffing CHC F currently does not have regular providers to fully staff the emergency department.

Our present full time providers live out of state making last minute coverage exceedingly difficult, if not impossible, to provide coverage if the Contractor Physician cannot cover a shift. The Contractor Physician must have a detailed contingency plan to provide coverage due to unforeseen absenteeism or tardiness. In the event the Contractor Physician is able to be replaced by a permanent federal hire the contractor will be responsible for all expenses and lost revenue incurred for said coverage by means of the penalty fee which shall be the hourly rate plus 30% administrative cost.

B-3.7.1 Initial Roster: Data from past experience at CHCF indicates that an average of 12 physicians are needed to cover emergency services each quarter of the year. Therefore, the Contractor Physician’s staffing company must have a minimum of 12 Contractor Physicians, fully credentialed and qualified as defined in the PWS, available to work on the first day of the contract.

B-3.7.2 Illness: The Contractor Physician shall provide written documentation from a qualified health care provider for absences of two (2) or more consecutive days, due to illness, stating:

A. The cause of the current illness/incapacitation AND

B. Indicating the contractor as contagious or non-contagious.

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

B-3.7.3 Conduct: The Contractor Physician shall meet standards as listed in the Federal Code of Conduct.

In the interest of patient care, Contractor Physician shall interact in a professional manner with patients, colleagues, and co-workers at all times.

B-3.7.4 Performance Evaluation: The Contractor Physician’s performance will be evaluated in accordance with the standards set forth in the contract and the medical staff bylaws, rules and regulations and approved hospital policies and procedures. This will be monitored by periodic chart reviews, patient satisfaction surveys and review of any formal patient complaints. Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome shall constitute a breach of contract.

B-3.7.5 Performance Based Matrix:

PERFORMANCE

OBJECTIVES

INDICATOR STANDARDS SURVEILLANCE

PLAN

CONTRACTOR

INCENTIVE

1) The Contractor Physician shall cover the Crownpoint Health Care Facility Emergency Department.

1) Quality of Care:

● The Contractor Physician shall provide immediate medical evaluation, treatment, and/or referral of patients who present for care in the CHCF emergency services area.

The emergency medical care provided shall cover the range of emergency room care typically provided in a rural civilian practice of similar size and remoteness.

● The Contractor Physician shall also provide medically appropriate care to the inpatient service. The Contractor Physician shall be responsible for admitting patients and providing coverage for the inpatient service when the Hospitalist is not available.

● The Contractor Physician shall serve as medical control for the Navajo Nation Emergency Medical Service stationed in Crownpoint, NM.

● When the Electronic Health Record (EHR) becomes operational in the Emergency Department;

Contractor Physicians shall be expected to use it for documentation.

1) Contractor Physician shall provide medical care according to the standards of medical practice adopted by the Crownpoint Health Care Facility pursuant to :

• Governing Board bylaws.

• Medical staff bylaws, rules, and regulations, and policies.

• Centers for

Medicare Medicaid Services (CMS).

• The Joint Commission (TJC).

• Applicable state licensure boards.

• Applicable federal authorities (I.H.S., DEA, etc.).

• Other applicable regulatory agencies.

1) Surveillance systems will include:

• Periodic chart reviews.

• Review of morbidity & mortality reports.

• Review of error reports.

• Substantiated complaints.

• Random sampling.

2) No more than three (3) failures per month to comply with documentation standards:

• Signing off on lab reports.

• Signing off on x-ray reports.

• Correcting charting errors.

• Chart completions.

3) No greater than three

(3) valid complaints of deficiencies regarding patient care, Contractor Physician behavior and/or professional demeanor/performance per six (6) month period.

4) No more than one (1) failure per quarter to respond to PI/QA and periodic review reports.

1) Payment of Contract monthly rate for Satisfactory Performance.

2) Successful Evaluation using the National Institutes of Health (NIH) Contractor Performance Report.

3) Contract Extension per Option Year.

B-3.7.6 Identification of Contractor: The Contractor Physician shall wear government issued contractor identification badge during performance of duty.

B-3.7.7 Management of Medical Information: The Contractor Physician shall manage all patient information, records, information entered into the RPMS in accordance with HIPAA standards, Privacy Act, and NAIHS Service Unit and/or Health Center specific policies and protocols.

B-3.7.7.a The Contractor Physician shall ensure adherence to DHHS IT system security policies and procedures. The IT policies and procedures will be made available to the Contractor Physician.

B-3.7.7.b The Contractor Physician shall immediately report to the Contracting Officer Representative (COR) any information or circumstances that may violate any statue, policy, or procedure.

B-3.7.7.c IHS Information Technology System: In performance of this contract, the Contractor Physician shall adapt to and successfully utilize IHS information systems that are deemed by the Supervisor as necessary for acceptable contractor performance. (RPMS)

The Contractor Physician shall ensure that NAIHS information technology system security policies and procedures are adhered to. The IT policies and procedures will be made available to the Contractor Physician at each NAIHS facility.

B-3.8.0 Contractor Qualification Requirements:

B-3.8.1 Qualifications:

B-3.8.1.a Credentials & Privileges:

The Contractor shall ensure that the Contractor Physician apply for Medical Staff membership and granted privileges through the hospital governing body. In accordance with the hospital bylaws and Governing Body process, the hospital will notify the Contractor and the candidate in writing of any individual not granted Medical Staff membership or privileges. Individuals who are not credentialed and granted privileges by at least one facility covered by the contract will be deemed unqualified to perform services under the contract.

B-3.8.1.b Licensure:

The Contractor shall ensure that the Contractor Physician holds and maintains active and unrestricted state license(s), as applicable, to practice independently in their professional field an active, to practice medicine in the United States, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

The Contractor shall ensure that the Contractor Physician be board certified, or board eligible by one of the following American Board of Medical Specialties (ABMS) recognized boards:

American Board of Emergency Medicine, American Board of Family Practice, American Board of Internal Medicine or other acceptable subspecialties with appropriate board certification or board eligibility and greater than two (2) years documented emergency medicine experience.

The Contractor Physician shall have an unrestricted DEA registration.

B-3.8.1.c Experience:

The Contractor shall ensure that the Contractor Physician has recent extensive experience in emergency medical care. The government defines recent emergency medical care experience to be within the past year and at least 40% of patients treated in an emergency department setting. The Contractor shall ensure that the Contractor Physician has at least greater than two (2) years emergency medicine experience and preferably emergency medicine trained.

B-3.8.1.d Drug Enforcement Agency (DEA):

The Contractor Physician must provide proof of an active and unrestricted DEA number.

B-3.8.2 Competencies:

The Contractor Physician shall be proficient in essential emergency medicine skills demonstrable by ONE of the following:

• Completion of an emergency medicine residency within the last 4 years.

• Presentation of a log documenting skill performance during the last 2 years.

• Copies of skill competency documentation from other facilities within the last 2 years.

• Signed attestation summarizing skill performance during the last 2 years.

• Presentation of CME documentation from courses providing hands-on training and evaluation of skill performance within the last two (2) years (non-ED trained).

• A combination of the above.

Contractor Physician shall be responsible for providing the above documentation, and the COR will have the authority to determine whether the documentation provided is adequate to support proficiency.

B-3.8.3 Continuing Medical Education (CME):

Documentation of CME is not required if within one year after graduating from an emergency medicine residency. Otherwise, a report documenting an average of 30 hours of CME per year in emergency medicine for the past three (3) years shall be required.

B-3.8.4 Health Requirements/Conditions of Employment:

The Contractor Physician shall also provide the following documentation before employment:

• Immunity to Rubella, Mumps, Measles

• Immunity to Hepatitis A and B

• History of chicken pox disease or positive titer

• Tetanus Diphtheria (Td) within the last 5 years

• Documentation of receiving a TB Manteaux skin test (PPD) within the past 12 months with documentation of follow-up for a positive test

• A signed declination of the Hepatitis B vaccination series will be accepted.

• Full disclosure of any condition that could affect the contractor physician’s ability to perform their duties.

B-3.8.5 Language Requirement and Cultural Awareness: The Contractor Physician shall read, understand, speak and write English to effectively communicate with patients and other health care workers, and shall be respectful of the local, American Indian and Alaska Native culture.

B-3.8.6 Information Technology Skills: The Contractor Physician shall possess basic knowledge, skills and abilities to use a computer. Familiarity with RPMS and past experience with our patient population would be much appreciated.

B-3.8.7 Background Checks: Contractor Physician shall undergo pre-screening, which includes fingerprinting as required by federal law. A complete pre-security package includes: FD-258 Fingerprint Cards, OF-306 Declaration of Federal Employment, OF-306 Childcare Addendum form, IHS Provisional Authorization Form, Current resume, college transcripts and HHS-745 HHS ID Badge Request Form. These forms will be provided by the CHCF human resources (HR) department.

The Contractor Physician shall provide all requested information necessary to perform Level I and Level II background checks. At the time of candidate presentation the Contractor Physician candidate will be required to complete and submit an OF-306 form with their CV for the purpose of security pre-screening tool. The Contractor Physician shall comply with the requirement to obtain security investigations. The Contractor Physician shall work with the HR department to ensure that the pre-employment screening process is completed in a timely manner.

The Contractor Physician shall be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

B-3.8.8 Any Contractor Physician demonstrating impaired judgment shall not be permitted to work in the NAIHS. The Government reserves the right to remove from the facility any Contractor who in the judgment of a licensed physician is impaired by drugs or alcohol. The Government also reserves the right to remove from the facility any Contractor who in the judgment of the Emergency Department Director, Clinical Director or Chief of Staff poses a risk to patients or there are serious patient care concerns.

B-3.9.0 Technical Direction:

B-3.9.1 The COR does not have the authority to, and will not, issue any instructions purporting to be technical direction that:

• Constitutes an assignment of additional work outside the statement of work;

• Constitutes a change as defined in the changes clause;

• In any manner causes an increase or decrease in the total estimated contract cost, fixed fee (if any), or the time required for contract performance;

• Changes any of the expressed terms, conditions, or specifications of the contract, or the terms and conditions of the contract.

B-3.9.2 All technical direction will be issued in writing by the COR. All verbal direction will be confirmed in writing within 24 hours (one business day).

B-3.9.3 The Contractor Physician shall proceed promptly with the performance of technical direction duly issued by the COR in the manner prescribed by this clause and within the authority. If, in the Contractor’s opinion, any instructions or direction by the COR falls within any of the categories defined in paragraph B-3.9.2 above, the Contractor shall not proceed but shall notify the Contracting Officer in writing within 5 working days after receiving it and shall request the Contracting Officer to take action as described in this clause. Upon receiving this notification, the Contracting Officer will either issue an appropriate contract modification within a reasonable time or advise the Contractor in writing that the instruction or direction is within the requirements of the contract and does not constitute a change under the changes clause of the contract and that the contractor shall proceed promptly with its performance.

B-3.9.4 A failure of the Contractor Physician and Contracting Officer to agree that the instruction or direction is both rescinded in its entirety; or within the requirements of the contract and does not constitute a change under the changes clause, or a failure to agree upon the contract action to be taken with respect to the instruction or direction shall be subject to the Disputes clause of this contract.

B-3.9.5 Any action taken by the Contractor Physician in response to any direction given by any person other than the Contracting Officer or the COR shall be at the Contractor Physician’s risk.

B-3.10.0 CHCF COVID-19 Guidance:

See Attachment – Crownpoint Health Care Facility COVID-19 Contractor Physician Guidance

B-4 NON-DISCRIMINATION IN SERVICES, BENEFITS, AND FACILITIES

It is the policy of the Department of Health and Human Services that no person otherwise eligible will be excluded from participation in, denied the benefits of, or subjected to discrimination in the administration of HHS programs and services based on non-merit factors such as race, color, national origin, religion, sex, gender identity, sexual orientation, or disability (physical or mental).

By acceptance of this contract, the contractor agrees to comply with this policy in supporting the program and in performing the services called for under this contract. The contractor shall include this clause in all sub-contracts awarded under this contract for supporting or performing the specified program and services. Accordingly, the contractor shall ensure that each of its employees, and any sub-contractor staff, is made aware of, understands, and complies with this policy.

B-5 PERIOD OF PERFORMANCE

1. Performance of this contract shall begin on Date of Award through December 31, 2021, unless the period is changed by written modification of the contract. This contract will be effective for one (1) base contract year and two (2) one (1) year option periods.

2. If the Government exercises its option pursuant to FAR 52.217-9 Option to Extend the Term of the Contract, the period of performance will be extended in accordance with the following schedule.

YEAR OPTION YEAR

Base Year Date of Award through December 31, 2021 First Year Option January 1, 2022 through December 31, 2022 Second Year Option January 1, 2023 through December 31, 2023

B-6 CONTRACTING OFFICER RESPONSIBILITY

Authority to negotiate changes in term, conditions, or amounts cited in this contract is reserved to the Contracting Officer.

B-7 CONTRACTING OFFICER’S REPRESENTATIVE (COR)

The COR for this contract will be:

Mr. Anthony Mattek, Safety Officer Crownpoint Healthcare Facility PO Box 358 Crownpoint, NM 87313

(505) 786 - 6250 anthony.mattek@ihs.gov

The COR is responsible for:

1. Monitoring the Contractor’s technical progress, including surveillance and assessment of performance and recommending to the Contracting Officer changes in requirement;

2. Performing technical evaluation as required;

3. Performing technical inspections and acceptance required by this contract; and

4. Assisting the Contractor in the resolution of problems encountered in performance.

B-8 TASK ORDERS

Individual Task Orders on government forms SF‐1449 (Solicitation/Contract/Order for Commercial Items) shall be utilized and issued for services rendered and authorized by NAIHS.

mailto:anthony.mattek@ihs.gov

8.1 Officials Authorized to place orders against this Contract

1. The authorized ordering officials, as listed below, shall represent the Government for the purpose of issuing and signing Individual Task Orders under this agreement.

2. The authority to obligate the Government shall be in accordance with the acquisition delegation of his/her authority.

NAIHS Medical Facilities Name: Limitation:

Crownpoint Health Care Facility Crownpoint, New Mexico 87313 Phone: 505/786-6217 Fax: 505/786-5840

Thomasina Willie Acting Supervisory Contracting Officer

$150,000

3. The authorized individuals listed under Navajo Area Indian Health Service (NAIHS) shall issue task orders ONLY in the absence of the medical facilities Acquisition Points of Contact.

Division of Acquisition Management and Contracts (DAMC) (NAIHS) St. Michaels, AZ 86515 Phone: 928/871-1310 Fax: 928/871-1447

Margaret Shirley-Damon Contracting Officer

DeeAndra Salabye Acting Chief Contracting Officer

UNLIMITED

UNLIMITED

8.2 The Government is obligated under this contract only to the extent of orders placed by authorized individuals. The Contractor shall only accept Task Orders from listed authorized individuals.

The contractor is cautioned that acceptance of orders from personnel other than those authorized herein could be considered as an unauthorized procurement and will jeopardize payment.

B-9 INVOICE SUBMISSION – The Contractor shall submit invoices in accordance with FAR

52.212-4 (g) as follows:

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

1. Contractor’s name and invoice date.

2. Contract Number and Task Order Number on each sheet attached to the invoice;

3. Description, cost or price, and the dates services were actually rendered; and payment terms;

4. The following certification shall be cited on each order/invoice submitted for payment:

“I certify that all services concerned with this invoice are accurate and complete as of the date of this invoice and that all payments requested are for appropriate purposes and in accordance with the contract terms.”

5. The Contractor shall include the following citation on each invoice submitted for payment:

“Services have been received and are acceptable in accordance with the terms of the contract.”

COR Signature Date

Authorized Ordering Official: “I hereby approve this invoice for payment”

Authorized Ordering Official’s Signature Date

Payment: Payment will be made in accordance with the Prompt Payment Regulations stated in the 5 CFR Part 1315 regulation code.

B-10 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

The Indian Health Services (IHS) is required to comply with the HIPAA in the provision of health care to IHS patients. HIPAA was implemented by the U.S. Department of Health Services, Office of Civil Rights, under the Code of Federal Regulations, Part 160 and 164. Accordingly, all health care providers, including contracted health care providers, are required to comply with HIPAA requirements. (Full text will be furnished upon request).

B-11 DEPARTMENT SUPERVISORY POINT OF CONTACT

MEDICAL FACILITY NAME

Crownpoint Health Care Facility Primary Point of Contact:

Crownpoint, New Mexico Dr. Kim Raney, Acting Director of the Emergency Department

Alternate Point of Contact(s):

Dr. Diane Adams, Chief of Staff

Dr. Miranda Haley, Co-Chief of Staff

Dr. Mary Slaughter, Clinical Director

B-12 CONTRACTOR’S CUSTOMER SUPPORT REPRESENTATIVE

Designate a person whom we may contract for prompt Contract Administration in the event your firm receives a contract as a result of this solicitation.

Name: Title:

Address:

Email:

Phone Number:

SECTION C – CONTRACT CLAUSES

C-1 FAR 52.202-1, Definitions (Jun 2020) When a solicitation provision or contract clause uses a word or term that is defined in the Federal Acquisition Regulation (FAR), the word or term has the same meaning as the definition in FAR 2.101 in effect at the time the solicitation was issued, unless-

(a) The solicitation, or amended solicitation, provides a different definition;

(b) The contracting parties agree to a different definition;

(c) The part, subpart, or section of the FAR where the provision or clause is prescribed provides a different meaning;

(d) The word or term is defined in FAR part 31, for use in the cost principles and procedures; or

(e) The word or term defines an acquisition-related threshold, and if the threshold is adjusted for…