SOO - National COVID-19 Critical Care Response Team.pdf

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Indian Health Service National COVID-19 Critical Care Response Team

STATEMENT OF OBJECTIVES (SOO)

4/15/2020 (DRAFT DOCUMENT SUBJECT TO CHANGE)

I. BACKGROUND:

The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. The mission of IHS is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level and assure that comprehensive, culturally acceptable personal and public health services are available and accessible to members of the 574 federally recognized Tribes across the United States. The Indian Health Service Strategic Plan for Fiscal Year 2019-2023 guides ongoing efforts to provide health care for American Indians and Alaska Natives across the United States. The plan addresses access to quality health care services, strengthening organizational capacity, and improving operations and communications across the system.

On March 13, 2020, the President declared the ongoing Coronavirus Disease 2019 (COVID-19) pandemic of sufficient severity and magnitude to warrant an emergency declaration for all states, tribes, territories, and the District of Columbia pursuant to section 501 (b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121-5207 (the “Stafford Act”). COVID-19 patients who admit to the hospital are likely to be in extreme respiratory distress and require 24 hour/7 days a week intensive medical care. IHS federally managed and tribally managed hospitals and other facilities lack an adequate supply of trained and available physicians, nurses, and other health professionals with foundational emergency medicine/critical care knowledge and skills. Specifically, IHS anticipates a need to augment the doctors, nurses, and other health professionals at many federally managed or tribally managed hospitals, with a mobile response team comprised of critical care medical, nursing, respiratory, and other experts that can provide direct patient care and teach frontline staff how to manage these complex critical care patients. IHS must do everything possible to stabilize and treat COVID-19 patients, and other critically ill patients, save lives, and stop the continued spread of COVID-19 across Indian Country.

As of 4/13/2020, IHS has at least 1,124 confirmed COVID-19 cases in all 12 IHS Service Areas, with the majority of confirmed cases in Navajo Area (636); Albuquerque Area (175); and Oklahoma City Area (76). Source: IHS daily Coronavirus dashboard.

https://www.ihs.gov/coronavirus/?CFID=176120161&CFTOKEN=13979843

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II. Purpose

The purpose of this contract is to deploy critical care response team(s) on an as needed basis who will provide urgent lifesaving medical care to stabilize and treat patients with suspected or confirmed COVID-19 admitted to an IHS or tribal hospital. The critical care response team(s) shall prepare and train frontline health care staff at IHS and tribal facilities using evidence-based/best practices. Critical Care Response team(s) shall deliver clinical education using a combination of approaches, including primarily onsite hands-on “at the bedside” to teach clinical competencies, support physician, and nurse clinical decision making; and synchronous or asynchronous virtual learning (when time permits). The Contractor shall ensure that offsite critical care clinical experts are available by telephone and/or virtual for provider-to-provider consultation for onsite staff and IHS or tribal medical/clinical leadership to seek advice to manage critically ill patients on a 24 hour/7 days a week basis.

III. Scope

The scope of this contract includes identification, staffing and managing multi-disciplinary, expert and mobile critical care response team(s). Critical Care Response team members shall also conduct hands-on clinical education while treating patients, in order to train the frontline health care professionals at each hospital the necessary skills and clinical competencies to perform procedures to care for the management of COVID-19 patients, and other critically ill patients.

The Contractor shall provide pre and post-engagement support to each location in the scope, which includes 24 hour/7 days a week provider-to-provider consultation, and virtual training, as needed.

IV. Period of Performance (Anticipated)

12-month Base period with additional option periods that may be exercised later. Options, if needed may be 6-month option periods.

V. Place of Performance

The location of direct patient care services includes all 23 IHS federal hospitals and 22 tribally managed hospitals. See Attachment 1: IHS Federal and Tribally Operated Hospitals Summary

Additional information about locations of service:

https://www.ihs.gov/newsroom/factsheets/ihsprofile https://www.ihs.gov/newsroom/factsheets/ihsprofile

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VI. Program Objectives and Requirements

Objective 1: Increase the survival rate of patients presenting to an IHS or tribal facility for known or suspected COVID-19.

Task Area 1: COVID-19 Critical Care Response Team Management

All patient care must be provided within nationally acceptable standards of care and guidelines, or currently available best practices. IHS recognizes that evidence-based standards of care for the treatment of patients with COVID-19 is evolving. The contractor shall have institutional knowledge and expertise with developing protocols and guidelines for treating patients with suspected or confirmed COVID-19, or shall have access to clinical experts with this knowledge and experience.

1.1 Contractor shall staff, provide all necessary administrative, logistics coordination and management necessary to deploy mobile, agile, and expert critical care rapid response team(s) to provide onsite life-saving, high quality health care to manage and treat critically ill American Indian/Alaskan Native patients.

1.2 Contractor shall staff the Critical Care Response team(s) with qualified physicians, RNs, respiratory therapists and other health professionals, as deemed necessary to meet the needs of the hospital, when directed by the designated IHS clinical leadership that one or more contractor critical care response team(s) are necessary to be deployed.

1.3 The contractor shall ensure continuity of patient care at all times during the contract period of performance.

1.3.1 The Contractor shall have adequate back-up/on-call policies, processes, and resources available for this contract, to ensure 100% coverage, for all required services.

1.3.2 All Critical Care Response Team members shall be available to be onsite within 24- 48 hour notice unless a verifiable emergency causes an excusable delay or the need for an alternate/back-up team member. In the event a team member is not available for scheduled engagement or scheduled tour of duty, the Contractor must provide notification to the government, with the reason for delay and contingency plan to ensure continuity of patient care.

1.4 Critical Care Response Team management shall include all necessary activities to establish, maintain and make team adjustments when necessary to meet requirements and objectives of the contract.

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Task Area 2: Provide evidenced-based/best practice high quality health care to treat critically ill patients, including individuals presenting to IHS or tribal facilities with suspected or confirmed COVID-19, who require intensive medical care.

2.1 The Contractor shall provide 100% coverage for all required labor categories for at least one IHS or tribal hospital in the scope of work. If resources are available, and in the event more than one location requires a team at the same time, the Contractor may be requested to provide a fully resourced team at each of the hospitals requiring services at the same time.

2.2 Contractor shall ensure that at a minimum, the labor categories identified in Task 2.3 are available for a Critical Care Response team and that all Critical Care Response team members meet or exceed the minimum requirements and performance levels during the contract performance period. See Attachment 2: IHS National COVID19 Critical Care Response Team Requirements; Attachment 3: IHS Emergency Disaster Privilege Pre-Application Checklist -

LIP.

2.2.1 The Contractor shall ensure that all services are performed by individuals who meet the minimum qualification standards identified on Attachment 2, as well as general standards for each position established by the Office of Personnel Management General Schedule qualification standards for the equivalent Job Series. Evidence must be substantiated in the individual’s current resume, curriculum vitae (CVs), verifiable references, and other required supporting documentation deemed necessary by the IHS or tribal facility to review the contractor’s qualifications in order to perform services in a patient care environment.

2.2.2 All Licensed Independent Practitioners (LIPs) must be credentialed, and at a minimum granted Disaster privileges to perform services under the contract. See also Task 2.7: Credentialing and Privileging Process & Requirements

2.2.3 The Contractor shall ensure that the individual has the necessary knowledge, skills and competencies to perform the essential duties to meet the terms of the SOO and as described in Contractor’s Performance Work Statement and Quality Control Plan.

2.2.4 All Contractors must meet mandatory federal security clearance requirements.

2.2.5 All Contractors must be willing to travel on short notice and abide by national and state travel restrictions and other laws that may be in effect to slow the spread of COVID- 19, which may include the possibility of being under a “Stay at Home” order and/or quarantined in accordance with state, tribal or local laws.

2.3 The Contractor may select to staff a team with all labor categories below or propose additional expertise (Task 2.3.6), when necessary. However, at a minimum, at least one credentialed and Disaster privileged Physician and 1-2 critical care RNs are required on each onsite team engagement. An Advanced Practice Provider with patient care experience and qualifications may be added to the team if deemed necessary, but cannot be substituted for a Physician. The contractor may staff the onsite engagement team with a Registered Respiratory

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Therapist, if there is a qualified and acceptable resource available.

Required

2.3.1 Physician services

2.3.2 Nursing services

2.3.3 Registered Respiratory Therapy services

Optional

2.3.4 Nurse Practitioner (NP)

2.3.5 Physician Assistant (PA-C)

2.3.6 Other Health Professional services

2.4 The Contractor shall ensure during the performance period(s), each team(s) is fully resourced and each accepted team member completed all required trainings and pre-clearances. Critical care response team members shall complete hospital specific orientation and required trainings, prior to arriving onsite, but no later than within the first 72 hours of Disaster privileges granted, or when arriving onsite. For this contract, fully resourced shall mean all Critical Care Response Team members meet and comply with the minimum performance standard requirements outlined in Attachment 4: Critical Care Response Team General Requirements (Non-Personal Services).

2.4.1 All LIPs are credentialed and at a minimum granted Disaster privileges.

2.4.2 Completed the necessary documentation and ISSA training to ensure appropriate access to required information technology systems (Electronic health Record and other applications).

2.4.3 Completed facility specific orientation and required IHS and/or facility new employee trainings.

2.4.4 Submitted fingerprints and required pre-clearance background investigation documentation and granted “Provisional Authorization – pending favorable adjudicated background investigation” status, as deemed by IHS Personal Security Representative/HR designee, prior to performing services in a patient care environment.

2.5 Contractor shall staff Critical Care Response team(s) that can provide onsite direct patient care 24 hours/7 days a week. The government intends that a response team may be staffing a hospital for minimally, no less than 3-5 consecutive working days per engagement, on an as needed basis. The IHS Chief Clinical Consultant, or their designee in consultation with the hospital clinical leadership will determine the total number of days onsite direct patient care is required. Any engagement that may exceed the maximum allowable hours for the Task Area and/or Labor Category shall require the advance approval of the Contracting Officer.

2.6 The Contractor shall coordinate logistics and ensure that all Critical Care Response team members are onsite at all required locations, within 24-48 hours of notification from IHS of the requirement to deploy the team. All Critical Care Response Team members must meet the minimum acceptable IHS National COVID-19 Critical Care Response Team qualification

6/18 requirements for each labor category (Attachment 2). All Licensed Independent Practitioners (MD, DO, Nurse Practitioner, PA-C, etc.) must be credentialed and granted Disaster privileges prior to seeing patients, in accordance with each hospital’s credentialing and privileging policies and application process.

2.7 Credentialing and Privileging Process & Requirements

2.7.1 General

Per the Indian Health Manual (IHM), Chapter 3, all Licensed Independent Practitioners (LIPs) (MDs, DOs; NPs; PA-Cs; etc.) shall be subject to each hospital’s credentialing and privileging requirements prior to being assigned to a patient care environment. Upon confirmation that privileges granted, the LIP can treat patients. The Contractor shall ensure each hospital’s credentialing and privileging processes are followed and that requirements for Medical Staff appointment and reappointment are met in accordance with IHS policy, each hospital’s Governing Body bylaws, CMS Conditions of Participation, and applicable national accreditation standards.

2.7.2 IHS Disaster Credentialing and Privileging Process & Requirements – Federal Hospitals only

The IHS Disaster credentialing and privileging process is applicable to IHS federal hospitals covered in the scope of this contract. Specific credentialing /privileging requirements for each tribally managed hospital where services may be performed will vary from facility to facility.

The IHS Disaster credentialing and privileging application process is the exception to the standard IHS credentialing and privileging process, and therefore, is only applicable to LIPs applying to work on the Critical Care Response team in order to provide care on short-notice, in an emergency situation, and on a short-term basis, to critically ill patients.

Incomplete and/or inaccurate credentialing and privileging files and supporting documents needed for the Pre-Application file may be basis for the LIP to be disqualified from performing services under this contract, delay the credentialing process and could result in a negative contractor performance evaluation rating, or other negative performance indicators.

2.7.3 Complete and Clean Pre-Application File Requirements

The Contractor shall ensure that all LIPs applying for Disaster privileges expeditiously submit a complete pre-application file in accordance with the IHS Disaster Credentialing and Privileges Checklist (Attachment 3). A complete and clean Disaster privileges application file submitted by each LIP, must contain:

a) The LIP’s recent resume/CV that clearly identifies all required information identified on the IHS Disaster Credentialing and Privileges Checklist (Attachment 3).

b) Supporting verification files, as required on Attachment 3.

c) Signed Statement of Understanding and Release, as required on Attachment 3.

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As deemed by IHS, each Pre-Application file must meet the minimum quality standards and requirements for the likely determination that the LIP will be granted Disaster privileges by each hospital:

d) Verification of a current, active, full, and unrestricted license or registration as a

Physician from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

e) Confirmation of relevant training, experience, current competency, and ability to perform privileges.

f) Favorable National Practitioner Data Bank (NPDB) report, and no current or previously successful challenges to licensure or registration; no subjection to involuntary termination of medical staff membership; or no subjection to involuntary limitation, reduction, denial or loss of clinical privileges.

g) Approval from authorized IHS facility leadership.

2.7.4 Additional Disaster Privilege Requirements: Within 72 hours of Disaster privileges granted, each LIP shall be subject to the following:

a) The Government will continue to verify the documents with their primary source and complete peer references and hospital affiliations verifications, according to each hospital’s Disaster privileging processes.

b) Initial Focused Professional Practice Evaluation (FPPE) will be done as part of the initial credentialing and privileging process.

c) If either requirement 2.7.4 (a) or 2.7.4 (b) are not satisfactory within, and up to, 72 hours, of being granted Disaster privileges, the hospital leadership can withdraw Disaster privileges.

2.8 Contractor must have a quality assurance process to ensure all care is delivered in accordance with national standards and best practices. All patient care must be performed and documented in accordance with CMS Conditions of Participation, and if applicable, national accreditation standards. The Critical Care Response team member (s) shall document the patient encounters in the applicable electronic health record and ensure 100% documentation of patient encounter, as deemed by the designated hospital official (s).

Task Area 3: 24 hours/7 days a week telephone/virtual remote access to trained and knowledgeable physician, nursing and other medical specialists for IHS and tribal staff to consult about critically ill patients.

During the performance period, the contractor shall ensure that offsite clinical experts are available by telephone and/or a virtual basis, for provider-to-provider consultation for onsite staff to seek advice to manage critically ill patients. Contractor must provide a combination of medical, nursing and specialist expertise who have recently managed critically ill patients, 8/18 including patients with confirmed or suspected cases of COVID-19 and other complex medical cases.

Objective 2: Increase IHS and tribal health care provider knowledge and competence to treat critically ill patients.

Task Area 4: Clinical Education

4.1 Hands-On Clinical Education Specific to Management of Patients with COVID-19

4.1.1 Critical Care Response teams shall have expert knowledge performing the necessary lifesaving procedures and teaching physician, nursing, and other health professionals evidence-based/best practices, while treating the patient (at the bedside/at the “elbow.”) Clinical education must be taught in a way that will increase both the individual learner’s knowledge, and the overall institutional knowledge.

4.1.2 The Contractor shall assess, identify, deliver and tailor clinical education based on the needs of each hospital or needs identified by IHS. The overall goal is that when the team leaves, IHS or tribal physicians, nursing, and other health professionals at that local facility have the ability to perform the procedure(s) to manage critically ill patients, specifically patients with confirmed or suspected cases of COVID-19. IHS understands that since COVID-19 is an emergent infectious disease, best practices for the management of patients with COVID-19 may not be evidence-based and could change frequently. Due to the COVID-19 pandemic, upon contract award, IHS requires at least one (1) critical response team(s) to begin immediately conducting hands-on clinical education at as many IHS hospitals as possible in order to prepare the staff at these hospitals to care for the significant influx of critically ill patients anticipated.

4.1.3 Nursing Education:

Based on IHS nursing competency checklists completed recently by IHS nurses assigned to emergency departments and ICUs who typically are not assigned to manage critically ill patients, and who are now managing ICU patients outside of a normal ICU environment, IHS nurses reported needing fundamental basic or refresher training on the following topics. At a minimum, the Contractor shall have experience teaching the following topics, but additional topics may be required at each location.

a) Clinical Decision-making for managing patients with multi-organ failure.

b) Basic intubation for patients on long-term and short-term ventilator.

c) Standards of care for managing airways.

d) Best practices for supporting the patient before they get on a ventilator including reviewing breathing treatment, oxygen flow and other topics.

e) Hour to hour management of a ventilated patient.

f) Managing the ventilator equipment in compliance with manufacture use for instruction, including proper use and care of equipment and cleaning in-between patients.

g) Nasogastric (NG) tube care.

h) Alaris pump use.

i) Central line administration and care.

j) Arterial line administration and care.

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k) Blood product administration.

l) Managing patients on perinatal dialysis.

4.2 During the contract performance period, the Contractor may be required to develop new training and/or teach in a virtual and/or clinical setting to train the IHS or tribal workforce to implement new guidelines, standards, policies, and/or practices. In the event that new or custom training is needed, the contractor shall coordinate the delivery of all pre-planned training sessions with the designated Government or facility clinical education point(s) of contact. All new training/webinars must be in the scope of services for this contract, and be specific to improving IHS or tribal staff’s skills to manage critically ill patients. IHS or tribal staff from any IHS or tribal facility may participate in trainings conducted by the Contractor, as determined by IHS.

4.3 Virtual Training:

If needed, virtual, web-based training may be delivered via synchronous or asynchronous methods and include simulation, mock drills, or other techniques. If virtual training is needed, the Contractor shall record in-person and/or virtual trainings, when possible. The contractor shall leverage technology that the local facility staff have access to and are approved technologies to be safely operated in the IHS network; which may include, but not limited to: Health Stream, Adobe Connect, Microsoft SKYPE, Zoom, Cisco Meeting to deliver online training/courses.

The IHS prefers that when possible, virtual trainings have an easy and trackable registration process to capture the number of participants and easily identify invitees and participants. The contractor may be asked to provide, upon successful course completion, a list of the attendees;

and/or individuals certificate of completion to each attendees. IHS must approve all new curriculums and content prior to training delivery. The Contractor shall ensure adequate lead-time to review content prior to launching training, when possible. All material developed under this contract, unless otherwise agreed to by IHS and the Contractor, is property of IHS. All training and materials have to be compliant with Section 508-accessibility standards.

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VII. ASSUMPTIONS/CONSTRAINTS:

1. Places of Performance

The locations of onsite direct patient care services only include IHS or tribally managed hospitals and do not include Alaska Village Clinics, IHS or tribally operated health centers, or other ambulatory healthcare facilities. For purposes of this contract, location of services shall only include hospitals. Patients may initially present at another IHS facility type, such as facilities with 24 hour/7 days a week emergency medicine capability, or other outpatient settings, but all critical care patients will be managed at a federal or tribally operated facility, or transferred to other facilities.

2. Government Furnished Information, Property and Services

2.1 Government Furnished Property

Contractor Exclusive Use: Personal Protective Equipment (PPE).

The Government will furnish the Contractor with appropriate PPE other than specified in Section VII (2.2). 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. During the contract performance period, the government will supply all necessary Personal Protective Equipment (PPE) and supplies, where Critical Care Response team(s) will perform direct patient care services.

2.2 Contractor Furnished Property

The Contractor shall provide all uniforms and other personal medical instruments subject to the following:

2.2.1 Uniforms and Lab Coats: Uniforms and Lab Coats shall conform to the requirements of the Indian Health Service Manual, Part 3 Chapter 4 and meet the approval of the Clinical Director, or their designee at each IHS facility.

2.2.2 Other personal medical instruments: “Other personal medical instruments” are defined as Contractor owned items may include but not limited to scissors, as appropriate to the work unit. The Contractor shall not use unsafe equipment or supplies at any time during performance of this contract. All Contractor furnished equipment and supplies shall be subject to inspection by the Government. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

2.3 Government Furnished Information (GFI): Government unique information related to this requirement, which is necessary for Contractor performance will be made available to the Contractor. A list of Government point of contacts will be provided to the contractor after Contract award. Example of GFI may include hospital-specific policies, procedures and protocols, for example:

• Written Competency Assessments

• Confidentiality/HIPAA/Patient’s Rights

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• EMTALA Compliance Exam, 2004

• Standard Emergency Codes

• Confidentiality: Legal and Ethical Concerns in Healthcare

• An Introduction to the Navajo Culture

• Verbal and Telephone Orders

• Pain Management

• Focus Charting

• Medical Staff Bylaws and Rules & Regulations

• Department specific policies and procedure manuals such as: Authoritative

Respiratory Therapy Policies and Procedures manual

2.4 Joint Use by the Government and the Contractor: 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.

2.5 Contractor Employee Training: Training of contractor employees assigned to this contract shall be performed at the contractor’s own expense. The Government will provide training necessary to onboard Critical Care Response Team members performing patient care in accordance with each hospital’s employee orientation process and mandatory IHS or facility-specific trainings.

2.6 Contract Administration

The IHS Chief Medical Officer (CMO) designated that all clinical services and related deliverables requested and inspected by the government, except where authorized by the CO or COR is the sole responsibility of the IHS Chief Clinical Consultant and the Deputy IHS Chief Clinical Consultant or their designees.

2.7 COR Appointment and Technical Instructions

Performance of work under this contract may be subject to written or verbal technical instructions signed by the COR. As used herein, technical instructions are defined to include the following and shall not be construed to be issued in a supervisory capacity or clinical capacity.

(1) Directions to the Contractor which suggest pursuit of certain lines of inquiry, redirect work emphasis, fill in details, provide safety alerts and otherwise serve to accomplish the contractual terms.

(2) Guidelines to the Contractor which assist in the interpretation of specifications or technical portions of work descriptions or processes.

(a) Technical instructions must be within the general scope of work stated in the SOO.

Technical instruction may not be used to:

(1) Assign additional work under the award;

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(2) Direct a change as defined in the "CHANGES" clause in this award;

(3) Increase or decrease the price, or the time required for contract performance;

(4) Change any of the terms, conditions or specifications of the award.

(2) If, in the opinion of the Contractor, any technical instruction calls for effort outside the scope of the award or is inconsistent with this requirement, the Contractor shall notify the Contracting Officer through the COR in writing within two (2) working days after the receipt of any such instruction. The Contractor shall not proceed with the work affected by the technical instruction unless and until the Contractor is notified by the Contracting Officer that the technical instruction is within the scope of the task order.

VIII. DELIVERABLES:

The Contractor shall provide the Schedule of Deliverables that at a minimum meet all task areas and contract requirements, including and deliverables specified as required in the SOO. The Government will review and determine the acceptability of the Schedule of Deliverables proposed by the Contractor, prior to contract award. All deliverables are subject to review and inspection by the Government.

IX. PERFORMANCE EVALUATION

The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract, Contractor’s Quality Control Plan, and Government’s Quality Assurance Surveillance Plan.

Performance Metrics:

The Government will review and determine the acceptability of the Quality Assurance and Surveillance Plan, proposed by the Contractor, prior to contract award. Performance measures may include:

(a) Patient Care

(b) Culturally Sensitivity

(c) Documentation

(d) Professionalism

(e) Compliance

(f) Management

Complete credentialing and privileging files Critical Care Response team member Acceptance rate, retention rate, reliability, and availability of all team members

(h) Clinical Education

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X. Additional Contractor Requirements:

1. Quality Control Program. The contractor shall establish and maintain a Quality Control Program (QCP) to ensure the requirements of this effort are provided as specified. The contractor shall submit to the government their quality processes in the form of a Quality Control Plan. This plan shall be submitted to the Contracting Officer’s Representative (COR) for review and acceptance, rejection, or further modification with the Proposal and the Final submission NLT 5 business days after contract post-award kick-off meeting. The COR will notify the contractor of acceptance or required modifications to the plan and any adjustment allowed to the performance date. The contractor shall make appropriate modifications (at no additional costs to the Government) and obtain acceptance of the plan by the COR. The contractor shall appoint a Quality Control representative that is knowledgeable of the necessary requirements of this program. Updates to the plan to assure compliance to the SOO requirements are the responsibility of the contractor as part of normal preventive and corrective actions. The plan shall include, but not be limited to, the following:

• Be structured to assure the individual responsible for Quality Control (QC) is authorized by the organization to take actions described.

• Contain procedures for written and verbal communication with the Government regarding performance of the contract

• Contain clear, measurable, and acceptable levels of performance

• Contain procedures for preventing defects and deficiencies, early detection of problems, and handling corrective actions without dependence upon Government intervention

• Contain surveillance procedures for each service to be monitored. These procedures shall identify the solution/service under surveillance, who will perform the surveillance, the frequency and method of surveillance, and procedures for correction of deficiencies.

• Include a system to investigate and resolve customer complaints from THE AGENCY. The investigation results shall be documented and forwarded to the COR to include immediate corrective actions to prevent future complaints.

• Provide a record of all contractor QC checks and corrective actions. These files shall be maintained by the contractor and shall be available upon request to the COR during the performance period.

2. Disclosure of Government Information. Contractor personnel shall comply with security requirements about disclosures of intelligence and proprietary sensitive information. No such information shall be provided by contractor personnel to any outside agency without the prior approval of the COR. Applicable Rights in Data clause(s) will be included in resulting award.

3. Continuity of Services. The Contractor recognizes that the services under this contract are considered vital to the Government and must be continued without interruption and that, upon contract expiration, a successor, either the Government or another contractor, may continue services. The contractor agrees to ensure a smooth phase-out to the next service provider at the end of the contract and the contractor shall furnish all work products in an editable format to the

IHS.

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4. HIPAA/Privacy Act.

Is applicable. Contractor will be required to complete a HHS Business Associate Agreement.

Applicable Systems Notices will be issued to awardee(s). Privacy and Information Systems Security Awareness training prior to commencing performance. Additional information will be provided at time of award.

5. Training.

Contractor personnel will be required to complete HHS/IHS Records Management, Privacy and Information Systems Security Awareness training prior to commencing performance. Additional information will be provided at time of award.

6. Applicable Reference Documents: Please see the web link listed unless document is listed as an attachment. This list is not all inclusive, and shall serve as a reference to meeting contract requirement, where applicable.

1. Indian Health Manual: https://www.ihs.gov/ihm/

2. The Joint Commission http://www.jointcommission.org/ (is applicable if hospital is accredited with TJC)

3. DNV-GL (applicable if hospital is accredited with DNV GL)

4. Centers for Medicare and Medicaid Services (CMS) Conditions of Participation http://www.cms.hhs.gov/

5. Section 231 of Public Law 101-647, the Crime Control Act of 1990.

http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml

6. Section 4087 of Public Law 101-630, the Indian Child and Family Violence Act.

http://www.nicwa.org/policy/law/protection/index.asp

7. Health Insurance Portability and Accountability Act (HIPAA) of 1996.

http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf

8. http://www.cms.hhs.gov/hipaa

9. Privacy Act of 1974. http://www.usdoj.gov/oip/privstat.htm

10. Computer Security Act of 1987 http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt

11. Federal Code of Conduct http://www.ihs.gov

12. IHS General Directives http://www.ihs.gov/adminmggrresouces

13. IHS Computer Security Directives http://www.ihs.gov/adminmggresources

14. Revised American Nurses Association Code of Ethics and Standards of Practice and

Care (1996) http://www.nursingworld.org

15. State Nurse Practice Act for the Contractor’s licensing state. http://medi smart.com/practice.htm

16. Computer Security Act of 1980 http://www.ihs.gov/adminmggrresouces/computersecurityact

17. Nurse License Look up http://www.nursys.com https://www.ihs.gov/ihm/ http://www.jointcommission.org/ http://www.cms.hhs.gov/ http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml http://www.nicwa.org/policy/law/protection/index.asp http://www.nicwa.org/policy/law/protection/index.asp http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf http://www.cms.hhs.gov/hipaa http://www.usdoj.gov/oip/privstat.htm http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt http://www.ihs.gov/ http://www.ihs.gov/adminmggrresouces http://www.ihs.gov/adminmggresources http://www.nursingworld.org/ http://medi/ http://www.ihs.gov/adminmggrresouces/computersecurityact http://www.ihs.gov/adminmggrresouces/computersecurityact http://www.nursys.com/

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DEFINITIONS

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

Asynchronous learning: Virtual training method that students can learn online from different locations at different times.

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.

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

IHS Chief Clinical Consultant: A federal employee delegated from the IHS Chief Medical Officer, for purposes of this contract to provide clinical leadership and oversight, provide day to day clinical guidance and direction as needed, and make contract management decisions pertaining to all services covered in the scope of the contract, expect those covered by the authority of the Contracting Officer, Contract Specialist, or the COR.

Deputy Chief Clinical Consultant: A federal employee, designated by the IHS Chief Medical Officer CMO or IHS Chief Clinical Consultant, with certain responsibilities to assist the IHS Chief Clinical Consultant, as needed for purposes of this contract, to carry out the necessary clinical and administrative oversight.

Complete and Clean Credentialing File: Per Task 2.7.3 of SOO.

Code of Ethics: The Code of Ethics for Respiratory Therapy as approved by the National Board for Respiratory Care.

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

Contractor: The legal entity awarded a legal binding contract to provide supplies and services.

Contractor employee: The term contractor employee shall refer to all Critical Care Team members rendering services on behalf of the Contractor.

Contracting Officer’s Representative (COR): The COR is a federal employee appointed by the Contracting Officer. The COR is primarily responsible for the technical assistance and day-to-day contract administration and management and will participate in the administrative

16/18 oversight of this contract, except in matters dealing with oversight and administration of clinical services or other responsibilities designated to the IHS Chief Clinical Consultants, or their designees. Any matter alleging a change to the scope, prices, terms, or conditions of this contract shall be referred to the Contracting Officer. The COR will represent the Contracting Officer in the technical phases of the work but will not be authorized to change any of the terms and conditions. The COR will act in a liaison capacity to coordinate activities between the Contracting Officer and the designated IHS Clinical leadership.

Cooperative Attitude: Behavior that is positive and displays a willingness to perform assigned patient care tasks and to be a team player.

Coronavirus Disease (COVID-19): Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

COVID-19 Pandemic: The 2019–20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Critical Care: The specialized care of patients whose conditions are life-threatening and who require comprehensive care and constant monitoring, usually in intensive care units

Cultural Awareness: Realization and respect for American Indian and Alaska Native practices.

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

Customer Evaluation/Input: Written comments made to the Contracting Officer or COR regarding the Contractor’s performance. This is one of the criteria used to evaluate the Contractor’s performance.

Dependability: Qualities of being trusted and being able to repeat the same task to yield the same result.

Disaster Privileges: As defined in IHS Manual, Section 3-1.1D https://www.ihs.gov/ihm/pc/part-3/p3c1/

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.

Fully resourced: As defined in SOO, Task 2.1.

Government Vehicle: An IHS owned motor vehicle or a vehicle leased by IHS through agreements with the General Services Administration (GSA) or through commercial rental agreements. For purposes of this contract, IHS does not anticipate the Contractor or Contractor https://www.ihs.gov/ihm/pc/part-3/p3c1/

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Employee (Critical Care Response team member) to be issued a Government Vehicle.

Intensive Care: continuous monitoring and treatment of seriously ill patients using special medical equipment and services.

Intensive Care Unit (ICU): a unit in a hospital providing intensive care.

Non-Personal Services Contract: 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.

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

Ordering Activity Contracting Officer: A Government employee of IHS authorized and warranted to issue task orders and to make subsequent task order modification(s) under this contract. The Ordering Activity CO has the authority to make initial determinations on all matters of dispute regarding task orders.

Orientation: An activity designed to provide basic familiarization of the facility and transition the Critical Care Response team member into the IHS or tribal hospital where the services will be provided.

Pandemic: An epidemic of disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of people.

Past Performance Information: Relevant information regarding a contractor’s actions under previously awarded contracts. This includes the contractor’s record of conformance to specifications and to standards of good workmanship; the contractor’s record of containing and forecasting costs on any previously performed cost reimbursable contracts; the contractor’s adherence to contract schedules, including the administrative aspects of performance; the contractor’s history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business-like concern for the interest of the customer.

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

Service Unit: The local administrative unit of IHS.

Synchronous Learning: Virtual training method that students can learn online from different or the same locations but at the same time, in “real-time.”.

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Supervisor: Government employee authorized to provide verbal and/or written technical direction to the contractor employee (Critical Care Response team member) for purposes of clarifying clinical services requirements of this non-personal services contract.

Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activities written order to obtain services, at a minimum will include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activities task order number.

Tour of Duty: The time of day the Critical Care Response Team member is scheduled to perform services.

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

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

Attachments:

Attachment 1: IHS Federal and Tribally Operated Hospitals Summary

Attachment 2: IHS National COVID19 Critical Care Response Team Requirements

Attachment 3: Emergency Disaster Privilege Pre-Application Checklist - LIP

Attachment 4: Critical Care Response Team General Requirements (Non-Personal Services)