SOW_medical services MD_PA 10.16.25_Draft_Sam.docx

STATEMENT OF WORK

NON-PERSONAL MEDICAL SUPPORT SERVICES

October 16, 2025

I. SCOPE OF WORK

1) The Portland Area Indian Health Service, Yakama Service Unit (YSU), is the principal federal health care provider for American Indian and Alaska Native people within its service area. To meet its mission, the YSU requires a non-personal services contract to obtain professional medical support services consisting of one (1) Physician (MD or DO) and one (1) Physician Assistant (PA-C) to provide direct patient care at the Yakama Indian Health Center (YIHC).

2) These services are non-personal as defined by FAR 37.104. No employer-employee relationship will exist between the Government and the Contractor’s personnel. The Contractor’s employees shall be accountable solely to the Contractor, who in turn is responsible to the Government through the Contracting Officer (CO) and the designated Contracting Officer’s Representative (COR).

3) Local YIHC management and the COR may provide direction on the technical and functional aspects of work—such as patient scheduling, clinic flow, and priorities of care—through the Contracting Officer’s Representative (COR) or designee. Such direction shall not constitute personal supervision or control of contractor personnel.

II. OBJECTIVE

The purpose of this requirement is to provide on-site professional medical care services that improve patient access and health outcomes for the eligible American Indian and Alaska Native population served by YIHC.

III. PERIOD OF PERFORMANCE AND LOCATION

1. All services are performed on-site at:

Yakama Indian Health Center 401 Buster Road Toppenish, WA 98948

1. The period of performance:

1. Base Period: Six (6) months – Not to Exceed 120 workdays

1. Option Period: One (1) six-month option period – Not to Exceed 120 workdays

1. (Option may be exercised at the Government’s discretion under FAR 52.217-9.)

1. Exact dates of performance are to be determined at contract award with one month lead time for background and credentialing.

IV. SERVICES PROVIDED BY THE CONTRACTOR

1) The Contractor shall provide medical services during clinic operating hours, not to exceed 40 hours per week per provider. Regular clinic hours are 8:00 a.m. to 5:00 p.m., Monday through Friday. The clinic is closed on federally recognized holidays and may close on additional days per Executive Order or facility conditions (e.g., weather or utilities).

2) The Contractor’s personnel shall perform all duties using existing Government facilities, equipment, and supplies, including exam rooms, diagnostic equipment, laboratory and radiology support, and the electronic health record (EHR).

3) Description of Duties:

a) Physician (MD/DO)

i) Perform medical examinations, order and interpret diagnostic tests, and provide treatment, order referrals and follow-up for acute and chronic conditions within the scope of Family Medicine or Internal Medicine.

ii) Provide preventive care, health promotion, and patient education.

iii) Prescribe medications in accordance with IHS formulary and YSU pharmacy policy.

iv) Document all encounters in the EHR within 48 hours of service in accordance with the YSU Medical-Professional Staff by-laws and IHS policy.

v) Collaborate with other YSU departments to coordinate care.

vi) Follow all infection control and patient safety policies and procedures, including but not limited to the proper wear of Personal Protective Equipment.

vii) Participate in peer review with the medical staff.

viii) Participate in medical home, medical staff meetings and trainings required of medical providers.

b) Physician Assistant (PA-C)

i) Perform medical examinations, order and interpret diagnostic tests, and provide treatment, order referrals and follow-up for acute and chronic conditions within the scope of approved privileges, clinic protocols and of a NCCPA certified physician assistant.

ii) Provide preventive care, health promotion, and patient education.

iii) Prescribe medications in accordance with IHS formulary and YSU pharmacy policy.

iv) Document all encounters in the EHR within 48 hours of service in accordance with the YSU Medical-Professional Staff by-laws and IHS policy.

v) Collaborate with other YSU departments to coordinate care.

vi) Follow all infection control and patient safety policies and procedures, including but not limited to the proper wear of Personal Protective Equipment.

vii) Participate in peer review with the medical staff.

viii) Participate in medical home, medical staff meetings and trainings required of medical providers.

c) Qualifications of Key Personnel (Physician and Physician Assistant)

i) Physician

(1) Current Board Certification (American Board of Family Medicine or American Board of Internal Medicine)

(2) Active, unrestricted medical license (U.S. state, territory, or D.C.)

(3) Current DEA license and state CDS if applicable

(4) Current BLS certification

(5) Minimum five (5) years clinical experience

ii) Physician Assistant

(1) NCCPA certified and active

(2) unrestricted state license (U.S. state, territory, or D.C.)

(3) Current DEA license and state CDS if applicable

(4) Current BLS certification

(5) Minimum two (2) years primary-care or urgent-care experience

iii) All contractor key personnel must meet YSU Credentialing and Privileging standards per the Indian Health Manual, Part 3, Chapter 1, and the YSU Medical-Professional Staff by-laws. The minimum privileges key personnel must obtain are listed in Table 1.

Table 1 – Required Privileges

Interpretation of laboratory Data

Preliminary interpretation and ordering of radiographs

Ordering and interpretation of EKG’s

Basic Life Support

Life-threatening emergency.

Prescriptions per Yakama Pharmacy Policies and Procedures

Arthritis

Cardiac disease

Connective tissue diseases

Dermatology

Gastrointestinal diseases

Hematological diseases

Hepatic diseases

Hypertension

Infectious diseases

Metabolic/Endocrine diseases

Neurological diseases

Pulmonary diseases

Renal diseases

Rheumatology

Care and treatment of bursitis and tendonitis and myositis

Care and treatment of simple closed fractures of extremities and ribs

Assist in follow-up with orthopedic consultants

External eye examination

Care and treatment of conjunctivitis

Problems of pediatric respiratory tract

GI & GU conditions in pediatrics

Note: Additional privileges above the minimum may be requested by the key personnel.

4) CONTRACTOR PERFORMANCE AND RESPONSIBILITIES

a) The Contractor shall ensure key personnel comply with all applicable medical staff bylaws, infection control, and quality assurance standards as a condition of continued performance.

b) General Medicine Duties: The physician will be expected to see empaneled patients by appointment and by walk-in visits as part of a patient-centered medical home model. See Table 1 for the list of minimum services required.

c) Urgent Care Duties: The physician assistant will be scheduled to work in the YIHC “Minor Acute Care” clinic, an urgent care clinic, for walk-in pediatric and adult patients. This may include patients who have suspected SARS-CoV-2 or “COVID-19” infection. See Table 1 for the list of minimum services required. The physician may be expected to also take shifts in the urgent care clinic as needed according to YSU staffing needs.

d) Optional privileges: The contractor key personnel may apply for additional privileges they feel they are qualified to render. The privilege form will be provided at the time of application for YSU Medical-Professional Staff membership and will list all options available. For any privilege provided, the provider (MD/DO or PA-C) shall demonstrate in their experience and training how they are qualified to provide care under the optional privileges listed.

e) Expected Workload: Medical providers are expected to see a minimum of seven (7) appointments per half-day (or 14 per full-day) scheduled with appointments or ten (10) walk-in visits per half-day (or 20 per full-day) scheduled in urgent care. Thursday mornings are given as administrative time to complete necessary trainings, catch up on provider notifications or other requests. There is time at the very start and end of the day to catch up on charting and notifications. Each provider has one medical assistant or one registered nurse assigned to work with them each shift. Actual patient volume may vary based on clinic demand and operational priorities, as determined by the COR or clinical leadership.

f) The Contractor shall provide qualified personnel meeting all requirements of this SOW. Any replacement of key personnel must be approved in advance with notice as soon as possible or at least 4 weeks in advance to allow adequate time for a replacement to complete credentialing. Qualified candidates must be presented within 2 weeks of contract award.

g) Maintain professional liability (malpractice) insurance of at last $1,000,000 per provider, per occurrence. See section on Malpractice Coverage below in this SOW for more details.

h) Ensure compliance with all HIPAA, privacy act, and IHS confidentiality regulations. The Contractor shall immediately report any suspected or confirmed breach of Protected Health Information (PHI) to the COR and the IHS Privacy Officer in accordance with HHS breach notification procedures.

V. INDIAN HEALTH SERVICE RESPONSIBILITIES

1) Credentialing and Privileging: The YIHC will complete medical credentialing and privileging according to Indian Health Service Policy: Indian Health Manual, Part 3, Chapter 1 – “Clinical Credentials and Privileges”. See also: https://www.ihs.gov/IHM/pc/part-3/p3c1/

a. Failure to complete the credentialing application or respond to follow-up inquiries in a timely manner will result in rejecting the key personnel.

2) Provide examination space, furniture, utilities, and routine medical and office supplies.

3) Provide access to the IHS Electronic Health Record (RPMS or successor) and conduct orientation and EHR training.

4) Furnish administrative support for patient scheduling, records management, and ancillary services.

5) Provide day-to-day coordination of clinic operations through the COR or designee; such direction shall be limited to the technical details and priorities of the work, not supervision of contractor employees.

VI. EVALUATION AND REPORTING REQUIREMENTS

A. All services rendered shall be in accordance with current YSU Medical Staff Bylaws and practices to assure quality of care.

B. Time and attendance sheets will be verified by the COR. The COR’s review of timekeeping records will serve as acknowledgment of satisfactory performance for the hours reported, but shall not be construed as personal supervision.

C. Designee will notify the COR that the services called for under the contract have been rendered.

VII. CLIN STRUCTURE

VIII. PAYMENT SCHEDULE

1) The hourly rate awarded is the Contractor’s contract price for each CLIN for services that covers all related costs to provide services on-site. See attached Schedule of Items.

2) Payment shall be made in accordance with the hourly rate of the Awarded Contractor’s list for the services provided at the clinic site.

3) Payment shall be made in accordance with the Prompt Payment Final Rule (5 CFR 1315, September 29, 1999), which states that disbursement will be made within 15 days of an accepted and Approved Invoice by a Contracting Officer when presented to the Finance Office.

4) Vendor shall maintain an “Active” status with the System Award Management (SAM) as prescribed by the Electronic Funds Transfer (EFT) procedures.

5) The Government is obligated only to the extent of authorized purchases actually made and received under this purchase order.

IX. INVOICING

1) Invoices shall be submitted to in accordance with clause 52.232-71 Electronic submission of payment request.

2) IPP invoicing is exercised with Invoices submitted monthly, covering the 1-31 days or however many days are in the specific month covered by the invoice.

3) For payment status, please e-mail POR_AODFMPAYABLES@IHS.GOV.

4) Note: Invoice must match the purchase order in description. Improper invoices will be rejected.

5) Upon receipt, the COR shall review the invoice(s) for accuracy. Payments will be made after submission of a proper invoice and after the Government accepts the services. Payment shall be made only for services actually completed at time of invoice submission.

X. ADMINISTRATION:

The contractor shall utilize a time keeping sheet for recording hours of contract performance. The Contractor shall sign the Record of Service Delivered, and record the time each day for the following events: arrival, departure for any reason including lunch and any subsequent return, and departure for the day.

The Contract Officer’s Representative (COR) and site contact under this contract shall be provided up award of the purchase order. The COR’s responsibilities will be to coordinate with the provider the technical aspects of this service and review of performance hereunder. The Contract Officer’s Representative does not have the authority to change or alter the order amount, terms or conditions of this purchase order.

XI. ADDITIONAL TERMS AND CONDITIONS

1) SUBSTITUTE PROVIDERS

The Contractor may request the right to provide a substitute Practitioner to cover a scheduled clinic when it is impossible for the Contractor to be in attendance due to illness or vacation. The proposed substitute must meet tile qualification, credentialing, and privileging requirements of the Service Unit and must be approved by the Contracting Officer and the COR. The proposed substitute must possess the same qualifications as specified in this contract prior to a scheduled clinic. Failure to possess or maintain such qualifications shall deem the offer or ineligible for an award and cause the contract to become null and void at no cost to the Government

2) MALPRACTICE COVERAGE

The Contractor shall provide professional liability (malpractice) coverage, in amounts that are reasonable and customary in the community for the appropriate specialty (not less than $1,000,000, per provider, per occurrence), covering liability for personal injury or property damage, including legal representation and expense of defense of any such liability claims, actions or litigation, resulting from participation by the Contractors employees under this requirement. This coverage may come from any source, but shall clearly cover the Contractors employees while participating under this agreement. The Contractors employees must provide documentary proof of the insurance coverage and such proof will be attached to this agreement. The Contractors employees further agree not to seek indemnification from either the United States or the Indian Health Service for any settlement, verdict or judgment resulting from any claim or lawsuit arising out of the negligent acts or omissions of its employees while working at this site.

Under the Federal Tort Claims Act (FTCA), 28 U.S.C. §§ 1346(b), 2401(b), 2671-80, the Federal government is liable for property damage, personal injury, or death caused by the negligence of any Federal government employee acting within the scope of her/his employment, and Training Site’s obligations under this agreement, including supervision of students. All claims alleging medical malpractice and other negligence by IHS physicians, dentists, nurses, and other health professionals are processed under this Act. The law provides that medical malpractice claims must be filed against the United States, not the individual health professional.

3) HIPAA REQUIREMENT

Pursuant to the Health Insurance Portability and Accountability Act (HIPAA) of 1996and its implementing regulation, the Standards of Privacy of individual Identifiable Health Information at 45 C.F.R. Part 160 and 164, Subpart A and E ("Privacy Rule"), the Indian Health Service is required to enter into an agreement with the Business Associate, pursuant to which the Business Associate shall comply with and appropriately safeguard Protected Health Information ("PHI") that it will use and disclose when performing functions, activities or services ("Services") for the Indian Health Service. The Business Associate, by signing the contract, shall comply with the following terms in addition to other applicable contract terms and conditions relating to the safekeeping, use and discloser of PHI.

4) Indemnification, Liability, Statute of Limitations:

Any provisions in the TOS related to indemnification and filing deadlines are hereby waived, and shall not apply except to the extent expressly authorized by law. Liability for any breach of the TOS as modified by this Amendment, or any claim arising from the TOS as modified by this Amendment, shall be determined under the Federal Tort Claims Act, or other governing federal authority. Federal Statute of Limitations provisions shall apply to any breach or claim.

5) Governing law:

Any arbitration, mediation or similar dispute resolution provision in the TOS is hereby deleted. The TOS and this Amendment shall be governed by and interpreted and enforced in accordance with the laws of the United States of America without reference to conflict of laws. To the extent permitted by federal law, the laws of the State of [Company to insert name of state if one is mentioned in its TOS] (excluding [Company's state] choice of law rules) will apply in the absence of applicable federal law.

6) Services under this contract are to be performed in accordance with the requirements and provision of P.L. 93-579, December 31, 1974 (5 USC 522a) and applicable agency regulations. Copies of these items are available upon request of the Contracting Officer.

Federal Acquisition Regulation (FAR) (48 CFR Chapter 1) Clauses

HHSAR Clauses Incorporated by Reference

For additional terms and conditions, please refer to the attached clauses incorporated by reference.

(End SOW)

Statement of Work – Non-Personal Medical Support Services