Statement of Work.pdf

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Indian Health Service

Monacan Service Unit

Monacan Health Center Non-Personal Family Nurse Practitioner Services

Statement of Work For

Non-Personal Family Nurse Practitioner Services at the Monacan Health Center

07/30/2025

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TABLE OF CONTENTS

1.0 General

2.0 Supplies or Services and Prices/Cost

3.0 Definitions

4.0 Government Furnished Products and Services

5.0 Statement of Work

6.0 Acceptance

7.0 Performance

8.0 Invoice Submission

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Statement of Work (SOW) for

Non-Personal Family Nurse Practitioner Services for the Monacan Health Center

1.0 General

1.1 Background

The Monacan Service Unit’s mission is to raise the physical, mental, and spiritual health of the Native American population that lives in the geographic area. The mission is implemented by developing Direct Care Services and administering the Purchased/Referred Care (PRC) program. This acquisition will assist the MHC, who is moving to direct care services by establishing a comprehensive health care clinic for newly federally recognized tribes in Virginia. This contracting action is for non-personal family nurse practitioner services agreement that is necessary to establish and conduct business in the Monacan Health Center.

1.2 Objective

The primary objective of this action is to provide a Non-Personal Family Nurse Practitioner (NP) for the newly built Monacan Health Center. The acquisition will be for a one-year base period of performance with four (4) 12-month option year periods of performance. The nurse practitioner will complete the Indian Health Service mandated security clearance requirement prior to commencement of services.

1.3 Scope of Work

The Monacan Health Center is in need of a Non-Personal Service Contract for a Family Nurse Practitioner to support the mission of the Indian Health Service (IHS). The contractor shall provide a full spectrum of outpatient medical evaluation and medical services to patients of all ages at the Monacan Health Center facility. This requires the ability to manage diabetes/hypertension and other adult chronic care needs for refills and referrals.

1.4 Period of Performance

Services under this contract shall commence NLT 10 days after all clearances occur. The estimated period of performance dates are as follows:

Base Year: October 1, 2025 – September 30, 2026 Option Year 1: October 1, 2026 – September 30, 2027 Option Year 2: October 1, 2027 – September 30, 2028 Option Year 3: October 1, 2028 – September 30, 2029 Option Year 4: October 1, 2029 – September 30, 2030

1.5 Place of Performance

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Hours of Operation: Schedule of work (30 hours) to be completed Monday-Friday between the hours of 8:00AM and 4:30PM local time. Schedule will be set with the COR.

Indian Health Service Monacan Health Center 108 Dixie Airport Rd Madison Heights, VA 24572

1.6 Points of Contact

Contract Specialist: Courtney Davis Email: courtney.davis@ihs.gov Phone: 629-248-4259

Contracting Officer: Henry Daniels Email: henry.daniels@ihs.gov Phone: 615-467-1516

Contracting Officer Representative (COR): Kaleigh Pollak Klaman

Kaleigh.Pollak@ihs.gov Phone: 804-334-1985

2.0 Supplies or Services and Prices/Costs

2.1. Price or Cost

This solicitation is to be issued for the quantities set forth in the price schedule.

2.2 General Contract Information

2.2.1 This is a non-personal health care service contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the contractor is an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment). The contractor indemnifies the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance.

2.2.2 As an independent Contractor; billing and collecting for the federal, state and other local city/county taxes is the burden of the Contractor, this includes any Virginia Business, Professional and Occupational License (BPOL) tax for services provided in any county of the Virginia.

2.2.3 The Contractor's price/cost for services under this contract should include all applicable taxes for Internal Revenue Service (IRS), Virginia Department of Taxation and/or other revenue agencies. The Indian Health Service will not withhold taxes nor will it issue a W-2 to the contractor.

mailto:courtney.davis@ihs.gov mailto:henry.daniels@ihs.gov mailto:Kaleigh.Pollak@ihs.gov

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2.2.4 Fingerprinting Requirements for Security and Suitability- "Prior to start of services specified by the contract scope of work, the Contractor must contact Tiffany Niles, PSR, Nashville Area Office (615) 467-1573, to schedule an appointment to complete the fingerprinting process required by the IHS regulations pertinent to security and character background investigations."

2.3 Contract Price

2.3.1 The Contractor shall be paid upon submission of an invoice and completion and acceptance (if deliverable) or verification (if service) by the Contracting Officer's Representative (COR), of the deliverables and/or services indicated below. Submit invoices in accordance with the instructions contained in FAR clause 52.232-25, Prompt Payment, and Section 8 of this contract.

2.4 Option Prices

2.4.1 Unless the Government exercises its option, pursuant to the option clause referenced in the Contract Clauses section, this contract consists only of the Base Period specified in this contract.

2.4.2 Pursuant to either the FAR Clause 52.217-8, Option to Extend Services or the FAR Clause 52.217-9, Option to Extend the Term of the Contract, set forth in Section I, Contract Clauses, of this contract, the Government may, a unilateral contract modification, require the Contractor to perform the Option Period(s) as defined in the SOW of this contract. A notice that the Government intends to exercise any of the options will happen prior to the contract’s expiration date.

Specific information regarding the timeframe for this notice is set forth in the OPTION PROVISION of this order.

2.4.3 Upon the delivery and acceptance of the Option Services described in the Statement of Work, the Government shall pay the Contractor the rate(s) set.

2.4.4 If the Government exercises its option pursuant to the OPTION PROVISION of this contract, the Government's total estimated contract amount, represented by the sum of the price of base plus option periods and the period of performance will be as follows:

2.4.5 Note: Unit price shall be an all-inclusive rate of all other fees including travel expenses, per diem, lodging all cities, state, federal, local taxes and miscellaneous cost associated with the above services.

2.4.6 Lunch break of 30 minutes is permitted (as non-paid) under the contract;

the contractor cannot invoice time as worked if its’ employee chooses not to take a lunch break. The Contractor also cannot invoice travel times to/from the facility site as time worked.

3.0 Definitions

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

3.2 Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, SOW for Non-Personal Family Nurse Practitioner Services for the Monacan Health Center Page 6 of 23 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.

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

3.4 Blanket Purchase Agreement (BPA): is a simplified method of filling anticipated repetitive needs for supplies or services.

3.5 Business Associate (BA): Any company or person that shown to, handles, or works with the data or medical records of the medical entity.

3.6 Business Associate Agreement (BAA): A BAA is a contract between a HIPAA-covered entity and a HIPAA BA. The contract protects personal health information (PHI) in accordance with HIPAA guidelines.

3.7 Code of Ethics: The Revised American Nurses Association Code of Ethics and Standards of Practice and Care, published in 1996 by the American Nurses Association, which makes explicit primary goals, values and obligations of the nursing profession.

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

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

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

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

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

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

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

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

3.16 Indefinite Delivery/Indefinite Quantity: No set delivery time and no set quantity amount (used for recurring purchases with no set delivery time or quantity).

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

FAR 37.401

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

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

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

3.21 Patient Outcome: End result of nursing care.

3.22 Performance Based Matrix: Lists the services and the standards to determine quality of performance.

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

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

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

3.26 Service Unit: The local administrative unit of IHS.

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

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

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

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

4.0 Government Furnished Property and Services

4.1 The Government will provide the following item(s) of Government property to the Contractor for use in the performance of this contract. This property shall be used and maintained by the Contractor in accordance with provisions of FAR Clause 52.245-1, Government Property (found in Section 4).

Item No

Property Description Property Value Qty. Location Date Available

1 Computer 1 MHC Upon Arrival 2 Telephone 1 MHC Upon Arrival 3 Desk/Chair 1 MHC Upon Arrival 4 PIV Card 1 MASU Upon Arrival 5 PPE Equipment MHC Upon Arrival

4.2 Government Furnished Information/ Property and Services

4.2.1 Information: Government unique information related to this requirement, which is necessary for Contractor performance, made available to the Contractor. The COR will be the point of contact for identification of any required information to be supplied by the Government.

4.2.2 Joint Use by the Government and the Contractor: Except for the property and service listed, the Government will provide, for joint use by the

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Government and the Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

4.2.3 Contractor Exclusive Use:

4.2.3.1 Personal Protective Equipment (PPE): The Government will furnish the Contractor with appropriate PPE other than specified in the contract. The Government will be responsible for any repair, cleaning, and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

4.2.3.2 The Government will provide facility specific contractor identification badges/keys for each contractor. For lost or destroyed badges/keys, there is a minimum charge of $20.00.

4.2.3.3 Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures. Training provided ONLY if the subject matter is necessary to improve or enhance the quality of services or includes mandates made by the IHS Service Units/Health Centers while the providers are working under this contract. Training not provided for the purpose of continuing education, career development or individual development.

4.3 Contractor Furnished Property

4.3.1 Except for the property specified as government furnished, the Contractor shall provide all uniforms and other personal medical instruments subject to the following:

4.3.2 Uniforms and Lab Coats: Uniforms and Lab Coats must conform to the requirements of the Indian Health Service Manual, Part 3, and Chapter 4 and meet the approval of the COR.

4.3.3 Other personal medical instruments: "Other personal medical instruments" defined, as Contractor owned items include but not limited to stethoscope, scissors, as appropriate to the work unit. The Contractor must 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 and must be approved by the COR prior to use by the Contractor. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

5.0 Statement of Work

5.1

• All providers under the contract must be a Board Certified NP or APRN who have permanent, full, and unrestricted license to practice medicine in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

Providers must also have a BLS certification.

• All Contract providers will be held to the same Standards of Conduct as federal employees "Standards of Conduct" http://www.fda.gov/

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AboutFDA/WorkingatFDA/Ethics/ucm071768.htm, Violence in the Workplace memorandum,SGM 95-4 https://www.ihs.gov/ihm/index.cfm?module=dsp_ihm_sgm_main&sgm=ihm_sgm_950 4; Courtesy and Respect in the Workplace Policy.

• Violations of these policies may lead to contract termination.

• Any negligent behavior or any behavior jeopardizing patient safety will not be tolerated.

Professional Review Action may be taken regarding any member of the Medical staff if activity, demeanor or conduct of the member is detrimental to patient care, disruptive to service unit operation, or in violation of the local Bylaws, Medical Staff Rules and Regulation, IHS policy or ethical. Each incident will be evaluated and documented.

Documentation will be submitted to the contractor. These incidents may be grounds for immediate removal. Credentialing actions giving rise to a hearing or appeals will be in accordance with the appropriate by-laws. No costs for travel, attorney fees, phone, mail, or other expenses associated with the candidates hearing or appeal will be provided by the IHS, or the local service unit.

• Primary Care-Outpatient Facility with some Same-Day Appointments •Primary Duties o Performs clinical duties, responsibilities and functions of a provider, including history taking, physical examination, the ordering of appropriate laboratory and xray procedures, the interpretations and synthesis of clinical data, formulation of therapeutic programs, assessing patients, diagnosing illnesses, developing treatment plans, prescribing medications, conveying of information to patients and their families, support of patients and families in times of illness, and the timely maintenance of adequate records detailing these activities.

o Determines when the services of a specialist are needed to treat unusual cases.

o Makes necessary arrangements for the admission of patients to the appropriate hospital.

o Renders care as needed, and as scheduled for the same day clinic.

o Maintains patient records in the Electronic Health Record.

o Participates in Quality Assurance/Risk Management activities of the clinic. Participate in activities to support AAAHC accreditation as assigned.

o The practitioner will participate in ongoing educational programs for all categories of health professions.

o Participates in medical staffing meetings as requested.

o Observes and abides by all the policies of Monacan Health Center including rules and regulations of the medical staff.

o May participate in Service Unit meetings and in-services.

o Performs other related duties as assigned.

• Work assignments will be defined by the Clinical Director/CEO (or designee) to include shifts within the hours of operation of the facility. The work hours/shifts

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• Contract providers shall generate and maintain proper medical record information on beneficiaries to whom treatment is provided in accordance with Indian Health Service, Accrediting Body. The Contractor provider shall prepare all electronic medical record documentation to meet or exceed the established standards of the IHS facility to include but not be limited to: timeliness, accuracy, content, and signature. Contract providers shall complete all third party reimbursement and referral forms. All medical record information and documentation generated in the performance of this contract must be completed at the time of departure and will remain the property of and subject to the exclusive control of the Indian Health Service. The Medical Records Department shall be notified in advance of the contract provider's last workday.

The Clinical Director/CEO (or designee) will not sign off on the contract provider's timesheet unless the contract provider is cleared by Health Information Management Systems (HIMS) utilizing the HIMS Clearance Form.

Failure to complete medical records before leaving may result in a delay of the processing of all invoices from the contract.

• To ensure that contract providers are in compliance with all facility regulations, MHC shall provide contract providers an orientation on Cultural Sensitivity, Customer Service, Resource & Patient Management System (RPMS), Purchased and Referred Care (PRC) and Electronic Health Record (EHR) systems. Each contract provider shall be granted access to RPMS and EHR systems for electronic documentation of patient care services. This orientation will be paid at the regular rate.

• The contractor's conformance with the technical requirements of this contract will be monitored for the period of performance. This assessment will include observations of the work system, methods and execution. Examples of monitoring methods include, but are not limited to: compliance with the Indian Health Service credentialing and privileging requirements, appropriateness of candidate placement (e.g., number of removals, number of early termination of assignments due to personality conflict, poor work habits, and inadequate skills for the assignment, unprofessional or discourteous behavior). An assessment spreadsheet with these methods will be monitored by the Clinical Director/ CEO and the Contracting Officer's Representative (COR).

• Conditions for Removal/Replacement of Contractor’s Employee/Staff:

o As mutually agreed upon between the Contracting Officer and the

Contractor, there may be grounds for removal and/or replacement of contractor personnel.

o Contractor staff will be removed from a facility if services are not performed in accordance with the terms and conditions of the contract.

o It is the accountability and responsibility of the Contractor to have replacement provider(s) on-board at the MHC facility as expeditiously as possible; by immediately informing the provider staff to complete and

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o The Contactor is responsible for having a replacement provider in place no more than three (3) to four (4) weeks or sooner, if possible, of notification for a replacement of a provider,

• The Contractor may be an individual, group or organization in which any individual providing the services meets the stated qualification requirements.

The Contractor shall ensure a qualified provider will be in attendance as scheduled.

• Certification forms and required documents must be completed in their entirety and returned demonstrating the minimum qualifications have been met, as follows:

o Medical Liability Insurance: Provide proof of current medical liability insurance carried in the minimum amount of One (1) million dollars per occurrence and Three (3) million-dollar aggregate.

o License: Nurse Practitioner as minimum basic eligibility requirements, must be prepared as nurse practitioner in either a family nurse practitioner master’s degree nursing program or a formal post graduate family nurse practitioner track or program within a school of nursing granting graduate level academic credit (i.e., graduate no matriculating program). Evidence of successful completion will be a certificate or letter from the program director. The educational program must have included both didactic and clinical components.

o Must have at least 12-months of clinical experience and expertise in the NP area of specialization in the last five (5) years.

o Hold a full unrestricted and current active Registered Nurse (RN) license in a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States (US) during the term of the term of this order.

o BLS Certification: Current Basic Cardiac Life Support (BLS) Certification.

• All providers placed at the Monacan Health Center MUST comply with Federal Vaccine/Immunization requirements. Under no circumstance will a provider by allowed to provide patient care services without the mandated vaccination and booster requirements of all federal agencies.

• Credentialing: The Contractor's employees shall apply and be approved for clinical privileges prior to providing patient care. Contractor's employees shall submit the following to the service unit medical staff office: pre-application, if approved; then they shall submit a complete medical staff application with request for clinical privileges, copies of active, unrestricted professional licensure, professional degree, residency and board certification in specialty, current curriculum vitae, proof of professional liability coverage, DEA certificate

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5.2 Work Schedule

• The contract provider(s) shall provide services at the Monacan Health Center between the hours of 8:00AM and 04:30PM local time from Monday through Friday with the exception of federal holidays. By the Department of Labor Regulations, all contractor providers will be allowed to take a 30-minute meal/rest break. If the contract provider choses to forego their meal/rest break, they cannot bill as hours worked.

• Hours of services during the contract period of performance shall not exceed 1560 hours. Approximately 30 hours per week. Contract providers under this contract shall be scheduled and required to perform services at the request of the Clinical Director or his/her designee.

• The POC at the Monacan Health Center must determine specific tour of duty.

The contractor’s employee must work 100% of the contracted hours.

• The Contractor must perform and obtain approval of the department Supervisor or designee prior to any absence from work. If the length of the absence exceeds working hours the Contractor must request from agency approval at least thirty (15) days, (the exception is verifiable emergencies) in advance of the desired absence.

• Approval of leave is contingent upon availability of a qualified replacement.

• The Contractor must perform and maintain documentation from a qualified health care provider for absences of three (3) or more consecutive days, due to illness, stating:

• The cause of the current illness or incapacitation AND 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.

• Training: Not provided to Contractor employees. The only training provided to the Contractor employees will be in-house at the Service Unit.

5.3 Performance Evaluation

• During the duration of this contract, the contractor’s performance will be evaluated on an interim and final basis pursuant to FAR Subpart 42.15.

Evaluation will become part of the contract file and will be used as past performance information in evaluating the Contractor’s, and any significant subcontractors or affiliates, past performance on future contracts.

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

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• Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome constitutes a breach of contract.

5.4 Conduct

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

5.5 Conditions of Contract Services: All contractors providing service under this contract must attend mandatory orientations specified by the Service Unit.

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

5.5.2 Identification of Contractor: The Contractor must wear a government issued contractor identification badge during performance of duty.

5.5.3 Management of Medical Information: The Contractor must manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols. The Contractor must immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

• The Contractor shall ensure adherence to DHHS IT system security policies and procedures. The IT policies and procedures will be made available to the Contractor.

• The Contractor shall immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

5.5.4 IHS Information Technology Systems: In performance of this contract, the Contractor must adapt to and successfully utilize IHS information technology systems such as Electronic Health Records (EHR) or RPMS, which the IHS has deemed necessary for acceptable contractor performance. The IT policies and procedures are available to the Contractor at the Service Unit and the Contractor will adhere to the IHS

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Information Technology System Security Policies and procedures. The Contractor must follow all appropriate federal required information Technology security requirements and will be operating under Health Insurance Portability and Accountability (HIPAA) and Privacy Act regulations.

5.6 Contractor Qualification Requirements

• Medical Liability Insurance: Provide proof of current medical liability insurance carried in the minimum amount of One (1) million dollars per occurrence and Three (3) million-dollar aggregate.

• License: Nurse Practitioner as minimum basic eligibility requirements, must be prepared as nurse practitioner in either a family nurse practitioner master’s degree nursing program or a formal post graduate family nurse practitioner track or program within a school of nursing granting graduate level academic credit (i.e., graduate no matriculating program). Evidence of successful completion will be a certificate or letter from the program director. The educational program must have included both didactic and clinical components.

• Must have at least 12-months of clinical experience and expertise in the NP area of specialization in the last five (5) years.

• BLS/ Certification: Current Basic Cardiac Life Support (BLS) Certification.

5.6.2 Motor Vehicle Operator's License: If required by the position, the Contractor shall possess a valid state driver’s license throughout the term of this contract.

Contractors will not operate any Government-Owned vehicles. If required to provide health care services, they are allowed only as passengers in the Government-Owned Vehicle driven by a Federal employee.

5.6.3 Health Requirements of Contracted Healthcare Providers: Furnish documentation that reflects immunity for the indicated vaccine preventable diseases through documented disease, vaccination history, serology results, and/or any documented episodes of adverse events after vaccination. Any contractor’s employee who is allergic to a component of a vaccine and/or have a history of a severe reaction to a vaccine is not required to receive that vaccine with documented proof of contraindication to the vaccination. The following are additional requirements for specific vaccine preventable diseases.

• Measles:

- Vaccinations with 2 doses of live measles or MMR vaccines administered at least 28 days apart,

- Laboratory evidence of immunity,

- Laboratory confirmation of disease, or

- Birth before 1957.

• Mumps:

- Vaccinations with 2 doses of live mumps or MMR vaccines administered at least 28 days apart,

- Laboratory evidence of immunity,

- Laboratory confirmation of disease, or

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- Birth before 1957.

• Rubella:

- Vaccinations with 1 dose of live rubella or MMR vaccines administered at least 28 days apart,

- Laboratory evidence of immunity,

- Laboratory confirmation of disease, or

- Birth before 1957

• Hepatitis B:

- Vaccinations with three doses of Hepatitis B vaccines, or

- signed declination of Hepatitis B vaccination series.

• Varicella:

- Vaccinations with two doses of varicella at least 4 weeks apart,

- Laboratory evidence of immunity or confirmation of disease,

- Diagnosis or verification of history of varicella disease by a health care provider, or

- Diagnosis or verification of a history of herpes zoster by a health care provider.

- signed declination of Varicella vaccination series.

• Influenza:

- Vaccination with one dose of current annual influenza season vaccine.

- Documented proof of the contraindication to the influenza vaccination as outlined by Advisory Committee on Immunization Practices recommendations, or

- Written statement justifying religious exemption from influenza vaccination.

Note: Unvaccinated contract staff with an approved medical or religious exemption must wear an IHS-provided surgical or similar mask when working in patient care areas or other areas frequented by patients in an IHS facility during the influenza season.

• Pertussis

- Vaccination with one dose of Tdap vaccine.

- Signed declination of Tdap vaccine

• Any additional immunization in accordance with IHS Immunization Policy that is available upon request.

• Tuberculosis

- The contract staff must have written documentation of TB test

(TST or IGRA) within the last 12 months.

- If documented Positive TB test: Provide chest x-ray report of “No active TB disease” following positive TB test.

- Annual sign and symptoms screen:

• If negative sign and symptom screen, follow up chest x-ray not indicated.

• If signs and symptoms screen positive, contract staff must have written documentation of chest x-ray and health care provider evaluation.

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• Credentialed provider contract staff must have documentation from the provider’s physician or chief of staff that confirms they do not have any health problems (including disability, emotional stability, drug, or alcohol dependency) that might impair his/her ability to care for patient at time of application.

• Annual N95 Fit Testing

5.6.4 Criminal History Background Check:

Contractor’s employees whose duties and responsibilities involve regular contact or control over children are subject to a character investigation as required by Public Law 101-630, The Indian Child Protection and Family Violence Act. The minimum standards of character shall ensure that none of the individuals described in this order have been found guilty of, or entered a plea of nolo contendere or guilty to, any felonious offense, or any of two or more misdemeanor offenses, under federal, state, or tribal law involving crimes of violence; sexual assault, molestation, exploitation, contact or prostitution;

crimes against persons; or offenses committed against children. These crimes do not hold a time statue and will be evaluated the same under any Child Care “CNACI” investigation with IHS. IHS will conduct these investigations following award of a contract. Until the character investigation has been completed and the Contracting Officer notified of the results, the Contractor’s employees must not have unsupervised contact with Indian children. Contractor’s employees are not able to work a scheduled shift until the security check is performed and clearance has been obtained by the appropriate agency. At a minimum, fingerprints are required, and upon clearance of this stage, a contractor’s employee may work a scheduled shift. However, Contractor’s employees are required to complete the detailed background application and the application is to be completed within 30 days once the contractor’s employee has been given physical and logical access. All Contractors’ employees are subject to criminal background check prior to performing services in accordance with the contract terms and conditions. The contractor shall ensure that each of their employees complete the Certification of Criminal History and Background Check Packet.

5.6.5 Required Training: Protecting Children from Sexual Abuse as stated in IHM Circular 19-05; Contractor Training Plan for Implementation of Indian Health Manual Part 3, Chapter 20;Protecting Children from Sexual Abuse by Health Care Providers; HHS Annual Emergency Preparedness Training; HHS Records Management; I-STAR training; Annual Ethics Training; ISSA Training;

Cybersecurity Awareness Training; IHS Patient Safety; Trauma Informed Care and Historical Trauma, HIPAA/Privacy Training; IHS Unauthorized Commitments, and IHS Reversing Opioid Overdose/Naloxone Training. Each provider must take this training within 30 days from their start date at the service unit. Certificate should be provided to the COR.

5.6.8 Subpoenas/Testimonies: Contractors are mandated to cooperate with the appropriate IHS managers when the contractors' employees are subpoenaed or

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5.7 Challenges to Conflicts: For any inconsistency between COR and Contractor's employee, the employee should contact their agency. If this situation needs further remedies, then the Contractor will contact the COR

5.8 When the Contractor demonstrates impaired judgement, they cannot continue working under the contract. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

6.0 Acceptance

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

7.0 Performance

7.1 Period of Performance

Services under this contract shall commence NLT 10 days after all clearances occur. The estimated period of performance dates are as follows:

Base Year: October 1, 2025 – September 30, 2026 Option Year 1: October 1, 2026 – September 30, 2027 Option Year 2: October 1, 2027 – September 30, 2028 Option Year 3: October 1, 2028 – September 30, 2029 Option Year 4: October 1, 2029 – September 30, 2030

7.2 Place of Performance

Work to be completed at the Monacan Health Center located at 108 Dixie Airport Rd, Madison Heights, VA 24572.

7.3 Travel to and from the facility are not included in the tour of duty.

7.4 Government Holidays

New Year's Day Martin Luther King's Birthday Washington’s Birthday Memorial Day Juneteenth Independence Day Labor Day Columbus Day Veteran's Day

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Thanksgiving Day Christmas Day *Any other day specifically declared by the President of the United States to be a national holiday.

7.5 Technical Monitoring

(a) Performance of work under this contract must be subject to the technical direction of the COR identified below in 7.5(f), or an Alternate COR designated in writing. The term "technical direction" includes, without limitation, direction to the Contractor that directs or redirects the labor effort, shifts the work between work areas or locations, fills in details and otherwise serves to ensure that task areas outlined in the SOW are accomplished satisfactorily.

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

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

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

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

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

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

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

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

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

(e) Failure of the Contractor and the CO to agree that technical direction is within the scope of the contract shall be subject to the terms of the clause entitled "Disputes" (FAR 52.233-1, Disputes).

(f) Contracting Officer’s Representative (COR) - The designated COR for this requirement will be:

Kaleigh Pollak Klaman, COR Kaleigh.Pollak@ihs.gov Phone: 804-334-1985 mailto:Kaleigh.Pollak@ihs.gov

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8.0 Invoice Submission

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

8.2 All information set forth in FAR Clause 52.212-4(g), Invoice, must be included in all invoices for it to constitute a proper invoice.

FAR 52.212-4(g) Invoice.

(1) 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—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

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

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

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

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

EFT.

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(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

8.3 In accordance with OMB Memorandum, M-11-32; Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. For a small business contractor not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty.

Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as "Small Business."

8.4 Additionally, in accordance with OMB Memorandum, M-12-16, fill prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner.

To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors. Consistent with OMS Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation. In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

8.5 All payments under this contract will be made by electronic funds transfer (EFT), following the guidelines in FAR 52.232-33 Payment by Electronic Funds Transfer – System for Award Management and HHSAR 352.232-71 – Electronic submission of payment requests.

Security Requirements and Personal Identity Verification Procedures (Non-Classified Contract)

FAR 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL

a. The Contractor shall comply with agency personal identity verification procedures identified in the contract that implement Homeland Security Presidential Directive-12 (HSPD-12), Office of Management and Budget (OMB) guidance M-05-24 and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

b. The Contractor shall account for all forms of Government-provided identification issued to the Contractor employees in connection with performance under this contract. The Contractor shall return such identification to the issuing agency at the earliest of any of the following, unless otherwise determined by the Government:

(1) When no longer needed for contract performance.

(2) Upon completion of the Contractor employee’s employment.

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(3) Upon contract completion or termination.

c. (c) The Contracting Officer may delay final payment under a contract if the Contractor fails to comply with these requirements.

d. (d) The Contractor shall insert the substance of this clause, including this paragraph (d), in all subcontracts when the subcontractor’s employees are required to have routine physical access to a Federally-controlled facility and/or routine access to a Federally-controlled information system. It shall be the responsibility of the prime Contractor to return such identification to the issuing agency in accordance with the terms set forth in paragraph (b) of this section, unless otherwise approved in writing by the Contracting Officer.

Qualifications of Employees

a. The Contracting officer or a designated representative may require the Contractor to remove any employee(s) from IHS controlled buildings or other real property should it be determined that the individual(s) are either unsuitable for security reasons or otherwise unfit to work on IHS controlled property.

b. The Contractor shall fill out and cause each of its employees performing work on the Contract work to fill out, for submission to the Government, such forms as may be necessary for security or other reasons. These forms shall be completed electronically. Upon request of the Contracting Officer, the Contractor and its employees shall be fingerprinted.

c. Each employee of the Contractor shall be a citizen of the United States of America, or an alien who has been lawfully admitted for permanent residence as evidenced by Alien Registration Receipt Card Form I-151, or, who presents other evidence from the Immigration and Naturalization Service that employment will not affect his immigration status.

Suitability Determinations

a. All Contract employees…