PHYSICIAN ASSISTANT (specializing in Ear, Nose and Throat)
Department of Health and Human Services, Indian Health Service | Published September 10, 2015 - Deadline September 24, 2015
This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice. This procurement is being conducted under Simplified Acquisition procedures pursuant to the authority of FAR Subpart 13.5, Test Program for Certain Commercial Items (41 U.S.C. 3305, 3306, and Chapter 37); FAR Part 12, Acquisition of Commercial Items (41 U.S.C. 1906 and 1907)); FAR 37.104, Personal Services Contracts (Public Law 103-332, Department of the Interior and Related Agencies Appropriation Act, Title II, September 30, 1994, 108 Stat. 2530 as implemented by 25 U.S.C. 1638c); and FAR Subpart 37.6, Performance-Based Contracting. This announcement constitutes the only solicitation; therefore, a written solicitation will not be issued. The Billings Area Indian Health Service (IHS) intends to award a fixed-price, personal services, performance-based commercial item contract in response to Request for Quotation (RFQ)-10-15-061-REL. The solicitation is issued on an unrestricted basis. The solicitation documents and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-84. The associated North American Industry Classification System code is 621399 and the small business size standard is $7.5 million.
PRICE SCHEDULE - PHYSICIAN ASSISTANT (specializing in Ear, Nose and Throat):
BASE YEAR: 112 DAYS @ $_______________ per day = $____________________;
OPTION YEAR ONE: 112 DAYS @ $_______________ per day = $____________________;
OPTION YEAR TWO: 112 DAYS @ $_______________ per day = $____________________;
OPTION YEAR THREE: 112 DAYS @ $_______________ per day = $____________________;
OPTION YEAR FOUR: 112 DAYS @ $_______________ per day = $____________________;
GRAND TOTAL: $____________________.
PERIOD OF PERFORMANCE: October 1, 2015, through September 30, 2016, with four 12-month options.
STATEMENT OF WORK: (1) The contractor shall coordinate monthly Ear, Nose, and Throat (ENT) Clinics at the Ft. Peck Service Unit, PHS Indian Health Centers, Poplar and Wolf Point, Montana; Northern Cheyenne Service Unit, PHS Indian Health Center, Lame Deer, Montana; and the Crow Service Unit, PHS Indian Hospital, Crow Agency, Montana (includes the Lodge Grass and Pryor Health Clinics as needed). This involves working closely with any contract Otolaryngologists, Audiologists, and all appropriate medical/administrative staff at each Service Unit. (2) The contractor shall perform direct clinic services, which include but are not limited to: (a) Report in-depth medical histories by interviewing patients. (b) Perform and interpret complete examinations of the ear, nose, and throat using otoscopy, otomicroscopy, audiometric test results, nasal speculums, nasalpharyngealscope, tongue depressors, and laryngeal mirrors, and report the findings of the evaluation. (c) Prescribe medical treatment of diagnosis resulting from the ear, nose, and throat evaluation. (d) Counsel patients regarding recommendations and results of the evaluation. (e) Serves as a primary ENT consultant to the Physicians, Audiologists, and other appropriate staff at the Service Units. (f) Schedule appointments and perform referrals to any contract Otolaryngologists or to Otolaryngologists through the Purchased/Referred Care (PRC) Program (formerly known as Contract Health Services) for those who are at risk for hearing loss and chronic ear, nose, and throat problems. (g) Assist any contract Otolaryngologists with ENT Clinics, referrals to other specialty clinics, and other subspecialties within the otolaryngology field. (3) The contractor shall coordinate the ENT surgical program when available at the Crow/Northern Cheyenne Indian Hospital in Crow Agency, Montana. This includes working closely with the Surgical Department to ensure all necessary surgical personnel and equipment is available for the contract Otolaryngologists. (4) The contractor shall perform in-service training to the Service Units Physicians, and other medical personnel on pathology and treatment of ear, nose, and throat diseases, as needed. (5) The contractor shall perform otologic screenings for school age children, Head Start children, and Nursing Home residents, as needed. The contractor shall work closely with the Audiologists for audiologic test results to assess the otologic and audiologic outcomes for determining referrals and follow-up testing, as needed. (6) The contractor shall be available to teach nursing, pharmacy, physician assistant, and medical students in the ENT Clinics during clinic rotations, as needed. (7) The contractor shall identify alternate resources for funding surgical care when services can not be provided at the Crow/Northern Cheyenne Indian Hospital. (8) The contractor shall maintain a surgery log of all patients in need of surgery, have had surgery and for follow up treatment. (9) The contractor shall oversee the care and maintenance of all otologic equipment including appropriate safety checks. (10) The contractor shall determine equipment and supply needs for the ENT Clinics and submit requests to the appropriate Service Unit or Area Communication Disorders Department. (11) The contractor will be subject to the same periodic Quality Assurance/Peer Review process at each Service Unit that is established in the policies and procedures for all health care providers either by an IHS Physician Supervisor or IHS contract Otolaryngologists. (12) The contractor will provide 112 days of ENT Clinics per year. This includes 64 days per year at the Crow Service Unit, Crow Agency, Montana; 18 days per year at the Fort Peck Service Unit, Poplar and/or Wolf Point, Montana; and 30 days at the Northern Cheyenne Service Unit, Lame Deer, Montana.
SUPERVISORY CONTROLS: The Chief Medical Officer provides general administrative direction which includes broadly defined agency goals and objectives. The contractor carries out most assignments with a high degree of autonomy. The contractor is recognized as an authority on ENT care. Review of the work concerns only the overall outcomes/goals of the projects. The contractor may be asked for specific output, but is usually at liberty to accomplish the assignments independently in the manner deemed most suitable. Results are considered technically authoritative and are normally accepted without change.
GUIDELINES: The contractor uses legislative (Federal, State and Tribal), agency policy statements, accreditation body standards, national professional standards that may be either specific or non-specific. These guidelines require continuous interpretation, adaptation to rural, trans-cultural setting, and application to conform to changes in the health care field and the needs of the Indian Health Service. The contractor is responsible for interpreting the legislation and policy and for developing specific standards, policies and guidelines for the Billings Area Indian Health Service.
COMPLEXITY: Work requires substantial depth of analysis applying to broad range of health care functions (i.e., administration, education, research and clinical practice). The contractor identifies issues and analyzes the interrelationships between the broad functions of health care and ENT, and predicts trends that will impact Indian Health Service. Work involves major area of uncertainty such as the continuing change in health care standards of practice, ENT program and role evaluation, new technological developments, increasingly complex legislation and regulation requirements, staffing utilization options, and budget constraints. The contractor solves problems that have potential political and cultural effects and that are interrelated with activities of other sectors of the health care delivery system. The contractor must remain continually up-to-date on changing legislation, technology and the role of the ENT Physician Assistant in order to implement solutions to problems or to meet established standards. Complexity of the contract requirements is enhanced by the numbers and varieties of health care disciplines, federal, state, local, and tribal representatives interfaced; diversity of the population served; remoteness of facilities and programs; and the variety of number of health care problems facing the serviced population.
SCOPE AND EFFECT: The purpose of this contract is to hire an ENT Physician Assistant to provide continuity and coordination of ENT services to the Crow, Northern Cheyenne and Fort Peck Service Units and to ensure the highest quality of care/services provided throughout the Billings Area. Work includes activities and interventions affecting the full range of services (inpatient, outpatient, public health, administration, etc.). Work also impacts the improvement of health care programs at the local, state and national levels, through involvement with other agencies and organizations. The work affects the overall mission and the goals of the Agency, large numbers of employees and the Indian population.
PERSONAL CONTACTS: Personal contacts are varied and numerous and include health care professionals; client and families; federal, state, local and tribal officials, employees and agencies, including elected officials, educated professionals and local media. Contacts may be with individuals or groups at the local or national level both in and outside of the federal and Indian Health Service system.
PURPOSE OF THE CONTACTS: The purpose of the contacts is to provide ENT Physician Assistant Services and expertise and to represent the Billings Area and/or Indian Health Service.
PHYSICAL DEMANDS: Work is essentially sedentary with some walking, standing, carrying of books, files, etc. Travel by automobile over long distances is required to make site visits in coordination with ENT Physician Assistant Services to the various clinics and hospitals.
WORK ENVIRONMENT: The work environment involves every day risks associated with offices, hospital and clinic environments and settings; and automobile travel, including but not limited to, exposure to cathode ray tube computer monitors, potential for repetitive motion syndrome from keyboard use, hazardous weather, long periods of sitting and animals on the road. Visits to the hospital and clinic setting may include exposure to communicable disease. Where required; necessary personal protective equipment will be supplied. Situations arise, such as interactions with angry individuals, which may invoke stress. Work may require irregular or long work and travel hours in a variety of work environments.
PERFORMANCE-BASED SERVICE DELIVERY SUMMARY: The contract Physician Assistant's performance will be measured based on the following Performance Requirements: (1) Quality of Performance; (2) Customer Service; (3) Adherence to contract schedules; and (4) Documentation of Medical Record or Electronic Health Record (EHR). The Performance Requirements will be measured against the following Government Performance Standards: (1) Provide direct Ear, Nose and Throat (ENT) services, and when the Otolaryngology contract services are available, coordinate the ENT surgeries; (2) Reasonable, cooperative, and a commitment to customer satisfaction; (3) Schedule ENT clinics; and when an Otolaryngology contract is awarded, schedule ENT pre-ops, surgeries and clinics with ENT physicians; (4) Appropriately completes and reviews the medical records or EHR for examining, diagnosing, and treating ENT disorders. The Method of Government Surveillance to determine compliance with the Performance Requirements is as follows: (1) Two quality assurance (QA) peer reviews a year from two different Service Units, conducted every six months, with a copy provided to the Contracting Officer's Representative (COR); (2) Validated call in patient complaints. (3) Misses two scheduled clinics a month, without valid reason; and (4) Two QA peer reviews a year from two different Service Units, conducted every six months, with a copy provided to the COR. Deduction Schedule: (1) A 5% deduction from the invoice every six months if no review is sent to the COR and has 50% or more inadequate marks; (2) 5% deduction from the invoice of two or more patient complaints per quarter; (3) 5% deduction from each monthly invoice; and (4) 5% deduction from the invoice every six months if no review is sent to the COR and has 50% or more inadequate marks. Deductions shall be assessed against the invoices when services are not performed or do not meet contract requirements.
SPECIAL CONTRACT REQUIREMENTS: The Federal Tort Claims Act coverage for medical related claims is extended to the individual providing services pursuant to this contract. However, the services must be within the scope of the personal services contract. The contractor shall prepare and complete all medical and other required reporting documents as required by IHS procedural guidelines and policies. The contractor shall comply with all IHS facility infection control and safety procedures, practices and standards. The contractor must maintain and demonstrate knowledge of, and adhere to, hospital and departmental safety regulations. The contractor shall comply with the following requirements: infection control, hazardous materials, safety, security, emergency preparedness, life safety, medical equipment and utilities in accordance with established management plans. Contractors cannot serve as expert witnesses in any suit against the Federal Government. Many of the IHS patients receiving services may only speak a native language and/or reside on a Native American Reservation, therefore, the contractor must demonstrate sensitivity to cross-cultural and language differences.
GOVERNMENT FURNISHED PROPERTY: The following will be provided: Office space, including a computer, supplies, telephone, clerical support, General Services Administration (GSA) vehicle, all medical and specialized ENT equipment, and supplies needed to perform and deliver services at the Crow, Northern Cheyenne and Fort Peck Service Units. The Department will provide orientation to the Contractor as to their specific duties and responsibilities. The Department will provide the Contractor with a computer. The Department is responsible for getting the Contractor access and clearances to all pertinent computer services necessary to carry out his/her duties. The Department will provide the Contractor with direction and proper workloads, which are appropriate with the normal day-to-day operations.
CONTRACTING OFFICER AUTHORITY: Authority to negotiate changes in the terms, conditions or amounts cited in this contract is reserved for the Contracting Officer.
CONTRACTING OFFICER'S REPRESENTATIVE (COR): The COR shall be responsible for: (1) Monitoring the Contractors technical progress, including surveillance and assessment of performance and recommending technical changes; (2) Interpreting the Statement of Work; (3) Technical evaluation as required; (4) Technical inspections and acceptance; and (5) Assisting the Contractor in the resolution of technical problems encountered during performance of this contract.
INVOICE SUBMISSION AND PAYMENT: The Contractor shall submit its invoices to the Billings Area Financial Management Branch, P.O. Box 36600, Billings, Montana 59107, with a courtesy copy to the Office of Health Care Programs. The Contractor agrees to include the following information on each invoice: (1) Contractor's name and address; (2) Contact name, title, and telephone number; (3) Contract Number; (4) Invoice number and date; (5) Description, quantity, unit of measure, unit price, and extended price of supplies delivered or services performed; (6) Remit to Address; (7) Taxpayer Identification Number (Employer Identification Number or Social Security Number); and (8) Data Universal Numbering System (DUNS) number (to ensure payment is made to the correct bank account) and vendor mailing address, as provided in the System for Award Management (SAM), formerly known as the Central Contractor Registration (CCR) database. Payment shall be made by the Billings Area Financial Management Branch, P.O. Box 36600, Billings, Montana 59107.
PRO-CHILDREN ACT OF 1994: The Contractor certifies that it will comply with the provisions of Public Law 103-227, Pro-Children Act of 1994, which imposes restrictions on smoking where federally funded children's services are provided.
CHILD CARE NATIONAL AGENCY CHECK AND INVESTIGATION (CNACI). A CNACI must be completed for all Indian Health Service (IHS) contractor personnel within the Billings Area. Public Law (P.L.) 101-630, Indian Child Protection and Family Violence Prevention Act and P.L. 101-647, Crime Control Act of 1990, require the IHS to conduct a character and criminal history background investigation on all contractors performing services in IHS facilities. The Billings Area Office of Human Resources, 2900 Fourth Avenue North, Billings, Montana will conduct the character and background investigation. Fingerprints must also be taken as part of the pre-employment process and must be completed before the physician assistant is allowed to work.
PROVISIONS AND CLAUSES: The following provisions and clauses apply to this acquisition. The FAR provision 52.212-1 Instructions to Offerors Commercial Items, and 52.212-3 Offeror Representations and Certifications Commercial Items are incorporated by reference. The provision at 52.212-2 applies to this acquisition and is provided in full text. FAR 52.212-2 EVALUATION - COMMERCIAL ITEMS (OCT 2014): (a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers for award purposes: (1) Professional Education/Specialty Training (The proposal must include a copy of a diploma or certificate.) = 10 POINTS; (2) Ear, Nose, and Throat (ENT) Physician Assistant Experience (The proposal must include a resume of experience. The proposal must include a narrative that describes the physician assistant's experience and technical skills to perform the statement of work.) = 25 POINTS; (3) Hospital Affiliations (The proposal must include a copy of all current hospital affiliations.) = 5 POINTS; (4) Professional Certification and Licensure (The proposal must include a copy of all professional certifications and licensure.) = 15 POINTS; and (5) Professional Affiliations (The resume submitted with the proposal must include professional affiliations.) = 5 POINTS; (6) Suitability (Offerors must submit documentation with offer.) = 10 POINTS = Identify those that apply with an explanation for each (a) Professional liability claims and judgments made against the offeror; (b) Previous denial or revocation of medical staff membership at another facility; (c) Previous reduction, suspension, revocation, voluntary relinquishment, or non renewal of privileges at another facility; (d) Problem with alcohol or drug abuse; (e) Previous loss, suspension, restriction, denial, or voluntary relinquishment of professional licensure or professional society membership; (f) Problem with health; (g) Revocation or suspension as a Medicare or Medicaid provider; (h) Professional liability cancellation within the past five years; (i) DEA licensing investigation or actions; and (j) More than five percent ownership of any medical facility, joint ownership or medical service, or equipment with a facility to which patients may be referred.); and (7) Past Performance Information (Offerors must submit documentation with offer) = 30 POINTS. The offeror must demonstrate its record of successful performance in past contracts and/or jobs, Government and/or commercial. Each offeror will be evaluated on its performance under existing and prior contracts/jobs. The offeror must list at least three contracts/jobs and include the following information. (1) Name of Government agency/Company; (2) Contract number, if applicable; (3) Dates of Service/Employment; (4) Total contract value/Hourly wage; (5) Description of contract work/Job duties; (6) Contracting Officer/Company Manager and telephone number; (7) Program Manager and telephone number, if applicable; and (8) Administrative Contracting Officer and telephone number, if applicable. Technical and past performance, when combined, are approximately equal to cost or price. (b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). (c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award. The following FAR and Health and Human Services Acquisition Regulation (HHSAR) clauses are applicable: 52.204-4, 52.204-7, 52.204-9, 52.204-13, 52.204-16, 52.204-17, 52.204-18, 52.204-19, 52.212-4, 52.212-5, 52.215-5, 52.217-8, 52.217-9, 52.223-5, 52.223-6, 52.224-1, 52.224-2, 52.225-25, 52.227-14, 52.227-17, 52.228-5, 52.232-3, 52.232-18, 52.232-39, 52.237-2, 52.237-3, 52.242-15, 52.242-17, 52.244-6, 52.245-1, 52.249-12, 52.251-1, 52.251-2, 352.201-70, 352.202-1, 352.203-70, 352.215-1, 352.215-70, 352.222-70, 352.223-70, 352.224-70, 352.227-70, 352.231-71, 352.237-70, 352.237-71, 352.237-72, 352.239-72, 352.239-73, 352.242-71, 352.242-72, 352.242-73, 352.270-2 and 352.270-3. The following FAR clauses cited in 52.212-5 are applicable to the acquisition: 52.203-6 with Alternate I, 52.204-10, 52.209-6, 52.219-8, 52.219-28, 52.222-3, 52.222-21, 52.222-26, 52.222-35, 52.222-36, 52.222-37, 52.222-50, 52.223-18, 52.225-13 and 52.232-33. Upon request, the Contracting Officer will provide full text copies of the FAR and HHSAR provisions and clauses. The provisions and clauses may also be accessed electronically at https://www.acquisition.gov/ and http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=3524d214210697effd2fd5c77848a806&rgn=div5&view=text&node=48:188.8.131.52.33&idno=48.
PROPOSAL SUBMISSION INSTRUCTIONS: The Contractor shall provide evidence of, or submit a written response to, the technical evaluation factors in FAR 52.212-2. In addition, the Contractor shall submit a completed copy of FAR 52.212-3 with its offer, if the electronic Representations and Certifications section of the System for Award Management (SAM) is not completed. Contractors intending to conduct business with the Federal Government must register with the System for Award Management (SAM). SAM replaces the Department of Defense's Central Contractor Registration (CCR) database. SAM is now the primary Government repository, which retains information on Government contractors. You may register via the Internet at www.sam.gov. All responsible offerors may submit a proposal, which shall be considered by the Agency. Offers shall be submitted to the Billings Area Indian Health Service, 2900 Fourth Avenue North, Room 304, Billings, Montana 59101, no later than 3:00 p.m. on September 24, 2015. The offer must be submitted in a sealed envelope, addressed to this office, showing the time specified for receipt, the solicitation number, and your name and address. Offers will also be accepted by e-mail at Rita.Langager@ihs.gov or by fax at (406) 247-7108.
ACCEPTANCE PERIOD: Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. In addition, it must contain a statement to the effect that it is firm for a period of at least 90 days from the date of receipt by the Government.