FBO Notice Date 11/20/17
BIDS Reference Number 658
Document Type: Combined Synopsis
Medical Services

Department of Health and Human Services, Indian Health Service, Billings Area Office, 59107

Q -- Nurse Midwife Services SOL RFQ-10-18-005-KN DUE 120517 POC Kenny Nicholson, Contract Specialist, Phone 4062477071, Email kenneth.nicholson@ihs.govThis 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. The procurementis being conducted under Simplified Acquisition procedures pursuant to the authority of FAR Subpart 13.5, Test Program for Certain Commercial Items (10 U.S.C. 2304(g) and 2305 and 41 U.S.C. 253(g) and 253a and 253b); FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994 (Public Law 103-355)); and FAR 37.4, Nonpersonal Health Care Services Contract (41 U.S.C. Chapter 33).

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 Requirements contract in response to Request for Quotation (RFQ)10-18-005-KN. The solicitation is issued on an unrestricted basis. The solicitation documents and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-96. The associated North American Industry Classification System code is 561320 and the small business size standard is $27.5 million. Potential contractors are asked to propose an all-inclusive daily rate. The quantities specified in the schedule are estimates only. If the Government's requirements do not result in orders in the quantities described as "estimated" in the Schedule, it does not constitute the basis for an equitable price adjustment.


01 Weekly Outpatient Clinic EST.QTY UnitUnit Price

Base Year 72 Clinic $_________
Option Year One 104 Clinic $_________
Option Year Two 104 Clinic $_________
Option Year Three 104 Clinic $_________
Option Year Four 104 Clinic $_________

PERIOD OF PERFORMANCE: 9 months (base) with four 12-month options.
If the Government exercises the options pursuant to Federal Acquisition Regulation (FAR) 52.217-9, Option to Extend the Term of the Contract (MAR 2000), the period of performance shall be extended in accordance with the following schedule:

Option Year One (1) October 1, 2018 to September 30,2019
Option Year Two (2) October 1, 2019 to September 30, 2020
OptionYear Three (3) October 1, 2020 to September 30, 2021
Option Year Four (4) October 1, 2021 to September 30, 2022

PURPOSE OF THE CONTRACT: The purpose of this acquisition is to contract for Certified Nurse Midwife Services at the Crow/Northern Cheyenne Hospital, Crow Agency, Montana 59022.

NON-PERSONAL HEALTH CARE SERVICE CONTRACT: The procurement is a nonpersonal health care service contract, as defined in 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 and professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment). The Contractor shall indemnify the Government for any liability producing acts or omissions by the Contractor, its employees and agents occurring during contract performance. The Contractor shall maintain medical liability insurance, which is not less than the amount normally prevailing within the local community for the medical specialty concerned. The Contractor is required to ensure that its subcontracts for provisions of health care services contain the requirements of the clause at 52.237-7, including the maintenance of medical liability insurance.

WORK SCHEDULE: One clinic per week from 9:00 am to 4:00 p.m with the option for an additional clinic each week. The schedule shall be coordinated with the Clinical Director.

STATEMENT OF WORK: The position is located at the Crow/Northern Cheyenne Hospital (CSU) in Crow Agency, Montana. The CSU is an Indian Health Service (IHS) facility and certified by CMS as a Critical Access Hospital. The CSU is a 24-bed inpatient facility with an outpatient clinic, Express Care clinic and a 24/7 Emergency Department services. CSU has the ability to admit patients needing inpatient services; patients needing a higher level of care can be transferred to Billings, Montana which is 60 miles away. This contract is to cover midwives services, and women's health services, in the Outpatient Clinic one (1) day per week. If demand increases, the optional 2nd weekly clinic rate will be utilized to satisfy the increased demand. The average patients seen per day by the provider would be 8-10 patients. The appointment length is 30 minutes. The contractor must provide any support staff needed by the Nurse Mid-Wife (CMA, CNA, LPN, RN). The cost per day submitted by the contractor must be all inclusive to include support staff, travel, per diem, lodging, et cetera.

Major Duties: The Certified Nurse Midwife provides healthcare, counseling and education to families of childbearing years, women from menarche through menopause, for women with gynecological problems and also for normal neonates. Performs and/or reviews health histories and performs assessment of the woman during antepartum, intrapartum, and postpartum. Identifies indicators of risk in pregnancy and performs appropriate interventions. Performs routine laboratory, radiology, screening and therapeutic procedures.

Implements the nurse-midwifery plan of care within prescribed nurse-midwifery interventions and procedures as appropriate and in accordance with nurse-midwifery care. Prescribes appropriate medications and instructs patients effectivelyin their use during antepartum, intrapartum and postpartum. Refers individuals for consultation when appropriate; prescribes and carries out, therapy in conformance with approved clinical privileges and Billings Area/IHS policy.

Educates individuals in the nature of health related conditions, recommendedtherapy, and the general promotion of health and prevention of illness/disease.

Conducts initial and periodic health examinations related to women's health for finding physical defects in need of correction, and prescribes and implements remedial treatments required to correct these defects. Administers immunizations to patients in compliance with established IHS and Billings Area policy.

Makes necessary arrangements and authorizes admission of patients to the appropriate hospital. This includes authorization for admission to contract facilities for emergency medical care and surgery. Keeps the Service Unit Director, or designee, informed of PRC (Purchased/Referred Care) admissions.

Records patient-provider transactions in the problem oriented medical recordformat and completes required data collection, referrals, and medical records as required. Documentation must be completed within 24 hours of the visit.

Assists in the provision of continuing education, on-the-job training, and orientation of Indian Health Service and Tribal staff as required. Assists in theprovision of technical/professional assistance to Tribal and community groups as required.

Refers patients and their families to MD's if necessary and Community HealthServices personnel (PHN's, nutritionists, social workers, diabetic counselors, behavioral health and WIC) as appropriate to their continued care and follow-up.

Participates, as required, in Service Unit/Area meetings to develop new, modify existing, and evaluate medical procedures and processes relative to assurance of quality patient care.

KNOWLEDGE REQUIRED BY THE POSITION: In this position the Certified Nurse Midwife needs:
- Knowledge of nursing management and care of mothers and babies throughout the maternity cycle, including normal deliveries, and care for women from menarche through menopause, women with gynecological problems.
-Knowledge and ability necessary to provide care appropriate to the age of patientsserved.
-Knowledge and empathy for bi-culturalism and practices in a manner which the patient determines is culturally safe.
-Ability to take obstetrical physical evaluation and evaluate and review finding with the physician and expectant mother.
-Ability to teach and counsel women during pregnancy and after childbirth.

The nurse midwife must possess the following to practice as a Certified Nurse Midwife (CNM):

(1) Successful completion of an accredited nursing program. Current ACNM certification. Current Montana RN and CNM license with prescriptive authority.
(2) Must have current certification in BLS/ACLS/PALS.

EVALUATION AND OVERSIGHT: The supervisor assigns work in terms of objectivesto be met, with little or no instruction. Technical guidance is provided by contract consultants in special areas of medicine. Work accomplished by the nurse midwife is considered definitive, technically authoritative and usually accepted without review. The work is evaluated through the Quality Assurance Program of the Medical Staff of the Service Unit.

TASK ORDERS: This contract type allow the Service Unit to place orders with the Contractor on an as needed basis. In accordance with Federal Acquisition Regulation (FAR) 52.216-18, Ordering (OCT 1995), the Indian Health Service (IHS) will obligate the funding and order the services by issuing task orders against the contract. The IHS will process the task orders through the Agency's automated accounting and procurement systems, iProcurement/UFMS and PRISM.

ORDERING PROCEDURES: Task orders will be processed through the automated procurement system PRISM. The Medical Services Department at the Crow/NortherCheyenne Hospital is responsible for generating the requisition in iProcurement/UFMS. Once the requisition is approved the procurement/supply office will process the requisition into a task order in PRISM. Once the task order is approved it should be faxed or e-mailed to the Contractor.
The following steps illustrate the ordering procedures for delivery/task orders:

Step 1: The Medical Services Department contacts the Contractor to coordinate the services (e.g., requests candidates and profiles, discusses starting and ending dates, etc.). Estimates are based on upcoming schedules.

Step 2: The Medical Services Department generates a requisition, both manualand in UFMS requesting a task order against the contract. The requisition should include: (1) the name of the contractor; (2) reference the contract number (3)a description of the services to be performed (e.g., Nurse Midwife or Mid-Levelor Outpatient Physician or Mid-Level Services); (4) the quantities and unit prices; and (5) the delivery or performance time frames (e.g., starting and ending dates).

Step 3: Once the requisition is approved the procurement/supply department will process the requisition into a task order in PRISM.

Step 4: The task order is faxed or e-mailed to the Contractor.

GUIDELINES: Guidelines available include PHS, IHS, Billings Area, Service Unit, and Medical Staff regulations, policies, procedures, and by-laws. In addition, traditional and currently accepted medical practices are available in the form of specialty consultation, medical journals, and textbooks. In nearly all cases, however, the CNM's judgment is the key factor in determining whether guidelines are to be adhered to, or deviated, or whether guides need to be developed to protect the interests of the patient.

COMPLEXITY: The work consists of a broad general practice of medicine, involving diagnosis and treatment of women's health issues with an extremely wide variety of physical and emotional problems and includes the broad functions of medicine: education, prevention, cure and rehabilitation, in addition to the practice within the Certified Nurse Midwife specialty.

Assignments are characterized by breadth and intensity of effort and generally involve the simultaneous application of multiple distinct skills, knowledge, and abilities in the care of one or more patients. The work is often difficult and further complicated by the fear and skepticism of patients, undefined or ill-defined problems presented in advanced stages, and conflicting data. The work requires continued efforts to establish programs to resolve chronic medical problems among the population served.

SCOPE AND EFFECT: The work of this position effects the health and well-being of individuals on an immediate basis; and impacts the health status of the community on a broad basis.

PERSONAL CONTACTS: Personal contacts of the nurse midwife are with patients,other employees, representatives of other Federal, State and Tribal health organizations, and administrators and physicians from the private sector. These contacts are made with individuals and occasionally groups in moderately unstructured setting.

PURPOSE OF CONTACTS: The purpose of contacts with individuals and groups is to educate, influence, and motivate the individuals and groups to understand andto accept recommended medical therapies.

PHYSICAL DEMANDS: The work of this position requires long periods of standing and recurring bending, crouching, stooping, stretching, and reaching. Patientsmay be required to be lifted from time to time.

WORK ENVIRONMENT: The work is performed in an outpatient clinic setting, with continued exposure to patients having a variety of illnesses and communicable diseases.

GOVERNMENT FURNISHED PROPERTY: The IHS shall provide all necessary equipmentand supplies. The Northern Cheyenne Service Unit will be responsible for getting the Contractor access and clearance to all computer services necessary to carry out his/her duties.

COMPUTER SECURITY: Pursuant to the Federal Information Security Management Act of 2002 (FISMA), the contractor will be required to complete a course in Computer Security Awareness Training (CSAT). This training must be completed annually by all employees including contractors, volunteers, students, and summer externs. The Contractor will be required to comply with the Federal Information Processing Standards Publication (FIPS PUB) Number 201, "Personal Identity Verification of Federal Employees and Contractors," and the associated Office of Management and Budget (OMB) implementation guidance for personal identity verification for all affected contractor and subcontractor personnel. Access/clearance to all pertinent computer systems, including completing the Security Checklist, Rules ofBehavior form, Security training; and if necessary, a Business Associate Agreement and/or Business Partner Interconnection Security Agreement (BPISA), should be coordinated with the Service Unit.

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 Contractor's technical progress, including surveillance andassessment 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 invoice to the Billings Area Financial Management Branch, P.O. Box 36600, Billings, Montana 59107, with a courtesy copy to the Contracting Officer's Technical Representative (COR) at the Crow/Northern Cheyenne Hospital, PHS Indian Health Center, Crow Agency, Montana. 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 deliveredor 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 in arrears 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 Service Unit will conduct thecharacter and background investigations. Fingerprints must also be taken as part of the pre-employment process and must be completed before the nurse midwife is allowed to work. The fingerprints should be coordinated with the Service Unit.

SPECIAL CONTRACT REQUIREMENTS: 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. The Privacy Act of 1974 mandates that the Contractormaintain complete confidentiality of all administrative, medical and personnel records, and all other pertinent information that comes to his/her attention or knowledge. The Privacy Act carries both civil and criminal penalties for unlawful disclosure of records. Violation of such confidentiality shall be cause for adverse action. All IHS regulations and policies applicable to these Acts shall beenforced. The Contractor shall comply with IHS facility infection control and safety procedures, practices, and standards.

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: (1) CURRENT, UNRESTRICTED R.N. ANDA.C.N.M. LICENSES = 35 POINTS. Potential contractors must submit a copy of registered nursing and American College of Nurse-Midwives licenses (all previous licenses ever held, at a minimum, license numbers and the State(s)) with price quote; (2) RESUME/CURRICULUM VITAE = 35 POINTS. Potential contractors must submit resume/CV with price quote. Resumes/CV's must include information relating to: (a)Professional Education; (b) Certifications; and (c) Previous jobs; and (3) COMPANY PAST PERFORMANCE = 30 POINTS. The Company 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 include at least three references. In evaluating past performance the Government may also use information from its own files, information provided by the offeror, or from any other sources it deems appropriate. Offerors will be given the opportunity to clarify information concerning the relevancy of an offeror's past performance information, and any adverse past performance information to which the offeror has not previously had an opportunity to respond. If the offeror has no relative past performance, they shall affirmatively state so. NOTE: The Government reserves the right to contact any reference provided by the offeror in evaluating the offeror's past performance. Furthermore,the Government reserves the right to use any information that comes to the attention of the Government in evaluating the offeror. (4) COST/PRICE: Price is not assigned an adjectival rating or scored. It will be evaluated to determine whether it is reasonable and if the quotation reflects an understanding of the requirement. This factor will be evaluated utilizing price analysis techniques identified in FAR Part 15.404-1. Analysis will include review of price reasonableness and balanced pricing. Offerors are cautioned that "materially unbalanced" prices and/or unreasonably high or low prices may cause your quotation to be deemed unacceptable and rejected. Technical and past performance, when combined, are considered 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 thetotal price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluationof 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 (orpart of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

EVALUATION APPROACH: The content of the written quotations, as well as information derived from discussions/negotiations, if discussions are held, will be evaluated to determine the degree and extent to which the requirements and objectives set forth in the solicitation are satisfied. No assumption will be made by Government evaluators regarding areas not defined in the offeror's written material/information provided to the Government for evaluation.

EVAULATION METHODOLOGY: A team of Government personnel will evaluate the quotations. The quotations will be evaluated in accordance with the aforementioned factors. Any quotation that is unrealistic, in terms of technical approach, schedule commitments, and or costs (high or low) will be deemed unacceptable.

BASIS FOR AWARD: Selection of the successful offeror will be made based on the evaluation criteria. The quotations will be evaluated and a contract awarded under the Best Value Continuum approach to permit tradeoffs among cost or price and non-cost factors. This will allow the Government to consider award to other than the lowest priced offeror or other than the highest technically rated offeror who meets or exceeds the technical acceptability standards established in thefactors referenced above.

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, 52.216-18, 52.216-19, 52.216-21, 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, 52.232-18, 52.232-39, 52.237-2, 52.237-3, 52.237-7, 52.242-15, 52.242-17, 52.243-1(alt I), 52.244-6, 52.245-1, 52.245-9, 352.203-70, 352.215-70, 352.222-70, 352.223-70, 352.224-70, 352.224-71, 352.226-3, 352.227-70, 352.237-70, 352.237-71, 352.237-72, 352.237-73, 352.237-74, 352.239-73 and 352.239-74. 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, 52.209-10, 52.219-8, 52.219-28, 52.222-3, 52.222-21, 52.222-26, 52.222-35, 52.222-36, 52.222-37, 52.222-40, 52.222-50, 52.222-54, 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://www.hhs.gov/grants/contracts/contract-policies-regulations/hhsar/part-352-solicitation-provisions-contract-clauses/index.html.

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 theSystem 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 ContractorRegistration (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 402, Billings, Montana 59101, no later than 4:00 p.m. on December 5, 2017. 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 acceptedby e-mail at Kenneth.Nicholson@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.

CITE: https://www.fbo.gov/spg/HHS/IHS/IHS-BILLINGS/RFQ-10-18-005-KN/listing.html