Western Oregon Service Unit Nurse Advice Line

Form / Attachment / Pricing Sheet

This document is the "Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form." It serves as a self-certification for offerors to confirm they meet the definition of an "Indian Economic Enterprise" as required by the Buy Indian Act. This form is to be submitted in response to a Sources Sought Notice, Request for Information (RFI), or Solicitation.

• Self-Certification: Offerors must indicate whether they meet the definition of an "Indian Economic Enterprise" with "Indian Ownership."
• Eligibility Period: The enterprise must meet the definition throughout the offer submission, contract award, and contract performance periods.
• Notification Requirement: Contractors must immediately notify the Contracting Officer if they no longer meet eligibility requirements.
• Documentation: Contracting Officers may require documentation of eligibility.
• Registration: Successful offerors must be registered with the System of Award Management (SAM).
• Penalties: False or misleading information is a violation of law and subject to penalties.
• Required Fields:
  • Name of Federally Recognized Tribal Entity
  • Name of the 51% owner of IEE Firm
  • Business Name
  • DUNS Number
  • Certifying Signature
  • Print Name

This form is critical for bidders who intend to claim status as an "Indian Economic Enterprise" under the Buy Indian Act. It outlines the self-certification process, ongoing eligibility requirements, and potential consequences of submitting false information. Bidders must accurately complete and submit this form to be considered for awards under this authority.

Form / Attachment / Pricing Sheet

This document is Attachment 1, the Schedule of Items for the 24/7 Nurse Advice Line Services solicitation (Solicitation No.: 75H71326Q00035). It requires offerors to enter firm-fixed prices for each performance period, including all costs necessary to perform the Performance Work Statement (PWS).

• CLINs: Includes a Base Period (0001) and four Option Periods (1001, 2001, 3001, 4001), each with defined start and end dates.
• Pricing Fields: Requires Unit Price and Total Price for each CLIN.
• Total Evaluated Price: A field to sum the prices for all periods.
• Offeror Information: Fields for Offeror Name, UEI, Authorized Offeror Representative, and Date.

This form is critical for bidders to complete their pricing proposal. Bidders must accurately enter their firm-fixed prices for the base period and all option periods. The Government will evaluate the total price, and the unit price may control in case of discrepancies. The evaluation of options does not commit the Government to exercising them.

Performance Work Statement (PWS)

To establish uninterrupted access to a dedicated 24/7 nurse advice line for eligible Indian Health Service (IHS) beneficiaries and their immediate family members within the Western Oregon Service Unit (WOSU). The service aims to provide timely clinical triage, appropriate care-seeking decisions, HIPAA-compliant documentation, and monthly utilization reporting.

• Provide remote, non-personal nurse advice line services 24 hours a day, 7 days a week, 365 days a year.

• Services to be performed by U.S. state-licensed Registered Nurses (RNs) using evidence-based triage protocols and clinical decision-support tools.

• Support for medical, dental, and behavioral health concerns, including triage, self-care guidance, referral, and escalation.

• Maintain a dedicated toll-free number exclusively for WOSU beneficiaries.

• Create complete, accurate, and clinically appropriate encounter documentation for each call, transmitted securely within 24 hours.

• Provide monthly utilization and performance reports by the tenth calendar day of the following month.

• Ensure services are culturally respectful, beneficiary-centered, and trauma-informed.

• Protect all protected health information (PHI) and personally identifiable information (PII) in accordance with HIPAA and other applicable regulations.

• Maintain continuity of operations plans for service disruptions.

• Coordinate transition-in and transition-out activities.

• Dedicated Toll-Free Access: Number active by service start date and available continuously.

• 24/7/365 Operations: No avoidable gap in coverage.

• RN Staffing: 100% compliance with U.S. state licensure for all clinical advice.

• Clinical Triage: Clinically appropriate documentation and disposition consistent with protocols.

• Encounter Documentation: At least 95% timely submission (within 24 hours) and 100% secure transmission.

• Monthly Reporting: Complete reports submitted on time.

• Privacy and Security: No unauthorized use or disclosure; timely incident reporting.

• Continuity of Operations: Prompt notification and corrective action for service degradation.

• Base Period: June 1, 2026 - May 31, 2027

• Option Periods: Four additional one-year options through May 31, 2031.

• Place of Performance: Contractor-controlled location(s).

• Hours: 24/7/365 coverage, operating on Pacific Time for WOSU beneficiary support.

• Staffing: RNs must be licensed in a U.S. state and in good standing. Contractor is responsible for all personnel management, training, and credential verification.

• Protocols: Use current, evidence-based clinical triage protocols and decision-support tools.

• Documentation: Secure, HIPAA-compliant transmission of encounter records.

• Reporting: Monthly utilization and performance reports required.

• Privacy/Security: Strict adherence to HIPAA, Privacy Act, and other relevant regulations. Immediate notification required for privacy, security, or service disruption incidents.

• Cultural Sensitivity: Services must be respectful and appropriate for American Indian and Alaska Native beneficiaries.

• Estimated Call Volume: 30-40 calls per month (for planning purposes only).

Form / Attachment / Pricing Sheet

This document is a U.S. Department of Labor Wage Determination (No. 2015-5573, Revision 28) for the Service Contract Act. It establishes the minimum wage rates and fringe benefits required for various occupations in the specified geographic area.

• Geographic Area: Oregon Counties of Marion and Polk.
• Occupational Listings: Provides a comprehensive list of occupations with corresponding wage rates.
• Fringe Benefits: Indicates that fringe benefits are required and follow the occupational listing.
• Executive Orders: Includes notes on Executive Order 13706 (Paid Sick Leave) and Executive Order 13658 (Minimum Wage), outlining their applicability and requirements for federal contractors.
• Conformance Process: Details the procedure for requesting additional classifications and wage rates not listed in the determination.

This document is crucial for bidders responding to solicitations that fall under the Service Contract Act. It dictates the minimum labor costs that must be factored into proposals for the specified occupations and geographic location. Bidders must ensure their proposed wages and benefits meet or exceed these requirements to be compliant.