NNMC - NPSC for General Surgery Nocturnist

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 declare their status as an "Indian Economic Enterprise" (IEE) in accordance with the Buy Indian Act. This form is required in response to Sources Sought Notices, Requests for Information (RFIs), or Solicitations.

• Eligibility Requirements: The enterprise must meet the definition of an IEE throughout the offer period, contract award, and the full contract performance period. Any change in eligibility requires immediate notification to the Contracting Officer.
• Documentation: Contracting Officers may request documentation of eligibility before awarding set-aside or sole source contracts under the Buy Indian Act.
• Registration: Successful Offerors must be registered with the System of Award Management (SAM).
• Penalties: False or misleading information is a violation of law, punishable under 18 U.S.C. 1001, and false claims are subject to penalties under 31 U.S.C. 3729-3731 and 18 U.S.C. 287.
• Representation Section: Bidders must indicate whether they represent that their offer does or does not meet the definition of an "Indian Economic Enterprise" with "Indian Ownership."
• Required Fields: Name of Federally Recognized Tribal Entity, Name of the 51% owner of IEE Firm, Business Name, DUNS Number, Certifying Signature, and Print Name.

This form is critical for any bidder seeking to qualify for contracts set aside under the Buy Indian Act. Bidders must accurately complete this self-certification to demonstrate their eligibility. Failure to meet the IEE definition or provide accurate information can lead to disqualification or penalties.

Statement of Work (SOW) / Performance Work Statement (PWS)

This Performance Work Statement (PWS) outlines the requirements for non-personal services for a General Surgery Nocturnist to support the mission of the Indian Health Service (IHS) at the Navajo Area Indian Health Service (NAIHS), Shiprock Service Unit - Northern Navajo Medical Center (NNMC) in New Mexico.

• Provide general surgery nocturnist services to IHS patients, encompassing diagnostic and therapeutic procedures for the full range of general surgical patients.

• Care for adults and children over 18 months, including routine and emergency cases.

• Provide on-call coverage, including call-back hours for consults/admissions from the ED, outpatient clinics, inpatient services, and local referral centers.

• Perform emergency general surgical cases and upper/lower endoscopies as needed.

• May be called to assist in emergency surgical cases with other surgical service providers.

• Review clinical records and adhere to documentation procedures.

• Period of Performance: Base of 6 months with four 6-month option periods.

• Place of Performance: Navajo Area Indian Health Service (NAIHS), Shiprock Service Unit - Northern Navajo Medical Center (NNMC), New Mexico.

• Services must be performed in accordance with competency standards listed in the Shiprock Service Unit Medical Staff By-Laws and the policies/procedures of the Service Unit's Medical Staff Bylaws and Rules & Regulations.

• Performance will be monitored by the Northern Navajo Medical Center's quality assurance plan.

• Medical records must meet established IHS, Joint Commission, and CMS standards for timeliness, legibility, accuracy, content, date, time, signature, and designated profession.

• Performance will be evaluated based on "What Success Looks Like" criteria, including competency, compliance, patient outcomes, professionalism, credentialing, documentation, and service quality.

• Contractor must be a Board Eligible or Board Certified General Surgeon.

• Must possess a current, valid, unrestricted license in any U.S. state, territory, or D.C.

• Must obtain and maintain medical staff clinical privileges and a personal or Federal DEA number.

• Required certifications: Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS).

• Health requirements include a fitness for duty certificate and specific immunizations (Rubella, Mumps, Measles, Hepatitis B, Chicken Pox, Tetanus Diphtheria, TB Mantoux test, Flu vaccination).

• Contractor must adhere to the Federal Code of Conduct and demonstrate respect for American Indian and Alaska Native culture.

• Contractor must manage patient information in accordance with HIPAA, Privacy Act, and IHS policies.

• Contractor must adapt to and utilize IHS information technology systems and adhere to IT security policies.

• Contractor must wear a government-issued identification badge.

• Work Schedule: Five weekly overnight on-call shifts (Wed-Sun, 1700-0700), with 1-2 weekends per month covering full weekend on-call. Specific tours of duty determined by the Chief of Surgery.

• Planned absences require at least 15 days advance notice, with approval contingent on a qualified replacement.

• Background checks (Level I and Level II) are required.

Form / Attachment / Pricing Sheet

This document is a Business Associate Agreement (BAA) that is attached to and incorporated into the main contract. It outlines the terms and conditions under which a "Business Associate" must safeguard Protected Health Information (PHI) when performing services for the Indian Health Service (IHS), which acts as the "Covered Entity."

• Definitions: Defines key terms such as "Business Associate," "Covered Entity," "HIPAA Rules," and "Master Patient Index (MPI)."
• Obligations of Business Associate: Details requirements for compliance with HIPAA Rules, safeguarding PHI (including electronic PHI), reporting unauthorized uses/disclosures and breaches, providing individual access to PHI, accounting for disclosures, and amending PHI.
• Permitted Uses and Disclosures: Specifies how the Business Associate may use or disclose PHI, generally limited to performing functions for the Covered Entity, with individual authorization, or for treatment, payment, or healthcare operations.
• Obligations of Covered Entity: Outlines what the IHS must provide to the Business Associate, such as its Notice of Privacy Practices and any limitations or restrictions.
• Termination: Defines the term of the agreement and conditions for termination, including obligations upon termination such as returning or destroying PHI.
• Indemnification: Addresses reimbursement for costs related to investigations or legal actions arising from non-compliance with HIPAA Rules.

Vendors who will handle Protected Health Information (PHI) as part of this contract must understand and agree to the terms of this Business Associate Agreement. It details their responsibilities and liabilities regarding HIPAA compliance, data security, and breach notification. Failure to comply can result in penalties and termination of the agreement.

Solicitation / RFP / RFQ

This is a combined synopsis/solicitation for commercial services, specifically General Surgery Nocturnist services at Northern Navajo Medical Center. The acquisition is set aside for an Indian Small Business Economic Enterprise (ISBEE). A separate written solicitation will not be issued.

• Provision of General Surgery Nocturnist services.

• Services are required for a Base Period and four (4) Option Periods, each six (6) months in duration.

• The estimated hours for each General Surgery Nocturnist are provided in the Schedule of Items.

• The Government may issue multiple awards to satisfy the requirement for two (2) General Nocturnists.

• Attachment A – Performance Work Statement (PWS) details specific requirements.

• Contract type: Not explicitly stated, but implied to be a contract for services.

• Period of Performance: Six (6) month Base Period and four (4) Option Periods of six (6) months each.

• Estimated Value: Not stated.

• Offers must be submitted in PDF format, divided into three volumes:

  • Volume I: Administrative Documents (SF-1449, SF-30 amendments, IEE Representation Form).
  • Volume II: Technical Capability (approach to meet PWS, key personnel qualifications, proposed schedule, personnel retention plan).
  • Volume III: Pricing Information (detailed pricing, budget narrative, hourly rate breakdown).

• Each volume must be a separate file, clearly labeled.

• Email subject line must reference the solicitation number and offeror name.

• Quotes failing to address all Volumes will be marked "Non-Responsive".

• Evaluation Factors: Technical capability and approach, key personnel qualifications, capability to recruit/retain personnel, and Price.

• This acquisition is an Indian Small Business Economic Enterprise (ISBEE) set aside.

• The solicitation incorporates provisions and clauses by reference. Full text can be accessed electronically at www.acquisition.gov and www.acquisition.gov/hhsar.

• Quotes are due by June 24, 2026, 3:00 pm MDT.

• Contact Michelle James at michelle.james@ihs.gov for additional information or questions.

Solicitation / RFP / RFQ

This document is a solicitation for commercial items, specifically for services to be provided to the Northern Navajo Medical Center. The acquisition is set aside 100% for small business.

Details regarding specific services, tasks, or deliverables are not fully provided in the visible sections of this form. The "SCHEDULE OF SUPPLIES/SERVICES" section is referenced but not detailed in the provided pages.

• The solicitation number is 75H71026Q00184.

• The issue date is June 16, 2026.

• The offer due date is June 24, 2026, at 1500 MDT.

• The North American Industry Classification Standard (NAICS) code is 621111, with a size standard of $16 million.

• Bidders are instructed to complete blocks 12, 17, 23, 24, and 30.

• The solicitation incorporates by reference FAR 52.212-1, 52.212-4, and 52.212-5, which are stated to be attached (though not provided in this excerpt).

• Electronic payment processes via www.ipp.gov are mentioned, with specific instructions for invoice submission.

• This acquisition is a 100% small business set-aside.

• The document is Standard Form 1449 (Rev. 11/2021).

• Contact for solicitation information is Michelle James at 928-871-5841.