75H701-21-R-00015 Sources Sought

Title: IHS OEHE Long Term Care Module Development Sources Sought Response

Purpose:  This is a SOURCES SOUGHT SYNOPSIS ONLY.  The purpose of this synopsis is to gain knowledge of interest, capabilities and qualifications of firms, including Large Businesses and Small Businesses with socio-economic set-asides.      

NO PROPOSALS ARE BEING REQUESTED OR ACCEPTED WITH THIS SYNOPSIS. THIS IS NOT A SOLICITATION FOR PROPOSALS AND NO CONTRACT WILL BE AWARDED FROM THIS SYNPOSIS. Respondents will NOT be notified of the results of this synopsis. No reimbursement will be made for any costs associated with providing information in response to this synopsis or any follow-up information requested.  Please note that a decision not to submit a response to this RFI will not preclude a vendor from participating in any future solicitation.

The government is seeking firms under the North America Industry Classification System Code (NAICS) 541990; All Other Professional, Scientific, and Technical Services, with a size standard of $15.0 Million. 

Interested PRIME CONTRACTORS are invited to submit a capabilities statement/narrative demonstrating the firm’s experience in construction projects of a similar nature as described above.  The submittal shall be no longer than twenty (20) letter-size pages and shall include the following:

1. Cover letter/sheet that includes: 
A. Your firm's Data Universal Numbering System (DUNS) number, 
B. CAGE code (if applicable), 
C. Company point of contact (POC) and 
D. Socioeconomic status under North American Industry Classification System (NAICS) 
code: 541990 (i.e., SBA Certified 8(a), SBA Certified HUBZone, SDB, SDVOSB, WOSB, Native American Owned, etc.), and any other relevant/appropriate data.
E. GSA MAS Contract Number (if applicable)

2. Indicate if a solicitation is issued, will your firm be submitting a proposal (Yes/No) 

3. General Business Information: Provide general information about your business, to include any relevant information pertaining to the requirement. 

4. Experience/Past Performance: Submit at least two (2) but no more than five (5) of similar projects completed within the last ten (10) years that are relevant to the work that will be required under this project. Firms shall include the following information:
a. Indicate whether Prime Contractor or Subcontractor for each project submitted;
b. Dates for each project submitted;
c. Contract value, location, completion date, and complexity of job for each project submitted;
d. Indicate whether the project is a federal, state, tribal or other for each project submitted; and
e. Project references/Agency point of contact (telephone number and e-mail address) for each project submitted.

Questions regarding this synopsis shall be emailed to Nicholas A. Aprea, Contracting Specialist at Nicholas.Aprea@ihs.gov and Jennifer Scroggins at Jenny.Scroggins@ihs.gov. Telephone solicitations and questions will not be entertained. This sources sought is for informational and planning purposes ONLY and is not to be construed as a commitment by the Government nor will the Government pay for any information solicited. Since this is a sources sought synopsis, no evaluation letters and/or results will be issued to the respondents.

How to Respond:
EMAIL RESPONSES ARE REQUIRED BY JANUARY 11, 2021 at 2:00PM Central Time.  Electronic versions of your submission package of twenty (20) PAGES OR LESS, shall be submitted VIA EMAIL to Nicholas Aprea, email: Nicholas.Aprea@ihs.gov and Jenny Scroggins, email: Jenny.Scroggins@ihs.gov. Please enter "IHS OEHE Long Term Care Module Development Sources Sought Response" into the email subject field.

Description/Scope of Work/Performance Work Statement:
1.1 Background
The Reauthorization of the Indian Health Care Improvement Act (IHCIA), included in the Patient Protection and Affordable Care Act (ACA), which provides authority for the Indian Health Service (IHS) to provide Long-Term Care (LTC) and related services such as, home- and community-based services, hospice care, and assisted living services. This Statement of Work is a response for the inclusion of such facilities as stated in the annual report to the President for the 10 top-priority specialized health care facility’s needs.  To deliver these services IHS is responsible for developing modules. A module is an explanation of a health service that specifically details the amount of staff, and space, which is usually a function of user population. 
The Federal Acquisitions Advisory Board (FAAB), a chartered IHS workgroup responsible for implementation of this provision, has identified LTC facilities as a priority for funding and construction.  In addition, the IHS Strategic Plan 2019 – 2023 has incorporated LTC services into Goal 1, Objective 1.3. (Increase access to quality community, direct, specialty, long-term care and support services, and referred health care services and identify barriers to care for AI/AN communities.) 
The IHS currently utilizes a Health Systems Planning (HSP) software tool designed to provide documents necessary for the government or its representative to plan and acquire approval for a medical program and collate and communicate the necessary information to an Architect/Engineer for the design of a facility.  In addition, an HSP committee was created to develop, test, and implement new developed HSP modules for the software. A sub-committee tasked with developing the LTC HSP module conducted a literature review and consulted with a subject matter expert to obtain an understanding of the issues.  The key findings were:
1.    There are five (5) sectors identified as LTC:
a.    LTC – Skilled Nursing Facility (SNF) (Short-term recovery after hospitalization)
b.    LTC – Nursing Facility (NF) (Permanent custodial assistance)
c.    Assisted living
d.    Inpatient hospice
e.    Elder Day Health
Each will require their individual separate module.  Some of the sectors can be combined into one LTC facility.  
2.    The LTC certification process varies from state to state.  Depending on the type of facility both state and federal certification may be required. All required certifications information shall be present in the developed modules.  
3.    Administrators of existing Tribal LTC facilities shall be interviewed to obtain lessons learned.
4.    Using state or federal requirements for staffing may not be enough to ensure success.  Literature shows a positive correlation between the ratio of licensed nursing staff and patient outcomes.  Subject matter experts also recommend a full time RN on duty 24 hours a day, 7 days a week.  
5.    American Indian and Alaska Native Veterans will need more services than non-Veteran patients. A review of the VA models for nursing homes shows significantly higher staffing levels than the current federal or state requirements. Identification of the percentage of Veterans in remote communities will have to be considered.  IHS may determine that incorporating VA standards may need to be an option.

Based on the review and discussions with our subject matter expert, the committee determined that hiring a contractor is necessary to develop the LTC modules. 

1.2    Objective

The IHS Division of Facilities Planning and Construction (DFPC) in collaboration with the Division of Planning, Evaluation and Research are in the process of developing a LTC facility modules for the HSP software with the intent that IHS will use the modules for future agency and joint venture facility construction projects. LTC is a complex issue that involves multiple regulations, unique staffing and space requirements, and several types of specialized services.  

1.3 Scope of Work

The purpose of this contract is to provide IHS with detailed specifications for six (6) LTC modules for the HSP software.  These modules will be used by IHS, Tribes and Tribal Health Organizations (T/TOs) to build, staff, and support LTC facilities for American Indian and Alaska Native (AI/AN) people.  
The Contractor shall research all the aspects of staffing, space, medical equipment, and ensure a strong correlation to user population to meet the requirements of LTC facilities to provide high quality and access to LTC.  Once the research is complete, the contractor shall identify all the components needed to create the modules to immediately be implemented into the HSP software. 

The contractor will be responsible for creating, evaluating, and implementing the logic for staffing and space criterion in each module for the following six (6) facilities:  
a.    Skilled Nursing
b.     Nursing home 
c.    Assisted Living 
d.    Elder Day Care
e.     Skilled Nursing with Nursing Home 
f.    Assisted living with Elder Day Care 
  A completed module shall include the following deliverables:
a.    An overview narrative of the service provided with brief background information 
b.    Specific detailed notes titled “Notes to the Planner,” explaining key planning elements found in item “a” 
c.    Standard explanation of each clinical staff position needed for the facility 
d.    Include the number of support staff (i.e. administration) needed to operate the facility
e.    Define the driving variables that produce staff  
f.    Correlate the staffing results to user population
g.    Provide the corresponding space needed 
h.    Provide the equipment needed 
i.    Correlate the space needed to staff or other important factors as noted in independent research and the data provided in square feet and square meters for each room, criteria, and other considerations when planning space.   
The contractor will be an advanced, high-level LTC functional specialist who directly advises the IHS project lead, with extensive experience based on their advanced subject matter knowledge.  The Contractor shall serve as a senior member of a specialized LTC project team, providing functional knowledge to the project and team leadership of the LTC functional area. 
Contractor shall produce design specifications for the modules, accounting for compliance of the modules with state and federal requirements for certification.  The modules shall address the special needs of AI/AN Veterans.  The contractor shall be responsible for ensuring the modules comply with all regulations for certification. 
In addition to federal and state compliance for certification, the contractor shall incorporate lessons learned from existing IHS and Tribal LTC facility directors.  This information will be applied to the new modules to ensure success design, infrastructure, and implementation of the facilities
1.4 Period of Performance 
The period of performance for this contract is six (6) months from date of written Notice to Proceed (NTP). The NTP date will be a mutually agreed to date established after contract award.  All tasks and deliverables shall be completed within the six (6) months period unless a modification signed by the Contracting Officer is provided. (Reference Paragraph 5.1 Deliverable Schedule for additional information). 
1.5 Place of Performance 
Within the US and entirely at the contractor’s facility, unless travel is required. 
1.6 Applicable Documents 
Attached to this SOW is an example of a completed Wellness Center Module. This document is for reference only to assist in meeting the deliverables. Please pay close attention the staffing and space areas. The finished LTC criteria shall follow this format. 
1.    The Contractor shall become familiar with the IHS Health Systems Planning software to ensure successful implementation of the goals of this project. The contractor will provide a written summary of the key features of the HSP to demonstrate their understanding of the software. 

2.    The Contractor shall meet with the Health Systems Planning sub-committee monthly by teleconference.  The purpose of these meetings is to identify new information that builds on the findings of IHS's completed literature review of LTC, with an emphasis on the following subjects:    
a.    The correlation between Nursing staff and patient outcomes;
b.    Examples of innovative models, such as, Greenhouse models, the role of nurse assistants.
c.    LTC models outside of Indian Country.
d.    User population considerations when sizing a facility to different scales.
e.    Explanation of space with COVID-19 considerations 
f.    Medical equipment needs of LTC facilities 
3.    Create a table comparing the state and federal requirements for certification of Nursing Homes and Skilled Nursing facilities.  Tables can be based on previously published work by Harrington (2010).
a.    Must include certification references from the 35 states that presently have IHS facilities.
b.    Certification includes
i.    Staffing ratios,
ii.    Number of beds,
iii.    Certification of Need Process (CON),
iv.    Combinations of services allowed.
v.    Identify variation in state and federal standards.

4.    Develop a contact list of existing Tribal Providers and subject matter experts of IHS LTC facilities to contact for discussion on lessons learn.  

5.    Draft a list of questions for the discussion guide, per IHS approval.

6.    Conduct subject matter expert discussions with up to 3 Tribal providers of existing LTC facilities to gain knowledge of staffing, facility size, and lessons learned.

7.    Review of how to best serve AI/AN Veterans,
a.    Trauma Care,
b.    Comparison of VA staffing requirements

8.    Define characteristics of AI/AN elders to identify special health needs, such as, trauma. This information may be obtained from facility director interviews and current literature.

9.    A detailed staffing diagram of modules needed with the following groupings;
a.    Skilled Nursing Facility
b.    Nursing Facility
c.    Assisted Living
d.    Elder Day Care
e.    Combine Skilled Nursing with Nursing Facility
f.    Assisted living with Elder Day Care

10.    Final modules that can comply with all states and federal requirements to be used nationwide.
11.    Determine space requirements for new LTC facilities that includes admin space (business office,) staff support, housekeeping, kitchen, etc.
Other Performance Requirements
1.    Work with the IHS programmer assigned to the Health Systems Planning software to ensure the modules are feasible for entry into a software program. Data provided shall be a function of user population and provide step functions that will trigger if a particular staff/ space/ and/or services is warranted and how much of that staff/ space and/or services to deliver high quality care
2.1 Contractor Personnel
The Contractor shall be responsible for managing and overseeing the activities of all Contractor personnel, as well as subcontractor efforts used in performance of this effort. The Contractor's management responsibilities shall include all activities necessary to ensure the accomplishment of timely and effective support, performed in accordance with the requirements contained in this statement of work. Resumes submitted for employees assigned to perform under this statement of work shall contain documented experience directly applicable to the functions to be performed. Further, these prior work experiences shall be specific and of sufficient variety and duration that the employee is able to effectively and efficiently perform the functions assigned.
3.1 Module Deliverables 
a.    An overview narrative of the service provided with brief background information 
b.    Specific detailed notes titled “Notes to the Planner,” explaining key planning elements found in item “a”, above. 
c.    Standard explanation of each clinical staff position needed for the facility. 
d.    Include the number of support staff (i.e. administration) needed to operate the facility.
e.    Define the driving variables that produce staff.  
f.    Correlate the staffing results to user population.
g.    Provide the corresponding space needed. 
h.    Provide the medical equipment needed.
i.    Correlate the space needed to staff or other important factors as noted in independent research.
j.    Final Criteria shall follow the example (completed Wellness Center Module) format included in this SOW. 
3.2 Reporting Deliverables 
a.    Provide a 2-page summary of the key features of the HSP program. 
b.    Prepare a table comparing the state and federal requirements for certification of Nursing Homes and Skilled Nursing facilities
c.    Develop a contact list of existing Tribal Providers and subject matter experts of IHS LTC facilities to contact for discussion on lessons learn.  
d.    Provide a monthly status report which shall include the following: 

•    The contractor shall document the efforts performed in the completion of each task in a detailed month. 
•    Labor hours and hourly rate expended during the reporting period by individual. 
•    Cumulative hours expended throughout the reporting period by job category/positions an incumbent employee. 
•    Progress for the period: detailed progress report of findings, activities and accomplishments during the reporting period, and summary of work accomplished during the reporting period and percent complete. 
•    Activities planned for the next reporting period: planned activities, as well as the status of any/all deliverables, including planned delivery date(s) and actual and/or anticipated delivery date(s). 
•    Problems encountered: identification of any problems, issues or delays and recommendations as to their resolution, and any corrective action that was taken to correct identified problems. 
•    Strategy revisions: recommended changes to include any lessons learned 
•    Monthly Status Report due on or before the 10th of each.

3.3 Submission 
Timely submission of deliverables and reports is essential to successful completion of this contract. All information and data the contractor gathers or obtains in relation to this project shall be both protected from unauthorized release, and treated as property of the United States Government. The Contracting Officer is the sole official authorized to release, verbally or in writing, any data; draft deliverables; final deliverables; or any other written or printed materials pertaining to this contract. 
The contractor shall attend monthly HSP Committee conference calls and any additional conference call meetings as needed.  
Phase 1:  
•    Learn how to use HSP software.
•    Continuation of Literature review. 
•    Created table of current regulations for certification.
Phase 2:  
•    Identify current IHS/Tribal providers and subject matter experts of LTC facilities. 
•    Develop questions for the interview guide for IHS/Tribal providers and subject matter experts.
•    Obtain IHS approval of interview questions.
•    Conduct interviews of existing IHS/Tribal LTC providers and report findings to IHS COTR and HSP Committee.
Phase 3:
•    Collaborate with the IHS programmer to discuss possible modules.
o    What can or cannot be included.
o    Existing staffing formulas.
o    Specifications for remote locations.
o    Space requirements for buildings
o    Other considerations.
Phase 4:
•    Create logic models for the six (6) LTC modules.
o    Present to IHS Area Planning officers for review and comments.
o    Finalize final logic modules.
o    Present final report to IHS.

Final Report
The final report will be presented to the IHS COR, the Division of Planning and Evaluation, the Office of Environmental Health and Engineering, and the HSP Planning Committee.  Allow 30 days for IHS comments and edits.  
5.1 Deliverable Schedule:
Phase    Milestone/Deliverable     Responsibility     Date (after NTP issuance)
1     Literature review, table of regulations, contact list of current IHS LTC facilities    Contractor     60 calendar days  
2    Survey and interviews for review. Report of results    Contractor     No more than 120 calendar days
3     Report from collaboration with programmer    Contractor / Government    60 calendar days
4     Final Report for review     Contractor     30 days before the end of the period of performance 
Government review period for each deliverable is 7 calendar days unless otherwise stated above.

AGAIN, THIS IS NOT A REQUEST FOR PROPOSALS. This is for planning purposes only and is a market research tool to determine availability and adequacy of potential sources particularly Small Business Sources. The Government will not reimburse responder for the cost of submittals.