Telemedicine Emergency and Sexual Assault Forensic Support Services Support for Five (5) Facilities within the Great Plains Area Indian Health Service (GPAIHS)

SECTION C — PERFORMANCE WORK STATEMENT (PWS) IDIQ — Telemedicine Emergency and Sexual Assault Forensic Support Services Support for Five Rural Hospitals C.1 Purpose This Performance Work Statement (PWS) describes requirements under an Indefinite- Delivery/Indefinite-Quantity (IDIQ) contract for 24/7/365 telemedicine clinical support services for five (5) rural hospitals (“Spoke Sites”). The Contractor shall provide (1) Tele-Emergency (Tele- ED) high-acuity emergency support and (2) Telemedicine Sexual Assault Medical Forensic Evaluation (TeleSAMFE/TeleSANE) support, as ordered by task order. C.2 Background • Rural hospitals often have limited on-site specialty and critical care coverage and variable access to emergency-trained clinicians. • Many rural hospitals lack consistent Sexual Assault Nurse Examiner (SANE) coverage, creating delays and inconsistency in forensic evaluations. • Telemedicine-enabled specialty support improves access to expertise, stabilization, documentation quality, evidence collection consistency, and patient-centered trauma- informed care. C.3 Scope of Work The Contractor shall provide synchronous audio-video telemedicine support using a hub-and- spoke model for the following service lines, as ordered by task order. The work will support 5 rural hospitals in South Dakota and North Dakota. Approximately ED volumes as follows: Facility Location Annual ED Volume Pine Ridge Hospital Pine Ridge, SD 27,794 Rosebud Hospital Rosebud, SD 16,324 Eagle Butte Hospital Eagle Butte, SD 14,141 Quentin Burdick Hospital Belcourt, ND 12,762 Fort Yates Hospital Fort Yates, ND 7,591 C.3.1 Tele-Emergency (Tele-ED) Support Real-time consultative support for emergent and time-sensitive clinical events in the ED and other authorized settings, including but not limited to: • Cardiac/respiratory arrest (ACLS/PALS guidance) and post-ROSC support • Trauma resuscitation support and stabilization • Airway emergencies and ventilatory support guidance • Sepsis and septic shock stabilization -- 1 of 8 -- • Pediatric emergency stabilization • Stroke and neurologic emergencies (triage/transfer support) • Toxicology/overdose stabilization • Obstetric emergencies (stabilization support within scope/privileges) • Surge/mass casualty events upon request Tele-ED Clinicians provide consultative guidance. On-site clinicians retain responsibility for direct patient care and local clinical decisions. C.3.2 TeleSAMFE / TeleSANE Support On-demand telemedicine support to enable timely, high-quality Sexual Assault Medical Forensic Evaluations (SAMFE), consistent with applicable standards of care and trauma-informed practices, including: • Trauma-informed patient engagement, consent guidance, and patient autonomy support • Medical and assault history guidance using non-leading techniques • Physical assessment and injury identification guidance • Forensic evidence collection and documentation support • STI and pregnancy prophylaxis guidance per site protocol • Safety planning and referral coordination • De-identified case review and quality improvement support C.4 IDIQ Structure and Ordering C.4.1. Contract Type: IDIQ. Services will be ordered via task orders issued by the Contracting Officer (CO) or authorized Ordering Official. C 4.2. Task orders may specify: covered Spoke Sites (up to five), service line(s) (Tele-ED, TeleSAMFE, or both), coverage model, staffing, response time standards, escalation, telehealth workflow integration, reporting requirements, and performance metrics (PRS). C 4.3. The Government may provide anticipated event types and estimated count volumes by site for planning purposes. Estimated workloads provided by the Government are planning estimates only and do not guarantee volumes. C.5 Period and Place of Performance C.5.1 Period of Performance: Base Period of 12 months with four (4) additional 12-month option periods (if exercised). C.5.2 Place of Performance: • Remote: Contractor telemedicine operations within the United States (unless otherwise authorized). • On-site: Five rural Spoke Sites identified by the Government: 1. Pine Ridge Hospital, Pine Ridge, SD 2. Rosebud Hospital, Rosebud, SD -- 2 of 8 -- 3. Eagle Butte Hospital, Eagle Butte, SD 4. Fort Yates Hospital, Fort Yates, ND 5. Belcourt Hospital, Belcourt, ND C.6 General Requirements C.6.1 Coverage and Availability • Provide 24/7/365 coverage, including weekends and federal holidays, unless otherwise specified by task order. • Maintain staffing sufficient to meet response times and continuous coverage, including handling concurrent events consistent with task order requirements. C.6.2 Activation, Escalation, and Workflow Integration • Provide a rapid activation process (dedicated call number and/or one-touch platform activation). • Define on-site roles (e.g., telepresenter RN) and provide a documented escalation pathway if the primary remote clinician is unavailable. • Provide real-time consultative guidance to the on-site care team, including differential diagnosis support and prioritization; resuscitation leadership support and closed-loop communication coaching; medication guidance (including weight-based dosing as applicable); procedural guidance within scope and privileges; transfer decision support; and post-event debrief support when requested. (On-site clinicians retain responsibility for direct patient care and local clinical decisions.) • Support multi-party participation when needed and maintain a backup modality (audio- only) during outages when clinically appropriate and permitted. • Remain connected for the duration of the emergency event/evaluation as clinically indicated. • Support stabilization priorities before transfer, documentation of transfer rationale and recommendations, and communication support with receiving facilities when authorized by site process. C.7 Technology and Telehealth Operations • Use a secure, encrypted telehealth platform compatible with…