BO Questions2

1. Can a single independently practicing NP provide all 400 hours without a physician? Yes—per SD law, a Certified Nurse Practitioner (CNP) may practice independently if they meet the criteria in SDCL 36 9A 13.1 (which includes >1,040 practice hours or a collaborative agreement). Up to half of the 4 hrs per 100 students/week physician requirement (i.e., 2 hrs/100 students/week) may be fulfilled by a qualified NP without physician presence, provided they work under a formal collaborative agreement outlining supervision terms. No additional government oversight is mandated beyond this Doc NP agreement and compliance with state practice authority. 2. In a mixed physician + NP/PA model, can hour allocations shift? Offeror’s can choose how to price and allocate hours, including separate line items for NP/PA and MD, if they wish. 3. Are any clinical functions restricted to physicians only? No specific clinical duties are reserved exclusively for physicians. A licensed NP/PA may perform any task within their scope—including visits, physicals, prescribing, minor procedures, and exams. 4. Current student census, monthly encounters, new-intake physicals? Current student census is: 95
Monthly encounters: 28-35 depending on medication management and need. New Intake Physicals: approximately 20
5. Existing supporting staff (nursing, behavioral health, admin)? Yes. Centers must maintain the following support staff (approved by the Regional Office): • Registered nurse coverage:
o OBS 250–299: 100 hours/week (≥ 80 RN hours)
o OBS 300–349: 120 hours/week (≥ 80 RN hours)
• Other health staff:
The Health & Wellness Director, staff nurses, TEAP specialists, mental health personnel, and administrative support will regularly be onsite to assist the provider during scheduled clinic hours. 6. Is ~8 hours/week sufficient subject to mutual adjustments? Yes. The 400-hour annual requirement aligns with a typical schedule of 1–2 days/week (approximately 8 hr/week, provided adjustments are mutually agreed and coordinated with the Center. 7. Are documentation, meetings, and calls included in the 400 hours? No. time spent on documentation, monthly reports, participation in DAC/coordination meetings, training, or after-hours calls is not included in the 400 compensated hours. Only on-site clinical hours are billable. 8. If a scheduled clinic day is canceled by the Center, how is that addressed? Scheduling and closures (e.g., for holidays, low census) are resolved by mutual agreement. Canceled clinic days should be rescheduled mutually. There is no minimum guaranteed utilization or guaranteed hours—it's strictly a Firm-Fixed-Price (FFP) hourly arrangement.