12b._Exhibit_A-1_DRAFT.pdf

California Department of Veterans Affairs Agreement Number: 24BS0031 Exhibit A-1 – Service Specifications TBD

TEMPORARY/RELIEF CHIEF MEDICAL OFFICER

1. PROVIDER’S QUALIFICATIONS

A. Providers assigned to CalVet must have the minimum experience/education outlined below:

1. Chief Medical Officer

a. Minimum of twelve (12) continuous months of experience within the last three (3) years performing services similar in scope to those defined herein, preferably in a public or private institution.

b. Education: Graduation from a medical school as recognized by the State of California.

B. Resident health care is of paramount importance. Accuracy in communications is critical to ensure timely, correct care is provided. Therefore, any Provider(s) providing services through this Agreement must be able to communicate effectively with CalVet.

C. Any Provider(s) who fails to meet the minimum qualifications shall not be permitted to perform service.

The Home’s Contract Manager, or designee, shall state in writing the reason(s) the Provider does not meet minimum.

2. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

Prior to providing services as outlined in this Agreement, Contractor shall:

A. Ensure that each Provider possess and maintain all current and valid licenses, permits, and certifications throughout the term of this Agreement for each classification noted below:

1. Chief Medical Officer:

A current and valid license recognized by the California Board of Medical Quality Assurance or the California Board of Osteopathic Examiners authorizing the physician’s medical practice in the State of California. Board Certified in Geriatric Medicine, Internal Medicine, or Family Practice.

B. Provide copies of any required license(s), permits, and/or certification(s) for each Provider to the Home’s Contract Manager, or designee, to be kept on file at the Home throughout the term of this Agreement.

Contractor shall ensure that all required licenses, permits, certifications, and any other requirements outlined herein are current and in effect at all times during the term of this Agreement.

C. Provide current/renewed license(s), permit(s) and/or certification(s) to CalVet not less than thirty (30) calendar days prior to their expiration. If, during the course of this Agreement, any of the licenses and/or requirements are found to be inactive or not in compliance, CalVet may withhold payment for services rendered during the expiration period and/or immediately terminate this Agreement.

D. Assume responsibility for verifying, through the appropriate licensing boards, that no current or unresolved adverse actions have been taken by the State licensing authorities against any Provider(s) assigned to CalVet, and that all licenses are active and void of misconduct. CalVet may, at its discretion, verify the current status of Provider(s) assigned.

E. Maintain current Cardiopulmonary Resuscitation (CPR) and Basic Life Support (BLS) certification for each Provider at Contractor’s expense.

3. PROVIDER’S RESPONSIBILITIES

Under the direction of the Home’s SNF Administrator, Contract Manager, or designee, Provider shall provide services as permitted within the scope of practice for Chief Medical Officer in accordance with CalVet/

Home policies and procedures.

A. Duties/Responsibilities shall include, but are not limited to:

1. Chief Medical Officer:

a. Perform the direct medical services and functions customary of an Ambulatory Care Clinic (ACC), Intermediate Care Facility (ICF), Skilled Nursing Facility (SNF), and Residential Care Facility for the Elderly (RCFE) medical director as required by federal and state Medicare and Medicaid (Medi-Cal) laws, regulations, rules, and policies, and in compliance with the Home medical care bylaws, rules, and regulations.

b. Provide on-site coverage at the ACC 7:30 a.m. to 5:30 p.m. as needed and part-time in the ICF 7:30 a.m. to 8:00 p.m. when required, and the SNF 7:30 a.m. to 8:00 p.m. when required. RCFE coverage is dependent on whether the Home obtains an RCFE license during the course of this contract.

c. Directly supervise the civil servant Nurse Practitioner (NP), currently classified as a 103 NP as required by California Assembly Bill 890 until the NP is classified as a 104 NP.

d. Perform all functions associated with the medical care management of resident patients in the ACC, ICF, SNF and the RCFE.

e. Provide Physician services with emphasis on geriatric medicine.

f. Provide consultation and assessment, treatment plan, and monitoring of response to treatment for each Home resident.

g. Call and discuss with Home Administrator and/or attending physician any pending admission of Home resident prior to admission of the resident for inpatient acute hospital care.

h. Provide administrative review of all Home Policies and Procedures relating to medical care.

i. Provide administrative consultation regarding the Home’s operations issues.

j. Assist with preparations for United States Department of Veterans Affairs and California Department of Healthcare Services surveys and/or resurveys.

k. Perform the physician’s role in admission prescreening and admission physicals.

l. As Chief Medical Officer, provide oversight for all physician services, PAs and NPs.

m. Provide review of referrals by PAs and NPs.

n. Provide consultation for the NPs in providing clinic services, especially with regard to patient care and management.

o. Perform all medical duties required for health care facilities under Title 22 (22CCR) of the California Codes of Regulations, and Titles 42 and 38 of the Code of Federal Regulations (42CFR and 38CFR).

p. Refer residents of the Home to other appropriate medical contractors only after consultation with the Home Administrator, or designee.

q. Ensure there is a continuity of care for residents of the Home during periods of absence by the Provider. The cross coverage selected by Contractor shall be approved and credentialed in advance by the Home.

r. Comply with the rules and regulations contained in Title 22 (22CCR) of the California Codes of Regulations and the Home Administrative Manual.

s. Shall assist in arranging for continuous physician coverage for medical emergencies.

t. Shall assist in obtaining the services of qualified professionals to serve as consultants to help meet residents’ special needs.

u. The provider must be inked to Medicare, Medi-Cal and all other applicable insurance vendors.

B. The Contractor must currently employ Chief Medical Officers, residing within a 100-mile radius from the Veterans Home of California – Barstow or must have a place-of-business where Chief Medical Officers employed by the Contractor report to the Contractor’s place-of-business within a 100-mile radius from the Home. The 100-mile distance limit has been established because the medical providers will be needed within a short time-period (1.5 hour or less) after Home staff have contacted the Contractor.

C. Shall acknowledge and sign Home policies on Resident Rights, Confidentiality, Discrimination, Sexual Harassment, and Zero Tolerance of Elder Abuse and any other required policies.

D. Sign-in at the front desk when entering the facility and sign-out when leaving, by using the contractor’s binder and shall understand that if this sign-in and sign-out procedure is not followed, the Home may dispute any or all invoices.

E. Provider shall wear an identification badge which includes the name of the Contractor, the Provider’s name, and a photo ID. This badge shall be worn at all times while on grounds of the Veteran’s Home.

F. Provider shall ensure resident medical record information is maintained as “CONFIDENTIAL” and shall be held in trust and confidence. Information shall be used only for the purposes contemplated under this contract.

G. Provider shall obtain the approval and authorization from the primary care physician through the Contract Manager, or designee, prior to referring resident to other health care/medical vendors/contractors.

Referral shall be made only to those health care/medical vendors/contractors set forth on the Home’s health care/medical vendor/contract list.

H. Prior Authorization Documentation shall include, but is not limited to the following:

1. Veterans Home referral process.

2. Resident progress notes/summary pertinent to reason for referral.

I. Equipment and/or supplies owned or customarily stocked by the Home and which are necessary for services may be used by the Provider. If the lack of equipment and/or supplies creates a limitation to services requested, the Provider shall make a recommendation to the Contract Manager, or designee, identifying equipment or supplies necessary for treatment. The Provider will not procure equipment or supplies and expect reimbursement from the Home/CalVet.