RFP_GPA__Amendment_Three.docx

Section A Indian Health Service Request for Proposal for Great Plains Area (GPA) Emergency Department Management & Staffing Services

(RFP) 17-236-SOL-00010

Amendment 0003

You are invited to submit a proposal in accordance with the requirements of the following Solicitation.

Proposals must be received by the Government no later than the local time on the Due Date stated in the table below.

(301) 945-3145 wendy.mcnorial@ihs.gov

SECTION B – PRODUCTS OR SERVICES AND PRICES/COSTS

B.1. OVERVIEW

The Contractor shall provide the commercial services described in Section C, Description/ Specifications/Performance Work Statement (PWS). Except as otherwise specified in the contract, the Contractor shall furnish the necessary personnel, equipment, materials, services, and otherwise do all things necessary for the performance of the work set forth herein.

B.2. CONTRACT TYPE

This is an indefinite Delivery Indefinite Quantity (IDIQ) contract with provisions to issue fixed-price task orders. The guaranteed minimum amount is $100,000 for the first year of the contract. The maximum amount of the contract for all five years is $100 million. Funding will be provided via individual task orders under this IDIQ contract.

B.3. CONTRACT PRICING

The Indian Health Service (IHS) intends to issue one or more Indefinite Delivery, Indefinite Quantity (IDIQ) contract vehicle(s) containing Fixed-Price burdened labor rates per the labor categories listed below. This requirement is being solicited among all qualified contractors. You are invited to submit a written proposal utilizing the below Schedule of Prices for the services specified in Section C, under Request for Proposal (RFP) 17-236-SOL-00010.

B.4. NUMBER OF HOURS INCURRED

Contractor shall include a time sheet with each invoice showing the number of hours worked. This time sheet shall show the number of hours worked per person by labor category during the time period invoiced.

B.5. ED Medical Services for other GPA Emergency Departments may be added. If and/or when that happens, burdened rates for the same labor categories as below will apply.

Schedule of Prices

Base Year: 12 Months Period

BASE YEAR

Rosebud Hospital (RBH), Rosebud, South Dakota

Pine Ridge Hospital (PRH), Pine Ridge, South Dakota

Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska

Fort Yates Hospital (FYH), Fort Yates, ND

Option Year 1: 12 Months Period

OPTION YEAR ONE

Rosebud Hospital (RBH), Rosebud, South Dakota

Pine Ridge Hospital (PRH), Pine Ridge, South Dakota

Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska

Fort Yates Hospital (FYH), Fort Yates, ND

Option Year 2: 12 Months Period

OPTION YEAR TWO

Rosebud Hospital (RBH), Rosebud, South Dakota

Pine Ridge Hospital (PRH), Pine Ridge, South Dakota

Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska

Fort Yates Hospital (FYH), Fort Yates, ND

Option Year 3: 12 Months Period

OPTION YEAR THREE

Rosebud Hospital (RBH), Rosebud, South Dakota

Pine Ridge Hospital (PRH), Pine Ridge, South Dakota

Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska

Fort Yates Hospital (FYH), Fort Yates, ND

Option Year 4: 12 Months Period

OPTION YEAR FOUR

Rosebud Hospital (RBH), Rosebud, South Dakota

Pine Ridge Hospital (PRH), Pine Ridge, South Dakota

Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska

Fort Yates Hospital (FYH), Fort Yates, ND

Section C – Description/Specifications/Performance Work Statement

1. GENERAL:

1.1. Agency: The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. The mission of IHS is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level and assure that comprehensive, culturally acceptable personal and public health services are available and accessible to members of the 567 federally recognized Tribes across the United States.

1.2. The Great Plains Area: The Great Plains Area Office (GPAO) in Aberdeen, South Dakota, works in conjunction with its 19 IHS Service Units and Tribal Managed Service Units to provide health care to approximately 130,000 Native Americans located in North Dakota, South Dakota, Nebraska, and Iowa. The GPAO's Service Units include seven hospitals, eight health centers, and several smaller health stations and satellite clinics. Each facility incorporates a comprehensive health care delivery system. The hospitals, health centers, and satellite clinics provide inpatient and outpatient care and conduct preventive and curative clinics.

1.3. Purpose:

1.3.1. The intent of this contract is to acquire twenty-four hour per day, seven days per week, three hundred sixty-five days per year (24/7/365) Emergency Department (ED) Management and Staffing Services for the Emergency Department in GPA facilities. The contractor shall provide ED Directors, ED Physicians, Advanced Practice Providers, Physician Assistants, ED Nurse Supervisors, Registered Nurses, and Medical Support Assistants (MSAs) to provide medical services for patients as required by this performance work statement (PWS) and in accordance with the terms and conditions in this agreement. The care provided by the health care providers shall be as comprehensive as the GPA supplied facilities; equipment and support services permit. Contractor health care providers shall provide services to eligible beneficiaries of the Indian Health Service who present themselves for treatment. Contracted services encompass the provision of medical services that are emergent and non-emergent.

1.3.2. The Contractor shall perform the services required under this contract within each hospital’s bylaws, policies and procedures. The Contractor will have an opportunity to respond to proposed changes to bylaws, policies and procedures when determined by the COR or Contracting Officer that the change will impact the contract terms and conditions. IHS will notify the Contractor of changes to bylaws, policies, and procedures.

1.3.3. The Contractor shall work within the existing medical directives, policies and procedures of the hospital’s current processes and structures, and may recommend improvements in order to manage the EDs through existing IHS resource allocation processes.

1.3.4. In consultation with IHS, the Contractor shall recruit, preliminarily credential, hire, and manage ED Directors, ED Physicians, Advanced Practice Providers, Physician Assistants, ED Nurse Supervisors, Registered Nurses, and Medical Support Assistants (MSAs) to provide 24/7/365 Emergency Medical Services for the EDs at the hospitals.

1.3.5. The Contractor shall provide qualified providers and support staff to provide medical and medical support services for patients as required by the performance work statement (PWS) and in accordance with the terms and conditions of the contract.

1.3.6. The Contractor shall ensure that all contractors selected to perform services undergo and pass the Indian Health Service mandated security clearances prior to entry of facilities (including orientation) or initiating services.

2. Requirement One – Contract Administration

2.1. The Contractor shall convene a contract kick-off meeting with the COR and necessary IHS officials, no later than five (5) business days from the effective date of this contract in South Dakota. The Contractor shall identify immediate actions necessary in order to implement the PWS, identify key personnel responsible for accomplishing each task, a timeline for completion, and identify challenges that may impede success. The Contractor shall identify and provide no later than five (5) business days from the date of execution of the contract a point of contact and alternate point of contact for:

2.1.1. Coordination of credentialing and privileging application review and submission.

2.1.2. Coordination of weekly time card verification and approvals.

2.1.3. Reviewing and approving invoices and supporting documentation and other payment questions.

2.1.4. Providing management and oversight of ED Directors, ED physicians, ED Advanced Practice Providers (APPs), ED nurse supervisors, ED nurses and MSAs.

2.1.5. Quality Assessment and Performance Improvement Monitor.

2.1.6. Health Information Portability and Accountability Act (HIPAA), Privacy Act (PA), and records management compliance.

2.1.7. Submission of weekly/monthly staffing rosters.

2.2. The Contractor shall participate in weekly status update calls with IHS and other meetings as needed to discuss contract implementation issues and challenges. The Contractor shall submit agenda items in advance of the calls when requested, and review meeting minutes within two (2) business days of request for comments. The Contractor shall maintain an ongoing Action Item list with updated status on each Action Item. The Action Item list shall maintain all completed and ongoing Action Items with related completion target dates and status. The Action Item list shall be submitted with the reviewed meeting minutes each week.

2.3. The Contractor shall submit monthly status reports that identify the Contractor’s progress in meeting the tasks outlined in the PWS, identify leads responsible for completing tasks, and how challenges or delays are being mitigated. The monthly status reports shall be submitted electronically to the COR, no later than the 5th calendar day of the month, following the end of the month that is the subject of the monthly status report, beginning on month after award and execution of any option years.

2.4. In the event that the Contractor recommends process or business improvement changes, or solutions that the Contractor identifies could improve the efficiency or management of the ED that the Contractor is responsible for under this contract, including staffing levels, the Contractor may include those suggestions on the monthly status report. IHS may consider the request, but the Contractor must not act on the recommendation unless written approval is obtained from the Contracting Officer or Contract Specialist. The Contractor is reminded the Government may require at least thirty (30) calendar days to review the recommendation and provide the Contractor with feedback or next steps.

2.5. The Contractor shall submit an Emergency Department Management and Staffing Plan outline for the overall management of Omaha/Winnebago, Rosebud and Pine Ridge Emergency Departments that describes the following requirements. The outline shall be due no later than five (5) calendar days from effective date of this contract in order to be discussed at the contract kick-off meeting. The Contractor shall submit a final management and staffing plan, no later than thirty (30) calendar days from the effective date of contract award.

2.5.1. The Contractor shall describe the overall plan for adequately staffing, organizing and managing the contract including: all key personnel working on the contract, subcontractors, a timeline for completion of tasks, and how the Contractor will monitor progress.

2.5.2. The Contractor shall indicate how organizational roles and responsibilities will be addressed, decisions made, work monitored, and quality and timeliness of products/services ensured.

2.5.3. The management and staffing plan shall describe the use of any consultants or subcontractors hired to carry out elements within the PWS under this contract. The management and staffing plan shall specify how the Contractor, consultants or subcontractors will work together, how the tasks will be coordinated, and how quality assessment will be accomplished. The Contractor shall notify the COR in writing within five (5) business days of any new subcontractors or consultants retained to perform services required under this contract. Subcontractors retained for purposes of this contract must comply with all provisions, terms and conditions of this contract.

2.5.4. The ED Management Plan shall be based on the start dates defined in contract award. The Contractor shall provide full staffing coverage at all times and shall provide suitable short-term coverage in the event of a vacancy. The Contractor shall maximize the length of assignments to minimize turnover in accordance with the QASP. The ED Management Plan shall include an estimated turn-around time for filling vacancies for each profession, but not to exceed fourteen (14) calendar days for providers and seven (7) calendar days for support staff. The ED Management Plan shall also describe specific activities planned to meet the requirements of this contract to recruit and retain qualified providers and support staff.

2.5.5. The Contractor shall describe in the Emergency Department Management and Staffing Plan, the overall plan for adequately staffing, organizing and managing the Emergency Departments. The Contractor shall monitor and track individual provider and overall ED operational performance using IHS systems and data, to the extent that IHS systems and data provide accurate and available data. This may include the use of ED dashboard reports currently available in the Resource and Patient Management System (RPMS).

2.5.6. The ED Management Plan shall discuss who will prepare and review the reports, frequency of the reports, and measures to be monitored in order for the Contractor to ensure their providers and support staff are in compliance with CMS Conditions of Participation (CoP) and TJC accreditation standards.

2.5.7. The ED Management Plan shall fully describe how the Contractor will work within each hospital’s Quality Assessment Performance Improvement Program (QAPI), including discussion of the peer review process for conducting chart reviews for quality of care and completeness of documentation for a minimum of the first thirty (30) days worked, in accordance with the hospital bylaws, and processes.

2.6. The Contractor shall designate a point of contact at each hospital for the review and approval of provider and support staff timecards on a weekly basis. Timecard approval shall consist of a review from an IHS official designated, and supporting documentation. The IHS review does not imply approval by the Government. The Contractor’s ED Director or Nursing Supervisor signature shall indicate approval. Providers with chart duties shall submit a signed Health Information Management Provider Clearance Form to their supervisor, each week, to verify that proper documentation in the Electronic Health Record (EHR) has been completed. The Contractor shall submit copies of approved timecards or a weekly report if timecard approval is done electronically, as part of the supporting documentation for invoice review and approval. Timecards shall be due 10:00AM Mountain Standard Time (MST) Mondays for the previous week, but no later than Tuesday 10:00AM MST.

2.7. The Contractor shall submit a management and staffing plan annually at the start of each option period. The Contractor shall submit a final management and staffing plan annually no later than thirty (30) days from the date the option period commences. Also, whenever the contract ends, the Contractor shall submit a final close out report to the COR.

3. Requirement Two – 24/7/365 Emergency Department Management and Staffing Services:

3.1. The Contractor shall provide the non-personal highly-skilled ED Directors, ED Physicians, Advanced Practice Providers, Physician Assistants, ED Nurse Supervisors, Registered Nurses, and Medical Support Assistants (MSAs) services on site in accordance with the specifications contained herein to all patients presenting for care in the Emergency Department or elsewhere on the hospital campus with an emergency medical condition. Services are to be as comprehensive as the IHS supplied facilities, equipment and support services permit. Contractor employees shall not be considered government employees for any purpose under this contract.

3.2. All emergency medicine physicians shall meet one of the following experience criteria.

3.2.1. Current ABEM (American Board of Emergency Medicine) or AOBEM (American Osteopathic Board of Emergency Medicine) certification with documented Emergency Department experience over the last 24 months; or

3.2.2. 3000 hours (or more) of clinical experience over the last 24 months in an Emergency Department with an annual volume of at least 18,000 and a combined admission/transfer rate of at least 10%; or

3.2.3. 5000 hours (or more) over the previous 60 months, and 1000 hours (or more) over the last 12 months, of clinical experience in an Emergency Department with an annual volume of at least 18,000 and a combined admission/transfer rate of at least 10%.

3.3. The Contractor shall perform the services required under this contract for either or both of the following scenarios for providing Emergency Department ED Management and Staffing Services:

3.3.1. Contractor Managed and Staffed – Contractor provides full ED management and staffing services to include Contractor ED Leadership/Supervisory positions: ED Director and ED Nurse Supervisor and staffing (ED Physicians, PA, APN, RN, and MSA). Under the Contractor Managed and Staffed scenario the Contractor’s ED Director and ED Nurse Supervisor, HCPs and services are monitored by the Federal Clinical Director, Chief Executive Officer and Contracting Officer’s Representative (COR) with the Governing Body having ultimately responsible for safe, quality care and operational performance of the ED. The COR appointed by the CO takes necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

3.3.2. Federally Managed – Contractor provides ED staff (ED Physicians, PA, APN, RN, and MSA). Under the Federally Managed and Staffed scenario the Contractor’s HCPs and services are monitored by the Federal ED Director, ED Nurse Supervisor, Clinical Director, Chief Executive Officer and Contracting Officer’s Representative (COR) with the Governing Body having ultimately responsible for safe, quality care and operational performance of the ED. The COR appointed by the CO takes necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken. This option would also allow for the Emergency Department to be staffed with both contractors and federal employees working together.

3.4. The Government is continuing to recruit to fill positions for the Emergency Departments within the GPA. In the event GPA is able to hire GPA staff to fill the Contractor filled positions in the Emergency Departments, GPA shall give the contractor a 60-day notice that a staff member has been hired and the impact on contract usage. Doing this period, the contractor will support IHS in transitioning the Emergency Department Management functions to federal management.

3.5. If the Government determines that an Emergency Department will be managed by the Contractor instead of by a federal employee, the contractor will also identify a physician to serve as the full-time Contractor Director of the Emergency Department and a Contractor Supervisory Nurse and each individual must have a minimum of 3 years of Emergency Medicine administrative experience. The contractor/Director will be responsible for ensuring Emergency department provider coverage on a 24/7 basis and will provide schedules to federal leadership at the Hospital 30 days in advance. The Contractor ED Director will provide medical leadership for case reviews, quality of care monitors, ongoing and focused professional practice evaluation, codes, patient transfers and patient complaint investigation. The Contractor ED Director and Contractor Supervisory Nurse will maintain an effective, ongoing, data driven quality assessment and performance improvement programs (QAPI) for Emergency Medicine and report the results through the hospital-wide QAPI process. The Contractor ED Director and Contractor Supervisory Nurse will serve on medical committees as requested and will assist federal staff in developing policies and procedures for the Hospital Emergency Department.

3.6. Places of Performance for the Emergency Department Management and Staffing Services: The Government will determine whether a single or multiple awards will be made for the provision of ED Management and Services for each GPA facility identified. Contractors may propose to provide services on site for all of the following places of performance or just selected places of performance:

3.6.1. Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska

3.6.1.1. Annual Patient Volume: 9,595

3.6.2. Rosebud Hospital (RBH), Rosebud, South Dakota

3.6.2.1. Annual Patient Volume: 14,725

3.6.3. Pine Ridge Hospital (PRH), Pine Ridge, South Dakota

3.6.3.1. Annual Patient Volume: 22,778

3.6.4. Fort Yates Hospital (FYH), Fort Yates, ND

3.6.4.1. Annual Patient Volume: 7,775

3.6.5. ED Medical Services for other GPA Emergency Departments may be added as noted in B.5.

3.7. Staffing Plan – Current staffing plans for each place of performance may vary by time of award and during the contract performance periods based upon the options described in paragraph 3.6 of this PWS.

3.7.1. Omaha/Winnebago Hospital (OWH), Winnebago, Nebraska

3.7.2. Rosebud Hospital (RBH), Rosebud, South Dakota

Shift

3.7.3. Pine Ridge Hospital (PRH), Pine Ridge, South Dakota

Shift Night Shift

ED Director

Nurse Supervisor

3.7.4. Fort Yates Hospital (FYH), Fort Yates, ND

Shift Night Shift

ED Director

7-7 / MID 11-11

AP or PA

7-7/1-1

Nurse Supervisor

Nurses

7-7 / MID 11-11

MSA

7-7

4. Health Care Provider Standards:

4.1. The Contractor shall provide technically competent HCPs and shall ensure that all services provided are in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations, The Joint Commission (TJC) standards, applicable CMS and agency specific regulations, directives, and policies, and facility specific policies, procedures, and job descriptions.

4.2. HCPs shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for Patients. The Contractor shall ensure quality services are provided; provide Contractor level management of task order awarded; conduct thorough and timely pre-performance screening; provide complete and timely credential/privileges, and security packages; and manage recruitment and retention of healthcare professionals.

4.3. The Contractor shall ensure that services meet the required standard of the specialty provided as defined by professional governing bodies, state, and federal agencies. The Contractor shall recruit/retain, privilege/credential, train, and manage, quality health care professionals and ensure that a full spectrum of health care services are provided to beneficiaries which meets the standards of governing bodies, laws and regulations of each facility. The Contractor shall ensure that HCPs perform essentially the same functions, within the scope of acceptable practice for the specific specialty or position, as those required by GPA health care professionals of similar experience and in similar duty assignments.

4.4. Policy/Handbooks: the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

4.4.1. – IHS Manual – “Health Care Service Standards”

4.4.2. – National Practitioner Data Bank Reports

4.4.3. – Credentialing and Privileging

4.4.4. – Health Information Management and Health Records

4.4.5. – Privacy Act of 1974 (5 U.S.C. 552a) as amended

4.5. Definitions/Acronyms- Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

4.5.1. ABIM: American Board of Internal Medicine http://www.abim.org/

4.5.2. ACEP: American College of Emergency Physicians

4.5.3. Advanced Practice Provider (APP): APPs are Licensed Independent Practitioners (LIPs), which means any individual permitted by law and by the organization to provide care and services, with little or no direction or supervision, within the scope of the individual’s license and consistent with individually granted clinical privileges.

4.5.4. ACLS: Advanced Cardiac Life Support

4.5.5. ATLS: Advanced Trauma Life Support

4.5.6. BLS: Basic Life Support

4.5.7. CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

4.5.8. CDC: Centers for Disease Control and Prevention

4.5.9. CDR: Contract Discrepancy Report

4.5.10. CEU: Certified Education Unit

4.5.11. CME: Continuing Medical Education

4.5.12. CMS: Centers for Medicare and Medicaid Services

4.5.13. Contracting Officer (CO) – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

4.5.14. Contract Specialist (CS) – The person who is administering the contract on behalf of the Contracting Officer.

4.5.15. Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

4.5.16. COS: Chief of Staff

4.5.17. CPARS: Contractor Performance Assessment Reporting System

4.5.18. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

4.5.19. DEA: Drug Enforcement Agency

4.5.20. ED: Emergency Department

4.5.21. EMTALA: Emergency Medical Treatment and Labor Act: https://www.acep.org/news-media-top-banner/emtala/

4.5.22. FSMB: Federation of State Medical Boards

4.5.23. Focused Professional Practice Evaluation (FPPE): FPPE is an evaluation process allows the organized medical staff to utilize a focused evaluation regarding a specific aspect of a practitioner’s performance. “Ongoing Professional Practice Evaluation (OPPE)” allows the Medical Staff to identify, on an ongoing basis, professional practice trends that impact on quality of care and patient safety.

4.5.24. Governing Body/Governing Board (GB): GB is the final authority on granting, restricting, suspending, or revoking delineated clinical privileges.

4.5.25. HCP: Health Care Provider

4.5.26. HHS: Department of Health and Human Services

4.5.27. HIPAA: Health Insurance Portability and Accountability Act

4.5.28. HR: Human Resources

4.5.29. ISO: Information Security Officer

4.5.30. Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or Causing serious or permanent dysfunction of any body-organ or part.

4.5.31. Medical Executive Committee (MEC): MEC is the body empowered by the MS to direct the course of medical care in the organization.

4.5.32. Medical Staff (MS): MS is the body that has the overall responsibility for the quality of the professional services provided by individuals with clinical privileges and is accountable to the GB. Members have delineated clinical privileges that allow them to provide patient care services independently or collaboratively within the scope of their clinical privileges as permitted by law and the organization. MS members and other persons with clinical privileges are subject to the hospital Bylaws, Rules & Regulations, departmental rules and regulations, and performance improvement activities. Standards are applied to evaluate the quality of MS performance.

4.5.33. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

4.5.34. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

4.5.35. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

4.5.36. NP: Nurse Practitioner

4.5.37. NPPES: National Plan and Provider Enumeration System

4.5.38. Physician Assistant (PA): A trained health care professional who has completed an American Medical Association accredited PA program. The PA is qualified to practice medicine within the scope determined by State law or a health care organization by virtue of his/her educational, professional, and clinical experience. PA’s employed by the IHS must be certified by the National Commission on Certification of Physician Assistants and must maintain that certification throughout their employment, and are licensed to practice in at least one U.S. jurisdiction.

4.5.39. Physician (MD, DO): A medical doctor or doctor of osteopathy who, by virtue of education and training, is qualified and licensed to practice medicine in at least one U.S. jurisdiction.

4.5.40. PALS: Pediatric Advanced Life Support

4.5.41. POP: Period of Performance

4.5.42. PPD: Purified Protein Derivative

4.5.43. Privileges: The authorization granted by the GB to a provider to provide specific care. Clinical privileges are delineated functions, procedures, treatments, surgeries and prerogatives of practice an individual may perform in the organization. Clinical privileges are dependent on provider qualifications, current competency, and the capacity of the institution to support the execution of requested privileges.

4.5.44. PWS: Performance Work Statement

4.5.45. Peer Review: The evaluation of an individual practitioner’s professional performance and includes the identification of opportunities to improve care

4.5.46. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

4.5.47. QASP: Quality Assurance Surveillance Plan

4.5.48. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

5. QUALIFICATIONS:

5.1. Staff

5.1.1. License - Health care provider(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia. SPECIAL NOTE: For procurements that require a Drug Enforcement Agency (DEA) registration, contract providers must have a medical license and be individually registered with the DEA. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Health care provider(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

5.1.2. Board Certification– Physicians

5.1.2.1. All emergency medicine physicians shall meet one of the following experience criteria.

5.1.2.1.1. Current ABEM (American Board of Emergency Medicine) or AOBEM (American Osteopathic Board of Emergency Medicine) certification with documented Emergency Department experience over the last 24 months; or

5.1.2.1.2. 3000 hours (or more) of clinical experience over the last 24 months in an Emergency Department with an annual volume of at least 18,000 and a combined admission/transfer rate of at least 10%; or

5.1.2.1.3. 5000 hours (or more) over the previous 60 months, and 1000 hours (or more) over the last 12 months, of clinical experience in an Emergency Department with an annual volume of at least 18,000 and a combined admission/transfer rate of at least 10%.

5.1.2.2. All physicians must be currently certified in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS), Advanced Trauma Life Support (ATLS) and Pediatric Advanced Life Support (PALS). All continuing education courses required for maintaining certification must be kept up to date all times. Documentation verifying current certification shall be provided by the Contractor to the GPA Credentialing Coordinator on an annual basis for each year of contract performance.

5.1.2.3. Nurses Practitioners shall have a license for the advanced practice level in accordance with the U.S. jurisdiction requirements of their currently held RN license. Some U.S. jurisdictions provide a separate license for the advanced practice specialty, while others provide only one license which indicates an advanced level of practice. A Master‘s degree in the specialty from a program accredited by a national nursing accrediting agency recognized by the U.S. Department of Education. A certification by a nationally recognized certifying body in the specialty. Twenty-four (24) months experience within the last thirty-six (36) months in the same specialty outlined in the task order.

5.1.2.4. Advanced practice privilege nurses in the specialties of Certified Nurse Midwives (CNM) and Certified Registered Nurse Anesthetists (CRNA) shall have a license for the advanced practice level in accordance the U.S. jurisdiction requirements of their currently held RN license. Some U.S. jurisdictions provide a separate license for the advanced practice specialty, while others provide only one license which indicates an advanced level of practice. A Master‘s degree in the specialty from a program accredited by a national accrediting agency recognized by the U.S. Department of Education. A certification by a nationally recognized certifying body in the specialty. Twenty-four (24) months experience within the last thirty-six (36) months in the same specialty outlined in the task order.

5.1.2.5. Credentialed Nurse’s Minimum Requirements - Clinical Nurses shall have: Successfully graduated from a nationally accredited associate’s degree or baccalaureate degree program in nursing and hold current certification as a registered nurse (RN). 24 months of experience within the last 48 months in the same specialty outlined in the task order. All licenses and/or certifications must be unencumbered and remain in effect during the task order.

5.1.2.6. Physician Assistants shall have a current National Commission on Certification of Physician Assistants (NCCPA) certification. Successfully completed a full four-year program for physician assistants leading to a bachelor's degree. The course of study or training must be approved by a nationally-recognized professional body such as the Committee on Allied Health Education and Accreditation or the Accrediting Bureau of Health Education Schools, or by a panel of physicians established by a Federal agency for this purpose. Twenty-four (24) months experience within the last thirty-six (36) months in the same specialty outlined in the task order.

5.1.2.7. Medical Technicians/Assistants shall have graduated from an accredited program in medical assisting, or Equivalent combinations of successfully completed education and experience from a formal enlisted military medical education program. If education is used to meet requirements, then such education must include courses directly related to the work of the position and be approved during the candidate approval process. 12 months of experience within the last 36 months. Experience shall be in the same clinical specialty.

5.1.3. Credentialing and Privileging – Credentialing and privileging is to be done in accordance with the provisions of GPA Credentialing and Privileging standards. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract HCPs prior to obtaining approval by the Great Plains Area Credentialing and Privileging Committee, and the GPA Medical Executive Committee.

5.1.3.1. If a HCPs is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

5.1.3.2. If a HCP is found not to be acceptable at one location said HCP’s will not be moved to another location without notifying the proposed receiving locations in advance and receiving their prior approval.

5.1.4. Credentialing Agreement - The Credentialing and Privileging process for health care providers is one of the critical tasks. To ensure that HCPs providing services under this contract are properly licensed, and that the IHS is made aware of all disciplinary actions taken against each HCPs, the Contractor shall:

5.1.4.1. Ensure that all health care providers are appropriately screened, credentialed and privileged to meet clinical standards of IHS, CMS Conditions of Participation, and accreditations.

5.1.4.2. Verify in writing to the GPA through the Federation of State Medical Boards database, all active, inactive, and lapsed licenses that are held or have been held by physicians who provide services in GPA hospitals and clinics.

5.1.4.3. Provide GPA with current status of all professional licenses for each physician including all reasons for each period of an inactive or lapsed license.

5.1.4.4. Provide at least three (3) letters of reference from health care providers whom have knowledge of the applicant’s clinical practice skills. One letter shall be from the Chief of Staff, or Service at the hospital where the physician holds or last held staff privileges. Provide any and all information pertaining to performance and/or disciplinary actions that are collected on physicians who will be providing services under this contract to the receiving IHS facilities Clinical Director. This includes all information that is collected and compiled on such physicians at the time of initial hire by the Contractor, as well as any performance and/or disciplinary actions reported during the contract period for which the Contractor is an agent of such physicians for a placement under this contract.

5.1.4.5. Certify that all information obtained on physicians whom they would assign to GPA hospital and clinics have been reviewed and primary source verification completed per the credentialing requirements. The Certification shall include a statement that the physician is competently and adequately trained and experienced to provide the Services contemplated pursuant to the assignment in accordance with all applicable federal, state, and local laws, rules and regulations, all applicable standards of the Joint Commission and any other relevant accrediting organizations; and the Contractor has found no reason to reject the physician’s application. The names of the contacts, their titles, telephone numbers, date of contacts and the name(s) of the Contractor’s representative(s) collecting and reviewing such information shall be recorded in writing and provided to the GPA by the contractor.

5.1.5. Technical Proficiency - Health care provider(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all health care provider(s) and health care provider(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations that govern medical staff behavior.

5.1.6. Medicare and Medicaid: Need to add the requirements necessary to ensure that IHS can bill Medicare and Medicaid for services rendered by the contract health care providers.

5.1.7. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide copies of current CMEs as required or requested by the GPA. Health care provider(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current.