Attachment_D_-_Statement_of_Work.pdf

Attachment D: Statement of Work

STATEMENT OF WORK

The Fort Yuma Service Unit is located on the Quechan/Ft. Yuma Indian Reservation and serves approximately 2,434 tribal members. This site gives residents of both the Quechan and Cocopah tribes access to our facilities within one hour. The facility is right across the river from Yuma. A small, family-oriented city, Yuma offers a good choice of housing and shopping centers, as well as recreational and educational opportunities. In addition to elementary and high schools, Arizona Western College is based here, and extension courses are available from Northern Arizona University. The municipality also includes an airport and a Marine Corps air station.

The services provided include general medical, ambulatory, pediatric, community health, preventative health, and mental health. Dental care is also available, with one dentist on staff.

Special ambulatory services are provided on-site by IHS staff based in Phoenix or private contract specialists. Obstetric patients and those requiring surgery are referred to the Yuma Regional Medical Center (YRMC), in Yuma, or to Phoenix Indian Medical Center (PIMC), in Phoenix.

Ground and air transport are available for emergency care.

1. SCHEDULES/LOCATIONS/SHIFTS/QUALIFICATIONS/CERTIFICATIONS:

SCHEDULE: The Contractor is requested to provide Medical Specialty Physician Healthcare Services, for a 12 month base period and four (4) 12-month option periods. This service is required by clinic with an estimated twenty four (24) clinics per Contract Year. A “Clinic” is defined as one (1) day, per the shifts identified below. The clinic will be within the Ft. Yuma Service Unit (FYSU) hours of operations between 8:00 am - 5:00 pm (0800-1700). Additional Clinics may be added by mutual agreement of both parties with prior agreement and coordination with the Contractor.

LOCATION: All services shall be performed at the following location:

Fort Yuma Service Unit (FYSU) One Indian Hill Road Winterhaven, CA 92283

SHIFTS: Contractors will be expected to abide by the facility’s Uniform Code and shift hour assigned, modalities of charting and care delivery and other rules and regulations of the facility.

Work within a designated schedule prepared by the Chief Medical Officer or his/her designee. Any period of absence or changes in the schedule will be communicated with the Chief Medical Officer or his/her designee 14 days prior, except for emergency situations.

Services:

A) Child and/or Adult Psychiatry Physician

SHIFTS: Total shifts worked quarterly shall be in accordance to the total number of work hours allocated for the year by FYSU. One (1) hour lunch breaks are included in shift hours and Government does not pay time taken for lunch. The Service Unit shall make every effort to submit a schedule two (2) weeks in advance. Shifts may be cancelled or shortened without time restriction or monetary penalty before the contractor’s employee arrives for duty.

MEDICAL SPECIALTY PHYSICIAN HEALTHCARE CLINIC

Day shift: 8:00 A.M. – 5:00 P.M. (0800-1700) with exception of Federal Holidays.

NOTE: The duration of each work “Clinic Day” shift may vary due to patient load, clinical complexity, weather and other circumstances.

A) Psychiatry: It is estimated that there will be twenty four (24) Clinics per contact year at 8 hours per Clinic day. (192 hours per year, evaluate an estimated 20 patients per 8 hour day clinic)

Work Schedule: At least two (2) clinical visits or clinic days each month. Clinic hours for the Fort Yuma Health Center are Monday through Friday 8:00am to 5:00pm with one (1) hours lunch with the exception of Federal Holidays.

Contractors shall attend assigned meetings, participate fully as staff members, and actively participate in ongoing quality management activities and any other FYSU or Indian Health Services initiatives deemed applicable to the specialist’s work.

QUALIFICATIONS/CERTIFICATIONS:

Education: The Psychiatry Specialist(s) shall have four (4) years of accredited medical school leading to MD/DO doctorate level diploma.

Training: Minimum three (3) years of residency training in Psychiatry.

Experience: Two (2) year experience in appropriate specialty.

Licensure: State License issued by any of the 50 states or District of Columbia as directed by state law. Each physician must have a permanent, full and unrestricted Licensed to practice medicine in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

Certification: Each physician must have completed residency training in the specialty of the position to be filed. Each physician needs to be board certified/ board eligible in their specialty and hold a current Advance Cardiac Life Support (ACLS), Pediatric Advance Life Support (PALS) and Basic Cardiac Life Support (BCLS) certifications.

Insurance: Appropriate medical malpractice liability coverage.

Privileges: The government shall allow only qualified, appropriately licensed or credentialed individuals, practicing within the scope of their license or credentials, to provide healthcare services on behalf of the government.

2. PRICE SCHEDULE

The unit prices paid to the Contractor shall be considered as payment in full for services provided under this award. In no way, unless directed by the IHS, shall any provider attempt to bill or collect from any IHS patient, or from any alternate resource for which the patient may be eligible, any monies for services provided under this award.

Clinic shall be inclusive of all other fees (holiday, nights, weekend), including travel expenses, per diem, lodging, all city, state, federal and local taxes, and all miscellaneous costs associated with the provision of services. The Government will pay a flat fixed rate (per month).

Contractor shall be paid for actual time services are performed under the terms of the contract at the firm fixed price. The clinic quantities are estimated and estimated totals not to exceed. There is no provisions for OVERTIME or ON CALL SERVICES. (30 minute lunch breaks are included in the CLINC fixed price rate.

Contractor’s employee must be present at the facility and must be actually performing the required services to receive payment for services.

See Attachment A – Price Schedule

Government housing not available.

3. SCOPE OF WORK:

The contractor shall be expected to assist and provide services and duties as may be requested for the normal operational requirements for the department and personnel. The contractor shall provide work that is consistent with the guidelines and procedures of the IHS. Failure of the contractor to meet these standards can result in cancellation of this contract. The contractor’s performance and abilities shall be evaluated based upon performance standards that are contained in this statement of work.

The contractor shall prepare and complete in a timely fashion, the medical and other required records for all parties he/she admits or in any way provides care for the hospital or health care facility (Service Unit Medical By-Laws). Documentation in the patient’s health record are to be completed on the day services are rendered. During the performance of their duties, the contractor shall provide for the consistent performance of patient care processes according to the standards for The Joint Commission (TJC) accreditation program within IHS. These standards include: The Comprehensive Accreditation Manuals for Critical Access Hospitals, and the Laboratory Standards as they represent the scope of services of this contract.

The contractor shall possess a professional medical education from a post-secondary academic institution or be licensed in a field of medical study. The contractor should be proficient in writing, typing and have a basic working knowledge and understanding of computer hardware and software applications. The contractor shall have sufficient knowledge, competence and experience in providing these services on a regular schedule to the Phoenix Indian Medical Center or similar medical clinic or hospital. The contractor shall possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that the contractor can relate constructively to IHS employees, contractors, vendors and individuals from the Native American community. The contractor shall not have any work or health restrictions, which could directly or indirectly interfere with the performance of providing services. The contractor shall maintain acceptable standards of personal hygiene, grooming and professional attire such that their image as a Federal contract employee is compatible with the expectations of the IHS staff.

The contractor shall be required to utilize the electronic health record for chart documentation, after receiving training at Government expense.

The Contractor’s employee(s) shall be sensitive to the unique culture factors of the people they treat, which may include use of an interpreter as necessary in communication of services being rendered. Unique cultural factors that may contribute to the patient’s treatment include: use of their language communications; village and tribal customs; use of traditional healers; isolation; housing conditions and lack of resources.

Each physician shall speak, understand, read and write the English language fluently.

MAJOR DUTIES REQUIRED:

The overall scope of this contract is to temporarily recruit and hire a qualified contractor under a Government Non-Personal Services contract. The Contractor shall have the necessary education, training, licensing, previous work experience and competence in being able to provide the services within the department. The contract resulting from this solicitation shall:

The contractor shall provide direct review of medications, direct psychiatric clinical evaluations, diagnosis, treatment and treatment planning providing psychotherapeutic and other psychological services. Services provided may include but are not limited to the following: individual services, group therapy, relaxation therapy, behavior therapy, and child and adolescent therapies. These are all provided with a sensitive understanding of culturally relevant issues.

The contractor shall prescribe, make preliminary diagnosis, direct, provide treatment or refer for specialized care following Indian Health Services guidelines for referrals.

• Psychiatric Physician Services shall be provided on-site at the Fort Yuma Indian Health Center. Psychiatric services to be provided shall include but limited to:

• Review of medication

• Interview and assessment

• Formulation of treatment plan

• Treatment and follow-up

• Phone consultation with service unit medical staff as needed

• Contractor shall send a monthly report to the project officer on the clinical status of each patient seen during the month

Psychiatric physician shall be fully certified or licensed as a psychiatrist in any state and shall have current, valid malpractice insurance and shall provide evidence of same to the contracting officer upon request.

4. CONDITIONS FOR REMOVAL/REPLACEMENT OF CONTRACTORS

EMPLOYEE):

As mutually agreed between the Contracting Officer and the Contractor there may be grounds for removal and/or replacement of a Contractor employee. The Contractor’s employee shall be removed from an IHS facility if services are not performed in accordance with terms and conditions of this award.

The Contractor shall request government pre-approval to substitute or replace any of the Contractor’s employee of which it has provided qualifications and resumes under this contract.

All Contractor-requested substitutes or replacements’ qualifications, experience and professional certifications must be at least equal to or greater than the original Contractor’s employee provided by the Contractor under this contract.

5. CONTRACTOR REQUIREMENTS:

To be considered for award the offer must comply with the following responsibility factors.

Failure to provide the following responsibility factors in the response may disqualify an offeror from further consideration.

The government shall allow only qualified, appropriately licensed or credentialed individuals, practicing within the scope of their license or credentials, to provide healthcare services on behalf of the government.

The Contractor may be an individual, group or organization in which a qualified provider providing services meets the stated qualification requirements described herein.

A qualified provider shall be in attendance for every scheduled shift.

The Contractor shall provide services in such a manner as to meet the highest standards of professional ethics and conduct particularly in regard to confidentiality and patient rights. If at any time during the term of the contract, the Government suspect's unprofessional behavior and practices, the Contractor will be contacted and requested to take appropriate action to correct the behavior or remove the Contractor’s employee.

The Contractor shall contact the Chief Medical Officer or the Acting and be responsible for all documentation required for eligibility and temporary staff privileges at Health Center.

The Contractor shall be responsible for notifying the Chief Medical Officer or the Acting in case of an emergency or inclement weather that would prevent him/her from providing his/her schedule/shift.

The Contractor shall be proficient in writing, typing and have a basic working knowledge and understanding of computer hardware and software.

The Contractor shall not be authorized to perform any services for the Government until the IHS Governing body has granted the Contractor such privileges in writing. Federal contract employees do not accrue any form of retirement, social security, insurance or any other form of benefits.

The Contractor shall comply with all IHS facility infection control and safety procedures, and standards.

The Contractor shall provide for the consistent performance of patient care process according to the standards of TJC and/or Centers for Medicare Services (CMS) who supplies accreditation to the health center(s). These standards shall include: The Comprehensive Accreditation Manual for Hospitals, the Laboratory Standards, and Ambulatory Care Standards as they represent the scope of services of this contract.

The Contractor shall assist and provide services and duties as may be requested for normal operational requirements for the department and personnel. The Contractor shall provide work that is consistent with the guidelines and procedures of the IHS. Failure of the Contractor to meet these standards can result in the cancellation of the contract.

The Contractor shall have sufficient knowledge, competence and experience in providing these services on a regular scheduled clinic at FYSU. The Contractor shall possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that the Contractor can relate constructively to IHS employees, Contractors, patients, clients and individuals from the Native American Community. The Contractor shall be sensitive to the needs and customs of the Native American Indian Patients.

The Contractor shall inform the COR, Contracting Officer or Program Manager or their designated representative of any problems encountered or which may be encountered in connection with meeting the needs of the Contractor’s duties.

The Contractor shall not have any work or health restrictions, which could directly or indirectly interfere with the performance of providing services as there will be some moderate lifting with regard to boxes of office supplies, boxes of medication, and equipment.

The Contractor shall maintain acceptable standards of personal hygiene and grooming such that their image as a Federal contract employee is compatible with the expectations of the IHS staff.

The Contractor shall be required to provide regular report of hours worked to the Designated COR with an invoice. This report shall be verified by the Chief Medical Officer, or, his/her designee, that can confirm the coverage.

If the Contractor is a locum tenens company, the Contractor(s) shall designate an individual who will be the “Project Manager” that will be available to discuss any problems or issues that arise with the COR. (Reference Addendum to FAR 52.212-2 Evaluation – Commercial Items, Technical Evaluation Factors, B. Key Personnel).

The Contract shall obtain and maintain, at his/her own expense, all state and/or medical licenses, registrations or certification required in the performance of the contract, and shall comply with all laws, regulations, (Federal, State, Tribal and respective hospital) ordinances in the performance of this contract.

If required by the Service Unit, the Contractor shall assure complete medical record documentation for all patients seen for care in order to provide for the accumulation and organization of all pertinent clinical data needed to provide comprehensive medical care. IHS will provide training for the Contractor’s employee on Electronic Health Records (EHR), the Contractor shall complete medical records on the same day, in the EHR and/or via hand written notes, in accordance with The Joint Commission (TJC) requirements, the Scope of Work Statement, and in accordance with the Service Unit Staff By-laws and Rules and Regulations.

Failure to abide by this requirement is basis for cancellation of this contract. After given access the EHR, the Contractor(s) shall be required to enter medical patient information, laboratory and X-Rays, etc. into the electronic health record. Medical Records will be the property of the U.S.

Government and will be placed in each patient’s chart at the health center. The Medical Records shall not leave the premises.

Pursuant to the Federal Information Security Management Act (FISMA) of 2002 the Contractor shall complete the Computer Security Awareness Training (CSAT) course before computer access is provided or within a few days after receiving their access and annually after that.

Within the Health and Human Services (HHS), there is a requirement for this training to be completed annually by all employees that includes the Contractor.

The Contractor shall comply with all IHS facility infection control and safety procedures, and standards. During the performance of this contract, the Contractor shall provide for the consistent performance of patient care process according to the standards of TJC and/or Centers for Medicare Services (CMS) who supplies accreditation to the Phoenix Area Indian Health Service hospitals and health centers. These standards shall include: The Comprehensive Accreditation Manual for Critical Access Hospitals, and the Laboratory Standards as they represent the scope of services of this contract.

The Contractor shall complete in a timely fashion, the medical and other required records for patients he/she admits or in any way provides treatment. Chart notes are to be completed on the day services are rendered. The Contractor shall abide by the Service Unit Medical By-laws and rules and regulations and meet all credentialing requirements in accordance with the Service Unit Medical Staff By-laws.

Upon award, the selected Contractor’s employee shall undergo Indian Health Service (IHS) mandated security clearance for work on-site for the health center. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check through the Office of the Inspector General's exclusion list at http://exclusions.oig.hhs.gov/.

Documented evidence of the clearances shall be provided to the Contracting Officer Representative at the FYSU.

All financial, statistical, personnel, and technical data which is furnished produced or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. Such data or information shall not be released nor legal rights claimed by the Contractor without prior written consent of the Contracting Officer. Any presentation of any statistical or analytical materials, or any reports based on information obtained from performance by this contract will be subject to review and approval of the Contracting Officer. (Refer to HHSAR 352.270-4b Protection of Human Subjects).

Contractor’s agreement to term and conditions of the contract, acknowledge performance shall be in a professional manner and demonstrate a level of competence in our work that meets and/ or exceeds the government requirements. The contractor shall perform with respect to the patient’s right to receive appropriate and quality healthcare services without discrimination due to race, dreed, gender, and national origin, sexual orientation, disability, type of illness or condition, need for health services.

The Contractor shall ensure the confidentiality of all patient medical records. Information contained in these records may not be disclosed to any person or agency, except pursuant to a written request and with prior written consent of the individual to whom the records pertain.

However, this obligation shall not prevent the disclosure of patient medical records to officials and employees of departments and agencies of the United States Government acting in performance of this official duties pursuant to laws and regulations governing local control of communicable diseases, preventive medicine, and safety programs; to official representative authorized surveying bodies during the conduct of certification and accreditation reviews, or to third party payers to whom the patient has authorized release of information.

The Contractor shall familiarize himself/herself with the particular needs of the Ft. Yuma Indian Health Center patient population.

The Contractor shall comply with all established policies, protocols and procedures of the Ft.

Yuma Indian Health Center.

Each physician shall speak, understand, read and write the English language fluently.

The contractor agrees to furnish the following documentation of immunization records prior to the performance of work. (Reference center for Disease control (CDC) guidelines and Indian Health Service circular 95-9A).

1. Tuberculosis: Annual PPD or Chest X-ray, if there is a history of positive skin test.

2. Documentation of two (2) MMR (Measles, Mumps & Rubella) vaccinations or proof of immunity. Employees born before 1957 do not need MMR or proof of immunity.

3. Documentation of two (2) varicella (chicken pox) vaccinations or proof of immunity or history of having disease.

Personal Hygiene. Contractor personnel shall be clean and neat in appearance.

The contractor shall comply with all appropriate AAAHC, HHS, IHS, facility policies/ procedures and other regulatory agencies record keeping requirements.

6. CONTRACTOR MINIMUM REQUIREMENTS/QUALIFICATIONS:

a) The Contractor shall maintain a valid state licensure and be a board certified or board eligible psychiatrist. It is preferable that physician have experience and/or practice in remote settings. The Contractor shall have a minimum of two (2) experience.

b) Each physician must have completed residency training in the specialty of the position to be filed.

c) When Contractors employee have been confirmed for an assignment with the Government, upon request, the contractor will provide the Government with the clinical certification and license requirements.

d) Registration: Applicants must have active, current unrestricted license in a State, District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States.

Contractor shall assure each license is in good standing.

e) Each Contractor physician must be eligible for billing to Medicare and Medicaid (CMS).

f) The Contractor shall comply with federal "EMTALA" regulation and hospital policies regarding the transfer of patients to and from other facilities and whenever possible shall utilize contracted medical services and facilities.

g) Each licensed physician shall present an original current license when reporting to the FYSU for duty or for orientation whichever comes first. A copy is required for the contract file. No reimbursement will be made for contractors who report to work with an expired license or a license that is not in good standing.

h) According to current FYSU Policy as referenced by the FYSU Credentialing Education and Competency Plan. All Contractor’s employee’s personnel shall have current certification described.

i) All Contractors must provide copy of resume for file. Contractor file will be kept by the FYSU for verification of license or certificate, also file will contain personal information such as home, address, and phone number, next of kin, person to notify in case of emergency, health requirements, mandatory in-service and continuing education, competency assessments and awards or disciplinary action.

j) Contractor is responsible for his/her own reliable transportation, travel, hotel, and per diem expenses in the performance of this contract.

k) Contractor is responsible for maintaining satisfactory standard of competence, conduct, appearance and integrity. The quality of work performance of the Contractor shall be subject to review.

l) Contractor shall abide by FYSU Standard of Conduct and policies and procedures.

m) Contractor is responsible for notifying the Chief Medical Officer and the on-call Chief

Medical Officer if he/she will be late or will be unable to work due to illness or any other reason.

n) Contractors who become sick while on duty will seek medical care from their own private physician, unless Contractor is eligible to receive health care from Indian Health Service.

o) Certification/License: The Contractors physician must possess and maintain an active unrestricted nursing licensure. Current certification is required in ACLS, PALS and BCLS certifications.

7. CONTRACTOR CREDENTIALS:

The contractor shall provide a list of qualified candidates and the following documents per candidate as applicable:

a) Current Resume.

b) Two (2) letters of reference from current or previous employers.

c) Verification of Employment (VOE) required from a current or previous employer within the last three (3) years.

d) Copy of valid credential of certification

e) Copy of a valid, unrestricted License to practice issued in a state, county or the District of

Columbia.

f) Copy of valid ACLS, PALS and BCLS certifications.

g) Copy of appropriate medical malpractice liability coverage.

h) OMB NO 0917-0028, Addendum to Declaration of Federal Employment (OF-306).

i) Past Work Performance Statement, applicants must describe their present/previous experience in this field.

j) Current Health Status Report.

k) Copy of College Transcripts; conferred degrees and certified training in the field.

l) Certificate of Immunization.

m) Child Care Form, Addendum OMB Approved Form-2012.

8. SECURITY CLEARANCES:

The contractor shall ensure their employees have been properly screened prior to presenting to FYSU for employment under this contract. The contractor shall inform their employees to obtain Fingerprint cards or electronically submit their fingerprints through the FYSU Human Resources Department and complete the appropriate background investigation form which will be submitted for processing. No performance under this contract shall be allowed until the contractor’s employee is cleared through the FYSU Human Resources Department and issued a badge.

9. CREDENTIALS AND PRIVILEGING:

The contractor will participate in the credentialing and privileging process in accordance with existing procedure. Contractor shall provide no services prior to obtaining approval by the Government Medical Executive and Governing Board. The Contractor will be provided copies of current requirements and updates as they are published. Privileges will require renewal at least every one - two years in accordance with Government credentialing privileging policy and JCAHO requirements.

10. SUPERVISORY CONTROLS:

The Chief Medical Officer, or supervising designee, provides primarily administrative supervision. The supervising designee sets overall health care objectives and specifies resources available. The Chief Medical Officer provides for clinical supervision on a 24-hour, media and tour of duty coverage. The Chief Medical Officer reviews work performance on a periodic basis in order to evaluate proficiency in providing health care, discuss deficiencies and problems encountered, outline and/or approve new or changed practices to be employed, and provides consultation on specific cases and related problems. Work which involves out-of-the-ordinary diagnostic decisions or treatment is discussed with Chief Medical Officer or designee who keeps aware of the condition of such patients and all aspects of treatment regimen. Work performance is reviewed for conformance to IHS policy, procedures and accepted professional practices; and the Quality Assurance Improvement Program of the Medical staff of the Service Unit.

FYSU Medical professional(s) will provide guidance and instruction to the contractor’s staff providing services during each shift worked. Within established guidelines, contractor(s) exercise latitude in planning and carrying out health care assignments and in undertaking new procedures, practices and approaches to extend both services provided and increase individual proficiency. Overall work performance is reviewed jointly by the clinical director/supervising physician for effectiveness in meeting requirements for healthcare services.

12. DELIVERABLES:

The Contractor is required to provide a copy of each Contractor’s employee profile to the Contracting Officer Representative prior to providing services at the FYSU.