Attachment_D_-_Statement_of_Work.pdf

Attachment D: Statement of Work

STATEMENT OF WORK

The overall intent of this contract is to acquire non-personal Nurse Telephone Triage Services for a qualified Contractor under a Government service contract. The contractor shall provide the necessary education, training, licensing, previous work experience and competence in being able to provide the services within the department. Work performance shall be performed according to the requirements and conditions contained in this Statement of Work.

The Health and Human Services (HHS), Phoenix Area Indian Health Service (PAIHS), Phoenix Indian Medical Center (PIMC), located in Phoenix, Arizona is seeking a contractor who can provide Nurse Telephone Triage Services.

PIMC is a general medical and surgical hospital which provides comprehensive health services primarily to Native Americans and Alaskan Natives. PIMC serves as a referral hospital for difficult and complex cases from other hospitals and health centers located throughout the PAIHS. It also serves as the primary health facility for a large number of urban Indians.

The Contractor shall provide Nurse Telephone Triage Services for PIMC, located in Phoenix, Arizona. The Contractor shall provide Registered Nurses who can fully provide Telephone Triage Services to patients within the specifications of the “Scope of Work”, within the standards of practice, and in accordance to The Joint Commission, Centers for Medicare & Medicaid Services (CMS), and PIMC policies.

1. SCHEDULES/LOCATIONS/QUALIFICATIONS/CERTIFICATIONS:

SCHEDULE: The Contractor shall provide a telephone-based Nurse Triage system for eligible American Indians and Alaskan Natives (beneficiaries), Monday through Sunday 24-hours per day, 7 days a week and all federally recognized holidays.

LOCATION: Services shall support the following locations:

Indian Health Service Phoenix Indian Medical Center 4212 N 16th Street Phoenix, AZ 85016-5319

QUALIFICATIONS/CERTIFICATIONS:

Education: Associates degree prepared registered nurse Experience: Minimum of three (3) years of experience in nurse triage.

Licensure: Registered Nurse (RN) licensed in the state in which the nurse triage service is physically located.

Accreditation: Maintain URAC accreditation, formally known as Utilization Review

Accreditation Commission.

Insurance: Appropriate medical malpractice liability coverage.

Privileges: None Cultural Sensitivity: The contractor shall provide cultural sensitivity training specific to the

American Indian/Alaska Native people as provided by the COR.

2. PRICE SCHEDULE

The unit prices paid to the Contractor(s) 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.

Services shall be inclusive of all other fees (holiday, nights, weekend), including 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 call (on a monthly basis).

See Attachment A – Price Schedule

3. STATEMENT OF WORK:

The Contractor shall provide a telephone-based Nurse Triage system for eligible American Indians and Alaskan Natives (beneficiaries), Monday through Sunday 24-hours per day, 7 days a week and all federally recognized holidays.

Federally recognized holidays can be found online at http://www.opm.gov/fedhol/index.asp. The contractor shall be notified within a minimum of thirty (30) days by the IHS Point of contact of any planned health center closures during normal business hours.

The contractor shall provide personnel, labor, materials, equipment, facility and services for providing a telephone-based nurse triage system. The contractor shall provide a clinical assessment and disposition to an appropriate level of care for all patients who utilize the nurse triage system.

PIMC estimates up to 500 calls per month to be processed by the Contractor.

A 15-second pre-recorded message will advise callers of their privacy rights and include a disclaimer for IHS payment responsibility for all health care advice. Script to be provided by PIMC.

The Contractor shall ask for personal details. Personal details include: Name, Date of Birth, facility where patient normally receive services, chart number, primary care provider, insurance, and tribal enrollment information. If the patient is not a member of a federally recognized tribe, the contractor shall advise the patient that the service is only for enrolled beneficiaries.

The contractor shall:

(a) Provide technical, operational, administrative and management support for the beneficiaries.

(b) Provide a toll free number for the nurse triage system (NTS).

(c) Perform triage caller interaction utilizing nationally recognized and physician approved clinical protocols and guidelines.

(d) Manage patient calls per protocols, maintain call summaries, provide feedback to practices/providers (as requested), and provide feedback to program and medical management.

Answering Calls: The contractor shall answer calls within an average of 30 seconds according to URAC Standards of Accreditation. The contractor will use protocols to determine the urgency of the call, transfer urgent calls directly to a registered nurse and respond to non-urgent calls by a registered nurse within an average of 30 minutes.

http://www.opm.gov/fedhol/index.asp

Emergency Room/Urgent Care Referral Instructions: If the patient meets URAC criteria for referral to emergency or urgent care, then the contractor shall direct the patient to go to an emergency room/urgent care facility. The contractor will ask the patient and document, if the information is available, which facility the patient plans to select.

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

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 suspects 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 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 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, 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 at PIMC. 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 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 be required to provide a regular work report of calls processed 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.

The Contractor 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 nursing 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.

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).

5. MAJOR DUTIES REQUIRED:

The overall scope of this contract is to contract for qualified nursing services under a Government Non-Personal Services contract. The Contractor shall have the necessary education, training, licensing, previous work experience and competence required to provide telephone-based nurse triage services to PIMC. The contract resulting from this solicitation shall provide PIMC patients treated under the terms of this contract proper and adequate nursing care within accepted professional standards.

6. SUPERVISORY CONTROLS:

The Chief Medical Officer, or supervising designee, provides primarily administrative supervision of the contract. The supervising designee sets overall health care objectives and specifies resources available. The Chief Medical Officer, in collaboration with the Chief Nursing Officer, reviews clinical performance on a periodic basis in order to evaluate proficiency in providing telephone-based nurse triage services and discuss deficiencies and problems encountered.

(a) The contract shall be a non-personal services contract, as defined in FAR 37.101, under which the contractor is an independent contractor;

(b) The Contractor shall perform the required services described independently of Government Supervision except as stated therein.

(c) No employer-employee relationship exists. Direct supervision aspects of the relationship can be minimized to where they are incidental to the series required and are for administrative guidance only.

(d) The Government may evaluate the quality of services provided, but retains no control over the services rendered.

(e) None of the services furnished under the Performance Work Statement shall be subcontracted or transferred to another Contractor or organization without the specific prior written approval of the Contracting Officer.

7. DELIVERABLES:

The Contractor shall provide a summary of each call to include patient demographics, subjective and objective assessments, medications, protocol used, plan, intervention, evaluation and follow-

up. If a patient is referred, the contractor shall document which facility the patient plans to use for care. Each individual’s call summary shall be provided to PIMC electronically or by facsimile by the next business day. Communication will be in a written format to facilitate follow-up and referral management with the primary care team, as appropriate.

Call Statistics Reporting: The contractor shall submit a monthly status report to the PIMC COR no later than the 10th business day of each month. The monthly report shall include comprehensive analysis of triage activity to include, but not limited to, day of the week, call time, response time, triage nurse identification, chief complaint, disposition, and any unusual circumstance, in order to identify trends and for future planning purposes.

8. QUALITY CONTROL:

The contractor shall provide a quality control program based on a combination of clinical and peer review to ensure appropriate triage protocols are used, patient calls are responded to a timely manner, and that all customers are satisfied with the services received. An example of the policies and procedure will have the following components for a successful call:

(a) Satisfied caller

(b) Adherence to protocols

(c) Complete documentation of assessment and advice

(d) Appropriate medical disposition

(e) Documentation whether patient plans to comply with care advice given

Quality Control Plan: The contractor shall implement a quality control program to ensure performance is in accordance with the contract requirements and URAC standards. The contractor shall make this plan available to the Project Officer within 30 days after the contract start date for review and approval.

New services shall not be introduced without prior recommendation to, and approval of, the Contracting Officer.

Complaints: Any complaints shall be forwarded to the IHS Point of contact for action and/or rectification.