Area-Wide_Mobile_Cardio_SOW.docx

Statement of Work

C-1 Purpose of the Contract

The purpose of the contract is for the provision of mobile cardiology services for the Oklahoma City Area Indian Health Services. This contractor will be providing services to the Claremore Service unit, El Reno Indian Health Center, Pawnee Service Unit, and Wewoka Indian Health Center, (the Government”), (“Government facilities”) subject to all of the terms and conditions hereinafter set forth.

The contract shall:

1. Be a fixed-price non-personal health care services contract under which the contractor is an independent contractor.

2. Allow the Government to evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of the services rendered (e.g., professional judgements, diagnosis for specific medical treatment);

3. Require the Contractor to indemnify the Government for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance; require the Government to indemnify the Contractor for any liability producing act or omission by the Government, its employees and agents occurring during contract performance.

4. Require the Contractor to maintain medical liability insurance, in the coverage amount acceptable to the Contracting Officer which is not less than the amount normally prevailing within the local community for the medical specialty concerned; and

5. Require the Contractor to ensure its subcontractors for provision of healthcare services, contain the requirements of the clause at FAR 52.237-7, including the maintenance of medical liability insurance.

C-2 Statement of Work

Vendor shall provide a cardiology system mounted in a mobile van (Referred to as the (“Mobile Unit”). Vendor represents that with regard to the mobile unit (a) it is in good working and operating order, repair and condition, (b) it has been consistently maintained as required or recommended by the manufacturer and repaired as needed and (c) it produces a high quality result consistent with accepted diagnostic interpretation standards.

Vendor shall cause the Mobile Unit to be moved from Government facility to Government facility in accordance with an established schedule and as need requires. The Mobile Unit will be maintained, operated and transported by vendor. The Government facility agrees to purchase from vendor, and vendor agrees to provide to the Government facility the cardiology services set forth on Schedule A.

The Government facility and vendor specifically recognize that it is each party’s intent to provide services to Government facility patients covered by primary payer sources such as the Medicare program (Title XVIII of the Social Security Act) and that each party has an obligation to comply with all applicable requirements of these programs.

Sec. 136361 Payor of last resort.

(a) The Indian Health Service is the payer of last resort for persons defined as eligible for contract health services under the regulations in this part, notwithstanding any State or local law or regulation to the contrary.

(b) Accordingly, the Indian Health Service will not be responsible for or authorize payment for purchased/referred care to the extent that:

(1) The Indian is eligible for alternative resources, as defined in paragraph (c ) of this section, or

(2) The Indian would be eligible for alternative resources if he or she were to apply for them, or

(3) The Indian would be eligible for alternate resources under State or local law or regulation but for the Indian’s eligibility for contract health services, or other health services, from the Indian Health Service or Indian Health Service Funded programs.

( c) Alternative resources mean health care resources other than those of the Indian Health Service. Such resources include health care providers and institutions, and health care programs for the payment of health services including but not limited to programs under title XVII or XIX of the Social Security Act ( i.e., Medicare, Medicaid), State or local health care programs, and private insurance.

Vendor agrees to comply with all applicable laws governing preparation and/or submission of bills, and claims to government agencies, including without limitation, the federal Social Security Act and implementing regulations relating to Medicare and Medicaid and other federal and states health care programs. Vendor warrants that its owners, trustees, officers, directors and employees have not been sanctioned under the Medicare/Medicaid program or debarred, suspended, or excluded from the Medicare/Medicaid program or any other federal program or agency. Should the Medicare/Medicaid program or any other federal agency or program initiate proceedings to sanction, debar, suspend, or exclude the Government facility, its owners, officers, directors or employees, Vendor shall immediately inform the Government facility in writing. Initiation if such proceedings shall be grounds for immediate termination of this Agreement. The Government facility hereby warrants that the Government facility, its owners, officers, directors and employees have not been sanctioned under the Medicare/Medicaid program or debarred, suspended or excluded from the Medicare/Medicaid program or any other federal program or agency. Should the Medicare/Medicaid program or any other federal program or agency initiate proceedings to sanction, debar, suspend or exclude the Government facility, its owners, officers, directors or employees, the Government facility shall immediately notify Vendor in writing. Initiation of such proceedings shall be grounds for immediate termination of this Agreement.

Vendor shall meet the same requirements as those which would be applicable if the Services were furnished directly by the Government facility. The Government facility will have the right to monitor and oversee Services provided by Vendor pursuant to this Agreement in the same manner as it does for services provided in any department of the Government facility to the extent required by statutory, regulatory, or accreditation standards. Vendor shall accept Government facility patients for treatment in accordance with the Government facility admission policies. Medical records of all Government facility patients shall be completed and maintained by Vendor in accordance with the Governments facility policies to which the Government facility is required to comply by statue, regulation, or accreditations requirements. Vendor shall maintain a complete and timely clinical record on each patient which includes diagnosis, medical history, physician’s orders, and progress notes relating to all services received.

Vendor shall provide certificates of insurance evidencing the coverage required by this Agreement, shall arrange for the respective insurers to notify the other party in writing thirty ( 30) days prior to any change in coverage, and shall provide written evidence of such arrangements.

Vendor personnel shall be subject to credentials review and meet the standards required by Joint Commission. Prior to providing services, vendor personnel providing direct patient care and/or operating the Mobile Unit longer than 60 days are required to provide the necessary forms and information required to obtain background investigations and complete the orientation process.

-OF306 Declaration for Federal Employment -OF612 or Resume -Addendum for Child Care (if identified CNACI position)

(a) The Contractor shall comply with agency personal identity verification procedure identified in the contract that implements Homeland Security Presidential Directive-12 (HSPD-12), Office of Management and Budget (OMB) guidance M-05-24 and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

(b) The Contractor shall insert this clause in all subcontracts when the subcontractor is required to have routine physical access to a Federal-controlled facility and/or access to a Federally-controlled information system.

All clinical documentation, reports and medical records resulting from services ( the “Records”) shall be prepared by Vendor, but owned and maintained by the Government facility as required by applicable law and regulations. Vendor will retain originals of records and provide a copy to the appropriate Government facility. Vendor shall maintain the confidentiality of any health information and records in accordance with applicable law and regulation and Vendor shall have reasonably necessary access in accordance with the Government facility’s policies and applicable law. The Parties shall work in good faith to execute any other documents pertaining to confidentiality of patient records to further Party’s compliance with applicable law and regulations.

The standards of medical practice and duties of the Contractor through its cardiology services shall be determined pursuant to the bylaws of the Government facility, the regulations of the Government facility, applicable provisions of the law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals, and the standards and recommendations of Joint Commission (JC). The contract cardiologist shall be required to participate in a quality improvement program which is consistent with current JC requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

Medical Services shall not be performed by a contract physician until IHS has received copies of physician licensure and malpractice insurance. Prior to assumption of duty on any scheduled work shift the Contract cardiologist may be briefed by the Service Unit Clinical Director or his designated representative concerning any matter relevant to the contract physician’s assumption and discharge of responsibilities under the terms of this contract. The Contractor shall advise the Clinical Director or his designated representative concerning any matter relevant to the contract physician’s assumption and discharge of responsibilities under the terms of this contract. The Contractor shall advise the Clinical Director or his designated representative of any problem encountered, or which may be encountered, in connection with meeting the needs of patients treated by the Contract Physician.

The Contract physician shall generate and maintain proper medical record information on beneficiaries to whom treatment is provided, in accordance with JC and IHS regulations. The Contract physician shall prepare all medical record documentation to meet or exceed the established standards of the IHS facility to include, but not be limited to: timeliness, legibility, accuracy, content and signature. All medical record information generated in the performance of this contract will remain the property of and subject to the exclusive control of IHS.

Vendor shall provide all supplies, including medications and linens that are reasonable and necessary for the proper provision of cardiology services if the patient is in need of oxygen or controlled substances such as narcotics, the Government facility will provide these services.

The Contract physician shall become familiar with and be guided by the IHS formulary. The Contract physician shall follow HIS procedures when prescribing drugs. The Contract physician authorized to prescribe pharmaceuticals shall do so according to availability of drugs listed in the IHS formulary. IHS pharmacy will provide instruction to the prescribing Contract physician as to substitutes of generic drugs for prescribed drugs. Drugs not on the formulary must be approved by the Service Unit Pharmacy and Therapeutics Committee.

The Contact physician shall comply with all IHS facility infection control and safety procedures, practices and standards.

The Contract physician shall respect and maintain the basic rights of patients, to include but not be limited to personal dignity.

Physician Qualifications The Contract cardiologist shall be Board Certified, or Board Eligible without additional education or training, by the American Board of Cardiology. It is a condition of this contract that all required certifications in this Statement of Work remain current during the life of this contract.

The Contract cardiologist shall hold a current, unrestricted State medical license from any of the fifty (50) United States.

The Contract cardiologist shall meet the same privileging requirements as permanent IHS physicians before being allowed to provide medical services at the Government IHS facility.

Current Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) certification is required of the Contract cardiologist.

The Contract cardiologist shall speak, understand, read and write English fluently and communicate with sufficient clarity to be understood by the Government facility’s personnel and patients.

C-3.Government furnished Property, Facilities and Services

The Government facility will be responsible for preparing the parking location suitable for use by the Mobile Unit and for obtaining certification that the site meets all specifications. Upon the Governments facility’s request, Vendor will assist the Government facility in this process. The Government facility will also be responsible for keeping the site free of all other vehicles, obstructions snow, ice and debris for all periods when the Mobile Unit is in use or is scheduled for use at the Government facility, if feasible.

The Government facility will be solely responsible for providing and area for patients and their families awaiting delivery and retrieval to and from the Mobile Unit. The Government facility will share its restrooms and dining facilities with patients, families and employees of the Mobile Unit.

The Government facility will be responsible for providing a Physician, a Physician Assistant or Advance Practice Nurse to be available for urgent/emergent situations. The Government facility will also be responsible for providing such other personnel as may be required to assist when Government facility patients are in the Mobile Unit to perform or cause to be performed all tasks of diagnosis and patient care.

The contract employee will be authorized to use all administrative and professional support available to Indian Health Service Personnel. This will include, but not be limited to, copy machines, telefax machines, medical library and telephone service. The same restrictions to use these items for official Indian Health Service business apply.

The contract employee will be provided with an orientation to the Indian Health Service and Indian community being served. The initial orientation and continuing orientation shall be provided by service unit personnel.

The Government facility will provide patient names, demographics and referral information from Primary Care Physicians to the Mobile Unit scheduling department. There will be a minimum of seven (7) patients per site visit, and no more than five (5) may be for nuclear exams ( aka “MPI”).

The Government facility will provide all required blank Government forms applicable to the Indian Health Service. An appropriate orientation to the necessity of such forms will be provided by service unit personnel.

The Government facility will provide the authority for the contractor employees to purchase meals in the service unit dining room when available.

The Government facility will provide an ongoing method of monitoring and evaluation of the quality and appropriateness of patient care and of identifying deficiencies in the quality of services performed before the level of performance becomes unacceptable. The unexpected standard level of care that Vendor provides must meet or exceed levels which are currently available within a hospital based Medical Center.

C-4. Contractor Furnished Equipment, Facilities and Services

Vendor shall be solely responsible for the hiring of personnel to operate the Mobile Unit. All personnel employed by Vendor shall be qualifies by training, education, licensing or certification and experience to operate the Mobile Unit. Vendor shall obtain any applicable licenses or permits for such operation.

Vendor shall be responsible for obtaining, and shall furnish the Government facility a copy of all licenses and permits for transportation and operation of the Mobile Unit. Vendor shall comply with all laws and regulations in connection with the provision, use and operation of the Mobile Unit in connection with the services rendered and shall make available to the Government facility any data or information necessary to comply with the requirements of the Government’s regulatory or accrediting agencies.

Vendor at its cost and expense shall be responsible for the maintenance and operation of the Mobile Unit. Vendor shall at a minimum follow any maintenance schedule recommended by the manufacturer of the Mobile Unit. Furthermore, Vendor shall undertake any unscheduled repairs or maintenance as may be required from time to time. All such repairs shall be done in a prompt fashion and to the extent possible during times when service is not scheduled in order to minimize the amount of time the Mobile Unit is available for service. Vendor shall keep records of all such maintenance activities for a period of five (5) years and make such records available to the Government facility, upon request.

Vendor shall conduct an evaluation of patient volumes and financial performance related to each service location after six (6) months. Based on this evaluation, Vendor shall be allowed to revise the locations and frequency of service.

Additionally, throughout the duration of the SOW, Vendor is allowed to cancel scheduled visits if scheduled patient volume is below agreed minimums.

Vendor shall provide networking connectivity from the Mobile Unit via phone or telemedicine to an On-Call Physician, at the expense of Government Facilities.

Vendor shall be responsible for proving such employees as are necessary for the prompt and orderly delivery and retrieval of patients into and from the Mobile Unit and for all such care required for such patients during such delivery and retrieval. It is understood that Vendor shall be performing the cardiology services.

CARDIOLOGY SERVICES-SCHEDULE A

Types of Procedures

· Treadmill Stress Test

· Medically Induced Stress Test

· Echocardiogram

· Electrocardiogram

· Ultrasound

· Vascular Diagnostic Studies

· Nuclear Medicine Diagnostic Studies

Specific Nuclear Medicine Exams:

a. Cardiac-Myocardial Perfusion Imaging (MPI)

b. Cardiac-Multiple Gated Acquisition (usually called MUGA)

c. Bone- Whole Body Bone Scan

d. Renal-Renogram (without Lasix)

e. Liver and Spleen Scan

f. Hida Scan

g. Liver Hemangioma Detection using Tc99m labeled Red Blood Cells

h. Lung Quantification Scan

Specific Ultrasound Exams:

· Abdomen

· Aorta Abdominal

· Abdomen Wall

· Carotid

· Lower Extremity Artery Doppler

· Lower Extremity Vein Doppler

· Upper Extremity Artery Doppler

· Upper Extremity Vein Doppler

· Gallbladder

· Liver

· Pancreas

· Pelvic (Trans Abdominal)

· Renal

· Spleen

· Thyroid

SCHEDULE B-PROCEDURE DESCRIPTION AND FEES

PROCEDURE SHORT DESCRIPTION

Cardiovascular Stress Test Cardiovascular Stress Test using maximal or submaximal treadmill or bicycle exercise, continuous electrographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report.

Stress TTE only Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induces stress with interpretation and report.

Stress TTE complete Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise, and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with Physician Supervision.

Cardiovascular Nuclear Exam Unlisted Cardiovascular procedure, diagnostic nuclear medicine.

Vascular Flow Imaging Non-cardiac vascular flow imaging (i.e., angiography, venography)

Vascular Study Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs : complete study