Area-Wide_Mobile_Mammo_SOW_2.docx

STATEMENT OF WORK (SOW)

Independently, and not as agent of the Government, the Contractor shall provide the personnel and supplies, except as may be otherwise provided herein by the Government, to provide the following services:

a. On-site screening mammography service

b. Diagnostic interpretation

c. Consultation services

d. Continuing Education

e. Reporting

A. On-Site Mammography Services Contractor shall provide mobile on-site screening mammography services at the respective IHS facilities: Anadarko Indian Health Center, Carnegie Indian Health Center, El Reno Indian Health Center, Kanza Health Center in Newkirk, OK, Oklahoma City Indian Clinic, Wah-Zha-Zhi Health Center in Pawhuska, OK, White Eagle Health Center in Ponca City, OK, and Watonga Indian Health Center, to include:

1. The screening examination shall include full-field digital mammogram of each breast. The mammography procedures and equipment must be state of the art.

B. Written Diagnostic Interpretation

1. The Contractor shall perform interpretation of mammograms taken at the IHS Facilities and reports provided to the referring facilities within seven (7) business days.

C. Consultative Services

1. The Contractor shall provide professional verbal and written consultation as appropriate to the IHS facilities committees, and may be requested by the respective Standing Committee Chairman in implementing compliance Joint Commission (JC) Standards.

2. The consultation shall be provided within 24 hours upon request of the respective IHS medical staff and shall include but not limited to:

a. Interpretation of diagnosis

b. Analysis and interpretation of pathological findings

c. Radiological assessment and diagnosis

d. Advisement of additional diagnostic examinations

e. Development of therapeutic plans

D. Continuing Education

The Contractor shall provide an on-going scheduled program or continuing education for medical staff as part of the facility in-service continuing education program.

1. Education shall be directed to the experience of the staff.

2. The Contractor shall provide video and printed mammography education materials for patients seen in the mobile van.

E. Reporting

The Contractor shall provide interpretation and completed consultation reports of diagnostics to each on-site IHS facility.

1. Significant pathological findings and interpretation shall be provided and brought to the attention of the requesting IHS physician by telephone.

F. Consultation Reports

The Contractor shall provide accurate mammography reports, timely.

1. Reports shall be available to the medical staff within seven (7) Business days of the examination.

G. Invoicing

The Contractor shall provide all of the above services and invoice the IHS using a UNIT fee secondary to the patient’s primary insurance as defined in the applicable Payor of Last resort regulation 42 CFR 136.61.

1. The “Unit for Payment” shall be the mammography examination. The fee charged for the individual mammography examination is inclusive for all services provide in this contract.

2. The “Unit Fee” shall be the same at each IHS facility within the respective Price Schedule.

EQUIPMENT SPECIFICATIONS AND PROFESSIONAL QUALIFICATIONS

A. Minimum Equipment Specifications

1. The mobile mammography service and programs shall be accredited by the American College of Radiology.

2. The Contractor shall be required to shall maintain a stringent Quality Control Program.

3. The on-board digital equipment shall be designed for and dedicated to low dose mammography examinations.

4. The mobile van shall have a back-up system to provide electrical power that is compatible with the IHS facilities.

5. The mobile van shall have steps and a ramp for patients to access on-site services. The ramp and steps must be secured to the mobile van and provide adequate safety for patients entering and exiting the mobile unit.

B. Personnel Qualifications

A radiologist with the following:

1. A current, valid and unrestricted license to practice medicine in the State of Oklahoma.

2. Maintain certification in diagnostic Radiology by the American Board of Radiology during the period of the contractual agreement.

3. Possess unrestricted diagnostic radiology privileges at a JC accredited facility.

4. Provide documentation within the last 18 months of acquired continuing education specific to mammography, and mammography interpretation of at least 500 diagnostics within the last 18 months.

5. Provide written evidence of mammography Quality Assurance studies and/or activities conducted under his/her direction from a JC accredited facility.

Evidence of all minimum equipment specifications and professional requirements shall be provided to the Contracting officer prior to the award of contract.

INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

A. It is expressed, agreed and understood that this is a non-personal service contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as independent Contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of services rendered, including by example, the Contractor’s professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts for omissions by it or by its employees or agents. The Contractor shall maintain liability insurance issued by a responsible insurance carrier in the amount of not less than $1,000,000.00 per occurrence during the term of this contract, $3,000,000.00 aggregate.

B. An apparently successful offeror, upon request by the Contracting Officer shall furnish prior to contract award evidence of its insurability concerning the medical liability insurance required by paragraph (A) of this clause.

GOVERNMENT FURNISHED FACILITIES/EQUIPMENT

The Government will provide the IHS facilities for use by the Contractor in performance of the contract. Government facilities shall include a parking area and, if required, the patient clinic area within the facility. The Government will provide an acceptable back-up power source (electrical receptacle) at all screening locations at no cost to the Contractor. All other mammography services shall be performed in the Contractor mobile unit.

CONTRACTOR FURNISHED FACILITIES/EQUIPMENT/SUPPLIES

A. The Contractor shall provide a mobile unit specifically designed for mammography screening which is completely self-contained with on-board electrical source.

B. The Contractor shall provide educational material necessary for provision of a continuing education program as may be requested by the facility staff.

C. The Contractor shall provide educational materials for use by the mammography patients (i.e. video and printed material).

SCHEDULE OR SERVICES AND PRICES/COST

2,480 each @ $_____ when no applicable primary payor exists. If patient’s primary insurance is an applicable payor source, IHS will be offset for these accrued and billed services by the contractor. Patient’s primary insurance will be coordinated for primary reimbursement. IHS will only be a payor when the primary insurance payment and contracted insurance adjustment does not meet the $ ____ charge per service. In these instances, IHS will only pay up to the $ ____ charge per service.

A. Hours of Operation

The work schedule, exclusive of Federal Holidays, shall be 8:30 A.M. to 4:30 P.M., Monday through Friday.

1. The day, starting time and length of the on-site visits to the IHS facility shall be established by mutual agreement between the Contractor and the IHS Contracting Officer’s Representative (COR).

2. The Contractor shall provide rotating, on-site visits to the IHS facilities as listed in Section A, to ensure that the total estimated number of examinations, by facility, shall be performed during the period of the contract.

3. The Contractor shall advise the COR immediately if the schedule must be modified due to extenuating circumstances such as mechanical or equipment breakdown.

B. Rotating Schedule The initial rotating on-site visits to, and from the IHS facilities, once established, cannot be changed without the IHS COR’s authorization and Contracting Officer’s approval.

C. Mammography Examination The Contractor shall provide on-site mammography examinations utilizing a mobile vehicle at the IHS facilities.

D. Interpretation The Contractor shall provide mammography interpretative reports being returned to the IHS facility within seven (7) working days of the examination.

E. Consultative Services The Contractor shall provide professional consultation to the respective IHS Medical Staff.

REPORTING REQUIREMENTS

The Contractor shall submit to the COR the following items in the quantities stipulated and within the time frames identified below.

A. Technical Reports

below.

below.

a. Monthly Narrative Progress Reports shall cover services provided during reporting period and shall briefly present the following information for each service component required in the contract. Reports shall be submitted with monthly invoice and shall include the following:

(1) A comparison of actual services provided with requirements established and the level of services provided that can be readily quantified.

(2) Problems encountered and circumstances, if any, adversely affecting delivery of services.

b. Monthly invoices shall be submitted on Contractor’s stationery and shall reflect signature of dully authorized agent of the Contractor. Invoices shall include itemized listing of all procedures performed, patients name, patient’s chart number, charges, and dates of service.

c. Special reports may be requested by the Contracting Officer or COR during the contract on technical or administrative aspects of contract performance. Requests for such reports will be provided in writing to the Contractor stipulating information required, time frames for response, and instructions on submissions.

Monthly invoices and Monthly Narrative Progress Reports shall be submitted to the COR at the respective IHS facility.

OTHER FACTORS

The Contractor shall have adequate staff, facilities and equipment to provide the required mammography services to the IHS.

Performance Conditions The Contractor shall provide the capacity to perform all services specified herein for the IHS. In any event of the Contractor’s absence within the on-site mobile unit, it shall be the responsibility of the Contractor to provide timely rescheduled service. The Contractor shall notify the IHS facilities at a minimum of 24 hours prior to the absence. The failure of the Contractor to provide such capability may be grounds for termination for default under the default clause of the contract.

The Contractor shall deliver to the Government such reports, items, services as specified in the Reporting Requirements. The Contractor shall also make such reports to the Government as called for by the COR.

Quality of Care The Contractor shall provide proper and adequate radiology services which shall include compliance by the Contractor with applicable standards of the American College of Radiology.

Quality of professional services provided shall be at a level commensurate with standards of the medical professional in general and of the American College of Radiology.

The Contractor shall perform the work described in this contract independent of Government supervision. Professional surveillance of services under this contract will be provided by the designated COR..

Contractor shall be required to participate in regular scheduled activities of the Continuous Quality Improvement Program of the IHS facility in coordination with the IHS facility Radiology Supervisor for services provided under this contract. The Continuous Quality Improvement Program for contracted mammography services shall meet the minimum requirements of Joint Commission.

Review and Inspection The OCA IHS Chief Medical Officer (CMO); Area PRC Officer; designated representatives of the contracting facility; and the Area Contracting Officer and/or COR shall have the right to, (1) review and inspect the Contractor’s operations prior to award of contract to determine capability of Contractor to provide professional services required by the contract and (2) review and inspect the Contractor’s facility and operations during the performance of this contract.

In preparation of proposal, Contractor may review the contracting IHS facility’s Radiology Department upon not less than three (3) working days prior to telephone request to the Radiology Supervisor at the respective IHS facility.

Pre-Performance Conference

Subsequent to award of contract and prior to beginning of services, the Contractor may be required to attend Pre-Performance Conference to be held at the OCA, IHS, 701 Market Drive, Oklahoma City, OK, 73114 for the purpose of acquainting the Contractor with all technical, administrative aspects and requirements of the contract.

Quality Control

The Contractor shall be responsible for monitoring and evaluating the safety, quality, and appropriateness of mammography services provided and shall maintain the quality control program to maximize the quality of diagnostic information available.

The Contractor must establish and maintain an effective working relationship with the medical and radiology staffs, and facility administration.

As part of the facility’s Continuous Quality Improvement Program, the quality and appropriateness of mammography services provided by the Contractor will be monitored and evaluated, and identified problems will be resolved. (JC Manual, Diagnostic Radiology Services). The Contractor shall be responsible for cooperating with IHS in assuring that the process is implemented and maintained.

Two (2) radiology audits are required yearly. The Contractor shall perform both of the audits, all of which shall be performed in accordance with the following:

1. The audit shall include assessment of the appropriateness of the radiographic examination being ordered by the clinicians. The Contractor shall develop the criteria for the mammography service. The criteria shall be submitted to and approved by the Area Chief Medical Officer (CMO) within 60 days of contract award. The results of this study/audit shall perform topics for continuing education for the respective IHS medical staff.

2. The audit shall include as a minimum, an assessment of the quality of clinical interpretation of the digital mammography screening program and review consultation reports of the contract radiologist.

The complete audits shall become part of the IHS facility’s quality assurance program.

Contract Coordination and Administration

In order to provide continuity of services, the Contractor shall designate someone to be available and responsible for day to day coordination and communication with IHS staff to:

a. Provide administrative and professional consultation,

b. Schedule continuing education for personnel, and

c. Discuss any problems that may arise.

Evidence of designation and description of the Contractor’s delegated authority shall be provided to the Contracting officer prior to award of the contract.

On-site visits are an applicable contracting monitor’s responsibility.

ACCEPTABLE QUALITY LEVELS (AQL)

2. Availability of Continuous telephone Not more than two Radiologist. consultation available. instances per month of Radiologist inaccessibility.

QUALITY ASSURANCE

The Contractor shall have adequate staff, facilities and equipment to provide the required mammography services to the IHS.

Performance Conditions The Contractor shall provide the capacity to perform all services specified herein for the IHS. In any event of the Contractor’s absence, it shall be the responsibility of the Contractor to provide timely rescheduled service. The Contractor shall notify the IHS facilities at a minimum of 24 hours prior to the absence. The failure of the Contractor to provide such capability may be grounds for termination for default under the default clause of the contract.

The Contractor shall deliver to the Government such reports, items, services as specified in the Reporting Requirements. The Contractor shall also make such reports to the Government as called for by the COR.

Quality of Care The Contractor shall provide proper and adequate radiology services which shall include compliance by the Contractor with applicable standards of the American College of Radiology.

Quality of professional services provided shall be at a level commensurate with standards of the medical professional in general and of the American College of Radiology.

The Contractor shall perform the work described in this contract independent of Government supervision. Professional surveillance of services under this contract will be provided by the designated COR.

Contractor shall be required to participate in regular scheduled activities of the Continuous Quality Improvement Program of the IHS facility in coordination with the IHS facility Radiology Supervisor for services provided under this contract. The Continuous Quality Improvement Program for contracted mammography services shall meet the minimum requirements of Joint Commission.

Review and Inspection

The OCA IHS Chief Medical Officer (CMO); Area PRC Officer; designated representatives of the contracting facility; and the Area Contracting Officer and/or COR shall have the right to, (1) review and inspect the Contractor’s operations prior to award of contract to determine capability of Contractor to provide professional services required by the contract and (2) review and inspect the Contractor’s facility and operations during the performance of this contract.

In preparation of proposal, Contractor may review the contracting IHS facility’s Radiology Department upon not less than three working days prior to telephone request to the Radiology Supervisor at the respective IHS facility.

Pre-Performance Conference

Subsequent to award of contract and prior to beginning of services, the Contractor may be required to attend Pre-Performance Conference to be held at the OCA, IHS, 701 Market Drive, Oklahoma City, OK, 73114 for the purpose of acquainting the Contractor with all technical, administrative aspects and requirements of the contract.

Quality Control

The Contractor shall be responsible for monitoring and evaluating the safety, quality, and appropriateness of mammography services provided and shall maintain the quality control program to maximize the quality of diagnostic information available.

The Contractor must establish and maintain an effective working relationship with the medical and radiology staffs, and facility administration.

As part of the facility’s Continuous Quality Improvement Program, the quality and appropriateness of mammography services provided by the Contractor will be monitored and evaluated, and identified problems will be resolved. (JC Manual, Diagnostic Radiology Services). The Contractor shall be responsible for cooperating with IHS in assuring that the process is implemented and maintained.

Two (2) radiology audits are required yearly. The Contractor shall perform both of the audits, all of which shall be performed in accordance with the following:

1. The audit shall include assessment of the appropriateness of the radiographic examination being ordered by the clinicians. The Contractor shall develop the criteria for the mammography service. The criteria shall be submitted to and approved by the Area Chief Medical Officer within 60 days of ward contract. The results of this study/audit shall perform topics for continuing education for the respective IHS medical staff.

2. The audit shall include as a minimum, an assessment of the quality of clinical interpretation of radiographic film of the contract radiologist.

The complete audits shall become part of the IHS facility’s quality assurance program.

Contract Coordination and Administration In order to provide continuity of services, the Contractor shall designate someone to be available and responsible for day to day coordination and communication with IHS staff to:

a. Provide administrative and professional consultation,

b. Schedule continuing education for personnel, and

c. Discuss any problems that may arise.

Evidence of designation and description of the Contractor’s delegated authority shall be provided to the Contracting officer prior to award of the contract.

All on-site visits shall be scheduled by mutual agreement of the Field Contracting Officer’s Representative and Contractor.

ACCEPTABLE QUALITY LEVELS (AQL)

2. Availability of Continuous telephone Not more than two Radiologist. consultation available instances per month of Radiologist inaccessibility

REPORTING REQUIREMENTS:

Reporting

The Contractor shall provide interpretation of all mammography examinations for each IHS facility after on-site visit.

1. Significant pathological findings and interpretation shall be provided and brought to the attention of the requesting IHS physician by telephone.

Consultative Reports

The Contractor shall provide consult report timely to applicable IHS locations.

1. Reports shall be available to the medical staff within seven (7) working days of the examination.

G. Consultation and Continuing Education

The Contractor shall include brief summary of consultation and continuing education activities provided as a part of the description of services included in the Monthly Report of Services.

H. Invoicing

The Contractor shall provide all of the above services and invoice the IHS using a UNIT fee.

1. The “Unit for Payment” shall be the mammography examination. The fee charged for the individual mammography examination is inclusive for all services provide in this contract. The payor of last resort regulation is applicable to this contract, IHS will pay a secondary charge if the primary payor’s rate does not exceed the agreed upon unit rate, per person.

2. The “Unit Fee” shall be the same at each IHS facility within the respective Price Schedule.

The Contractor shall submit to the COR the following items in the quantities stipulated and within the time frames identified below.

A. Technical Reports

a. Monthly Narrative Progress Reports shall cover services provided during reporting period and shall briefly present the following information for each service component required in the contract. Reports shall be submitted with monthly invoice and shall include the following:

(1) A comparison of actual services provided with requirements established and the level of services provided that can be readily quantified.

(2) Problems encountered and circumstances, if any, adversely affecting delivery of services.

b. Monthly invoices shall be submitted on Contractor’s stationery and shall reflect signature of dully authorized agent of the Contractor. Invoices shall include itemized listing of all procedures performed, patients name, patient’s chart number, charges, and dates of service.

c. Special reports may be requested by the Contracting Officer during the contract on technical or administrative aspects of contract performance.

Requests for such reports will be provided in writing to the Contractor stipulating information required, time frames for response, and instructions on submissions.

Monthly invoices and Monthly Narrative Progress Reports shall be submitted to the COR at the respective IHS facility.

DELIVERABLES:

Mammography Services 2480 each @ $_____ x 12 months = $_______ Secondary to payor of last resort regulation 42 CFR 136.61.

A. Hours of Operation

The work schedule, exclusive of Federal Holidays, shall be 8:30 A.M. to 4:30 P.M., Monday through Friday.

1. The day, starting time and length of the on-site visits to the IHS facility shall be established by mutual agreement between the Contractor and the IHS Contracting Officer’s Representative (COR).

2. The Contractor shall provide rotating, on-site visits to the IHS facilities, to ensure that the total estimated number of examinations, by facility, shall be performed during the period of the contract.

B. Rotating Schedule The initial rotating on-site visits to, and from the IHS facilities, once established, cannot be changed without the IHS COR’s authorization and Contracting Officer’s approval.

C. Mammography Examination The Contractor shall provide on-site mammography examinations utilizing a mobile van at the IHS facilities.

D. Film Interpretation The Contractor shall provide mammography film interpretations with the interpretative report being returned to the IHS facility within seven (7) working days of the examination.

E. Consultative Services The Contractor shall provide professional consultation to the respective IHS Medical Staff.

LIST OF GOVERNMENT-FURNISHED PROPERTY:

The Government will provide the IHS facilities for use by the Contractor in performance of the contract. Government facilities shall include a parking area and, if required, the patient clinic area within the facility. The Government will provide an acceptable back-up power source (electrical receptacle) at all screening locations at no cost to the Contractor. All other mammography services shall be performed in the Contractor mobile unit.