SOW - EKG Interpretation 2024 - 2029-Signed.pdf

Department of Health and Human Services Indian Health Service Oklahoma City Area

Statement of Work (SOW) EKG Interpretation Services

1. PURPOSE OF THE PROJECT

The Indian Health Services (IHS) has a requirement for Electrocardiogram (EKG) Interpretation Services for Pawnee Indian Health Center.

The Pawnee Service Unit is a Joint Commission accredited outpatient facility. To meet the mission, EKG Interpretation services are deemed necessary to augment the services within the service unit. Therefore, contracted services are necessary to support and supplement health care within the Service Unit.

2. DETAILED DESCRIPTION OF THE TECHNICAL REQUIREMENTS

The following shall be provided by the contractor, but not limited to:

• Interpretation of EKG’s to include quality.

• Provide differential diagnosis from the EKG in writing to the referring clinic.

• Communicate, in a timely fashion, to the referring clinic/physician all clinical information necessary for continuity of care and documentation of quality of performance.

• Work shall be performed outside the Indian Service facility in the contractor’s facility.

• The designated Indian Health Service staff member form each clinic shall mail EKG’s during the period specified above to the Contractor’s office.

• The Contractor shall respond within seven (7) days with a written report.

3. PERIOD OF PERFORMANCE

The base year Period of Performance will be 12 months from date of award with four (4) twelve (12) month option years.

Base Year: 02/15/2024 to 02/14/2025

Option Year 1: 02/15/2025 to 02/14/2026

Option Year 2: 02/15/2026 to 02/14/2027

Option Year 3: 02/15/2027 to 02/14/2028

Option Year 3: 02/15/2028 to 02/14/2029

4. LEVEL OF EFFORT

4.1. The Contractor shall complete Interpretations and provide written report within seven (7) days.

4.2. The contractor shall perform services in compliance with applicable standards of The Joint Commission (TJC), which is available to the general public and the Professional Services Policies of the IHS Manual, which is available from the IHS.

4.3. The contractor shall participate in the Service Unit Improving Organizational Performance (IOP) Activities when requested.

4.4. The contractor shall provide the following Quote/Technical Requirements to ensure physicians providing services under this contract are properly licensed and that the IHS made aware of all disciplinary actions taken against such physicians, the contractor will provide:

4.4.1. Copy of Current resume or CV

4.4.2. Copy of current unrestricted License to practice in the United States.

4.4.3. Copy of current professional liability insurance of at least $1,000,000.00 per occurrence.

4.4.4. Obtain at least three (3) letters of reference from the health care providers whom have knowledge of the applicant’s clinical practice skills. One letter must be from the Chief of Staff, or Service, at the hospital where the physician hold, or has held, staff privileges.

4.4.5. Provide all information regarding performance and disciplinary actions for physicians placed under this contract to the HIS Clinical Director.

4.5. Provide UEI Number (note: Contractors must be registered in the System for award Management (SAM) Registration to be eligible for award. This can be done at https://www.sam.gov)

4.6. All-inclusive hourly rate for Base Year plus each option year (4), for a total of five years.

5. SPECIAL REQUIREMENTS

5.1. In accordance with HHSAR 304.1300(b) non-routine contractor employees shall comply with OPDIV DHHS/SE

Region – Human Resources, Security Clearance Guidance – Visitors (3/29/12) policy for contract performance period. Contractor employees will be required to obtain a visitor’s pass upon arrival for services from Facilities Management.- (Security Clearance for on-site human services)

5.2. The USPHS Pawnee Indian Heath Center is a tobacco/smoke free environment (buildings and grounds). No tobacco/smoking use will be tolerated during service.

5.3. Security Requirements: Contractor personnel will be required to contact the government designated point of contact upon arrival when reporting for service calls or delivery supplies. The contractor shall be responsible for the security of all organizational information. Current rules and regulations applicable to the premises, where the work shall be performed shall apply to the contractor and its employees while working on the premises. These regulations include but are not limited to, escort by Pawnee Indian Health Center employee, presenting valid identification, smoking restriction and any safety procedures.

All contractors shall undergo a fingerprint check and shall be cleared prior to hire. Contractor’s continued employment is contingent upon the outcome of a complete and favorable background investigation as determined by the sensitivity level of the position. If contractors are found not suitable, they will be removed.

5.3.1. This is a designated position covered by Public Law 101-647, 101-630, Crime Control Act of 1990, and the

Indian Child Protection and Family Violence Prevention Act, requiring contact or control over Indian children. Contractors shall be required to complete, sign, and submit the Addendum to OF-306, Child Care & Indian Child Care Worker Position form. Due to this requirement, the agency shall ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes. Failure to comply with these statutes shall result in immediate removal.

https://www.sam.gov/

5.4. The contractor shall provide during the term of the contract documentation of immunization record to reflect CDC’s Recommended Vaccines for Healthcare Workers (specifically MMR, Tdap, varicella, Hep B immunity, current (within the past year) influenza vaccination and covid vaccination and current annual tuberculosis screening.

Documentation shall be provided to the Employee Health Nurse.

5.5. The contractor shall not disclose or cause to disseminate any information concerning operations of Pawnee Indian

Health Center. Such action(s) could result in violation of the contract and possible legal actions.

5.5.1. All inquiries, comments, or complaints arising from any matter observed, experienced or learned of as a result of or in connection with the performance of the contract, the resolution of which may require the dissemination of official information, shall be directed to the government’s designated representative.

6. DELIVERABLES AND REPORTING REQUIREMENTS

6.1. Contractor Point of Contact: The contractor shall furnish one designated point of contact (POC) to the government’s designated representative for coordination of supplies, delivery, and/or maintenance. The POC will be empowered to make daily decisions to ensure that the contract implementation and day-to-day maintenance meets the terms and conditions of this contract.

6.2. Contractor’s Phone Numbers: The contractor shall provide a toll-free telephone number for service calls, which must be answered during at least eight working hours, between 8:00 am and 4:30 pm, Monday through Friday.

6.3. Personnel Qualifications:

6.3.1. Shall possess a current, unrestricted license to practice in the United States for each physician providing services under this contract.

6.3.2. Shall have current professional liability insurance ($1,000,000/$3,000,000)

6.3.3. Verify through the Federation of State Medical Boards database, all active, inactive, and lapsed licenses that are held, or have been held, by physicians providing services under this contract.

6.3.4. Must have completed an approved Internal Medicine or Cardiology Residence Program. The Physician(s) must be Board Eligible or Board Certified in Internal Medicine or Cardiology.

6.3.5. Obtain at least three (3) letters of reference form health care providers whom have knowledge of the applicants; clinical practice skills. One letter must be from the chief of staff at the hospital where the physician holds, or held, staff privileges. If the physician recently competed a residency, one letter must be form the residency program director or service chief.

6.3.6. Shall apply for and be credentialed by Pawnee Indian Health Center.

6.3.7. Physicians shall apply and be accepted as Associate members of the Pawnee Service Unit Medical Staff.

6.3.8. Shall be a United States Citizen

7. GOVERNMENT FURNISHED PROPERTY, FACILITIES AND SERVICES

7.1 Government facilities are not required by the Contractor. The work is to be performed at the Contractor’s facility, outside the Indian Health Service. The Government will furnish EKG’s to the Contractor’s Office for interpretation.

7.2 The Government shall provide application forms for appointment and privileging as associate staff members and will also be provided by the Government

8. CONTRACTOR FURNISHED PROPERTY, FACILITIES AND SERVICES

8.1. Required personnel, materials, supplies and equipment: The contractor shall furnish all personnel, materials, supplies and equipment required to perform work under the contract, to include but not limited to: personnel.

9. CHANGES TO THE STATEMENT OF WORK (SOW)

Any changes to this SOW shall be authorized and approved only through written correspondence from the Contracting Officer. Costs incurred by the contractor through the actions of parties other than the Contracting Officer shall be borne by the contractor.

10. DELIVERABLES/PERFORMANCE MATRIX

Contract will be monitored and evaluated routinely using the following matrix:

10.1. Provide documents to maintain credentialing in timely manner: Yes No

10.2. Provided quality customer service according to PIHC mission: Yes No

10.3. Met professional qualifications: Yes No

10.4. Met the terms of the SOW: Yes No

10.5. Issues were addressed in a timely manner: Yes No

Department Supervisor Signature:_________________________

Chief Executive Officer:_________________________