3-DHHS26256 SOW Podiatry Services at USH.docx

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Attached to
Podiatry Services at Utah State Hosptial
Solicitation number
DHHS26156
Issued by
Utah

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This is a Scope of Work document for podiatry services at Utah State Hospital, issued by the Utah Department of Health and Human Services (DHHS). The contract requires a licensed podiatric physician to provide comprehensive foot care services to hospital patients, including consultations, diagnostic testing, treatment, and preventative services such as diabetic foot care protocols, trauma evaluation, nail debridement, orthotics, therapeutic injections, and fungal treatment. The contractor must maintain consistent service delivery, document all podiatry issues in the electronic medical record, notify clinical staff of patient conditions, and preserve all records at the facility. Services are provided on a part-time basis, estimated at approximately 12 hours per month, with scheduling determined by the DHHS Clinical Director based on patient need. The contractor must provide 60 days advance notice for planned absences and notify clinical leadership immediately of unforeseen circumstances such as illness. DHHS will supply clinic space, telephone access, and computer access for the contractor's use.

The contractor must submit monthly invoices to the DHHS Business Office detailing service descriptions, dates rendered, contract number, invoice number, contractor name, address, phone number, and signature. Invoices lacking required information will be returned for revision and not processed for payment. The contractor shall track and report monthly on the number of patients seen, patients unable to be seen with reasons provided, and patients referred to off-campus providers. As a condition of engagement, the contractor must maintain a current and valid podiatric medicine license from the State of Utah, Division of Occupational and Professional Licensing, and execute a Business Associate Agreement in compliance with HIPAA regulations. DHHS does not guarantee a minimum number of hours or weekly service requirements, as hours fluctuate based on patient need.

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9-DHHS26256 Cost Proposal Form.doc DOC document
4-DHHS26256 Podiatry IFB.docx DOCX document
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ATTACHMENT B: SCOPE OF WORK

Podiatry Services

Article 1

CONTRACTOR QUALIFICATIONS

1.1 Contractor Qualifications. The Contractor shall be a podiatric physician and maintain a current and valid license to practice podiatric medicine issued by the State of Utah, Division of Occupational and Professional Licensing.

ARTICLE 2

CONTRACTOR REQUIREMENTS

2.1 Contractor Requirements. The Contractor is responsible for all podiatry services at Utah State Hospital and shall assume management and administrative responsibility for all podiatry services. The Contractor shall:

(1) to the extent possible, have the same Podiatrist provide services;

(2) provide podiatry consultations for all patients as requested by DHHS physicians;

(3) provide diagnostic testing, treatment and preventative services related to foot care to Utah State Hospital patients to include, but not limited to;

(A) podiatry for diabetic protocol;

(B) evaluation/treatment for foot pain/trauma;

(C) excision of granuloma;

(D) foot and ankle strapping;

(E) incision and drainage of abscess, hematoma, infected bursa and Paronychia;

(F) nail debridement;

(G) navicular padding;

(H) new patient examination;

(I) orthotics;

(J) tecommendation for Ted Hose;

(K) reduction of callus tissue;

(L) removal of xubcutaneous foreign body;

(M) removal of toenail, partial (including ingrown) or total;

(N) removal of warts from feet;

(O) therapeutic injections;

(P) treatment of bunions; and

(Q) nail and skin fungus.

(4) notify the DHHS Clinic Manager of any podiatry issue, and document the issue in the electronic chart to which the Contractor will be given access. The DHHS Clinic Manager shall then notify medical and nursing staff of any podiatry issue;

(5) ensure records remain at Utah State Hospital;

(6) sign a Business Associate Agreement in compliance with the Health Insurance Portability and Accountability Act of 1996;

(7) see Utah State Hospital patients at times and days determined by the DHHS Clinical Director (estimated to be approximately 12 hours per month). Because service hours are dependent upon need, there may be some weeks where limited services are required. DHHS does not guarantee a minimum number of hours per week. DHHS will provide clinic space, telephone and computer access; and

(8) notify the DHHS Clinical Director or designee of any vacations or other planned time off. Notice must be provided 60 days in advance for the Contractor's absence to establish the Contractor's monthly work schedule. In cases of unforeseen absence due to circumstances (such as illness) the Contractor shall notify the DHHS Clinical Director or designee as soon as possible.

ARTICLE 3

OUTCOMES

3.1 Outcomes. The outcomes of this contract will ensure that patients obtain needed podiatry services.

3.2 Performance Measures. The Contractor shall contribute to the following outcomes and report to DHHS the following measures:

(1)Measure: Number of patients seen each month;
(2)Measure: Number of patients unable to be seen and the reason; and
(3)Measure: Number of patients referred to an off-campus provider

3.3 Reporting. The Contractor shall submit monthly reports to the DHHS Clinics Manager or as requested.

Article 4

BILLING REQUIREMENTS

4.1 Invoicing.

(a) The Contractor shall submit monthly invoices for services to the DHHS Business Office, statehospitalinvoices@utah.gov 1300 E Center Street, Provo, UT 84604. The invoice must include:

(1)service description;
(2)dates services rendered;
(3)contract number;
(4)uniquely identifiable invoice number;
(5)Contractor name;
(6)Contractor’s address for payment;
(7)Contractor’s phone number; and
(8)Contractor’s signature.
(b)Invoices submitted without the required information will not be paid and will be returned to the Contractor for revision.
(e)All payments made will be made in the name of the Contractor as it appears on the cover page. Any change must be submitted in writing to the DHHS Administrative Services Director.

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