3 - PWS Licensed Child or Adult Therapist.pdf

PWS No. 08-21 17 August 2021

Performance Work Statement (PWS) for Nonpersonal Services

Licensed Child / Adult Therapist

Table of Contents Section Page

1.0 General 1

2.0 Definitions 3

3.0 Government Furnished Information, Property, & Services 6

4.0 Contractor Furnished Property 7

5.0 Performance-Based Requirements 8

6.0 Contractor Qualification Requirements 13

7.0 Federal Tort Claims Act (FTCA) & Medical Liability Insurance 16

8.0 Challenges to Conflicts 18

9.0 52.249-12 Termination (Apr 1984) 18

10.0 Performance-based Matrix 19

11.0 List of Attachments and Exhibits 20

Performance Work Statement (PWS) for Nonpersonal Services

Licensed Child / Adult Therapist

1.0 General: This performance work statement describes the requirements for non-personal services for a Licensed Child / Adult Therapist to support the mission of the Indian Health Service (IHS).

1.1 Background: IHS is an agency within the U.S. Department of Health and Human

Services and is responsible for providing federal health services to American Indians and Alaska Natives. The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes. The IHS is the principal federal health care provider and health advocate for the Indian people.

The goal is to assure that comprehensive and culturally acceptable personal and public health services are available and accessible to American Indians and Alaska Natives. The IHS currently provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 34 states.

1.1.1 Navajo Area Indian Health Service (NAIHS) administers health centers and hospitals providing health care to approximately 201,583 members of the Navajo Nation. The Navajo Nation is the largest Indian tribe in the United States and has the largest reservation, which encompasses more than 25,516 square miles in northern Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico. The NAIHS is the primary provider of inpatient, ambulatory care, preventive and community health, and environmental health services for members of the Navajo Nation and the San Juan Southern Paiute Tribe.

1.2 Scope: The Contractor shall provide outpatient services in accordance with section 5.0, performance based requirements.

1.2.1 Duties and responsibilities will encompass outpatient, license child / adult therapist services to IHS patients.

1.2.2 Place of Performance: Services are to be performed at Counseling Department of Chinle Comprehensive Health Care Facility and Tsaile Health Center.

1.2.3 Period of Performance: Will be flexible to allow for short term (13 weeks), long term (1-year to 3-year), and where feasible, include intermittent support to meet unplanned needs that develop on a frequent basis.

1.3 Applicable Documents: Please see the web link listed unless document is listed as an attachment.

1.3.1 The Joint Commission

http://www.jointcommission.org/

1.3.2 Centers for Medicare and Medicaid Services (CMS) Standards http://www.cms.hhs.gov/

1.3.3 Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaahc.org

1.3.4 Section 231 of Public Law 101-647, the Crime Control Act of 1990.

http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml

1.3.5 Section 4087 of Public Law 101-630, the Indian Child and Family Violence Act. http://www.nicwa.org/policy/law/protection/index.asp

1.3.6 Health Insurance Portability and Accountability Act (HIPAA) of 1996.

http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf

1.3.7 Privacy Act of 1974.

http://www.usdoj.gov/oip/privstat.htm

1.3.8 IHS Service Unit and Health Center Policies, Procedures and Protocols.

(See section 11.0 for a list of attachments and exhibits)

1.3.9 Computer Security Act of 1987

http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt

1.3.10 Federal Code of Conduct http://www.ihs.gov

1.3.11 IHS General Directives http://www.ihs.gov/adminmggrresouces

1.3.12 IHS Computer Security Directives

http://www.ihs.gov/adminmggresources http://www.jointcommission.org/ http://www.cms.hhs.gov/ http://www.aaahc.org/ http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml http://www.nicwa.org/policy/law/protection/index.asp http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf http://www.usdoj.gov/oip/privstat.htm http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt http://www.ihs.gov/ http://www.ihs.gov/

2.0 Definitions:

2.1 Acceptance: Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart 46.5 and subject to other terms and conditions of the contract.

2.2 Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements. Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

2.3 Area: A defined geographical region for Indian Health Service administrative purposes. Each Area Office may administer several Service Units.

2.4 Code of Ethics: The Code of Ethics for Licensed Therapist.

2.5 Contracting Officer (CO): A Government employee with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.6 Contractor: The individual awarded a legal binding contract to provide supplies and services.

2.7 Contracting Officer’s Representative (COR) or Project Officer (PO): A federal employee who assists the ordering/issuing activity contracting officer in the administration of task orders issued under this contract. The COR is primarily responsible for the technical assistance and day-to-day program management of the ordering activity’s task orders. Ordering activities may have different designators for this employee (e.g. GTR – Government Technical Representative, COTR–Contracting Officer’s Technical Representative, or PO - Project Officer).

2.8 Cooperative Attitude: Behavior that is positive and displays a willingness to fulfill assigned patient care tasks and to be a team player.

2.9 Cultural Awareness: Realization of and respect for American Indian and Alaska

Native beliefs and practices.

2.10 Customer: Patients, staff and visitors of an IHS service unit and health center.

2.11 Customer Evaluation/Input: Written comments made to the Contracting Officer regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor’s performance.

2.12 Dependability: Qualities of being trusted and being able to repeat the same task to yield the same result.

2.13 Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal Executive agencies in their acquisition of supplies and services with appropriated funds.

2.14 Government Vehicle: An IHS owned motor vehicle or a vehicle leased by IHS through agreements with the General Services Administration (GSA) or through commercial rental agreements.

2.15 Health Center: A facility physically separated from a hospital, with a full range of ambulatory services including at least primary care providers, nursing, laboratory, and x-ray which are available at least 40 hours a week for outpatient care.

2.16 Non-personal Services Contract: A contract under which the personnel rendering the services are not subject, either by the contract’s term or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees, as defined in FAR 37.401.

2.17 Ordering Activity: An authorized user of IHS that may issue a task order to obtain required services under this contract.

2.18 Ordering Activity Contracting Officer: A Government employee of IHS authorized and warranted to issue task orders and to make subsequent task order modification(s) under this contract. The Ordering Activity CO has the authority to make initial determinations on all matters of dispute regarding task orders.

2.19 Orientation: An activity designed to provide basic familiarization of the facility and transition the anesthesiologist into the IHS Service Unit and/or Health Center and the nursing unit where the services will be provided.

2.20 Past Performance Information: Relevant information regarding a contractor’s actions under previously awarded contracts. This includes the contractor’s record of conformance to specifications and to standards of good workmanship;

the contractor’s record of containing and forecasting costs on any previously performed cost reimbursable contracts; the contractor’s adherence to contract schedules, including the administrative aspects of performance; the contractor’s history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business-like concern for the interest of the customer.

2.21 Patient Outcome: End result of outpatient, therapeutic patient care.

2.22 Performance based Matrix: Lists the services to be monitored and the standards to be applied.

2.23 Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

2.24 Service Unit: The local administrative unit of IHS.

2.25 Standards of Practice and Standards of Care: Authoritative statements by which the medical profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for professional medical practice and a framework for the evaluation of practice. The standards of professional medical practice may pertain to general or specialty practice.

2.26 Supervisor: Government employee authorized to provide verbal and written performance direction to the Contractor that the Contractor must follow without exception.

2.27 Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activities written order to obtain services, at a minimum will include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activities task order number.

2.28 Tour of Duty: The time of duty is scheduled to perform outpatient and inpatient consults is 8 hours a day, Monday through Friday, 8:00 a.m. to 5:00 p.m. with one hour lunch.

2.29 Valid Patient Complaint: Justifiable accusation made by a patient and supported by investigation.

2.30 Verifiable Emergency: An unexpected/unplanned absence by the contractor requiring valid documentation to confirm the occurrence.

3.0 Government Furnished Information, Property and Services

3.1 Information: Government unique information related to this requirement, which is necessary for Contractor performance, will be made available to the Contractor. The Contracting Officer or designee will be the point of contact for identification of any required information to be supplied by the Government.

3.2 Joint Use by the Government and the Contractor: Except for the property and service listed in 3.3 and 4.0, the Government will provide, for joint use by the Government and the Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

3.2.1 Government Vehicle: If required by the position, authorization shall be in accordance with IHS Chapter 12, Section 13 Motor Vehicle Management.

3.3 Contractor Exclusive Use:

3.3.1 Personal Protective Equipment (PPE): The Government will furnish the Contractor with appropriate PPE other than specified in paragraph 4 of the contract. The Government will be responsible for any repair, cleaning, and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

3.3.2 Badge: The Government will provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 will be charged for lost or destroyed badges.

3.4 Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures. Training will be provided ONLY if the subject matter is necessary to improve or enhance the quality of psychiatry, mental health, and social work services (whichever is applicable) or includes mandates made by the IHS Service Units/Health Centers while the board certified/licensed mental health care provider is working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

4.0 Contractor Furnished Property

4.1 Except for the property specified in paragraph 3 as government furnished, the

Contractor shall provide all uniforms and other personal medical instruments subject to the following:

4.1.1 Uniforms and Lab Coats: Uniforms and Lab Coats shall conform to the requirements of the Indian Health Service Manual, Part 3 Chapter 4 and meet the approval of the Clinical Director at each IHS facility.

4.1.2 Other personal medical instruments: “Other personal medical instruments” are defined as Contractor owned items may include but not limited to stethoscope, scissors, as appropriate to the work unit. The Contractor shall not use unsafe equipment or supplies at any time during performance of this contract. All Contractor furnished equipment and supplies shall be subject to inspection by the Government and must be approved by the COR prior to use by the Contractor. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

5.0 Performance-Based Requirements. The Contractor shall provide outpatient and inpatient therapeutic mental health services in the delivery of patient care to the Indian Health Service. Specific tasks include the following:

5.1 Licensed Child/Adult Therapist Duties:

5.1.1 The Contractor shall perform outpatient and inpatient consults including Emergency Room, and to manage patient needs as described in the (PD) as identified by the Service Unit and as directed by the Supervisor.

5.1.2 The Contractor shall provide direct patient care services as follows as schedule permits:

A. Work under the administrative supervision of the Chinle Comprehensive

Health Care Facility (CCHCF) Director of Counseling Services.

B. Contractor shall provide direct therapeutic mental health services to a wide range of patients including children and adolescents, or adults and their families.

C. Contractor’s services include but not limited to: Evaluation services, crisis stabilizations, psychotherapy (individual, family and group), interactive therapies for children, adolescent and adults, and behavior modification planning, interventions based on diagnoses and needs assessments and provide education to patients and their families on mental health issues.

D. Contractor shall serve as a consultant to other hospital physicians, nurse, and staff as well as other community agencies and service providers on issues pertaining mental health.

E. Contractor will need to be knowledgeable of clinical management of patients. Demonstrates ability in the application of appropriate modern and accepted approaches to psychotherapy, group therapy, day treatment, psychosocial rehabilitation, interactive therapies and managed care systems.

F. Knowledge of mental health documentation for different types of services and stages of evaluation and treatment. Skill in developing and documenting treatment plans and mental health evaluations. Maintains appropriate documentation for services delivered.

G. Knowledge of the range of mental health problems and diagnostic understanding particularly as they refer to children and adolescents or adults. Knowledge of DSM-V and its use for guiding and implementing treatment.

H. Contractor will participate in group staffing within the Chinle

Comprehensive Health Care Facility and community agencies such as schools, Department of Social Services, Department of Behavioral Health, etc. when children and/or family mental health issues are involved.

I. Assures preparation or appropriate medical records for all patients sent to assure the accumulation and organization of all pertinent clinical data needed to provide comprehensive medical care. Prepares clinical reports and correspondence concerning patients under his/her care to physicians, hospitals, and other individuals and facilities in a timely fashion. Clinical data reports for the records of each patient shall be maintained in compliance with TJC standards.

J. The Contractor shall provide direct patient care services under the terms of this contract, appropriate and timely medical services in accordance with the standards of care established by recognized medical care organizations and in accordance with policies and procedures of Service Unit’s Medical Staff Bylaws, Rules and Regulations, including attendance at department and staff meetings.

K. The Contractor shall be scheduled from Monday through Friday from 8:00 a.m. to 5:00 p.m. Also, all federal holidays are excluded. There are no flex times. The Contractor may participate in on-call rotation on assigned weekdays and weekends as determined by department.

L. Make appropriate referrals and obtain appropriate consultations after primary completion of evaluation and documentation has been completed.

M. The Contractor shall complete the electronic character investigation forms on-line as required by Public Law 101-360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eQIP) system.

N. The Contractor shall follow all appropriate federal and locally required Information Technology security requirements and will be operating under HIPAA and Privacy Act regulations.

O. Contractor will be subject to peer review per Joint Commission standards.

P. Contractor will submit invoices as required for payment of services rendered and hours worked. Contractor shall submit an original invoice.

Invoice shall be certified by Contractor that services have been provided and attach daily sign-in/sign-out sheets that verify the hours worked.

Invoices will also include certification statement of services received which are to be signed by the Project Officer or Alternate.

Q. Safety management reporting requirements will be in accordance with the

Service Unit Safety Measure Policy.

R. Contractor shall be responsible for all applicable Federal, State, and Local Taxes, Meals, and Travel/Transportation. Lodging is provided but must be paid for the Contractor or contract agency. Government quarters are available at prevailing rental rates plus utilities, as applicable, if government quarters are utilized. The Contractor shall be responsible and liable for the proper care of government owned or leased property furnished in occupied quarters.

S. Contractor shall adhere to all CSU COVID policies and procedures.

5.2 Work Schedule:

5.2.1 The Supervisor at each IHS facility shall determine specific tour of duty. The Contractor shall work 100% of the contracted hours.

5.2.2 The Contractor shall obtain approval of the department Supervisor or designee prior to any absence from work. If the length of the absence exceeds eight (8) work hours the Contractor shall request approval at least fifteen (15) days, (the exception is verifiable emergencies) in advance of the desired absence.

The contractor is not authorized sick leave, annual leave and compensatory time hours.

5.2.3 Approval of leave is contingent upon availability of a qualified replacement.

5.2.4 The Contractor shall provide written documentation from a qualified health care provider for absences of three (3) or more consecutive days, due to illness, stating:

A. The cause of the current illness or incapacitation; AND

B. Indicating the Contractor as contagious or non-contagious.

The Government reserves the right to examine and/or re-examine any Contractor who meets the criteria.

5.3 Conduct: The Contractor shall meet standards as listed in the Federal Code of Conduct.

5.3.1 The Contractor shall be subject to character investigation as required by Public Law 101-360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance of a contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eQIP) system and this shall include all fingerprinting procedures and clearances. The Contractor shall provide all requested information necessary to perform Level I and Level II background checks. The Contractor shall comply with the requirement to obtain security investigations. The Contractor shall work with the I.H.S. to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms will be reviewed by the Contractor and forwarded to appropriate government personnel. The Contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

5.4 Performance Evaluation:

5.4.1 The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 10.0.

5.4.2 Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome constitutes a breach of contract.

5.5 Identification of Contractor:

5.5.1 The Contractor shall wear a government issued contractor identification badge during performance of duty.

5.6 Management of Medical Information: The Contractor shall manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols.

5.6.1 Medical Records and Other Required Documentation: 100% percent of all medical records and other required documentation meets established IHS Medical Facility, Joint Commision, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession. (Note: payment will be withheld for inaccurate or incomplete medical records per paragraph 10.0 of this performance work statement.)

5.6.2 The Contractor shall ensure adherence to DHHS IT system security policies and procedures. The IT policies and procedures will be made available to the Contractor.

5.6.3 The Contractor shall immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

5.7 IHS Information Technology Systems:

5.7.1 In performance of this contract, the Contractor shall adapt to and successfully utilize IHS information technology systems that are deemed by the Supervisor as necessary for acceptable contractor performance.

5.7.2 The Contractor shall ensure that IHS information technology system security policies and procedures are adhered to. The IT policies and procedures will be made available to the Contractor at each IHS facility.

6.0 Contractor Qualification Requirements: The Contractor must meet the following qualifications and retain this status throughout the term of the contract.

6.1 Experience: The Contractor shall serve as a consultant therapist with limited knowledge of local epidemiogical concerns, customs, and attitudes. The Contractor must have completed full licensure requirements and be actively licensed to practice therapy. The Contractor must be a licensed therapist, and show evidence of competency and experience in working with adults and/or with children and adolescents and their families.

6.2 Certification/License/Registration: The Contractor shall be licensed with an accredited licensing’s board with preference given for additional eligibility for Child and Adolescent Therapist with some knowledge in providing services to adults, and possess a current, valid, unrestricted license in any state, the District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States, throughout the term of this contract. The Contractor’s provider shall maintain an appropriate license (a valid, current, full and unrestricted license to practice as a licensed therapist in any state within the United States, District of

Columbia or the Common-Wealth of Puerto Rico) and certification throughout the term of this contract. The Contractor’s provider shall meet the qualifications and credentialing standards.

6.2.1 Motor Vehicle Operator’s License: If required by the position, the Contractor shall possess a valid state driver’s license throughout the term of this contract.

6.2.2 The Contractor shall maintain a valid and current CPR/BLS certification and any additional certifications as appropriate to each specialty.

6.3 Health Requirements/Conditions of Employment:

6.3.1 Medical Evaluation: The Contractor shall provide a fitness for duty certificate issued by a licensed provider to perform the proposed job without significant risk to personal health or the health and safety of others.

6.3.2 Immunization: The Contractor shall also provide documentation of current immunization in accordance with NAIHS policy including:

• Hepatitis A - 2 dose series at 0 and 6 months.

• Hepatitis B - 3 dose series at 0, 1, and 6 months or documented immunity.

A signed declination of Hepatitis B vaccination series will be accepted.

• Measles, Mumps, Rubella (MMR) - 2 doses or titer documentation.

• Varicella (chickenpox) – 2 doses, titer documentation or history of varicella/shingles.

• Tetanus, diphtheria, pertussis (Tdap/Td) - 1 dose of Tdap, then tetanus

(Td) booster every 10 years thereafter.

• Meningococcal - Two vaccines (MenACWY and MenB) recommended for microbiologists routinely exposed to N. meningitidis.

• Documentation of annual TB test- may include Mantoux TB skin test

(PPD). All new employees will require the 2 step TST.

o Acceptable lab testing: Quantiferon Gold or T-Spot test.

o For positive TB test results, please submit a copy of recent chest x-ray results.

• Influenza - MANDATORY annual vaccination

6.4 Language Requirements and Cultural Awareness: The Contractor shall read, understand, speak, and write English to effectively communicate with patients and other health care workers, and shall be respectful of the local, American Indian and Alaska Native culture.

6.5 Information Technology Skills: The Contractor shall possess basic knowledge, skills, and abilities to use a computer.

6.6 Orientation: All licensed therapists providing service under this contract shall attend mandatory orientations and training specified by the government.

6.7 Background Checks: As directed by the Contracting Officer, the Contractor shall provide all requested information necessary to perform Level I and Level II background checks. The Contractor shall comply with the requirement to obtain security investigations. The Contractor shall work with the IHS to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms will be reviewed by the Contractor and forwarded to the Supervisor. The Contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

An Agreement to a Temporary Waiver of Character investigation form shall be signed and used pending completion of background investigation.

6.8 General Requirements:

6.8.1 Obtain at least three current letters of reference from other health care providers familiar with the candidate's clinical practice skills. One letter must be from the Chief of Staff/Medical Director at the hospital in which the provider either holds or last held staff privileges. If the Contractor's provider has just completed a residency program, one of the letters shall be from the program director or service chief.

6.8.2 If the Contractor is a psychologist, Contractor shall work directly with the Chinle Service Unit Credentials Committee to attain approval of credentials and privileges and shall retain status of appointment throughout the term of this contract.

6.8.3 Contractor/Credentialed medical staff members will be subject to Medical Staff Professional Practice. Evaluation and Focused Provider Performance Evaluation as specified in the Chinle Service Unit Policy & Procedures Evaluation & Ongoing Professional Practice Evaluation.

7.0 Federal Tort Claims Act (FTCA) & Medical Liability Insurance:

7.1 FTCA is not extended to Non-personal Service Contracts to Staffing Agencies.

Staffing Agencies shall adhere to clause 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997).

(a) It is expressly agreed and understood that this is a non-personal services 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 an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the 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 or omissions by it or by its employees or agents. The Contractor shall maintain during the term of this contract liability insurance issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrence: $1,000,000 per occurrence; $3,000,000 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.

(c) Liability insurance may be on either an occurrences basis or on a claims-made basis. If the policy is on a claims-made basis, an extended reporting endorsement (tail) for a period of not less than 3 years after the end of the contract term must also be provided.

(d) Evidence of insurance documenting the required coverage for each health care provider who will perform under this contract shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on a claims-made basis and evidence of an extended reporting endorsement is not provided prior to the commencement of services, evidence of such endorsement shall be provided to the Contracting Officer prior to the expiration of this contract. Final payment under this contract shall be withheld until evidence of the extended reporting endorsement is provided to the Contracting Officer.

(e) The policies evidencing required insurance shall also contain an endorsement to the effect that any cancellation or material change adversely affecting the Government’s interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer. If, during the performance period of the contract the Contractor changes insurance providers, the Contractor must provide evidence that the Government will be indemnified to the limits specified in paragraph (a) of this clause, for the entire period of the contract, either under the new policy, or a combination of old and new policies.

(f) The Contractor shall insert the substance of this clause, including this paragraph (f), in all subcontracts under this contract for health care services and shall require such subcontractors to provide evidence of and maintain insurance in accordance with paragraph (a) of this clause. At least 5 days before the commencement of work by any subcontractor, the Contractor shall furnish to the Contracting Officer evidence of such insurance.

8.0 Challenges to Conflicts: For any inconsistency between supervisor directions, this

Performance Work Statement, attachments and exhibits, the following order of precedence will apply:

(a) First Priority: Supervisor’s directions

(b) Second Priority: Position Description (attached)

(c) Third Priority: Performance Work Statement Exhibits

(d) Fourth Priority: Performance Work Statement Narrative

9.0 52.249-12 Termination (Personal Services) (Apr 1984): The Government may terminate this contract at any time upon at least 15 days’ written notice by the Contracting Officer to the Contractor. The Contractor, with the written consent of the Contracting Officer, may terminate this contract upon at least 15 days’ written notice to the Contracting Officer.

9.1 Any Contractor employee demonstrating impaired judgment shall not be allowed to continue working on the contract. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

10.0 Performance – Based Matrix

Performance-based Task Indicator Standard Quality Assurance Incentives

State the end results or outputs that you, the customer will formally accept or reject.

For the requirement, state the feature(s) of end result that will be surveilled.

For each “indicator,” state a performance level that, when met, means the task has been performed satisfactorily.

This Standard describes “What Success Looks Like.”

For each “Standard”, state the method used to check performance (i.e. random sampling, 100% inspection, periodic inspection, customer complaints).

List Positive and Negative Incentives. Address method of linking payment to quality of service.

Contractor shall provide outpatient & inpatient services and be board eligible/certified psychiatrist or certified/licensed mental health therapist/counselor in the delivery of patient care to the Navajo Area Indian Health Service, Chinle Comprehensive Health Care Facility.

a. Competency

b. Compliance

c. Patient Outcomes

d. Professionalism

e. Documentation

f. Service Quality

Perform 100% required tasks at 100% of the required competencies (refer to 11.0)

100% compliance with IHS Service Units and/or Health Centers published Policies;

Procedures; Standards of Care; and hospital and Laboratory Protocols.

No reports of breached patient safety, infection control, and other procedures that might adversely affect patient outcome.

Performance characterized by continual cultural awareness and focus on customer service. 100 % adherence to the Code of Ethics and Federal Code of Conduct.

100% of all medical records and other required documentation meets established IHS Medical Facility, Joint Commision, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

Satisfaction with quality of service is evidenced by valid customer inputs.

Surveillance systems will include periodic inspections and customer complaints. See

QASP.

Payment of contract price for satisfactory service.

No payment for incomplete work.

Contractor performance will be evaluated using the Contractor Performance Assessment Report (CPAR).

The evaluation will be considered when future IHS contract selections are made.

• CPARS evaluation will be forwarded to the GSA/FSS Contracting Officer.

PWS No. 08-21 17 August

11.0 List of Attachments and Exhibits. To be provided by the Contracting Officer upon request.

11.01 Attachments: Position Description (Service Unit specific)

11.02 Written Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

11.2.1 Standard Emergency Codes

11.2.2 Confidentiality: Legal and Ethical Concerns in Healthcare

11.2.3 An Introduction to the Navajo Culture

11.2.4 Verbal and Telephone Orders

11.2.5 Pain Management

11.2.6 Focus Charting

11.2.7 Medical Staff By Laws