3(l)_SOW Physician AssistantFamily Nurse Practitioner_PA_NP.docx

Note: The terms Contractor, Contract Provider and Physician Assistant/Family Nurse Practitioner shall mean the provider or providers of care throughout this document.

1. Scope of Work. The Contractor shall provide an individual to provide personal medical services to all Active Duty beneficiaries within the capabilities normally granted to a Physician Assistant/Family Nurse Practitioner (PA/FNP).

A. The Contract Provider shall perform in accordance with established principles, practices and ethics of the American Nurse Practitioners Association. The standards of performance for all employees provided by the contractor shall reflect the degree and care, skill and learning expected of a reasonably prudent health care provider in the Family Nurse Practitioner profession in the state of their practice.

B. The Family Nurse Practitioner will provide professional service, instruction and supervision to U.S. Coast Guard locations specified in the Performance Work Statement (PWS) (Attachment 3).

2. Qualifications. The provider of PA/FNP service shall possess and maintain for the duration of this agreement:

A. A diploma from an accredited Physician Assistant program (Bachelor's Degree at a minimum) or an accredited School of Nursing with a Masters Degree in Nurse Practitioner (a specialty of Family Nurse Practitioner is required);

B. PAs are required to maintain certification from the National Commission on Certification of Physician Assistants (NCCPA) and FNPs are required to maintain certification from either the American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC);

C. A current Drug Enforcement Agency (DEA) registration certification if applicable in the State of licensure.

D. A current unrestricted active license to practice as a PA/FNP from one of the 50 states, District of Columbia, Puerto Rico, Guam, or the U. S. Virgin Islands;

E. Maintain current certification in Basic Cardiac Life Support (BLS) for the Health Care Provider by the American Heart Association (AHA), American Red Cross (ARC), American Safety & Health Institute (ASHI) or the American College of Emergency Physicians (ACEP).

F. A minimum of two (2) years recent clinical experience (immediately preceding the submission of this offer).

G. “No adverse information on file” with the National Practitioners Data Bank (NPDB).

3. Credential Review. The contractor shall submit the following credentials in order to be evaluated for technical acceptability.

A. A current curriculum vitae including AT LEAST the following information:

(1) Social security number;

(2) Date of birth (to be used only for the purposes of independent query of the NPDB);

(3) Degrees earned;

(4) Career history;

(5) Professional Training/Courses attended in the past two years;

(6) Professional organization affiliations and memberships;

ATTACHMENT 3(l) Page of

PHYSICIAN ASSISTANT/FAMILY NURSE PRACTITIONER SERVICES

Rev. 11/1/18

(7) Previous work references including name of organization, number of years services rendered, address and name of point of contact with telephone number;

(8) Awards and certifications received;

B. Copies of:

(1) A diploma from an accredited Physician Assistant training program or an accredited school of Nursing (a “Polaroid” picture is acceptable as a copy);

(2) A current unrestricted active license to practice as a PA/FNP from one of the 50 states, District of Columbia, Puerto Rico, Guam, or the U. S. Virgin Islands;

(3) A current certificate from the National Commission on Certification for Physician Assistants (NCCPA) or from either the American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC);

(4) Evidence of immunity to Hepatitis “A” and “B” and evidence of freedom from chronic communicable disease(s) i.e., HIV, TB and Sexual transmitted diseases (within 30 days of start of work);

(4) Current certification in Basic Cardiac Life Support (BLS) for the Health Care Provider by the American Heart Association (AHA), American Red Cross (ARC), American Safety and Health Institute (ASHI), or the American College of Emergency Physicians (ACEP);

(5) Proof of insurability against malpractice in the amount of one million ($1,000,000) dollars per occurrence;

(6) At least three (3) letters of recommendation from previous employers addressing PA/FNP services.

4. Professional Services. The Contractor shall perform a full range of PA/FNP services on site, using government furnished facilities, equipment and supplies to a variety of patients. All aspects of PA/FNP services shall be commensurate with the capabilities of the provider and the Medical Department including but not limited to the items listed below; and in the PWS.

A. The healthcare worker is responsible for a full range of diagnostic examinations, the development of comprehensive treatment plans when indicated, delivery of treatment within the personnel and equipment capabilities of the treatment facility, provision of mandated medical surveillance and preventive services, and the quality and timeliness of treatment records and reports required to document procedures performed and care provided. The healthcare worker shall refer patients to staff specialists for consultation and continuation of care and shall see the patients of other government staff healthcare providers who have been referred for consultation and treatment;

B. The healthcare worker shall provide training and/or direction as applicable to supporting government employees (i.e., Health Service Technicians assigned to them during the limited administrative duties that include: maintaining statistical records of clinical workload, participating in education programs, and participating in clinical staff quality assurance functions at the prerogative of the Senior Medical Officer;

C. To treat all Active Duty beneficiaries presented for care;

D. Assessment: Obtain patient health and developmental history. Perform and record a health appraisal including physical assessment and evaluation;

E. Differentiate between normal findings and those that require consultation and/or referral;

F. Diagnose patients with common acute conditions, illnesses or minor trauma within legally accepted protocols, for a PA/FNP;

G. Request x-rays and laboratory tests as deemed necessary;

H. Plan: Formulate a health care plan for patients presenting for treatment, emphasizing self-care responsibility through the participation of the patient, family, physician and other health care Professionals;

I. Intervention: Treat patients with common acute conditions, illnesses or minor trauma within accepted protocols and/or in collaboration with a physician;

J. Collaborate with the physician in the health care of patients with chronic illnesses;

K. Identify resources and coordinate referrals for patients requiring further evaluation and services;

L. Evaluation: Modify the health care plan as warranted. Implement and participate in follow-up;

M. Support preventive maintenance and report equipment failures and inadequacies. Promote economical utilization of equipment, supplies and be cost conscious when ordering lab and radiological studies;

N. Know the location and operation of emergency equipment;

O. Adhere to departmental and clinical safety guidelines;

P. Administrative Services: To be assigned by the Senior Medical Officer as required;

Q. Boards and Committee Attendance;

R. Continuing Education;

S. Expert opinion in related medical board action;

T. Prepare and submit appropriate documentation as specified in applicable regulations.

5. Hours of Performance. The contractor shall provide all aspects of personal PA/FNP services at locations the PWS (Attachment 3) and hours specified by the Clinic Administrator.