3(o)_SOW Clinical psychologist.docx

Note: The terms Contractor, Contract Provider and Psychologist shall mean the provider or providers of care throughout this document.

1. Scope of Work. The Contractor shall supply an individual to provide personal medical services to all Active Duty beneficiaries within the capabilities normally granted to a Clinical Psychologist.

A. The Clinical Psychologist shall meet or exceed the professional standards in accordance with established practices, principles and ethics of a professional Mental Health Clinician. 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 Mental Health profession in the state of their practice.

B. The Clinical Psychologist will provide professional services, instruction and supervision to U.S. Coast Guard locations specified in the Performance Work Statement (PWS) (Attachment 3).

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

A. Must have graduated with a Doctor of Philosophy (Ph.D.) in Psychology or a Doctor of Psychology (Psy.D) degree from an American Psychological Association (APA) accredited university or professional school. Additionally, must have completed a one year (APA) accredited internship. Waivers for the (APA) accredited internship requirement may be considered for individuals who have completed a post-doctoral residency for fellowship or have attained board certification by the American Board of Professional Psychology (ABPP).

B. A current unrestricted active license to practice Psychology from one of the 50 states, District of Columbia, Puerto Rico, Guam, or the U. S. Virgin Islands.

C. A minimum of at least two (2) years of clinical experience as a Psychologist; which has taken place recently (within the five years immediately preceding the submission of this offer); not including specialty or residency training.

D. A 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).

E. A “no unfavorable information on file” rating with the National Practitioners Data Bank (NPDB).

3. Credential Review. The Contractor shall submit at least, but not limited to, the following documents/information in addition to that set forth in the PWS for evaluation of 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; Professional organization affiliations and memberships;

6. Previous work references including name of organization, number of years services rendered, address and name of point of contact with telephone number;

A ttachment 3( o Page of 3 Clinical Psychologist

Rev. 11/1/18

7. Evidence that active practice in clinical Mental Health care has taken place during 2 of the last 5 years immediately preceding performance under this contract;

8. Awards and certifications received.

B. Copies of :

1. A diploma from an accredited school/program providing education as a Clinical Psychologist.

2. A current unrestricted active license to practice Psychology from one of the 50 states, District of Columbia, Puerto Rico, Guam, or the U. S. Virgin Islands.

3. A list of any malpractice claims filed, or pending, or settled, and/or any other adverse professional actions that involve the contractor;

4. A 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. Three letters of recommendations from previous employers;

7. Evidence of immunity to Hepatitis “A” and “B” and evidence of freedom from active communicable disease(s) i.e. TB (within 30 days of start of work).

4. Professional Services. The Contractor shall perform a full range of Mental Health services to a variety of patients at one or more USCG site(s), within the scope of clinical privileges granted by CG-1122, using government furnished facilities, equipment and supplies. All aspects of Mental Health 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. Conduct bio-psychosocial assessments utilizing clinical interview techniques, mental status examination, collection of history from collaborative sources, psychometric screening tools and psychological testing, laboratory and imaging studies, collaboration with other clinic staff and TRICARE referrals, as needed for the purpose of determining of an accurate Mental Health diagnosis and plan of treatment;

B. Develop, review and implement Treatment Plans for care of behavioral health conditions, providing appropriate follow-up care, discharge plans, and transfers to other health care facilities (psychiatric units, residential care, nursing homes, rehabilitation hospitals, MTFs, VA and civilian facilities) as indicated;

C. Treat outpatients in individual, group, couples, and family modalities as appropriate, exercising professional judgment and using a range of clinical skills to include psychotherapy (including Cognitive Behavioral Therapy and Psychodynamic approaches), recommendations for lifestyle / behavioral change.

D. Make a health record entry for every patient utilizing a S.O.A.P. format in the Electronic Health Record in accordance with the Coast Guard Medical Manual;

E. To the greatest extent possible, ensure the fitness of active duty personnel for unrestricted worldwide duty and attempt to learn of any circumstances which might adversely affect a member’s ability to safely and effectively carry out a mission;

F. Within HIPAA confidentiality guidelines, maintain open and professional communications with other Clinic Healthcare staff and Commands and provide consultation services regarding mental health issues including diagnosis, condition, treatment plans, prognosis and fitness for duty status;

G. Provide appropriate and timely evaluation and management for urgent and emergent problems as they occur in addition to providing regularly scheduled appointments. Provide crisis intervention services, as needed;

H. Provide immediate notification to the Medical Department should a medical emergency occur and report the nature of the emergency to the Commanding Officer or their authorized representative. Inform the Senior Coast Guard Medical Officer of any patient exhibiting significant non- compliance with the prescribed treatment program;

I. Plan, develop and maintain referral and coordination services with other mental health resources and social service agencies to provide optimal patient care. Act as liaison with Work-Life personnel, Substance Abuse Program Specialists, Chaplains, EAP providers, civilian TRICARE mental health providers, Department of Defense mental health providers and psychiatric hospitals to coordinate care as needed;

J. Make appropriate referrals to specialists utilizing appropriate resources as directed by the clinic administrator. TRICARE Network resources will be used when availability exists within the TRICARE access standards. Use of other military treatment facilities is encouraged when/where available;

K. Provide expert opinion related to Mental Health diagnoses, condition, prognosis and applicable Coast Guard policy in Medical Board actions as required;

L. Prepare and submit appropriate documentation as specified in applicable Coast Guard regulations which may require input from a professional Mental Health provider such as recommendations for administrative separation, judgment and mental state as related as to security clearances, mental competency determination for legal and administrative issues and pre/post-deployment Mental Health assessments;

M. Provide recommendations in writing to command regarding Duty status and duration, for all active duty members under mental health care;

N. Participate in the Health Services Quality Improvement Program;

O. Share responsibility for developing and implementing psycho-educational programs, training and referral resources which might improve the level of behavioral health and awareness within a defined community or area of responsibility;

P. As requested by the Chief of Health Services or the Clinic Administrator, provide in-service training on Mental Health related issues to clinic personnel and (at Petaluma only) to students in the Health Services School;

Q. Monitor rates of mental health related behavior and resource utilization, such as psychiatric admissions, suicide behavior, family violence cases, substance abuse treatment, and DUl's;

R. In all aspects of care, follow applicable Coast Guard regulations, policies and directives.

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