3(r)_SOW Flight surgeon.docx

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

1. General Scope of Work: The contractor shall provide an individual to provide personal medical services at locations specified in the contract to eligible beneficiaries as described in the Coast Guard Medical Manual.

A. The Physician shall meet or exceed the professional standard in accordance with established practices, principals and ethics of the National and State Medical Boards standard of practice. The contractor’s employees shall reflect the degree of skill, care and learning that is expected of a reasonably prudent health care professional working as a Physician.

2. Qualifications: The Physician shall possess and/or maintain the following:

A. Degree from an accredited school of Medicine in the 50 United States and the District of Columbia;

B. At least twenty four (24) months working in the aerospace medicine field;

C. Experience must have been recent. The twenty four (24) months ending not later than 6 months before placement;

D. Maintain all current licenses and certifications necessary to practice as a physician;

E. Possess a Basic Military Aerospace Medicine Certification or be Board Certified in Aerospace Medicine;

F. Be board certified in Family Practice, Internal Medicine or Emergency Medicine;

G. Maintain current CPR certification by either the American Heart Association or the Red Cross;

H. Maintain current ACLS certification;

I. Maintain a current Drug Enforcement Administration (DEA) registration;

3. Credentials Review: Prior to commencement of this agreement, the Contractor shall submit the following credentials to be reviewed for technical acceptability:

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

(1) Degrees earned;

(2) Career History;

(3) Awards and certifications received;

(4) Professional Training/Courses attended in the past two (2) years;

(5) Professional organization affiliation and memberships; and

(6) Previous work reference(s) including name of organization(s), number of years services rendered, address and name of the point of contact with telephone number;

ATTACHMENT 3(r) Page 1 of

Flight Surgeon Services

Rev. 11/1/18

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

(8) Social security number;

(9) Evidence that active Flight Surgeon services have been practiced during 3 of the last 5 years immediately preceding performance under this contract;

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

B. Copies of:

(1) Board Certifications and a copy of the letter from the board indicating the physician has completed the certification process;

(2) Military Aerospace Medicine training or Board Certification letter and certificate;

(3) A current unrestricted active license to practice medicine from one of the 50 states, District of Columbia, Puerto Rico, Guam, or the U. S. Virgin Islands;

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

(5) 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);

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

(7) Three letters of recommendation from previous employers.

(8) 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. Performance Requirements: The contract provider shall perform a full range Physician’s and Flight Surgeon duties, within the scope of clinical privileges granted by the Senior Medical Officer, on site, using Government furnished supplies, facilities and equipment. The contract provider’s actual clinical performance will be a function of the overall demand for Physician and Flight Surgeon services. The Flight Surgeon shall:

A. Ensure the fitness for unrestricted worldwide duty of active duty personnel;

B. Make appropriate referrals to specialists as required of eligible beneficiaries following existing policy and regulations;

C. Diagnose and treat the sick and injured in accordance to the acceptable standards of the profession;

D. Treat eligible beneficiaries for chronic medical conditions;

E. Prevent and control disease;

F. Promote health, and healthy life styles;

G. Give advice on such matters as hygiene, sanitation and safety;

H. Ensure that personnel are physically and psychologically fit for duty and attempt to learn of any unusual circumstances, which might adversely affect proficiency;

I. Maintain open and professional communication with members of the clinic and the command;

ATTACHMENT 3(r) Page 1 of

Flight Surgeon Services

J. Request diagnostic studies such as laboratory and x-rays, electrocardiograms (EKGs);

K. Notify, or assure notification, to each patient of the results of PAP smears, mammograms, biopsies, pregnancy tests, and all tests whose results indicate a need to initiate or change in treatment. Notifications shall be made within 48 hours of the receipt of the results from the respective laboratory;

L. Prescribe appropriate medications in accordance with Chapter 10 of the Coast Guard Medical Manual;

M. Report any occurrence of communicable diseases to the Coast Guard Supervising Medical Officer, and Cooperate with Federal. State, and Local Agencies for preventing disease reporting communicable diseases and collecting vital statistics;

N. Be familiar with Chapter 3 of the Coast Guard Medical Manual dealing with Physical Standards for Aviation personnel.

O. Perform routine physical examinations in accordance with the requirements of Chapter 3 of the Coast Guard Medical Manual and report all findings on Standard Form 88, Report of Medical Examination and Standard Form 93, Report of Medical History;

P. Follow Coast Guard regulations, policies and directives when arranging appropriate referrals or consults. The contract provider shall inform the patient of the required referral or consult and the specialty evolved. The provider shall not recommend to the patient that he/she consult a specific practitioner or use a specific practice. The provider shall forward the referral, consult and the patient to the appropriate clinic staff to process the request for referral or consult;

Q. Be familiar with the duties, responsibilities, and limitations of health service technicians as described in appropriate manuals and instructions which will be made available upon commencement of services during clinic orientation;

R. Provide on-the-job medical training in clinical treatment for Health Services School students (at Petaluma only) and clinic personnel as requested by the Chief of Health Services or the Clinic Administrator;

S. Evaluate and determine each patient’s ability to work and record such determination in the patient’s health record, including an expiration date for the assigned duty status and specific limitations. The following statuses apply:

a. Fit for Full Duty (FFFD): Patient is not physically restricted or limited for any job that the Coast Guard might assign to him/her, regardless of current job assignment.

b. Fit for Limited Duty (FFLD): Patient is physically restricted or limited. Examples are: office work only; no lifting, stooping, prolonged standing, jumping; no sea duty; etc.

c. Not Fit for Duty (NFFD): Patient cannot perform any assigned tasks regardless of assignment.

T. Inform the Senior Coast Guard Medical Officer of any patient not using or following the prescribed treatment program;

U. Report any occurrence of communicable diseases to the Senior Coast Guard Medical Officer;

V. Make a health record entry for every patient the provider sees in accordance with ATTACHMENT 3(r) Page 1 of

Flight Surgeon Services

Chapter 4 of the Coast Guard Medical Manual.

W. Subjective Objective Assessment Plan (S.O.A.P.) format and other criteria. Update as required by the medical officer each patient's health record entry a written determination of the patient's ability to work, including an expiration date for the assigned duty status, and specific limitations. There may be special limitations for persons with sea duty or aviation duty status;

X. (depending on workload) be required to take blood pressure, temperature and all other related duties as required during the screening of patients;

Y. (depending on workload) be required to obtain laboratory specimens as required;

5. Hours of performance: The Contractor shall provide all aspects of personal Flight Surgeon Physician’s services at locations in the PWS (Attachment 3) and hours specified by the Clinic Administrator.