75H70621R00004.pdf

SOL - Solicitation Number

These clauses, terms and conditions are incorporated into Solicitation Number 75H70621R00004.

B - Supplies or Services and prices/costs

Unit Price

The "Unit Price" is an all-inclusive cost. "All inclusive cost" is defined to include travel, lodging, per diem, fringe benefits, i.e., life insurance, social security, federal, state, and local taxes, plus all other costs pertinent to the performance of this purchase order.

C - Description/specifications/statement of work

STATEMENT OF WORK

PHYSICIAN SERVICES FOR THE

ROSEBUD IHS OUTPATIENT/INPATIENT DEPARTMENT

Rosebud Service Unit, Great Plains Area Indian Health Services

A. PURPOSE OF CONTRACT:

The mission of the Rosebud Comprehensive Healthcare Facility (Rosebud) is to provide the best possible health care services to the Native American population of the Rosebud Reservation in South Dakota. To meet this mission this requires contractor support to provide Hospitalist, Family Medicine and/or Internal Medicine Physician services on a temporary basis.

Many of the IHS patients receiving services may only speak a native language and/or reside on a Native American Reservation, therefore, the Contractor must demonstrate sensitivity to cross-cultural and language differences.

The Rosebud Comprehensive Healthcare Facility requires assistance in the recruitment and placement of Board Certified or Board Eligible physicians on the medical staff for a temporary duty assignment either for inpatient (hospitalist) or outpatient provider. The purpose of the contract is for the recruitment, credentialing and placement of a Physician as either a hospitalist or an outpatient provider; Family Medicine or Internal Medicine Physician for Rosebud.

B. SPECIFICATIONS OF SERVICES:

The contract is a non-personal health care services contract, as defined at Federal Acquisition Regulation (FAR) part

37.01 under which the contractor is an independent contractor and shall allow the Government to evaluate the quality of professional and administrative services provided, but retains no control over the medical, professionals aspects of the services rendered (e.g., professional judgments, diagnosis for specific medical treatment, or treatment plan). A Non-Personal Service Contract is established to provide Family/Internal Medicine physician services.

The contract physician as a hospitalist will be anticipated to work 7 days/week consisting of call 24 hours per day for admissions or emergencies and 5 days weekly, Monday through Friday from 7:30 am to 4:30 pm (40 regular hours paid), with a 30-minute lunch break regarded as on call hour. Beyond 4:30 pm on weekdays it will be regarded as on call hours unless the provider is doing direct patient care related to hospitalized patients, Emergency Room Consultations and admissions. On weekends the inpatient provider is to arrive by 9:00 am (both Saturday and Sunday) to the hospital for rounding and completion of care for the inpatients. Then the rest of the hours are on call hours, Saturdays and Sundays except the time spent on inpatient rounds, attending Inpatient emergencies, Emergency Room consultations and new admissions which would be listed and paid as call back hours. Because of the nature of our hospital and the possibility of limited inpatient volume, the Contractor for Inpatient will agree on low volume days to report to the outpatient clinic and see walk in patients, i.e., the inpatient provider could provide inpatient rounding in the morning and work in the clinic in the afternoon. The number of patients seen in the outpatient department will be determined by the inpatient volume and the possible need to attend to inpatients or calls to the ER for patient evaluation or admission. Call may be nightly, or may be divided among several providers to cover the inpatient call, depending on the volume of inpatients and the amount of calls and night admissions. The contractor understands the Rosebud Facility shall set the on call schedule and it may vary from every day, to several days in a row with intermittent other coverage to alternating coverage days. The Contractor understands they are to take 30-60 minutes for lunch during their Monday through Friday shift time, which is then paid at the call rate.

Should their lunch time be decreased it would need to be noted on their time sheet as to why (Consult/Admission).

The contractor may be outside of the facility during on call time; however they are to remain within the Rosebud area, being able to respond back to the hospital within 10-15 minutes if needed (for codes, patient evaluation, admissions). The contractor is to keep track of time inside the facility actively working, call back time for admissions or consults, and time being on call outside the facility. If the contractor is outside the facility it can only be listed as call time and does not get increased level of pay for phone calls. The contractor will perform according to this Statement of Work.

The contract physician as an outpatient provider will typically work Monday through Friday, with the potential for some evening or weekend clinics. The outpatient provider's shift will normally be 8:00 am - 5:00 pm CST; shifts may fluctuate to accommodate evening or weekend clinics. Times may also vary if there are meetings. Provider will begin seeing patients in the OPD at 8:30 am and work until 5:00 pm CST with a minimum of a 30 minute lunch break required. The contract provider, on occasion, may need to work for short periods of time beyond their respective shift hours, at times when such extra time is necessary to finish a patient visit, increased number of patients that need to be seen. The normal work day would not be more than 9 hours, not including lunch. If the provider is needed to work more than 9 hours per day, approval of such hours must be obtained by the Clinical Director or designee prior to working the extended hours.

Work assignments will be defined by the Clinical Director or designee to include shifts within the hours of operation of the facility including inpatient and outpatient clinic. The contract physician's regular work duties may include the clinical supervision of mid-levels, students and residents. Teaching is considered a vital role in providing good patient care. Regular work schedules for contractors may include Federal holidays. The work hours/shifts cannot be changed/traded/switched without prior approval from the Clinical Director or designee.

The contractor shall be paid a fixed flat rate per hour as stated on the issued contract for inpatient services, clinic services and for call as outlined. All charts and records should be completed during the day shifts or call back time for admission H & P and orders. No differential pay for government holidays, compensation time, and overtime will be approved.

The Contractor shall indemnify the Government for any liability producing act or omission by the contractor its employee and agents occurring during contract performance. The Contractor shall maintain medical liability insurance in the coverage amount acceptable to the Contracting Officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned.

The contractor shall furnish one or more physicians for hospitalist/outpatient assignments for Rosebud as requested.

The facility at times may need coverage 365 days per year, or may only need intermittent coverage. Contract physician care shall cover the range of primary care typically provided in a rural civilian practice of similar size.

Contractor will provide the provider who will cover inpatient hospitalist and be willing to perform outpatient clinic services as well. The Contractor shall provide a skilled physician to perform the necessary medical diagnostics, management, procedures, and treatments.

Upon the receipt of contract, the contractor shall locate, credential, and have available sufficient staffing to provide "seamless" physician coverage on a regular work schedule. Physician primary care work schedules are inclusive of weekends and all federally established holidays. Failure to provide "seamless" coverage will result in the contract going into default.

The standards of medical practice and duties of the contractor through its physicians shall be determined pursuant to the governing body bylaws, medical staff bylaws, rules and regulations of the Indian Health Service (IHS), applicable provisions of law including but not limited to The Joint Commission, Centers for Medicare, Medicaid Services (CMS) compliance, rules and regulations of any and all governmental authorities related to licensure and regulations of physicians in health care and standards and recommendations of the Accreditation Association for Ambulatory Health Care ('AAAHC').

In accordance with the Indian Health Service credentialing policy, the contractor shall complete primary source verification for the contract physician performing services under the contract. Upon the placement of a physician at Rosebud the physician shall timely complete a credentials packet, background clearance forms and be credentialed by the Rosebud Governing Body. Compliance with IHS privileging requirements is essential in the performance of the contract.

The contractor shall provide a physician for the professional management of patients being treated at the Rosebud Hospital. The contract physicians shall provide medical support for the outpatient department as described above.

The Contractor health care providers shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity. The Contractor shall ensure strict compliance to the release of Protected Health Information in accordance with the Coder of Federal Regulation, Title 45, Public Welfare, Subtitle A, Department of Health and Human Services, Part 164, Security and Privacy (45 CFR 164) and AFI 41-210, "Patient Administration Functions" paragraph 2.2.3, "Health Insurance Portability and Accountability Act (HIPPA)" and paragraph 2.3, "General Guidelines on Releasing Medical Information".

The Contractor shall ensure contract providers maintain open and professional communication with members of the Medical Staff. Complaints validated by the Quality Assurance Personnel (QAP) and Clinical Director shall be reported in writing to the Contracting Officer (CO) and the Contractor for action.

Contract providers shall perform procedures compatible with their privileging and the medical facility's operating capacity and equipment. New medical procedures/services/or personal medical equipment (other than stethoscope) shall not be introduced without prior recommendation and approval of the Rosebud I.H.S Clinical Director or authorized representative.

The contract physician shall generate and maintain proper medical record information on beneficiaries to who treatment is provided in accordance with Indian Health Service, AAAHC and CMS regulations. The contract physician shall prepare all medical record documentation exclusively on the Electronic Health Record (EHR) to meet or exceed the established standards of the IHS facility to include but not limited to: timeliness, legibility, accuracy, content and signature. An orientation to the EHR will be given by the Clinical Applications Coordinator (CAC) prior to any patient care. All medical recording information and documentation generated in the performance of this contract must be completed by the time of departure and will remain the property of and subject to the exclusive control of IHS. All medical records must include proper documentation to allow for coding and billing of all inpatient and outpatient visits based on current standards.

The Rosebud Hospital will provide support personnel to assist with clinic to equivalent of a licensed practical nurse and registration staff. Exam rooms equipped with standard supplies including computers for completing electronic medical records.

The contractor shall document all patient encounters legibly on all medical records. All documentation shall be timed and dated. The Contractor must place in the EHR all of their orders in a timely fashion and verbal ordered are to be used in an emergency basis only. All Medical records are to be completed by the end of the provider's scheduled shift and must be verified by the HIM department. All documentation shall meet the current CMS guidelines.

Inpatient duties include but are not limited to: Reporting to morning rounds by 7:40 am every morning to give inpatient report, review patient plans, and review any special needs for patient care. The inpatient provider is required to perform a daily, in-person evaluation of each inpatient which includes but not limited to appropriate examination, review of laboratory test results, and medications. New orders and daily progress notes are to be completed daily. If needed, a reevaluation is conducted later in the day with addendum added to the morning note.

Notes from ER consultations and admission History and Physicals must be completed immediately at the time of service per hospital policy. EHR items will include the review of outpatient medications, order of proper inpatient medications including DVT prophylaxis if warranted (or reasons why not), and EHR order entry required with minimal to no verbal orders. Necessary duties include review and signing of laboratory investigations, orders, review and sign off radiographic studies, interpretation and sign off of all EKG tracings and placing a note in the

EHR with EKG interpretation. Discharge orders must be written early in the day to allow for arrangement of transportation. Medication reconciliation must be completed for all patients on admission and discharge. At discharge, discharge medications must be ordered along with discharge instructions and home supplies.

Consultations (ER or outpatient) and discharge summaries must be completed the day of discharge and Nutrition Guidelines per requirements. All records of transfer will need to be completed prior to transfer of patients, this includes transfer note, Purchased/Referred Care (PRC), and all appropriate records must be ready for the transfer team. All consults must be placed and PRC completed for any outside treatment or testing needed upon discharge or transfer.

Final payment will be withheld until all medical records are completed by the contract physician. The contractor will be required to create a time work record by utilizing a contractor provided timecard. The contractor is to be honest with arrival and departure times and to only include times actively working. No "padding" of hours is allowed and will be considered fraud, waste and abuse of government funds. Once inpatient work is completed, the contract provider should report to outpatient, complete medical records or report to the Clinical Director for direction. If the contract provider should need to re-evaluate inpatients prior to leaving work, an addendum on the daily note should be placed. Daily charge sheet must be completed to include the correct diagnosis on the front sheet and the appropriate level of charges for admission, daily note, and discharge. This must be completed on all charts on a daily basis.

On a weekly basis, or per the Contractor policy, timecards and timesheets will be turned in to the Clinical Director or his designee for verification and signature prior to submitting to the Contractor's timekeeper. No invoices shall be processed for payment until a complete, signed, and verified work record is submitted along with the medical records documentation completion verification.

**All patient health record documentation initiated by the contract physician from patient encounters must be completed to the satisfaction of the supervisor, or designee, of the HIM (Health Information Management) Department & Business office supervisor or designee. The approving authority of the contract provider's time sheets will not sign off on the final time sheets unless the provider has successfully completed all required patient medical encounter documentation (medical records). Further, if the provider has delinquent medical records as determined by the supervisor, or designee, of the HIM department, the approving authority will not sign off on any time sheets or process any invoices generated from "unauthorized" time sheet signatures. This is a condition of the Statement of Work (SOW).

The contract will be provide one or more MD staffed for the described Outpatient/Inpatient duty shift for the entire contract period providing "seamless coverage" AKA "continuous coverage". It is imperative that the contracting agency ensures qualified and credentialed MDs will be physically present in the Rosebud inpatient and/or outpatient clinic every day as needed throughout the entirety of this contract.

Skills and knowledge of established concepts, principles, and practices related to health care assignments requiring training equivalent to an educational program leading to a Degree of Medicine (MD/DO) and additional training or experience in assessing the conditions of patients, in providing medical care and in advising on health care needs, all with full consideration of mental, emotional, and physical factors. Extensive knowledge of disease entities.

Knowledge of diagnostic, preventive and therapeutic procedures related to a variety of medical and health care fields.

Ability to collect, organize, record and communicate, in a meaningful way, data relevant to primary health assessments including detailed family and medical history, physical examinations and selective laboratory tests.

Skill in making diagnoses and in choosing, initiating, and modifying selected therapies, and ability to provide emergency treatments. Skill in simple laceration repair, casting/ splinting, and in other ER or urgent care- related procedures. Skill in the management of simple fractures.

Ability to assess the physical-psychosocial health status of patients and family based upon the knowledge of growth and development patterns and health conditions that require medical management. Knowledge of human behavior during stressful situations in order to exercise emotional control, tact, patience and reliability in providing emergency/ urgent patient care.

Knowledge of pharmaceuticals to be able to determine proper medications to order, including dosages and able recognize the desired effects, side effects and complications of their use and interactions.

Ability to provide individual and family counseling, guidance, and health instruction to help patients to understand how to prevent disease and maintain good physical and mental health. The ability to work closely with families with death and dying issues related to end of life care. The ability to understand and work within the culture of the patients we serve.

The Contractor will provide diagnostic, preventive, and therapeutic health services to patients and family members in the Emergency Department, or an urgent care setting affiliated with the Emergency Department.

The Contract physicians' medical documentation will undergo peer review to ensure acceptable medical care is being provided. The Contract physician shall secure a thorough health history from the patient or patient's parent and record findings. A thorough history and physical examination shall be performed which is consist with the patient's presenting complaints and/or presenting signs and symptoms. Appropriate diagnostic testing shall be ordered, reviewed, interpreted, and acted upon to address and treat the patients? complaints, signs, symptoms, and in the patient's best medical interests. The Contractor will discriminate between normal and abnormal findings to recognize early stages of serious physical, emotional, or mental problems. The Contactor will consult available in-house medical services when indicated and available. If consulting services are not available in-house the Contractor will consult with the shift OPD physician or clinical director about appropriate referrals.

Provides direct medical care in the presence of illness or disability in order to maintain life, provide comfort, reduce distress and enhance coping ability.

Provides surveillance over medical practices applied to stabilize chronically ill persons; adjusts treatment within established standing orders, recognizing when to refer the patient to another physician, another hospital or other health team members.

Works collaboratively with physicians in management of selected complex medical problems. When clinically engaged with a medically complex patient the Contractor will present the case to the physician clinic consultant for the day for proper follow up and disposition.

The physician will have knowledge of how to look up hospital policies and procedures and will abide by the outlined policies and procedures.

C. GOVERNMENT FURNISHED EQUIPMENT, FACILITIES AND PROPERTY:

The Hospital shall provide a patient examination area and all medical and non-medical equipment and supplies used in the Indian Health Service facility for the care and maintenance of patients either on inpatient or outpatients. The contract physician will be authorized to use all areas of the medical treatment facility available to civil service and Commission Corps personnel in similar positions. The same restrictions apply to the Contractor as any other Indian Health Service personnel to use these areas for official business activities only.

The contract physician will be authorized to use all administrative and professional support available to Indian Health Service personnel. This will include but not limited to copy machines, fax machines, medical library, and telephone services. The same restrictions to use these items for official Indian Health Service business apply. All equipment is for the use of patient care only and personal use is not authorized. The contractor shall not use hospital electronics for personal use including searching the web for anything other than non-clinical purposes.

The facility shall provide all medical and non-medical equipment and supplies used in the Rosebud Hospital for the care and management of patients.

The facility shall provide all blank government forms applicable to the Indian Health Service. The facility personnel will provide an appropriate orientation to the necessity of such forms.

The facility shall provide an ongoing method of monitoring and evaluation of the quality and appropriateness of patient care and identifying deficiencies in the quality service performed before the level of performance becomes acceptable.

The facility shall provide to the contract physician and support staff a contractor orientation to the facility, of which must be completed timely.

D. CONTRACTOR FURNISHED EQUIPMENT, FACILITIES, AND PROPERTY:

The Rosebud Hospital does not anticipate a need for contractor furnished equipment beyond a stethoscope. Hospital Accreditation does require any equipment brought in to a facility to be assessed and approved by Biomed and Administration.

The contract physician and support staff shall provide his or her own uniforms which must be clean and tidy.

E. WORK SCHEDULE/PAYMENT SCHEDULE:

The MD's work schedule is as follows: Each work day will consist of one 8-1/2 - 9 hour tour of duty in the Rosebud IHS hospital Inpatient and/or Outpatient, typically weekdays, Monday through Friday (potentially with evening or weekend outpatient clinics). Weekends for inpatient is only actual rounding time required to see the patients on the inpatient service unit usually 2-4 hours, depending on the number of patients hospitalized. On the weekend rounding must be completed in the morning hours, with arrival around 9:00 am on Saturday and Sunday and will resume call after rounding completed. Inpatient on call weekend hours will be from on the weekends begins at 8:00 am and will resume after rounding until 8:00 am the following day. The on call schedule is listed in the inpatient area, administration and in the ER. The inpatient provider will start their weekday work shift at 7:40 am CST with morning report and Inpatient Rounds. During the week days the inpatient provider may leave the facility by 4:30 to 5:00 pm when records and charting is completed. Outpatient providers will report to clinic at 8:00 am and begin seeing patients at 8:30 am and work until 5:00-5:30 pm CST with a 30 minute lunch break as allowed. The outpatient contract MD, on occasion may need to work for short periods of time beyond their respective shift hours, at times when such extra time is necessary to finish a patient visit and charting. The outpatient physician may also be scheduled to provide call after clinic to the next morning. Actual call hours will be on the schedule. Note there is time allotted within the scheduled day to allow for charting to be completed and additional overtime hours must be approved prior to happening should there be extenuating circumstances.

The Contractor will adhere to work duties and schedule for shifts in accordance with the SOW with no more than one unplanned absence per quarter. Any changes more than that on the side of the contractor, resulting in any open shifts on the schedule will result in the contract going into default.

F. QUALITY ASSURANCE:

Is under the administrative supervision of the Medical Director the Rosebud Service Unit or his/her designee. Will participate with the Rosebud Hospital medical staff Chart Review Processes for the facility and/or department as well as participate in Corrective Actions, if needed. Incumbent performs assignments under general supervision, and will work directly under the on-duty ER physician. In addition, the Supervisor will monitor the contractors work and provide feedback to the contractor.

Performance objectives will include a written summary provided to the Contract Provider as well as the Contractor summarizing the provider's performance while on duty at the Rosebud Hospital. Criteria for evaluation will be as follows:

Medical practice must be within the standards of their credentialed specialty.

Documents medical assessments, History and Physicals, observations, discharge summaries and daily progress notes all must be consisted with current standards and meet billing requirements.

Utilizes EHR/RPMS computer system to enter and sign off lab results, pharmacy orders, notes; must be signed off at the end of each shift.

Complies with safety policies.

Complies with all required trainings within the scheduled timeline.

Consults with other specialty practitioners when needed.

Maintains patient privacy/confidentiality and meets all HIPPA compliance standards.

Adheres to work duties and scheduled shifts consistently without tardiness or absences.

Understands that we have an FPPE and OPPE process and process improvement needs will be reviewed with the provider. Failure to improve may result in removal of the provider.

Complaints on quality of care and/or conduct will be not more than 4 per quarter. There is zero tolerance for negligence or incompetence resulting in morbidity or mortality. Zero tolerance for violence or sexual harassment in the work place.

Rosebud Hospital's Clinical Director or designee will conduct an exit interview with the provider to obtain any feedback from the contract provider regarding the work conducted. If the contract provider is unable to meet with the Clinical Director in person, the Rosebud Hospital requests feedback to be provided in writing within 2 days prior to departure from the Rosebud facility.

G. REPORTING REQUIREMENTS:

The Contractor shall ensure that all new contract providers participate in the Rosebud I.H.S. Facility Orientation with an overlap of services to include one additional day. Emergency Room providers must arrive on a Monday ?

Friday excluding holiday and participate in the orientation prior to providing services at the Rosebud I.H.S.

Hospital. Credentialing and background evaluation must be completed timely to allow individuals to be orientated and ready for their shifts. Please allow 4-6 weeks to complete background and credentialing. Orientation is offered every two weeks starting on Mondays and that is the best time for new contractors to begin.

H. PROFESSIONAL QUALIFICATIONS CRITERIA:

The Contractor must hold an active, current, and unrestricted state Medical Doctor or Doctor of Osteopathy license from any of the 50 United States or the Commonwealth of Puerto Rico.

The Contractor cannot be under any exclusions or sanctions from the Medicare/ Medicaid programs.

The Contractor must have a Medical Doctor (MD) or Doctor of Osteopathy (DO) degree from an accredited college or university in the specialty area required to provide medical services.

The Contractor must fulfill all the requirements for appointment to the Rosebud IHS Medical Staff and for the granting of privileges, in accordance with IHS policies and with the Service Unit Medical Staff Bylaws.

The Contractor must have current BLS, ACLS certification for adult patient care, and PALS and/or NALS certification for pediatric care prior to starting work at Rosebud.

The provider shall have basic core privileges granted upon verification of all credentialing processes. The provider shall have the onus of supplying documentation supporting any requested privilege that is deemed outside the normal basic scope of a Medical Doctor or Doctor of Osteopathy. Requested privileges shall be denied by the medical director if the provider is unable to prove sufficient training, and State law citing specific allowance to perform requested privileges.

Required credential and appointment documents needed to allow initial provisional and subsequent active privileges and appointment shall include but not limited to the following items.

1) Unrestricted active State license photocopied, primary source verification will be completed at the service unit.

2) Photo of Individual that is recognizable, example driver's license or passport work well.

3) Evidence of a two-step PPD skin test with annual TB testing evidence that followed or Interferon Gold with results not less than one-(1) year old:

*If TB positive then chest radiograph reading results must be submitted.ss *If TB positive then record of treatment must be submitted.

*If TB skin test is positive secondary to BCG shots, do IFG blood test.

4) Immunization Required Prior to Arrival:

Rosebud Service Unit Health Requirements

1. 2 documented MMR vaccines OR positive antibody titers on each Measles, Mumps, and Rubella.

2. 2 documented varicella vaccines OR a positive antibody titer OR paperwork indicating by a physician diagnosis of the disease (must be complete documentation).

3. TDAP documented in past history AND at least a tetanus vaccine within the past 10 years.

4. 3 documented hepatitis B vaccines OR a positive hepatitis B antibody titer OR a signed declination of refusal.

5. 2 negative TB skin tests within the last 12 months OR a negative IGRA within the last 12 months.

a. If history of a positive reaction to either TB skin testing (secondary to BCG then do IGRA, if exposure need CXR and dates treated) or to an IGRA we will need the last chest x-ray, and dates of treatment (if treated).

All Civil Service employees, contract staff, temporary employees, students, and volunteers, who work in an IHS health care facility, must receive a seasonal influenza vaccination by October 31 of each year or have on file a valid medical exemption for vaccination signed by a licensed independent practitioner *Individuals with a valid medical exemption for vaccination will be required to wear a mask provided by IHS during the influenza season (November 1 through March 31) and during other periods of increased influenza activity as defined by the Centers for Disease Control and Prevention and/or State public health authorities.

5) Complete Curriculum Vitae with complete and current medical provider work history listing months and years. All gaps of medical employment eight-(8) weeks or greater must include an explanation by the applicant to the reason of this prolonged period of unemployment.

6) Current and active BLS, ACLS, and PALS as listed above with recommendation of NALS, NRP or any other certifications which will remain active throughout the provider's tour while seeing patients in Rosebud Hospital.

7) Three letters of professional reference from supervisors or peers not less than 3 months old.

8) Active DEA license including prescription privileges of Schedule 2 & 2N.

9) Current Liability Insurance of not less than $300,000/$1,000,000.

10) Record of recent (2 years) continuing education units (CEUs) or (CMEs). Must possess CME/CEUs that satisfies state licensing requirements if credentialing is to be beyond a 120-day Temporary medical staff appointment.

Providers must furnish adequate number of CMEs new residency graduates are exempt from 30 hours CME/CEUs as they have just successfully completed their training. However; fully credentialed new graduates with active medical staff membership will be required to provide an adequate number of CME/CEUs before they can be re-credentialed in 2 years with active medical staff membership.

I. CHARACTER INVESTIGATION FOR CONTRACTORS WHO WILL HAVE CONTACT

WITH INDIAN CHILDREN:

The contractor is prohibited from having any unsupervised contact with Indian Children in the performance of this contract unless:

1. They act under the direct supervision and within the sight of a Government employee who has obtained a satisfactory "Criminal History Check" in accordance with the "Indian Child Protection and Family Violence Prevention" P.L. 101-630 and "Crime Control Act" P.L. 101-647.

Prospective contractors who duties and responsibilities involve regular contact or control over children are subject to a character investigation as required by P.L. 101-630, the Indian Child Protection and Family Violence Prevention Act. IHS personnel offices will conduct these investigations following award of a contract. The character investigations may be waived if, in judgment of the Contracting Officer, in consultation with the Personnel Officer, and investigation has already been conducted and is on file. Until the character investigation has been completed and the Contracting Officer notified or the results, the Contractor must not have unsupervised contact with Indian Children.

2. The Physician has obtained a satisfactory "Criminal History Check" which satisfies the requirements for the "Indian Child Protection and Family Violence and Prevention Act" P.L. 101-630 and "Crime Control Act" P. L.

101-647.

J. REQUIRED MALPRACTICE INSURANCE:

Current Liability Insurance of not less than $300,000/$1,000,000 covering the duration of the contract.

A Certificate of Insurance evidencing the required coverage shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on claims-made basis, evidence of an extended reporting 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 endorsement is provided to the Contracting Officer.

K. COMPLIANCE WITH IHS RULES AND REGULATIONS:

Medical Practices must be within the standards of their established credentialed specialty and maintains continuing medical education, licensing, registration and certifications 100% of the time.

Complies with all policies, By-laws, Safety, Infection Control, and rules and regulations of HHS/IHS/Rosebud Hospital with zero violations.

Maintains patient privacy/confidentiality/HIPAA with zero breaches of privacy.

The contract physician shall follow IHS Purchase Referred Care (PRC) regulations and policies when arranging for a referral or consult. The contract physician shall be required to consult with other specialty practitioners for consultative opinions and continuation of care. The provider shall inform patients of the required referral or consult by indicating the specialty involved. The contract physician will be required to facilitate transportation arrangements for patients referred to facilities for a higher level of care.

The contract physician shall use and follow the Rosebud IHS formulary list which is approved and maintained by the Rosebud IHS Pharmacy and Therapeutics Committee. Any drug not listed on the formulary must be approved by the Pharmacy and Therapeutics Committee.

Timely documentation that is completed 100% of the time which is to be completed prior to the end of the daily shift and prior to signing an invoice for payment.

Complaints on quality of care and/or conduct should be minimal and no more than three per quarter (all issues will be addressed in writing to the contractor so that action can be taken).

The standards of medical practice and duties of the Contractor through its Physician(s) shall be determined pursuant to the bylaws of the Service Unit. The regulations of the hospital, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals must be followed. Also the standards and recommendations of The Joint Commission, Centers for Medicare and Medicaid Services (CMS) or the Accreditation Organization must be adhered to. The Contract Physician(s) shall be required to participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

L. ANY SPECIAL REQUIREMENTS:

Utilizes EHR and RPMS computer system to enter and sign off on laboratory orders (90% of orders must be signed off at the end of each shift).

M. CONTRACTING OFFICER REPRESENTATIVE (COR):

For the purpose of this contract, the Clinical Director or designee will act as the COR and serve as the contractor?s supervisor.

N. Performance Surveillance Plan for Hospitalist/Internal Medicine/Family Practice

Performance surveillance monitors will be established to comply with regulatory guidelines and to monitor contract performance. The performance surveillance plan has been developed to describe the Indian Health Service's general plan in providing effective and systematic surveillance and reporting of all aspects of contract performance. This plan recognizes the responsibility of the contractor to carry out its own quality control obligations in the performance of this contract.

Surveillance will be accomplished via insight into the contractor's performance against requirements listed in the work statement and performance standards listed in this plan. Performance-based incentives are consistent with the intent and purpose of the contract and are outlined on the following grid:

Upon completion of the contract, the Government will complete and keep on record the Contractor's performance evaluation form, see (Section J).

OBJECTIVE/TASK PERFORMANCE

STANDARD

ACCEPTABLE

QUALITY LEVEL

(AQL)

SURVEILLANCE

METHOD/MEASURES

CONTRACTOR

INCENTIVE

PERFORMANCE

OBJECTIVE 1

THE CONTRACTOR

SHALL ESTABLISH

A TECHNICAL

APPROACH AND

MANAGEMENT

PLAN FOR THE

PLACEMENT OF

HOSPITALIST

PHYSICIANS

INTO TEMPORARY

ASSIGNMENTS IN

AAIHS FACILITIES

ONCE A

CALL/REQUEST IS

RECEIVED:

CONTRACTOR

SHALL LOCATE A

BOARD ELIGIBLE,

BOARD

CERTIFIED,

PHYSICIAN

WITHIN 21 DAYS

COMPLETE IHS

CREDENTALING

PACKET

INFORMATION &

RETURN TO

LOCAL IHS CD

WITHIN 5 DAYS

PLACEMENT OF

STAFF 100% OF

THE TIME

REFERENCES

FROM

INDIVIDUALS

THAT HAVE

WORKED WITH

APPLICANT

WITHIN LAST 12

MONTHS OR

DOCUMENT WHY

THIS IS NOT

POSSIBLE

CD?S SHALL SUBMIT

MONTHLY SPREADSHEET OF

PLACEMENT DATES TO THE

CONTRACTING OFFICER'S

TECHNICAL

REPRESENTATIVE (COTR) TO

MONITOR THE 21 DAY

PLACEMENT REQUIREMENT

SPREADSHEET TO COTR

MONTHLY

AAIHS WILL

PROVIDE A

POSITIVE

PERFORMANCE

REPORT ON

HOSPITALIST

PHYSICIAN

PLACEMENT

CAPABILITIES

OBJECTIVE/TASK PERFORMANCE

STANDARD

ACCEPTABLE

QUALITY LEVEL

(AQL)

SURVEILLANCE

METHOD/MEASURES

CONTRACTOR

INCENTIVE

OBJECTIVE 2

PROVIDERS

CAPABLE AND

KNOWLEDGABLE

OF EFFECTIVE

COMMUNICATION

PROVIDERS

SHALL BE

RESPECTFUL,

COURTEOUS, AND

CULTURALLY

SENSITIVE TO IHS

PATIENTS AND

STAFF

THREE (3)

ANNUAL

COMPLAINTS PER

PROVIDER ARE

ACCEPTABLE

THE CONTRACTOR SHALL

RESPOND TO THE

CONTRACTING OFFICER'S

TECHNICAL

REPRESENTATIVE (COTR) IN

WRITING. WHENEVER, THEY

RECEIVE NOTICE OF MORE

THAN THREE COMPLAINTS

AGAINST A PROVIDER WITH

AN EXPLANATION OF WHAT

WAS DONE TO ADDRESS THE

MATTER

THE INVOICE FOR

THE PHYSICIAN IN

QUESTION WILL

BE PUT ON HOLD

UNTIL THE

COMPLAINT IS

INVESTIGATED

AND RESOLVED IN

7 WORKING DAYS.

OBJECTIVE 3

COMPLETION OF

MEDICAL RECORD

DOCUMENTATION

COMPLETES

MEDICAL RECORD

DOCUMENTATION

PRIOR TO LAST

WORKDAY &

NOTIFIES

MEDICAL

COMPLETED 100%

OF THE TIME

CLINICAL DIRECTOR

REVIEWS CHECKLIST FROM

MEDICAL RECORDS PRIOR

TO PHYSICIAN LEAVING

FACILITY

THE INVOICE FOR

THE PHYSICIAN IN

QUESTION WILL

BE PUT ON HOLD

UNTIL PROPER

OF THE CHART IS

RECORDS

DEPARTMENT OF

LAST WORKDAY

COMPLETED

G - Contract Administration Data

Period of Performance

Period of Performance will be from June 1, 2021 to May 31, 2022 with four 1-year options with performance dates of:

Option Year One (1): June 1, 2022 to May 31, 2023 Option Year Two (2): June 1, 2023 to May 31, 2024 Option Year Three (3): June 1, 2024 to May 31, 2025 Option Year Four (4): June 1, 2025 to May 31, 2026

Invoice Submission & Payment

The Contractor shall submit a signed and approved invoice to request payment on at least a monthly basis.

(a) The Contractor shall submit an original invoice to:

Attn: Accounts Payable Great Plains Area Indian Health Service Division of Financial Management 115 4th Avenue Southeast Room 309 Federal Building Aberdeen, South Dakota 57401-4360

(b) The Contractor shall include the following information on each invoice in accordance with the Prompt Payment Act (5 CFR Part 1315.9(b)):

1. Contractor's name;

2. Invoice number and date;

3. Entire award number or other authorization number for delivery of goods or services;

4. Description (including dates of service), price, and quantity of goods and services rendered;

5. Shipping and payment terms;

6. DUNS number and Taxpayer Identifying Number (TIN); and

7. Contact name (where practicable), title and telephone number

Payment shall be made by the Great Plains Area Financial Management Branch, Room 309 Federal Building, Aberdeen, South Dakota 57401-4360.

The Government reserves the right to accept or reject services if the level or work is unsatisfactory.

H - Special Contract Requirements

Additional Applicable Published Policy & Procedure

These referenced published policies and procedures are applicable to any contractor personnel providing services in accordance with this contract and are hereby incorporated by reference. The contractor is responsible for ensuring that all applicable contractor and subcontractor employees engaged in the direct delivery of services for this contract are aware of the applicable terms and conditions that apply and have read and familiarized themselves with the content.

Indian Health Service Circular 2016-04, Mandatory Seasonal Influenza Immunizations for the Civilian Health Care Personnel https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health-care-personnel/.

IHS Special General Memorandum No. 95-04, Workplace Violence https://www.ihs.gov/ihm/sgm/1995/sgm-9504/.

https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health-care-personnel/ https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health-care-personnel/ https://www.ihs.gov/ihm/sgm/1995/sgm-9504/

HHS Residual Standards of Conduct https://ethics.od.nih.gov/lawreg/hhs-resid-std.htm

CFR Title 5, Chapter XLV-DHHS, Part 5501, Supplemental Standards of Ethical Conduct for Employees of the Department of Health and Human Services https://ethics.od.nih.gov/lawreg/5-CFR-5501-Unofficial-Compilation.pdf

CFR Title 5, Part 2635.101, Basic Obligation of Public Service https://www.govinfo.gov/app/details/CFR-2019-title5-vol3/CFR-2019-title5-vol3-sec2635-101

Standards of Medical Practice

The standards of medical practice and duties of the Contractor through its Physician(s) shall be determined pursuant to the bylaws of the Service Unit. The regulations of the hospital, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals must be followed. Also the standards and recommendations of Centers for Medicare and Medicaid Services (CMS) or the Accreditation Organization must be adhered to. The Contract Physician(s) shall be required to participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

Employee Health Requirements

Contract Providers shall provide health information, proof of immunizations as recommended by the CDC (Centers for Disease Control) concerning health-care workers in the United States. Health information must include previous immunization history and proof of the following immunization records: Hepatitis B (Vaccination-declination required), Measles, Mumps, Rubella (MMR), Varicella, Influenza, and Tuberculosis.

Security Clearance

Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S. facilities or systems, each person must complete a FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System. Contractors shall allow five business days for I.H.S. processing of fingerprints taken electronically at an I.H.S. site and thirty business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer.

The Indian Health Service utilizes the eQIP (Electronic Questionnaire Investigations Processing) system to process background investigations. Contractors are required to work with the Service Unit Background Coordinator or other designee to properly complete their eQIP entry without error. Proper submission of the eQIP entry to the Office of Personnel Management (OPM) is required prior to the individual being allowed to begin their performance under this contract. Computers have been provided to the service unit for this purpose.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE), http://exclusions.oig.hhs.gov.

As soon as practicable, prior to the performance of the work, the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

The Contractor is responsible for conducting security preclearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the LEIE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access. If this is a Time and Materials, Labor-Hour or Cost Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access or the excess time required to resolve and clear unfavorable security clearance findings. If this is a Fixed-Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

https://ethics.od.nih.gov/lawreg/hhs-resid-std.htm https://ethics.od.nih.gov/lawreg/5-CFR-5501-Unofficial-Compilation.pdf https://www.govinfo.gov/app/details/CFR-2019-title5-vol3/CFR-2019-title5-vol3-sec2635-101 http://exclusions.oig.hhs.gov/

Government will pay for the cost to process the contractor's suitability clearances. However, multiple investigations for the same position may, at the Contracting Officer's discretion, lead to reduction(s) in the contract price of no more than the cost of the extra investigation(s).

Employees that DO NOT have access to LMS, contractors, volunteers, or IHS employees with IPAs or MOAs to tribal organizations please, click here IHS Sexual Abuse Prevention website (https://www.ihs.gov/sexualabuseprevention/training/). When the contractors have completed and passed the training, please have them send a copy of the last page of the training with Name, Date, and Time to their Supervisor, COR, and Kimmen LeBeau, e-mail: Kimmen.LeBeau@ihs.gov.

Contractor's Performance Conditions & Responsibilities

1. Contractor is responsible for reporting all taxes from wages earned under this contract to the appropriate State and Federal Agencies, provided the awardee is an individual.

2. Contractor is responsible for his/her own reliable transportation in the performance of the contract.

3. Contractor is responsible for Fringe Benefits and other benefits such as health, retirement, etc. for his/her employees, if other than self.

4. Contractor is responsible for maintaining satisfactory standards of competence, conduct, appearance and integrity. The quality of work performance of the contractor shall be subject to review.

5. Contractor is responsible for notifying the designated supervisor/director if he/she will be late, ill or unable to work for other reasons.

6. Contractor earns no leave and is compensated only for hours actually worked at the agreed compensatory rate.

7. Contractor is responsible for signing-in and signing-out of immediate work area, utilizing…