PWS_AMD01.pdf

Blackfeet Service Unit Performance Work Statement (PWS) for Non-Personal Services – Amendment 01

Medical Provider Locums - Physician Services

Table of Contents

Section Page

1.0 General 2

2.0 Scope 2 - 3

3.0 Applicable Documents 3 - 4

4.0 Definitions 4 - 6

5.0 Government Furnished Information, Property, & Services 6 - 7

6.0 Contractor Furnished Property 7

7.0 Performance-Based Requirements 8 - 9

8.0 Conduct 9

9.0 Work Schedule 9

10.0 Deliverables 10

11.0 Contractor Physician Qualification Requirements 10

12.0 Background Check / Clearance 10 - 11

13.0 Health Requirements/Conditions of Employment 11

14.0 Transportation and Lodging 11

15.0 Performance Evaluation 11

16.0 Identification of Contractor 12

17.0 Management of Medical Information 12

18.0 IHS Information Technology Systems 12

19.0 Orientation 12

20.0 Language Requirements and Cultural Awareness 12

21.0 Challenges to Conflicts 12

22.0 Place of Performance 14

23.0 Period of Performance 14

24.0 Task Order Period of Performance 14

25.0 Technical Point of Contact 14

26.0 Performance based Matrix 15

27.0 List of Attachments and Exhibits 16

AMD01 - BFSU PWS September 7, 2022

Performance Work Statement (PWS)

Non-Personal Services Medical Provider Services

1.0 General: This performance work statement (PWS) describes the requirements for non-personal service

Medical Provider Services 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, 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. The positions to be filled: OB/GYN

Physician; Nurse Midwife; Pediatric Nurse Practitioner; Family Practice Physician, Hospitalist

Physician, ER Physician; ER Nurse Practitioner; Outpatient Mid-Levels (Nurse Practitioner /

Physician’s Assistant).

1.2 Blackfeet Hospital, Billings Area-Indian Health Service, Browning, Montana provides support to the Blackfeet Indian Reservation and includes a clinic at Heart Butte, Montana.

2.0 Scope: The Contractor shall provide physician services in accordance with Section 7.0, performance based requirements. Duties and responsibilities consist of providing Medical Provider services in an

Outpatient (clinic), Critical Care, Emergency Room, Medical/Surgical (inpatient), Obstetric (Labor &

Delivery), Medical/Surgical (inpatient), Surgical (operating room) and Public Health settings to IHS patients. If determined necessary, the Contractor may accompany a patient on direct patient care related transports.

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

3.1 The Joint Commission on Accreditation of Healthcare Organizations (The Joint Commission) http://www.jointcommission.org

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

3.3 Need for Background Checks: Section 231 of Public Law 101-647, The Crime Control Act of

1990. https://www.govinfo.gov/content/pkg/STATUTE-104/pdf/STATUTE-104-Pg4789.pdf

3.4 Need for supervision with Children: Section 4087 of Public Law 101-630, the Indian Child and

Family Violence Act.

https://www.govinfo.gov/content/pkg/CFR-2002-title42-vol1/xml/CFR-2002-title42-vol1-part136-subpartK.xml

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

http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.sh tml http://www.jointcommission.org/ http://www.cms.hhs.gov/ http://www.cms.hhs.gov/ https://www.govinfo.gov/content/pkg/STATUTE-104/pdf/STATUTE-104-Pg4789.pdf https://www.govinfo.gov/content/pkg/CFR-2002-title42-vol1/xml/CFR-2002-title42-vol1-part136-subpartK.xml https://www.govinfo.gov/content/pkg/CFR-2002-title42-vol1/xml/CFR-2002-title42-vol1-part136-subpartK.xml http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml

3.6 Section 4087 of Public Law 101-630, the Indian Child and Family Violence Act.

http://www.nicwa.org/policy/law/protection/index.asp

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

http://www.cms.hhs.gov/hipaa

3.8 Privacy Act of 1974. http://www.usdoj.gov/oip/privstat.htm http://medi smart.com/practice.htm

3.9 IHS Service Unit and Health Center Policies, Procedures and Protocols. (See section 11.0 for a list of attachments and exhibits)

3.10 Federal Computer Security Act of 1987. https://www.congress.gov/100/statute/STATUTE-

101/STATUTE-101-Pg1724.pdf

3.11 Information Systems Security Awareness (ISSA). https://www.ihs.gov/issa/

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

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

3.14 IHS Computer Security Directives. http://www.ihs.gov/adminmggresources

4.0 Definitions:

4.1. 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.

4.2. 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.

4.3. Area: A defined geographical region for Indian Health Service administrative purposes. Each

Area Office may administer several Service Units.

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

4.5. Contractor: The Company awarded a legal binding contract to provide supplies and/or services.

4.6. Contracting Officer’s Representative (COR): 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). The Service

Unit Clinical Director (CD), designated Supervisory Medical Staff, or Technical Point of

Contact (TPOC) providing assistance with management of facility Task Order(s), will be responsible for monitoring the technical progress including surveillance and assessment of performance for this order.

http://www.nicwa.org/policy/law/protection/index.asp http://www.cms.hhs.gov/hipaa http://www.usdoj.gov/oip/privstat.htm http://www.usdoj.gov/oip/privstat.htm http://medi‐smart.com/practice.htm http://medi‐smart.com/practice.htm http://medi‐smart.com/practice.htm https://www.congress.gov/100/statute/STATUTE-101/STATUTE-101-Pg1724.pdf https://www.congress.gov/100/statute/STATUTE-101/STATUTE-101-Pg1724.pdf https://www.ihs.gov/issa/ http://www.ihs.gov/ http://www.ihs.gov/ http://www.ihs.gov/adminmggrresouces http://www.ihs.gov/adminmggrresouces http://www.ihs.gov/adminmggresources

Technical Point of Contact: Dr. Ernest Gray, Physician, (406) 338-6404.

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

4.8. Cultural Awareness: Realization and respect for American Indian and Alaska Native practices.

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

4.10. 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.

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

4.12. 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.

4.13. 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.

4.14. Health Insurance Portability and Accountability Act (HIPPA): a US law designated to provide privacy standards to protect patients’ medical records and other health information provided to health plans, doctors, hospitals and other health care providers.

4.15. Health Station: A facility physically separated from a hospital, with a wide 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.

4.16. Non-personal Services Contract: A contract under which the personnel rendering the services are not subject, either by the contract’s terms 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.

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

4.18. 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.

4.19. Orientation: An activity designed to provide basic familiarization of the facility and transition the Contractor Physician into the IHS Service Unit and/or Health Center and the department where the services will be provided.

4.20. 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.

4.21. Patient Outcome: End result of Medical Provider care.

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

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

4.24. Service Unit: The local administrative unit of IHS.

4.25. Standards of Practice and Standards of Care: Authoritative statements by which the Medical provider profession describes the responsibilities for which its practitioners are accountable.

The standards provide direction for Medical provider practice and a framework for the evaluation of practice. The standards of Medical provider practice may pertain to general or specialty practice.

4.26. Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activity’s 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 activity’s task order number.

4.27. Tour of Duty: The time of day the physician is scheduled to perform medical service duties;

to include thirty minutes to one hour lunch as scheduled for Internal Medicine or Family

Practice.

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

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

5.0 Government Furnished Information, Property and Services:

5.1. 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.

5.2. Joint Use by the Government and the Contractor: Except for the property and service listed in

5.3 and 6.0, 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.

(a) Each Contract Provider shall be granted access to RPMS and EHR systems for electronic documentation of patient care services.

5.3. Contractor Exclusive Use:

(a) 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.

(b) 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.

5.4. 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 medical provider services or includes mandates made by the IHS Service Units/Health

Centers while the candidates are working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

6.0 Contractor Furnished Property:

6.1. 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:

6.1.1. 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 the IHS facility.

6.1.2. Other personal medical instruments: “Other personal medical instruments” are defined as Contractor owned items and may include but not is 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, SCN or TPOC prior to use by the Contractor. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

7.0 Performance-Based Requirements: The Contractor shall provide professional medical providers for the delivery of patient care through performance of provider duties and management of patient’s needs as described in the PWS to the Billings Area Indian Health Service hospitals, clinics and health stations.

Contractor Candidates shall comply with IHS facility policies, procedures, protocols and Standards of Care.

The care shall be in compliance with Joint Commission on Accreditation of Healthcare Organizations

(JCAHO) and Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, and Emergency

Medical Treatment & Labor Act (EMTALA) regulations. The Contractor shall be able to provide qualified candidates in the following areas:

(a) OB/GYN - 1 FTE

(b) NURSE MIDWIFE - 1 FTE

(c) PEDIATRIC NURSE PRACTITIONER - 1 FTE

(d) FAMILY PRATICE PHYSICIAN - 2 FTE

(e) HOSPITALIST PHYSICIAN - 2 FTE

(f) ER PHYSICIAN - 3 FTE

(g) ER NURSE PRACTITIONER - 1 FTE

(h) OUTPATIENT MID-LEVELS - NP/PA - 3 FTE

7.2. The contractor shall provide Medical Provider services in direct patient care.

7.3. The Contractor shall ensure 100% percent of all documentation meets established IHS Medical

Facility, Joint Commission, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

7.4. The Contractor Candidate shall perform in accordance with the competency standards listed in

Section 27, Exhibits. Specific tasks include the following. The Contractor Candidate shall:

(a) Provide full range of emergency care to patients of all age ranges.

(b) Exercise Knowledge of the medical provider procedures and its application to clinical practices in order to provide individualized, goal oriented medical provider care to the pediatric and adult patient.

(c) Exercise knowledge of scientific and psychosocial medical provider theory, principles, practices, and techniques in order to plan and provide quality medical care which meets the physical, spiritual, and social-cultural needs of the Native

American/Alaskan Native patient.

(d) Exercise knowledge of biological aspects of disease processes and illness in order to recognize complications and implement appropriate therapeutic intervention required.

(e) Exercise knowledge of the medications and dosages in order to recognize their desired effects, side effects, and complications of their use.

(f) Exercise knowledge of childhood immunizations, vaccines and up to date patient education resources and information.

(g) Analyze the results of various medical procedures and translate them into appropriate medical interventions.

(h) Work effectively and harmoniously within the health care teams and with Native

American/Alaskan Native patients and their families.

(i) Provide Inter-Facility transports when needed and supported by schedule requirements.

(j) Follow facility policies and procedures, JACHO, OSHA, I.H.S. and other federal licensing, accreditations, and regulating body standards.

(k) Coordinate care teams, offer guidance, and support to team members.

(l) Teach and offer appropriate health education to staff, patients, and customer owners.

(m) Perform clinical procedures, intravenous access, and phlebotomy, point of care laboratory testing, IVIG infusions, EKG, SVN Respiratory Treatments and response to emergency codes.

(n) Be competent to meet EMTALA requirements for the performance of a medical screening exam, patient stabilization, medical record documentation with date and time recorded for all orders and services, and patient transfer internally or externally, as appropriate. Stabilization of the patient may require that a patient be observed for the effects of treatments and medication effects, as well as, the repeated laboratory tests to assure patient improvement.

(o) Examine and diagnose the health related conditions of individuals requesting care, refer individuals for consultation when appropriate, prescribe and carry out, or directs others in carrying out, appropriate therapy in conformance with approved clinical privileges, educate individuals in the nature of health related conditions, recommended therapies and in the general promotion of health and prevention of disease. Services shall be inclusive of, but not limited to, examination, diagnosis, prognosis, treatment plan, follow up and consultation of all patients presenting for care.

(p) Record patient-provider transactions in the problem oriented medical record format and complete required data collection instruments, EHR templates, referrals and medical records as required. Failure to complete records or document care is not acceptable.

(q) The non-surgical Contract Provider shall be available to assist in emergency surgery cases as first assistant, if appropriate. The Contract Provider shall be available to attend deliveries and to provide resuscitation and support care to the newborn after delivery, if appropriate.

7.4. The Contractor Physician shall be subject to peer review per Joint Commission standards.

7.5. The Contractor Provider shall adhere to local Bylaws, Medical Staff Rules and Regulations, IHS Policy or ethics. Professional review Action may be taken if any demeanor or conduct of the Provider is detrimental to patient care, disruptive to Service Unit operation, or in violation of the local Bylaws, Medical Staff Rules and Regulations, IHS Policy or ethics. Each incident will be evaluated and documented. Documentation will be submitted to the Contractor by the COR or the Contracting

Officer. These incidents may be grounds for immediate removal of the Physician. The final decision is at the discretion of the Clinical Director and Chief Executive Officer (CEO). Disciplinary actions giving rise to a hearing or appeals will be in accordance with the local Medical Staff Rules and

Regulations.

7.6. The Contractor Physician shall meet the Safety management reporting requirements in accordance with the Service Unit Safety Measure Policy.

7.7. The Contractor Physician shall maintain Medical Staff clinical privileges as granted by the facility

Governing Body or Service Unit Credentials Committee.

7.8. The Contractor Physician shall not perform medical services until professional staff membership and the Billings Indian Health Service Governing Body has granted clinical privileges in writing.

7.9. The Contractor Physicians regular work duties may include the clinical supervision of mid-levels (IHS and locums mid-levels), students and residents.

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

8.1. The Government reserves the right to remove from the facility any Contractor employee failing to abide with the Federal Code of Conduct.

8.2. A Contractor Provider demonstrating impaired judgment will not be allowed to continue working on the contract. The Government reserves the right to remove from the facility any Contractor Provider whom in the judgment of a licensed healthcare practitioner is impaired.

9.0 Work Schedule: The Medical Staff Program Assistant at the IHS facility will determine specific tour of duty for each Contractor Physician within the scope of the task order. Contractor Physician shall work in accordance with the tour of duty as scheduled to meet the patient care needs of the Service Unit facility.

The Contractor Physician will be scheduled for lunch breaks of thirty minutes to one hour as assigned and/or rotated, based upon department scheduling.

9.1. Overtime, Holiday, Call-Back and On-Call hours shall be performed as agreed upon by the SCN and

Contractor Physician and within the limits of the task order. Overtime hours will be scheduled where there are departmental coverage gaps, to ensure adequate staffing for patient care.

9.2. The Contractor Physician shall provide notice of unavailability to their employer (The Contractor) and the Medical Staff Program Assistant or designee prior to any absence from work. The Contractor

Physician shall provide notification at least fifteen (15) days in advance of a desired absence if the length of the absence exceeds eight (8) work hours. Verifiable emergencies are the only exception to the advanced notification requirements.

9.3. The Contractor shall provide a qualified replacement Physician for any absence of more than 8 work hours.

9.4. All Contractor Physicians shall complete the credentialing and clearance requirements at the appropriate level before reporting for work.

9.5. Work assignments will be defined by the Department Supervisor (or designee) to include shifts within the hours of operation of the facility. The Contractor Physicians shall work no more than seven (7) consecutive 12-hour shifts if assigned to the Emergency Department or not more than four

(4) consecutive 16-hour shifts if assigned.

9.6. The Contractor Provider shall be available for the following schedule possibilities. The selected shift will be coordinated by the requesting Program when contacting the Contractor for candidates.

(a) 8-hour Clinic Shift

(b) 10-hour Clinic Shift

(c) 12-hour Emergency Department Shift

(d) 16-hour Emergency Department Shift

(e) 24-hour On-Call Shift

(f) Call Back (OB/GYN)

10.0 Deliverables

10.1. Monthly Data Report: The contractor shall provide a monthly data report that identifies the task order, Contract Line Item Number (CLIN), Contractor Physician name, dates of service, quantity of hours worked, and hourly rate. The Contractor shall provide a summary of task order hours authorized, hours worked, balance of hours remaining, estimated monthly invoice amount, and estimated balance of funds remaining.

10.2. The Contractor shall notify the Contractor Officer and the COR via email when 75% of the authorized hours or 75% of the obligated funding has been expended.

11.0 Contractor Physician Qualification Requirements: The Contractor physicians shall be board certified, or demonstrate competency by residency completion, years of experience and/or current work assignments. The Contractor mid-level provider shall be board certified by their appropriate board and have experience in the setting they are being assigned (Clinic or Emergency Department). The physicians shall be currently licensed and fully credentialed at the Indian Health Service Hospital at

Browning, Montana.

11.1. The Contractor Physician shall be privileged in accordance with Indian Health Service/Billings Area

Credentialing policy before performing any medical services. Therefore, compliance with the

Indian Health Service privileging requirements is essential in the performance of the contract. Any failure to adhere to IHS privileging requirements will constitute noncompliance with the contract requirements. The governing Body will not grant clinical privileges until it is determined that credentials have been verified. Exceptions to the HIS credentialing review and clinical privilege process will be considered only in the most dire of emergencies. Any contract physician who fails to maintain medical staff appointment and be promptly replaced by the Contractor. Candidates shall complete the entire formal credentialing/privileging process, including approval by the

Credentialing Committee and the Medical Staff, prior to beginning their scheduled tour. Adequate time must be permitted for this process, which is a minimum of 30 calendar days but may take as long as six (6) months.

11.2. Experience. The Contractor Physician shall have a minimum of twelve months (12) in the specialty required by the contract, unless otherwise approved by the Contracting Officer and selecting SCN.

(a) Experience shall equip the Contractor Physician with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the physician services category to be filled.

11.3. License/Registration. The Contractor Physician shall possess a current, valid, unrestricted medical provider license in a state, the District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States, throughout the term of this contract.

11.4. Motor Vehicle Operator’s License. The Contractor Physician shall possess a valid state driver’s license throughout the term of this contract.

11.5. Certifications. The Contractor Physicians shall possess current Basic Life Support (BLS), Advanced

Cardiovascular Life Support (ACLS) and Pediatric Advanced Life Support (PALS). Specifically, the following is required and evidence shall be provided:

(a) ER Providers (MD/DO) are required to have ACLS, ATLS and PALS certifications;

(b) NP-ER require ACLS, ATLS (attendance) and PALS certifications;

(c) PA-C ER require ACLS, ATLS (attendance if they are to assist with Trauma’s) and PALS certifications;

(d) OB/GYN require ACLS, PALS or NPR certifications;

(e) Pediatrician requires PALS and NRP certifications;

(f) Clinic Providers require PALS and BLS certifications;

(g) Nurse Practitioners require BLS certifications;

(h) Physician Assistants require BLS certifications;

(i) Psychiatrists/Psychologists require BLS certifications;

(j) All other providers who work in the clinic, Ward, or outpatient settings do not need to have ATLS certification as they will never manage a Trauma in the ER.

11.6. Degree or Diploma. The Contractor Physicians shall possess a degree or diploma from a professional medical program approved by the legally designated state accrediting agency at the time of the program was completed by the applicant.

11.7. Review of Qualifying Factors. The Supervisory Physician at the onboarding IHS facility, or their designee, will review all required documentation, conduct candidate interview, and reference checks for each Contractor Physician, to ensure verification and compliance prior to proceeding with background check/clearance process.

12.0 Background Checks / Clearance: As directed by the Contracting Officer, the Contractor Physician shall provide all requested information necessary to perform background checks. The Contractor

Physician shall comply with the requirement to obtain security investigations. The Contractor

Physician 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 Physician and forwarded to the Government personnel. IHS will immediately remove a Contractor from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known. A full investigation is required for personnel working 120 days or more in a covered position. A provisional investigation (fingerprint check only) is required for personnel working less than 120 days in a covered position.

12.1. Clearance: Upon presentation of a Candidate, the contractor shall provide the following \ information:

(a) Full Name

(b) Date of Birth

(c) Social Security Number (in accordance with policies regarding personally identifiable information)

(d) Contact Phone Number and Email Address

(e) Curriculum Vitae, include any previous IHS Tribal or Urban sites

(f) Release of information for signed by the Candidate

12.2. Credentialing: In accordance with the Indian Health Service credentialing policy, the

Contractor shall complete a primary source verification for each primary care physician performing.

At least five (5) business days prior to the first day of assignment at the Blackfeet Service Unit, the

Service Unit must receive the candidate’s completed credentialing packet. The standards of medical practice and duties of the Contractor through its physicians shall be determined pursuant to

Governing Body bylaws, medical staff bylaws, rules, and regulations of the Blackfeet Indian Health

Hospital, applicable provisions of law including, but not limited to, Centers for Medicare and

Medicaid Services (CMS) compliance, rules and regulations of any and all governmental authorities related to licensure and regulation of physicians and hospitals, and standards and recommendations of the Joint Commission (JC).

13.0 Health Requirements/Conditions of Employment:

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

13.2. Immunization: The Contractor Physician shall provide the documentation of the following:

A. Hepatitis A – 2 dose series at 0 and 6 months.

B. 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.

C. Measles, Mumps, Rubella (MMR) – 2 doses or titer documentation.

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

E. Tetanus, diphtheria, pertussis (Tdap/Td) – 1 dose of Tdap, then tetanus (Td) booster every 10 years thereafter.

F. Meningococcal – Two vaccines (MenACWY and MenB) recommended for microbiologists routinely exposed to N. meningitides.

G. Documentation of annual TB test – may include Mantoux TB skin test (PPD). Acceptable lab testing: Quantiferon Gold or T-Spot test. For positive TB test results, please submit a copy of recent chest x-ray results.

H. Influenza – MANDATORY annual vaccination.

I. Highly encourage COVID vaccination.

14.0 Transportation and Lodging: The Contractor shall be responsible for all applicable Federal, State, and

Local Taxes, Meals, Travel/Transportation. Lodging is available but must be paid for by the Contractor or Contractor Physician. 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. Government

Housing may be available for those who take Call, such as OB/GYN, and is dependent on housing vacancies.

15.0 Performance Evaluation:

15.1. The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 26.0.

15.2. 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.

16.0 Identification of Contractor: The Contractor Physician shall wear a government issued contractor identification badge during performance of duty.

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

17.1. The Contractor Physician shall ensure adherence to Department of Health and Human Services

(DHHS) IT system security policies and procedures. The IT policies and procedures will made available to the Contractor Physician upon request.

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

18.0 IHS Information Technology Systems: The Contractor Physician shall possess basic knowledge, skills, and abilities to use a computer.

18.1. The Contractor Physician shall adapt to and successfully utilize IHS information technology systems that are deemed by the SCN as necessary for acceptable contractor performance.

18.2. The Contractor Physician 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.

19.0 Orientation: The Contractor Physician providing service under this contract shall attend mandatory orientations and training specified by the IHS, the Service Unit or the SCN.

20.0 Language Requirements and Cultural Awareness: The Contractor Physician 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.

21.0 Challenges to Conflicts: The Contractor Physician shall maintain an appropriate professional demeanor in the presence of patients and with each other. Harmony and good communication between the staff is necessary to maintain the best patient care environment and all staff members are expected to contribute to a positive milieu. Violent language, profanity, and any threatening behaviors are specifically prohibited.

22.0 Place of Performance: Services shall be performed at the Blackfeet Hospital, Browning, Montana.

23.0 Period of Performance: Will include a base ordering period of twelve months (12) plus three (3) one-year option periods. Task orders will be issued with specified periods of performance.

BASE ORDERING PERIOD: 11/1/2022 – 10/31/2023

OPTION PERIOD 1: 11/1/2023 – 10/31/2024

OPTION PERIOD 2: 11/1/2024 – 10/31/2025

OPTION PERIOD 3: 11/1/2025 – 10/31/2026

24.0 Task Order Period of Performance: The period of performance for each order placed under this contract shall be specified in the individual order. No order may exceed eighteen (18) months, inclusive of options, from the date that the order is placed. Orders issued within the ordering period may not extend past the time period found in paragraph (d) of clause 52.216-22 of this contract. The terms and conditions of the basic contract remain valid and in full force and effect for the performance of any order issued prior to the ordering period expiration.

25.0 Technical Point of Contact: Dr. Ernest Gray, Physician, (406) 338-6404.

26.0 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

Medical Provider services in the delivery of patient care to the Billings Area

Indian Health Service.

Competency

Compliance

Quality

Patient Outcomes

Professionalism

Documentation

Maintain 100% of the required competencies (refer to Sections 11.3, 11.5)

100% compliance with IHS Service Units and/or Health Centers published Policies; Procedures; Standards of Care;

and hospital Protocols.

Perform 100% of the required tasks (refer to Section 7.0) during scheduled tour of duty (refer to Section 9.0)

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 at 100% adherence to the Code of Medical Ethics and Federal Code of Conduct.

100% percent of all documentation meets established IHS Medical Facility, Joint Commission, and Centers for Medicare and Medicaid Services (CMS) standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

See QASP. Surveillance systems will include direct observation, periodic inspections, validated customer complaints, random sampling, and verification of documentation provided by the contractor.

Payment of contract price for satisfactory service.

Contractor performance will be evaluated using the Contractors Performance Assessment Report (CPAR). The evaluation will be considered when future IHS Contract selections are made.

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

27.1. Exhibits

A - Quality Assurance Surveillance Plan (QASP)

B - Contract Data Requirements List (CDRL) DD Form 1423

27.2. Attachments

27.2.1. Witten Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

c. Age Specific Competency Verification

d. Intravenous Therapy Exam

e. Venipuncture Procedure Skills competency Verification

f. Pain Management Competency Verification

g. Restraints

h. Soft Restraint Application Competency Verification

i. Hard Leather Restraint Application

27.2.2. Contract Physician Orientation Check List

27.2.3. Contract Physician Orientation Competency Verification Instructions

27.2.4. Contract Physician Billing Information

27.2.5. Standard Emergency Codes

27.2.6. Confidentiality: Legal and Ethical Concerns in Healthcare

27.2.7. EMTALA – Emergency Medical Treatment and Labor Act

27.2.8. What are Age‐Specific Competencies?

27.2.9. An Introduction to the Native American Culture

27.2.10. Verbal and Telephone Orders

27.2.11. Medication Administration

27.2.12. Pain Management

27.2.13. Latex Allergy

27.2.14. Focus Charting

27.2.15. Patient Restraints

27.2.16. Charge Physician Duties: Responsibility and Expectation

27.2.17. Immunization documentation

27.2.18. Required certification documentation