PWS FBSU EMS Services.pdf

BAO PWS/FBSU May 2025

Billings Area Performance Work Statement (PWS) for Non-Personal

Services

Emergency Medical Technician 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 - 7

5.0 Government Furnished Information, Property, & Services 7

6.0 Contractor Furnished Property 7-8

7.0 Performance-Based Requirements 8 - 10

8.0 Conduct 11

9.0 Work Schedule 11

10.0 Deliverables 11 - 12

11.0 Contractor Qualification Requirements 12

12.0 Credentialing 12

13.0 Background Check 12

14.0 Health Requirements/Conditions of Employment 12 - 13

15.0 Transportation and Lodging 13

16.0 Performance Evaluation 13

17.0 Identification of Contractor 13

18.0 Management of Medical Information 13

19.0 IHS Information Technology Systems 13 - 14

20.0 Orientation 14

21.0 Language Requirements and Cultural Awareness 14

22.0 Challenges to Conflicts 14

23.0 Technical Point of Contact 14

24.0 Performance based Matrix 15

25.0 List of Attachments and Exhibits 16

BAO PWS/FBSU September 16, 2024

Performance Work Statement (PWS) Non-Personal Services

Emergency Medical Technician Services

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

Emergency Medical Technician Services to support the mission of the Indian Health Service (IHS) at Fort Belknap Service Unit (FBSU), located at Harlem, MT and Hays, MT.

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 Fort Belknap Service Unit also provides Emergency Medical Services to the Fort Belknap Reservation communities, covering 1,014 square miles in north-central Montana. There is a nationwide shortage of emergency medical technicians which is amplified by the remote and rural areas served by the Indian Health Service. This performance work statement covers requirements for the Billings Area. The positions to be filled: Two (2) Full-Time-Equivalent (FTE) Emergency Medical Technician (Basic or Advanced EMT, Paramedic EMT).

1.2 Fort Belknap Service Unit provides support to the Fort Belknap Hospital and Eagle Child Clinic, providing pre-hospital Emergency Medical Services to the 1,014 square miles of the Fort Belknap reservation area as well as inter-facility patient transfers per Fort Belknap Hospital Emergency Department and following Montana EMT protocols.

2.0 Scope: The Contractor shall provide emergency medical services in accordance with Section 7.0, performance based requirements.

2.1 Duties and responsibilities consist of providing pre-hospital emergency medical services and inter-facility transfer emergency medical services to the level of Montana EMT license held (Basic EMT, AEMT, Paramedic) and based upon Montana EMT protocols and Fort Belknap IHS Hospital Emergency Department.

2.1.1. Place of Performance: Services shall be performed at the Fort Belknap IHS

Hospital in Harlem, MT, the Eagle Child Health Clinic in Hays, MT, and across the Fort Belknap Indian Reservation as well as across Montana and neighboring states for inter-facility transfers per the Fort Belknap Hospital Emergency Department.

2.1.2. Period of Performance: Will include a base ordering period of twelve months (12) plus four (4) one-year option periods. Estimated order periods listed below:

BASE ORDERING PERIOD: 8/25/2025–8/24/2026

OPTION PERIOD 1: 8/25/2026–8/24/2027

OPTION PERIOD 2: 8/25/2027–8/24/2028

OPTION PERIOD 3: 8/25/2028–8/24/2029

OPTION PERIOD 4: 8/25/2029–8/24/2030

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 Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaahc.org

3.6 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

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

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

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

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

3.9 Privacy Act of 1974. http://www.usdoj.gov/oip/privstat.htm

3.10 NAEMT Code of Ethics, Code of Ethics for EMS Practitioners.

https://www.naemt.org/about-ems/code-of-ethics (2013).

3.11 Montana EMT Scope of Practice (11-2017).

https://leg.mt.gov/content/Committees/Interim/2017-2018/Economic-Affairs/Meetings/Nov- 2017/EMT-scope-of-practice11-2017.pdf

3.12 Montana EMS Protocols. Montana Board of Medical Examiners, Montana Prehospital Treatment Protocols (version 11). 03/2019.

https://boards.bsd.dli.mt.gov/_docs/med/ecp/mt-protocol.pdf

3.13 Montana Inter-Facility Transport Guidelines. (02/2019).

https://boards.bsd.dli.mt.gov/_docs/med/transport-guidelines.pdf

3.14 Montana EMT License Application and Summary of Examination. (2022).

https://www.emt-national-training.com/montana-emt.php

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

3.16 Federal Computer Security Act of 1987.

https://www.congress.gov/100/statute/STATUTE-101/STATUTE-101-Pg1724.pdf

3.17 Information Systems Security Awareness (ISSA). https://www.ihs.gov/issa/ 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.aaahc.org/ 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 http://www.nicwa.org/policy/law/protection/index.asp http://www.cms.hhs.gov/hipaa http://www.usdoj.gov/oip/privstat.htm https://www.naemt.org/about-ems/code-of-ethics https://leg.mt.gov/content/Committees/Interim/2017-2018/Economic-Affairs/Meetings/Nov-2017/EMT-scope-of-practice11-2017.pdf https://leg.mt.gov/content/Committees/Interim/2017-2018/Economic-Affairs/Meetings/Nov-2017/EMT-scope-of-practice11-2017.pdf https://boards.bsd.dli.mt.gov/_docs/med/ecp/mt-protocol.pdf https://boards.bsd.dli.mt.gov/_docs/med/transport-guidelines.pdf https://www.emt-national-training.com/montana-emt.php https://www.congress.gov/100/statute/STATUTE-101/STATUTE-101-Pg1724.pdf https://www.ihs.gov/issa/

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

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

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

3.21 Montana Department of LABOR & Industry, License Search.

https://ebizws.mt.gov/PUBLICPORTAL/searchform?mylist=licenses

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. Code of Ethics: The Revised National Association of Emergency Medical Technicians Code of Ethics for EMS Practitioners.

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

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

4.7. 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 Director of Nursing (DON), designated Supervisory Clinic Nurse (SCN), 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. Technical Point of Contact: .

Eric C. Chenworth, D.O., Director of Clinical Services, FBSU, 406-353-3143.

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

http://www.ihs.gov/ http://www.ihs.gov/adminmggrresouces http://www.ihs.gov/adminmggresources https://ebizws.mt.gov/PUBLICPORTAL/searchform?mylist=licenses http://www.nursys.com/

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

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

4.11. 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.

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

4.13. 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.

4.14. 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.

4.15. Health Insurance Portability and Accountability Act (HIPAA): 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.

4.16. 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.

4.17. 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.

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

4.19. Ordering Activity Contracting Officer: A Government employee of IHS authorized and warranted to issue purchase orders and to make subsequent modification(s) under this contract. The Ordering Activity CO has the authority to make initial determinations on all matters of dispute regarding purchase orders.

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

4.21. 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.

4.22. Patient Outcome: End result of emergency medical care.

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

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

4.25. Purchase Order: An order issued in accordance with the terms 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, and the ordering activity’s contract number.

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

4.27. Scope of Practice: Authoritative statements by which the emergency medical technician profession describes the scope of work for various levels of emergency medical technician (Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT), and Paramedic).

4.28. Montana EMS Protocols: Montana EMS protocols, which list the required standard practice to provide direction for emergency medical services practice and a framework for the evaluation of practice. The Montana EMS Protocols may pertain to general or advanced EMT or Paramedic practice.

4.29. Tour of Duty: The time of day the EMS Provider is scheduled to perform emergency medical services duties; to include thirty minutes to one hour lunch as scheduled for Internal Medicine or Family Practice.

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

4.31. 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.

5.3. Contractor Exclusive Use:

5.3.1. 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.

5.3.2. The Government will provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 may 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 emergency medical services or includes mandates made by the IHS Service Units/Health Centers while the EMS provider is 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: Uniforms shall conform to the requirements of the Indian Health Service Manual, Part 3 Chapter 4 and meet the approval of the EMT Supervisor and Clinical Director at each 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 Emergency Medical

Technician (EMT) with a Montana EMT license (MT EMT, MT AEMT, MT EMT Paramedic) for the delivery of patient care through performance of emergency medical services and management of patient’s needs as described in the PWS and as identified by the Service Unit to the Billings Area Indian Health Service hospitals, clinics and health stations. Contractor EMS provider shall comply with IHS facility policies, procedures, protocols and Standards of Care.

7.1. The Contractor EMS provider shall perform in accordance with the competency standards listed in Section 25, Exhibits. The contractor shall provide prehospital emergency medical services and inter-facility transfer emergency medical services care for patients to the level of current Montana EMT license scope and according to Montana EMT protocols as well as local policy and procedure.

7.2. Ensure that 100% percent of all documentation meets established IHS Medical Facility, Montana EMS Documentation Standards, Joint Commission, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

7.3. The Contractor EMT shall perform all duties and departmental and equipment responsibilities of local permanent staff, including:

7.3.1. Respond on-site to accidents and other emergencies involving injury and illness, potentially encountering life-threatening situations. Provide full range of emergency medical care to patients of all age ranges.

7.3.1.1. Upon arrival at the scene, determines scene safety, makes an independent preliminary assessment of the patient’s condition and selects from a variety of approved basic and advanced protocols, the one which is considered appropriate under the given circumstances. Proceeds to provide basic and advanced treatment as prescribed within the protocol. Makes modifications to the protocol, if necessary and within prescribed limits. Conducts a complete advanced examination of the patient to determine the nature, extent, and seriousness of the patient’s condition, and searches for medical alert symbols.

Determines the appropriate way to facilitate the movement and transport of the patient, with due regard to the patient’s condition. Prioritizes treatments for the patient having multiple problems and employs a variety of established basic and advanced emergency medical techniques, methods, and equipment enroute to the medical facility. Recognizes the need for ancillary personnel;

directs all aspects of patient care and communication in the field for the Paramedic level and below. Provide care to patient’s during interfacility transports according to local protocols.

7.3.1.2. Attends patients during medical evacuation, ground or air in the field as well as at hospital, as available.

7.3.1.3. For environmental emergencies assesses the seriousness of a patient’s condition and provides basic and advanced treatment for heat/cold emergencies, drowning/near drowning, and falls, etc.

7.3.1.4. When treatment requires the administration of select pharmacology interventions via protocol, calculates the dosage required, prepares, administers (via IVP, IV infusion, IM, SQ, ET, PO, etc.), documents, and reports administration of the medication appropriately.

7.3.1.5. When extrication and packaging of victims, uses a variety of light rescue tools and equipment for removal of victims/patients, assists with moving, lifting, and carrying patients to transport vehicles. Supervises all patient extrication and packaging at the scene for emergency personnel with less training.

7.3.1.6. For communication uses radio, cellular, and satellite equipment while following FCC procedures to contact and communicate with other ancillary and emergency personnel, e.g., dispatch, ED personnel, ER Physician, and the transmitting of EKG information. Supervises all communication from the field and ensures all verbal reports of patient assessment and treatments administered are clear and concise.

7.3.1.7. Perform complete, accurate, timely, and thorough documentation of patient care/transport on all necessary forms written and electronic, including those necessary to facilitate the billing of services provided.

7.3.1.8. Operation of Emergency & Non-Emergency Patient Transport Vehicle:

Selects the most efficient route to and from the dispatched location, considers traffic patterns, health facility location, etc. Correctly uses emergency warning equipment available on the vehicle, adheres to protocols, traffic ordinances, and regulations pertaining to the operation of emergency and ono-emergency transport vehicles, safely transports patients to various destinations.

7.3.1.9. Maintenance and safety: Perform thorough safety and maintenance inspections on a daily basis, on emergency and non-emergency transport vehicles and a variety of medical equipment. Minor repairs to equipment are to be performed as necessary. Contract EMS personnel must attend a driver training course provided by Fort Belknap EMS during orientation and annually thereafter. Personnel must maintain a passing score and current certification at all times.

7.3.1.10. Operator Maintenance: Performs operator maintenance on vehicles and equipment, as required. Ensures vehicles are kept clean and in good operational condition. Vehicles are cleaned and decontaminated in accordance with local infection control procedures.

7.3.1.11. Restocking: After each trip, replaces used linens, blankets, and other supplies, sends any supplies and equipment for reserialization as required, and checks ambulance supplies and equipment to ensure the vehicle is ready for the next call. This shall include appropriate re-fueling, not to allow the fuel level fall below full on the fuel gauge.

7.3.1.12. Works in conjunction with physician and nursing staff to provide patient care up to, but not to exceed, the prehospital treatment protocol for EMT license level. Assist physician with a variety of examinations and procedures as requested and as allowed by scope of practice as well as local facility policy.

7.3.1.13. Diagnostic support duties: provides a range of diagnostic support duties, when necessary, to include answering telephone calls, assisting with patient registration, obtaining patient medical records, taking and documenting vital signs, triage, labeling, and transporting laboratory specimens.

7.3.1.14. Must obtain and maintain an unencumbered Montana license as EMT (Basic EMT, AEMT, EMT Paramedic).

7.3.2. Exercise Knowledge of EMS care and skills along with its application to prehospital emergency medical services as well as inter-facility transfers in order to provide individualized, goal-oriented emergency medical care based on Montana protocols and local facility policy and procedures for patients of all ages.

7.3.2.1. Demonstrates and extensive advanced knowledge of major body symptoms, i.e., skeletal, muscular, nervous, respiratory, circulatory, digestive, and genitourinary. Performs advanced level patient examinations and decides from basic and advanced treatments to provide prompt and appropriate patient care.

7.3.3. Exercise knowledge of scientific and psychosocial emergency medical theory, principles, practices, and techniques in order to plan and provide quality emergency medical care to meet the physical, spiritual, and social-cultural needs of the Native American/Alaskan Native patient.

7.3.4. Exercise knowledge of biological aspects of disease processes and illness in order to recognize complications and implement appropriate therapeutic intervention and communication based on state and local facility protocol.

7.3.5. If applicable (based on scope of practice for Montana EMT license), exercise knowledge of the medications and dosage in order to recognize their desired effects, side effects, and complications of their use.

7.3.6. Work effectively and harmoniously within the health care teams and with Native

American/Alaskan Native patients and their families.

7.3.7. Follow facility policies and procedures, JACHO, OSHA, I.H.S. and other federal and state licensing, accreditations, and regulating body standards.

7.3.8. Offer appropriate health education to staff, patients, family, and community members.

7.3. The Contractor EMS Provider shall be subject to supervisor and peer review per Joint Commission standards.

7.4. The Contractor EMS provider shall meet the Safety management reporting requirements in accordance with the Service Unit Safety Measure Policy.

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 EMS 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 EMS provider whom in the judgment of a licensed healthcare practitioner is impaired.

9.0 Work Schedule: The Supervisory Emergency Medical Technician (EMT) at the Fort Belknap Service

Unit will determine a specific tour of duty for each Contractor EMS provider within the scope of the purchase order. The Contractor EMS provider will be scheduled to work 12 hour shifts, typically followed by a 12 hour period of on-call status. Shifts may be day-shift (0700 – 1900), night shift (1900 – 0700), or a scheduled mid-day shift. The contractor will be scheduled for at least 36 hours during the first week and approximately 48 hours during week 2 of each 14 day scheduled tour of duty. Contractor EMS provider shall work in accordance with the tour of duty as scheduled to meet the patient care needs of the Service Unit facility. The Contractor EMS provider 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 EMS provider and within the limits of the purchase order. Overtime hours will be scheduled where there are departmental coverage gaps, to ensure adequate staffing for patient care.

9.2. The Contract EMS provider shall provide notice of unavailability to Contractor and the department SCN or designee prior to any absence from work. The Contractor EMS provider shall provide notification at least fifteen (15) days in advance of a desired absence if the length of the absence exceeds eight (12) work hours. Verifiable emergencies are the only exception to the advanced notification requirements.

9.3. The Contractor shall provide a qualified replacement EMS provider for any absence of more than 12 work hours.

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

10.0 Deliverables

10.1. Monthly Data Report: The contractor shall provide a monthly data report that identifies the purchase order, Contract Line Item Number (CLIN), Contractor EMT name, dates of service, quantity of hours worked, and hourly rate. The Contractor shall provide a summary of purchase 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 Emergency Medical Technician Qualification Requirements:

11.1. Experience. The Contractor EMS provider shall have twenty-four (24) months of emergency medical services experience, with a minimum of twelve months (12) paramedic experience, unless otherwise approved by the Contracting Officer and selecting SCN.

11.1.1. Experience shall equip the Contractor EMS provider 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 EMT services category to be filled.

11.2. License/Registration. The Contractor EMS provider shall possess a current, valid, unrestricted EMT license in the state of Montana, throughout the term of this contract.

Montana EMT licensing information can be found at https://boards.bsd.dli.mt.gov/_docs/med/ecp/ecp-app.pdf

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

11.4. Certifications. The Contractor EMS provider shall possess current Basic Life Support (BLS).

11.5. Degree or Diploma. The Contractor EMS provider shall possess a high school diploma or equivalent and completion of a course of ECP instructions.

12.0 Credentialing: EMS providers do need to complete the provider credentialing process.

13.0 Background Checks / Clearance: As directed by the Contracting Officer, the Contractor EMS provider shall provide all requested information necessary to perform background checks. The Contractor EMT shall comply with the requirement to obtain security investigations. The Contractor EMT 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 EMT 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.

14.0 Health Requirements/Conditions of Employment:

14.1. Medical Evaluation: The Contractor EMT 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.

https://boards.bsd.dli.mt.gov/_docs/med/ecp/ecp-app.pdf

14.2. Immunization: The Contractor EMT 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). All EMTs require the 2 step TST. 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.

15.0 Transportation and Lodging: The Contractor shall be responsible for all applicable Federal, State, and Local Taxes, Meals, Travel/Transportation. Lodging may be available but must be paid for by the Contractor or Contractor EMT. Government quarters may be 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.

16.0 Performance Evaluation:

16.1. The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 24.0.

16.2. 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.

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

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

18.1. The Contractor EMT 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 EMT upon request.

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

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

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

19.2. The Contractor EMT 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.

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

21.0 Language Requirements and Cultural Awareness: The Contractor EMT 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.

22.0 Challenges to Conflicts: The Contractor EMT 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.

23.0 Technical Point of Contact:

Eric C. Chenworth, D.O., Director of Clinical Services

Fort Belknap Service Unit Department of Health and Human Services/Indian Health Service 669 Agency Main Street Phone: (406) 353-3143.

24.0 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 emergency medical services in the delivery of patient care at the Fort Belknap Service Unit, of the Billings Area Indian Health Service.

Competency

Compliance

Quality

Patient Outcomes

Professionalism

Credentialing

Documentation

Maintain 100% of the required competencies (refer to Section 25.0)

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

and hospital and nursing 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 EMS Practitioners Code of Ethics and Federal Code of Conduct.

EMTs do need to complete the provider credentialing process.

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 System (CPARS). The evaluation will be considered when future IHS Contract selections are made.

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

25.1. Exhibits

A - Quality Assurance Surveillance Plan (QASP) B - Contract Data Requirements List (CDRL) DD Form 1423

25.2. Attachments

25.2.1. Witten Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

c. Montana EMT protocols for prehospital & inter-facility transfers.

d. Medication & Intravenous Administration Competency Verification, as applicable.

f. Venipuncture Procedure Skills competency Verification

h. Pain Management Competency Verification

i. Restraints, as applicable

25.2.2. Contract EMT Orientation Check List

25.2.3. Contract EMT Orientation Competency Verification Instructions

25.2.4. Contract EMT Billing Information

25.2.5. Standard Emergency Codes

25.2.6. Confidentiality: Legal and Ethical Concerns in Healthcare

25.2.7. EMTALA – Emergency Medical Treatment and Labor Act

25.2.8. What are Age-Specific Competencies?

25.2.9. An Introduction to the Native American Culture

25.2.10. Medication Administration, if applicable by EMT scope of practice

25.2.11. Pain Management

25.2.12. Latex Allergy

25.3. Focus Charting

25.4. Patient Restraints

25.5. Required certification documentation