TAB 3- PWS.pdf

PWS No.: CPSU-ED April 14, 2025

Crownpoint Service Unit Performance Base Work Statement (PBWS)

For Personal Services

REGISTERED NURSING SERVICE — EMERGENCY DEPARTMENT

Table of Contents

Section Page

1.0 General 1-4

2.0 Definitions 4-7

3.0 Government Furnished Information, Property, & Services 7-9

4.0 Contractor Furnished Property 9-10

5.0 Performance Based Requirements 10-14

6.0 Contractor Qualification Requirements 14-15

7.0 Federal Tort Claims 15

8.0 Challenge of Conflict 15

9.0 52.249-12 Termination (Personal Services) (Apr. 1984): 15

10.0 Technical Direction 15- 16

11.0 Health Requirement/Condition of Employees 16

12.0 Language Requirement and Cultural Awareness 17

13.0 Privacy Act Notification 17-20

14.0 List of Attachments and Exhibits 21-22

REGISTERED NURSING SERVICE — EMERGENCY DEPARTMENT

1.0 General: This performance base work statement describes the requirements for a Personal Service

Contract— Registered Nursing 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.

There is a nationwide shortage of nurses which is amplified by the remote and rural areas served by the Indian Health Service. The nursing vacancy rate within IHS has been consistently at 32%. These vacancies are being filled through the use of contracts.

1.2 Scope: The Contractor shall provide nursing services for the Navajo Area Indian

Health Service (NAIHS) in accordance with section 5.0, performance base requirements.

1.2.1. Duties and responsibilities will encompass outpatient, inpatient and community health nursing services to all patients.

1.2.2 Place of Performance: Services will be performed at various NAIHS facilities

(Service Units, Health Centers) located throughout the State of Arizona, New

Mexico and Utah. The NAIHS administers health centers, and hospitals, providing health care to approximately 201,583 members of the Navajo Nation. The Navajo

Nation is the largest Indian tribe in the United States and has the largest reservation, which encompasses more than 25,516 square miles in northern

Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico. The NAIHS is the primary provider of inpatient, ambulatory care, preventive and community health, and environmental health services for members of the Navajo Nation and the San Juan Southern

Paiute Tribe.

1.2.3 Point of Contact: The Contractor shall provide a point of contact that will be responsible for the performance of the work. This individual shall have full authority to act for the Contractor on all matters relating to the daily operation of the contract. The point of contract may be a provider providing care in accordance with this Performance Base Work Statement. The Contractor shall designate this individual in writing to the Contracting Officer (CO) before the contract start date.

An alternate may be designated, but the Contractor shall identify those times when the alternate shall be the primary point of contact.

1.2.4 Availability: The point of contact shall be available via telephone 24 hours a day, seven days a week including federal holidays.

1.2.5 Arrange for Replacement Staff: The Contractor shall arrange for pre-credentialed replacement staff when their health care provider(s) is unable to provide services for one (1) or more consecutive scheduled shifts.

1.2.6 Work Roster: The point of contact shall provide a list by date, time, and individual nurse’s name for those days the contractor shall be providing services. The work roster shall be provided to the Project Officer by the 20th of each month of the preceding month. Any proposed work schedule changes shall be submitted to the

Project Officer at least 48 hours in advance.

1.2.7 Continuity of Services: The Contractor shall ensure that qualified backup nurses are available to provide coverage during scheduled and unscheduled absences to primary contract providers. Absences without backup coverage will be subject to deduction in accordance with FAR Part 52-212-4(a)

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

1.3.1 The Joint Commission on Accreditation of Healthcare Organizations. The Joint Commission (TiC) http://www.iointcommission.org

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

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

1.3.4 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

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

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

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

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

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

1.3.8 Revised American Nurses Association Code of Ethics and Standards of Practice and Care (1996) http://www.nursingworld.org

1.3.9 State Nurse Practice Act for the Contractor’s licensing state. http://medi -smart.com/practice. htm

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

1.3.11 Location Map (attached)

1.3.12 Sample Task Order (attached)

1.3.13 Customer Evaluation Form (attached)

1.3.14 Computer Security Act of 1980

http://www.ihs.gov/adminmggrresouces/computersecurityact

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

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

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

1.3.18 Nurse License Look up http://www.nursys.com

2.0 Definitions

2.1. 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.

2.2. 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.

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

Each Area Office may administer several Service Units.

2.4. Code of Ethics: The Revised American Nurses Association Code of Ethics and Standards of Practice and Care, published in 1996 by the American Nurses Association which makes explicit primary goals, values and obligations of the nursing profession.

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

2.6. Contractor: The individual awarded a legal binding contract to provide supplies and services.

2.7. Contracting Officer’s Representative (COR) or Project Officer (PC): 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 P0 Project Officer).

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

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

2.10. Customer: Patients, staff and visitors of an NAIHS service unit and NAIHS health center.

2.11. Customer Evaluation: Written comments made to the Contracting Officer regarding the

Contractors performance. This is one of the criteria used to evaluate the Contractor’s performance.

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

2.13. 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.

2.14. Government Vehicle: A NAIHS owned motor vehicle or a vehicle leased by NAIHS through agreements with the General Services Administration (GSA) or through commercial rental agreements.

2.15. Pueblo Pintado Health Clinic & Thoreau Health Station, (THS): A facility physically separated from a hospital, with a full range of ambulatory services including at least primary care physicians, nursing, and laboratory, and x-ray which are available at least 40 hours a week for outpatient care.

2.16. 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.

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

2.18. Ordering Activity Contracting Officer: A Government employee of NAIHS 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.

2.19. Orientation: An activity designed to provide basic familiarization of the facility and transition the nurse into the NAIHS Service Unit and/or Health Station and the nursing unit where the services will be provided.

2.20. 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.

2.21. Patient Outcome: End result of nursing care.

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

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

2.24. Quality Assurance Surveillance Plan (QASP): Service Unit: Written document prepared and used by the government for Quality Assurance surveillance of the contractor’s performance.

2.25. Quality Control Plan (QCP): Those actions taken by the Contractor to control the quality of services provided. The Contractor’s QCP must be equivalent to the Government’s Quality Assurance Plan.

2.26. Standards of Practice and Standards of Care: Authoritative statements by which the nursing profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for professional nursing practice and a framework for the evaluation of practice. The standards of professional nursing practice may pertain to general or specialty practice.

2.27. Supervisor: Government employee authorized to provide verbal and written performance direction to the Contractor that the Contractor must follow without exception.

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

2.29. Technical Direction: A directive to the Contractor that approves approaches, solutions, designs, or refinements; fills in details or otherwise completes the general description of work or documentation items; shifts emphasis among work areas or tasks; or furnishes similar instruction to the Contractor. Technical direction includes requiring studies and pursuit of certain lines of inquiry regarding matters within the general tasks and requirements in Section 5 of this contract.

2.30. Tour of Duty: The time of day the nurse is scheduled to perform nursing care duties; also considered the shift of the day. The time can vary according to the needs of each NAIHS facility and/or clinic, e.g. 11.5 hour Tour of Duty, with one shift at 11 hour Tour of Duty totaling 80 hours every two weeks. There may be a mid-shift scheduled from 1100 to 2330 or 1500 to 0330.

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

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

3.0 Government Furnished Information, Property and Services

3.1. 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.

3.2 Joint Use by the Government and the Contractor: Except for the property and service listed in 3.3 and 4.0, 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.

3.2.1 GSA Vehicle: If required by the position, authorization shall be in accordance with NAIHS Chapter 12, Section 13 Motor Vehicle Management. Contractors may ride in Government vehicle but not authorized to drive a Government vehicle.

3.2.2 Government Housing: No government housing is available, unless there is a vacancy. This will be determined by the Housing Committee

3.3 Contractor Exclusive Use:

3.3.1 Personal Protective Equipment (PPE): The Government will furnish the Contractor with appropriate PPL other than specified in paragraph 4 of the PBSOW.

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.

3.3.2 The Government will provide facility specific contractor identification badges for each contractor. A minimum fee of $5.00 will be charged for lost or destroyed badges.

3.4 Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., NAIHS 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 nursing services or includes mandates made by the NAIHS Service

Units/Health Centers while the nurse is working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

3.5 Supervisor: The contractor is subject to the supervision and direction of Dorothina

Francisco, Supervisory Nurse (SN) for Emergency Department or her designee, Fern Detsoi, SN, for this order.

3.5.1 Contracting Officer Representative (COR): James Tom, Health System Specialist is primarily responsible for monitoring the technical progress including surveillance and assessment of performance for this order.

3.5.2 Point of Contact (POC): Dorothina Francisco, Supervisory Nurse (SN) (505) 786-

3.6 Protection of Government Building, Equipment, and Vegetation: The Contractor shall use reasonable care to avoid damaging existing building, equipment, and vegetation on the

Government installation. If the Contractor’s failure to use reasonable care causes damage to any of this property, the Contractor shall replace or repair the damage at no expenses to the Government as the Contracting Officer directs. If the Contractor fails or refuses to make such repair or replacement, the Contractor shall be liable for the cost, which may be deducted from the contract price.

4.0 Contractor Furnished Property

4.1.1. 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:

4.1.2. 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 Chief Nurse Executive at each IHS facility.

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

4.1.4 Indemenification and Medical Liability Insurance:

(a) It is expressly agreed and understood that this is a personal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the professional aspects of the services rendered, including by example, the

Contractor’s professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The Contractor shall maintain during the term of this contract liability insurance issued by a responsible insurance carrier of not less than $1,000.000 per specialty per occurrence, $3,000.000 aggregate.

(b) An apparently successful offer or upon request by the Contractor Officer, shall furnish prior to contract award evidence of its insurability concerning the medical liability insurance required by paragraph (a) of the clause.

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PWS No : CPSU-ED April 14, 2025

(c) Liability insurance may be on either an occurrences basis or on a claims-made basis. If the policy is on a claims-made basis, an extended reporting endorsement (tail) for a period of less than 3 years after the end of the contract term must also be provide.

(d) Evidence of insurance documenting the required coverage for each health care provider who will perform under this contract shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on a claims-made basis and evidence of an extended reporting endorsement is not provided prior to the commencement of services, evidence of such 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 reporting endorsement is provided to the Contracting Officer.

(e) The policies evidencing required insurance shall also contain an endorsement to the effect that any cancellation or material change adversely affecting the

Government’s interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer. If, during the performance period of the contract the Contractor changes insurance providers, the Contractor must provide evidence that the Government will be indemnified to the limits specified in paragraph (a) of this clause, for the entire period of the contract, either under the new policy, or a combination of old and new policies.

(f) The Contractor shall insert the substance of this clause, including this paragraph (f), in all subcontracts under this contract for health care services and shall require such subcontractors to provide evidence of an maintain insurance in accordance with paragraph (a) of this clause. At least 5 days before the commencement of work by any subcontractor, the Contractor shall furnish to the Contracting Officer evidence of such insurance.

4.1.3 Housing/per diem/travel and other associated cost:

(a) Contractor shall be responsible for housing, per diem, travel and other associated cost for their employee. Government housing will be available

ONLY if there is a Vacancy.

5.0 Performance Based Requirements: The Contractor shall provide nursing services in the delivery of patient care to the NAIHS. A specific task includes the following:

5.1 Nursing Duties:

5.1.1. The Contractor shall perform nursing duties and manage patient’s needs as described in the attached Position Description (PD) - identified by the Service Unit and as directed by the Supervisory Nurse.

5.1.2. The Contractor shall perform in accordance with the competency standards listed in Exhibits, paragraph 11.2.

5.1.3. The contractor shall provide professional nursing service in direct patient care as follows:

(a) Contractor shall provide full range of Emergency services to patients in the Emergency Department.

(b) Contractor shall exercise knowledge of the nursing process and its application to clinical practice in order to provide individualized, goal-orientated nursing care to the adult! pediatric patient.

(c) Contractor shall exercise knowledge of scientific and psychosocial nursing theory, principles, practices and techniques in order to plan and provide quality nursing care which meets the physical, spiritual, and social-cultural needs of the Indian patient.

(d) Contractor shall exercise knowledge of biological aspects of disease processes and illness in order to recognize complications and implement appropriate therapeutic interventions required.

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

(f) Contractor shall analyze the results of various medical procedures and translate them into appropriate nursing interventions.

(g) Contractor shall work effectively and harmoniously within the health care team and with Indian patients and their families.

(h) Inter-Facility Transports.

(i) Provide appropriate documentation regarding care rendered using Crownpoint Service Unit (CPSU) Electronic Health Record (EHR) & RPMS system. All documentation by the provider shall be entered electronically using the Electronic Health Record system. The provider is responsible for utilizing the EHR/RPMS system to obtain pertinent patient information in assisting care. It is the responsibility of the provider to use the training resources provided to develop competency in utilizing the Electronic Health Record system,RPMS.

(j) Follows facility policies and procedures, The Joint Commission (TJC), Occupational Safety and Health Administration (OSHA), Indian Health Services (IHS) and other federal licensing, accreditation and regulating body standards.

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

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

5.1.6 Contractor shall be responsible for all applicable Federal, State, And Local Taxes, Meals, Travel/Transportation. Lodging is provided but must be paid for by the contractor or contract agency. 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.

5.2 Work Schedule:

5.2.1. Work shift: The Supervisor at each NAIHS facility will provide technical direction on the specific tour of duty. The Contractor shall work 100% of the contracted hours.

5.2.2. Work Flexibility. As directed by the Supervisor, the Contractor shall rotate into other duty sections as needed to support patient care.

5.2.3. The Contractor shall obtain approval of the department Supervisor or designee prior to any absence from work. If the length of the absence exceeds eight (8) work hours the Contractor shall request approval at least fifteen (15) days, (the exception is verifiable emergencies) in advance of the desired absence.

5.2.4. Approval of leave is contingent upon availability of a qualified replacement.

5.2.5. The Contractor shall provide written documentation from a qualified health care provider for absences of three (3) or more consecutive days, due to illness, stating:

A. The cause of the current illness or incapacitation AND B. Indicating the Contractor as contagious or non-contagious.

The Government reserves the right to examine and or re-examine any Contractor who meets the criteria.

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

5.3.1. The contractor shall be subject to character investigation as required by Public Law 101-360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance of a contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eOJP) system and this shall include all fingerprinting procedures and clearances. The contractor shall provide all requested information necessary to perform Level I and Level II background checks. The contractor shall comply with the requirement to obtain security investigations. The contractor shall work with the I.H.S. 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 and forwarded to the government personnel. The contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

5.4. Performance Evaluation:

5.4.1. The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 11.0.

5.4.2. 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.

5.5. Identification of Contractor:

5.5.1. The Contractor shall wear a government issued contractor identification badge during performance of duty. PIV cards are issued after 6 months at Service Unit.

5.6. Management of Medical Information: The Contractor shall manage all patient information in accordance with HIPAA standards, Privacy Act, and NAIHS Service Unit and/or Health

Center specific policies and protocols.

5.6.1. The Contractor shall ensure adherence to DHHS IT system security policies and procedures. The IT policies and procedures will be made available to the

Contractor.

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

5.7. IHS Information Technology Systems:

5.7.1. In performance of this contract, the Contractor shall adapt to and successfully utilize IHS information technology systems that are deemed by the Supervisor as necessary for acceptable contractor performance.

5.7.2. The Contractor shall ensure that NAIHS information technology system security policies and procedures are adhered to. The IT policies and procedures will be made available to the Contractor at each NAIHS facility.

5.7.3. The Contractor shall follow all appropriate federal and locally required information Technology security requirements and will be operating under Health Insurance Portability and Accountability (HIPAA) and Privacy Act regulations.

5.7.4. Information Technology Skills. The Contractor shall possess basic knowledge, skills, and abilities to use a computer

6.0 Contractor Qualification Requirements:

6.1 Experience: The Contractor shall have thirty-six {36) months of nursing experience, with a minimum of two (2) years in the specialty required by the contract, unless otherwise approved by the Contracting Officer.

6.2 License/Registration: All nurses shall possess a current, valid, unrestricted nursing 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.

6.3 Motor Vehicle Operator’s License. If required by the position, the Contractor shall possess a valid state driver’s license throughout the term of this contract.

6.4 Certifications: Current Basic Life Support (BLS) is mandatory for all specialties.

Pediatric Advanced Life Support (PALS), Newborn Life Support (NLS), Advanced Trauma Care Nurse (ATCN) or Trauma Nurse Critical Care (TNCC), and Advanced Cardiac Life Support (ACLS) are required for each appropriate duty section at the time of selection for contract award. The contractor shall ensure that the contract nurse’s certifications remain valid throughout the term of this contract.

6.5 Orientation: All nurses providing service under this contract shall attend mandatory orientations and training specified by the government.

6.6 Background Checks: As directed by the Contracting Officer, the Contractor shall provide all requested information necessary to perform Level I and Level II background checks. The Contractor shall comply with the requirement to obtain security investigations. The Contractor shall work with the NAIHS 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 and forwarded to the Supervisor. The Contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

PWS No.: CPSU-ED AprH 14, 2025

An Agreement to a Temporary Waiver of character investigation form shall be signed and used pending completion of background investigation.

7.0 Federal Tort Claims Act (28 USC 1346 (B) l946)j FTCA is not extended to Non-Personal Service Contractors, refer to clause 52.237-7 Indemnification and Medical Liability Insurance.

8.0 Challenges to Conflicts: For any inconsistency between supervisor directions, this Performance Work Statement, attachments and exhibits, the following order of precedence will apply:

(a) First Priority: Supervisor’s directions

(b) Second Priority: Position Description (attached)

(c) Third Priority: Performance Work Statement Exhibits

(d) Fourth Priority: Performance Work Statement Narrative

9.0 52.249-12 Termination (Personal Services) (Apr 1984):

The Government may terminate this contract at any time upon at least 15 days’ written notice by the Contracting Officer to the Contractor. The Contractor, with the written consent of the Contracting Officer, may terminate this contract upon at least 15 days’ written notice to the Contracting Officer.

9.1. Any Contractor employee demonstrating impaired judgment shall not be allowed to continue working immediately on the contract. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

10.0 Technical Direction:

10.1 Performance of the work under this contract is subject to the written and verbal technical direction of the Nursing Supervisor.

10.2 The Nursing Supervisor does not have the authority to, and shall not, issue any instructions purporting to be technical direction that:

• Constitutes an assignment of additional work outside the performance work statement;

• Constitutes a change as defined in the changes;

• In any manner causes an increase or decrease in the total estimated contract cost, fixed fee (if any), or the time required for contract performance;

• Changes any of the expressed terms, conditions, or specifications of the contract;

or the terms and conditions of the contract.

10.3 All technical direction shall be issued in writing by the Nursing Supervisor. All verbal direction will be confirmed in writing within 24 hours (one business day). The

Contractor shall proceed promptly with the performance of technical direction duly issued by the Nursing Supervisor in the manner prescribed by this clause and within the authority. If, in the Contractor’s opinion, any instructions or direction by the Nursing Supervisor falls within any of the categories defined in paragraph above, the Contractor shall not proceed but shall notify the Contracting Officer in writing within 5 working days after receiving it and shall request the Contracting Officer to take action as described in this clause. Upon receiving this notification, the Contracting Officer shall either issue an appropriate contract modification within a reasonable time or advise the Contractor in writing that the instruction or direction is within the requirements of the contract and does not constitute a change under the changes clause of the contract and that the contractor shall proceed promptly with its performance.

10.4 A failure of the Contractor and Contracting Officer to agree that the instruction or direction is both rescinded in its entirety; or within the requirements of the contract and does not constitute a change under the changes clause, or a failure to agree upon the contract action to be taken with respect to the instruction or direction shall be subject to the Disputes clause of this contract.

10.5 Any action taken by the Contractor in response to any direction given by any person other than the Contracting Officer or the Nursing Supervisor shall be at the Contractor’s risk

11.0 Health Requirements/Conditions of Employment:

11.1 Medical Evaluation. The Contractor 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.

11.2 Immunization. The Contractor shall also provide the following documentation prior to RN Candidate selection: . Immunity to Rubella, Mumps, and Rubeota (Measles);

• Proof of Hep B vaccination x3 OR positive titer OR a signed declination of the Hep B vaccinations will also be accepted; • Documented history of chicken pox OR varicella vaccination x2 OR positive varicella titer; • History of Tdap vaccination, with subsequent Td vaccination if older than 10 years; • Documentation of Tuberculosis testing (TB skin test or IGRA) within the past 12 months with documentation of chest x-ray and follow-up for a positive history; 12 months with documentation of follow-up for a positive test. • Proof of influenza vaccination from October -1 thru March 31, per IHS Mandatory Influenza Vaccination Policy. Proof of Vaccination against SARS-COV-2, the virus that causes COVID 19

12.0 Language Requirements and Cultural Awareness.

The Contractor 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.

13.0 PRIVACY ACT NOTIFICATION (APR 1984)

The Contractor will be required to design, develop, or operate a system of records on individuals, to accomplish an agency function subject to the Privacy Act of 1974, Public Law 93-579, December 31, 1974(5 U.S.C. 552a) and applicable agency regulations.

Violation of the Act may involve the imposition of criminal penalties.

13.1 PRIVACY ACT (APR 1984)

(a) The Contractor agrees to—

(1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and regulations issued under the Act in the design, development, or operation of any system of records on individuals to accomplish an agency function when the contract specifically identifies—

(I) The systems of records; and

(ii) The design, development, or operation work that the contractor is to perform;

(2) Include the Privacy Act notification contained in this contract in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract requires the redesign, development, or operation of a system of records on individuals that is subject to the Act; and

(3) Include this clause, including this paragraph (3), in all subcontracts awarded under this contract which requires the design, development, or operation of such a system of records.

(b) In the event of violations of the Act, a civil action may be brought against the agency involved when the violation concerns the design, development, or operation of a system of records on individuals to accomplish an agency function, and criminal penalties may be imposed upon the officers or employees of the agency when the violation concerns the operation of a system of records on individuals to accomplish an agency function. For purposes of the Act, when the contract is for the operation of a system of records on individuals to accomplish an agency function, the Contractor is considered to be an employee of the agency.

(1) ‘Operation of a system of records,” as used in this clause, means performance of any of the activities associated with maintaining the system of records, including the collection, use, and dissemination of records.

(2) ‘Record,” as used in this clause, means any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and that contains the person’s name, or the identifying number, symbol, or other identifying particular assigned to the individual, such as a fingerprint or voiceprint or a photograph.

(3) “System of records on individuals,” as used in this clause, means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual.

13.2 Privacy or Security Safeguards (Aug 1996)

(a) The Contractor shall not publish or disclose in any manner, without the Contracting Officer’s written consent, the details of any safeguards either designed or developed by the Contractor under this contract or otherwise provided by the Government.

(b) To the extent required to carry out a program of inspection to safeguard against threats and hazards to the security, integrity, and confidentiality of Government data, the Contractor shall afford the Government access to the Contractor’s facilities, installations, technical capabilities, operations, documentation, records, and databases.

(c) If new or unanticipated threats or hazards are discovered by either the Government or the Contractor, or if existing safeguards have ceased to function, the discoverer shall immediately bring the situation to the attention of the other party.

13.3 Privacy Act (December 18, 2015)

This contract requires the Contractor to perform one or more of the following:

(a) design;

(b) develop; or (c) operate a Federal agency system of records to accomplish an agency function in accordance with the Privacy Act of 1974 (Act) (5 U.S.C.

552a(m)(1)) and applicable agency regulations. The term system of records means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual. Violations of the Act by the Contractor and/or its employees may result in the imposition of criminal penalties (5

U.S.C. 552a(i)). The Contractor shall ensure that each of its employees knows the prescribed rules of conduct in 45 CFR part 5b and that each employee is aware that he/she is subject to criminal penalties for violation of the Act to the same extent as Department of Health and Human Services employees. These provisions also apply to aN subcontracts the Contractor awards under this contract which require the design, development or operation of the designated system(s) of records (5 U.S.C.

552a(m)(1)). The contract work statement:

(a) Identifies the system(s) of records and the design, development, or operation work the Contractor is to perform; and

(b) Specifies the disposition to be made of such records upon completion of contract performance.

13.4 Confidential Information (December 18, 2015)

(a) Confidential Information, as used in this clause, means information or data of a personal nature about an individual, or proprietary information or data submitted by or pertaining to an institution or organization.

(b) Specific information or categories of information that the Government will furnish to the Contractor, or that the Contractor is expected to generate, which are confidential may be identified elsewhere in this contract. The Contracting Officer may modify this contract to identify Confidential Information from time to time during performance.

(c) Confidential Information or records shall not be disclosed by the Contractor until:

(1) Written advance notice of at least 45 days shall be provided to the Contracting Officer of the Contractor’s intent to release findings of studies or research, to which an agency response may be appropriate to protect the public interest or that of the agency.

(2) For information provided by or on behalf of the government,

(i) The publication or dissemination of the following types of information are restricted under this contract: P11.

(ii) The reason(s) for restricting the types of information identified in subparagraph

(i) is/are: protected under the Privacy Act and HIPAA.

(iii) Written advance notice of at least 45 days shall be provided to the Contracting Officer of the Contractor’s intent to disseminate or publish information identified in subparagraph (2)(i). The contractor shall not disseminate or publish such information without the written consent of the Contracting Officer.

(d) Whenever the Contractor is uncertain with regard to the confidentiality of or a property interest in information under this contract, the Contractor should consult with the Contracting Officer prior to any release, disclosure, dissemination, or publication.

13.5 Federal Indemnification

(a) Indemnification, Liability, Statute of Limitations: Any provisions in the TOS related to indemnification and filing deadlines are hereby waived, and shall not apply except to the extent expressly authorized by law. Liability for any breach of the TOS as modified by this Amendment, or any claim arising from the TOS as modified by this Amendment, shall be determined under the Federal Tort Claims Act, or other governing federal authority. Federal Statute of Limitations provisions shall apply to any breach or claim.

(b) Governing law: Any arbitration, mediation or similar dispute resolution provision in the TOS is hereby deleted. The TOS and this Amendment shall be governed by and interpreted and enforced in accordance with the laws of the United States of America without reference to conflict of laws. To the extent permitted by federal law, the laws of the State of [Company to insert name of state if one is mentioned in its TOS] (excluding [Company’s state] choice of law rules) will apply in the absence of applicable federal law

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

14.1.1. Attachments

1. Position Description (Service Unit specific)

14.1.2 Exhibits Applicable to the Navajo Area HIS

14.1.3. Written Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

c. Age Specific Competency Verification

d. RN Medication Administration Competency Examination

e. RN Medication Administration Competency Verification

f. Intravenous Therapy Exam

g. Venipuncture Procedure Skills competency Verification

h. Pain Management Competency Verification

i. Restraints

j. Soft Restraint Application Competency Verification

k. Hard Leather Restraint Application

14.1.4. Contract Nurse Orientation Check List

14.1.5. Contract Nurse Orientation Competency Verification Instructions

14.1.6. Contract Nurse Billing Information

14.1.7 Standard Emergency Codes

14.1.8. Confidentiality: Legal and Ethical Concerns in Healthcare

14.1.9 EMTALA — Emergency Medical Treatment and Labor Act

14.1.10. What is Age-Specific Competencies?

14.1.11 An Introduction to the Navajo Culture

14.1.12 Verbal and Telephone Orders

14.1.13. Medication Administration

14.1.14. Pain Management

14.1.15. Latex Allergy

14.1.16. Focus Charting

14.1.15. Patient Restraints

14.1.16. Charge Nurse Duties: Responsibility and Expectation

14.1.17. Nursing Standards

14.1.18. Standards of Nursing Practice