A05 - SOW.docx

Statement of Work (SOW)

1. PROJECT TITLE: Women’s Health Services at the Northern Cheyenne Service Unit (NCSU) Lame Deer, MT.

2. BACKGROUND/PURPOSE: The Northern Cheyenne Service Unit is an ambulatory healthcare facility with a 24/7 urgent care department. We are located in southeastern Montana, 104 miles away from the nearest urban city (Billings, MT). The outpatient department provides services to an average of 150 patients per day, many of which are for Women’s Health services. The volume and complexity of prenatal and women’s health issues exceeds the capacity of our current staff. In an effort to provide our patients with the most comprehensive and timely access to care for these issues we utilize the services of a Certified Nurse Midwife group, mid-level providers or OB providers. This allows our patients, and more specifically our highest risk females, to access the specialty services they require without having to travel to Billings, MT. The purpose of this contract is to continue these specialty services to ensure our patients continue to receive the best care possible.

3. SCOPE: The overall scope of this contract is to establish a Certified Nurse Midwife (CNM) group, mid-level provider or OB provider consisting of at least two Womens Health/prenatal personnel to provide direct patient care services at the Northern Cheyenne Service Unit in Lame Deer, MT. In addition to the onsite services the contracted provider shall have the ability to consult/co-manage with an OBGYN or Maternal Fetal Medicine as needed to ensure comprehensive care for high risk patients.

4. APPLICABLE DOCUMENTS: Guidelines available include Public Health Service (PHS), Indian Health Service, Billings Area, Service Unit, and Medical Staff regulations, policies, procedures, and by-laws. In addition, traditional and currently accepted medical practices are available in the form of specialty consultation, medical journals, and textbooks. In nearly all cases, however, the providers judgment is the key factor in determining whether guidelines are to be adhered to or deviated or whether guidelines need to be developed to protect the interests of the patient.

5. SPECIFIC TASKS: The contracted provider shall:

a. Provide healthcare, counseling and education for families of childbearing years, women from menarche through menopause, for women with gynecological problems and also for normal neonates.

b. Performs and/or reviews health histories and performs assessment of the woman during antepartum, intrapartum, and postpartum.

c. Identifies indicators of risk in pregnancy and performs appropriate interventions.

d. Performs routine laboratory, radiology, screening and therapeutic procedures.

e. Implements the plan of care within prescribed interventions and procedures as appropriate.

f. Prescribes appropriate medications and instructs patients effectively in their use during antepartum, intrapartum and postpartum.

g. Refers individuals for consultation when appropriate; prescribes and carries out therapy in conformance with approved clinical privileges and Billings Area/IHS policy.

h. Educates individuals in the nature of health related conditions, recommended therapy, and the general promotion of health and prevention of illness/disease.

i. Conducts initial and periodic health examinations related to women’s health for finding physical defects in need of correction, and prescribes and implements remedial treatments required to correct these defects.

j. Administers immunizations to patients in compliance with established IHS and Billings Area policy.

k. Makes necessary arrangements and authorizes admission of patients to the appropriate hospital. This includes authorization for admission to contract facilities for emergency medical care, surgery and labor and delivery units. Keeps the Chief Executive Officer, or designee, informed of PRC (Purchased Referred Care) admissions.

l. Records patient-provider transactions in the problem oriented medical record format and completes required data collection, referrals, and medical records as required. Documentation must be completed within 24 hours of the visit within the NCSU Electronic Health Record (EHR) and/or supplemented with scanned documents as necessary.

m. Refers patients and their families to MD's if necessary and Community Health Services personnel (PHN's, nutritionists, social workers, diabetic counselors, behavioral health and WIC) as appropriate for their continued care and follow-up.

n. Complete administrative tasks such as pre-visit planning, charting and ensuring that all necessary updates to the patient’s medical record are completed in a timely manner. This may require the provider to access the Electronic Health Record securely through a virtual private network (VPN) off site both before and after clinic services are provided.

6. REQUIREMENTS: The Contractor shall provide personnel that can provide womens health services and can include Licensed Certified Nurse Midwife, mid-level providers or OB providers. OBGYN experience is preferred however a new graduate is acceptable. The provider shall be credentialed/privileged not only at the Northern Cheyenne Service Unit (NCSU) but also have delivery privileges at one or both of the hospitals or an accredited birthing center in Billings MT. NCSU is not a hospital and we do not have a labor and delivery unit or operating room (OR). All prenatal patients and women who may need surgical interventions will be sent to the nearest hospital with a labor and delivery unit/OR or accredited birthing center (Billings MT). Support staff qualifications require a current active license as a Registered Nurse or a Licensed Practical Nurse. Responsibilities include previsit planning, triage/assessment and education, rooming patients, assisting with procedures, documentation of services provided, connecting patients to outside resources, scheduling patients for specialty visits and follow up visits.

7. DELIVERABLES AND DELIVERY SCHEDULE:

a. Clinics: The Contractor shall provide clinics once a week for a total of 52 on site clinics at NCSU per year. Clinics will be scheduled from 9:00 to 15:30. Provider and support staff shall report from 8:00 to 17:00 on clinic days. The Contractor shall provide at least one (1) provider (Certified Nurse-Midwife, mid-level provider or OB provider) and one (1) support staff for each weekly clinic. If the volume of patients scheduled is such that additional staff are needed to accommodate appointment requests, staffing may increase to two (2) providers and two (2) support staff per clinic. The NCSU Clinical Director will notify the Contractor no less than two (2) weeks in advance of the clinic if two (2) providers and two (2) support staff are needed.

b. Pricing: The Contractor pricing shall be an all-inclusive daily rate. This shall include provider and support staff hourly rate, allowable indirect costs, fuel, mileage, etc.

8. GOVERNMENT-FURNISHED EQUIPMENT AND INFORMATION: The outpatient department shall provide the provider with office space including a desk, chair, computer and office supplies. The provider shall be authorized to use all areas of the facility made available to them. The provider shall request clearance in order to access restricted areas of the facility, authorization must be granted and is to be used only for official business activities relating to job performance. The provider shall be authorized to coordinate with administrative and professional support personnel in carrying out their specified tasks. The contractor shall be allowed to utilize copy machines, facsimile machines, and telephone services for duties that relate to specified tasks. The contractor shall be given an orientation to the IHS role and the Indian community that is being served. The outpatient department will provide the provider with standard and specialized equipment and supplies needed for the performance and delivery of services.

9. PLACE OF PERFORMANCE: Services will be provided at:

Northern Cheyenne Service Unit 420 N. Cheyenne Ave Lame Deer, MT 59043

For consultation with Maternal Fetal Medicine and Telehealth, visit services may be provided with a combination of on-site provider and offsite consultation services.

10. PERIOD OF PERFORMANCE:

Base year: May 1, 2024 thru April 30, 2025 Option year one: May 1, 2025 thru April 30, 2026 Option year two: May 1, 2026 thru April 30, 2027 Option year three: May 1, 2027 thru April 30, 2028 Option year four: May 1, 2028 thru April 30, 2029

11. SECURITY: Security standards that are required for the position include: Privacy Act Compliance: Federal Employee Standards of Ethical Conduct Compliance: IHS Standards of Ethical Conduct: Child care National Agency Check and Investigation Compliance: Federal Security Identification Badge Request. It is the responsibility for the department to provide the necessary clearances to IHS computer systems as well as other security requirements needed for the contractor to perform their services. All computer security trainings must be completed prior to computer access being provided and must be maintained per IHS standards throughout the contract.

12. BACKGROUND CHECKS / CLEARANCE: As directed by the Contracting Officer, the Contractor shall provide all requested information necessary to perform background checks. The Contractor shall comply with the requirement to obtain security investigations.

Personnel must be cleared before reporting to work. 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.

The Contractor 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 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.