A06 - PWS_CSU Audiologist.docx

BAO PWS June 30, 2022

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

Audiology Services

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Performance Work Statement (PWS) Non-Personal Services Audiology Services

1.0 General: This performance work statement (PWS) describes the requirements for non-personal service Audiology Services to support the mission of the Indian Health Service (IHS).

1.1 Background: IHS is an agency within the U.S. Department of Health and Human Services and is responsible for providing federal health services to American Indians and Alaska Natives. The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes. The IHS is the principal federal health care provider and health advocate for the Indian people. The goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indians and Alaska Natives. The IHS currently provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 34 states. The position to be filled: Audiologist. These services are provided onsite at the Crow Service Unit during approximately 96 clinic days plus 24 optional days per calendar year. Minimum of eight clinic days per month with ability to provide services on extra days that may be required to meet the changing needs of the community.

1.2 Crow Service Unit, Billings Area-Indian Health Service, Crow Agency, Montana provides support to the Crow and Northern Cheyenne Indian Reservations.

2.0 Scope: The Contractor shall provide audiology services in accordance with Section 7.0, performance-based requirements. Services shall be provided between 96 and 120 clinic days per year with a minimum of 8 clinic days per month.

2.1 Duties and responsibilities consist of providing Audiology services in an Outpatient (clinic). Services will include direct diagnostic and rehabilitative audiology services to patients of all ages (newborn, infant, child, adolescent, adult, elder, etc.) and with a variety of acute and chronic health needs. Responsible for the selection, provision and interpretation of comprehensive audiologic evaluations to include, but not limited to, the following: Air and bone conducting testing; Otoacoustic Emissions testing; Soundfield testing; Play Audiometry; and other Site-of-Lesion tests. Provides comprehensive audiologic rehabilitation services to include: Hearing aid evaluations; Hearing aid orientations; Aural rehabilitation; hearing aid fittings and follow-ups; counseling the hearing-impaired person, his/her family and other pertinent persons to help alleviate the effects of the hearing impairment. Upon request and approval, the Audiologist will participate in the Universal Newborn Hearing Screening Program by providing training for the nurses, reporting data to the State of Montana, scheduling re-screenings and appropriate referrals for further diagnostic evaluations. Responsible for maintaining inventory and accessories needed to provide a fully functioning hearing aid practice at the Service Unit. Provide necessary paperwork to the Service Unit such as hearing aids/ repairs, ear mold order forms, requesting hearing aid supplies and complete a "Hearing Aid File" card on each hearing aid dispensed. Properly record audiology services in the patients Electronic Health Record (EHR) to assess audiology needs and provide the required audiology care. Maintain inventory and calibration of audiologic equipment. Establish hearing conservation programs, in-service training to nurses, providers and other appropriate staff; such as Maintenance and Dental Department staff, when necessary.

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2.1.1. Place of Performance: Services will primarily be performed at the Crow/Northern Cheyenne Hospital, 10110 South 7650 East, Crow Agency, MT 59022, with potential services for Lodge Grass Clinic and Pryor Clinic.

2.1.2. Period of Performance: Will include a base ordering period of twelve months (12) plus four (4) one-year option periods. Task orders will be issued with specified periods of performance.

BASE ORDERING PERIOD: 8/1/2026 – 7/31/2027

OPTION PERIOD 1: 8/1/2027 – 7/31/2028

OPTION PERIOD 2: 8/1/2028 – 7/31/2029

OPTION PERIOD 3: 8/1/2029 – 7/31/2030

OPTION PERIOD 4: 8/1/2030 – 7/31/2031

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

3.6 Privacy Act of 1974. Office of Privacy and Civil Liberties | Privacy Act of 1974

3.7 IHS Service Unit and Health Center Policies, Procedures and Protocols. Access will be provided once contract is awarded.

3.8 Federal Computer Security Act of 1987. https://www.congress.gov/100/statute/STATUTE-101/STATUTE-101-Pg1724.pdf

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

3.10 Federal Code of Conduct. Will be provided once contract is awarded.

4.0 Definitions:

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4.1. Acceptance: Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart 46.5 and subject to other terms and conditions of the contract.

4.2. Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements. Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

4.3. Area: A defined geographical region for Indian Health Service administrative purposes. Each Area Office may administer several Service Units.

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

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

4.6. Contracting Officer’s Representative (COR): A federal employee who assists the ordering/issuing activity contracting officer in the administration of task orders issued under this contract. The COR is primarily responsible for the technical assistance and day-to-day program management of the ordering activity’s task orders. Ordering activities may have different designators for this employee (e.g., GTR – Government Technical Representative, COTR–Contracting Officer’s Technical Representative, or PO Project Officer). The Service Unit 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: Robert Roe, Chief of Physical Therapy, (406) 638-3370.

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

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

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

4.10. Customer Evaluation/Input: Written comments made to the Contracting Officer regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor’s performance.

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

4.12. Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal Executive agencies in their acquisition of supplies and services with appropriated funds.

4.13. Government Vehicle: An IHS owned motor vehicle or a vehicle leased by IHS through agreements with the General Services Administration (GSA) or through commercial rental agreements.

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

4.15. Service Unit: A facility physically separated from a hospital, with a wide range of ambulatory services including at least primary care providers, nursing, laboratory, and x-ray which are available at least 40 hours a week for outpatient care.

4.16. Non-personal Services Contract: A contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees, as defined in FAR 37.

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

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

4.19. Orientation: An activity designed to provide basic familiarization of the facility and transition the Audiologist into the Northern Cheyenne Service Unit and the department where the services will be provided.

4.20. Past Performance Information: Relevant information regarding a contractor’s actions under previously awarded contracts. This includes the contractor’s record of conformance to specifications and to standards of good workmanship; the contractor’s record of containing and forecasting costs on any previously performed cost reimbursable contracts; the contractor’s adherence to contract schedules, including the administrative aspects of performance; the contractor’s history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business-like concern for the interest of the customer.

4.21. Patient Outcome: End result of Audiology care.

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

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

4.24. Standards of Practice and Standards of Care: Authoritative statements by which the Audiology profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for audiology practice and a framework for the evaluation of practice.

4.25. Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activity’s written order to obtain services, at a minimum will include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activity’s task order number.

4.26. Tour of Duty: The time of day the Audiologist is scheduled to perform duties; to include thirty minutes to one hour lunch as scheduled based upon patient care needs.

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

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

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5.0 Government Furnished Information, Property and Services:

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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. 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 if contractor does not have identification badges that meet the facility requirements. A minimum fee of $10.00 will be charged for lost or destroyed badges.

5.4. Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures. Training will be provided ONLY if the subject matter is necessary to improve or enhance the quality of services or includes mandates made by the IHS Service Units while the candidates are working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

6.0 Contractor Furnished Property:

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6.1. Contractor shall provide all uniforms and other personal medical instruments subject to the following:

6.1.1. Uniforms and Lab Coats: Uniforms and Lab Coats shall conform to infection control standards and facility policies and procedures.

6.1.2. Other personal medical instruments: “Other personal medical instruments” are defined as Contractor owned items and may include but is 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, 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 an Audiologist for the delivery of patient care through performance of Audiologist duties and management of patient’s needs as described in the PWS and as identified by the Northern Crow Service Unit. Contractor Candidates shall comply with IHS facility policies, procedures, protocols and Standards of Care.

7.1. The contractor shall provide Audiology services in direct patient care.

7.2. The Contractor shall ensure 100% of all documentation meets established IHS Medical Facility, Joint Commission, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

7.3. The Contractor Candidate shall perform in accordance with the competency standards listed in Section 24, Exhibits. Specific tasks include the following. The Contractor Candidate shall:

7.3.1. Provide direct diagnostic and rehabilitative audiology services to patients of all ages (newborn, infant, child, adolescent, adult, elder, etc.) and with a variety of acute and chronic health needs.

7.3.2. Responsible for the selection, provision and interpretation of comprehensive audiologic evaluations to include, but not limited to, the following: Air and bone conducting testing; Otoacoustic Emissions testing; Soundfield testing; Play Audiometry; and other Site-of-Lesion tests.

7.3.3. Provides comprehensive audiologic rehabilitation services to include: Hearing aid evaluations; Hearing aid orientations; Aural rehabilitation; hearing aid fittings and follow-ups; counseling the hearing-impaired person, his/her family and other pertinent persons to help alleviate the effects of the hearing impairment.

7.3.4. Upon request and approval, the Audiologist will participate in the Universal Newborn Hearing Screening Program by providing training for the nurses, reporting data to the State of Montana, scheduling re-screenings and appropriate referrals for further diagnostic evaluations.

7.3.5. Responsible for maintaining inventory and accessories needed to provide a fully functioning hearing aid practice at the Service Unit.

7.3.6. Provide necessary paperwork to the Service Unit such as hearing aid/ repairs, ear mold order forms, requesting hearing aid supplies and complete a "Hearing Aid File" card on each hearing aid dispensed.

7.3.7. Properly record audiology services in the patients Electronic Health Record (EHR) to assess audiology needs and provide the required audiology care. Maintain inventory and calibration of audiologic equipment.

7.3.8. Establish hearing conservation programs, in-service training to nurses, providers and other appropriate staff; such as Maintenance and Dental Department staff, when necessary.

7.3.9. Work effectively and harmoniously within the health care teams and with Native American/Alaskan Native patients and their families.

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

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7.3. The Contract Audiologist shall be subject to peer review per Joint Commission standards.

7.4. The Contract Audiologist 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 Contract employee failing to abide with the Federal Code of Conduct.

8.2. A Contractor 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 whom in the judgment of a licensed healthcare practitioner is impaired.

9.0 Work Schedule: The Medical Staff Program Assistant at the IHS facility will determine specific tour of duty for the contract Audiologist within the scope of the task order. Contractor shall work in accordance with the tour of duty as scheduled to meet the patient care needs of the Service Unit. The Contractor will be scheduled for lunch breaks of thirty minutes to one hour as assigned and/or rotated, based upon department scheduling. This contract will require services for a minimum of 8 days per month with up to 120 days per year.

9.1. Overtime, Holiday, Call-Back and On-Call hours shall be performed as agreed upon by the Clinical Director and Contractor and within the limits of the task order.

9.2. The Contractor shall provide notice of unavailability to their employer (The Contractor) and the Medical Staff Program Assistant or designee prior to any absence from work. The Contractor shall provide notification at least fifteen (15) days in advance of a desired absence if the length of the absence exceeds eight (8) work hours. Verifiable emergencies are the only exception to the advanced notification requirements.

9.3. The Contractor shall provide a qualified replacement Audiologist if needed to meet the contract requirements.

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

10.0 Deliverables

10.1. Invoice submission: The contractor shall submit invoices via the IPP platform that identifies the task order, Contract Line-Item Number (CLIN), Contractor’s name, dates of service, quantity of hours worked, and hourly rate.

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

11.0 Contractor Qualification Requirements:

11.1. Experience: The Contractor shall have 5 years of audiology experience unless otherwise approved by the Contracting Officer and CSU Clinical Director.

11.1.1. Experience shall equip the Contract Audiologist 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 services category to be filled.

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

11.3. Certifications: The Contractor shall possess current Basic Life Support (BLS).

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

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

13.0 Health Requirements/Conditions of Employment:

13.1. Medical Evaluation: The Contractor shall complete all requirements, including medical fitness evaluation or attestation if requested, for successful credentialing and privileging.

13.2. Immunization: The Contract Audiologist shall provide documentation of all vaccinations to include annual mandatory Influenza vaccination.

14.0 Transportation and Lodging: The Contractor shall be responsible for all applicable Federal, State, and Local Taxes, Meals, Travel/Transportation. Lodging is available but must be paid for by the Contractor. 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.

15.0 Performance Evaluation:

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15.1. The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 23.0.

15.2. Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome constitutes a breach of contract.

16.0 Identification of Contractor: The Contractor shall wear an agency or government issued contractor identification badge during performance of duty.

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

17.1. The Contractor shall ensure adherence to Department of Health and Human Services (DHHS) IT system security policies and procedures. The IT policies and procedures will be made available to the Contractor upon request.

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

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

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

18.2. The Contractor 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 the IHS facility.

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

20.0 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.

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

22.0 Technical Point of Contact: Robert Roe, Chief of Physical Therapy, (406) 638-3370.

PWS No.: 08-01 April 2015

23.0 Performance – Based Matrix

This Standard describes “What Success Looks Like.”

Contractor shall provide Audiology services in the delivery of patient care at the Northern Cheyenne Service Unit.

Competency

Compliance

Quality

Patient Outcomes

Professionalism

Documentation

Maintain 100% of the required competencies

100% compliance with IHS and Service Units published Policies; Procedures; Standards of Care; and facility 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 Federal Code of Conduct.

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

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

Payment of contract price for satisfactory service.

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

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

24.1. Exhibits

A - Quality Assurance Surveillance Plan (QASP)

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