DRAFT_Maritime_Medical_Support_Services_PWS_(14Feb14)_posted_to_FBO.docx

14 February 2014 Performance Work Statement Maritime Medical Support Services

1. GENERAL

1.1. Scope

The contractor shall provide medical support services via telephone and secure electronic data transmission capability (to include images) including medical treatment advisement and programmatic support recommendations to the Government’s United States Public Health Service (USPHS) medical officers—Physician Assistants (PAs), Nurse Practitioners (NPs), and Registered Nurses (RNs)—working aboard National Oceanic and Atmospheric Administration (NOAA) ships while underway or in foreign ports. When in US ports, patients are referred to military facilities or public hospitals; medical support services performed for NOAA ships in US ports are NOT included within the scope of this contract. The Government will make ALL final decisions regarding patient care.

1.2. Mission/Background

The NOAA fleet consists of 17 ships representing over 500 berths for officers, crew, and scientists. The ships are designated as oceanographic, fisheries, and hydrographic survey ships and are operated by NOAA’s Office of Marine Aviation Operations (OMAO) and led by academic institutions and NOAA scientists to conduct operations throughout the world’s oceans. See Figure 1, NOAA Research Ship Fleet Characteristics, and Figure 2, NOAA Research Ship Maximum Endurance and Complement.

NOAA provides medically trained personnel to provide care aboard these ships while underway and to provide occupational health services in its marine centers. There are 5 NOAA ships that have permanent USPHS medical officers stationed aboard (one ship currently inactive for a total of 4): (1) Oscar Elton Sette, (2) Hi’ialakai, (3) Ronald H. Brown, (4) Okeanos Explorer, and (5) Ka’imimoana (inactive). These ships have Advanced Cardiac Life Support (ACLS) capability (drugs, equipment and supplies, and trained medical officers) and can offer the highest level of medical care while underway. The Government may determine at any time that other NOAA ships require USPHS medical officers for a given tour on a temporary and as-needed basis.

All NOAA ships have one or more MPICs (Medical Persons in Charge, individual(s) with United States Coast Guard (USCG) approved training equivalent to a basic emergency medical technician) aboard at all times while underway. NOAA Health Services trains its own MPICs through a USCG approved curriculum and provides all medical supervision and oversight. One USPHS medical officer on each coast (rotating) has an on-call phone on a 24/7 basis to support all NOAA ships and MPICs. This designated on-call medical officer is the first point of contact for an MPIC in need of medical instruction. If an MPIC is unable to reach the NOAA Health Services medical officer on call within two minutes in a serious emergency he or she is instructed to call the contractor’s 24/7 phone number for immediate assistance. In all other circumstances the contractor will be contacted by a USPHS medical officer for advisement.

All NOAA ships have a standard formulary; the formulary for ships with medical officers is more comprehensive than the ships with MPICs only. There is a designated space aboard each ship for the provision of medical evaluation and treatment. Medical evacuations at sea are uncommon and are arranged by NOAA.

1.3. Impact

Sound medical advice and support from the contractor help prevent complications in the treatment of patient medical conditions. It can also support justification for the Government’s decisions to divert/evacuate ships. Alternately, the medical support services may also support the Government in averting unnecessary and costly ship diversions/evacuations. The medical support services identified in this Performance Work Statement (PWS) are required to enable the Government to make the best medical decisions possible, minimizing the risk of serious injury or death at sea while also minimizing the costs associated with unnecessary medical actions.

1.4. Place of Performance/Hours

The performance of work described in this PWS requires remote global access via telephone and secure electronic data transmission capability (to include images) from the contractor’s facility to the NOAA fleet of ships operating in and out of United States ports and various locations in the Atlantic, Pacific, and Arctic Oceans and the Gulf of Mexico. See Figure 1, NOAA Research Ship Fleet Characteristics, and Figure 2, NOAA Research Ship Maximum Endurance and Complement. The contractor shall be available during regular business hours, Monday through Friday, for tasks described below in PWS paragraphs 2.2. and 2.3. The contractor shall be available on a 24/7 basis for the services described below in PWS paragraphs 2.1.1. and 2.1.2..

1.4.1. Non-Emergency Line. The contractor shall provide a telephone number for administrative and programmatic issues that are non-emergency in nature (PWS paragraphs 2.1.2., 2.2., and 2.3.).

1.5. Confidentiality

The contractor shall adhere to all professional and legal standards of confidentiality of records consistent with the needs and requirements related to specific medical services including Health Insurance Portability and Accountability Act (HIPPA).

2. TASKS

2.1. Unlimited 24/7 Access to Medical Advice and Case Management Services (Contract Line Item Numbers (CLINs) 0001, 1001, 2001, 3001, and 4001)

2.1.1. Emergency Line. Medical advice calls to the contractor will be initiated by the NOAA medical officer on an as-needed basis. The contractor shall provide and maintain an emergency telephone line with one or more board certified emergency physicians with maritime medicine experience (attending) to respond immediately to requests for medical advice calls on a 24 hours a day, seven-days a week (24/7) basis (PWS paragraphs 2.1.1. and 2.1.2.). Medical advice calls shall always be answered promptly (within ten rings or less). Under no circumstance will unanswerable, unanswered, interrupted, or dropped calls be acceptable (e.g., busy line, technical problem). The contractor shall note that ships may be 3,000 plus miles out at sea with the nearest evacuation point a 2-3 day sail away and that the emergency phone line shall have the capacity to meet all requirements of the PWS.

The attending shall provide consultation, assessment, recommendation(s) for treatment, and, when applicable, advice regarding whether a medical at-sea patient evacuation is deemed necessary. The Government will make the final decision regarding patient care.

The contractor shall provide immediate medical consultation directly to the medical officer who initiated the contact. For each case, the contractor shall communicate information regarding the request for consultation and medical status to the NOAA Director of Health Services (DHS) within 24 hours, and thereafter on an as-needed basis, consistent with all applicable laws regarding such disclosures, until the case is closed. This communication may be either by fax or email. Initial notification of the request for consultation and medical status shall be sent to the DHS within 24 hours and thereafter on an as-needed basis. A short summary of the case shall be sent to the DHS within one week of closure of the case

2.1.2. The contractor shall provide case management services for patients treated at any onshore medical facility upon the request of the NOAA medical officer. This involves the contractor communicating with patients’ healthcare providers or emergency medical facilities to monitor patients’ conditions, appropriateness of care, prognosis, fitness for travel determination, and further case management services as appropriate.

2.2. Medical and Administrative Consultations (CLINs 0002, 1002, 2002, 3002, and 3002)

2.2.1. The contractor’s appointed medical director, or assistant medical director as applicable, shall be available to the NOAA DHS for consultation and/or discussion regarding medical, administrative, or other related issues as necessary. The contractor shall respond with a timely period and provide updates as necessary. Historically, the average number of calls have been approximately five calls or less made per month with numbers fluctuating month to month.

2.2.2. Quarterly Reviews. The medical director, or assistant medical director as appropriate, shall conduct a quarterly review evaluating all shipboard medical care provided by USPHS medical officers whose ships were underway during the quarter.

2.2.2.1. A minimum of 5% of patient care medical visits from each sick call log shall be selected for review by the contractor no later than 2 weeks after submission of the sick call logs. In addition to review of this 5% of the, a medical case review of every visit where controlled substances were prescribed shall be done by the contractor.

2.2.2.2. The NOAA DHS shall be notified of this selection of medical visits after submission of the medical sick call logs. The NOAA DHS will collect the requested medical visits and submit to the contractor for review.

2.2.2.3. A written summary of the quarterly chart review shall be sent to the NOAA DHS no later than 3 weeks after receipt of all medical documentation for cases requested. This summary shall include, but not be limited to, the following:

- Quarter and year for which the review is being provided

- Medical officer and ship name being reviewed

- Patient name

- Date of review

- Name of reviewer (contractor employee)

- Comments that address the quality of documentation provided, the degree to which the medical standard of care was met, other considerations in the differential diagnoses or in the physical exam, and other pertinent instructions, recommendations, or guidance that would improve the patient care or outcome

2.3. Not-Fit for Duty Consultations (CLINs 0003, 1003, 2003, 3003, and 4003)

NOAA documents all fitness for duty evaluations via an established policy and written format called the Individualized Assessment (IA) process. The contractor shall review NOAA IAs and make a recommendation(s) regarding employees’ fitness for duty status. This recommendation shall be made in writing and sent to the NOAA DHS no later than one week after receipt of the IA.

3. KEY PERSONNEL

This is a non-personal services commercial contract. All personnel assigned to perform under this contract shall be employees of the contractor and not construed to be or identified as employees of the Government. The contractor shall ensure that no employer-employee relationship develops among Government and contractor personnel. The contractor shall ensure that the conduct and appearance of its employees while working under this contract in no way reflect discredit upon NOAA.

All personnel shall be able to read, write, speak, and understand the English language. All personnel shall communicate on technical issues and possess the oral and written communication skills and investigative skills required to perform work in accordance with this PWS.

The contractor shall not employ persons for work on this contract if such employee is considered by the Contracting Officer (CO) to be a potential threat to the health, safety, security, general well-being, or operational mission of NOAA.

Failure to Provide Qualified Personnel: Repeated failure or excessive delay by the contractor to provide qualified personnel that meet the stated requirements may be deemed sufficient reason by the CO to terminate work under this contract in whole or in part for cause.

After award, any changes to personnel, as described in this section, shall be approved by the Contracting Officer’s Representative (COR). Key personnel (see CAR 1352.237-75 KEY PERSONNEL) will be appointed by letter at the time of award; any replacements thereafter shall be approved by the COR and, accordingly, will be appointed by letter.

3.1. Medical Director Services. The contractor shall provide an emergency physician who will have overall responsibility for the medical services described in this PWS, to include maintaining communications with the Government and arranging all services. The contractor shall provide clinical oversight through direct communication with USPHS medical officers for medical care provided onboard ships. Additionally, the contractor shall provide an assistant medical director to act for the medical director when he/she is not available.

Minimum/General Experience: Board certification (American Board of Medical Specialties) and one year experience in maritime medicine.

3.2. Emergency Physician Services. The contractor shall respond immediately to requests for medical advice calls on a 24/7 basis as described in PWS paragraph 2.1.1.

Minimum/General Experience: Board certification (American Board of Medical Specialties) and one year experience in maritime medicine.

PAGE 1 AB-133M-14-RQ-0031

4. PERFORMANCE REQUIREMENTS SUMMARY (PRS). The contractor service delivery requirements are summarized into performance objectives that relate directly to standards of performance required to meet mission essential needs. The performance threshold briefly describes the minimum acceptable overall levels of service required for each required service. These thresholds are critical to mission success.

Performance Requirement Summary

5. DELIVERABLES

DELIVERABLE LIST

Initial: Within 24 hours of each case, and thereafter on an as-needed basis. A short summary of the case shall be sent to the DHS within one week of closure of the case.

Subsequent: Same as above for each case.

Initial: No later than one week after receipt of the IA.

Subsequent: No later than one week after receipt of subsequent IAs.

Written Summary of Quarterly Chart Review (PWS paragraph 2.2.2.3.)

Subsequent: Within 3 weeks after receipt of all medical documentation for cases requested thereafter.

Figure 1. NOAA Research Ship Fleet Characteristics

*Note: Miller Freeman has been decommissioned

Figure 2. NOAA Research Ship Maximum Endurance and Complement

(END OF PERFORMANCE WORK STATEMENT)

image1.png image2.png