Atch D - Statement of Work Elko REV.pdf

Professional Primary Care/Family Medicine Nurse Practitioner/Physician Assistant Services Scope of Work (SOW)

INTRODUCTION

It is the intent of the Phoenix Area Indian Health Service to acquire non-personal professional medical services as described herein for the Elko Southern Bands Health Center located in Elko, Nevada.

Selected candidate shall undergo the Indian Health Service mandated security clearance requirement prior to commencement of services at the Elko Service Unit. The security pre-clearance requirement must be adhered to;

the process includes a fingerprint check and a screen check of the provider through the Office of the Inspector General’s Exclusion List at https://exclusions.oig.hhs.gov/.

SCHEDULES/LOCATION/SHIFTS/QUALIFICATIONS/CERTIFICATIONS:

Schedule: The Contractor is requested to provide Physician Assistant or Nurse Practitioner SERVICES for a base period of 12 months with one year option period. Shift times and schedules are subject to change based on the medical needs of the patient populace and hospital/clinic operations.

All services shall be performed at the Elko Southern Bands Health center located in Elko, Nevada.

NURSE PRACTITIONER:

SHIFT: Either 4- 10 hour shifts or 5 – 8 hours shifts

LOCATION:

QUALIFICATION/CERTIFICATION

Nurse Practitioner must possess and maintain an active, valid, and current certification as a Nurse Practitioner by the American Nurse Credentialing Center from a nationally recognized certifying body. Current certification is required in BLS (Basic Life Support), ACLS (Advanced Cardiac Life Support, and PALS (Pediatric Advanced Life Support). Degree or diploma from a professional nursing program approved by the legally designated State accrediting agency at the time the program was completed by the applicant. Applicants must have active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States. Applicants must have completed a Nurse Practitioner training program of at least 4 months in duration.

PHYSICIAN ASSISTANT:

SHIFT: Either 4- 10 hour shifts or 5 – 8 hours shifts LOCATION: Prime Care

QUALIFICATION/CERTIFICATION

Physician Assistant must possess and maintain a current, active, full, and unrestricted license or registration as a Physician Assistant from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. Current certification is required in BLS (Basic Life Support), ACLS (Advanced Cardiac Life Support, and PALS (Pediatric Advanced Life Support). Degree or diploma from a physician assistant educational program, accredited by the Accreditation Review Committee on Education for the Physician Assistant (ARC-PA) or its predecessors, at a college, university, or educational institution that is accredited by an accrediting body or https://exclusions.oig.hhs.gov/ organization recognized by the U.S. Department of Education at the time the degree was obtained. Successful completion of the National Commission on Certification of Physician Assistants (NCCPA) examination; must maintain status as a certified physician assistant, including completion of all requirements for Continuing Medical Education (CME) and re-certification.

STATEMENT OF WORK (SOW):

Nurse Practitioner/Physician Assistant: The Contractor shall provide Primary Care/Family Medicine medical services for the Elko Sothern Bands Health Center.

1. The Vendor shall provide Contractors with the competency and experience to perform the following:

a. The Contractor shall provide onsite coverage as scheduled.

b. Assignments include providing comprehensive and continuing health and medical care services for adult and pediatric patients. The contractor is expected to handle the full range of cases and problems in specialty, including the very difficult and complex. Cases are sometimes critical and require immediate decisions.

c. Provides Primary Care/Family Medicine as required, by interviewing (if possible) and examining any and all patients seeking Primary Care/Family Medicine. Contract provider(s) review past medical history, and immediately requests and/or performs diagnostic tests and examinations deemed necessary to obtain all possible information related to each case.

d. Contract provider(s) make preliminary diagnosis, directs, prescribes or provides treatment, or arranges for specialized care or patient referral as required. Provider(s) base medical decisions upon information obtained and professional medical knowledge and skills. Contract provider(s) makes notes of observations and incorporates these into clinical records. Contract provider(s) provide definitive management, in all medical categories, for cases that do not require a referral. The provider gives total patient care including prevention, developing patient care plans, health maintenance, early diagnosis, providing instruction/counsel, treatment, and follow-up services to patients under his/her care.

e. The contract provider(s) shall comply with all Elko Service Unit policies and procedures.

The provider(s) shall prepare and complete, in a timely fashion, the medical and other required records for all parties he/she admits or in any way provides care for the hospital or health care facility (consistent with Elko Service Unit Medical Staff Bylaws). During the performance of their duties, the contractor(s) shall provide for the consistent performance of patient care processes in accordance with the CMS Conditions of Participation, EMTALA, and the Accreditation Association for Ambulatory Health Care (AAAHC). The provider(s) shall also adhere to the Comprehensive Accreditation Manuals for Hospitals, The Laboratory Standards and Ambulatory Care Standards as they represent the scope of services of this contract. Documentation in the Primary Care/Family Medicine department is through a combination of paper and the electronic health record (EHR). The contract provider is expected to document using this combination.

f. Provider(s) conducts urgent/emergent services, making observations appropriate to the patient’s underlying disease and treatment plan. Provider(s) review the patient’s medications, diet therapy course, and management plan. The provider modifies regimen as indicated. Provider instructs and counsels patients and family members as required.

g. Contract provider(s) refer patients to appropriate contracted medical (or other) facilities, providing full clinical information for care and diagnostic procedures that cannot be adequately provided at local IHS facilities. Coordinates and integrates information obtained into the ongoing Health Care Program at the Service Unit and assures timely follow-up care as required. Contract physician(s) also complete all necessary paperwork for Contract Health Services for all patients referred.

h. Contract Provider(s) work closely with allied health professionals (i.e., nursing, Community Health Nurse, Social Workers, Health Educator, etc.) to utilize and coordinate the services of Health Care Professionals in the management of the patient’s medical, psychological and social problems.

i. The Elko Service Unit Governing Body or Executive Committee shall formally grant all contract provider clinical privileges in Primary Care/Family Medicine prior to assuming clinical responsibilities.

j. Performance and Deliverables: Period of performance TBD.

k. Schedule: The contractor shall record time and attendance that shall be verified by the supervisor and/or his/her designee.

l. Contractor shall ensure that proposed providers cooperate with and assist the

Government in conduction of any necessary background checks.

CONDITIONS FOR REMOVAL/REPLACEMENT OF CONTRACTOR(S):

As mutually agreed between the Contracting Officer and the Contractor there may be grounds for removal and/or replacement of a Contractor.

The Vendor’s employee shall be removed from an IHS facility if services are not performed in accordance with terms and conditions of this award, and/or the Vendor’s VA/FSS contract.

PRICING SCHEDULE (See Attachment A – Rate Schedule)

The unit price paid to the Vendor shall be considered as payment in full for services provided under this award.

In no way, unless directed by the IHS, shall any provider attempt to bill or collect from any IHS patient, or from any alternate resource for which the patient may be eligible, any monies for services provided under this award.

Hourly fixed rate shall be inclusive of all other fees (holiday, nights, and weekend), including travel expenses, per diem, lodging, all city, state, federal and local taxes, and all miscellaneous costs associated with the provision of services. The government will pay one flat rate. Overtime shall be priced out separately.

Vendor shall be paid only for actual time services are performed under the terms of the contract at the hourly fixed rate (one flat rate). There is no provision for holiday, nights, and weekend except for overtime. *30-minute lunch breaks are included in the shift hours and will not be paid by the Government.

VENDOR REQUIREMENTS:

For Medical & Professional Contractors, the Contractor shall comply with all IHS facility infection control and safety procedures, and standards. During the performance of this contract, the Contractor shall provide for the consistent performance of patient care process according to the standards of The Accreditation Association for Ambulatory Health Care (AAAHC) and/or Centers for Medicare Services (CMS) who supplies accreditation to the Phoenix Area Indian Health Service hospitals and health centers. These standards shall include: The Comprehensive Accreditation Manual for Critical Access Hospitals, and the Laboratory Standards as they represent the scope of services of this contract.

For Medical & Professional Contractors, the Contractor shall complete in a timely fashion, the medical and other required records for patients for which he/she provides treatment in any way. Chart notes are to be completed on the day services are rendered. The contractor shall abide by the Service Unit Medical By-laws, rules, and regulations and meet all credentialing requirements in accordance with the Service Unit Medical Staff By-laws.

Upon award, the selected Provider(s) shall undergo Indian Health Service (IHS) mandated security clearance for work on-site for the Elko Service Unit. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check through the Office of the Inspector General's exclusion list at https://exclusions.oig.hhs.gov/.

MAJOR DUTIES REQUIRED BY THE POSITION:

Skill and knowledge of established concepts, principles and practices related to health care assignments and additional training or experience in assessing the conditions of patients, in providing medical care and in advising on health care needs, all with full consideration of mental, emotional and physical factors.

Knowledge of the diagnostic, preventive and therapeutic position related to Primary Care/Family Medicine Nurse Practitioner/Physician Assistant, emergencies, medicine, minor/major surgery and nutrition.

Ability to collect, organize, record and communicate, in a meaningful way, data relevant to primary health assessments including the detailed family and medical history, a physical examination and selective laboratory tests.

Ability to perform special screening and developmental tests and assess routine and specialized laboratory and radiological services.

Skill in making diagnosis and in choosing, initiating and modifying selected therapies and ability to provide Primary Care/Family Medicine treatment.

Ability to assess the physical-psychosocial health status of patients and family based upon the knowledge of growth and development patterns and health condition is that require medical management.

Knowledge of pharmaceuticals in order to recognize their desired effects, side effects and complications of their use.

https://exclusions.oig.hhs.gov/

Knowledge of human behavior during stressful situations in order to exercise emotional control, tact, patience and reliability in carrying out patient care.

Knowledge of the availability and use of resources designated as primary care/family medicine and referral services.

Ability to provide individual and family counseling, guidance and health instruction to help patients to understand how to prevent disease and maintain good physical and mental health.

Knowledge of quality assurance and evaluation process to improve care and facilitate monitoring and program planning.

Knowledge of health record aspects of patient care and ability to accurately and completely document related clinical data.

Ability to provide guidance and leadership to other healthcare providers.

A license to practice in the United States is required. Compliance with Indian Health Service – Service Unit Medical Staff/Governing Body By-laws, Rules and Regulations and compliance with requirements for credentialing/privileging as an active member of the medical staff.

Skill in diplomacy and tact while working in stressful situations.

Skill in working with people from a wide variety of backgrounds and different cultures.

CONTRACTOR CREDENTIALS:

The contractor shall provide a list of qualified candidates and the following documents per candidate (after time of award for credentialing):

1. Current resume

2. OF-306 – Declaration for Federal Employment (all questions must answered and signature with date in 17a is required)

3. OF-306 Addendum – Addendum to the OF-306 (Declaration for Federal Employment)

4. IHS Provisional Access Memo

5. Protecting Children from Sexual Abuse in Health Care Settings; complete the Certificate of Completion

6. NoFEAR Act Training; complete the Certificate of Completion

7. OFI-86C form along with two fingerprint cards and applicable state forms

8. HHS-745, Section A

9. Two IDs (driver’s license and social security card – names must match and be unexpired)

NOTE: No photo submission of forms, please have the forms scanned. Wet signature and date is highly recommended. No PDF signatures will be accepted

SUPERVISORY CONTROLS:

The Chief or Supervisor of the Department, or designee, provides primarily administrative supervision. The supervising physician sets overall health care objectives and specifies resources available. The supervising physician provides for clinical supervision on a 24-hour, media and tour of duty coverage. The supervising physician reviews work performance on a periodic basis in order to evaluate proficiency in providing health care, discuss deficiencies and problems encountered, outline and/or approve new or changed practices to be employed, and provides consultation on specific cases and related problems. Work which involves out-of-the-ordinary diagnostic decisions or treatment is discussed with supervisor or supervising Primary Care/Family Medicine department physician who keeps aware of the condition of such patients and all aspects of treatment regimen. Work performance is reviewed for conformance to IHS policy, procedures and accepted professional practices; and the Quality Assurance Improvement Program of the Medical staff of the Service Unit.

Within established guidelines, contractor(s) exercise latitude in planning and carrying out health care assignments and in undertaking new procedures, practices and approaches to extend both services provided and increase individual proficiency. Overall work performance is reviewed jointly by the clinical director/supervising physician for effectiveness in meeting requirements for healthcare services.

SECURITY CLEARANCES:

The contractor shall ensure their employees have been properly screened prior to presenting to Elko Service Unit for employment under this contract. The contractor shall inform their employees to obtain Fingerprint cards or electronically submit their fingerprints through the Elko Service Unit- Human Resources Department and complete the appropriate background investigation form which will be submitted for processing. No performance under this contract shall be allowed until the contractor’s employee is cleared through the Elko Service Unit Human Resources Department and issued a badge.

CREDENTIALING AND PRIVILEGING:

The contractor will participate in the credentialing and privileging process in accordance with existing procedure. Contractor shall provide no services prior to obtaining approval by the Government Medical Executive and Governing Board. The Contractor will be provided copies of current requirements and updates as they are published. Privileges will require renewal at least every one - two years in accordance with Government credentialing privileging policy and JCAHO requirements.

DELIVERABLES:

A. The Contractor is required to provide a copy of each Contractor’s employee profile to the COR prior to providing services at the Elko Service Unit.

B. Timesheet shall be submitted to the Chief or Supervisor of the Department, or designee. The timesheets shall be reviewed for accuracy and certified by signature as accurate and acceptable for payment, then forwarded to the receiving official for further processing of receipt of services through

PRISM.

CONTRACTOR OFFICER REPRESENTATIVE (COR):

The Contracting Officer will designate in writing a COR who shall be responsible for:

1. Monitoring the Contractor’s technical progress, including the surveillance and assessment of performance and recommending to the Contracting Officer, changes in requirements;

2. Interpreting scope of work;

3. Performing technical evaluations required;

4. Performing technical inspections and acceptances required by this contract;

5. Monitoring funds available for obligation under this contract;

6. The resolution of technical problems encountered during performance of this contract;

In no event is the COR empowered to change any of the terms and conditions of the contract. Changes in the scope of work, contract price, quantity, and quality or delivery schedule shall be made only by the Contracting Officer by a properly exercised modification.

The designation of a COR does not authorize or provide a legal right to change any kind of contractual terms regardless of the Contractor’s apparent difficulties in fulfilling contract requirements.

CONTRACTING OFFICER (CO) RESPONSIBILITIES:

The Contracting Officer is the only person delegated the authority to negotiate changes in terms, conditions, or amounts cited in this contract.

PERFORMANCE CONDITIONS:

A. The COR will submit schedules of required coverage a minimum of 15 calendar days prior to the first day of coverage requested.

B. In the event the Contractor’s employee is unable to render service on a previously agreed schedule, the Contractor shall provide a minimum seventy-two (72) hour notification to the COR. The Contractor shall then make a full, good-faith effort to provide coverage with a replacement.

C. Both parties recognize that on occasion there shall be a need to fill coverage requests with less than a 15-day notice. In such an emergency scheduling situation, the Contractor shall make a full, good-faith effort to accommodate the emergency request. If the Contractor is unable to meet the emergency scheduling request, they shall immediately notify the COR and those involved in scheduling.

ADDENDUM:

a. Pro-Children Act of 1994 The Contractor certifies that it will comply with the provisions of Public Law 103-227, Pro-Children Act of 1994 which imposes restrictions on smoking where federally funded children’s services are provided. The Act requires that smoking should be prohibited in any indoor facility owned, leased, or contracted for or used for the routine or regular provision of health care, day care, or early childhood development (Head Start) services to children under the age of 18. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 per violation and/or the imposition of an administrative compliance order on the responsible entity. By submitting an offer and entering into a contractual agreement with the Government, Contractors certify that they will comply with the requirements of the Act. Contractors must obtain the same certification from subcontractors.

b. P.L. 101-630, The Indian Child Protection and Family Violence Prevention Act

Contractors whose duties and responsibilities involve regular contact or control over children are subject to a character investigation as required by Public Law 101-630, The Indian Child Protection and Family Violence Act.

IHS will conduct these investigations following award of a contract. The character investigation may be waived if, in the judgment of the Contracting Officer, in consultation with the Personnel Officer, an investigation has already been conducted and is on file. Until the character investigation has been completed and the Contracting Officer notified of the results, the Contractor must not have unsupervised contact with Indian children.

c. Department of Health and Human Services Tobacco Policy The Contractor’s employee shall comply with the Department of Health & Human Services Tobacco-Free Policy (copy available upon request). Contractor’s employee shall not use tobacco products of any kind (e.g., cigarettes, cigars, pipes, and smokeless tobacco) while on any HHS Property- owned or controlled.

d. Indian Child Protection and Family Violence Prevention Act No performance under this contract will be allowed without full compliance with the Indian child protection and family violence prevention act, Public Law 101-630 and the Indian Health Service memo dated February 3, 1997, investigations on child care workers. Contractor shall ensure that proposed providers cooperate with and assist the government in the conduction of any necessary background checks.

e. Crime Control Act of 1990 No performance under this contract will be allowed without full compliance with the crime control act of 1990, Public Law 101-647 and the Indian Health Service memo dated February 3, 1997, investigations on child care workers. Contractor shall ensure that proposed providers cooperate with and assist the government in the conduction of any necessary background checks.

END OF STATEMENT OF WORK