Atch D - Statement of Work ER PHY.pdf

Physician Services

Colorado River Service Unit

Arizona

It is the intent of the Phoenix Area Indian Health Service to acquire non-personal professional

Physician Services as described herein for the Colorado River Service Unit (CRSU) for the Parker

Indian Health Center located in Parker, Arizona.

All responses to this solicitation shall contain a complete profile and current work history of the candidate(s) presented, including copies of licensure and certifications.

Selected candidate shall undergo the Indian Health Service mandated security clearance requirement prior to commencement of services at the Colorado River Service Unit. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check of the physician through the office of the inspector general's exclusion list at http://exclusions.oig.hhs.gov/.

1. SCHEDULES/LOCATION/SHIFTS/QUALIFICATIONS/CERTIFICATIONS:

The Contractor is requested to provide PHYSICIAN SERVICES for a 12-month base period and up to four

(4) 12-month option year periods. Shift times and schedules are subject to change based on the medical needs of the patient populace and hospital/clinic operations.

A) Emergency Room Physicians (Parker only) 1 – 12-hour shift during the day 7 days per week and 1 – 12-hour shift during the night 7 days per week. Approximate number of shifts to be filled in the Emergency Room is one (1) 12-hour shifts per day.

QUALIFICATION/CERTIFICATION -- EMERGENCY ROOM PHYSICIAN:

Contractor shall provide Emergency Room Physician candidates submitted in the proposal that shall be board certified by the American Board of Emergency Medicine, American Board of Family Medicine, or American Board of Internal Medicine. General Practitioners (non-residency trained physicians) or

Board-eligible physicians or other specialties will be considered on a case-by-case basis. Experienced

ABEM or AOBEM certified physicians are preferred due to the facility’s limited in-house clinical support. All physician applicants require at least three (3) years of current emergency care experience in an emergency department with an annual volume of at least 10,000 visits. A license to practice in the United States is required. Current certification is required in BLS (Basic Life Support), ACLS

(Advanced Cardiac Life Support, PALS (Pediatric Advanced Life Support) and ATLS (Advanced

Trauma Life Support).

2. PRICING SCHEDULE: See Attachment A – Rate Schedule for Estimated Hours

The unit price paid to the Contractor 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, overtime, nights, weekend or call services, etc.), 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.

Contractor 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, overtime, nights, weekend or call services, etc. *The government does not pay for the time taken for meals.

3. STATEMENT OF WORK:

The overall scope of this contract is to temporarily recruit and hire a qualified contractor under a

Government service contract. The contractor will be expected to have the necessary education, training, licensing, previous work experience and competence in being able to provide the services within the department. Work performance shall be performed according to the requirements and conditions contained in this Statement of Work. The contract resulting from this solicitation includes:

The contractor shall be expected to assist and provide services and duties as may be requested for the normal operational requirements for the department and personnel. The contractor shall provide work that is consistent with the guidelines and procedures of the IHS. Failure of the contractor to meet these standards can result in cancellation of this contract. The contractor’s performance and abilities shall be evaluated based upon performance standards that are contained in this statement of work

The contractor 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

(Service Unit Medical By-Laws). Chart notes are to be completed on the day services are rendered. During the performance of their duties, the contractor shall provide for the consistent performance of patient care processes according to the standards for TJC accreditation program within IHS. These standards include: The Comprehensive Accreditation Manuals for Critical Access

Hospitals, and the Laboratory Standards as they represent the scope of services of this contract.

The contractor shall possess a professional medical education from a post-secondary academic institution or be licensed in a field of medical study. The contractor should be proficient in writing, typing and have a basic working knowledge and understanding of computer hardware and software applications. The contractor shall have sufficient knowledge, competence and experience in providing these services on a regular schedule to the Colorado River Service Unit. The contractor shall possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that the contractor can relate constructively to IHS employees, contractors, vendors and individuals from the Native American community. Due to some limited driving requirements, the contractor should have a current, valid state driver’s license from any of the 50

United States or the Commonwealth of Puerto Rico.

The contractor shall not have any work or health restrictions which could directly or indirectly interfere with the performance of providing services. The contractor shall maintain acceptable standards of personal hygiene, grooming and professional attire such that their image as a Federal contract employee is compatible with the expectations of the IHS staff.

The contractor shall be required to utilize the electronic health record for chart documentation, after receiving training to enter all lab, x-ray and medication requests.

The Contractor’s employee(s) shall be sensitive to the unique culture factors of the people they treat, which may include use of an interpreter as necessary in communication of services being rendered.

Unique cultural factors that may contribute to the patient’s treatment include: use of their language communications; village and tribal customs; use of traditional healers; isolation; housing conditions and lack of resources.

Contractor may be required to work beyond normal duty hours, on weekends, holidays and after regularly scheduled duty hours on an as needed basis for emergencies. In accordance with the facility’s defined campus under EMTALA the contractor may need to respond to emergencies in the facility or on the facility grounds.

Accommodations/Lodging – The Contractor shall provide accommodations or a housing allowance for the selected physicians for the duration of the period of performance.

4. CONDITIONS FOR REMOVAL/REPLACEMENT OF PHYSICIAN(S):

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

The Contractor’s employee shall be removed from an IHS facility if services are not performed in accordance with terms and conditions of this award.

1. CONTRACTOR 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

Joint Commission (TJC) 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 he/she admits or in any way provides treatment. Chart notes are to be completed on the day services are rendered. The contractor shall abide by the Service

Unit Medical By-laws and rules and regulations and meet all credentialing requirements in accordance with the Service Unit Medical Staff By-laws.

Upon award, the selected physician(s) shall undergo Indian Health Service (IHS) mandated security clearance for work on-site for the Colorado River 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 http://exclusions.oig.hhs.gov/.

MAJOR DUTIES REQUIRED BY THE POSITIONS:

Has skill and knowledge of established concepts, principles and practices related to health care assignments with additional training or experience in assessing the conditions of a wide variety of patients and patient presentations.

Experience in providing emergency medical care and also providing professional advice on associated health care needs. Participates in the development of individualized care plans that take into consideration mental, emotional, social and physical well-being.

Knowledge of a wide range of diagnostic, preventive and therapeutic medical services and interventions in turn related to the medical health care fields included in primary care. This includes some degree of obstetrics, gynecology, pediatrics, geriatrics, orthopedics, internal medicine, psychiatry, dentistry, hospital medicine, family care, minor surgery and nutrition as well as emergency medicine.

Interviews and examines patients, reviews past medical history, and requests and/or performs diagnostic tests and examinations deemed necessary to obtain all possible information related to each case.

Collects, organizes, records and communicates, in a meaningful way, data relevant to primary health assessments including a detailed family and medical history, a physical examination and selective laboratory tests.

Examines, makes preliminary diagnosis, directs, prescribes and/or provides treatment, or arranges for specialized care consultation or emergency patient transfer as required. Provides definitive management in all medical categories for cases that do not require referral. An assigned facility

APRN may also assist in the examination and treatment of emergency department patients with consultation as required.

Addresses timely preparation of appropriate medical records for all patients seen to ensure the accumulation and organization of all pertinent clinical data needed to provide comprehensive medical care. Provides for other physicians, hospitals and departments as well as specified individuals to receive clinical records as required for patient care or reimbursement.

Knowledge of (and experience with) stressful situations in order to exercise the emotional control, tact and patience necessary to reliably carry out patient care.

Works closely with assigned mid-level providers (NP and PA) along with other Allied Health

Professionals in the provision of a broad spectrum of health program services. Has the professional acumen and willingness to provide advice, guidance and leadership to other healthcare providers.

Knowledge of pharmaceuticals in order to recognize their desired effects, side effects and complications of their use. Frequent consultation with on- or off-site pharmacy associates may be required due to patient care requests and limited pharmaceutical availability, etc.

Knowledge of, or willingness to ascertain, the availability of and uses for local resources designated for primary care and referral services. Able to provide individual and family counseling, providing guidance and other health instructions to help patients understand how to prevent disease and maintain both good physical and mental health.

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

Complies with Indian Health Service and Service Unit-specific Medical Staff/Governing Body By-laws, Rules and Regulations. Also complies with ongoing requirements for credentialing and privileging as an active member of the medical staff.

CONTRACTOR CREDENTIALS:

The Contractor shall provide a list of qualified candidate(s) and the following documents for each to be credentialed after Award:

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.

10. SUPERVISORY CONTROLS

The Chief Medical Officer, 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 emergency 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.

E.D. physicians will provide guidance and instruction to the E.D. nursing staff providing services during each shift worked.

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.

11. DELIVERABLES:

A. The Contractor is required to provide a copy of each Contractor’s employee profile to the Project

Officer prior to providing services at the Colorado River Service Unit.

B. Timesheet shall be submitted to the Clinical Director or designee of the Colorado River Service

Unit; 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.

12. PROJECT OFFICER:

A. The designated Project Officer shall be the Clinical Director of the Colorado River Service Unit.

B. The Project Officer’s responsibilities shall be to coordinate with the provider the technical aspects of this service and the review of performance hereunder. The Project Officer does not have the authority to change or alter the contract amount, terms or conditions.

C. The Project Officer shall review whether services were received as ordered.

D. Upon certification of timesheets, the Project Officer, or designated alternate, will forward the signed timesheets to the receiving official of the Colorado River Service Unit for further processing.

13. Performance Conditions:

A. The Project Officer 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 Project Officer.

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 Project Officer and those involved in scheduling.

14. Timesheets: See Attachment E

Timesheet shall be submitted to the Clinical Director or designee of the Colorado River Service

Unit; the timesheets shall be reviewed for accuracy and certified by signature as accurate and acceptable for payment thru IPP.

15. 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 of portion of a facility owned, leased, or contracted for a 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 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.

CONTRACT ADMINISTRATION DATA –

Payment and Invoicing Instructions: Timesheets shall be submitted to the Medical Director of the CRSU

(or his designate); the timesheets shall be reviewed for accuracy and certified by signature as accurate and acceptable for payment. The Contractor shall submit bi-weekly invoice(s) through IPP.

Invoices shall be prepared with the following information CLEARLY identified on the invoice:

1. Invoice Date and Number

2. Contract Number

3. Charges for service or products identified BY LINE ITEM Number

4. Brief description of products or services rendered

5. Charges should follow Line Item structure on contract to include Quantity, Unit of Issue, Unit Price, and Total Amount as applicable

6. Dates of Service or Shipment

Finance: All invoice submitted through the US Treasury Department via IPP.

Service Unit Representatives: designates will be appointed after contract award.

ELECTRONIC FUNDS TRANSFER - The Debt Collection Act of 1996 requires that Federal non-tax payments made after January 1, 1996 be made by Electronic Funds Transfer (EFT).

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

CONTRCTING OFFICER’S REPRESENTATIVE (COR) - The Contracting Officer will designate in writing a COR who shall be responsible for:

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

ii. Interpreting scope of work;

iii. Performing technical evaluations required;

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

v. Monitoring funds available for obligation under this contract;

vi. 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.

END OF STATEMENT OF WORK