Atch D- Statement of Work -PCMC NP PA.pdf

Family Nurse Practitioners Services

Phoenix Indian Medical Center

Yavapai Apache Health Center

Statement of Work

INTRODUCTION:

The contractor herein, shall provide Non-Personal Nurse Practitioners (NPs)/Physician

Assistants (PAs) (Family & Adult Geriatric) services as described herein for the

Phoenix Indian Medical Center (PIMC) located at 4212 North 16th St. in Phoenix, Arizona and or at the Yavapai Apache Health Center (YAHC) located in Camp Verde, Arizona.

This will be an award with a one-year base period of performance with four (4) one-year option year periods of performance.

Nurse Practitioners/Physician Assistants shall complete the Indian Health Service mandated security clearance requirements prior to commencement of services at the PIMC and YAHC health care facilities.

SCHEDULES/LOCATION/SHIFTS/QUALIFICATIONS/CERTIFICATIONS:

Schedules: The Contractor will provide one (1) NP or (1) PA services for a 12-month base period with four (4) 12-month option periods. Shift times and schedules are subject to change based on the medical needs of the patient populace and hospital and clinic operations.

All services shall be performed in the Primary Care Medical Clinic (PCMC) Phoenix

Indian Medical Center (PIMC) located in Phoenix, Arizona and or the Yavapai Apache

Health Center located in Camp Verde, Arizona.

A. Nurse Practitioners/Physician Assistants (Family & Adult Geriatrics):

SHIFTS:

7:30 a.m. – 6:00 p.m. (10 hours shift) with 30-minutes unpaid lunch

8:00 a.m. – 4:30 p.m. (8 hours shift) with 30-minute unpaid lunch

8:00 a.m. – 5:00 p.m. (8 hours shift) with 60-minute unpaid lunch

Under emergent conditions, Fifty Overtime (50 OT) hours will be granted.

LOCATIONS: The Family Practice & Primary Care Medicine Clinic (PCMC), Phoenix

Indian Medical Center (PIMC) located at 4212 North 16th Street in Phoenix, Arizona.

QUALIFICATIONS/CERTIFICATIONS – Nurse Practitioners/Physician Assistants

(Family & Adult Geriatrics)

Nurse Practitioners 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 Basic Life Support (BLS) certification is required.

Physician Assistants must possess and maintain an active, valid, and current certification as a Physician Assistant by 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. Current Basic Life Support (BLS) certification is required.

Degree or diploma from a professional nursing or physician assistant program approved by the legally designated state accrediting agency at the time the program was completed by the applicant. Nurse Practitioner(s) must be a member in good standing with the Association of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC).

Physician Assistant(s) must be a member in good standing with the National Commission on Certification of Physician Assistants (NCCPA)

Applicants must have active, current registration as a Professional Nurse or Physician

Assistant 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 or Physician

Assistant training program of at least 4 months in duration.

Experience: NPs/PAs must have a minimum of three (3) years experience.

On-Call services is not required.

B. Nurse Practitioner/Physician Assistant services (NP/PA), Family & Adult Geriatric at Yavapai

Apache Health Center located in Camp Verde, Arizona

SHIFTS:

7:30 a.m. – 6:00 p.m. (10 hours shift) with 30-minutes unpaid lunch

8:00 a.m. – 4:30 p.m. (8 hours shift) with 30-minute unpaid lunch

8:00 a.m. – 5:00 p.m. (8 hours shift) with 60-minute unpaid lunch

LOCATION: The Yavapai Apache Health Center is located at 2121 Reservation Loop

Road, Camp Verde, AZ 86322

QUALIFICATION/CERTIFICATION- NURSE PRACTITIONER (FAMILY &

ADULT GERIACTRIC)

Nurse Practitioners 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 Basic Life Support (BLS) certification is required.

Physician Assistants must possess and maintain an active, valid, and current certification as a Physician Assistant by 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. Current Basic Life Support (BLS) certification is required.

Degree or diploma from a professional nursing or physician assistant program approved by the legally designated State accrediting agency at the time the program was completed by the applicant. Nurse Practitioner(s) must be a member in good standing with the Association of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC).

Physician Assistant(s) must be a member in good standing with the National Commission on Certification of Physician Assistants (NCCPA).

Applicants must have active, current registration as a professional nurse or physician assistant 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 or Physician

Assistant training program of at least 4 months in duration.

Experience: NPs/PAs must have a minimum of three (3) years experience.

On-Call services is not required.

Demonstrate proficiency in writing, typing and possess basic knowledge and understanding of computer hardware and software applications;

Possess sufficient initiative, interpersonal relationship skills, social and cultural sensitivities and appropriate professional behavior in order to relate constructively to IHS employees, contractors, vendors and individuals from various Native American communities or Tribes;

Possess a current, valid state driver’s license from any of the 50 United States or the

Commonwealth of Puerto Rico;

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.

PRICING SCHEDULE – Complete Attachment A- Rate Schedule

The Unit Price paid to the Contractor shall be considered as Payment in Full for services provided under this award. Under no circumstances, unless directed by IHS, shall any provider attempt to bill or collect from an IHS patient; bill or collect from any alternate resource which the patient may be eligible for; or 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, local, city, state, federal taxes, and all miscellaneous costs associated with the provision of services. The government will pay one flat rate. On-Call and overtime shall be priced out separately.

Nurse Practitioners/Physician Assistants 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 nights, weekends, and holidays except for overtime and on-call. *Thirty (30) minutes lunch breaks are included in the shift hours and will not be paid by the Government.

SCOPE OF WORK:

The overall scope of this government service contract is to provide clinical Nurse

Practitioner/Physician Assistant services in Primary Care Medical Clinic; Internal Medicine or

Family Practice at the PIMC and YAHC locations. Clinic day services shall be performed in accordance with a work schedule established by the Chief of Primary Care or Internal Medicine or designee.

The healthcare provider shall conform to all Primary Care Family Nurse Practitioners/Physician

Assistant Adult Geriatric standards of care as established by the Indian Health Services Physician

Quality of Care document. The following describes knowledge, skills and abilities NPs/PAs must possess:

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 a variety of medical health care fields to include Nurse Practitioners, Physician Assistant, emergencies, medicine, minor/major surgery and nutrition;

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 and referral services;

Skills in making diagnosis and in choosing, initiating and modifying selected therapies; and ability to provide emergency treatment;

Skill in diplomacy and tact while working in stressful situations;

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

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;

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;

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;

Ability to provide guidance and leadership to other healthcare providers;

Attend required training in order to utilize the Electronic Health Record (EHR) for chart documentation to enter all lab, x-ray and medication requests.

Shall be sensitive to the unique cultural factors of the patients they treat, which may include, use of an interpreter to communicate services being rendered. Unique cultural and socio-economic factors that may contribute to the patient’s treatment outcome include: use of their language communications; village and tribal customs; use of traditional healers;

isolation; housing conditions and lack of resources.

Nurse Practitioners/Physician Assistants 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.

There will be no provision for Government housing as housing is readily available within metropolitan Phoenix, Arizona.

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 NP/PA.

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, and/or the Contractor’s

VA/FSS contract.

CONTRACTOR REQUIREMENTS

For Medical & Professional Contractors, the Nurse Practitioners/Physician Assistants shall comply with IHS facility infection control; safety policy and procedures; and standards. During the performance of this contract, the Contractor shall provide consistent performance of patient care processes according to TJC and/or Centers for Medicare

Services (CMS) who issues 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 Nurse Practitioners 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 providers 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.

CONTRACTOR CREDENTIALS:

The Contractor shall provide a list of qualified Nurse Practitioners/Physician Assistants and the following documents for each provider:

Current resume

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

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

IHS Provisional Access Memo

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

NoFEAR Act Training; complete the Certificate of Completion

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

HHS-745, Section A

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 administrative supervision and conducts the following:

1. Sets overall health care objectives and specifies available resources

2. Provides clinical supervision during tour of duty during clinic operating hours

3. 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

4. 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

5. Work performance is reviewed for conformance to IHS policy, procedures and accepted professional practices

6. Assures participation in Quality Assurance and Performance Improvement activities

Within established guidelines, Nurse Practitioners/Physician Assistants 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 performance reviews will be conducted jointly by the clinical director/supervising physician for effectiveness in meeting requirements for healthcare services.

SECURITY CLEARANCES

The Contractor shall ensure their Nurse Practitioners/Physician Assistants complete the following security clearance activities prior to reporting to work:

1. Obtain Fingerprint cards or

2. Process their fingerprints electronically, in person, at the PIMC Human

Resources Department

3. Complete the appropriate background investigation form which will be submitted for processing to the Office of the Inspector General's exclusion list at http://exclusions.oig.hhs.gov/

No performance under this contract shall be allowed until security clearances have been received by the PIMC Human Resources Department and a PIMC employee badge has been issued.

CREDENTIALING AND PRIVILEGING

The Nurse Practitioners/Physician Assistants will participate in the credentialing and privileging process in accordance with existing procedures. Nurse Practitioners/Physician

Assistants shall provide no services prior to obtaining approval by the Government

Medical Executive and Governing Board. The Nurse Practitioners 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 TJC requirements.

DELIVERABLES

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

Timesheets (Attachment E) 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 by the Practice

Manager; or his/her designee; and forwarded to the receiving official for further processing of receipt of services http://exclusions.oig.hhs.gov/

CONTRACTOF 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