Atch D - Statement of Work Pediatric Services.pdf

PEDIATRIC SERVICES FOR THE WHITERIVER SERVICE UNIT

SCOPE OF WORK:

It is the intent of the Whiteriver Service Unit (WRSU) to acquire non-personal professional medical services described herein for the Whiteriver Indian Hospital located in Whiteriver, Arizona.

Contractor is requested to provide non-personal professional medical services for Pediatrician services for a 12 month base period and four (4) 12-month option periods. The intent of this contract is to establish a method whereby the Whiteriver Service Unit (WRSU) can minimize disruptions in clinical service because of staff changes and shortages over the next 4 years. Also, even when the best plans are laid to hire and retain staff, our remote location makes this difficult and we can have staff shortages despite trying to hire a full-time employee. Requests for contractor coverage will be based on the consistently changing needs of the clinic.

All responses to this solicitation shall contain a complete profile and current work histo1y of the candidate(s) presented, including licensure and certifications.

Selected candidate shall undergo the Indian Health Service mandated security clearance requirement prior to commencement of services at the WRSU. 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/. Documented evidence of the clearances shall be provided to the

Director, Human Resources, Whiteriver Indian Hospital, 200 W. Hospital Drive, Whiteriver, AZ 85941.

LOCATION:

All services shall be performed at the following location:

Whiteriver Service Unit

200 W Hospital Drive

Whiteriver, AZ 85935

SHIFTS:

Shift times and schedules are subject to change based on the medical needs of the patient populace and hospital/clinic operations. The contracted services will augment the current full-time staff.

WRSU currently has the following operational hours: Outpatient service, Monday through

Thursday of 8:00 am to 9:00 pm. Friday 8:00 am through 5:00 pm. Emergency Room, OB and

Inpatient services 24 hours 7 days a week. Future possibility for additional day of services as well as after hour coverage. In addition, coverage will be required when any full time staff is on leave. Specific days may change based upon the needs of WRSU. All services shall be performed at the Whiteriver

Indian Hospital located in Whiteriver, Arizona. Work week is Sunday 12:00 AM to Saturday 11:59 PM.

SHIFTS: Contractors will be expected to abide by the facility’s Uniform Code and shift hour assigned, modalities of charting and care delivery and other rules and regulations of the facility. Specifically, the

Contractor must be available to cover daily 8-12 hour shifts Monday through Friday, depending upon need. Ideally, the contractor will be able to provide coverage on short notice if necessary.

http://exclusions.oig.hhs.gov/.%20Documented

Work within a designated schedule prepared by the Chief Medical Officer or his/her designee. Any period of absence or changes in the schedule will be communicated with the Chief Medical Officer or his/her designee 14 days prior, except for emergency situations.

* Government does not pay time taken for lunch. Total shifts worked annually shall be in accordance to the total number of work hours allocated for the year by WRSU.

Thirty (30) minute lunch breaks are included in shift hours and Government does not pay time taken for lunch. The Service Unit shall make every effort to submit a schedule two (2) weeks in advance. Shifts may be cancelled or shortened without time restriction or monetary penalty before the Contractor’s employee arrives for duty.

Unless exempt, medical professionals covered by the Fair Labor Standards Act must receive overtime pay for hours worked over 40 in a workweek.

PRICING SCHEDULE:

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.

Contractor shall provide an hourly fixed rate and hourly overtime fixed rate. Overtime fixed rate shall be a separate rate for all non-physician services. However, it is not expected that contractors will be asked to work overtime as a general rule and will be limited as much as possible for those who are working under this contract. Overtime would only be requested when the need to finish patient care precludes the contractor leaving on time or in an emergency situation. The Government will pay hourly fixed rate and a rate for overtime. The Contractor shall be paid only for actual time services are performed under the terms of the contract at the hourly fixed rate and if needed overtime rate. Overtime is currently not projected to be needed for these services.

QUALIFICATION/CERTIFICATION – PROFESSIONAL AND RELATED SERVICES:

Contractor shall provide medical and related professionals with experience in these areas.

1. Physician (Pediatrics):

a. Years of Experience: Completion of a 3 year residency program in a primary care specialty such as Family Practice, Pediatrics or Internal Medicine. Board certification is preferred.

b. Minimum Education: Doctorate degree of Osteopathic or Allopathic medicine

c. Current certification in BLS (Basic Life Support)

d. Applicants must have an active, unrestricted, and free of disciplinary action license as a physician in a State, District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States.

STATEMENT OF WORK:

The overall scope of this contract is to provide qualified and experienced healthcare and medical care providers under a Government service contract. The Contractor(s) 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(s). 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 Contractors(s) shall be expected to assist and provide services and duties as may be requested for the normal operational requirements for the respective 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 or at a minimum a request that the

Contractor(s) be dismissed and a new Contractor(s) be dispatched. The contractor’s performance and abilities shall be evaluated based upon performance standards that are contained in this statement of work

The Contractor(s) shall prepare and complete in a timely manner the required documents, in accordance with the WRSU Medical By-Laws and Service Unit Policy. Chart notes (where applicable) are to be completed on the day services are rendered and specifically, with rare exception, immediately after finishing with the patient. During the performance of their duties, the contractor shall provide for the consistent performance of patient care processes according to the standards for AAAHC accreditation within IHS. The Contractor(s) shall:

1. Be proficient in writing, typing and have a basic working knowledge and understanding of computer hardware and software applications.

2. Have sufficient knowledge, competence and experience in providing these services on a regular schedule at WRSU.

3. Possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that he/she can relate constructively to IHS employees, contractors, vendors and individuals from the Native American community.

4. Have a valid state driver’s license from any of the 50 United States or the Commonwealth of

Puerto Rico.

5. Not have any work or health restrictions, which could directly or indirectly interfere with the performance of providing services.

6. Maintain acceptable standards of personal hygiene, grooming and professional attire such that their image as a Federal contractor is compatible with the expectations of the IHS staff.

7. Be required to utilize the electronic health record for chart documentation (where applicable) after receiving training.

8. Be sensitive to the unique culture factors of the people they serve, 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.

9. Have tact and diplomacy while working in stressful situations.

The Contractor(s) may be required to work beyond normal duty hours, on an as needed basis for emergencies.

CONDITIONS FOR REMOVAL/REPLACEMENT OF MEDICAL PERSONNEL:

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

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

The Contractor shall relieve contracted staff within 24 hours of notice and, if a replacement is needed, the replacement should be available within one week of the removal.

CONTRACTOR REQUIREMENTS:

Upon award, the selected medical professional(s) shall undergo Indian Health Service (IHS) mandated security clearance for work on-site at WRSU. 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/ and www.sam.gov (best checked through www.verifycomply.com as this checks all exclusion lists).

• 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.

MAJOR DUTIES REQUIRED BY POSITION:

Physician (Pediatrics):

As a qualified specialist in Pediatrics, assumes responsibility for the diagnosis, prevention, therapy, maintenance and rehabilitation of patients. Typical, but not all inclusive assignments include the following:

1. 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. Provides definitive management and full spectrum pediatric practice in all medical categories for cases.

2. Conducts outpatient clinics making observations appropriate to the outpatient's underlying disease and treatment plan, including current symptoms. Reviews the patient's medications, diet, therapy course, adherence to management plan and patient observations. Modifies regimen as indicated. Instructs and counsels patients and family members as required and does so in a culturally sensitive manner.

3. Refers patients to appropriate contracted medical facilities, providing full clinical information for care and diagnostic procedures that cannot be adequately provided at the Whiteriver

Service Unit.

4. Assures preparation of appropriate medical records for all patients seen to assure the accumulation and organization of all pertinent clinical data needed to provide comprehensive medical care. Provides clinical reports and correspondence concerning patients under his/her care to physicians, hospitals, and other individuals and facilities.

http://exclusions.oig.hhs.gov/ http://www.sam.gov/ http://www.verifycomply.com/

5. Works closely with allied health professionals (i.e., clinical nurses, social workers, health educators, etc.) to utilize and coordinate the services of other health care professionals in the management of the patients medical, psychological and social problems.

6. Provides pediatric care from newborn to adulthood and is familiar with growth, development, disease states and the unique status of pediatric patients.

7. Is active in pre-visit planning of the clinic, coordination of care and participates in clinic improvement activities.

8. Efficiently navigates via electronic medical record for a-prescribing, documentation, and orders including referrals in compliance with Meaningful Use and ICD-10 requirements.

9. Evaluates and treats approximately 12-20 patients during an 8-hour work day. Performs Peer

Review and attends assigned committee meetings.

10. Performs diagnostic and therapeutic procedures normally performed by pediatricians such as but not limited to:

A. Performs minor surgery including but not limited to laceration repair and excision of skin lesions.

B. Supervises other health care providers including physicians, physicians' assistants, nurse practitioners, nurses, pharmacists and medical clerks.

CREDENTIALING AND PRIVILEGING:

The contractor will participate in the credentialing and privileging process in accordance with existing procedure where applicable (e.g. medical providers). In cases where clinical privileging is required, the

Contractor shall provide no services prior to being credentialed as per local by-laws. 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 AAAHC requirements.

SUPERVISORY CONTROLS:

The supervisor of the respective department to which the Contractor(s) is assigned to work or his/her designee, provides primarily administrative supervision. The Supervisor or designee:

1. Sets overall health care objectives and specifies resources available.

2. Provides for clinical supervision during the tour of duty.

3. Assigns work.

4. 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 designee 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.

Within established guidelines, contractor(s) may 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 by the Supervisor for effectiveness in meeting requirements for healthcare services.

DELIVERABLES:

The Contractor is required to provide a copy of each Contractor profile to the Contracting Officer

Representative (or service unit representative(s)) prior to providing services at WRSU.

Timesheet shall be submitted to the supervisor of the respective department to which the Contractor(s) is assigned to work or his/her 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 US Treasury utilizing IPP.

CONTRACTING OFFICER REPRESENTATIVE (COR) RESPONSIBILITIES:

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:

The COR (or service unit representative(s)) will submit schedules of required coverage a minimum of 15 calendar days prior to the first day of coverage requested.

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

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 service unit representative(s).

PAYMENT AND INVOICING INSTRUCTIONS:

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

Invoices shall be prepared and submitted electronically and in accordance with rates and terms as stated in the contract. Invoices shall be submitted electronically in IPP through the US Treasury. Notification and a copy of the Invoice shall be submitted to:

1. Acquisitions: Michele.Lodge@ihs.gov, A copy of the invoice should be sent electronically to the contract specialist(s) at the address listed above.

2. Service Unit Representatives: brian.campbell@ihs.gov and james.mcauley@ihs.gov A copy of the invoice should be sent electronically to the Service Unit Representative(s) at the address listed above.

END OF STATEMENT OF WORK