Att K - SOW.docx

Attachment K

RFS 27-87834

STATEMENT OF WORK

I. EXECUTIVE SUMMARY

The Contractor will perform a full range of clinical laboratory services including, but not limited to chemistry, toxicology, microbiology, hematology, cytology, endocrinology, immune-hematology, immunology, and histology. The Laboratory shall agree to maintain accreditation as deemed necessary by the College of American Pathologists.

II. BACKGROUND AND CURRENT STATE

Residents of the Indiana Veterans’ Home (IVH) will require various clinical laboratory services from time to time during their residency. The safety, well-being, and privacy of IVH residents and other people require that clinical laboratory services be available to IVH residents.

III. SCOPE OF WORK

a. OBJECTIVES OF ENGAGEMENT

Laboratory will provide consultations as follows:

i) The laboratory clinical pathologists shall be available for consultation with IVH staff concerning laboratory results and their interpretation. At least one full-time staff board-certified pathologist, will provide consultation with IVH as needed.

ii) The laboratory will provide Quality Assurance Office information necessary to generate reports as required by the IVH Medical Director. IVH will provide identification numbers for the doctors to the laboratory to assist with this request. A list of all tests ordered by IVH and charges for each doctor will be provided monthly. This will include testing paid by insurance.

iii) IVH will provide necessary space and storage for supplies and the storage and refrigeration of specimens needed by the laboratory.

iv) IVH will provide information regarding each facility Resident sufficient to allow the laboratory to process third party claims. Information to include, but not limited to, Medicare and Medicaid numbers, date of birth, and diagnosis codes pertinent to the laboratory tests to be performed.

b. DELIVERABLES AND DEADLINES

The Contractor will provide the following services:

Clinical-Medical Laboratory Services:

i) Handling of special situations (Stat-Testing)

a. Pick up of STAT specimens are to be picked up within (2) hours of lab order and results reported within four (4) hours of the draw. STAT results will be telephoned routinely to an IVH Unit nurse. The units will fax the order and call the Laboratory and schedule laboratory pick up. The laboratory contract will be available to IVH for STAT-Testing and after normal working hours. The Laboratory staff will be “on call” twenty-four (24) hours per day, seven days a week. State understands that subcontractor may be providing STAT lab services.

ii) Routine Specimen pickup will be Monday, Wednesday, and Friday, no earlier than 5:30 AM, and no later than 12:00 PM.

c. PAYMENT MILESTONES

i) Billing Requirements:

a. The lab will bill and accept third-party payments, when available, as full payment for resident services performed. Where no-third party billing is possible, the lab will bill the Indiana Veteran’s Home, per the Medicare Physician Fee Schedule and invoice the state for approval, audit, and payment on a monthly invoice. Billing must follow the Medicare billing guidelines and be billed within a year of the Date of Services (DOS). IVH will provide information regarding each IVH resident sufficiently to allow the Contractor to process third-party claims. Information to include but not be limited to Medicaid, Medicare, or other insurance carriers and date of birth, etc. IVH residents identified as VA Per Diem (VA Prevailing Rate) are explicitly excluded from third-party billing and shall be billed to IVH. “Proof of filing” and Rejection of any third-party insurance for services must accompany invoice for payment where no third-party billing is possible.

b. The Laboratory will perform the following duties outside the scope of resident services: Environmental Culture for Arclave once annually

IV. PROJECT MANAGEMENT

a. PROJECT MANAGEMENT PLAN

Laboratory will:

i) Provide all necessary supplies and maintain equipment, excluding refrigeration, for the collection and transport of specimens.

ii) Provide in-service training for IVH staff that will be responsible for collection and handling of specimens. Laboratory will work with IVH infection control coordinator to develop the in-service training.

iii) Licensed staff of laboratory must be available by phone to answer specific informational-type questions. Laboratory personnel will be available to address and assist in the training of IVH personnel. Laboratory will provide information to assist the Quality Assurance Program.

iv) Laboratory personnel will be available to address and assist in the Waive testing competency training for all appropriate nursing staff. Laboratory personnel will be available to assist the infections control nurse in maintaining competency regarding draws.

b. STATUS UPDATES AND REPORTING

i) Laboratory must have ongoing quality controls and must provide periodic reports required by the infection control nurse. Laboratory must also provide Performance Improvement Data and other information when requested by IVH.

ii) Reporting Procedures:

a. Routine test results of procedures ordered will be faxed or telephoned to the units by laboratory personnel within twelve (12) hours or the next morning.

b. HIV reports will be placed in a separate sealed envelope labeled “CONFIDENTIAL and PERSONAL” to the attention of the physician and unit involved and delivered to the nursing administration.

V. INDEPENDENT VALIDATION AND VERIFICATION

In the event the State determines that any independent verification and validation ("IV&V") oversight is required by the State during the term of this Contract, the Contractor shall comply with any such oversight during the term of this Contract, pursuant to which an independent third-party review may be conducted by a reviewer selected by the State, for the purpose of verifying that the Contractor has performed its obligations in compliance with the terms of this Contract. In the absence of any such IV&V oversight, the Contractor shall comply with any other appropriate methods or means for verification and validation required by the State during the term of this Contract for the purpose of verifying and validating that the Contractor has performed its obligations in compliance with the terms of this Contract. The Contractor shall provide all information and documentation requested during the State's IV&V oversight or verification and validation efforts related to this Contract and in connection with any IV&V oversight or verification and validation efforts related to an initiative of which this Contract is a part.

VI. COMPLIANCE REQUIREMENTS

a. CLIA Certification

i. Laboratory must maintain CLIA CERTIFICATION, as mandated by the Federal regulations. Laboratory will meet standard PE 1.10.22 as stated in the “Comprehensive Accreditation Manual for Hospitals, 2000.”

VII. KEY PERFORMANCE INDICATORS

The State will use Key Performance Indicators (KPIs) to measure performance and outcomes of the Contract. The specific KPIs and their targets will be defined and agreed upon by the State and the Contractor during the initial phases of the requirements under the Contract. At a minimum, on time delivery at quality standards of the scope provided within the budget set forth in the Contract will each be measured. Additionally, the State will collect a modified Net Promoter Score from customers to this Contract in its discretion. Low ratings on the modified Net Promoter Score or failure to meet any other KPIs may be deemed, at the discretion of the State, to constitute default under the Contract.