ATTACHMENT 1 - Statement of Work Nurse Practitioner.docx

NURSE PRACTITIONER SUPPORT SERVICES SOLICITATION NO. 75H71324Q00047

WELLPINIT SERVICE UNIT

STATEMENT OF WORK NURSE PRACTITIONER

I. Statement of Work: Nurse Practitioner

The Contractor shall provide Nurse practitioner services at the Wellpinit Indian Health Center, Wellpinit, Washington. These services are to be provided Monday through Friday, 8:00 a.m. through 4:30 p.m, usually no more than 40 hours a week. The clinic is not open on federally recognized holidays or certain day(s) of closure pursuant to an Executive Order by the President of the United States. Inclement weather conditions or facility issues (electrical, water, etc.) may also hinder the normal operating hours and notice of closure will be provided as soon as is practicable by the Wellpinit Indian Health Service Unit administrative staff. Period of performance shall be one (1) year.

Contract providers are expected to comply with reasonable dress, grooming and hygiene standards based on comfort, productivity, health and type of position occupied as compatible with the expectations of the Wellpinit Service Unit Indian Health and the Native American community. Contract providers’ attire will be professional and in compliance with the expectations of the Wellpinit Service Unit Policy and Procedures, including displaying their identification badge on their outer clothing at all times.

II. Objective:

The purpose of the work is to improve the overall health care status of the eligible American Indian, Alaska Native patient population served. Contacts with patients will largely be in the provision of family/general medical care.

III. Location and Period of Performance:

Services will be performed at the following location:

Wellpinit Indian Health Service Unit 6203 Agency Loop Rd Wellpinit, WA 99040

The Period of Performance shall be: 1 Year IV. Services to be Provided

Nurse Practitioner support to be provided shall include, but are not limited to the following:

A. The contracted Nurse Practitioner shall interview and examine patients, review past medical history and request and/ or perform diagnostic tests and examinations as necessary to make diagnosis for primary care services. They make diagnosis after evaluating information obtained and provide medical or surgical treatment and/ or referral as appropriate.

B. The Nurse practitioner shall counsel and educate patients, families, community and medical staff about general health care.

C. The Nurse practitioner shall prescribe drugs and tests necessary to provide quality health care including the use of radiology and laboratory services.

i. The nurse practitioner shall become familiar with and be guided by the Indian Health Service formulary and shall follow IHS procedures when prescribing drugs

ii. The nurse practitioner authorized to prescribe pharmaceuticals shall do so according to the availability of drugs listed in the IHS formulary

iii. IHS pharmacy services will provide instructions to the prescribing contract physician as to substitution of generic drugs for prescribed drugs

iv. The service unit pharmacy must approve drugs not on the formulary

D. The nurse practitioner shall participate in a continual process of quality of health care evaluation to assure the provision of quality services.

E. Strive for excellence in providing general family medicine medical services.

F. Comply with all IHS facility infection control and safety procedures, practices, and standards G. Respect and maintain the basic right of patients, to include but not limited to personal dignity H. Referrals- all referrals shall be done utilizing the Patient Referred Care (PRC) process. The PRC Committee utilizing PRC guidelines will review these referrals.

V. Qualifications and Personnel Requirements

The Contractor shall provide documented evidence of the following minimum professional qualifications.

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A. Shall be certified through the American Academy of Nurse Practitioners B. Possess a current, unrestricted state medical license from any of the 50 states or Puerto Rico C. Maintain continuing education/ certification.

D. Current Advanced Cardiac Life Support (ACLS) and/or Basic Life Support (BLS) certification.

The Contractor shall complete, sign and return the required forms:

1. Certification of Immunization

2. Declaration of Employment

3. Certification of Education and Insurance

4. Addendum to Declaration of Federal Employment (OF 306) Indian Health Service Child Care and Indian Child Care Worker Positions.

Additional information may be required at the Wellpinit Indian Health Service Unit. The Contractor will complete a federal Credentialing process initiated by the Service Unit. A provider will not be paid or an official representative under this contract until the Credentialing process is full and complete and the applicant has been successfully approved by the Service Unit’s Credentialing Committee. The Contractor shall have no work or health restrictions that would interfere with the performance of patient care services.

Key Personnel consists of the Nurse Practitioner.

The Contractor shall submit resumes for the Key Personnel. All Key Personnel shall have a minimum of Five (5) years of specialized experience in their field of work. Specifically working with Native American communities. All resumes must include the following information:

· Name

· Years of experience with respective firm(s) and position(s) held

· Active professional registration or relevant certifications; year for registered, if applicable

· Other experience and qualification relevant to the work required under this contract

· List of projects in which the individual has worked to include the contract number, contracting agency, name of projects(s), project location(s), start and end dates, and project position held if different from the employment history

VI. Government Furnished Property and Services

A. The Wellpinit Indian Health Clinic shall furnish all supplies and equipment necessary.

B. Use of government furnished facility space, equipment, and supplies are for the provision of services set forth in this contract only.

C. Orientation service for the Contractor shall be provided by the Wellpinit Indian Health Clinic.

VII. Contractor Provided Equipment

The Contractor shall not be required to provide any type of equipment to perform the duties identified in this contract.

VIII. Contact with Indian Children This position is subject to P.L. 101-630, The Indian child Protection and Family Violence Prevention Act, as determined by the Acting CEO. 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.

IX. Evaluation and Reporting Requirements

A. All services rendered shall be in accordance with current Medical Staff Bylaws and practices to assure quality of care.

B. Time and attendance sheets will be verified by the Acting CD or Acting CEO C. Acting CD/CEO or designee will notify the COR that the services called for under the contract have been rendered.

X. Payment Schedule

The hourly rate awarded shall covers all related costs to provide service on-site. The price shall include all necessary supervision, management, labor, transportation, equipment, materials, any other direct incidental costs, overhead ad profit, unless the cost is identified as a separately priced contract line item.

Payments shall be made in accordance with the hourly rate of the services provided at the clinic site.

Vendor shall maintain an “Active” status with the System Award Management (SAM) as prescribed by the Electronic Funds Transfer (EFT) procedures.

XI. Invoice Submission

The Contractor shall submit invoice once a month to the Electronic Submission of Payment Request in accordance with clause 352.232-71.

XII. Invoice Payment Payment will be made on this purchase order as close as possible to, but not later than thirty

(30) calendar days after an invoice containing the required information set forth in the invoice submission article of this contract is received in the payment office designated in this contract. An invoice will be deemed to have been received on the later of:

The date the invoice is actually received in the designated payment office, or the date on which the government accepts the property or service required under this purchase order.

Unless a different time period is stated elsewhere in this contract, inspection/acceptance required by this contract will be completed by the government not later than five (5) government working days after the services are rendered or the goods are delivered.

The date of the check issued in payment or the date of payment by wire transfer through the Treasury Financial Communications System shall be considered to be the date payment is made.

XIII. Additional Duties and Responsibilities A. The Contractor shall work in conjunction with other members of the Wellpinit Indian Health Center departments, clinic employees, outside consultants, and others as requested.

B. The Contractor shall provide and accomplish any other duties as requested that are pertinent to the completion of patient care and the mission of the Wellpinit Indian Health Center. While these duties are not individually identified they consist of actions that are consistent with the day-to-day responsibilities of a Nurse Practitioner/Health Care Provider in a medical/clinical facility setting.

XIV. Privacy Act and Confidentiality of Information Services under this contract are to be performed in accordance with the requirements and provision of P.L. 93-579, December 31, 1974 (5 USC 522a) and applicable agency regulations. Copies of these items are available upon request of the Contracting Officer.

Federal Acquisition Regulation (FAR) (48 CFR Chapter 1) Clauses

HHSAR Clauses Incorporated by Reference

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