Attachment 2 - Statement of Duties.docx

IHS Solicitation No. 75H70426R00007 Physician (Emergency Medicine) PSC Attachment 2: Statement of Duties

STATEMENT OF DUTIES

I. BACKGROUND

The IHS provides comprehensive primary health care and disease prevention services to approximately 2.8 million American Indian and Alaska Native (AI/AN) people in 574 federally recognized tribes through a network of more than 605 hospitals, clinics, and health stations on or near Indian reservations. IHS facilities are located across 12 Areas and serve populations in rural and urban locations in 37 states. IHS healthcare facilities are accredited, and Centers for Medicare & Medicaid Services (CMS) certified to ensure high quality, safe, evidence-based care and to support third party billing for eligible AI/AN patients.

This position is located in the Emergency Department of the Whiteriver Indian Health Service Hospital, Whiteriver, Arizona. The Whiteriver Hospital is 40-bed general medical and surgical referral hospital that serves as the primary health care facility for approximately 19,000 indigenous beneficiaries of the White Mountain Apache Tribe. The hospital provides inpatient and ambulatory care, emergency medical care and community health services (i.e., Environmental Health, Community Health Nursing, Social Services, Dental Services and Preventive Health). Other medical services include Family Practice, Ambulatory Surgery, Obstetrics & Gynecology, Newborn Care, Optometry/Ophthalmology, Psychiatry, Pediatrics, Internal Medicine, Orthopedics, and Radiology.

II. BASIC FUNCTION

The incumbent serves as a Medical Officer (Emergency Medicine) providing direct patient care and consultation services in the Emergency Department. Responsibilities include ambulatory and emergency medical treatment for patients of all ages, including urgent care, trauma, surgical, gynecological, and general medical services, in hospitals, clinics, or other designated health care facilities.

The position operates in a 24-hour emergency care setting providing specialized trauma and emergency services. The Emergency Department treats approximately 40,000 patients annually, with a majority presenting for urgent and emergent care after hours.

The incumbent provides comprehensive and continuous medical care, managing a full range of cases from routine to complex, including critical situations requiring immediate decision-making and appropriate referral. The incumbent performs diagnostic and surgical procedures within their scope of practice and credentials.

Additional responsibilities include serving as a consultant to WRSU medical personnel and physicians at Cibecue Health Center, providing medical direction to Emergency Medical Services personnel, and maintaining admitting privileges with responsibility for inpatient care as needed. In rare cases, the incumbent may assist with ambulance transport of critically ill patients. Participation in teaching activities is also expected.

III. MAJOR DUTIES AND RESPONSIBILITIES

As an optimally qualified Physician, and within specialty area, assumes responsibility for the diagnosis, prevention, therapy, maintenance and rehabilitation of patients in the capacity of a senior specialist or expert. 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. Makes preliminary diagnosis, directs, prescribes, or provides treatment. Bases decisions on information obtained professional medical knowledge and skills and prescribed policies and procedures. Makes notes of observations to be incorporated into clinical records. Provides emergency care as required. Provides definitive management in all medical categories for cases that do not require referral. Gives total patient care including prevention, health maintenance, early diagnosis, treatment and follow-up services to patients under his/her care. May consult with specialist in other medical specialties.

2. 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. Performs or assists other physicians in the performance of minor surgery.

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. Coordinates and integrates information obtained into the ongoing Health Care Program at the Service Unit and assures the provision of timely follow-up care as required.

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. Dictates clinical reports and correspondence concerning patients under his/her care to physicians, hospitals, and other individuals and facilities.

5. Serves as Consultant to the Field Hospitals in providing professional expertise in his/her specialty area. Provides regular documented in-service conferences for clinical and technical staff.

6. 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 patient's medical, psychological and social problems.

7. May act as Chief of Emergency Medicine in the absence of the Chief. When acting, assumes all responsibilities or the position.

8. Performs other duties as assigned. As required, performs medically related or patient care assignments that 1) fall outside the designated area of specialization or experience and 2) involve working in other service units or facilities on an emergency or other contingency basis.

IV. PERSONAL SERVICES - EMPLOYER-EMPLOLYEE RELATIONSHIP

IHS is authorized by statute (FY 1995 appropriation act (Department of the Interior and Related Agencies Appropriations, 1995, Pub. L. 103–332, 108 Stat. 2499, 2527 (1994)) to enter into personal services contracts with entities, either individuals or organizations, for the provision of services in facilities owned, operated or constructed under the jurisdiction of the Indian Health Service. Individuals providing health care services pursuant to these contracts are covered by the Federal Tort Claims Act.

b. Supervision Relationship:

The incumbent for the position works under the supervision of the IHS Chief of Emergency Medicine who provides general professional and administrative supervision to all Emergency Department staff at the facility. The incumbent is expected to act as an expert in the field of Emergency Medicine. Technical supervision is minimal. Work performance is reviewed and monitored by the Chief for conformance to policies, procedures, and practices relating to Emergency Care, safety and delivery.

c. Supervisory Controls:

The supervisor provides very broad administrative guidance and policy direction. The incumbent plans and initiates work independently; plans, designs, and carries out the work to be completed and serves as a technical authority. Recommendations of changes in both services and/or equipment are discussed with and approved by the supervisor. Performance and peer review are completed by the Chief of Emergency Medicine in accordance with the requirements of the Medical Staff Bylaws and service unit policies.

V. MINIMUM QUALIFICATIONS

Applications will be initially screened for eligibility in accordance with the minimum qualification criteria listed in sections a through e. Applicants must address each criterion in their application in order to meet the minimum qualifications stated for the position.

a. Education: A Doctor of Medicine or Doctor of Osteopathy degree.

b. Licensure:

· Incumbent must possess a current, active, full and unrestricted medical license or registration as a Physician from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

· Other: In order to accomplish the duties and responsibilities of the position, the incumbent may be required to drive government vehicles. Therefore, the incumbent may be required to maintain a current US Government Motor Vehicle Operators Identification Card.

c. Certifications:

· Board eligible or board certified in emergency medicine.

· The Physician will be required to have certifications as dictated by medical staff bylaws. These include Basic Life Support, Advanced Cardiac Life Support, Advanced Trauma Life Support and Pediatric Advanced Life Support certifications. If not immediately available, these will be required to be completed within 3 months of credentialing.

d. Work Experience:

· Completion of formal residency training of 3-4 years as required by Emergency Medicine specialty board or progressive experience equivalent in breadth and intensity.

· Quality resident - Completion of 2 years Emergency Medicine residency training plus 1-2 years of experience beyond the residency training (Board eligible) or progressive experience equivalent in breadth and intensity.

e. Technical Knowledge, Skills, Abilities:

· Demonstrated mastery of, and skill in applying, expertise in advanced patient care services, theories, concepts, principles, and methods.

· Ability to apply experimental theories and/or new advanced developments to solve complex healthcare problems not susceptible to treatment by accepted/traditional methods;

· Ability to function as a recognized technical authority in a particular discipline or function.

· Makes decisions or recommendations on changing existing, or developing new health policies or programs.

· Knowledge of, and compliance with, IHS and Whiteriver regulatory, licensing, and The Joint Commission accrediting agency requirements, and statutes governing clinical or medical facility operations.

· Knowledgeable of service unit’s medical staff by-laws, rules, and regulations.

· Knowledge of instructional methods to provide professional training, medical consultative services, and guidelines for interns, residents, and other hospital staff to follow when carrying out patient care services.

· Ability to assess program effectiveness for the delivery of patient care services.

f. Interview and Professional References:

The Government may request an interview and/or professional references upon determining a candidate meets the minimum qualifications upon initial screening of their resume. Candidates should be prepared to schedule an interview and/or provide up to two professional references at the Government’s request. The Government may contact additional references at its discretion.

g. Disqualifications:

An Offeror will automatically be disqualified from receiving an award if they are included on the Department’s List of Excluded Individuals and Entities (LEIE). LEIE is an online database managed by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). It identifies people and organizations prohibited from participating in Medicare, Medicaid, and other federally funded healthcare programs due to fraud, patient abuse, or other offenses. All Offerors will be checked against this database at https://exclusions.oig.hhs.gov/?AspxAutoDetectCookieSupport=1

Additionally, an Offeror who is not able to obtain the necessary security clearances and/or credentials for any facility will be no longer eligible for award.

V. OTHER FACTORS RELATED TO EXECUTION OF DUTIES

a. Technical Guidelines: The incumbent is expected to use Departmental, Agency, IHS Area and local manual issuances and policy and procedural directives as well as medical and related discipline textbooks and publications as technical guidance in the performance of work. Specifically, the incumbent is expected to use guidelines such as national regulatory (The Joint Commission, CMS, EMTALA, Patient Centered Medical Home), broad policy statements, recent scientific findings, or reports that are often ambiguous in nature and require extensive interpretation. The incumbent uses judgement and ingenuity and exercises broad latitude to interpret new or revised professional standards and codes, guidelines, policy statements, or regulations. Management officials recognize the Physician as a technical expert in the development, interpretation, and the implementation of professional guidelines.

b. Complexity of Work:

The nature of assignments consist of providing authoritative medical competency in evaluating and correlating medical evidence with regard to the impact of disease or injury. The physician conducts extensive investigation and analysis of largely undefined factors and conditions to determine the nature and scope of healthcare problems and to devise solutions. The Physician initiates continuing efforts to develop new concepts, theories, policies or programs and/or to solve problems that have previously resisted resolution. The physician will perform a variety of duties requiring the application of many different, unrelated processes and methods to a broad range of activities or to the in-depth analysis of issues.

The Physician analyzes and resolves novel and obscure problems, complicating factors, and is required to make decisions based on intricate and unrelated items of information and assumptions from inconclusive or variable data. The Physician develops new standards, methods, and techniques or extends existing methodology; evaluates the impact of technological developments, and anticipates future trends and requirements.

c. Scope and Effect:

Scope: The work involves isolating and defining unprecedented issues and unknown conditions; formulating and exploring new theories and phenomena; developing, testing, and advising on new approaches, theories, or methods; and providing expert advice and guidance to officials, administrators, and healthcare providers on a wide range of medical and healthcare concerns.

Effect: The work results affect the development, quality, and success of major aspects of agency programs or missions, the work of other experts and high-level officials within and outside the agency, and the well-being of substantial numbers of people.

d. Personal Contacts:

Contacts include patients and families, professional staff and individuals or groups from within and outside the agency, including consultants, contractors or professional associations, in moderately unstructured settings. This level may also include contacts with agency officials who are several managerial levels removed from the employee when contacts occur on an ad hoc basis. The Physician must recognize or learn the role and authority of each party during the course of the meeting.

Contacts with other healthcare personnel are for the purposes of information exchange, consultation, patient education, and collaborative program development. Contacts with patients and families are to provide care, treatment, counseling, support and teaching. Patients and family members are often anxious and fearful. Contacts with them require professionalism, tact, sensitivity and patience.

e. Physical Demands The work requires some physical exertion such as long periods of standing, or recurring and considerable crouching, bending, standing, stooping, stretching, or walking such as in performing regular and recurring medical activities, inspections, or to observe healthcare operations in treatment facilities. Work also includes frequent lifting of moderately heavy items weighing less than 23 kilograms (i.e. under 50 pounds) such as equipment or assisting in self-care transfer activities.

f. Work environment The work involves regular and reoccurring exposure to moderate risks, discomforts, and unpleasantness such as contagious diseases, infectious materials, carcinogenic materials, noxious fumes, radiation, potentially pathogenic bacteria, or patients suffering from agitation or delirium. Special safety precautions such as personal protective equipment (PPE) may be necessary.

g. Conditions for Continuity to Provide Personal Services

· The incumbent must comply with all requirements for the position and maintain status as an active member of the medical staff.

· The incumbent must obtain and maintain medical staff privileges, including any licensure requirements. If privileges are not obtained or maintained during the contract period, the PSC will be subject to adverse actions, up to and including contract termination.

· The incumbent must remain in good standing with the Internal Revenue Service (IRS) in ensuring applicable taxes are paid timely.