Attachment 3 - Statement of Work.pdf

Purpose To ensure that dental laboratories utilized by the clinic provide appropriate support for the dental department. Fixed Dentistry involves crown and bridge and abutments to implants. Removable Dentistry involves dentures and partials are a cost effective way to restore a patient to function, esthetics and nutrition. It is a Level of Care V type of dental procedure, complex rehabilitative.

Definitions Removable prosthodontics are dentures and partials. Fixed prosthodontics are individual crowns, retainers and pontics, and abutments/above the gingiva superstructure. Dental implants are placed in bone to provide an immobile structure for above gum restorations.

Policy The dental department will utilize dental labs that can provide adequate support for the dental procedures performed. This may be done with a single lab or a combination of labs. These labs will also be evaluated ensure that they provide quality service.

Procedures

1. Initial selection of dental labs will be performed by the dental director. The selection criteria will be based on location of laboratory, patient needs, service unit need, method of delivery (to and from), costs, laboratory experience, time in laboratory, types of lab services desired and delivered, quality, HIPAA compliance, responsibility of work that needs to be redone, advanced scanning technology and milling, and acceptable esthetics and retentive function of delivered completed cases.

2. The lab(s) selected will have the capabilities to support the dental procedures provided within the dental department. The selection should utilize the input of other dental providers in the department.

3. Traditional crown and bridge dentistry will still be acceptable if fabricated from poly vinyl or poly ether or similar impression materials, .however

4. If the services of the Dental Clinic upgrade to fixed prosthodontics through in-the-mouth scan technology, there will be a need for manufactured abutments from either digital scans as well as the older technology.

5. Removable prosthodontics can be upgraded to the new scan technology as well and it recommended that the dental lab be upgraded as well.

6. The Contractor shall provide dental prosthetic unit fabrication services on a monthly basis as follows:

1. Dental services include the fabrication of Complete Dentures and Removable Partial Dentures as specified in the Price and Cost section of the Contract.

2. All materials must be new and arrive to the Dental Program in original container sealed by the laboratory/manufacturer.

3. Packing must clearly show the laboratory/manufacturer’s name, materials contained, and a brief description of the contents.

4. All materials will become property of the U.S. government.

7. Minimum Performance Requirements

A. Removable Prosthodontics

1. Complete Dentures shall be fabricated using Lucitone 199 acrylic resin and Imperial or equivalent grade denture teeth.

2. Removable Traditional Partial Dentures shall be fabricated using Vitallium metal bases, Lucitone 199 acrylic resin and Imperial or equivalent grade denture teeth.

3. Other removable work can be night guards, interim partials, flexi partials based on nylon technology, addition of teeth to existing work.

4. Remakes of Complete or Removable Partial Dentures will be at NO CHARGE to the Dental Program as long as there is no deviation or change from the original prescription, and if, in the dentist’s determination, the final restoration has a poor fit, or is incompatible with oral health.

The contractor will give a 1 year warranty on ALL completed prosthetic cases to include: metal framework and clasps, acrylic resin and denture teeth, and repairs/re-dos to flexi partials. Repairs to complete or partial dentures will be at NO CHARGE to the Dental Program during this warranty period.

The dental laboratory should anticipate being able to fabricate from a digital scan in the future.

Shipping charges from the Service Unit to the Contractor will be at the cost of the laboratory unless negotiated otherwise.

Shipping charges from the Contractor to the Fort Yuma Health Center (FYHC) will be at the cost of the contractor/laboratory. Any priority or expedited shipping charges from the Contractor/laboratory to the FYHC Dental Program will be at the cost of the contractor.

Prosthetic cases being shipped by the Contractor shall have a method of tracking to insure delivery. Cases that may be lost in transit will be remade at NO COST to the FYHC Dental Program. Shipping should be at the most expedited rate (FEDEX

OVERNIGHT TO MAINTAIN AMBIENT TEMPERATURE OF LESS THAN 24

DEGREES CELSIUS INSIDE CONTAINER/PACKAGE) possible to reduce transit time while package is in Yuma AZ (the southwest). During the peak of summer, if it becomes necessary, COLD GEL/STROFOAM packaging may be necessary at no cost to the service unit to maintain ambient temperature. Packages will be heat sensitive. During the ‘Winter’ or as temperatures in the Southwest decrease, it may agreeable between both shipper and receiver to use Regular overnight - this must be agreed by both parties.

In the event of non agreement, cold gel packaging/Styrofoam will continue by default.

5. There will be no minimum volume number of cases sent to the dental laboratory.

B. Fixed Prosthodontics

1. Remakes of Crown and Bridge and Abutment/retainers will be at NO CHARGE to the Dental Program as long as there is no deviation or change from the original prescription, and if, in the dentist’s determination, the final restoration has a poor fit, or is incompatible with oral health.

2. The contractor will give a 1 year warranty on ALL completed fixed cases to include fracture of material, shade matching, poor marginal adaptation and poor geometric integrity with fit with remaining teeth or existing dental work.

3. The dental laboratory should anticipate being able to fabricate from a digital scan in the future.

Shipping charges from the Service Unit to the Contractor will be at the cost of the laboratory unless negotiated otherwise.

Shipping charges from the Contractor to the Fort Yuma Health Center (FYHC) will be at the cost of the contractor/laboratory. Any priority or expedited shipping charges from the Contractor/laboratory to the FYHC Dental Program will be at the cost of the contractor.

Fixed prosthodontic cases being shipped by the Contractor shall have a method of tracking to insure delivery. Cases that may be lost in transit will be remade at NO COST to the FYHC Dental Program. Shipping should be at the most expedited rate.

THE POINT OF CONTACT RESPONSIBILITIES WILL BE TO

COORDINATE WITH THE CONTRACTOR THE

TECHNICAL ASPECTS OF THIS SERVICE; PERFORM INSPECTION AND

THE REVIEW OF PERFORMANCE

HEREUNDER.

8. Patient selection criteria include

1. Patients presenting to the FYHC Dental Program requesting a dental prosthesis must have a current comprehensive dental exam and treatment plan by a FYHC dental officer. The dental treatment plan must be completed prior to the fabrication of the dental prosthesis.

2. Patients requesting a dental prosthesis must be Service Unit Patients and reside within the Service Unit boundaries as defined by the FYHC. They must be CHS- Direct eligible.

3. Patients requesting a dental prosthesis should support the IPC model and should be empaneled to a FYHC primary care provider. The patient should have 2 current primary care provider visits on record addressing current or chronic conditions of the patient.

4. Preference will be given to medically compromised patients presenting with a need for a dental prosthesis. Medically compromised conditions include patients with diabetes, hypertension, weight loss due to inability to masticate food and severe, aggressive periodontitis or caries of the oral cavity.

5. Patients must comply with the Dental Program Broken Appointment Policy. The policy states

"BROKEN APPOINTMENTS are when a patient is over 15 minutes late for their appointment. When a patient breaks an appointment, they may be required to procure another appointment from the dental front desk. If the patient breaks 2 such appointments in a 6 month period, they may be required to receive treatment on a walk-in/emergency basis only for the following 6 months. This can allow the dental clinic to maintain available appointments for patients who can predictably arrive to their appointments."

6. Dental prostheses will be fabricated, fit and delivered only once in a 5 (five) year period.

Lost or broken prostheses will not be replaced using FYHC funding and will be evaluated on a case by case basis.

9. The dental labs will be evaluated on an ongoing basis.

1. THE POINT OF CONTACT (Dental Chief or assigned dental providers) SHALL

BE RESPONSIBLE FOR THE FOLLOWING:

1. SHALL MONITOR THE CONTRACTOR’S TECHNICAL PROGRESS,

INCLUDING THE SURVEILLANCE AND ASSESSMENT

OF PERFORMANCE;

2. SHALL SUBMIT WRITTEN REQUESTS TO THE CONTRACTING

OFFICER OF DESIRED CHANGES TO THE CONTRACT,

3. SHALL PERFORM (DAILY AND FINAL) INSPECTION AND

ACCEPTANCE OF SERVICES AS REQUIRED BY THIS

CONTRACT;

4. SHALL ASSIST THE CONTRACTOR IN THE RESOLUTION OF

TECHNICAL PROBLEMS ENCOUNTERED DURING THE

PERFORMANCE OF THIS CONTRACT;

5. SHALL CERTIFY RECEIPT AND ACCEPTANCE OF SERVICES BY

SUBMITTING A MONTHLY RECEIVING REPORT WITHIN 2 DAYS

OF ACCEPTABLE SERVICES RECEIVED.

10. Dental labs can be added, dropped, and/or changed at any time.