Chiropractor SOW.pdf

Department of Health and Human Services Indian Health Service

Statement of Work (SOW) Claremore Indian Hospital

Chiropractic Services

1. PURPOSE OF THE PROJECT

The purpose of this contract is to provide chiropractic services for the Claremore Indian Hospital (CIH). The Indian Health Services (IHS) requires chiropractic services without interruption of during the term of this contract and to limit the scope of work (SOW) to the patient’s pain. The mission of the CIH is to provide the best possible health care services to the Native American population. To meet the mission, CIH requires contractor support to provide chiropractic services.

2. DETAILED DESCRIPTION OF THE TECHNICAL REQUIREMENTS

The contractor shall provide part-time chiropractic services, no less than 2 days per week, 8 hours per day at the CIH as mutually agreed upon by the contractor and IHS for patients over 18 years of age. Services shall include but not limited to the following:

1. Evaluates the neuro-musculo-skeletal systems as they pertain to the patient’s referral for treatment.

2. Records the evaluation and designs a treatment program with goals set appropriately for the diagnosis.

3. Provides on-going treatment and re-evaluations of the response to treatment as they relate to the goals.

4. Utilizes appropriate manual skills and physical agents to realize the goals for the patient.

5. Documents on-going progress towards reaching goals and appropriate changes I the neuro-musculo-skeletal systems in the Electronic Health Record (EHR).

6. Contract chiropractor shall not have any work or health restrictions, which interfere with the performance of Chiropractic services.

7. Conduct patient visits for the purpose of determining appropriate plan of care regarding management of patient’s chronic pain.

8. Documents all visits in Resource and Patient Management System (RPMS) and EHR. Medical record documentation must meet or exceed the established standards of the CIH to include, but not limited to timeliness, legibility, accuracy, and content. All medical record information generated in the performance of this contract will remain the property of and subject to exclusive control of the IHS.

9. Perform all required training timely for HIPPA and computer access, as required by CIH.

10. Performs manual and manipulative therapies with an emphasis on spinal manipulation as feasible and appropriate.

11. Contractor shall work with the Clinical Director to ensure proper licensure, credentialing and privileging of staff required to provide these services at CIH.

12. Contractor shall work with the Clinical Director and/or designees to establish the dates and times for the clinic. The clinic schedule may be expanded or extended, if patient demand justifies such, and with permission and agreement of all parties. The contractor shall notify the Clinical Director and/or designee as soon as possible if unable to work during scheduled hours, no weekend or federal holidays are worked.

13. The contractor shall not bill for patients seen as CIH nor bill any third party payors for services provided at CIH. The contractor shall be eligible for enrollment in the service unit’s Medicare/Medicaid program and any other alternate resource payor, to all the hospital to bill these entities for the contractor’s services, as applicable.

14. The contractor shall respect and maintain the basic rights of patients, to include but not limited to personal dignity. The contractor shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to patients for the Native American community.

15. The contractor shall adhere to CIH dress code policy and ensure that his/her image as a chiropractor is compatible with the expectations of CIH staff and community.

16. The contractor shall perform special assignments as requested to fulfill objectives of the department, facility or service unit. These will be discussed in advance with the contractor and agreement reached before any new duties are assigned

I. Special Terms and Conditions:

A. Privacy Act: In accordance with the Privacy Act, the Contractor shall direct any questions regarding maintaining system of records to this contract to the Oklahoma City Area Privacy Act Coordinator, Jennifer Farris at 405-951-3708.

b. Non-personal Services:

(1) This contract is a non-personal health care services contract, as defined in 37.101, under which the contractor is an independent contractor,

(2) The professional services of the contractor will be evaluated for quality by the Government via routine IHS staff members review of patient charts on a quarterly basis or more often as appropriate, however, the Government retains no control over the medical professional aspects of services rendered (e.g. professional judgments, diagnosis for specific medical or psychological treatment)

c. Contractor Qualifications:

The contractor shall:

(1) Have one (1) year experience as a chiropractor;

(2) Have current professional liability insurance;

(3) Apply for and be credentialed at Claremore Indian Hospital;

Quote/Contract Documentation Requirements to be submitted:

(1) Copy of current resume or CV;

(2) Copy of current license to practice medicine;

(3) Copy of current professional liability insurance;

II. Schedule of Work:

The contractor shall provide part-time chiropractic services no less than 2 days per week, 8 hours per day.

Contractor shall work with the Clinical Director and/or designee to establish the days and times for the clinic.

The clinic schedule may be expanded or extended, if patient demand justifies as such, and with the permission and agreement of all parties. The contractor shall notify the Clinical Director and /or designee as soon as possible if unable to work during scheduled hours. No weekends or federal holiday are worked.

II. Rates of Payment:

The rate shall be an all-inclusive clinic fee (eight-hour shift) for conduction of the study, assessment of the results, and production of written report detailing the findings and any recommendations for improvement.

Indemnity and Insurance:

The government assumes no responsibility of negligent acts of the Contractor. Therefore, the Contractor is responsible for personal insurance if the Contractor indicates that it is necessary. The Contractor will hold harmless and indemnify the government against any or all loss, cost, damage, claims, expense or liability whatsoever as a result from the performance of the Contractor. The Contractor will hold the Federal Government and its agents including the Clinical Director and the Governing Body immune from civil or professional liability for all acts related to quality care management and enforcement of this contract.

3. PERIOD OF PERFORMANCE

Base plus an additional four (4) option years base year: 09/01/2023-08/31/2024 option year 1: 09/01/2024-08/31/2025 option year 2: 09/01/2025-08/31/2026 option year 3: 09/01/2026-08/31/2027 option year 4: 09/01/2027-08/31/2028

4. LEVEL OF EFFORT

4.1. The contractor shall ensure all providers furnished by the contractor complete orientation sessions conducted by the on-site Health Records Department and the Human Resource Department.

4.2. The contractor’s professional services shall be subject to evaluation on quality by the Government via routine staff members review of emergency department/urgent care charts on a quarterly basis or more often as appropriate, however, the government retains no control over the medical professional aspects of services rendered (e.g. professional judgements, diagnosis for specific medical treatment).

4.3. The contractor shall be required to develop familiarity and abide by current policies, procedures, by-laws and regulations of the on-site clinical and medical staff.

4.4. The contractor shall perform services in compliance with applicable standards of The Joint Commission (TJC), which is available to the general public and the Professional Services Policies of the IHS Manual, which is available from the IHS.

5. SPECIAL REQUIREMENTS

5.1. Security Requirements: All contractors shall undergo a fingerprint check and shall be cleared prior to hire.

Contractor’s continued employment is contingent upon the outcome of a complete and favorable background investigation as determined by the sensitivity level of the position. If contractors are found not suitable, they will be removed.

5.1.1. This is a designated position covered by Public Law 101-647, 101-630, Crime Control Act of 1990, and the Indian Child Protection and Family Violence Prevention Act, requiring contact or control over Indian children.

Contractors shall be required to complete, sign, and submit the Addendum to OF-306, Child Care & Indian Child Care Worker Position form. Due to this requirement, the agency shall ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes. Failure to comply with these statutes shall result in immediate removal.

5.2. The contractor shall provide during the term of the contract documentation of provider’s immunization record to reflect CDC’s Recommended Vaccines for Healthcare Workers (specifically MMR, Tdap, varicella, Hep B immunity, current (within the past year) influenza vaccination) and current annual tuberculosis screening.

Documentation shall be provided with the completed Application for Appointment to Medical Staff and continual updates to the immunization record supplied to the Employee Health Nurse.

5.3. The contractor shall not disclose or cause to disseminate any information concerning operations of Claremore Indian Hospital. Such action(s) could result in violation of the contract and possible legal actions.

5.3.1. All inquiries, comments, or complaints arising from any matter observed, experienced or learned of as a result of or in connection with the performance of the contract, the resolution of which may require the dissemination of official information, shall be directed to the government’s designated representative.

6. DELIVERABLES AND REPORTING REQUIREMENTS

6.1. The contractor shall perform quality assurance activities that are acceptable for The Joint Commission (TJC) certification regarding the monitoring of family & internal medicine services and shall provide a quarterly quality assurance letter to the Oklahoma City Area hospitals and service units were these physicians are stationed for temporary duty. This letter shall identify the kind of studies performed, results, and recommendations.

6.2. Contractor Point of Contact: The contractor shall furnish one designated point of contact (POC) to the government’s designated representative for coordination of supplies, delivery, and/or maintenance. The POC will be empowered to make daily decisions to ensure that the contract implementation and day-to-day maintenance meets the terms and conditions of this contract.

6.3. Contractor’s Phone Numbers: The contractor shall provide a toll-free telephone number for service calls, which must be answered during at least eight working hours, between 8:00 am and 4:30 pm, Monday through Friday.

7. GOVERNMENT FURNISHED PROPERTY, FACILITIES AND SERVICES

7.1. The Government will provide the facilities, supplies and the equipment of the hospital and support staff. A person to provide orientation to contract physicians. Use of government furnished facility space, equipment, supplies, and personnel are for the provision of care and services set forth in this contract only.

7.2. A written Orientation Manual of Policies and Procedures for the hospital or service unit, and application forms for appointment and privileging as associate staff members and will also be provided by the Government.

8. CONTRACTOR FURNISHED PROPERTY, FACILITIES AND SERVICES

8.1. Required personnel, materials, supplies and equipment: The contractor shall furnish all personnel, materials, supplies and equipment required to perform work under the contract, to include but not limited to:

9. CHANGES TO THE STATEMENT OF WORK (SOW)

Any changes to this SOW shall be authorized and approved only through written correspondence from the Contracting Officer. Costs incurred by the contractor through the actions of parties other than the Contracting Officer shall be borne by the contractor.

10. DELIVERABLES/PERFORMANCE MATRIX

10.1. Provided Chiropractor: Yes No

10.2. Chiropractor was credentialed: Yes No

10.3. Chiropractor met professional qualifications: Yes No

10.4. Met the terms of the SOW: Yes No

10.5. Chiropractor was on time and in proper attire: Yes No

10.6. Any issues were addressed in a timely manner: Yes No

Department Supervisor Signature:_________________________

Administrative Officer Signature:_________________________

5-24-23