DRAFT PWS_CSU PT Services.pdf

Billings Area Performance Work Statement (PWS) for Non-Personal

Services

Crow Service Unit Physical Therapy Services

Table of Contents

Section Page

1.0 General 2

2.0 Scope 2 - 3

3.0 Applicable Documents 3 - 4

4.0 Definitions 4 - 6

5.0 Government Furnished Information, Property, & Services 6 - 7

6.0 Contractor Furnished Property 7

7.0 Performance-Based Requirements 8 - 9

8.0 Conduct 9

9.0 Work Schedule 9

10.0 Deliverables 10

11.0 Contractor Qualification Requirements 10

12.0 Background Check 10 - 11

13.0 Health Requirements/Conditions of Employment 11

14.0 Transportation and Lodging 11

15.0 Performance Evaluation 11

16.0 Identification of Contractor 12

17.0 Management of Medical Information 12

18.0 IHS Information Technology Systems 12

19.0 Orientation 12

20.0 Language Requirements and Cultural Awareness 12

21.0 Challenges to Conflicts 12

22.0 Technical Point of Contact 12

23.0 Performance based Matrix 13

24.0 List of Attachments and Exhibits 14

Performance Work Statement (PWS)

Non-Personal Services Physical Therapy Services

1.0 General: This performance work statement (PWS) describes the requirements for non-personal service

Physical Therapy Services to support the mission of the Indian Health Service (IHS).

1.1 Background: IHS is an agency within the U.S. Department of Health and Human Services and is responsible for providing federal health services to American Indians and Alaska Natives. The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes. The

IHS is the principal federal health care provider and health advocate for the Indian people. The goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indians and Alaska Natives. The IHS currently provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 34 states. The positions to be filled: Two (2) Physical

Therapist Positions.

1.2 Crow/Northern Cheyenne Indian Hospital, Billings Area-Indian Health Service, Crow Agency, Montana provides support to the Crow Indian Reservation and Northern Cheyenne Indian

Reservation and includes clinics at Pryor, Montana and Lodge Grass, Montana.

2.0 Scope: The Contractor shall provide physical therapy services in accordance with Section 7.0, performance-based requirements.

2.1 Duties and responsibilities consist of primarily provide therapy services in our Physical Therapy

Department at.

2.1.1. Place of Performance: Services shall be performed at the Crow/Northern Cheyenne

Indian Hospital, however, contractor may be asked to provide therapy service at the

Lodge Grass Clinic (Lodge Grass, MT) and/or the Pryor Clinic (Pryor, MT)

2.1.2. Period of Performance: A base year of twelve months (12) plus four (4) one-year option periods.

BASE YEAR: March 1, 2026-February 28, 2027

OPTION YEAR 1: March 1, 2027-February 29, 2028

OPTION YEAR 2: March 1, 2028- February 28, 2029

OPTION YEAR 3: March 1, 2029- February 28, 2030

OPTION YEAR 4: March 1, 2030- February 28, 2031

3.0 Applicable Documents: Please see the web link listed unless document is listed as an attachment.

3.1 The Joint Commission on Accreditation of Healthcare Organizations (The Joint Commission) http://www.jointcommission.org http://www.jointcommission.org/

3.2 Centers for Medicare and Medicaid Services (CMS) Standards http://www.cms.hhs.gov

3.3 Need for Background Checks: Section 231 of Public Law 101-647, The Crime Control Act of

1990. https://www.govinfo.gov/content/pkg/STATUTE-104/pdf/STATUTE-104-Pg4789.pdf

3.4 Need for supervision with Children: Section 4087 of Public Law 101-630, the Indian Child and

Family Violence Act.

https://www.govinfo.gov/content/pkg/CFR-2002-title42-vol1/xml/CFR-2002-title42-vol1-part136-subpartK.xml

3.5 Section 231 of Public Law 101-647, the Crime Control Act of 1990.

http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.sh tml

3.6 Section 4087 of Public Law 101-630, the Indian Child and Family Violence Act.

http://www.nicwa.org/policy/law/protection/index.asp

3.7 Health Insurance Portability and Accountability Act (HIPAA) of 1996.

http://www.cms.hhs.gov/hipaa

3.8 Privacy Act of 1974. http://www.usdoj.gov/oip/privstat.htm

3.9 Revised American Physical Therapy Association Code of Ethics and Standards of Practice and

Care (1996) http://www.apta.org

3.10 State Physical Therapy Practice Act for the Contractor’s licensing state http://www.apta.org

3.11 IHS Service Unit and Health Center Policies, Procedures and Protocols. (See section 11.0 for a list of attachments and exhibits)

3.12 Federal Computer Security Act of 1987. https://www.congress.gov/100/statute/STATUTE-

101/STATUTE-101-Pg1724.pdf

3.13 Information Systems Security Awareness (ISSA). https://www.ihs.gov/issa/

3.14 Federal Code of Conduct. http://www.ihs.gov

3.15 IHS General Directives. http://www.ihs.gov/adminmggrresouces

3.16 IHS Computer Security Directives. http://www.ihs.gov/adminmggresources

4.0 Definitions:

4.1. Acceptance: Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart

46.5 and subject to other terms and conditions of the contract.

4.2. Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements. Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

4.3. Area: A defined geographical region for Indian Health Service administrative purposes. Each

Area Office may administer several Service Units.

4.4. Code of Ethics: The American Physical Therapy Associations Code of Ethics.

4.5. Contracting Officer (CO): A Government employee with the authority to enter, administer, and/or terminate contracts and make related determinations and findings.

http://www.cms.hhs.gov/ http://www.cms.hhs.gov/ https://www.govinfo.gov/content/pkg/STATUTE-104/pdf/STATUTE-104-Pg4789.pdf https://www.govinfo.gov/content/pkg/CFR-2002-title42-vol1/xml/CFR-2002-title42-vol1-part136-subpartK.xml https://www.govinfo.gov/content/pkg/CFR-2002-title42-vol1/xml/CFR-2002-title42-vol1-part136-subpartK.xml http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml http://www.nicwa.org/policy/law/protection/index.asp http://www.cms.hhs.gov/hipaa http://www.usdoj.gov/oip/privstat.htm http://www.apta.org/ http://www.apta.org/ https://www.congress.gov/100/statute/STATUTE-101/STATUTE-101-Pg1724.pdf https://www.congress.gov/100/statute/STATUTE-101/STATUTE-101-Pg1724.pdf https://www.ihs.gov/issa/ http://www.ihs.gov/ http://www.ihs.gov/adminmggrresouces http://www.ihs.gov/adminmggresources

4.6. Contractor: The Company awarded a legal binding contract to provide supplies and/or services.

4.7. Contracting Officer’s Representative (COR): A federal employee who assists the ordering/issuing activity contracting officer in the administration of the contract. The COR is primarily responsible for the technical assistance and day-to-day program management of the department’s contract. The Service Unit Supervising Physical Therapist, or Technical

Point of Contact (TPOC) providing assistance with management of the facility, will be responsible for monitoring the technical progress including surveillance and assessment of performance for this order.

Technical Point of Contact: Supervising Physical Therapist, (406) 638-3370.

4.8. Cooperative Attitude: Behavior that is positive and displays a willingness to perform assigned patient care tasks and to be a team player.

4.9. Cultural Awareness: Realization and respect for American Indian and Alaska Native practices.

4.10. Customer: Patients, staff, and visitors of an IHS service unit and health center.

4.11. Customer Evaluation/Input: Written comments made to the Contracting Officer regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor’s performance.

4.12. Dependability: Qualities of being trusted and being able to repeat the same task to yield the same result.

4.13. Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal

Executive agencies in their acquisition of supplies and services with appropriated funds.

4.14. Government Vehicle: An IHS owned motor vehicle or a vehicle leased by IHS through agreements with the General Services Administration (GSA) or through commercial rental agreements.

4.15. Health Insurance Portability and Accountability Act (HIPAA): a US law designated to provide privacy standards to protect patients’ medical records and other health information provided to health plans, doctors, hospitals, and other health care providers.

4.16. Health Station: A facility physically separated from a hospital, with a wide range of ambulatory services including at least primary care providers, nursing, laboratory, and x-ray which are available at least 40 hours a week for outpatient care.

4.17. Non-personal Services Contract: A contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees, as defined in FAR 37.

4.18. Orientation: An activity designed to provide basic familiarization of the facility and transition the Contractor Physical Therapist into the IHS Service Unit and/or Health Center and the department where the services will be provided.

4.19. Past Performance Information: Relevant information regarding a contractor’s actions under previously awarded contracts. This includes the contractor’s record of conformance to specifications and to standards of good workmanship; the contractor’s record of containing and forecasting costs on any previously performed cost reimbursable contracts; the contractor’s adherence to contract schedules, including the administrative aspects of performance; the contractor’s history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business-like concern for the interest of the customer.

4.20. Patient Outcome: Result of physical therapy.

4.21. Performance based Matrix: Lists the services to be monitored and the standards to be applied.

4.22. Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

4.23. Service Unit: The local administrative unit of IHS.

4.24. Standards of Practice and Standards of Care: Authoritative statements by which the Physical

Therapy profession describes the responsibilities for which its practitioners are accountable.

The standards provide direction for Physical Therapy practice and a framework for the evaluation of practice. The Standards of Physical Therapy practice may pertain to general or specialty practice.

4.25. Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activity’s written order to obtain services, at a minimum will include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activity’s task order number.

4.26. Tour of Duty: The time of day the physical therapist is scheduled to perform physical therapy services duties; to include thirty minutes to one hour lunch as scheduled for Rehabilitative

Care Department.

4.27. Valid Patient Complaint: Justifiable accusation made by a patient and supported by investigation.

4.28. Verifiable Emergency: An unexpected/unplanned absence by the contractor requiring valid documentation to confirm the occurrence.

5.0 Government Furnished Information, Property and Services:

5.1. Information: Government unique information related to this requirement, which is necessary for Contractor performance, will be made available to the Contractor. The Contracting Officer or designee will be the point of contact for identification of any required information to be supplied by the Government.

5.2. Joint Use by the Government and the Contractor: Except for the property and service listed in

5.3 and 6.0, the Government will provide, for joint use by the Government and the Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

5.3. Contractor Exclusive Use:

5.3.1. Personal Protective Equipment (PPE): The Government will furnish the Contractor with appropriate PPE other than specified in paragraph 4 of the contract. The

Government will be responsible for any repair, cleaning, and inventory required for the

PPE. This does not include any type of uniform or laboratory coat.

5.3.2. The Government will provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 will be charged for lost or destroyed badges.

5.4. Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures.

Training will be provided ONLY if the subject matter is necessary to improve or enhance the quality of medical provider services or includes mandates made by the IHS Service Units/Health

Centers while the candidates are working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

6.0 Contractor Furnished Property:

6.1. Except for the property specified in paragraph 3 as government furnished, the Contractor shall provide all uniforms and other personal medical instruments subject to the following:

6.1.1. Uniforms and Lab Coats: Uniforms and Lab Coats shall conform to the requirements of the Indian Health Service Manual, Part 3 Chapter 4 and meet the approval of the Supervisor of Physical Therapy at the IHS facility.

6.1.2. Other personal medical instruments: “Other personal medical instruments” are defined as Contractor owned items and may include but not is limited to stethoscope, scissors, as appropriate to the work unit. The Contractor shall not use unsafe equipment or supplies at any time during performance of this contract. All Contractor furnished equipment and supplies shall be subject to inspection by the Government and must be approved by the COR, SCN or TPOC prior to use by the Contractor. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

7.0 Performance-Based Requirements: The Contractor shall provide professional physical therapy rehabilitative care for the delivery of patient care through performance of provider duties and management of patient’s needs as described in the PWS and as identified by the Service Unit to the

Billings Area Indian Health Service hospitals, clinics and health stations. To ensure continuity of care the contractor will supply the same physical therapist for each year. Failure to produce the same physical therapist for the full year will constitute breach of contract. Contractor Candidates shall comply with IHS facility policies, procedures, protocols, and Standards of Care.

7.1. The contractor shall provide qualified physical therapy services in direct patient care.

7.2. The Contractor shall ensure 100% percent of all documentation meets established IHS Medical

Facility, Joint Commission, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

7.3. The Contractor Candidate shall perform in accordance with the competency standards listed in

Section 24, Exhibits. Specific tasks include the following. The Contractor Candidate shall:

7.3.1. Provide full range of rehabilitative physical therapy care to patients of all age ranges for treatment or prevention of physical disabilities or diseases in order that patients will derive the maximum benefits from therapeutic activities.

7.3.2. Exercise Knowledge of the physical therapy procedures and its application to clinical practices in order to provide individualized, goal oriented physical therapy care to the pediatric and adult patient.

7.3.3. Determines the objectives, methods, and techniques of therapy to be employed with emphasis on patient needs and limitation imposed by patient conditions.

7.3.4. Correlates the methods and procedures with a wide variety of medical problems, which range from those of a non-traumatic nature to patients which possess severe physical or mental disabilities including those with secondary complications.

7.3.5. Consults with patients and health professionals to gain understanding of the nature of problems, assesses physical capabilities, limitation, and motivates participation in therapeutic activities.

7.3.6. Conducts therapeutic activities for the various physical and medical problems encountered in order to directly appeal to and meet the treatment needs of patient.

Such activities are designed to provide such outcomes as, increasing dexterity and mobility, relieving pain, speeding recovery, and aiding in physical and mental rehabilitation.

7.3.7. Applies methods and procedures that encompass standardized, non-standardized, innovative, and developmental approaches to physical therapy.

7.3.8. Evaluates the effectiveness of PT activities in terms of modifying and predicting beneficial outcomes which includes utilizing PT tests and measurements, as a basis to determine whether medical, surgical, or orthopedic procedures are indicated.

7.3.9. Conducts ongoing evaluations of therapy results in order to assess patient progress and response. Modifies, redirects, adjusts, and augments procedures to accommodate changes and to correct deficiencies in treatment modalities.

7.3.10. Follow facility policies and procedures, JACHO, OSHA, I.H.S. and other federal licensing, accreditations, and regulating body standards.

7.3.11. Educates individuals on the nature of health-related conditions, recommended therapy, and the general promotion of health and prevention of illness/disease.

7.3.12. Participates with health care team in providing consultation services on patient management, discharge planning, special equipment, and training as appropriate or as assigned.

7.3.13. Record patient provider encounters and completes required consults necessary for patient care via the Electronic Health Record.

7.3. The Contractor Physical Therapist shall be subject to peer review per Joint Commission standards.

7.4. The Contractor Physical Therapist shall meet the Safety management reporting requirements in accordance with the Service Unit Safety Measure Policy.

8.0 Conduct: The Contractor shall meet standards as listed in the Federal Code of Conduct.

8.1. The Government reserves the right to remove from the facility any Contractor employee failing to abide with the Federal Code of Conduct.

8.2. A Contractor Provider demonstrating impaired judgment will not be allowed to continue working on the contract. The Government reserves the right to remove from the facility any Contractor Provider whom in the judgment of a licensed healthcare practitioner is impaired.

9.0 Work Schedule: The Supervising Physical Therapist at the IHS facility will determine specific tour of duty for each Contractor Physical Therapist within the scope of the task order. Contractor Physical Therapist shall work in accordance with the tour of duty as scheduled to meet the patient care needs of the Service

Unit facility. The Contractor Physical therapist will be scheduled for lunch breaks of thirty minutes to one hour as assigned and/or rotated, based upon department scheduling. The contractor needs to be available on holidays and weekends.

9.1. Overtime, Holiday, Call-Back and On-Call hours shall be performed as agreed upon by the Supervising

Physical Therapist and Contractor and within the limits of the task order. Overtime hours will be scheduled where there are departmental coverage gaps, to ensure adequate staffing for patient care.

9.2. The Contractor Physical Therapist shall provide notice of unavailability to their employer (The

Contractor) and the Supervising Physical Therapist or designee prior to any absence from work. The

Contractor Physical Therapist shall provide notification at least fifteen (15) days in advance of a desired absence if the length of the absence exceeds eight (8) work hours. Verifiable emergencies are the only exception to the advanced notification requirements.

9.3. The Contractor shall provide a qualified temporary replacement Physical Therapist for any absence of more than 8 work hours.

9.4. All Contractor Physical Therapist shall complete the credentialing and clearance requirements at the appropriate level before reporting for work.

10.0 Deliverables

10.1. Monthly Data Report: The contractor shall provide a monthly data report that identifies the task order, Contract Line-Item Number (CLIN), Contractor Physical Therapist name, dates of service, quantity of hours worked, and hourly rate. The Contractor shall provide a summary of task order hours authorized, hours worked, balance of hours remaining, estimated monthly invoice amount, and estimated balance of funds remaining.

10.2. The Contractor shall notify the Contractor Officer and the COR via email when 75% of the authorized hours or 75% of the obligated funding has been expended.

11.0 Contractor Physical Therapist Qualification Requirements:

11.1. Experience. The Contractor Physical Therapist shall have at least 10 years (120) months of physical therapy experience. This experience must include at least 2 years in each of the following areas:

outpatient, inpatient, swing bed, and home health.

11.1.1. Experience shall equip the Contractor Physical Therapist with the knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the physical therapy services category to be filled.

11.2. License/Registration. The Contractor Physical Therapist shall possess a current, valid, unrestricted physical therapist license in a state, the District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States, throughout the term of this contract.

11.3. Motor Vehicle Operator’s License. The Contractor Physical Therapist shall possess a valid state driver’s license throughout the term of this contract.

11.4. Certifications. The Contractor Physical Therapist shall possess current Basic Life Support (BLS).

11.5. Degree or Diploma. The Contractor Physical Therapist shall possess a degree or diploma from a professional physical therapy program approved by the legally designated state accrediting agency at the time of the program was completed by the applicant.

11.6. National Physical Therapy Examination (NPTE). The Contractor Physical Therapist shall have passed the National Physical Therapy Examination exam.

11.7. Review of Qualifying Factors. The Supervisory Physical Therapist at the Crow Service Unit, or their designee, will review all required documentation, conduct candidate interview, and reference checks for each Contractor Physical Therapist, to ensure verification and compliance prior to proceeding with background check/clearance process.

12.0 Background Checks / Clearance: As directed by the Contracting Officer, the Contractor Physical

Therapist shall provide all requested information necessary to perform background checks. The

Contractor Physical Therapist shall comply with the requirement to obtain security investigations.

The Contractor Physical Therapist shall work with the IHS to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed.

All completed forms will be reviewed by the Contractor Physical Therapist and forwarded to the

Government personnel. IHS will immediately remove a Contractor from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

13.0 Health Requirements/Conditions of Employment:

13.1. Medical Evaluation: The Contractor Physical Therapist shall provide a fitness for duty certificate issued by a licensed physician to perform the proposed job without significant risk to personal health or the health and safety of others.

13.2. Immunization: The Contractor Physical Therapist shall provide the documentation of the following:

A. Hepatitis A – 2 dose series at 0 and 6 months.

B. Hepatitis B – 3 dose series at 0, 1, and 6 months or documented immunity. A signed declination of Hepatitis B vaccination series will be accepted.

C. Measles, Mumps, Rubella (MMR) – 2 doses or titer documentation.

D. Varicella (chickenpox) – 2 doses, titer documentation or history of varicella/shingles.

E. Tetanus, diphtheria, pertussis (Tdap/Td) – 1 dose of Tdap, then tetanus (Td) booster every 10 years thereafter.

F. Meningococcal – Two vaccines (MenACWY and MenB) recommended for microbiologists routinely exposed to N. meningitides.

G. Documentation of annual TB test – may include Mantoux TB skin test (PPD). Acceptable lab testing: Quantiferon Gold or T-Spot test. For positive TB test results, please submit a copy of recent chest x-ray results.

H. Influenza – MANDATORY annual vaccination.

I. Highly encourage COVID vaccination.

14.0 Transportation and Lodging: The Contractor shall be responsible for all applicable Federal, State, and

Local Taxes, Meals, Travel/Transportation. Lodging, if available, must be paid for by the Contractor or Contractor Physical Therapist. Government quarters are available at prevailing rental rates plus utilities, as applicable, if government quarters are utilized. The Contractor shall be responsible and liable for the proper care of government owned or leased property furnished in occupied quarters.

15.0 Performance Evaluation:

15.1. The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 24.0.

15.2. Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome constitutes a breach of contract.

16.0 Identification of Contractor: The Contractor Physical Therapist shall wear a government issued contractor identification badge during performance of duty.

17.0 Management of Medical Information: The Contractor Physical Therapist shall manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health

Center specific policies and protocols.

17.1. The Contractor Physical Therapist shall ensure adherence to Department of Health and Human

Services (DHHS) IT system security policies and procedures. The IT policies and procedures will made available to the Contractor Physician upon request.

17.2. The Contractor Physical Therapist shall immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

18.0 IHS Information Technology Systems: The Contractor Physical Therapist shall possess basic knowledge, skills, and abilities to use a computer.

18.1. The Contractor Physical Therapist shall adapt to and successfully utilize IHS information technology systems that are deemed by the Supervising Physical Therapist as necessary for acceptable contractor performance.

18.2. The Contractor Physical Therapist shall ensure that IHS information technology system security policies and procedures are adhered to. The IT policies and procedures will be made available to the Contractor at each IHS facility.

19.0 Orientation: The Contractor Physical Therapist providing service under this contract shall attend mandatory orientations and training specified by the IHS, the Service Unit and/or the Supervising

Physical Therapist.

20.0 Language Requirements and Cultural Awareness: The Contractor Physical Therapist shall read, understand, speak, and write English to effectively communicate with patients and other health care workers, and shall be respectful of the local, American Indian, and Alaska Native culture.

21.0 Challenges to Conflicts: The Contractor Physical Therapist shall maintain an appropriate professional demeanor in the presence of patients and with each other. Harmony and good communication between the staff are necessary to maintain the best patient care environment and all staff members are expected to contribute to a positive milieu. Violent language, profanity, and any threatening behaviors are specifically prohibited.

22.0 Technical Point of Contact: CAPT. Robert Roe, Supervising Physical Therapist, (406) 638-3371.

BAO PWS June 30, 2022

23.0 Performance – Based Matrix

Performance based Task Indicator Standard Quality Assurance Incentives

State the end results or outputs that you, the customer will formally accept or reject.

For the requirement, state the feature(s) of end result that will be surveilled.

For each “indicator,” state a performance level that, when met, means the task has been performed satisfactorily.

This Standard describes “What Success Looks Like.”

For each “Standard”, state the method used to check performance

(i.e. random sampling, 100% inspection, periodic inspection, customer complaints).

List Positive and Negative

Incentives. Address method of linking payment to quality of service.

Contractor shall provide

Physical Therapy services in the delivery of patient care to Crow Service Unit.

Competency

Compliance

Quality

Patient Outcomes

Professionalism

Documentation

Maintain 100% of the required competencies (refer to Section 25.0)

100% compliance with IHS Service Units and/or Health Centers published Policies; Procedures; Standards of Care;

and hospital and physical therapy protocols.

Perform 100% of the required tasks (refer to Section 7.0) during scheduled tour of duty (refer to Section 9.0)

No reports of breached patient safety, infection control, and other procedures that might adversely affect patient outcome.

Performance characterized by continual cultural awareness and focus on customer service at 100% adherence to the Physical Therapy Code of Ethics and Federal Code of Conduct.

100% percent of all documentation meets established IHS Medical Facility, Joint Commission, and Centers for Medicare and Medicaid Services (CMS) standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

See QASP. Surveillance systems will include direct observation, periodic inspections, validated customer complaints, random sampling, and verification of documentation provided by the contractor.

Payment of contract price for satisfactory service.

Contractor performance will be evaluated using the Contractors Performance Assessment Report (CPAR). The evaluation will be considered when future IHS Contract selections are made.

BAO PWS June 30, 2022

24.0 List of Exhibits and Attachments. To be provided by the Contracting Officer upon request.

24.1. Exhibits

A - Quality Assurance Surveillance Plan (QASP)

B - Contract Data Requirements List (CDRL) DD Form 1423

24.2. Attachments

24.2.1. Witten Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

c. Age Specific Competency Verification

24.2.2. Contract Physical Therapist Orientation Check List

24.2.3. Contract Physical Therapist Orientation Competency Verification

Instructions

24.2.4. Contract Physical Therapist Billing Information

24.2.5. Standard Emergency Codes

24.2.6. Confidentiality: Legal and Ethical Concerns in Healthcare

24.2.7. EMTALA – Emergency Medical Treatment and Labor Act

24.2.8. What are Age‐Specific Competencies?

24.2.9. An Introduction to the Native American Culture

24.2.10. Verbal and Telephone Orders

24.2.11. Medication Administration

24.2.12. Pain Management

24.2.13. Latex Allergy

24.2.14.Focus Charting

24.2.15.Patient Restraints

24.2.16.Charge Physician Duties: Responsibility and Expectation

24.2.17.Immunization documentation

24.2.18.Required certification documentation