Draft PWS Nephrology.pdf

Performance Work Statement (PWS)

Non‐Personal Services Nephrology Services

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

Nephrology 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: Nephrologist.

1.1.1 Blackfeet Hospital, Billings Area‐Indian Health Service, Browning, Montana provides support to the Blackfeet Indian Reservation and includes a clinic at Heart Butte, Montana.

1.2 Scope: The Contractor shall provide Nephrology Physician Services in accordance with section

5.0: Performance Based Requirements.

1.2.1 Duties and responsibilities: will encompass outpatient, Nephrology Physician services to IHS patients.

1.2.2 Place of Performance: Services shall be performed at the Blackfeet Hospital, Browning, Montana.

1.2.3 Period of Performance: Will include a base ordering period of twelve months (12) plus four (4) one‐year option periods.

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

1.3.1 The Joint Commission http://www.jointcommission.org

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

1.3.3 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

1.3.4 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

1.3.5 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

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

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

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

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

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

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

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

101/STATUTE‐101‐Pg1724.pdf

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

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

1.3.13 IHS General Directives. http://www.ihs.gov/employeeresources

IHS Computer Security Directives. http://www.ihs.gov/employeeresources

2.0 Definitions:

2.1. 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.

2.2. 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.

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

Area Office may administer several Service Units.

2.4. Code of Ethics: HHS/IHS Ethics Training

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

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

2.7. Contracting Officer’s Representative (COR): A federal employee who assists the ordering/issuing activity contracting officer in the administration of task orders issued under this contract. The COR is primarily responsible for the technical assistance and day-to-day program management of the ordering activity’s task orders. Ordering activities may have different designators for this employee (e.g. Outpatient Medical Officer Supervisor; or

Technical Point of Contact (TPOC) providing assistance with management of facility Task

Order(s), will be responsible for monitoring the technical progress including surveillance and assessment of performance for this order.

Technical Point of Contact:

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

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

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

2.11. 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.

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

2.13. 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.

2.14. 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.

2.15. 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.

2.16. 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.

2.17. 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.

2.18. Ordering Activity: An authorized user of IHS that may issue a task order to obtain required services under this contract.

2.19. Ordering Activity Contracting Officer: A Government employee of IHS authorized and warranted to issue task orders and to make subsequent task order modification(s) under this contract. The Ordering Activity CO has the authority to make initial determinations on all matters of dispute regarding task orders.

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

2.21. 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.

2.22. Patient Outcome: End result of Provider care.

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

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

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

2.26. Standards of Practice and Standards of Care: Authoritative statements by which the medical profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for physician practice and a framework for the evaluation of practice. The standards of medical practice may pertain to general or specialty practice.

2.27. Tour of Duty: The time of day the physician is scheduled to perform nursing services duties;

to include thirty minutes to one hour lunch as scheduled for Internal Medicine or Family

Practice.

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

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

3.0 Government Furnished Information, Property and Services:

3.1. 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.

3.2. 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.

3.3. Contractor Exclusive Use:

3.3.1. 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.

3.4. 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.

4.0 Contractor Furnished Property:

4.1 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:

4.2 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 Clinical

Director at the IHS facility.

4.3 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.

5.0 Performance‐Based Requirements: The contractor shall provide Nephrology Physician/Specialty Clinic

Services in the delivery of patient care to the Indian Health Service.

Specific tasks include the following:

5.1 On‐Site Nephrology Physician/Specialty Clinic Duties:

5.1.1 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.

5.1.2 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:

5.1.3 Provide full range of emergency care to patients of all age ranges.

5.1.4 Exercise Knowledge of the medical procedures and its application to clinical practices in order to provide individualized, goal oriented nephrological care to the adult patient.

5.1.5 Exercise knowledge of scientific and psychosocial medical theory, principles, practices, and techniques in order to plan and provide quality medical care which meets the physical, spiritual, and social‐cultural needs of the Native

American/Alaskan Native patient.

5.1.6 Exercise knowledge of biological aspects of disease processes and illness in order to recognize complications and implement appropriate therapeutic intervention required.

5.1.7 Exercise knowledge of the medications and dosages in order to recognize their desired effects, side effects, and complications of their use.

5.1.8 Exercise knowledge of childhood immunizations, vaccines and up to date patient education resources and information.

5.1.9 Analyze the results of various medical procedures and translate them into appropriate interventions.

5.1.10. Work effectively and harmoniously within the health care teams and with Native

American/Alaskan Native patients and their families.

5.1.11 Provide Inter‐Facility transports when needed and supported by schedule requirements.

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

5.1.13. Coordinate care teams, offer guidance, and support to team members.

5.1.14. Teach and offer appropriate health education to staff, patients, and customer owners.

5.1.15. Perform clinical procedures and response to emergency codes.

5.1.16. The Contractor Physician shall be subject to peer review per Joint Commission standards.

5.1.17. The Contractor Physician shall meet the Safety management reporting requirements in accordance with the Service Unit Safety Measure Policy.

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

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

5.2.2. 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.

6.0 Work Schedule: The Medical Staff Supervisor of each department at the IHS facility will determine specific tour of duty for each Contractor Physician within the scope of the task order. Contractor

Physician shall work in accordance with the tour of duty as scheduled to meet the patient care needs of the Service Unit facility. The Contractor Physician will be scheduled for lunch breaks of thirty minutes to one hour as assigned and/or rotated, based upon department scheduling.

6.1. Overtime, Holiday, Call‐Back and On‐Call hours shall be performed as agreed upon by the SCN and Contractor Physician 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.

6.2 The Contractor Physician shall provide notice of unavailability to their employer (The Contractor) and the Medical Staff Program Assistant or designee prior to any absence from work. The

Contractor Physician 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.

6.3. The Contractor shall provide a qualified replacement Physician for any absence of more than 8 work hours.

6.4. All Contractor Physicians shall complete the credentialing and clearance requirements at the appropriate level before reporting for work.

7.0 Deliverables:

7.1. Monthly Data Report: The contractor shall provide a monthly data report that identifies the task order, Contract Line‐Item Number (CLIN), Contractor Physician 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.

7.2. 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.

8.0 Contractor Physician Qualification Requirements:

8.1. Experience. The Contractor Physician shall have a minimum of twelve months (12) in the specialty required by the contract, unless otherwise approved by the Contracting Officer and selecting SCN.

8.1.1. Experience shall equip the Contractor Physician with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the physician services category to be filled.

8.2. License/Registration. The contractor shall be board certified with the American Board of Internal

Medicine and the American Board of Nephrology. The contactor shall possess a current, valid, unrestricted medical license in any state, the District of Columbia, the Commonwealth of Puerto

Rico, or a Territory of the United States, throughout the term of this contract. If the contractor is asked to perform outside the normal training parameters of his/her specialty, then the contractor shall provide certification of hospital privileges in those additional field/s of practice.

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

8.4. Certifications. The Contractor Physicians shall possess current Basic Life Support (BLS).

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

8.6. Review of Qualifying Factors. The Supervisory Physician at the onboarding IHS facility, or their designee, will review all required documentation, conduct candidate interview, and reference checks for each Contractor Physician, to ensure verification and compliance prior to proceeding with background check/clearance process.

9.0 Background Checks / Clearance: As directed by the Contracting Officer, the Contractor Physician shall provide all requested information necessary to perform background checks. The Contractor

Physician shall comply with the requirement to obtain security investigations. The Contractor

Physician 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 Physician 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.

10.0 Health Requirements/Conditions of Employment:

10.1. Medical Evaluation: The Contractor Physician 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.

10.2. Immunization: The Contractor Physician 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.

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

Local Taxes, Meals, Travel/Transportation. Lodging is available but must be paid for by the Contractor or Contractor Physician. 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.

12.0 Performance Evaluation:

12.1. 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.

12.2. 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.

13.0 Identification of Contractor: The Contractor Physician shall wear a government issued contractor identification badge during performance of duty.

14.0 Management of Medical Information: The Contractor Physician shall manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols.

14.1. The Contractor Physician 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.

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

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

15.1 The Contractor Physician shall adapt to and successfully utilize IHS information technology systems that are deemed by the SCN as necessary for acceptable contractor performance.

15.2. The Contractor Physician 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.

16.0 Orientation: The Contractor Physician providing service under this contract shall attend mandatory orientations and training specified by the IHS, the Service Unit or the SCN.

17.0 Language Requirements and Cultural Awareness: The Contractor Physician 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.

18.0 Challenges to Conflicts: The Contractor Physician shall maintain an appropriate professional demeanor in the presence of patients and with each other. Harmony and good communication between the staff is 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.

19.0 Technical Point of Contact:

BAO PWS June 30, 2022

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

21.1. Exhibits

A ‐ Quality Assurance Surveillance Plan (QASP)

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

21.2. Attachments

21.2.1. Witten Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

21.2.2. Contract Physician Orientation Check List

21.2.3. Contract Physician Orientation Competency Verification Instructions

21.2.4. Contract Physician Billing Information

21.2.5. Standard Emergency Codes

21.2.6. Confidentiality: Legal and Ethical Concerns in Healthcare

21.2.7. EMTALA – Emergency Medical Treatment and Labor Act

21.2.8. What are Age‐Specific Competencies?

21.2.9. An Introduction to the Native American Culture

21.2.10. Verbal and Telephone Orders

21.2.11. Medication Administration

21.2.12. Pain Management

21.2.13. Latex Allergy

21.2.14. Focus Charting

21.2.15. Patient Restraints

21.2.16. Charge Physician Duties: Responsibility and Expectation

21.2.17. Immunization documentation

21.2.18. Required certification documentation