Attachment 9 - Table B-2 Sample TOPR and Sample LOIA.pdf

DEPARTMENT OF THE AIR FORCE

(intentionally left blank)

Attachment 9, Table B-2

DATE

MEMORANDUM FOR ALL CLINICAL ACQUISITION FOR SUPPORT

SERVICES (CLASS) CONTRACTORS

FROM: Intentionally Left Blank

SUBJECT: Task Order Proposal Request, (Intentionally Left Blank) Clinical Nurse – General Ward

Nurse and Pediatrician – Board Certified.

1. An official proposal is hereby requested for one (1) full-time equivalent (FTE) Clinical Nurse –

General Ward Nurse, and one (1) FTE Pediatrician – Board Certified. These non-credentialed and credentialed positions will support the (Intentionally Left Blank) Military Treatment Facility, as outlined in your notional Air Force Medical Commodity Council Clinical Acquisition for Support Services

(CLASS) contract.

2. The Government contemplates the period of performance for these requirements (intentionally left blank) with a base year and two one-year option periods. An in place start date is desired on

(intentionally left blank) for the non-credentialed Clinical Nurse-General Ward Nurse position and on

(intentionally left blank) for the credentialed Pediatrician-Board Certified position. Should your company be selected to fill this task order, you will be provided a letter of intent to award (See attached sample letter of intent to award).

3. This position must, as a minimum, meet the requirements stated in the RFP and the position description’s attached to this Sample Task Order Proposal Request. The basic task order information in terms of the duty schedule and performance background applicable to these positions is intentionally left blank:

a. Clinical Nurse – General Ward Nurse (with addendum) - 1 FTE:

i. Work schedule: (intentionally left blank)

ii. Annual estimated regular hours: (intentionally left blank)

iii. Federal holidays (intentionally left blank)

iv. Annual estimated overage hours: (intentionally left blank)

v. Annual estimated on-call hours: (intentionally left blank)

vi. Mission essential position: (intentionally left blank)

vii. Criminal history background check: (intentionally left blank)

viii. Service Contract Manager contact information (intentionally left blank)

b. Pediatrician – Board Certified - 1 FTE:

i. Work schedule: (intentionally left blank)

ii. Annual estimated regular hours: (intentionally left blank)

iii. Federal holidays (intentionally left blank)

iv. Annual estimated overage hours: (intentionally left blank)

v. Annual estimated on-call hours: (intentionally left blank)

vi. Mission essential position: (intentionally left blank)

vii. Criminal history background check: (intentionally left blank)

viii. Service Contract Manager contact information (intentionally left blank)

4. The Task Order evaluation criteria (intentionally left blank).

5. Questions regarding this requirement (intentionally left blank).

Contracting Officer

Attachments:

1. Position Descriptions

2. Pricing Detail – (intentionally left blank)

3. TOPR Summary – (intentionally left blank)

CLINICAL NURSE - GENERAL WARD NURSE

1 QUALIFICATIONS.

1.1 Knowledge of professional care theories, principles, practices, disease process, and procedures to perform nursing assignments of moderate difficulty and experience to acutely ill pediatric, adult and geriatric patients as appropriate.

1.2 Demonstrates knowledge of growth and development, and pathophysiology of disease processes, specific to the unit population to include all ages of the spectrum from pediatrics to geriatrics.

1.3 Knowledge of a variety of pharmacological agents used in patient treatment, the desired effects, side effects, and complications of their use as well as the accurate administration of the pharmacologic agent, including dosage calculations as required.

Knowledge of the administrative requirements for proper documentation of patient’s condition including nursing assessment/reassessment, planning, interventions, evaluation, outcomes, patient/family teaching, and follow up care.

1.4 Assesses, coordinates, facilitates, delivers and evaluates care for infant to geriatric patients using the nursing process.

1.5 Synthesizes information and makes appropriate clinical decisions using a wide variety of data sources, specifically patient response, physician and nurse progress notes, interdisciplinary consultations, results of tests/procedures, and applicable guidelines and standards.

1.6 Knowledge of computer operations and proficiency in the use of basic word processing, data entry and automated medical records.

2 TYPE OF WORK. The duties include but are not limited to the following:

2.1 Coordinates patient care through a continuum and facilitates the achievement of optimal outcomes in relation to care, quality and cost effectiveness

2.2 Participates in the orientation and training of newly assigned personnel, as appropriate.

2.3 Ensures compliance with standards of care and practice in accordance with all established policies, procedures, and guidelines used in the medical treatment facility. Provides care within ethical and legal boundaries.

2.4 Assesses patients. Uses the nursing process as a basis for professional practice.

Demonstrates proper preparation of patients for treatments and procedures, to include surgical interventions. Provides proper care and evaluation of post-procedural patients.

2.5 Effectively communicates plans/actions and collaborates with a diverse healthcare team for the benefit of the patient, family and organization. Effectively educates patients and families regarding involvement in the plan of care, promotion of self care, management of symptoms, and followup care.

2.6 Possesses excellent written communication skills to perform accurate documentation, both written and electronic, of all activity in accordance with requirements.

2.7 Skilled in setting up, operating, and monitoring specialized medical equipment such as IV infusion pumps, cardiac monitoring devices, EKG units, oxygen analyzers, nebulizers and other unit specific equipment.

2.8 Recognizes adverse signs and symptoms and reacts quickly and appropriately in emergency situations.

2.9 Maintains accountability for making patient care assignments based on the scope of practice and skill level of assigned personnel.

2.10 Possesses a good foundation in organization and prioritization.

2.11 Serves and participates in committees, functions and other meetings as directed.

Provides relevant and timely information to these groups, and assists with decision-making and process improvement. Participates in customer service initiatives and medical readiness activities, designed to enhance health services.

2.12 Ensures a safe work environment, employee safe work habits and patient safety in accordance with regulatory agencies, infection control policies, and process improvement initiatives.

CLINICAL NURSE - GENERAL WARD NURSE

ADDENDUM

Duty Hours: Employee may be required to work rotating shifts, including 12-hr shifts on Saturday and Sunday to include Holidays as necessary.

N95 and/or Duck Bill testing is required before employment begins at no cost to the

Government.

PEDIATRICIAN – BOARD CERTIFIED

1. QUALIFICATIONS.

1.1 Successfully completed an internship and residency in an accredited U.S. Pediatric

Training Program.

1.2 Be board certified.

1.3 Have and maintain current Pediatric Advanced Life Support (PALS) certification.

2. TYPE OF WORK. The duties include but are not limited to the following:

2.1 Capable of performing the full range of general medical services to include the ability and experience to adequately diagnose and treat urgent/acute diseases and injuries including:

Skin

Pulmonary System

Head

Gastrointestinal System

Eyes

Musculoskeletal System

Ears

Genitourinary System

Nose

Reproductive System

Throat

Lymphopoietic System

Neck

Central Nervous System

Cardiovascular System

Endocrine System

2.2 Become familiar with the hospital formulary.

2.3 Prepare and maintain proper medical records on beneficiaries to whom treatment is provided in accordance with MTF procedures.

2.4 Follow the established operating procedures for the pediatric clinic. He/she shall participate in the quality control activities of the department of pediatrics.

NOTICE OF INTENT TO AWARD LETTER

(for Task Order Number – Intentionally Left Blank)

[Name of Contractor (Intentionally Left Blank)]

[Address of Contractor (Intentionally Left Blank)]

SUBJECT: Task Order Award for Clinical Nurse- General Ward Position and Pediatrician –

Board Certified Position

Dear [Contractor (Intentionally Left Blank)]:

We are pleased to inform you that you have been selected to provide services for one (1) full-time equivalent (FTE) Clinical Nurse – General Ward Nurse and one (1) FTE Pediatrician –

Board Certified at (intentionally left blank). This notice of intent to award a task order against your IDIQ contract, however, is subject to your successful satisfaction of the requirements contained in Sections H.3 of your contract regarding candidate approval. Specifically, within 20 calendar days of this notice, you are required to provide the following:

1. Qualifying documentation against preliminary Government minimum requirements on candidates ready, willing, and able to work at (intentionally left blank).

2. Valid contact telephone number for each candidate for Government review and approval.

Should the Government approve your candidate(s), or you fail to receive information on candidate approval within seven (7) business days, you shall proceed with the hiring process for each candidate.

Should the Military Treatment Facility (MTF) not receive a valid telephone contact number or qualifying documentation within 20 calendar days (or the next calendar day if the 20 th calendar day falls on a weekend, holiday, or non-duty day), or disapprove any candidate for failing to meet the preliminary Government minimum requirements, the candidate approval requirements of Sections H.3 will not have been met, and the award of a task order will not be pursued further.

If the Government decides to enter into negotiations, the candidate approval requirements stated above require satisfaction prior to the issuance of any task order.

Should you have any questions, please contact (Intentionally Left Blank)

Contracting Officer