CHIROPRACTIC_SERVICES_CLAREMORE_INDIAN_HOSPITAL.docx

STATEM ENT OF WORK FOR CHIROPRACTIC SERVICES CLAREMOR E INDIAN HOSPITAL

1. Purpose of the project:

The purpose of the contract is to provide chiropractor services for the Indian Health Service (IHS), Claremore Indian Hospital (CIH). The Indian Health Service requires chiropractic services without interruption during the term of this contract and to limit the scope of work to patient's lower back pain.

The contract resulting from this solicitation shall:

1. be a non-personal health care services contract under which the contractor is an independent contractor;

2. allow the Government to evaluate the quality of professional and administrative services provided, but retains no control over the technical aspects of services rendered;

3. require the contractor to indemnify the Government for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance;

4. require the contractor to maintain liability insurance, i n the coverage amount acceptable to the Contracting Officer, which is not less than the amount normally prevailing within the local community for the specialty concerned.

2. Background Information:

The mission of the Claremore Indian Hospital is to provide the best possible health care services to the Native American population. To meet the mission, the Claremore Indian Hospital requires contractor support to provide chiropractor services.

3. Detailed description of the technical requirements:

The contractor shall provide part-time chiropractic services, one (I) eight (8) hour day per week. Services shall include but not be limited to the following:

1. Evaluates the neuro-muscular-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 set for the patient.

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

6. The contract Chiropractor shall not have any work or health restrictions, which interfere with the performance of Chiropractor services.

7. Conduct patient visits for the purpose of determining appropriate plan of care regarding management of patients' chronic lower back pain.

8. Document all visits in Resource & Patient Management System (RPMS) and EH R. Medical record documentation must meet or exceed the established standards of the CI H to include, but not limited to timeliness, legibility, accuracy, and content. All medical record information generated in the performance of this contract wi1l remain the property of and subject to the exclusive control of the Indian Health Service. Perform all required training timely for HIPAA and computer access, as required by CI H.

9. Perform s manual and manipulative therapies with an emphasis on spinal manipulation as feasible and appropriate at CIH.

10. The contractor shall provide a portable chiropractic table.

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. The contractor shall work with the Clinical Director and/or designee 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 weekends or federal holidays are worked.

13. Using the Resource & Patient Management System (RPMS) package and Electronic Health Record (EHR), the contractor shall perform chiropractic treatment for lower back pain at CI H.

14.The contractor shall not bill for patients seen at 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 allow the hospital to bill these entities for the contractor's services, as applicable.

15. 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 from the Native American community.

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

4. Reference Materials:

The Contractor shall be required to perform services in accordance with the policies, procedures and medical by-laws of the Claremore Service U nit. Copies of these items are available upon telephone request to the Clinical Director at 918-342-6434.

5. Level of Effort:

Contractor shall work with the Clinical Director and/or designee 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 weekends or Federal holidays are worked.

6. Special Requirements:

1. Orientation of the CIH will be provided on the first day of duty.

2. Persons born after December 31, 1956, if awarded a contract, must provide proof of immunity to Rubella and Measles prior to award of contract. Serological testing to confim1im munity and/or immunizations will be provided to the Government. Special considerations may be allowed to individuals, who are allergic to component of a vaccine, has history of severe reaction of a vaccine or who are currently pregnant.

3. Contractor shall:

-have a current, unrestricted Oklahoma medical license -document annual continuing medical education required for licensure -have one year experience as a chiropractor -meet the standards required by The Joint Commission.

4. Prior to providing treatment, contractor is required to provide all the necessary forms and information required to obtain background investigations and complete the orientation process:

a. OF306 Declaration for Federal Employment

b. OF612 or Resume

c. Addendum to OF306 for Child Care (if identified CNACI position)

5. Contractor shall be required to develop familiarity with current policies, procedures, by-laws and regulations of the clinical and medical staff of the Claremore Service Unit. These are available upon request to the Clinical Director at 918-342-6434.

7. Deliverables and reporting requirements:

1. 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.

2. The contractor shall work under the oversight of the Clinical Director and/or designee who defines the objectives, priorities, deadlines, and informs the contractor about changing priorities, unusual deadlines and objectives. The contractor shall meet or exceed the same requirements as those which would be applicable if the services were furnished directly by the Government facility. The contractor shall participate i n a continual process of self-evaluation and strive for excellence in providing Chiropractic services. The Clinical Director or designated representative will conduct the evaluations of the contractor's performance. The contractor shall advise the Clinical Director and/or designated representative of any problem(s) encountered in connection with meeting the needs of patients served by the chiropractor.

8. Government furnished property, facilities and services:

1. The CIH shall provide office space including room for patient examination and treatment. The contract chiropractor will be authorized to use all areas of the medical treatment facility available to civil service and commissioned personnel i n similar positions. The same restrictions apply to the chiropractor as any other Indian Health Service personnel to use these areas for official business activities only.

2. The contract chiropractor will be authorized to use all administrative and professional support available to Indian Health Service personnel. This will include but not be limited to copy machines, telefax machines, medical library, and telephone service. The same restrictions to use these items for official Indian Health Service business.

9. Contractor furnished property, facilities and services:

1. The contractor shall provide a portable chiropractic table.