SOW_Gen_Surgeon_Claremore.pdf

Statement of Work

General Surgeon Physician Claremore Indian Hospital, Indian Health Service

1. General

The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. The mission of IHS is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level and assure that comprehensive, culturally acceptable personal and public health services are available and accessible to members of the 566 federally recognized Tribes across the United States.

2. Statement of Objectives

The purpose of this purchase order is for the placement of three general surgery physicians in the inpatient hospital.

The care provided by the physicians shall be as comprehensive as the Indian Health Service supplied facilities;

equipment and support services permit. The contractor shall provide qualified physicians to provide medical services for patients as required by this statement of work (SOW) and in accordance with the terms and conditions of this purchase order. Contract physicians shall provide services to eligible beneficiaries of the Indian Health Service who present themselves for treatment.

3. Statement of Work

The Contractor shall provide services to include, but not limited to the following:

a) Rendering the initial assessment of which surgery patients which will require admission to the Indian Hospital.

b) Providing on call surgical consultations for other members of the CIH staff, and providing surgical services on an emergency basis after regular hours.

c) Requesting laboratory and radiological tests, as necessary, for diagnosis.

d) Providing and ordering medically indicated treatment.

e) Prescribing medication.

f) Initial interpretation of x-rays.

g) Suturing minor lacerations.

h) Splinting uncomplicated fractures.

i) Referring patients to routinely-scheduled clinics of the Indian Hospital Outpatient Department following an exam.

j) Rendering assessments of which Emergency Department patients will require transfer to a tertiary care center and consulting the appropriate Emergency service physician.

k) Completing a history, physical exam and admission orders for patients to be admitted to the IHS

Comprehensive Indian Health Center.

l) Charting and recording clinical data as per the Medical Staff By-laws.

m) Treatment in a timely manner of patients presenting to the Emergency Room needing a surgical consultation.

n) Competent surgical consultation care of patients of all ages.

o) Performance of Basic Cardiac Life Support (BLS) in emergency situations.

p) The Contractor shall be cognizant of COBRA/EMTALA regulations. All patients presenting to the surgical department shall be evaluated and stabilized.

q) Providing general surgical procedures based on privileges.

r) Providing endoscopic procedures based on privileges(preferred by not required).

s) Providing sedation for endoscopic patients based on privileges.

4. Verification of Licensure

A. To ensure that physicians providing services under this purchase order are properly licensed, and that the IHS is made aware of all disciplinary actions taken against each physician, the Contractor shall:

a) Verify through the Federation of State Medical Boards database, all active, inactive, and lapsed licenses that are held or have been held by physicians who provide services in IHS hospitals and clinics under this contract.

b) Inform the IHS of the status of all licenses for each physician who would provide services under this contract in IHS hospital and clinics, including all reasons for each inactive or lapsed license.

c) Shall provide all information immediately regarding performance and disciplinary actions that is collected on physicians who would be placed under this contract to the receiving IHS facility Clinical Director and contract specialist. This includes all information that is collected and compiled on such physicians at the time of initial hire by the Contractor, and/or information that is reported during periods that the Contractor is an agent of such physicians for a placement under this contract.

d) Certify that all information obtained on physicians whom they would assign to IHS hospital and clinics has been reviewed and verified by the Contractor. The Certification shall include a statement that the Contractor has found no reason to reject the physician’s application. The names of the contacts, their titles, telephone numbers, date of contacts and the name(s) of the Contractor’s representative(s) collecting and reviewing such information shall be recorded in writing and made available to the IHS by the contractor.

B. The Contractor shall provide physician(s) who meet the following minimum qualifications and requirements:

(1) Shall provide a complete IHS Medical Staff Application.

(2) Physicians who spend 50 percent or more of their clinical time under contract with the Federal

Government, and prescribe controlled substances shall obtain IHS Opioid Prescriber Training and provide Certification within six months of appointment and every 3 years after.

(3) Shall provide documentation and maintain current professional liability insurance coverage in the amounts of $1 million per occurrence and $3 million aggregate per provider.

(4) Physicians shall have a permanent, current, full and unrestricted license to practice medicine in a state, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

(5) Shall provide a copy of documentation of past insurance carriers during the past 10 years,

(6) Shall provide a copy of documentation of work history since graduation from professional school to present day in chronological order. Any time periods of gaps greater than 30 days since graduation from professional school, shall be explained and a person with contact information who can verify the gap.

(7) The physician(s) shall be board certified in or board eligible in general surgery.

(8) Physician(s) provided by the Contractor shall apply and be accepted as Associate member of the On-Site

Medical Staff.

(9) Successful completion of a residency program in an approved General Surgery Training Program.

(10) Shall provide a copy of documentation of physicians Basic Cardiac Life Support (BLS) and Advanced

Cardiac Life Support (ACLS).

(11) Shall speak, understand, read and write English fluently and communicate with sufficient clarity to be understood by IHS personnel and patients.

(12) Shall be a United States Citizen.

(13) Shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to patients of the Native American communities.

(14) Shall maintain standards of personal hygiene and grooming such that his/her image as a physician is compatible with the expectations of the on-site supervisor.

C. In proving such service, the Contractor shall comply with the policies, procedures and by-laws of the on-site facility. The Contractor shall also be required to perform this service in compliance with applicable standards of The Joint Commission and Quality Improvement.

5. IMMUNIZATION RECORD

Physicians born after December 31, 1956, if awarded a contract, shall provide proof of immunity to Rubella and Measles prior to award of contract. Serological testing to confirm physician’s immunity and/or immunizations shall be provided to the Government. Physicians requesting hospital/clinic privileges shall submit documentation of a current (within the past 12 months) TB skin test or chest x-ray if the skin test was previously positive. 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.

Any Contractor employees who provide direct patient care shall meet the following requirements:

1. A yearly PPD is required for all persons who have had no previous positive tuberculin skin test.

2. A series of three (3) Hepatitis B immunizations or serologic proof of past infection is required.

6. CONTACT WITH INDIAN CHILDREN

The contract physician shall perform in accordance with Section 231 of the Crime Control Act of 1990, P.L. 101-647 and the Indian Child Protection and Family Violence Prevention Act, P.L. 101-630, and failure to comply with these statutes shall result in immediate removal.

7. QUALITY CONTROL

The Contractor shall be required to perform services in accordance with the policies, procedures and by-laws of the Medical Program of the IHS Indian Hospital. Copies of the items are available upon request to the Clinical Director.

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

8. WORK SCHEDULE

Surgeons shall report according to the following schedule:

a. Weekday Monday through Friday, 8:00 am - 5:00 pm

b. Weekday Night (on-call), Monday thru Friday, 5:00 pm - 8:00 am

c. Weekend Friday –Monday, 5:00 pm – 8:00 am

d. Weekend (on-call) Friday –Monday, 5:00 pm – 8:00 am

e. Call-back hours

f. Holiday on-call (Memorial Day, July 4th, Labor Day, Thanksgiving Day, Christmas Day and New Year’s

Day)

g. Holiday Call-back

Item Schedule Cost per Hour

a. Weekday Coverage

b. Weekday Night Coverage (On-call)

c. Weekend Coverage

d. Weekend Coverage (On-call)

e. Call-back Coverage

f. Holiday Coverage (On-call )

g. Holiday Call-back

9. MEDICAL RECORDS

All medical records entries shall be complete and signed by the attending physician. Physician signatures shall be legible, with the name printed clearly below the signature to make certain signatures can be read. Receiving Reports for time periods worked SHALL NOT BE COMPLETED until Medical Records has reviewed chart entries certifying he/she has completed all required information and signatures are completed. Before departing the contract, the Contractor shall report to Contracting Officer that all medical records entries have been completed. If medical records are not completed, the last invoice will not be paid until the Physician completes the medical records entries.

10. PLACE OF PERFORMANCE:

Claremore Indian Hospital 101 South Moore Ave Claremore, OK 74017 Monday-Friday: 7:45 am-4:30 pm