ATTACHMENT_3(d)_-_General_Dentistry_Dentist_with_Exodontias_PD.pdf

RFP HSCG23-17-R-P1C000 ATTACHMENT 3(d) Page 1 of 2

GENERAL DENTISTRY/DENTIST with EXODONTIAS SERVICES

Note: The terms Contractor, Contract Provider and General Dentist shall mean the provider or providers of care throughout this document.

1. Scope of Work. The Contractor shall provide an individual to provide personal dental services to all

Active Duty beneficiaries within the capabilities normally granted to a board certified General Dentist.

A. The General Dentist shall meet or exceed the industry standards in accordance with established principles, practices and ethics of the Dental profession. The standards of performance for all employees provided by the contractor shall reflect the degree and care, skill and learning expected of a reasonably prudent health care provider in the Dental profession in the state of their practice.

B. The General Dentist will provide professional service, instruction and supervision to U.S. Coast

Guard locations specified in the Performance Work Statement (PWS) (Attachment 1).

2. Qualifications. The provider of Dental services shall possess and maintain for the duration of this agreement:

A. A diploma from an accredited school of Dentistry.

B. A current unrestricted license to practice dentistry in one of the 50 States.

C. A Current Drug Enforcement Agency (DEA) registration certification.

D. “No unfavorable information on file” rating with the National Practitioners Data Bank

(NPDB).

E. A current certification in Basic Cardiac Life Support (BLS) for the Health Care Provider by the American Heart Association (AHA), American Red Cross (ARC), American Safety and Health Institute (ASHI), or the American College of Emergency Physicians (ACEP).

F. A minimum of two (2) years recent experience (immediately preceding the submission of this offer).

3. Credential Review. Prior to commencement of this agreement, the Contractor shall submit the following credentials to be reviewed for technical acceptability.

A. A current curriculum vitae including AT LEAST the following information:

(1) Degrees earned;

(2) Career History;

(3) Awards and certifications received;

(4) Professional Training/Courses attended in the past two (2) years;

(5) Professional organization affiliation and memberships;

(6) Previous work reference(s) including name of organization(s), number of years services rendered, address and name of the point of contact with telephone number;

(7) Tax identification number;

(8) Date of birth (to be used only for the purposes of independent query of the NPDB;

(9) Social security number;

(10) “No adverse information on file” with the National Practitioners Data Bank (NPDB).

RFP HSCG23-17-R-P1C000 ATTACHMENT 3(d) Page 2 of 2

GENERAL DENTISTRY/DENTIST with EXODONTIAS SERVICES

B. Copies of :

(1) A diploma from an accredited school of dentistry;

(2) A current unrestricted license to practice dentistry in the assigned State.

(3) A list of any malpractice claims filed, or pending or settled, and/or any other adverse professional actions, that involve the contractor;

(4) Evidence of immunity to Hepatitis “A” and “B” and evidence of freedom from chronic communicable disease(s) i.e., HIV, TB and Sexual transmitted diseases;

(5) A current certification in Basic Cardiac Life Support (BLS) for the Health Care Provider by the American Heart Association (AHA), American Red Cross (ARC), American Safety and Health Institute (ASHI), or the American College of Emergency Physicians (ACEP);

(6) Proof of insurability against malpractice in the amount of one million ($1,000,000.00) dollars per occurrence;

(7) Current Drug Enforcement Agency (DEA) registration/certification;

(8) Social Security Card;

(9) Three letters of recommendations from previous employers addressing general dentistry services.

4. Professional Services The Contractor shall perform a full range of General Dentistry service on site, using government furnished facilities, equipment and supplies to a variety of patients. All aspects of General Dentistry services shall be commensurate with the capabilities of the provider and the Dental Department including but not limited to the items listed below; and in the PWS.

A. Detailed history, testing and examination.

B. Diagnostic, preventive, restorative, endodontic, and periodontal initial therapy services.

C. Fixed and removable prosthetics; and oral surgery services.

D. Case consultation with referring Dental Officer.

E. Treatment plan recommendation and review.

F. Participate in the Health Services Quality Improvement Program.

G. Provide instruction to clinic staff on an ad hoc basis.

H. Provide immediate evaluation and management of emergent problems as they occur in addition to regularly scheduled appointments.

1) Procedures necessary for relief of dental pain, swelling and infection with endanger the over health of the patient;

2) The repair of dental prostheses where lack of such repair would cause the patient suffering;

5. Hours of Performance. The contractor shall provide all aspects of personal General Dentistry and/or exodontias services at locations in the PWS (Attachment 1) and hours specified by the Clinic Administrator.

Note: The terms Contractor, Contract Provider and General Dentist shall mean the provider or providers of care throughout this document.