Solicitation_Chinle_Nephrology_IHS5419232.pdf

On‐Site Nephrology Clinics Chinle Comprehensive Health Care Facility

Solicitation Number: IHS5419232 Date Issued: 01/18/2019 Date Closing: 01/30/2019

This notice is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued.

This synopsis/solicitation notice is a request for proposals for a Non‐Personal Service Contract for a Contractor to provide Nephrologist(s) to provide On‐site Nephrology Clinics to the Chinle Comprehensive Health Care Facility (CCHCF), Navajo Area Indian Health Service (IHS). Services shall be performed in accordance with the attached respective Performance Work Statement (PWS). Refer to the PWS for Shift hours.

CCHCF is based in Chinle, Arizona (Northeast Arizona near Canyon De Chelly National Monument). The CCHCF is a 60 bed hospital which serves as the health care hub for the region. The medical staff includes Family Physicians, Internists, Pediatricians, General Surgeons, OB/GYN's, Anesthesiologists, and a Psychiatrist. In addition to routine outpatient and inpatient primary care, services available to our patients include: Adult Intensive Care, General Surgery (including laparoscopic surgery), routine and operative Obstetrics, and 24‐Hour Emergency Room Services. Health care services are provided to approximately 37,000 active users. Strong Navajo cultural traditions exist within the community, offering an opportunity to learn the Navajo language, or to learn about traditional Navajo medicine. The service unit is located on the Colorado Plateau with excellent opportunities for photography, hiking, running, road biking, cross country skiing, and mountain biking. Canyon de Chelly National Monument is within 5 miles of the hospital and is a wonderful place for exploring and sightseeing, running and mountain biking.

PERIOD OF PERFORMANCE:

Base Year 03/01/2019‐10/31/2019 First Year Option 11/01/2019‐10/31/2020 Second Year Option 11/01/2021‐10/31/2021

EVALUATION CRITERIA: The Government reserves the right to issue a single award or multiple awards to contractor(s) whose quote represents the best value as defined by FAR 2.101. In determining best value, Price and other Evaluation Factors will be considered: Past Performance, Experience, and Qualifications of the provider. The Evaluation Factors and significant sub factors when combined are significantly more important than cost or price. As part of the evaluation process, candidates may be interviewed to ensure their understanding of the PWS and to verify their qualifications to perform required services. The socio‐economic status of an offer may also be considered, should one or more quotes represent the best value.

SUBMITTAL PROCESS: Email offer directly to the Contracting Officer for this action is: Tanya Begay, Supervisory Contract Specialist, 928‐674‐7635, tanya.begay2@ihs.gov . Limit offer size to 8MB. All questions shall be submitted in writing and will be accepted 5 days before response date. To be considered for award, your offer shall include the following documents or it will be non‐responsive and removed from award consideration:

1) Pricing: Complete and sign Fee Schedule (attached). The Government will consider competitive rates upon negotiation.

2) Experience: Provide complete Candidate Profile such as Curriculum vitae, resumes, licensures, and all relative documents for proposed candidates.

3) Past Performance: Provide evidence of the Contract Company’s Past Performance of comparable scope and complexity in providing services within the past three (3) years.

PRE‐SECURITY/FINGERPRINTING CLEARANCE: The providers shall comply with Agency Personal Identity Verification procedures identified in the contract that implement Homeland Security Presidential Directive‐12 (HSPD‐12), Office of Management and Budget (OMB) Guidance M‐05‐24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201; this includes fingerprinting guidelines.

Pre‐Security/Fingerprinting must be cleared prior to starting tour of duty and incurring costs.

If provider is selected, then the Contractor and provider shall provide the following Pre‐Security/Fingerprinting documents.

1) Complete Resume

2) OIG Clearance

3) Licenses/Certifications (ACLS, PALS, BLS, TNCC, Diplomas etc.)

4) Copy of school transcripts

5) Declaration of Federal Employment (Typed/Original Signature)

6) Child Addendum (Typed/Original Signature)

7) OFI Form 86C

Selected provider will be subject to a pre‐employment fingerprint check.

Selected provider will be subject to a background investigation.

CLAUSES AND PROVISIONS:

52.204‐9 Personal Identity Verification of Contractor Personnel (JAN 2011)

(a) The Contractor shall comply with agency personal identity verification procedures identified in the contract that implement Homeland Security Presidential Directive‐12 (HSPD‐12), Office of Management and Budget (OMB) guidance M‐05‐24 and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

(b) The Contractor shall account for all forms of Government‐provided identification issued to the Contractor employees in connection with performance under this contract. The Contractor shall return such identification to the issuing agency at the earliest of any of the following, unless otherwise determined by the Government:

(1) When no longer needed for contract performance.

(2) Upon completion of the Contractor employees employment.

(3) Upon contract completion or termination.

(c) The Contracting Officer may delay final payment under a contract if the Contractor fails to comply with these requirements.

(d) The Contractor shall insert the substance of this clause, including this paragraph (d), in all subcontracts when the subcontractors employees are required to have routine physical access to a Federally‐controlled facility and/or routine access to a Federally‐controlled information system. It shall be the responsibility of the prime Contractor to return such identification to the issuing agency in accordance with the terms set forth in paragraph (b) of this section, unless otherwise approved in writing by the Contracting Officer.

The Contractor shall insert this clause in all subcontracts when the subcontractor is required to have routine physical access to a Federally‐Controlled Facility and/or routine access to a Federally‐Controlled Information System.

52.237‐7 Indemnification and Medical Liability Insurance (Jan 1997)

(a) It is expressly agreed and understood that this is a nonpersonal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor’s professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The Contractor shall maintain during the term of this contract liability insurance issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrence: $1,000,000 per occurrence; $3,000,000 aggregate.

(b) An apparently successful offeror, upon request by the Contracting Officer, shall furnish prior to contract award evidence of its insurability concerning the medical liability insurance required by paragraph (a) of this clause.

(c) Liability insurance may be on either an occurrences basis or on a claims‐made basis. If the policy is on a claims‐made basis, an extended reporting endorsement (tail) for a period of not less than 3 years after the end of the contract term must also be provided.

(d) Evidence of insurance documenting the required coverage for each health care provider who will perform under this contract shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on a claims‐made basis and evidence of an extended reporting endorsement is not provided prior to the commencement of services, evidence of such endorsement shall be provided to the Contracting Officer prior to the expiration of this contract. Final payment under this contract shall be withheld until evidence of the extended reporting endorsement is provided to the Contracting Officer.

(e) The policies evidencing required insurance shall also contain an endorsement to the effect that any cancellation or material change adversely affecting the Government’s interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer. If, during the performance period of the contract the Contractor changes insurance providers, the Contractor must provide evidence that the Government will be indemnified to the limits specified in paragraph (a) of this clause, for the entire period of the contract, either under the new policy, or a combination of old and new policies.

(f) The Contractor shall insert the substance of this clause, including this paragraph (f), in all subcontracts under this contract for health care services and shall require such subcontractors to provide evidence of and maintain insurance in accordance with paragraph (a) of this clause. At least 5 days before the commencement of work by any subcontractor, the Contractor shall furnish to the Contracting Officer evidence of such insurance.

Department of Health and Human Services Applicable Clauses:

352.202‐1 Definitions. (JAN 2006) 352.224‐70Privacy Act (DEC 2015) 352.226‐1Indian Preference (DEC 2015) 352.226‐2Indian Preference Program (DEC 2015)

352.237‐70 Pro‐Children Act. (Dec 2015) (a) Public Law 103‐227, Title X, Part C, also known as the Pro‐Children Act of 1994 (Act), 20 U.S.C. 7183, imposes restrictions on smoking in facilities where certain federally funded children's services are provided. The Act prohibits smoking within any indoor facility (or portion thereof), whether owned, leased, or contracted for, that is used for the routine or regular provision of: (i) kindergarten, elementary, or secondary education or library services or (ii) health or day care services that are provided to children under the age of 18. The statutory prohibition also applies to indoor facilities that are constructed, operated, or maintained with Federal funds.

(b) By acceptance of this contract or order, the Contractor agrees to comply with the requirements of the Act. The Act also applies to all subcontracts awarded under this contract for the specified children's services. Accordingly, the Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understands, and complies with the provisions of the Act. Failure to comply with the Act may result in the imposition of a civil monetary penalty in an amount not to exceed $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. Each day a violation continues constitutes a separate violation.

352.237‐71 Crime Control Act of 1990‐Reporting of Child Abuse (Dec 2015)(a) Public Law 101‐647, also known as the Crime Control Act of 1990 (Act), imposes responsibilities on certain individuals who, while engaged in a professional capacity or activity, as defined in the Act, on Federal land or in a federally‐operated (or contracted) facility, learn of facts that give the individual reason to suspect that a child has suffered an incident of child abuse.

(b) The Act designates covered professionals as those persons engaged in professions and activities in eight different categories including, but not limited to, teachers, social workers, physicians, dentists, medical residents or interns, hospital personnel and administrators, nurses, health care practitioners, chiropractors, osteopaths, pharmacists, optometrists, podiatrists, emergency medical technicians, ambulance drivers, alcohol or drug treatment personnel, psychologists, psychiatrists, mental health professionals, child care workers and administrators, and commercial film and photo processors. The Act defines the term child abuse as the physical or mental injury, sexual abuse or exploitation, or negligent treatment of a child.

(c) Accordingly, any person engaged in a covered profession or activity under an HHS contract or subcontract, regardless of the purpose of the contract or subcontract, shall immediately report a suspected child abuse incident in accordance with the provisions of the Act. If a child is suspected of being harmed, the appropriate State Child Abuse Hotline, local child protective services (CPS), or law enforcement agency shall be contacted. For more information about where and how to file a report, the Childhelp USA, National Child Abuse Hotline (1‐800‐4‐A‐CHILD) shall be called. Any covered professional failing to make a timely report of such incident shall be guilty of a Class B misdemeanor.

(d) By acceptance of this contract or order, the Contractor agrees to comply with the requirements of the Act. The Act also applies to all applicable subcontracts awarded under this contract. Accordingly, the Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understands, and complies with the provisions of the Act.

352.237‐72 Crime Control Act of 1990‐Requirement for Background Checks (Dec 2015)(a) Public Law 101‐647, also known as the Crime Control Act of 1990 (Act), requires that all individuals involved with the provision of child care services to children under the age of 18 undergo a criminal background check. Child care services include, but are not limited to, social services, health and mental health care, child (day) care, education (whether or not directly involved in teaching), and rehabilitative programs. Any conviction for a sex crime, an offense involving a child victim, or a drug felony, may be grounds for denying employment or for dismissal of an employee providing any of the services listed above.

(b) The Contracting Officer will provide the necessary information to the Contractor regarding the process for obtaining the background check. The Contractor may hire a staff person provisionally prior to the completion of a background check, if at all times prior to the receipt of the background check during which children are in the care of the newly‐hired person, the person is within the sight and under the supervision of a previously investigated staff person.

(c) By acceptance of this contract or order, the Contractor agrees to comply with the requirements of the Act. The Act also applies to all applicable subcontracts awarded under this contract. Accordingly, the Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understands, and complies with the provisions of the Act.

Health Insurance Portability and Accountability Act (HIPAA) The Indian Health Service (IHS) is required to comply with HIPAA in the provision of health care to IHS patients. HIPAA was implemented by the U.S. Department of Health and Human Services, Office of Civil Rights, under the Code of Federal Regulations, Part 160 and 164. Accordingly, all health care providers, including contracted health care providers are required to comply with HIPAA requirements (Full text will be furnished upon request).

ADDITIONAL APPLICABLE FEDERAL ACQUISITION CLAUSES:

52.204‐7 System Award Management (Oct 2016) 52.209‐5 Certification Regarding Responsibility Matters (Oct 2015) 52.209‐11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony conviction under any Federal Law (Feb 2016) 52.212‐4 Contract Terms and Conditions‐Commercial Items (Oct 2018) 52.212‐5 Contract Terms and Conditions Required To Implement Statutes or Executive Orders‐Commercial Items (Oct 2018) 52.224‐1 Privacy Act Notification (Apr 1984) 52.224‐2 Privacy Act (Apr 1984) 52.229‐3 Federal, State, and Local Taxes (Feb 2013) 52.232‐18 Availability of Funds (APR 1984) 52.232‐33 Payment by Electronic Funds Transfer System for Award Management (Jul 2013) 52.232‐40 Providing Accelerated Payments to Small Business Sub‐Contractors (Dec 2013) 52.237‐2 Protection of Government Buildings, Equipment, and Vegetation (Aug 1984

LIST OF ATTACHMENTS:

1) Performance Work Statement (PWS No. CSU‐19‐01 NEPH)

2) Fee Schedule

PWS No. CSU-19-01 NEPH 14 JAN 2019

Performance Work Statement (PWS) for Non-Personal Services

NEPHROLOGIST

Table of Contents

Section Page

1.0 General 1-2

2.0 Definitions 3-5

3.0 Government Furnished Information, Property, & Services 6

4.0 Contractor Furnished Property 7

5.0 Performance-Based Requirements 8-11

6.0 Contractor Qualification Requirements 12-13

7.0 Challenges to Conflicts 14

8.0 52.212-4 Contract Terms and Conditions-Commercial Items (MAY 2015) (m): 14

9.0 Performance-Based Matrix 15-16

10.0 List of Attachments and Exhibits 17

Performance Work Statement for Non-Personal Services

NEPHROLOGIST

1.0 General: This performance work statement describes the requirements for non-personal services for a Nephrologist to support the mission of the Indian Health Service (IHS) by providing accessible, safe, high quality, community guided public health services.

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.

1.1.1 Navajo Area Indian Health Service (NAIHS) administers health centers and hospitals providing health care to approximately 201,583 members of the Navajo Nation. The Navajo

Nation is the largest Indian tribe in the United States and has the largest reservation, which encompasses more than 25,516 square miles in northern Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico. The NAIHS is the primary provider of inpatient, ambulatory care, preventive and community health, and environmental health services for members of the Navajo Nation and the San Juan Southern

Paiute Tribe.

1.1.2 Chinle Comprehensive Health Care Facility (CCHCF) provides medical care for approximately 35,000 Navajo. Serving a rural area, many of our patients travel 100 miles round trip to receive care and do not have electricity or running water in their homes. And, most of our elderly patients speak only Navajo, and live according to traditional Navajo cultural practices.

The Chinle Comprehensive Health Care Facility and Ambulatory Care Center is a 60 bed inpatient hospital and outpatient facility. Services offered are: Adult inpatient and Pediatric Inpatient

Care, Outpatient Primary Care, Adult Intensive Care, Emergency Medicine, General Surgery, Podiatry, OBGYN, Labor & Delivery, Women's Health, Midwifery, Mental Health, Pharmacy, Optometry, Dental, PT, OT, Speech Pathology, Audiology, Lab, Public Health and School Health.

1.2 Scope: The Contractor shall provide outpatient 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

I.H.S. patients.

1.2.2 Place of Performance: Services are to be performed at the CCHCF Outpatient – Specialty

Clinic as well as other hospitals, clinics, and other healthcare facilities in the Navajo IHS Areas within the CCHCF.

1.2.3 Period of Performance: Will be flexible to allow for short term (13 weeks), long term (1-year to 3-year) and, where feasible, include intermittent support to meet unplanned needs that develop on a frequent basis. Department requests for candidates to be available up to at least at minimum 4 weeks.

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 Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaahc.org

1.3.4 Section 231 of Public Law 101-647, the Crime Control Act of 1990.

http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml

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

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

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

http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf

1.3.7 Privacy Act of 1974.

http://www.usdoj.gov/oip/privstat.htm

1.3.8 IHS Service Unit and Health Center Policies, Procedures and Protocols.

(See section 11.0 for a list of attachments and exhibits)

1.3.9 Computer Security Act of 1987

http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt

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

1.3.11 IHS General Directives http://www.ihs.gov/adminmggrresouces

1.3.12 IHS Computer Security Directives http://www.ihs.gov/adminmggresources

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.

2.5 Code of Ethics: The Code of Ethics for Internal Medicine Service as approved by the American

Board of Internal Medicine and the Code of Ethics for Nephrology Service as approved by the American

Board of Nephrology.

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

2.7 Contractor: The organization awarded a legal binding contract to provide supplies and/or services; includes the organization’s employees.

2.8 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. GTR –

Government Technical Representative, COTR–Contracting Officer’s Technical Representative, or PO -

Project Officer).

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

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

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

2.12 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.

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

2.14 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.

2.15 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.

2.16 Health Center: A facility physically separated from a hospital, with a full 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 contact’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

37.401.

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 nephrologist physician into the IHS Service Unit and/or Health Center and the nursing unit 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 outpatient Nephrology physician 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 professional medical practice and a framework for the evaluation of practice. The standards of professional medical practice may pertain to general or specialty practice.

2.27 Supervisor. Government employee authorized to provide verbal and written performance direction to the Contractor that the Contractor must follow without exception.

2.28 Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activities written order to obtain services, at a minimum will include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activities task order number.

2.29 Tour of Duty: The time of day the contractor is scheduled to perform duties.

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

2.31 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

3.3 and 4.0, 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.

3.2.1 Government Vehicle: If required by the position, authorization shall be in accordance with

IHS Chapter 12, Section 13 Motor Vehicle Management.

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.

3.3.2 The Government will provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 will be charged for lost or destroyed badges.

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 physician service or includes mandates made by the IHS Service Units/Health Centers while the physician is working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

3.5 Inspection: All services rendered in the specialty of Nephrology in the delivery of patient care services will be inspected, reviewed and monitored by Nurit Harari, MD, Primary Care Director or designee for this order.

3.5.1 Contracting Officer Representative (COR): Georgina Nez is primarily responsible for monitoring the technical progress including surveillance and assessment of performance for this order.

3.5.2 Point of Contact: Georgina Nez, (928) 674-7450 and Aurelia Tsosie, (928) 674-7451 are the points of contact for this requirement.

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:

4.1.1 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 each IHS facility.

4.1.2 Other personal medical instruments: “Other personal medical instruments” are defined as Contractor owned items may include but not 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 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 uninterrupted outpatient

Nephrology Physician Services in the delivery of patient care to the Indian Health Service. Specific tasks include the following:

5.1 Nephrology Physician Duties:

5.1.1 Work under the general technical, administrative supervision of Nurit Harari, MD, CCHCF Primary Care Director or her designee.

5.1.2 The contractor shall provide professional medical services or direct patient care services under the terms of this contract, appropriately and timely medical services in accordance with the standards of care established by recognized medical care organizations and in accordance with the policies and procedures of Service Unit's Medical Staff Bylaws and Rules

& Regulations at CCHCF.

5.1.3 The contractor shall provide direct patient care services:

A. In the capacity of a senior specialist or expert within the contractor’s specialty area, the contractor shall assume responsibility for the diagnosis, prevention therapy, maintenance and rehabilitation of patients by performing interviews and examines each patient, review past medical history and requests or performs complex diagnostic tests and examinations deemed necessary to obtain all possible information related to each case. Make preliminary diagnosis, directs, prescribes or provide treatment or arranges for specialized care or patient referral as required.

Bases decision upon information obtained, professional medical knowledge and skills and prescribed policies and procedures. Make note of observations to be incorporated into clinical/EHR records. Provides emergency care as required, provide definitive management in all medical categories for cases that do not require referral. Give total patient care including prevention, health maintenance, early diagnosis, treatment and follow-up services to patient under his/her care.

B. The contractor shall provide specialty consultative services to the clinicians at the

CCHCF by staffing a Nephrology Outreach Clinic as needed.

C. The contractor conducts outpatient clinics making observations appropriate to the outpatient’s underlying disease and treatment plan, including current symptoms.

Reviews and reconciles the patient’s medications, diet and therapy course, adheres to management plan and patient observations. Modifies regimen as required, instructs and counsels patients and family members as required. Performs or assists other physicians in the performance of minor and outpatient surgery.

D. The contractor shall recommend patients to appropriate contracted medical and government facilities providing full clinical information for care and diagnostic procedures that cannot be adequately provided at CCHCF per Purchased Referred

Care methodology.

E. Provides consultation on difficult cases to practitioners in the same or other specialties. Provides supervision and teaching to medical practitioners, residents and students on the most complex patients.

F. The contractor shall provide appropriate documentation on rendered patient care utilizing CCHCF’s EHR system. The contractor is responsible for utilizing the CCHCF

EHR system to obtain, dictate, electronically enters and assures preparation of appropriate medical records for all patients seen to assure the accumulation and organization of all pertinent clinical data needed to provide comprehensive medical care. Clinical data reports shall be completed in a timely manner and shall be maintained in compliance with Joint Commission standards. It is the responsibility of the contractor to use the training resources provided by the CCHCF to develop competency in utilizing the EHR system.

5.1.4 The contractor shall be subject to peer review per Joint Commission standards.

5.1.5 The contractor shall adhere to the Safety management reporting requirements in accordance with CCHCF’s Safety Measure Policy.

5.1.6 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 contract agency. 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.

5.1.7 The contractor shall submit a proper invoice as required for payment of services rendered and attach timesheet/work record to verify the hours worked. A certification statement of service rendered will be included with a signature from the designated COR for this contract.

5.2 Work Schedule:

5.2.1 The contractor shall work 100% of the contracted services. The contracted on-site clinic services shall be arranged by Nurit Harari, MD, Primary Care Director or designee for this order.

The CCHCF is using two schedules to operate the On-Site Nephrology Specialty Clinics.

Schedule One and Schedule Two are as follow:

Schedule One:

Tour of Duty: 8:00 am to 5:00 pm, the 1st and 3rd Tuesdays of each month.*

The contractor shall provide on-site Nephrology Clinic services every month.

*If a change in scheduling occurs, the contractor shall notify and work with the Primary Care

Director or the Specialty Clinic Supervisory Clinical Nurse.

The contractor shall provide a monthly rate in which allows the contractor to provide a steady clinic services on a monthly basis for the multi-year.

Schedule Two:

Tour of Duty: 1:00 pm to 5:00 pm, each Thursday of the week.*

The contractor shall provide on-site Nephrology Clinic services every month.

*If a change in scheduling occurs, the contractor shall notify and work with the Primary Care

Director or the Specialty Clinic Supervisory Clinical Nurse.

The contractor shall provide a monthly rate in which allows the contractor to provide a steady clinic services on a monthly basis for the multi-year.

5.2.2 Continuity of Patient Care: The contractor shall ensure the continuity of patient care and shall provide a qualified replacement to authorize the approval of time off and within the time frame specified by the Contracting Officer.

5.2.3 Work Flexibility. The contractor shall rotate into other duty sections as needed to support patient care.

5.2.4 The contractor shall obtain approval of the department Supervisor or designee prior to any absence from work. If the length of the absence exceeds eight (8) work hours the

Contractor shall request approval at least fifteen (15) days, (the exception is verifiable emergencies) in advance of the desired absence. The contractor is not authorized sick leave, annual leave and compensatory time hours.

5.2.5 The contractor shall provide written documentation from a qualified health care provider for absences of three (3) or more consecutive days, due to illness, stating:

A. The cause of the current illness or incapacitation AND

B. Indicating the Contractor as contagious or non-contagious.

The Government reserves the right to examine and or re-examine any Contractor who meets the criteria.

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

5.3.1 The contractor shall be subject to character investigation as required by Public Law 101-

360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance of a contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eQIP) system and this shall include all fingerprinting procedures and clearances. The contractor shall provide all requested information necessary to perform Level I and Level II background checks. The contractor shall comply with the requirement to obtain security investigations. The contractor shall work with the I.H.S. 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 and forwarded to the government personnel. The contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

5.4 Performance Evaluation:

5.4.1 The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 10.0.

5.4.2 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 and shows cause for termination.

5.5 Identification of Contractor:

5.5.1 The Contractor shall wear a government issued contractor identification badge during performance of duty.

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

5.6.1 Medical Records and Other Required Documentation: 100% percent of all medical records (EHR) and other required 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. (Note: payment will be withheld for inaccurate or incomplete medical records per paragraph 10.0 of this performance work statement.)

5.6.2 The Contractor shall ensure adherence to DHHS IT system security policies and procedures. The IT policies and procedures will be made available to the Contractor.

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

5.7 IHS Information Technology Systems:

5.7.1 In performance of this contract, the Contractor shall adapt to and successfully utilize

IHS information technology systems that are deemed by the Supervisor as necessary for acceptable contractor performance.

5.7.2 The Contractor 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.

5.7.3 The contractor shall follow all appropriate federal and locally required Information

Technology security requirements and will be operating under HIPAA and Privacy Act regulations.

6.0 Contractor Qualification Requirements: The contractor shall meet the qualifications and credentialing standards and retain the qualifications and certification throughout the term of this contract.

6.1 Training/Experience. The Contractor shall have completed thirty-six (36) months of Internal

Medicine Residency Training and one year of Fellowship Training in Nephrology with a minimum of six (6) months experience in the specialty required by the contract, unless otherwise approved by the CCHCF’s Credentials Committee. There must be no lapse of services of no more than 6 months prior to beginning tour of duty with CCHCF.

6.2 Certification/License/Registration. The Contractor shall be board certified with the American

Board of Internal Medicine and the American Board of Nephrology. If the provider is to perform out the normal training parameters of his/her specialty, then the provider shall provide certification of hospital privileges in those additional scope of practice(s). The Contractor shall maintain appropriate licensure, a valid, current, full and unrestricted license to practice

Nephrology in any state within the United States, District of Columbia or the Common-Wealth of

Puerto Rico, and certification throughout the term of this contract.

6.2.1 Drug Enforcement Administration (DEA) License. The contractor shall maintain a valid, current, full and unrestricted DEA license with Schedule types II through V and maintain certification throughout the term of the contract.

6.2.2 The contractor shall maintain a valid and current Cardiopulmonary Resuscitation (CPR), Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) certifications and are for mandatory Nephrology.

6.2.3 Motor Vehicle Operator’s License. If required by the position, the contractor shall possess a valid state driver’s license throughout the term of this contract.

6.3 Health Requirements/Conditions of Employment:

6.3.1 Medical Evaluation. The Contractor 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.

6.3.2 Immunization. The contractor shall provide documentation as evidence of immunization as required by NAIHS immunization policy for the following:

� Hepatitis A - Two dose series at zero and six months.

� Hepatitis B - Three dose series at zero, one, and six months or documented immunity. A signed declination of Hepatitis B vaccination series will be accepted.

� Measles, Mumps, Rubella (MMR) - Two doses or titer documentation.

� Varicella (chickenpox) – Two doses, titer documentation or history of varicella/shingles.

� Tetanus, diphtheria, pertussis (Tdap/Td) - one dose of Tdap, then tetanus (Td) booster every 10 years thereafter.

� Meningococcal - Two vaccines (MenACWY and MenB) recommended for microbiologists routinely exposed to N. meningitidis.

� Documentation of annual TB test- may include Mantoux TB skin test (PPD). All new employees will require the two step TST.

Acceptable lab testing: Quantiferon Gold or T-Spot test.

For positive TB test results, please submit a copy of recent chest x-ray results.

� Influenza – Mandatory annual vaccination.

6.4 Language Requirements and Cultural Awareness. The Contractor 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.

6.5 Information Technology Skills. The Contractor shall possess basic knowledge, skills, and abilities to use a computer.

6.6 Orientation. The contractor shall attend mandatory orientations and training specified by the government.

6.7 Background Checks: As directed by the Contracting Officer, the Contractor shall provide all requested information necessary to perform Level I and Level II background checks. The

Contractor shall comply with the requirement to obtain security investigations. The Contractor 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 and forwarded to the Supervisor. The Contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

6.8 General Requirements:

6.8.1 The contractor shall provide three current letters of reference from other health care providers familiar with the contractor's clinical practice skills within the same discipline. One letter must be from the Chief of Staff/Medical Director or Immediate Supervisor at the hospital in which the contractor either holds or last held staff privileges. If the contractor has just completed a residency program, one of the letters shall be from the program director or service chief.

6.8.2 The contractor shall be subject to Medical Staff Ongoing Professional Practice Evaluation and Focused Provider Performance Evaluation as specified in the CCCHF Policy & Procedure, Focused Provider Performance Evaluation & Ongoing Professional Practice Evaluation.

6.8.3 The contractor shall work directly with the Chinle Service Unit Credentials Committee to attain approval of credentials and privileges and shall retain status of appointment throughout the term of this contract.

7.0 Challenges to Conflicts: For any inconsistency between supervisor directions, this Performance

Work Statement, attachments and exhibits, the following order of precedence will apply:

(a) First Priority: Supervisor’s directions

(b) Second Priority: Position Description (attached)

(c) Third Priority: Performance Work Statement Exhibits

(d) Fourth Priority: Performance Work Statement Narrative

8.0 52.212-4 Contract Terms and Conditions-Commercial Items (MAY 2015) (m): Termination for cause. The Government may terminate this contract, or any part hereof, for cause in the event of any default by the Contractor, or if the Contractor fails to comply with any contract terms and conditions, or fails to provide the Government, upon request, with adequate assurances of future performance. In the event of termination for cause, the Government shall not be liable to the Contractor for any amount for supplies or services not accepted, and the Contractor shall be liable to the Government for any and all rights and remedies provided by law. If it is determined that the Government improperly terminated this contract for default, such termination shall be deemed a termination for convenience.

8.1 Any Contractor employee demonstrating impaired judgment shall not be allowed to continue working on the contract. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

9.0 Performance – Based Matrix

Performance-based Task Indicator Standard Quality Assurance Incentives

State the end results or outputs that you, the customer will formally accept or reject.

For the requirement, state the feature(s) of end result that will be surveilled.

For each “indicator,” state a performance level that, when met, means the task has been performed satisfactorily.

This Standard describes “What Success Looks

Like.”

For each “Standard”, state the method used to check performance (i.e. random sampling, 100% inspection, periodic inspection, customer complaints).

List Positive and Negative

Incentives. Address method of linking payment to quality of service.

Contractor shall provide outpatient Nephrology in the delivery of patient care to the

Navajo Area Indian Health

Service, Chinle Comprehensive

Health Care Facility, Chinle, Arizona.

a. Patient Care

b. Compliance

c. Culturally Sensitivity

d. Documentation

e. Professionalism

Contractors provided fully successful or excellent patient care as rated under Element 1

& Element 3 of the Peer Review CSU Provider

Exit Profile (refer to 9.1).