Questions_NAO-19-0348.pdf

Questions: NAO‐19‐0348 Crownpoint ED

1. Number of FTE’s required for presentation?

It was required in the previous contract that the agency keep 15 doctors credentialed to always have someone available for ill providers. 15 doctors does not mean that 15 will be working full time, but that was a number that made sure there was adequate backup for emergencies. When we hired two full time employees, the requirement was relaxed because the agency was not covering all the hours. Now, we have one full time employee on extended sick leave with still an uncertain return date, and one who is likely to leave federal service this year, so some number like 12 would be reasonable. Based on our experience this year with losing both permanent and contract staff due to protracted medical illness, I would say at least 10. Do to our requirements for background security clearance; we need a large pool of providers to cover unexpected changes in the schedule/ill providers, etc.

If these were permanent federal employees, taking account for annual leave, sick leave, time off awards, CME leave and all, it would take about 6 FTEs to cover the ED 24 hours a day.

2. Number of hours per year?

Assuming we had two full time ED providers and a director who works one shift a week, we calculated 5,760 hours.

3. The SOW under 7.1 Qualifications states ABEM is preferred however great than 2 year experience for FP, IM, etc. is acceptable?

Yes, greater than 2 years of full time Emergency Department experience in a high volume ED working with other Emergency Medicine trained physicians is a minimum. For work performed in lower volume EDs, such as single coverage EDs, the experience needed is longer.

ABEM candidates are preferred over candidates who are board certified in other specialties.

4. Hours: The Performance Work Statement states 100% of night and holiday shifts and 100% of those day shifts that our Emergency Department providers cannot staff. And Contractor physician will be responsible for any admissions to the hospital that occur from 7pm‐7am

a. What hours are required to be staffed during holiday shifts? Which holidays are required to be covered?

The ED must be staffed 24 hours a day. Thus, all 24 hours of holiday shifts must staffed, a 12‐hour day shift and a 12‐hour night shift. Federal holidays. (New Year’s Day, President’s Day, Memorial Day, Fourth of July, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving Day, Christmas.

b. Can you advise the expected number of day shifts that will require coverage?

At present, we are requiring that about 16 day shifts covered per month. That could go up to 28 if one of our doctor leaves and the other does not come back from medical leave, or go down to 6 or 7 if both are working again.

5. What is the annual patient volume?

Annual patient volume in the entire ED, including the lower acuity wing, which is like an urgent care, is about 18,000. In the higher acuity wing, it is about 7,000.

6. How many patients per hour?

The number of patients per hour varies wildly, but averages about one patient per hour. In addition, tends to be less busy on the night shifts.

7. What backup support is available?

We usually have an "OB resource" person, a nurse midwife or sometimes FP/OB doc, on call to assist with pregnancy related problems beyond 20 weeks gestation. Recently there have been times when they could not keep that schedule filled every day.

Gallup Indian Medical Center OB/Gyn is available for consultation as well regarding OB emergencies.

We have Pediatricians available in daytime hours.

We are pending approval of a Pediatric Emergency Medicine telemedicine service provided by the University of New Mexico Pediatric Emergency Medicine Residency attending faculty.

We have CT scan on call 24 hours a day.

We have the University of New Mexico Hospital "PALS" line phone consultation and transfer service available 24/7.

There are no in‐house surgeons, or operating room. In addition, we have no respiratory therapist or anesthesia providers.

8. Where are patients shipped out to?

Crownpoint works with the following nearby hospitals:

Gallup Indian Medical Center and Rehoboth McKinley Christian Hospital in Gallup.

San Juan Regional Medical Center in Farmington, NM.

University of New Mexico, Presbyterian Hospitals, and Lovelace Hospitals in

Albuquerque

Rarely to Flagstaff and Phoenix, AZ.

9. Is this requirement just through 12/31/19 or are option periods included?

This requirement is through December 31, 2019 with the option to extend for three months if necessary.

10. What is the location of the Government Housing indicated in 3.2.2 and what is the distance from this housing to the facility?

There are two government‐housing areas. One is walking distance a couple blocks to the hospital. The other is less than 2 miles south.

11. Are incumbent providers offered first right of refusal?

If you mean the permanent government employees, when you say “incumbent providers" and you mean get first choice of schedule when you say, "first right of refusal", then yes, the permanent employees choose their schedules first.

12. How many FTE are required for the subject solicitation?

Please refer to question 1.