PWS_No._09-02.pdf

PWS No. 09-02 April 2018

Performance Work Statement (PWS) for Nonpersonal Services

Emergency Medicine/Fast Track

Table of Contents

Section Page

1.0 General 1-2

2.0 Definitions 2-5

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 12-14

7.0 Federal Tort Claims Act 14

8.0 Challenges to Conflicts 14

9.0 52.212-4 Contract Terms and Conditions-Commercial Items 14

10.0 Performance-based Matrix 15

11.0 List of Attachments and Exhibits 16

Performance Work Statement (PWS) for Nonpersonal Services

Emergency Medicine (Including Fast Track Service)

1.0 General: This performance work statement describes the requirements for nonpersonal services for an Emergency Medicine Physician to support the mission of the Indian Health Service

(IHS).

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.

1.2 Scope: The Contractor shall provide medical services in the Emergency Department/Fast Track in accordance with section 5.0, performance based requirements.

1.2.1 Duties and responsibilities shall encompass Emergency Medicine and Fast Track medical services to IHS patients.

1.2.2 Place of Performance: Services are to be performed under the Navajo Area Indian Health Service (NAIHS), Shiprock Service Unit - Northern Navajo Medical Center (NNMC) within the State of New Mexico. The award pricing schedule shall identify the exact place of performance. Contractor will perform outpatient clinical duties in varying locations throughout the facility, based on patient need, to include the Urgent Care Clinics, Family Medicine outpatient clinics, Internal Medicine outpatient clinics and DZ Health Center.

1.2.3 Period of Performance: shall be flexible to allow for short term (13 weeks), long term (1-year) and, where feasible, include intermittent support to meet unplanned needs that develop on a frequent basis.

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 http://www.jointcommission.org/ http://www.cms.hhs.gov/ http://www.aaahc.org/ http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml http://www.nicwa.org/policy/law/protection/index.asp http://www.usdoj.gov/oip/privstat.htm http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt http://www.ihs.gov/

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.

2.4 Code of Ethics: The Code of Ethics for Physicians approved by the Indian Health Service Headquarters and the Code of Ethics for Physicians approved by the American Medical Association.

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

2.6 Contractor: The individual awarded a legal binding contract to provide supplies and services.

2.7 Contracting Officer’s Representative (COR) or Project Officer (PO): 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).

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

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

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

2.11 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.

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

2.13 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.

2.14 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.

2.15 Health Center: Emergency Department located at the Northern Navajo Medical Center, seeing approximately 35,000 patients per year. There is a four bed dedicated Fast Track area for lower acuity patients, as well as Provider in Triage area where emergency department patients can also be seen 24 hours a day, 7 days a week.

2.16 Nonpersonal Services: A contract under which the personnel rendering the service are not subject, either by the contract’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.

2.16 Ordering Activity: An authorized user of IHS that may issue a task order to obtain required services under this contract.

2.17 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.

2.18 Orientation: An activity designed to provide basic familiarization of the facility and transition the physician assistant into the IHS Service Unit and/or Health Center and the nursing unit where the services shall be provided.

2.19 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.

2.20 Patient Outcome: End result of outpatient, Emergency Department care.

2.21 Performance based Matrix: Provision of Emergency Medicine care in the Emergency Department, which includes a dedicated Fast Track for lower acuity patients.

2.22 Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

2.23 Service Unit: The local administrative unit of IHS.

2.24 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.

2.25 Supervisor. The Chief of Emergency Medicine is the primary supervisor and authorized to provide verbal and written performance direction to the Contractor that the Contractor must follow without exception.

2.26 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 shall include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activities task order number.

2.27 Tour of Duty: The Emergency Department is open 24 hours a day, 7 days a week with 10 hour shifts (7am-5pm; 3pm-1am; 9pm-7am). Fast Track hours are 8:00 a.m. through 9:00 p.m.

and the Provider in Triage hours are 9:00 a.m. through 9:00 p.m. The contractor occasionally may stay later, if needed to complete same day visits or deal with acute medical illnesses. The shifts may change at discretion of the Chair of Emergency Medicine.

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

2.29 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, shall be made available to the Contractor. The Contracting Officer or designee shall 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 shall 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 shall furnish the Contractor with appropriate PPE other than specified in paragraph 4 of the contract. The Government shall 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 shall provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 shall 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 shall 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 shall not be provided for the purpose of continuing education, career development or individual development.

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 Emergency Medicine Physician Services in the delivery of direct patient care services to the Indian Health Service. Specific tasks include the following:

5.1 Emergency Medicine Direct Patient Care Services: This position is located at Northern Navajo Medical Center [NNMC], Shiprock Service Unit [Shiprock], Navajo Area, Indian Health Service, in Shiprock, New Mexico. NNMC has a hospital, outpatient clinics, and Emergency Department.

The NNMC has about 50 inpatient beds, which provider medical, surgical, pediatric, and obstetric care. The Emergency Department and the parallel Fast Track care for approximately 36,000 patients per year. The Emergency Department consists of 11 beds including one resuscitation room, and services are provided 24 hours a day. The Fast Track has four beds and is staffed by mid-level providers (nurse practitioners and physician assistants) and physicians, and provides services 13 hours a day from 8am to 9pm. There is also a Provider in Triage (PIT) area for patients to have Medical Screening Exams and be seen by a provider.

5.1.1 The contractor shall provide professional emergency medical duties and manage patient’s needs 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 and as described and identified in NNMC’s position description. All services rendered in this specialty in the delivery of patient care services shall be inspected, reviewed, and monitored by the Chair of Emergency Medicine or designee.

5.1.2 The contractor shall provide professional emergency medical services or direct patient care services as follows:

A. The contractor shall make preliminary diagnosis, directs, prescribes or provides treatment, or arranges for specialized care of patient referral as required. Evaluates patients who come to the emergency room.

B. The contractor shall provide patient care as needed and obtain consultant as needed.

Patients are often critical and may require immediate decision or are complicated because patient fail to respond to previously tried treatment regimens. Provides primary medical care to patients with wide spectrum of illnesses in the emergency room.

C. The contractor shall provide emergency care on a regular and ongoing basis to patients seen in the emergency room. This includes stabilization and transfer of major trauma (penetrating wounds, hemorrhage, traumatic brain injury, significant blunt trauma etc.). Contractor must be competent in the management, stabilization and transfer of pediatric trauma, pediatric advanced life support, adult cardiac life support, advanced trauma life support, psychiatric emergencies such as suicide, and complex/critical medical conditions (septic shock, cardiopulmonary shock, end stage renal disease etc.)

D. The contractor may serve as a first responder for “codes,” that is, ACLS/PALS administration for patients found in life threatening situations for which the “code blue” activation system has been initiated on the NNMC campus, including the outpatient departments.

E. The contractor shall make appropriate referrals and obtain appropriate consultations after primary complete evaluation and documentation has been completed.

F. The contractor shall recognize and give initial treatment of acute psychiatric problems.

G. The contractor shall provide consultation and assistance to the Fast Track midlevel providers, physician assistants or nurse practitioners, assisting them with patient care as needed. The contractor may also work in the Fast Track or Provider in Triage Area as well.

H. The contractor shall provide appropriate documentation on rendered patient care utilizing NNMC’s EHR system. The contractor is responsible for utilizing the NNMC 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 NNMC to develop competency in utilizing the EHR system.

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

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

5.1.5 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.

5.1.6 The contractor shall submit original invoices as required for payment of services rendered and hours worked. Invoice shall be certified by the contractor that services have been provided and attach daily time sheet to verity the hours worked. Invoices will also include certification statement of service rendered, which will be signed by the COR.

5.2 Work Schedule

5.2.1 The contractor shall work 100% of the contracted hours. The contracted hours shall be arranged by the Chair of Emergency Medicine or designee for this order. Tour of Duty: 7:00 am to 5:00 pm; 3:00 pm to 1:00 am; or 9:00 pm to 7:00 am; Sunday through Saturday including Holidays, ten hours per shift. Shifts in Fast Track are 8:00am to 9:00pm, 7 days a week. Shifts in PIT are 9:00am-9:00pm 7 days per week. Overtime: Additional hours are admissible to a contractor that works more than 10 hours providing direct patient care. A contractor shall be subject to working longer hours in the rare instance patient load demands the contractor remain past their scheduled 10 hours in the Emergency Room. NOTE:

Additional time spent completing written or electronic patient care documentation shall not be claimed as overtime after shift has ended. The contractor is responsible for appropriate documentation using the EHR during patient care – refer to Page 9 – Item H. The contractor will submit a sign out, or clearance for separation sheet, prior to departure.

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. As directed by the Supervisor, the contractor shall rotate into other duty sections as needed to support patient care, including the Fast Track and PIT.

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.

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 an ACGME approved Emergency Medicine Residency Training Program; or other accredited residency training in Family or Internal Medicine with significant experience (as determined by Chair of Emergency Medicine at NNMC) working in high-acuity emergency departments, unless otherwise approved by the NNMC Credentials Committee. There must be no lapse of services of no more than six (6) months prior to beginning tour of duty with NNMC.

6.2 Certification/License/Registration. The contractor shall be board certified or board eligible with the American Board of Emergency Medicine. If not trained in Emergency Medicine, must be board certified in their given specialty. If the contractor is to perform out the normal training parameters of his/her specialty, then the contractor 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 Emergency Medicine 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 all schedule types (I 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), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS) and Advanced Trauma Life Support (ATLS) certifications, unless they are board certified in Emergency Medicine.

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:

Immunity to Rubella, Mumps, Measles Immunity to Hepatitis B series History of chicken pox (varicella) disease or positive titer Tetanus Diphtheria (Td) and Pertussis within the last 5 years Influenza within the last year Documentation of receiving a TB Mantoux skin test (PPD) within the past 12 months with documentation of follow-up for a positive test.

A signed declination of the Hepatitis B vaccination series will be accepted.

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.

6.6.1 The contractor shall complete an orientation check in sheet if they have not had previous employment at the NNMC. Contractors shall be compensated for a minimum of four hours for the orientation process, and shall be granted additional hourly compensation for every hour the orientation process exceeds the estimated four hours.

6.6.2 The contractors who have not provided service to the NNMC within the last 90 days, are mandated to report to the NNMC Credentialing Office before 12:00 pm the day prior to their scheduled ER shift if they are working at 7:00 am, or before 12:00 pm the day of their shift if they begin their shift at 3:00 pm or 9:00 pm for orientation and to gain temporary employee access/privileges.

6.6.3 If the contractor is working either shift on a Sunday, then they are mandated to report to the NNMC Credentialing Office before 12:00 pm on the subsequent Monday for orientation and to gain temporary employee access/privileges.

6.7 Background Checks: 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.

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 NNMC Policy & Procedure, Focused Provider Performance Evaluation & Ongoing Professional Practice Evaluation.

6.8.3 The contractor shall work directly with the Shiprock 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 Federal Tort Claims Act (28 USC 1346 (B), 1946): Independent Contractors: Previously, health care providers working at Indian Health Service or Tribal facilities under nonpersonal services contracts—such as locums tenens providers—were generally not covered under the Federal Tort Claims Act and had to secure their own malpractice insurance. However, the recently passed 25 U.S.C. 1680c(e) may extend Federal Tort Claims Act coverage to these “non-Service health care practitioners” who are given clinical privileges and who provide health care services to patients eligible for services from the Indian Health Service or under an ISDEAA contract. More information can be found at website link:

https://www.ihs.gov/riskmanagement/ftca/.

8.0 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

9.0 52.212-4 Contract Terms and Conditions-Commercial Items (JAN 2017) (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.

9.1 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.

https://www.ihs.gov/riskmanagement/ftca/

10.0Performance – Based Matrix

Performance-based Task Indicator Standard Quality Assurance Incentives

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

For the requirement, state the feature(s) of end result that shall 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 & inpatient and physician assistant/nurse practitioner in the delivery of patient care to the Navajo Area Indian Health Service.

Competency

Compliance

Patient Outcomes

Professionalism

Credentialing

Documentation

Service Quality

Perform 100% required tasks at 100% of the required competencies (refer to 11.0)

100% compliance with IHS Service Units and/or Health Centers published Policies;

Procedures; Standards of Care; and hospital and Laboratory Protocols.

No reports of breached patient safety, infection control, and other procedures that might adversely affect patient outcome.

Performance characterized by continual cultural awareness and focus on customer service. 100 % adherence to the Code of Ethics and Federal Code of Conduct.

MDS Exit profile.

Uninterrupted credentialing as defined in

6.0 to 6.8 for period of contract.

100% of all medical records and other required documentation meets established IHS Medical Facility, Joint Commision, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

Satisfaction with quality of service is evidenced by productivity that meets or exceeds peer group provider – specific rates of LWBS or LBTC are with national norms.

See QASP. Surveillance systems shall include periodic inspections and customer complaints.

Payment of contract price for satisfactory service.

No payment for incomplete work.

Contractor performance shall be evaluated using the Contractor’s Performance Assessment Report (CPAR).

The evaluation shall be considered when future IHS contract selections are made.

11.0 List of Attachments and Exhibits. To be provided by the Contracting Officer upon request.

11.1 Attachments

Position Description (Service Unit specific)

11.2 Written Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

11.2.1 Standard Emergency Codes

11.2.2 Confidentiality: Legal and Ethical Concerns in Healthcare

11.2.3 An Introduction to the Navajo Culture

11.2.4 Verbal and Telephone Orders

11.2.5 Pain Management

11.2.6 Focus Charting

11.2.7 Medical Staff By Laws