Performance Work Statement.pdf

Chinle Comprehensive Health Care Facility Performance Work Statement (PWS) for Non-Personal Services

RESPIRATORY THERAPIST

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 8-12

6.0 Contractor Qualification Requirements 12-13

7.0 Challenges to Conflicts 13

8.0 52.212-4 Contract Terms and Conditions-Commercial Items (MAY 2015) (m): 13

9.0 Performance-Based Matrix 14-15

10.0 List of Attachments and Exhibits 16

PWS No. CSU-22-RT 25 AUG 2021

Chinle Comprehensive Health Care Facility Performance Work Statement (PWS) for Non-Personal Services

RESPIRATORY THERAPIST

1.0 General: This performance work statement describes the requirements for a Non-Personal Services Respiratory Therapist to support the mission of the Indian Health Service (IHS) by raising the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

1.1 Background: The IHS, an agency, within the Department of Health and Human Services, is responsible for providing federal healthcare services to American Indians and Alaska Natives.

The provision of healthcare 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 American Indians and Alaska Natives, and its goal is to raise their health status to the highest possible level. The IHS provides a comprehensive health service delivery system for approximately 2.6 million American Indians and Alaska Natives who belong to 573 federally recognized tribes in 37 states.

1.1.1 Navajo Area Indian Health Service (NAIHS) administers health centers and hospitals providing health care to approximately 244,209 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) is a NAIHS 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.

In addition, most of our elderly patients speak only Navajo, and live according to traditional Navajo cultural practices. The CCHCF and Ambulatory Care Center is a 60-bed inpatient hospital and outpatient facility. Services offered are:

• Adult Inpatient • Mental Health • Physical Therapy

• Adult Intensive Care • Native Medicine • Podiatry

• Anesthesiology • Nurse Phone Triage Services* • Public Health

• Audiology • OB/GYN & Midwifery • Radiology

• Dental • Occupational Therapy • Respiratory Therapy

• Emergency Medicine • Optometry • School Health

• General Surgery • Outpatient Primary Care • Speech Pathology

• Lab • Pediatric Inpatient • Women’s Health

• Labor & Delivery • Pharmacy *Available after hours.

1.2 Scope: The contractor shall provide respiratory therapy services in accordance with Section 5.0, performance-based requirements.

1.2.1 Duties and responsibilities will encompass outpatient and inpatient respiratory therapy services to IHS patients.

1.2.2 Place of Performance: Services are to be performed in the Respiratory Department, Emergency Room (ER), Outpatient, and Inpatient: Adult Care Unit (ACU), Pediatric Care Unit (PCU)/Nursery and Special Care Unit (SCU) 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.

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 10.0 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/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.

2.4. Code of Ethics: The Code of Ethics for Respiratory Therapy as approved by the National Board for Respiratory Care.

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): 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: 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.

2.16. Non-Personal Services Contract: a contract under which the personnel rendering the services 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.

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

2.18. 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.

2.19. Orientation: An activity designed to provide basic familiarization of the facility and transition the respiratory therapist into the IHS Service Unit and/or Health Center and the nursing unit where the services will be provided.

2.20. 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.

2.21. Patient Outcome: End result of outpatient and inpatient, Respiratory Therapy care.

2.22. Performance-Based Matrix: Lists the services to be monitored and the standards to be applied.

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

2.24. Service Unit: The local administrative unit of IHS.

2.25. Standards of Practice and Standards of Care: Authoritative Respiratory Therapy Policies and Procedures manuals which provide the duties and responsibilities of the Respiratory Therapy department staff. The standards provide direction for Respiratory Therapy practice and a framework for the evaluation of practice. The standards of Respiratory Therapy practice may pertain to general or specialty practice.

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

2.27. 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.

2.28. Tour of Duty: The time of day the respiratory therapist is scheduled to perform respiratory therapy duties.

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

2.30. 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 medical technology service or includes mandates made by the IHS Service Units/Health Centers while the medical technologist 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 Respiratory Therapy in the delivery of patient care services will be inspected, reviewed and monitored by Andrew Baker, MD, Assistant Clinical 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 Contacts: Georgina Nez, (928) 674-7450, Alfreda Lee, (928) 674-7017, and Aurelia Tsosie, (928) 674-7451 are the point of contacts 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 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 Respiratory Therapy services in the delivery of patient care to the Indian Health Service. Specific tasks include the following:

5.1 Respiratory Therapy Duties:

5.1.1 The contractor shall work under the general technical, administrative supervision of the CCHCF Chief Respiratory Therapist or his designee.

5.1.2 The contractor shall provide professional medical services or direct patient care services under the terms of this contract, appropriate 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, Medical Staff Bylaws and Rules & Regulations at CCHCF. The contractor shall be scheduled to provide on-call services after their regularly scheduled shift during the week and as scheduled on weekends. The contractor shall provide medical services in both inpatient and outpatient settings which includes consultation services during evening and weekend shifts. There is some variability of daily and weekly hours based on workload, emergency cases, scheduling of cases and staffing variability.

5.1.3 The contractor shall provide direct patient care services as follows:

A. On a regular and recurring basis, the contractor shall independently provide emergency inhalation therapy treatments without prior instructions to critically ill and high-risk patients who require extensive skill, training and experience. Such assignment occurs when incumbent serves as sole technician during periods when physicians are not readily available. Under emergency conditions, adjust machines providing mechanical ventilation to patients based on blood gas analysis and other ventilator data. Advise physicians on change in the patient’s condition and on corrective measures that can be taken.

B. The contractor shall set up and operate positive pressure ventilators, pneumatic nebulizers and volume ventilators to administer complex inhalation therapy treatments to patients who are critically ill. These treatments include intermittent and positive pressure breathing, continuous ventilation, oral pharyngeal insufflations by nasal catheter, endotracheal intubation, ultrasonic aerosol, infant incubator oxygen therapy, oxygen tent therapy, chest physiotherapy involving postural drainage and percussion and vibration. Perform external cardiac massage and pulmonary resuscitation on patients in cardiac arrest.

C. The contractor shall set, operate and monitor pulmonary functions instruments and equipment, such as blood gas analyzers, pulmonary bedside Spiro meter, wate Spiro meters. Performs blood gas analysis to determine acid-base balance and partial pressures of gases in the blood. Calculate blood-inspired gas relationships from raw data on blood and gas analysis. Perform pulmonary functions test on patients whose conditions precludes full cooperation and assesses the accuracy of such test results. These test include bedside spriometry, vital capacity, tidal volumes, exhaled/inhaled oxygen concentrations, minute volumes, peak flows, lung compliance, inspiratory/expiratory capacities, prebronchodilator and post-bronchodilator ratios, arterial punctures, blood oxygen saturations, complete blood gas analysis.

D. The contractor shall calibrate and maintain blood gas analyzer and blood gas supplies. Instruct nursing and physician staff on pulmonary functions tests and on proper arterial puncture and blood gas analysis techniques.

E. The contractor shall provide technical assistance to other personnel in the

Respiratory Therapy Department.

F. The contractor shall provide technical guidance to nursing personnel in order to maintain a high quality of service. Maintain records of patient care given and provide statistics for evaluation of audit. Maintain record of in-service and orientation of nursing personnel receiving such in-service.

G. The contractor shall provide consultation on difficult cases to practitioners in the same or other specialties and works closely with allied health professionals (community health nurses, social workers, health educators, etc) in the provision of broad health program services.

H. The contractor shall provide in-service continuing education and instruct nursing and physician staff on the latest developments in this field on specialization.

Participate in professional workshops to upgrade present skills and knowledge.

Serve in planning and implementing in-service education programs to meet their needs. Serve as technical advisor and evaluator for the purchase of new equipment and for the maintenance of old equipment. In order to perform the above functions, keeps abreast of changes through review of latest journals and articles in the field of respiratory therapy.

I. The contractor shall assure proper care and maintenance of respiratory therapy equipment and supplies. Assures uninterrupted supply of necessary equipment accessories and supplies.

J. 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 familiar with the cultural, social, political, geographic, demographic, economic, and epidemiological characteristic of the patients and the communities served. The contractor shall be receptive and respectful of the culture at CSU.

Cultural awareness and cultural diversity includes language barriers, rural Native lifestyles and native ceremonies. The contractor shall be aware of the basic traditional medicines and ceremonies that are available to patients, from the womb to geriatrics. CSU has traditional providers on staff providing traditional diagnostic care for all patients who seek it. The contractor shall embrace and incorporate these elements into the care of the patients for positive outcomes. The contractor shall complete a mandatory on-line training made available during orientation.

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

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

5.1.7 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.

5.1.8 The contractor shall submit a proper invoice as required for payment of services rendered and attach time sheet to verify worked hours. 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 hours. The contracted hours shall be arranged by the Chief Respiratory Therapist or designee for this order. Tour of Duty: 12 Hour Shifts from 7:00 pm to 7:30 am (30-minute lunch) or 7:00 am to 7:30 pm (30-minute lunch), both with no stand-by coverage.

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.

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 9.0.

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 Section 9.0).

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 qualification requirements and retain certifications throughout the term of this contract.

6.1 Experience. The contractor shall have a minimum twelve (12) months of Respiratory Therapy experience, including: ICU, Nursery, Pediatrics, Geriatrics, and Emergency/Trauma.

6.2 Certification. All Respiratory Therapist shall be either certified or registered by the National Board for Respiratory Care (NBRC) and maintain appropriate licensure, a valid, current, full and unrestricted license to practice Respiratory Therapy 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 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.

6.2.2 The contractor shall maintain a valid and current Cardiopulmonary Resuscitation (CPR) and Basic Life Support (BLS) certifications and are mandatory.

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. All respiratory therapists providing service under this contract 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.

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 Respiratory Therapy services in the delivery of patient care to the Navajo Area Indian Health Service, Chinle Comprehensive Health Care Facility, Chinle, Arizona

(a) Patient Care

(b) Culturally Sensitivity

(c) Documentation

(d) Professionalism

(e) Compliance

No reports of breached safety or other procedures that may have adversely affect patient outcomes. A rating of “fully successful” or “exceptional” must be attain for Patient Care.

Contractor is compassionate and Culturally sensitive. A rating of “fully successful” or “exceptional” must be attain for Culturally Sensitivity.

Contractor completes require documentation in clear and legible form in a timely manner.

A rating of “fully successful” or “exceptional” must be attain for Documentation.

Contractor presents in professional appearance, demonstrates exceptional ethical conduct with effective communication, and exhibits exemplary attitude by being flexible and being adaptable. A rating of “fully successful” or “exceptional” must be attain for Professionalism.

No quality of care issues or disciplinary actions for violations of published Policies;

Procedures; Standards of Care or Hospital Protocols. No quality of care issues or disciplinary actions during performance period for Compliance.

Direct observation, 100% inspection, periodic inspection, and/or analysis of contractor’s progress reports shall be the surveillance methods for all the indicators (a – e).

Payment of contract price for satisfactory service.

No payment for incomplete work.

Contractor performance will be evaluated using the Contractor Performance Assessment Report (CPAR).

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

CPARS evaluation will be forwarded to the GSA/FSS Contracting Officer.

9.1 Quality Assurance Monitoring Form (QAMF). The QAMF will be completed for each contractor. The completed QAMF is a peer review document and is confidential as afforded under Arizona Revised Statutes 36.445 and 36.445-01. The QAMF will not be shared or disclosed.

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

10.1 Attachments

a. Position Description (Service Unit specific) – available upon request.

b. Certification Statement for Performance Work Statement No. CSU-22-RT.

10.2 Written Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

10.2.1 Standard Emergency Codes

10.2.2 Confidentiality: Legal and Ethical Concerns in Healthcare

10.2.3 An Introduction to the Navajo Culture

10.2.4 Verbal and Telephone Orders

10.2.5 Pain Management

10.2.6 Focus Charting

10.2.7 Medical Staff Bylaws and Rules & Regulations