Performance Work Statement PWS No. CSU-24-01 OR-Surgical Technician dated October 06, 2023.pdf

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

SURGICAL TECHNICIAN

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

PWS No. CSU-24-01 OR/SURGICAL TECHNICIAN 06 OCTOBER 2023

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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

SURGICAL TECHNICIAN

1.0 General: This performance work statement describes the requirements for Non-Personal Surgical Technician Nursing services 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 • Labor & Delivery • Physical Therapy

• Adult Intensive Care • Mental Health • Podiatry

• Anesthesiology • Native Medicine • Public Health

• Audiology • Nurse Phone Triage Services* • Radiology

• Clinical & Community Nutrition • OB/GYN & Midwifery • Respiratory Therapy

• Dental • Occupational Therapy • School Health

• Emergency Medicine • Optometry • Speech Pathology

• General Surgery • Outpatient Primary Care • Social Services

• Integrated Behavioral Health • Pediatric Inpatient • Urgent Care

• Lab • Pharmacy • Women’s Health *Available after hours.

1.2 Scope: The contractor shall provide surgical technician nursing services in accordance with Section 5.0 - Performance Based Requirements.

1.2.1 Duties and responsibilities may encompass outpatient, inpatient, and community health nursing services to IHS patients. If supervisor determines necessary, then contractor may accompany patient on direct patient care related transports.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

1.2.2 Place of Performance: Services are to be performed in the Operating Room (OR) Department at CCHCF under NAIHS within the State of Arizona.

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 (JC) 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/

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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 and Standards of Practice and Care for Surgical Technicians approved by National Board of Surgical Technology and Surgical Assisting formulates primary goals, value, and obligations for the surgical technician profession.

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

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 contractor’s 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.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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 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.

2.17 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 contractor 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, inpatient, and community health surgical technician nursing 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 statements by which the nursing profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for professional nursing practice and a framework for the evaluation of practice.

The standards of professional nursing 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 activity written order to obtain services, at a

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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 contractor is scheduled to perform contractual duties; also considered the shift of the day. The time can vary according to the needs of each facility and/or clinic, e.g. 8-hour Tour of Duty, 10-hour Tour of Duty, and 12-hour Tour of Duty with thirty minutes lunch for day shift.

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.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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 surgical technician nursing services or includes mandates made by the IHS Service Units/Health Centers while the surgical technician 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 under this contract in the delivery of patient care services will be inspected and verified by Gloria Fulton, Supervisory Clinical Nurse (SCN) or designee for this order.

3.5.1 Contracting Officer Representative (COR): Henrietta James, Health System Specialist, is primarily responsible for monitoring the technical progress including surveillance and assessment of performance for this order.

3.5.2 Point of Contact: Gloria Fulton, SCN, (928) 674-7232 or Hazel Tso, Health System Specialist, (928) 674-7450 or Henrietta James, Health System Specialist, (928) 674-7189 are the points of contact for this requirement.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

4.0 Contractor Furnished Property

4.1 Except for the property specified in paragraph 3 as government furnished, the contractor shall provide 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.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

5.0 Performance-Based Requirements. The contractor shall provide surgical technician nursing services in the delivery of patient care to the Indian Health Service.

5.1 Surgical Technician Duties:

5.1.1 The contractor shall perform in accordance with the competency standards listed in Exhibits, Section 10.

5.1.2 The contractor shall provide surgical technician nursing services in direct patient care as follows:

Operating Room Duties:

The contractor serves as a member of the surgical team comprised of an Anesthetist/Anesthesiologist, Surgeon, one to two Assistant Surgeons, one circulating nurse, and other surgical personnel; delivers patient care and assumes appropriate responsibilities before, during, and after surgical procedures.

The contractor shall perform duties for advanced and complex General, OB/GYN, Podiatry & Hand, Emergency Thoracic and Endoscopic procedures.

General Laparoscopic and Open Cholecystectomy with Common Duct Exploration, Laparoscopic and Open Appendectomy, and Hernia repair.

OB/GYN Caesarian Section, Hysterectomy, and Birch procedures, Dilation and Curettage. Bilateral Tubal Ligations, Laparoscopy, Cystoscopy, Hysteroscopy, and major Pelvic Reconstruction.

Podiatry/Hand Carpal Tunnel Release, Ulnar Nerve Transposition, PIP & MP Joint Replacement, Ankle, Below Knee and Toe Amputations, and Bunion Removal.

Thoracic Surgery Emergency trauma cases.

Endoscopic Colonoscopy, Gastroscopy, and Sigmoidoscopy

Pre-Operative:

The contractor assists surgeons and any assistants don their surgical gowns and gloves; adheres with quality assurance criteria continuously; reviews board for procedures: pulls packs for procedures according to preference cards for each surgeon.

The contractor sets up the operating surgeon's sterile table with appropriate instruments, equipment, supplies, and medicaments needed for a specific surgical procedure.

The contractor greets and assists with change of clothes; takes blood pressure. temperature, and EKG; Reviews patient charts, identifies, verifies, and ensures accuracy of patient to be performed of surgical services: obtains consent forms; assists the Surgical team in obtaining and sharing information of medical importance with the patient and family for comfort measure which enhance the patient's understanding of surgical services being provided;

During Procedure: The contractor maintains standards of sterile technique during procedure, assists in draping the sterile field (back table, mayo stand, and OR table), ensures aseptic techniques in an appropriate manner to provide optimum patient care: assists preparation of operating room and equipment for the next patient;

The contractor assists the surgeon's need at each stage of operation or procedure, passes instruments and materials to and retrieves them from the surgeon, illuminates field of surgery, Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

retracts and stabilizes tissue, keeps field of surgery from debris using irrigation solutions, suction tip and evacuator, counts surgical sponge, needle, and instruments or hard and soft items being used during the surgical procedure: scrubs. gowns, and gloves for surgical procedures, adheres to necessary aseptic precautions throughout procedure.

Post-Operative:

The contractor retrieves and locates laboratory test results from the patient automated data system when assigned with a nurse PACU:

The contractor takes vital signs for blood pressure, 02 sat, temperature and pulse; operates, reads, and interprets EKG reading and informs surgical team of any unusual readings from vital signs, takes A1C to measure glucose levels and other patient duties; and assists with positioning of patients.

The contractor transports patients to and from the operating room; reports any adverse signs and symptoms to appropriate surgical team members;

The contractor assists surgical team with administration of life saving measures of oxygen.

emergency supplies for the physician and/or anesthetist, including cardiopulmonary resuscitation; maintains continued education in the field and SU mandatory.

Equipment and Instrument Maintenance:

The contractor removes contaminated instruments after surgery and materials using precautionary procedures; prepares instruments for terminal sterilization:

The contractor organizes supplies and equipment in the operating room, coordinates activities in cooperation with supervisor and Lead OR Nurse, ensures good working order in sufficient quantity, and communicates between Central Sterile and Housekeeping Departments to ensure quality control.

The contractor informs appropriate supervisor or Operating Room Nurse Team leader when new purchase or repair of instruments and equipment are needed, receives orientation on new instruments and equipment as needed.

Monitors equipment and material for repairs to avoid malfunction for:

Compressed Gases Pulse Oximeter X-Ray Shields

X-Ray Gowns & Thyroid Shield Bair Hugger Bair Paw

Hyperthermia Blanket Hotline Fluid/Blood Warmer Level one System 1000 Rapid Infuser

Autoclaves Steris Sterilizer Flowtron Excel Venodyne

PACU Monitors Fluid/Blanket Warming Cabinet Electrocautery Unites (ESU)

Surgical Table. Stretchers Anesthesia Monitor Slider Board

IV Poles Allen Yellowfin stirrups Laryngoscope Set-up

Hand Table Alaris IV Pumps A Line/Swan Ganz Setup

Olympus Video Printer Meshograft & Dermatome Smoke Evacuator

Chest Tube Set-Up & Pleuravac Olympus Video Monitor Olympus Light Source

Olympus lnsufflator Olympus Camera Box Olympus Camera/light Cord

Laparoscopic Scopes 1/30/all-in-one Pentax Light Source & monitor Doppler

Fiberoptic Head Lamp/Light Source Zimmer ATS1500 tourniquet Linvatec surgical drill system

Stryker TPS Drill (Orally only) Hall micro controller Ohmeda infant warmer system

Mayfield Headrest Cystoscopes/Resectoscopes Flexible Cystoscope

Rigid Sigmoidoscope Flexible Sigmoidoscope Flexible Gastroscope

Choleduchoscope Dental X-ray Machine Berkeley Suction Machine (D&C)

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

Versapoint Resectoscope System Olympus Fluid Management Sys Cystoscopes/Resectoscopes

Flexible Cystoscope ACCU Check Monitor NiHon Kohdeh (Life Scope)

Temporal Scanner Force Triad C-Arm

Eye Wash Casting/plaster, fiber glass

The contractor troubleshoots with Biomed Department within scope or trained duties, assists in repairs by disassembling and pre-assembling, replaces any instruments or pieces of equipment within specified protocols, ensures and monitors availability and inventory of surgical supplies, laparoscopic supplies, and other specialty equipment, reports repairs needed for equipment and low levels of supplies.

Instruments: The contractor shall complete all preliminary paperwork, looks for improved equipment for surgical procedures, estimates and reviews cost or instruments and supplies, works with government official for samples, finds accurate and economical prices of instruments, direct issue supplies, and equipment needed to meet surgical procedures.

The contractor sets up and updates individual preference cards for surgical procedures and reference according to each surgeon.

5.1.3 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 JC 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 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 include 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 JC standards, Occupational Safety and Health Administration (OSHA), IHS, and other federal licensing, accreditation, and regulating body standards.

5.1.6 The contractor shall adhere to 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 provided 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.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

5.1.8 The contractor shall submit a proper invoice as required for payment of services rendered and attach timesheet/work record to verify the hours worked, by uploading to IPP.gov. 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 Work Shift: Eight (8) Hours shifts totaling ten (10) shifts/Two (2) week period, rotating on-call during week nights and weekends, as scheduled by the SCN based on the unit’s need for coverage. With thirty (30) minutes lunch for day shift. Weeknight On-Call/Standby Hours: 15.5 Hours per night, 3:30 pm to 7:00 am, Monday through Friday. Weekend/Holiday On- Call/Standby Hours: Twenty-four (24) Hours per day.

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

5.2.3 The contractor shall obtain approval from the Supervisory Clinical Nurse (SCN) 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.

5.2.4 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:

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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 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 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.

5.6.2 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 Supervisory Clinical Nurse (SCN) 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.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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

6.1 Training/Experience. A graduate of a surgical technology program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES) is preferred, with a minimum of twelve (12) months in the specialty required by the contract, unless otherwise approved by the Contracting Officers.

6.2 Certification. A contractor certified with the National Board of Surgical Technology and Surgical Assisting is preferred.

6.2.1 The contractor shall maintain a valid and current American Heart Associations Cardiopulmonary Resuscitation (CPR) and Basic Life Support (BLS) certifications and are mandatory for Surgical Technicians.

6.2.2 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.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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.

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.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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 Surgical Technician 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. Compliance

c. Culturally Sensitivity

d. Documentation

e. Professionalism

No reports of breached safety or other procedures that may have adversely affect patient outcomes.

No reprimands or disciplinary actions for violations of published Policies; Procedures;

Standards of Care or Hospital Protocols.

Contractors were compassionate and Culturally sensitive.

Contractors completed require documentation in clear and legible form in a timely manner.

Contractors presented in professional appearance, demonstrated exceptional ethical conduct with effective communication, and exhibited exemplary attitude by being flexible and being adaptable.

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.

Provide a rate which allows agency to procure a steady supply of candidates on a monthly basis for the Fiscal Year .

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

10.1 Attachments

a. Certification Statement for Performance Work Statement No. CSU-24-01 OR/SURGICAL TECHNICIAN.

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

10.2 Exhibits Applicable to the NAIHS

10.2.1 Written Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

c. Age Specific Competency Verification

10.2.2 Contractor Orientation Check List

10.2.3 Contractor Orientation Competency Verification Instructions

10.2.4 Standard Emergency Codes

10.2.5 Confidentiality: Legal and Ethical Concerns in Healthcare

10.2.6 EMTALA- Emergency Medical Treatment and Labor Act

10.2.7 What are Age-Specific Competencies?

10.2.8 An Introduction to the Navajo Culture

10.2.9 Latex Allergy

10.2.10 Standards of Surgical Technic ian Practice