PWS -75H70523Q00009 - DOCS..pdf

PERFORMANCE WORK STATEMENT

Emergency Room and/or Primary Physicians

I. GENERAL.

1.1. Description of Work. The Contractor shall provide personnel to perform non-personal professional physician services for the Emergency Room (ER) and/or the primary care clinic (family practice, pediatrics, internal medicine clinic), or other primary care locations as Identified within the Indian Health Services Bemidji Area (Cass Lake Hospital. The provider may be required to provide services in any/all of these areas should the need arise. The physician shall be required to perform emergency trauma work and/or primary care work. The contract employees performing this service are hereafter referred to as Health Care Providers (HCP). The locations will be referred to hereafter in this document as Bemidji Area Service

Units.

1.1.1. FAR Subpart 37.4 Nonpersonal Health Care Services

This is a non-personal services contract as defined in FAR 37.101, under which the contractor will perform independently and not as an agent of the Government. Contracted personnel rendering 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.

The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment);

The contractor hereby agrees to indemnify the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance. The contractor shall maintain medical liability insurance, a coverage amount acceptable to the contracting officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned; and, The contractor is required to ensure that its subcontracts for provisions of health care services, contain the requirements of the clause at 52.237-7, including the maintenance of medical liability insurance.

SPECIFIC TASKS. The contract ER and/or Primary Care Physicians shall perform essentially the same duties as those required of any Government Civil Service ER or Primary Care Physician of similar experience and in similar duty assignments.

The HCPs shall be fully aware that, other than ancillary and support personnel, the HCPs shall be fully prepared to provide all of the emergency services required without assistance or supplementation by other Bemidji Area Service Units physicians. The HCPs will also be required to respond to cardiac arrest victims on the hospital property when a code is called. HCPs performing services under this contract shall have sufficient experience to be able to adequately diagnose and treat diseases/injuries; perform medical procedures/tasks to include, but not limited, to the following:

Skin Reproductive System

Head Central Nervous System

Eyes Cardiovascular System

Ears Gastrointestinal System

Nose Lymphatic System

Throat Musculoskeletal System

Neck Genitourinary System

Psychiatric

Disease

Central and Peripheral Nervous

Systems

Major

Trauma

Endocrine System

5.2. The HCPs shall provide initial emergency medical care required to any presenting patient requiring it in life-threatening situations.

http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/52_237.htm#P58_11076

5.3. The HCPs shall be required to complete the following procedures and tasks including, but not limited to:

Incision and drainage Suture simple lacerations

Nail trephination Remove sutures

Sling or swath injuries Tube thoracostomy

Bandage Utilize paraprofessional staff as appropriate

Reduce dislocations and fractures when appropriate

Stabilize and evaluate cervical spine injuries as appropriate

Lumbar puncture

Remove foreign bodies as appropriate

Deliver babies/emergency vaginal deliveries

Venous punctures for lab studies and interpret results

Draw arterial blood gases for evaluation and interpret results

Bladder catherization

Local anesthesia

Restraints

Consult with consultants on the appropriate utilization of HIPAA

Interpret electrocardiograms

Provide medical care instructions via radio communications with ambulance personnel

Rapid sequence intubation

Obtain an adequate history, physical and assessment on each patient and develop a treatment plan

Secure and maintain an adequate airway by such means as oral airways

Oral tracheal intubation

Nasal/tracheal intubation

Cricothyrotomy (needle and surgical)

Splint and stabilize traumatic injuries to extremities

Administer intravenous, intramuscular and subcutaneous medications as appropriate

Secure and maintain adequate intravenous access by peripheral and by central routes

NG/OG tubes

Coordinate with accepting facility and other ER

Departments when patient transport is needed

Complete all required paperwork

Provide interpretation of radiographs

Provide discharge instructions and any paperwork

Respond to cardiopulmonary arrest as appropriate and arrange appropriate backup from the EMS

The HCPs shall examine all presenting patients for emergency medical care to render a medical assessment of their condition, take appropriate action.

The HCPs shall provide immediate evaluation and management of emergency patients as they present themselves for care. When treating urgent and non-urgent patients (and sufficient patients are available in these categories), the HCPs shall see all those screened while on duty.

The HCPs shall provide definitive medical care to reduce the emergency situation and enable the patient to safely continue care as an outpatient with follow-up care as required. Follow-up of abnormal reports is the responsibility of the ordering physician. However, to assure correct medical follow-up for these patients, all abnormal x-ray and lab reports received on patients seen by the contractor’s physicians shall be reviewed by the contract physician on duty at the time these reports are available for review. HCPs shall review laboratory and x-ray reports daily and inform the medical officer of the day of actions taken.

The HCPs shall provide emergency medical care to both inpatients, if part of code team response, and outpatients, summon appropriate on-call specialists as necessary, and continue medical management until the arrival of the appropriate specialist.

The HCPs shall respond to “Code Blue” (cardiac or respiratory arrest) medical emergency alerts within the hospital and provide resuscitation treatment until more specialized treatment arrives. Should resuscitation efforts be unsuccessful, the HCPs shall pronounce the patient dead, complete necessary records, and notify the next-of-kin, if the next-of-kin is physically present.

Patients presenting themselves with non-acute conditions will be reassured and treated in priority as established by medical triage.

The HCPs shall provide emergency care to patients in the holding area when necessary.

The HCPs shall prepare appropriate narrative summaries and patient profile changes, document history, physical examinations, and preoperative diagnosis. The HCPs shall maintain documentation of treatment in accordance with established procedures.

The HCPs shall use an electronic medical record system for keeping records, ordering of ancillary procedures, ordering of medications, writing doctor’s orders, and performing other required patient record functions.

The HCPs shall respond to a staff nurse’s request for assistance to the emergency needs of hospitalized patients, to carry out procedures, and for writing orders, until the patient’s staff physician arrives, as required by the Bemidji

Area Service Unit.

If staffing permits, the HCPs shall accompany emergency room technicians on ambulance runs when indicated by the nature of the emergency. This includes initial response for disaster-type situations. The HCPs shall remain on the scene until relieved by a staff physician.

The HCPs shall perform emergency room procedures compatible with the medical facility’s operating capacity and equipment. The HCPs shall respond to mass casualty situations in accordance with hospital procedures.

As workload permits during scheduled duty, the HCPs shall attend meetings and trainings as required by the

Bemidji Area Service Units. The Clinical Medical Director (CMD) may require contract providers to attend a one-hour staff meeting with all contract providers once a quarter. The CMD will schedule the meeting at least 30 days in advance. The meeting will be coordinated through the COR and the Contractor. The Contractor will be reimbursed at the contract rate.

The HCPs shall become familiar with the hospital formulary. The HCPs shall prescribe pharmaceuticals according to the availability of drugs listed therein. The HCPs use only prescription forms provided by the facility for outside prescriptions. Only a physician/advance practice providers can dispense medication to emergency room patients. Nursing staff may access the Omni Cell system, but cannot label medication or dispense medication to patients. HCPs prescribing medications for patients after the Bemidji Area Service Units pharmacy has closed must dispense the medications themselves.

The HCPs shall remain in the facility throughout the tour of duty, except in response to emergencies and/or disaster ambulance runs. The HCPs shall remain on tour of duty until appropriate replacement is on site.

The HCPs shall maintain medical records in accordance with Bemidji Area Service Units Medical Record

Administration and facility medical staff by-laws. Medical records completed by the contract physician shall be subject to review by the Clinical Director and a medical records review committee established by the Bemidji Area

Service Units.

The HCP shall be notified of deficiencies in his/her entries and shall be instructed to correct the deficiencies. All records generated in the performance of the contract will remain the property of and subject to exclusive control of the government.

The HCPs shall use an electronic medical record system in order to facilitate documentation of patient care.

The HCPs shall verify the content and correctness of all prepared and/or transcribed reports by affixing his/her own electronic signature to all copies of the document and validating its contents.

The HCPs shall document appropriate history, physical examination, required laboratory and x-ray examinations, and preliminary diagnosis (as appropriate) prior to healthcare treatment.

The HCPs shall provide patient referrals to outside practitioners only after providing notification to the Cass Lake

Indian Hospital staff in accordance with emergency room procedures at the Cass Lake Indian Hospital.

The HCPs shall spend one hour, once a quarter, reviewing a percentage of another ER physician’s charts. The

CMD will randomly pull the charts and assign them to the contract physician for review and provide the physician with a checklist for each chart. The checklist will contain such areas as legibility, documentation, results of labs, x-rays, etc. The HCP shall return the checklists to the CMD citing the deficiencies found and corrective actions taken.

The HCPs shall be required to treat patients from other provider panels.

Lab tests, x-rays, pharmaceuticals, referrals, etc. shall be ordered independently on the computer by the HCP.

The HCP shall order consults in the electronic medical record system per Bemidji Area Service Units Contract

Health Service, "Referral and Preauthorization Process.”

The HCP shall use Bemidji Area Service Units facility electronic medical record for inputting and retrieval of all patient data.

The providers under this contract are considered key personnel and mission essential. This means the providers shall make every attempt to be at work on time and work their assigned shift regardless of inclement weather conditions or other circumstances. Some staff may be granted leave or a few extra hours before having to report to work during inclement weather but such leave or delayed reporting does not apply to providers under this contract.

The HCPs shall complete all documentation of care provided in the Bemidji Area Service Units computer programs for which training was/is provided.

II. QUALIFICATIONS AND REQUIREMENTS.

The HCPs shall have graduated from an accredited educational college or university and must be licensed in good standing in a state, Puerto Rico or District of Columbia. The providers qualify by meeting the following standards:

a. HCPs shall have a minimum of two years’ experience as a practicing provider in the last three years.

Residency time counts as practicing experience. Time spent in an administrative capacity as a claims reviewer, medical school instructor, medical director, internet physician, etc. does not qualify as practicing time.

b. HCPs shall be a Medical Doctor (M.D.) or Doctor of Osteopathic Medicine (D.O.) and be capable of treating all ages of patients.

c. HCPs shall have and maintain, at all times and at Contractor expense, current certification in Basic Life

Support (BLS) for Family Practice/Primary care providers, and the following additional requirements for

Emergency Room Providers - Advanced Cardiac Life Support (ACLS) Certificate, and Pediatric Advanced

Life Support (PALS) Certificate by way of an American Heart Association training program and Advance

Trauma Life Support (ATLS) or equivalent.

d. HCPs shall possess and maintain at all times a current Drug Enforcement Administration (DEA) registration number.

e. HCP’s must be board eligible or board certified.

f. HCP’s must have completion of a nationally recognized postgraduate training program in Emergency

Medicine or have completed of at least 2 years of a nationally recognized primary care specialty postgraduate training program (FP, Emergency Medicine, Pediatrics, OB/Gyn., General Surgery) or one year of recognized postgraduate training in a general primary care specialty WITH board certification in Emergency Medicine for

Emergency Room Providers.

The following shall disqualify, at any time, any provider from consideration/performing under this contract. If none of these conditions are applicable, the contractor shall provide a letter so stating.

A provider under probation/revocation/indictment/suspension action at any time from any state, the District of

Columbia, Commonwealth of Puerto Rico, Guam or U.S. Virgin Islands where the provider has/had a license;

A provider who has a documented past of sexually abusing people whether convicted or not;

A provider who has defective color vision (applies to Emergency Room Providers only);

A provider who is chemically (alcohol or drug) dependent or impaired;

A provider who was previously convicted of any felony;

A provider who is awaiting possible adverse action administration action by any board of medicine;

Failure of the contractor or provider to disclose any information listed herein.

CONTRACTOR REQUIREMENTS.

The Contractor shall not employ any individual to provide direct health care services who is listed on the Health and

Human Services (HHS) list of providers excluded from federally funded health care programs. The list may be found at http://oig.hhs.gov/fraud/exclusions.asp.

The HCPs shall be a U.S. citizen or otherwise meet other applicable requirements.

The HCPs shall successfully complete a criminal history background check.

The HCPs shall be able to read, write, and speak English well enough and enunciate with sufficient clarity to effectively communicate with patients and other health care providers.

The HCPs shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that the

HCP can relate to a variety of patients from diverse backgrounds.

The HCPs shall be able to operate a personal computer utilizing Microsoft applications, such as Word, Excel, and efficiently utilize an Electronic Medical Record. The providers shall be able to type and have had experience using computers. The providers will not be required to type a certain amount of words per minute. Bemidji Area

Service Units will provide computer training on their electronic medical records system. Failure to learn the computer system at Bemidji Area Service Units and perform actions independently within 2 weeks of beginning service may be grounds for immediate removal of the provider.

The HCPs shall use the various clinical automation systems as required, such as, but not limited : EHR; PACS, Vista

The HCPs shall be required to meet Continuing Medical Education (CME) requirements as determined by the provider’s State of licensure. The Government will not reimburse for these costs.

III. ADMINISTRATIVE.

1.3.1. This is a locum tenens procurement, therefore the use of short-term rotating HCPs seriously detracts from continuity of patient care that is of utmost importance. Substitutes are permitted during scheduled or unscheduled absences of the primary HCP. The Contractor shall have adequate pre-credentialed/pre-privileged replacement HCPs available in such instances so a lapse in coverage does not occur. Substitutes shall be as qualified and privileged as the primary HCP.

Substitutes are not allowed so the HCP can accept another assignment or to meet the needs of the Contractor. Note – The

Contractor’s attention is directed to the fact that normal credentialing/ privileging process takes between 30-45 days, and this is the same for replacement personal. There is no allowance/excused lapse in coverage based on a change of personnel, and may be considered grounds for termination for cause.

IV. ORIENTATION AND TRAINING.

Prior to working, HCPs will be provided a Government paid orientation to familiarize HCPs with the policies and procedures of the Bemidji Area Service Units. Orientation attendance will be required of all HCPs and will be scheduled by the medical staff secretary or COR during normal duty hours.

The Contractor shall ensure that each HCP is knowledgeable of the policies and procedures of his/her specific place of duty and of the medical activity. The Contractor shall ensure HCPs receive any staff training required by the Bemidji Area

Service Units, as a precondition/condition to performance. Such training may include instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training shall be conducted during the scheduled shift of the HCP.

Government Unique Training. The Government may elect to provide unique Government training to HCPs who are performing services under this contract. If the Government elects to provide such training, the Government will provide http://oig.hhs.gov/fraud/exclusions.asp such training at no additional expense to the Contractor or to the HCP. When directed by the Contracting Officer (CO), HCPs shall attend all such training in a paid status as part of the normal services required and billed under the contract.

Such training shall require a performance commitment by the Contractor and the Contractor shall reimburse the

Government (by means of a reduction in an invoice) if a HCP fails to satisfy the performance commitment after the HCP receives the unique Government training. The amount of the reimbursement shall be the prorated cost of training, calculated based on the total cost of the training and the number of months by which the HCP fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first. Details of any subsequent training agreement will be agreed upon by all parties, and such training agreements will be designated by modification to the contract.

The HCPs shall attend all and take all training prescribed for personnel as required. Training shall be part of the workday.

HCPs shall attend training provided by CLIH , regarding their unique computer systems and programs. Failure to learn the computer system at CLIH and perform actions independently within 2 weeks of beginning service may be grounds for immediate removal of the provider.

V. ELECTRONIC MEDICAL RECORD KEEPING SYSTEMS.

The Government will provide training to HCPs in the Electronic Medical Record Keeping Systems and other procedures that the medical activity's staff is required to use. Access to such patient data systems is an "Automated Data Processing

Sensitive" position requiring compliance with the Health Insurance Portability and Accountability Act (HIPAA) Security

Rule. Refer to the Additional Information section “ADP Security Requirements” in this contract for further guidance.

Electronic Health Record (EHR) contains the facilities’ appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the Bemidji Area Service Units. The Government will provide training to HCPs in the EHR and/or other procedures that the medical activity’s staff is required to use. Access to such patient data systems is an “Automated Data Processing Sensitive” position requiring compliance with the Health Insurance

Portability and Accountability Act (HIPAA) Security Rule.

Training for EHR and other computer training will be scheduled through the medical secretary and/or COR prior to the

HCPs providing direct patient care. The training will be on-site and during normal duty hours. This training will be at no cost to the Contractor.

If additional training is needed due to mission changes, the Bemidji Area Service Units Information Management Office will conduct required computer training. This training will be at no cost to the Contractor. The COR will schedule this training.

VI. REPORTING REQUIREMENTS.

The Contractor shall submit reports to the medical secretary and/or COR as requested for use in monitoring Contractor performance. Such reports may include, but are not limited to: personnel recruitment/credential status; time sheets, etc.

Safety. The Contractor shall ensure that its HCPs comply with all installation safety regulations. Such regulations include, but are not limited to, general safety, fire prevention, waste disposal and infection control. Copies of these regulations are on file in the medical activity safety office or may be obtained through the COR.

Hours of Performance.

Billing. The Government will only pay for hours, days or units actually worked/provided. The Contractor shall only submit payment requests for hours, days or units actually worked/provided. Submitting a payment request for more than the amount due based on the number hours, days or units actually worked/provided may constitute fraud or a false claim and may result in administrative or criminal action or both.

The providers shall be able to provide services 24 hours a day, seven days a week including holidays. Shifts will be eight to 12 hours in length. No guarantee can be made that the shift will end as scheduled. A minimum break of 30 minutes will be given during the shift if patient care permits. Work hours and days will be determined by Bemidji Area Service Units, and confirmed by the contractor. A schedule discussed between a contract physician and staff is not considered valid.

Schedules are subject to change due to cancellations, hospital staff changes, organization day, emergencies, exodus, training holidays and unexpected events. The most a provider can work is eight consecutive days in a row and then a minimum of a one day break is required.

Signing in prior to scheduled time will not be considered as hours worked. The above timeframes are subject to change.

The hours do not include any break periods to eat. Break times are not billable. The contract physician shall be prepared to be the sole provider of medical treatment in the facility and shall remain in the facility through the shift. The government reserves the right to verify the hours worked by the HCPs by sign-in/sign-out sheet, checking computer logs, use of a time clock, etc.

Shift Scheduling. Bemidji Area Service Units will provide a schedule of needed shifts to the Contractor 45 days before the first scheduled shift. This schedule shall be used to determine any monthly bonus/reduction. The Contractor shall furnish the names of the physicians scheduled to work each shift to the medical secretary within 15 working days of receiving schedule.

On-call Services: On-call services shall/may be required for inpatient services.

Overtime/Extended Shift: Overtime is not authorized under this contract.

Unscheduled Absences. Unscheduled absences shall be called into the medical secretary, charge nurse or the Clinical

Medical Director by the contractor at least 24 hours before the start of the shift. The contractor shall only be payed for actual hours worked.

Hours worked do not include travel time to reach the facility or other place of performance.

The HCPs shall be rested and fully physically and mentally capable of performing the duties required under this contract.

The HCPs shall not have worked the eight hours before beginning services at a Bemidji Area Service Unit.

Closures. During anticipated closure of the facility due to a Bemidji Area Service Units, declared training, holiday or during unplanned closure of the facility due to natural disasters, emergencies, severe weather, or otherwise, the Contractor shall not invoice the Government for services not performed and the Government will not be liable to the Contractors for any such closures.

Holidays. There are ten federal holidays observed by the facility; the HCP may be the sole medical provider in the facility on these days.

NOTE: Any holidays that are declared by Presidential Executive Order shall be observed in the same manner as the holidays listed above

CONDUCT.

The Contractor shall ensure that each HCP records the time worked according to procedures determined by the Bemidji

Area Service Unit to include documenting hours on the time sheet.

The Clinical Medical Director, where services are being performed, or his/her representative, will define the scope of practice. The Contractor shall ensure that its HCPs do not introduce new procedures or services without prior approval of the CMD or representative. In disagreements or deviations from established or new protocols, the CMD, or representative, will be the deciding authority.

The Contractor shall ensure that its HCPs comply with Bemidji Area Service Unit policies regarding personal appearance and conduct.

The Contractor shall ensure that its HCPs abide by federal and local Bemidji Area Service Units regulations and requirements concerning the nature of limited privileged communication between patients and the HCP as may be necessary for security and personnel reliability programs. The Contractor shall also ensure that its HCPs abide by federal and local Bemidji Area Service Units regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act of 1996. All regulations referenced are available for review from the COR or Bemidji Area Service Unit. All medical records and reports are and will remain the property of the Government.

Contractor shall abide by all local Bemidji Area Service Unit policies/rules. All personnel shall maintain and support the standards necessary to meet Joint Commission (JC) and CMS (Centers for Medicare and Medicaid Services), and AAAHC certification. When commencing work under this contract, Contractor shall obtain an in-processing checklist from the COR and provide the COR a copy when completed. The Contractor shall wear a Bemidji Area Service Unit identification badge.

The COR will assist the Contractor in obtaining the identification badge through the Bemidji Area Service Units, Division-

Security Officer. Upon termination of work at a Bemidji Area Service Unit, the contractor will be required to return the hospital identification badge and out-process through the activities identified on the out-processing checklist obtained from the COR.

The Contractor shall ensure that its HCPs abide by Bemidji Area Service Unit bylaws, the AAAHC, JC, HHS, and Medical

Department regulations with regard to Utilization Review and Quality Assurance directives, including, but not limited to, in-service training, maintenance of records, performance evaluation, and release of medical information.

The Contractor shall ensure that its HCPs make use of all appropriate equipment; supplies and services made available by the Government and shall ensure that its HCPs make referrals and seek consultations, as deemed necessary, for the optimal care of the patients.

REMOVAL OF HCPS.

Removal of HCPs. At any time during the performance of this contract, the CO or COR may direct the Contractor to immediately remove any HCP whose actions or impaired/insubordinate state raises reasonable suspicion that clear and present danger of physical harm exists to a patient, other HCPs, Government personnel or to the impaired individual. This provision will be used in emergency situations only and not for the purpose of bringing performance issues or other non-urgent concerns to the attention of the Contractor.

If the need for a removal occurs, the COR will contact the Contractor's point of contact and direct the Contractor to remove that individual from the facility and to not use that individual to perform any healthcare services required under this contract until the issue has been resolved by the CO. The Contractor shall formally meet with the COR to discuss further action in accordance with the Bemidji Area Service Units Medical Staff By-laws. A review of the basis for removal will be made by the CO within three working days after the COR directed the removal.

If, after any investigation deemed necessary by the CO and discussions with the Contractor's representative, the CO concludes that the HCP’s impairment requires permanent removal from performance under the contract, the CO will notify the Contractor that permanent removal is required. In the event of disagreements between the Government and the

Contractor's representative concerning matters of impaired/insubordinate HCPs, the decision of the CO will be final.

During the period of time between the removal and the final decision of the CO, the Contractor shall provide a backup/replacement HCP in accordance with the terms and conditions of this contract.

The Bemidji Area Service Units has the prerogative to hold in abeyance, to deny, or to summarily suspend clinical privileges/practice when there is a reasonable cause to doubt the health care provider’s competence to practice or for any cause affecting the safety of patients or others. The Medical By-laws outlines the adverse clinical privileging and practice actions for privileged personnel and adverse practice actions and peer review for non-privileged personnel.

Inquiries. Contractor shall ensure that its personnel do not respond to any media inquiries. Any inquiries from the media shall be immediately relayed to the COR, who will relay them to the Bemidji Area Service Units Chief Executive Officer

(CEO). There shall be no interviews, comments, or any other response without the knowledge and approval of the Bemidji

Area Service Units CEO. Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the HCP’s Government supervisor.

Smoking. The Contractor shall ensure that its HCPs comply with the Bemidji Area Service Units smoking policy.

Complaints. Complaints will be validated by the COR and be reported in writing to the CO and to the Contractor for action, if it constitutes a failure to perform, as determined by the Government. Patients may also be a source of legitimate complaints that constitute a failure to perform. The Contractor shall have no more than two substantiated complaints per

12-month period per HCP. Any patient complaints received on services provided by the HCP will be taken very seriously at the Cass Lake Indian Hospital and as such will be considered a part of the inspection process. The CMD will submit documentation to the COR regarding all patient and/or clinical complaints. Receipt of two valid complaints on the HCP within any twelve-month period may be considered grounds for immediate removal.

Conflict of Interest.

The Contractor/HCP shall not bill the patient for services rendered under this contract. The Contractor/HCP shall be prohibited from receiving compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract, at the rate specified.

The Contractor or HCP shall not, while performing services under this contract, advise, recommend, or suggest to persons eligible to receive medical care at Government expense that such persons should receive care from the Contractor or HCP at any place other than as designated under this contract and shall ensure that its HCPs do not do so.

The Contractor’s HCPs are not prohibited by reason of their employment under this contract from conducting private practice provided there is no conflict with the performance of services under this contract, subject to any agreement between the Contractor and its employees. The CO will unilaterally resolve any issues concerning potential conflicts pertaining to the performance of this contract, not including disputes solely (as determined by the CO) between the

Contractor and its employees.

The Contractor shall not use Government facilities or other Government property in connection with conducting a private practice and shall ensure that its employees do not do so.

Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which are furnished, produced or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. The Contractor shall not release any of the above information without prior written consent of the CO and shall ensure that its employees do not do so. The Contractor shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication and shall ensure that its employees do not do so.

RESPONSIBILITY AND PROCEDURES.

If any suit or action is filed or any claim is made against the HCP, which occurred as a result of work performed by the

HCP under this contract, the HCP shall immediately notify the Contractor, the CO and the CD of the appropriate services and promptly furnish them copies of all pertinent documents received.

The Contractor and HCP shall cooperate with the Government, without further compensation, in the processing, review, settlement, or defense of the suit, action, or claim. The HCP may, at the HCP’s own expense, participate in defense of such claim or litigation.

QUALITY MANAGEMENT.

Quality Control Plan (QC). The Contractor is required to follow the current QC program in place at the Bemidji Area

Service Unit to ensure that the medical services are provided at a level of quality that meets Bemidji Area Service Units standards.

Quality Assessment and Improvement (QA&I). The Government will monitor the Contractor's performance under this contract using the QA&I procedures established by the medical activity and pursuant to the Contract Terms and

Conditions-Commercial Items clause, paragraph entitled Inspection/Acceptance. Additionally, the Contractor's performance is subject to scheduled and unscheduled review by the QA&I Committee as defined by the medical activity

Quality Assurance (QA) Plan.

CONTRACTOR REPRESENTATION.

The Contractor shall designate a representative for this contract. This representative may be employed under another contract/task order with the Contractor at the same Bemidji Area Service Units. At least ten working days prior to performance start date, the Contractor shall provide in writing to the COR, Contractor representative contact information.

Changes in the contract representative, at any time after contract commencement, shall be in writing to the COR at least five working days prior to the change.

The Contractor's representative shall, at no additional cost, meet with the COR when requested by the COR to discuss any problems that the Contractor's personnel may be experiencing during the performance of this contract. Problems experienced by the Government with the Contractor's performance will be discussed and resolved. Unresolved problems will be referred to the CO for resolution.

The Contractor shall provide points of contact (POC) information for administration of the contract during normal business hours and after normal business hours. The POC for other than normal business hours will be contacted only in the event of emergencies. Accordingly, the named individual(s) shall possess sufficient corporate authority to effectively deal with emergency situations and the telephone number provided shall be functioning at all times other than normal business hours.

If there are different POCs for different conditions, such as weekdays, weekends, holidays, clearly provide such information.

GOVERNMENT PROPERTY

The Government will provide use of all available Bemidji Area Service Units facilities and support services, materials, publications and forms, equipment, and specialty clothing required for contract performance (except as designated in the contract). The Contractor shall ensure that its HCPs keep Government-furnished supplies, equipment, and work areas in a safe, orderly and clean condition. The Contractor shall notify the Government whenever maintenance of equipment is required. Personal long distance calls are not authorized and the cost of all personal long distance calls made will be deducted from the Contractor’s invoice.

The Government will provide a Bemidji Area Service Unit identification card and vehicle access stickers/passes. The

Contractor shall ensure its HCPs comply with the Bemidji Area Service Units policy regarding the identification cards and stickers/passes. The HCP shall coordinate with the COR in obtaining an identification badge and vehicle decal. The HCP shall wear the identification badge in accordance with the Bemidji Area Service Units policy. The HCP shall surrender both identification badge and vehicle decal to the COR on his/her last contracted day of duty at the Bemidji Area Service

Unit.

Any space or equipment used by the Contractor’s HCPs in performance of this contract may be used by the Government for other purposes during his/her absence. Items of clothing, personal effects, or equipment may not be able to be secured at all locations. The Government will not incur any liability for theft, damage to, or loss of such personal items.

Emergency Health Care for HCPs. The Cass Lake Indian Hospital will provide emergency health care for injuries or life threatening medical emergencies occurring while on duty. The Contractor shall reimburse the Government for such services as billed by the Cass Lake Indian Hospital, unless the HCP is otherwise authorized to receive such services at no cost (e.g., is retired military or other).

CONTRACTOR FURNISHED SUPPLIES/SERVICES.

Uniforms. The Contractor shall provide or ensure HCPs have their own stethoscopes and smocks.

The Contractor shall provide badges for all HCPs providing services under this contract.

REQUIREMENTS FOR MEDICAL LICENSE/CERTIFICATION AND DRUG ENFORCEMENT

ADMINISTRATION (DEA) CERTIFICATE.

7.2.1. The Contractor shall ensure that each of its HCPs follows any medical license and DEA certification requirements specified in this contract to perform at a Bemidji Area Service Unit. The Contractor shall ensure that each of its HCPs meets all applicable licensing and certification requirements.

7.2.2. All contract health care providers must maintain a current, active, valid and unrestricted license or authorizing document from any U.S. state, District of Columbia; or U.S. territory or jurisdiction to provide health care within the scope of practice for a specific health care discipline. In addition, contract health care providers who write prescriptions for controlled substances must have a current Drug Enforcement Agency (DEA) certificate or Controlled Drug Substance number as appropriate. The Contractor shall ensure that renewal actions are accomplished well before expiration of the provider’s license and/or DEA certification to ensure compliance with the contract.

CONTRACTING OFFICER’S REPRESENTATIVE (COR). The COR will be appointed in writing by the CO after the contract is awarded. The CO will provide a copy of this designation and COR contact information to the Contractor.

VII. ACCESS TO GOVERNMENT INFORMATION SYSTEMS

Contractor Employees Who Require Access to Government Information Systems (IS). All Contractor employees with access to a government info system must be registered in the Information Technology Access Control (ITAC ) at commencement of services, and must successfully complete the Information Systems Security Awareness (ISSA) Training prior to access to the IS and then annually thereafter.