PWS.pdf

Pine Ridge Indian Health Service Obstetrician Gynecologist Performance Work Statement

Performance Work Statement (PWS)

Obstetrician Gynecologist (OB/GYN)

1) Background

The Pine Ridge Service Unit (PRSU), Great Plains Area, Indian Health Service (IHS), provides inpatient, outpatient, and emergency care to the Oglala Lakota Nation. Due to high patient demand, limited permanent staffing, and critical access requirements, PRSU requires contracted OBGYN services to ensure continuity of care and compliance with

IHS mission standards.

The mission of the Pine Ridge Service Unit (PRSU) Indian Health Service is to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level. To meet this mission, Obstetrician

Gynecologist (OB/GYN) services are extensively utilized through the reservation for nearly all aspects of Obstetric and

Gynecologic (OB/GYN) health care, including Labor and Delivery services. The Pine Ridge Reservation is in the southwestern corner of South Dakota, approximately 100 miles from Rapid City. Surrounded by rolling prairies, Badlands and Black Hills, the Pine Ridge Reservation is home to the Oglala Lakota Nation.

The people of the Pine Ridge Reservation have a low life expectancy and high infant mortality rates. Furthermore, Oglala Lakota County has consistently been the poorest county in the United States (US) according to the US

Government. Unemployment is high in this population. The closest higher level of care is 35 minutes away by life flight and 1 hour and 30 minutes by ground ambulance. Weather conditions at times can be challenging thus precluding air or even ground transfer.

C.2) General Requirements

C.2.1 Purpose of Contract

The purpose of this Performance Work Statement (PWS) is to define the requirements for providing OB/GYN Physician services at Pine Ridge Hospital and associated Pine Ridge Service Unit (PRSU) facilities. This contract shall be awarded as a firm-fixed-price, non-personal services contract, in compliance with the Federal Acquisition Regulation

(FAR), Health and Human Services Acquisition Regulation (HHSAR), Public Health Service Acquisition Regulation

(PHSAR), and Indian Health Manual (IHM) Part 5 policies.

The purpose of this non-personal services contract is to provide direct patient care services in support of the existing Obstetrics/Gynecology (OB/GYN) and Women’s Health staff. These services are intended to ensure the continuity and quality of care during periods of temporary staffing shortages.

The contractor shall furnish up to two (2) qualified Obstetrician-Gynecologists (OB/GYNs) as Full-Time Equivalent

(FTE) providers. The contractor’s personnel shall be licensed, board-certified, and experienced in providing comprehensive OB/GYN and women’s health services in accordance with the standards of care and the terms and conditions specified in the resulting contract.

The objective is to ensure seamless coverage and continuity of patient care by integrating the contractor’s personnel into the existing clinical team. The services provided shall be indistinguishable from those provided by government personnel and shall comply with all applicable federal, state, and facility-specific policies and procedures.

C.2.2 Contract Type

This requirement will be acquired through a Firm-Fixed-Price (FFP), Performance-Based Service Contract for

Obstetrician-Gynecologist (OB/GYN) services.

Although this contract is performance-based, there are operational constraints that limit the Contractor’s flexibility in determining how to achieve the required outcomes. These constraints arise from the clinical staffing model, which is governed by patient acuity levels and established standards of care within the Pine Ridge Service Unit (PRSU).

Accordingly, the contract establishes minimum coverage levels that must be maintained during each shift to ensure safe and continuous patient care. While there are no restrictions on the maximum number of Contractor Personnel employed under this contract, the physical presence of medical staff may not fall below the contractually required minimum staffing levels, regardless of fluctuations in patient workload.

As a result, although this contract is Firm-Fixed-Price in structure and performance-based in principle, the staffing requirement assumes certain characteristics of a labor-hour arrangement, insofar as it specifies defined labor categories, skill levels, and expected availability (hours or shifts) to maintain compliance with coverage requirements.

For the purposes of this contract:

• The term “Contractor” refers to the awardee entity.

• The term “Contractor Personnel” refers to all individuals provided by the Contractor in fulfillment of the contract requirements.

C.2.3 Contract Performance Period

The period of performance for this contract shall consist of a Base Period (10 weeks) and up to twenty-five (25)

10-week Option Periods, exercised at the discretion of the Government. Each performance period shall be established in accordance with the schedule specified in the contract award.

Option periods may be exercised in accordance with FAR 52.217-9, Option to Extend the Term of the Contract, subject to the Government’s determination of continuing need and contractor performance.

b. Termination for Convenience

This contract may be terminated for the convenience of the Government should sufficiently number of permanent government OB/GYN providers be hired to fulfill the required service capacity. In such an event, the Contracting

Officer (CO) shall issue a written preliminary notice to the Contractor at least sixty (60) calendar days prior to the intended termination date.

Termination shall be executed in accordance with FAR 52.249-2, Termination for Convenience of the Government

(Fixed-Price), and shall not constitute a default on the part of the Contractor.

C.2.4 Contract Place of Performance

The Pine Ridge Service Unit (PRSU) encompasses one (1) hospital, four (4) outlying health centers, and one (1) mobile medical unit. The Contractor’s primary duty station shall be the Pine Ridge Hospital (PRH), located in Pine

Ridge, South Dakota.

As mission requirements dictate, the Contractor may also be required to provide OB/GYN and Women’s Health services at any of the following outlying facilities, justice centers (jails), or the mobile unit within the Pine Ridge Service

Unit.

PRSU Facilities:

1. Pine Ridge Hospital (PRH) – Primary duty station

Location: Pine Ridge, South Dakota

2. LaCreek Clinic – Outlying clinic

Location: Martin, South Dakota

3. Kyle Health Center – Outlying clinic

Location: Kyle, South Dakota

4. Wanblee Health Center – Outlying clinic

Location: Wanblee, South Dakota

5. Mobile Medical Unit – Typically parked at PRH and deployed throughout the Pine Ridge Reservation as needed

The Contractor shall ensure that Contractor Personnel are available to provide services at any of these sites as directed by the Government to meet patient care demands and operational requirements. Travel between locations shall be coordinated in accordance with facility policy and the terms of the resulting contract.

C.2.5 Weather

The Pine Ridge Service Unit (PRSU) is in Pine Ridge, South Dakota, a geographic area characterized by extreme seasonal temperature variations. Winters can be very cold, windy, and subject to hazardous driving conditions, while summers may experience high heat and occasional severe storms.

Contractor Personnel must be prepared to operate safely and effectively in these environmental conditions. The

Contractor shall ensure that personnel possess reliable transportation and can travel between the hospital, outlying clinics, justice centers, and mobile units as required under this contract. All travel to and from the duty location shall be at the Contractor’s expense, unless otherwise specified in the contract. The Chief Executive Officer

(CEO) of Pine Ridge Hospital (PRH) holds sole authority to determine whether PRH or any outlying clinics will close due to weather or other emergencies. If the hospital or clinics remain open, the Contractor and Contractor

Personnel are expected to report for duty on time, consistent with the requirements of this contract and in the same manner as government personnel. Failure to report for duty in accordance with these requirements may be considered nonperformance under the terms of the contract.

C.3) Performance Requirements

C.3.1 Scope

The Pine Ridge Service Unit (PRSU) operates 365 days per year, providing continuous healthcare coverage. To meet this requirement, the Contractor may employ multiple qualified Contractor Personnel to ensure adequate staffing and compliance with the coverage levels established under this contract.

The Government reserves the right to increase or decrease the level of effort through formal contract modification in response to changes in patient workload, mission needs, or staffing requirements.

The Contractor shall furnish Obstetrician-Gynecologist (OB/GYN) primary care services as described herein.

a. Nature of the Services

The services provided under this contract are non-personal services, meaning that no employer-employee relationship shall exist or be implied between the Government and Contractor Personnel.

Contractor Personnel shall not:

1. Be placed under the supervision, direction, or evaluation of any Government employee, except in the case of mandatory peer review or authorized work direction necessary to accomplish the mission.

2. Be placed in a position of supervision, management, or control over Government personnel, personnel of other contractors, or become integrated as part of the Government organization.

b. Work Direction and Team Integration

Given the clinical and operational environment, designated Government supervisory personnel may issue limited

“work direction” to Contractor Personnel to ensure safe, coordinated, and efficient patient care. This work direction is not supervision and is carried out in a manner that preserves the non-personal services nature of the contract.

The Contractor and Contractor Personnel are expected to operate as collaborative team members, supporting the

Government’s mission while maintaining independent management control and accountability.

c. Contractor Management Responsibilities

The Contractor retains full responsibility for the management, quality, and performance of Contractor Personnel.

This includes all administrative and employer-related functions such as:

• Completing and approving timecards.

• Managing and providing coverage for leave.

• Monitoring and ensuring quality of work.

• Maintaining staff morale and motivation; and

• Addressing and correcting any performance concerns identified by the Government.

The absence of an on-site Contractor supervisor does not relieve the Contractor of these responsibilities.

Administrative tasks such as timekeeping, scheduling, and coverage management are the sole responsibility of the

Contractor, not the Government.

d. Professional Standards

Contractor Personnel shall possess and maintain a high level of professional knowledge, skills, and abilities in

Obstetrics and Gynecology. Successful performance requires the ability to function effectively as part of a multidisciplinary healthcare team and to adapt to the operational demands of the PRSU.

Contractor management plays a vital role in fostering a high-performing, motivated, and responsive workforce that upholds the reputation of the PRSU and contributes to building trust with the Native American population served by the facility.

C.3.2 OB/GYN Qualifications

a. Professional Qualifications

The Contract Obstetrician-Gynecologist (OB/GYN) shall demonstrate professional competence and clinical skills as defined by the American Board of Obstetrics and Gynecology (ABOG) and shall be board-certified (or board-eligible with documented plan of certification) in Obstetrics and Gynecology.

• The applicant must possess a current, unrestricted license to practice as an OB/GYN in one (1) of the fifty

(50) United States, the District of Columbia, or a U.S. Territory.

• The Contractor bears full responsibility for submitting documentation to support any requested clinical privileges that fall outside the standard scope of OB/GYN practice.

• Credentialing and Privileging shall be conducted in accordance with the Credentialing & Privileging (C&P) procedures outlined in Section [Insert C&P Section Number].

The Contractor’s services shall be compatible with the facility’s operational capacity, resources, and equipment, and delivered in compliance with all applicable medical, ethical, and legal standards of care.

b. Reporting Structure

The Contractor OB/GYN shall report to the OB/GYN Supervisor, and/or the Clinical Director, and/or the Deputy

Clinical Director of the Pine Ridge Service Unit (PRSU), as designated.

c. Scope of Services

The Contractor shall provide comprehensive OB/GYN services to eligible beneficiaries served by the Pine Ridge

Indian Health Service (PRIHS). Services shall include, but are not limited to, the following duties consistent with privileges granted:

1. Obstetric Management o Manage intrapartum care for routine and high-risk pregnancies.

o Perform vaginal and cesarean deliveries, obstetric and gynecologic surgeries, and postpartum care.

o Admit, discharge, and transfer OB/GYN patients in accordance with hospital procedures.

2. Emergency and On-Call Services o Provide on-call and consultative coverage, including Labor and Delivery, postpartum care, emergent gynecologic issues, and sexual assault forensic examinations (SAFE/SANE).

3. Consultation and Collaboration o Provide consultation to Certified Nurse Midwives (CNMs), Emergency Department staff, and outpatient clinic personnel.

o Perform admission orders, histories, and physicals as necessary for assigned cases.

4. Preventive and Routine Care o Deliver comprehensive women’s health services across the lifespan, including adolescent and maternal care.

o Educate, counsel, and advise patients on all aspects of the reproductive cycle and related psychosocial issues.

5. Clinical Knowledge and Skills o Demonstrate knowledge of medical management practices for women’s health, obstetrics, gynecology, and sexual assault response.

o Exhibit competence in the use of commonly prescribed medications, including knowledge of dosage, administration, effects, and side effects.

o Perform and interpret appropriate diagnostic and laboratory tests.

6. Patient Education and Technology Utilization o Teach, counsel, and facilitate patient participation in care decisions.

o Utilize and supervise electronic health records and related medical data systems; accurately document and interpret information for patient management.

7. Infection Control and Safety Compliance o Comply with all PRSU infection control and safety standards, including COVID-19 procedures, PPE protocols, and hand hygiene requirements.

8. Patient Rights and Cultural Sensitivity o Uphold patient dignity, privacy, and confidentiality in accordance with PRSU policy.

o Adhere to the PRSU Chaperone Policy during all sensitive examinations.

o Demonstrate awareness and respect for the cultural values and needs of the Native American population served.

d. Physical and Environmental Requirements

The duties of this position may involve:

• Prolonged standing and walking on uneven surfaces.

• Recurring bending, stooping, stretching, and lifting of moderately heavy objects or patients (occasionally exceeding 50 pounds).

• Exposure to physical and emotional stressors are inherent in providing round-the-clock patient care.

Personnel must possess above-average agility, dexterity, and endurance to perform the essential functions of the position safely and effectively.

e. Removal and Replacement of Contractor Personnel

The Government reserves the right to request the removal and replacement of Contractor Personnel at any time for reasons including, but not limited to:

• Failure to meet security or credentialing requirements.

• Incompetence, habitual carelessness, or unprofessional conduct.

• Inability to perform assigned tasks; or

• Any behavior determined to be inconsistent with the standards of professional practice or the mission of the

PRSU.

The Contractor shall promptly provide qualified replacement personnel to ensure uninterrupted services, subject to

Government approval and credentialing.

C.3.3 Credentialing & Privileging (C&P)

a. Standards of Practice

The standards governing the practice of Obstetrics and Gynecology (OB/GYN) under this contract shall be consistent with the current Medical Staff Bylaws, clinical guidelines, and policies and protocols of the Pine Ridge Service Unit

(PRSU).

Contractor OB/GYNs shall perform all services in strict compliance with:

• Their state licensure and clinical privileges,

• The scope of practice authorized by the PRSU Governing Body,

• The Joint Commission (TJC) standards, and

• Applicable Centers for Medicare & Medicaid Services (CMS) regulations.

The Contractor and Contractor Personnel are required to participate in the PRSU’s Quality Improvement (QI)

Program, consistent with TJC standards for the ongoing monitoring and evaluation of the quality and appropriateness of care.

b. Privileging Requirement Prior to Service

No Contractor OB/GYN shall perform services under this contract until the PRSU Governing Body has granted professional staff membership and clinical privileges in writing.

As a prerequisite to performance, each Contractor OB/GYN must be credentialed and privileged in accordance with

PRSU and Great Plains Area IHS credentialing policies.

Compliance with all credentialing and privileging requirements is mandatory. Failure to comply with any Indian Health

Service (IHS) credentialing, privileging, or background investigation requirements shall be considered nonperformance under the terms of this contract.

The Governing Body shall not grant privileges until:

1. All credentials have been verified and approved; and

2. The provider has successfully completed the background investigation process, including e-QIP submission and issuance of a Personal Identity Verification (PIV) card.

The credentialing and privileging process typically requires up to forty-five (45) business days to complete.

c. Privilege Determination

Upon completion and verification of all credentialing requirements, the Contractor shall be granted basic core privileges commensurate with verified experience, training, and certification.

The Supervisory OB/GYN and/or Clinical Director retain authority to deny or limit privileges if the Contractor fails to provide evidence of:

• Current medical licensure.

• Sufficient specialized training.

• Relevant procedural experience (e.g., procedure logs); or

• Professional references confirming competency in requested procedures.

d. Required Credentialing Documentation

The Contractor shall furnish complete and current documentation to support initial provisional, active, and renewal privileges. The following materials are required (at minimum):

1. Recognizable photo identification.

2. Copy of an active, unrestricted OB/GYN state license.

3. Proof of board certification or eligibility from the American Board of Obstetrics and Gynecology

(ABOG).

4. Curriculum Vitae (CV) with complete and current professional work history, listing months and years. All employment gaps of eight (8) weeks or longer must include a written explanation by the applicant.

5. Current and active Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Neonatal

Resuscitation Program (NRP) certifications, valid throughout the contract period.

6. Three (3) professional reference letters, less than six (6) months old—one (1) from a supervisor and two

(2) from peers.

7. Active DEA registration, including prescribing privileges for Schedule II and IIN controlled substances.

8. Proof of professional liability insurance with minimum coverage of $1,000,000 per occurrence /

$3,000,000 aggregate.

9. Documentation of Continuing Medical Education (CME) or Continuing Education Units (CEU) within the past three (3) years, totaling at least 20 credits annually in OB/GYN practice.

10. Contractors who fail to maintain the required CME credits prior to the expiration of their current appointment will be ineligible for renewal of privileges and medical staff appointment.

e. Credentialing Point of Contact

For all credential and privileging matters, the Contractor shall coordinate directly with:

PRSU IHS Credentialing & Privileging Point of Contact

Name: Tammy Bailey

Office: (605) 867-3043

Fax: (605) 867-3271

Email: Tammy.Bailey@ihs.gov

C.3.4 Security – Character Investigation

a. General Requirements

All Contractor Personnel performing services under this contract shall comply with Pine Ridge Indian Health

Service (PRIHS) procedures for obtaining and maintaining a Federal background investigation.

Everyone shall complete all required documentation in the Electronic Questionnaires for Investigations Processing

(e-QIP) system and successfully pass a background investigation conducted by the Office of Personnel Management

(OPM) prior to performing any services under this contract.

A Personal Identity Verification (PIV) card will be issued only after successful completion of this background investigation. The PRSU IHS will initiate and process investigations for all Contractor Personnel through OPM.

b. PIV Card Processing

Processing of PIV cards shall be completed by the Great Plains Area (GPA) HSPD-12/Suitability Office, in coordination with PRSU IHS PIV Card Stations.

Contractor Personnel must be physically present at one of the designated HSPD-12 enrollment and issuance workstations to complete the enrollment and issuance process.

Each applicant must present two (2) forms of valid, matching identification at the time of PIV enrollment. (Refer to attached list of acceptable identification documents.)

c. Required Pre-Employment Documentation

Prior to performing services under this contract, each Contractor shall ensure that all Contractor Personnel complete the following documentation and receive clearance from the GPA/PRIHS:

1. Capture of fingerprints for digital processing.

o Hard copy (FD-258) fingerprint cards may be used if digital capture is not available.

o Cards must be mailed to PRIHS at the Contractor’s expense (tracked shipping is highly recommended).

o FD-258 is the only acceptable fingerprint card format.

2. Completion of OF-306, Declaration for Federal Employment.

3. Completion of Addendum to the OF-306.

4. Completion of Provisional Waiver Form.

5. Submission of Curriculum Vitae (CV) or Resume.

mailto:Tammy.Bailey@ihs.gov

6. Completion of SF-86C (Certification Form).

7. Completion of General Release Form.

8. Submission of e-QIP for background investigation.

9. Enrollment for PIV issuance following e-QIP completion.

10. Completion of individualized State Packets as required; Contractor shall consult with the PRSU IHS HSPD-

12 Representative for state-specific documentation guidance.

d. Contractor Responsibilities

The Contractor shall:

• Monitor and ensure timely completion of all required background documentation.

• Follow up regularly with Contractor Personnel to avoid delays in processing.

• Ensure that all proposed personnel have a reasonable expectation of approval prior to submission.

Failure of Contractor Personnel to complete required background documentation within seven (7) calendar days of receipt will result in the candidate’s withdrawal from consideration.

If any Contractor Personnel are determined to be ineligible or found unsuitable during the investigation process, the individual shall be immediately removed from performance under this contract.

All background investigations will be conducted by PRSU IHS at no cost to the Contractor.

e. Mailing Instructions for Hard Copy Fingerprints

When hard copy fingerprint cards (FD-258) are used, they shall be addressed to:

Pine Ridge I.H.S. Hospital

Attn: Contracting Officer’s Representative (COR)

607 Indian Health Road

P.O. Box 1201

Pine Ridge, SD 57770

f. Secure Transmission of Background Documents

All background investigation documents shall be transmitted securely—via password-protected or encrypted files— to the designated PRSU IHS HSPD-12 Background Point of Contact. Courtesy copies shall be provided to the

Contracting Officer’s Representative (COR) or Technical Point of Contact (TPOC).

g. PRSU IHS HSPD-12 / Background Investigation Point of Contact

Name: Raine Little

Department: Administration, Pine Ridge Hospital

Office: (605) 867-3390

Email: Raine.Little@ihs.gov

Courtesy Copy: COR II / TPOC

C.3.5 Tour of Duties

a. General mailto:Raine.Little@ihs.gov

The Contract Obstetrician-Gynecologist (OB/GYN) shall perform services on a schedule that may vary based on the operational needs of the Pine Ridge Service Unit (PRSU), including but not limited to patient volume, acuity, and complexity of medical cases.

Scheduling modifications will be coordinated by the Supervisory OB/GYN, Deputy Clinical Director, or Clinical

Director of PRSU IHS, who shall communicate such changes directly to the Contractor.

The Contractor is responsible for ensuring all Contractor Personnel are informed of and adhere to established

OB/GYN Department and Women’s Health Department hours of operation, shift assignments, and on-call rotations.

b. Scheduling Authority

The work schedule of each Contractor OB/GYN shall be assigned, maintained, and monitored by the OB/GYN

Department and Women’s Health Department Supervisors or their designees.

Contractor Personnel shall be subject to shifts as assigned and must maintain the flexibility to accommodate schedule changes required to ensure adequate patient coverage and continuity of care.

c. Regular Hours

Regular clinical hours are defined as 8:00 a.m. to 4:30 p.m., Monday through Friday.

• The standard workday shall consist of eight (8) hours, exclusive of a thirty (30) minute unpaid lunch break.

• The lunch period shall be taken in a manner that does not adversely affect patient care.

• If workload requires work during the standard noon period, the 30-minute break may be taken at a later, more convenient time.

These hours are classified as Regular Hours.

d. On-Call Hours

The Contractor OB/GYN shall also participate in the on-call rotation for evenings, nights, weekends, and holidays as scheduled. On-call shifts shall include, but are not limited to, the following coverage periods:

• 4:30 p.m. to 8:00 a.m.

• 8:00 a.m. to 8:00 p.m.

• 8:00 p.m. to 8:00 a.m.

While a provider is scheduled for an On-Call Shift they are expected to report to duty within 20 minutes.

On-call duties encompass Labor and Delivery, postpartum and gynecologic emergencies, women’s health consultations, and sexual assault forensic examinations (SAFE/SANE), as required.

These hours are classified as On-Call Hours.

e. Handoffs and Briefings

Prior to assuming duty for any scheduled work shift, the Contract OB/GYN shall be briefed by the Supervisory

OB/GYN or designated representative using the Situation, Background, Assessment, and Recommendation

(SBAR) format.

The briefing shall include:

• Updates on current inpatients and active labor patients.

• Summary of ongoing cases, care plans, and pending consults.

• Any pertinent operational or staffing issues.

At the end of each shift, the contract OB/GYN shall brief the incoming duty OB/GYN and Certified Nurse Midwife

(CNM) to ensure continuity of care.

If at any time the contract OB/GYN encounters problems or obstacles that interfere with the provision of safe patient care, these issues shall be reported immediately to the Supervisory OB/GYN or designated government representative.

f. Flexibility Requirement

Due to the 24-hour operational nature of the PRSU, Contractor Personnel must maintain schedule flexibility to accommodate unforeseen changes in workload, emergencies, or staffing shortages.

Failure to meet assigned shift coverage or on-call responsibilities may constitute nonperformance under the terms of this contract.

C.4) Special Requirements

C.4.1 Health Information Management (HIM)/Electronic Health Record (EHR)

a. General Requirements

The Contractor shall utilize the Pine Ridge Service Unit (PRSU) Electronic Health Record (EHR) system to maintain complete, accurate, and up-to-date clinical documentation for all patient care activities performed under this contract.

Experience and proficiency with electronic medical record systems are highly recommended. The Contractor shall ensure that all patient care documentation, including diagnoses, coding, and purposes of visit, are recorded in compliance with PRSU policy and medical staff bylaws.

All medical documentation shall meet or exceed the established standards of the PRSU in the areas of:

• Timeliness

• Legibility

• Accuracy

• Completeness

• Authentication (signature)

All records generated during the performance of this contract are the property of PRSU and remain under its exclusive control. Contractor Personnel shall not remove, copy, or disclose patient information except as expressly authorized by the PRSU and in full compliance with HIPAA and Privacy Act requirements.

b. Timeliness and Documentation Standards

All patient medical records initiated by Contractor Personnel must be completed and signed within the timeframe established by PRSU policies and medical staff bylaws.

Incomplete or deficient documentation is considered nonperformance under this contract and must be corrected promptly upon notification by PRSU Health Information Management (HIM) staff.

c. Health Information Management (HIM) Clearance Requirement

The Contractor’s timesheets will not be approved unless the Contractor has obtained a Health Information

Management Clearance Form (HIMCF) indicating zero (0) deficiencies in medical documentation.

The HIMCF shall be submitted with each timesheet at the end of every rotation to the Supervisor, with a courtesy copy to the Contracting Officer’s Representative (COR) or Technical Point of Contact (TPOC).

If the HIMCF indicates any deficiencies or failure to correct documentation issues, the Supervisor shall notify the

Contracting Officer (CO) and COR within two (2) business days.

The Contractor is responsible for working directly with the HIM Department to correct all deficiencies and obtain a zero-deficiency clearance prior to submission of invoices or timesheets.

No invoices or time sheets shall be processed without an approved HIMCF.

d. Process for Obtaining HIM Clearance

At the conclusion of each rotation, Contractor Personnel shall:

1. Email the PRSU Health Information Management Department to request the HIM Clearance Form.

2. Obtain HIM approval confirming all required medical encounters and documentation are complete.

3. Submit the approved HIM Clearance Form with the final timesheet to their supervisor, copying the

COR/TPOC.

Failure to complete this process will result in nonpayment for the corresponding period until documentation is corrected and verified.

e. Health Information Management Points of Contact

Health Information Management (HIM) Department – Points of Contact

1. Flora “Ellie” Bettelyoun

Office: (605) 867-3208

Email: Flora.Bettelyoun@ihs.gov

2. Angela Swallow

Office: (605) 867-3156

Email: Angela.Swallow@ihs.gov

Summary of Contractor Responsibilities

• Maintain complete and accurate medical documentation in the EHR system.

• Adhere to PRSU standards for timeliness, accuracy, and authentication.

• Resolve all HIM deficiencies prior to timesheet submission.

• Obtain and submit a zero-deficiency HIM Clearance Form with each timesheet.

• Coordinate with HIM staff and comply with all documentation policies and deadlines.

C.4.2 Timesheet mailto:Flora.Bettelyoun@ihs.gov mailto:Angela.Swallow@ihs.gov

All Contractor Personnel shall utilize the PRSU time clock system to record hours worked (see Section C.5, Contractor-Furnished Property). The Contractor shall ensure all personnel adhere strictly to established timekeeping and documentation procedures.

Timesheets must accurately capture:

• Daily time in and time out, and

• A mandatory thirty (30) minute unpaid lunch break.

All time entries shall be recorded and tallied in fifteen (15)-minute increments in accordance with PRSU policy.

b. Time Rounding Policy

For purposes of calculating total hours worked:

• 1 to 7 minutes shall be rounded down and not counted as time worked.

• 8 to 14 minutes shall be rounded up and counted as one-quarter (¼) hour worked.

This rounding policy shall be applied consistently to all Contractor Personnel time entries.

c. Overtime Authorization

All overtime must receive prior written approval from the Supervisory OB/GYN, Deputy Clinical Director, or designated representative. Unauthorized overtime will not be compensated under this contract. The Contractor shall maintain records of all approved overtime for audit and verification purposes.

d. Health Information Management (HIM) Clearance Requirement

Each timesheet must be accompanied by a Health Information Management Clearance Form (HIMCF), as required under Section C.4.1 (Health Information Management/EHR).

The HIMCF must indicate zero (0) deficiencies in medical record documentation before timesheet submission.

Timesheets and HIMCFs must be:

1. Signed and approved by the Supervisory OB/GYN, Deputy Clinical Director, or designee; and

2. Submitted together to the Contracting Officer’s Representative (COR) or Technical Point of Contact

(TPOC) for validation.

No invoices shall be processed or paid unless both the timesheet and HIMCF have been properly approved and submitted.

e. Contractor Responsibilities

The Contract OB/GYN is responsible for:

• Completing daily timesheets and ensuring accuracy.

• Obtaining the required supervisory approvals and HIMCF signatures.

• Returning approved timesheets and HIMCFs to their contract company and the COR/TPOC within established submission timelines.

Failure to comply with timekeeping, documentation, or approval procedures may result in nonpayment for the affected work period and may be treated as contract nonperformance.

C.4.3 Invoicing

The Contractor shall submit invoices on a minimum bi-weekly basis through the Invoice Processing Platform

(IPP) in accordance with Department of Health and Human Services (HHS) electronic invoicing requirements.

All invoices must be complete, accurate, and fully supported by the documentation specified below. The Contractor shall be responsible for ensuring that all required approvals and attachments are obtained prior to submission.

b. Supporting Documentation Required

Each invoice shall include the following attachments:

1. Approved Timesheet(s) – Signed and approved by the Supervisory OB/GYN, Deputy Clinical Director, or designee.

2. Approved Health Information Management Clearance Form(s) (HIMCF) – Confirming zero (0) documentation deficiencies in accordance with Section C.4.1 (Health Information Management/EHR).

Invoices submitted without both required attachments will be considered incomplete and will not be processed for payment until corrected.

c. Payment Calculation

Payment shall be made based on:

• Hours worked, verified through approved timesheets; and

• The fixed hourly rate, as specified in the contract by labor category.

The Contractor shall not invoice for unapproved overtime, meal breaks, or unverified hours. All payments are subject to review and acceptance by the Contracting Officer’s Representative (COR).

d. Invoice Routing and Contact Information

Invoices submitted via IPP shall be addressed to the following officials:

• Brandi Dimmitt – PRSU Clinical Director

Brandi.Dimmitt@ihs.gov

• Rachel Olson – Great Plains Area (GPA) Accounts Payable (AP) Accountant

Rachel.Olson@ihs.gov

• Brian Julius – PRSU Contracting Officer Representative (COR)

Brian.Julius@ihs.gov

• Raine Little – PRSU IHS Technical Point of Contact (TPOC)

Raine.Little@ihs.gov

Invoices shall be copied to all parties listed above to ensure timely processing and accountability.

e. Payment Terms

• Payment will be made in accordance with the Prompt Payment Act (FAR 52.232-25) and HHS payment policies.

• The Contractor shall verify that all documentation is accurate and complete prior to submission to avoid delays in payment.

• Disputes regarding invoice content, hours, or supporting documents shall be resolved between the Contractor, COR, and Contracting Officer before resubmission.

C.4.4 Employee Health Requirements

The Contractor shall adhere to the Pine Ridge Service Unit (PRSU) Employee Health Program Policy.

The purpose of this requirement is to ensure that all Contractor Personnel are free from communicable diseases or other medical conditions that could impair their ability to safely and effectively perform assigned duties.

mailto:Raine.Little@ihs.gov

All Contractor Personnel shall comply with PRSU employee health screening, immunization, and disease prevention requirements as a condition of employment under this contract.

b. Documentation Requirements

Each Contractor employee shall provide complete immunization records to the PRSU Employee Health

Department within seven (7) calendar days of employment or arrival on site. Documentation must verify that the employee meets all immunization and screening requirements listed below.

Failure to provide required documentation within this timeframe may result in suspension or termination of the individual’s clinical privileges until compliance is achieved.

c. Required Immunizations and Screenings

The following immunizations and screenings are required for all Contractor Personnel performing duties under this contract. (Refer to the PRSU Employee Health Policy for complete procedural details and medical exemption provisions.)

a. Measles, Mumps, and Rubella (MMR)

b. Varicella (Chicken Pox)

c. Tetanus, Diphtheria, and Pertussis (Tdap)

d. Tuberculosis (TB) screening and annual testing, as applicable

e. Hepatitis A

f. Hepatitis B

g. Influenza – Annual seasonal vaccination required

h. Meningococcal

i. Shingles (Shingrix)

j. COVID-19 vaccination series, including boosters as required by federal or IHS policy

All vaccines and screenings must be kept current throughout the period of performance.

d. Compliance

Contractor Personnel are responsible for maintaining up-to-date immunization records and for submitting any updates

(e.g., boosters or renewals) to the Employee Health Department as they occur.

The Contractor shall ensure all personnel comply with PRSU policies concerning:

• Infection prevention and control.

• Reporting of communicable diseases; and

• Temporary work restrictions following exposure incidents or illness.

Noncompliance with employee health requirements may be considered contract nonperformance and may result in the removal of affected personnel from duty until full compliance is achieved.

e. Point of Contact

PRSU Employee Health Nurse Point of Contact

Name: JoDee Bettelyoun

Office: (605) 867-3286

Email: JoDee.Bettelyoun@ihs.gov mailto:JoDee.Bettelyoun@ihs.gov

C.4.5 Purchased Referred Care (PRC)

All patient care shall be provided within Pine Ridge Service Unit (PRSU) facilities whenever possible.

However, when specialized diagnostic procedures, treatments, or definitive care are not available within PRSU, patients may be referred to outside private or specialty facilities through the Purchased/Referred Care (PRC) program.

b. Referral Procedures

The Contract OB/GYN shall follow all PRSU policies and procedures governing the PRC process.

This includes:

• Documenting the medical justification for the referral within the Electronic Health Record (EHR);

• Completing all required PRC referral forms and supporting documentation; and

• Ensuring the referral entry contains sufficient clinical detail for review and processing by the PRSU PRC

Department.

Each referral shall clearly indicate:

• The specific service or procedure requested,

• The clinical indication or diagnosis, and

• The reason is the service cannot be provided at PRSU facilities.

c. PRC Department Review

Once the referral is entered in the EHR, it will be automatically routed to the PRSU Purchased/Referred Care

Department.

The PRC Department convenes daily to review, approve, or deny patient referrals based on medical necessity, program criteria, and funding availability.

To ensure timely processing and continuity of care, the Contract OB/GYN must provide complete and accurate clinical justification when initiating any referral.

d. Documentation and Compliance

The Contract OB/GYN shall ensure all PRC referrals are:

• Entered promptly into the EHR upon determining the need for external services.

• Documented in accordance with PRSU Medical Staff Bylaws, PRC policy, and IHS guidelines; and

• Discussed with the patient to ensure understanding of the referral process and follow-up expectations.

Failure to provide adequate documentation or justification for PRC referrals may delay patient care and will be considered a performance deficiency under this contract.

C.4.6 Pharmaceuticals

The Contract Obstetrician-Gynecologist (OB/GYN) authorized to prescribe medications shall do so in accordance with the Pine Ridge Service Unit (PRSU) Indian Health Service (IHS) Formulary.

Prescribing practices must comply with:

• Federal and state laws governing controlled substances.

• IHS and PRSU medical staff bylaws.

• Facility-specific prescribing procedures; and

• Established standards of medical care and patient safety.

b. Formulary Compliance

All prescriptions issued by the Contract OB/GYN shall utilize medications that are available and approved within the

PRSU IHS formulary.

The PRSU IHS Pharmacy Department will provide guidance and instructions to prescribers regarding:

• Generic substitution of equivalent medications; and

• The proper procedures for requesting non-formulary medications when clinically indicated.

c. Non-Formulary Drug Requests

When the Contract OB/GYN determines that a non-formulary medication is medically necessary, a Non-Formulary

Drug Request Form must be completed in full and submitted in accordance with PRSU policy.

The completed form will be reviewed by the PRSU Pharmacy and Therapeutics (P&T) Committee at its next scheduled meeting. Approval or denial of the request will be determined by the Committee based on:

• Medical necessity and clinical justification.

• Safety, efficacy, and therapeutic alternatives; and

• Formulary and budgetary considerations.

No non-formulary medication shall be dispensed until formal approval is granted by the P&T Committee or its authorized delegate.

d. Substitution and Coordination with Pharmacy

The Contract OB/GYN shall coordinate directly with the PRSU IHS Pharmacy Services when prescribing medications that:

• Require substitution for a generic or formulary-approved equivalent; or

• Have been identified as restricted, controlled, or subject to special monitoring.

The Pharmacy Department retains authority to substitute or modify prescriptions in accordance with federal regulations, PRSU policy, and Pharmacy and Therapeutics Committee directives.

e. Documentation

All prescribed pharmaceuticals shall be documented in the Electronic Health Record (EHR) in compliance with PRSU documentation standards, including:

• Medication name, dosage, route, and frequency.

• Duration of therapy; and

• Clinical rationale when applicable.

Prescriptions must be electronically signed by the Contract OB/GYN using the assigned DEA credentials and privileges.

f. Ongoing Professional Practice Evaluation (OPPE)

The Contractor shall comply with all Medical Staff performance monitoring requirements, including participation in ongoing professional practice evaluation (OPPE) and peer review as required by the facility.

C.4.7 Third Party Enrollment

All Contractor Personnel performing services under this contract shall complete the Third-Party Enrollment process with the Pine Ridge Indian Health Service (PRIHS) Business Office (BO) prior to the submission of any timesheets or invoices for payment.

This process ensures that the Contract OB/GYN is properly enrolled and credentialed with applicable third-party payers, including but not limited to Medicare Part B and other insurance providers, to allow the Government to bill and recover costs associated with patient care.

b. Enrollment Process

During New Employee Orientation, the PRIHS Business Office will provide the necessary insurance provider enrollment documentation to the Contractor for completion.

The Contractor shall:

• Accurately complete and sign all required insurance enrollment and credentialing forms.

• Submit all documentation to the PRIHS Business Office for review; and

• Respond promptly to any requests for additional information or corrections.

All enrollment documentation must be completed to the satisfaction of the PRIHS Business Office and approved prior to the Contractor beginning clinical duties or submitting timesheets.

c. Approval and Processing Time

The PRIHS Business Office typically processes insurance enrollment applications within two (2) to three (3) business days, provided that all required information is accurate and complete.

No initial timesheets or invoices shall be approved or processed until:

1. The Contractor has fully completed the insurance enrollment documentation; and

2. The PRIHS Business Office has confirmed approval of enrollment.

d. Compliance

The Contractor is responsible for ensuring that all required enrollment information remains accurate and current throughout the performance period. Any changes in provider status, licensing, or credentialing that could affect billing or reimbursement must be reported immediately to the PRIHS Business Office.

Failure to comply with third-party enrollment requirements or delays in completing documentation may result in payment delays and may be considered contract nonperformance.

C.4.8 New Employee Orientation (NEO) & Annual Trainings

All Contractor Personnel performing services under this contract shall attend and successfully complete the Pine

Ridge Service Unit (PRSU) New Employee Orientation (NEO) and all other mandatory training requirements prior to the commencement of clinical duties.

New Employee Orientation ensures Contractor Personnel understand PRSU policies, procedures, safety protocols, patient care standards, and compliance obligations necessary to perform within a federal healthcare environment.

b. New Employee Orientation (NEO)

1. Schedule and Attendance o NEO sessions are conducted every other week at the PRSU facility.

o Attendance is mandatory for all new Contractor Personnel prior to assuming any work assignments.

o The Contractor shall coordinate with the PRSU Human Resources Department to schedule attendance for all newly assigned staff.

2. Content

The NEO program includes, but is not limited to, the following topics:

o PRSU organizational overview and mission.

o Workplace safety, emergency preparedness, and environmental awareness.

o HIPAA and Privacy Act compliance.

o Information Security and Electronic Health Record (EHR) use.

o Infection control and employee health policies.

o Cultural sensitivity and patient rights; and o Ethics, standards of conduct, and incident reporting procedures.

c. Mandatory and Annual Training Requirements

In addition to NEO, all Contractor Personnel shall complete mandatory annual refresher training as required by

PRSU policy and accrediting standards.

This includes, but is not limited to:

• Infection control and bloodborne pathogens.

• HIPAA and patient privacy.

• Emergency procedures (fire safety, active shooter, disaster response).

• Workplace violence prevention.

• Patient safety and cultural awareness; and

• Any additional clinical or administrative training required by PRSU or the Great Plains Area (GPA) IHS.

The Contractor shall ensure all personnel remain current and in full compliance with training and certification requirements throughout the period of performance.

d. Documentation and Verification

The Contractor shall maintain documentation verifying completion of all required NEO and annual trainings.

Copies of completion certificates or training rosters shall be submitted to the Contracting Officer’s Representative

(COR) or Technical Point of Contact (TPOC) upon request.

Failure to complete mandatory or annual training may result in suspension of clinical duties or removal from the contract until compliance is achieved.

C.4.9 Work Identification Badge

Once the Contract Obstetrician-Gynecologist (OB/GYN) has been fully cleared to begin providing services under this contract, he/she shall obtain a Pine Ridge Service Unit (PRSU) Indian Health Service (IHS) work identification badge issued by the PRSU IHS Information Technology (IT) Department.

b. Issuance

The work identification badge will be issued after the Contractor has:

• Successfully completed all background investigations and security clearance requirements; and

• Been approved to perform clinical duties under the contract.

The badge serves as both a form of official identification and a facility access credential for authorized work areas within PRSU facilities.

c. Wearing of Badge

The Contractor is required to always wear the work identification badge visibly while on duty or within any PRSU

IHS facility.

Badges shall:

• Be worn above the waist, with the photo and name clearly visible.

• Not be altered, defaced, or lent to another individual; and

• Be returned immediately to the PRSU IHS IT Department or designated official upon completion or termination of the contract, or upon reassignment of duties.

Failure to comply with identification badge requirements may result in restricted access to PRSU facilities and may be considered a security violation under this contract.

C.4.10 Contractor Furnished Property

The Contractor shall furnish and maintain all equipment, supplies, and communication devices necessary to perform the requirements of this contract. All items provided shall be fully functional, secure, and compatible with the operational needs of the Pine Ridge Service Unit (PRSU) Indian Health Service (IHS).

Unless otherwise stated, all expenses related to the procurement, maintenance, and operation of contractor-furnished property shall be borne by the Contractor.

b. Communication Devices

The Contractor shall ensure that each Contractor OB/GYN maintains a reliable, working form of communication

(e.g., cellular phone or pager) always during duty hours and while on call.

These devices shall:

• Be used to…