PWS - NATLS.pdf

PERFORMANCE WORK STATEMENT (PWS)

Nurse Advice Telephone Line Services

Phoenix Area Indian Health Service

1. Background: The Phoenix Area Indian Health Service (IHS) provides comprehensive healthcare services to eligible American Indian and Alaska Native beneficiaries through the Colorado River Service Unit (CRSU), Uintah & Ouray Service Unit (U&O), and Southern Bands Health Center (SBHC).

To improve timely access to clinical guidance outside normal clinic operating hours, IHS requires a contractor-operated Nurse Advice Telephone Line (NATL) that provides evidence-based telephone triage by licensed Registered Nurses (RNs).

The Contractor shall provide all personnel, supervision, facilities, equipment, telecommunications, software, supplies, management, and other resources necessary to perform the services described in this Performance Work Statement (PWS).

2. Objective: Provide continuous, high-quality nurse advice telephone services that:

• Improve access to healthcare advice.

• Improve patient safety.

• Support appropriate utilization of healthcare resources.

• Reduce avoidable emergency department utilization.

• Improve continuity of care.

• Deliver consistent evidence-based telephone triage.

3. Scope: The Contractor shall provide a comprehensive Nurse Advice Telephone Line serving eligible beneficiaries receiving healthcare services from:

Service Unit Location

Colorado River Service Unit Parker, Arizona

Uintah & Ouray Service Unit Fort Duchesne, Utah

Southern Bands Health Center Elko, Nevada

Services shall be available:

• 24 hours per day

• 7 days per week

• 365 days per year

• Including all Federal holidays

4. Government-Furnished Information (GFI): The Government shall provide:

• Facility-specific contact information

• Clinic operating hours

• Local emergency department and urgent care information

• After-hours procedures

• Approved patient privacy disclaimer

• Facility reporting contacts

• Required encounter report formats

5. Government Responsibilities: The Government shall:

• Designate a Contracting Officer (CO).

• Designate one or more Contracting Officer's Representatives (CORs).

• Review Contractor deliverables.

• Monitor contract performance.

• Provide timely feedback.

• Coordinate operational changes affecting performance.

6. Contractor Responsibilities: The Contractor shall:

• Operate a toll-free Nurse Advice Telephone Line.

• Provide uninterrupted telephone access.

• Ensure callers do not receive busy signals during normal operations.

• Provide telephone triage performed by licensed Registered Nurses.

• Utilize nationally recognized, physician-approved telephone triage protocols.

• Document all encounters.

• Maintain patient confidentiality.

• Submit required reports.

• Maintain required licenses and accreditations.

• Provide sufficient staffing to meet performance standards.

The Contractor shall furnish all labor, supervision, equipment, software, telecommunications, office space, and management necessary to perform this contract.

7. Nurse Advice Services: The Contractor shall provide:

• Symptom assessment

• Clinical triage

• Home care advice

• Medication guidance within scope of practice

• Referral recommendations

• Appointment recommendations

• Urgent care recommendations

• Emergency department recommendations

• EMS activation guidance

• Follow-up telephone calls when clinically indicated

8. Staffing Requirements: The Contractor shall ensure:

• Registered Nurses possess unrestricted U.S. licensure.

• Licensure remains current throughout contract performance.

• Nurses possess a minimum of three (3) years of clinical nursing experience, including telephone triage or equivalent emergency, urgent care, or primary care experience.

• Appropriate nursing supervision is available during all operating hours.

• Clinical protocols are overseen by a licensed physician.

9. Clinical Protocols: The Contractor shall utilize nationally recognized evidence-based clinical telephone triage protocols.

Protocols shall:

• be physician-developed;

• be routinely updated;

• support adult and pediatric populations;

• provide consistent clinical decision-making;

• document patient disposition.

Equivalent nationally recognized protocols are acceptable.

10. Telephone Performance Requirements: The Contractor shall:

• Answer calls promptly.

• Maintain adequate staffing.

• Prevent excessive wait times.

• Ensure callers do not receive busy signals.

• Maintain reliable telecommunications capability.

11. Reporting Requirements: Daily Encounter Notifications

The Contractor shall provide secure electronic notification no later than the next business day.

Each notification shall include:

• Patient name

• Date of birth

• Service Unit

• Date and time of call

• Chief complaint

• Clinical disposition

• Nurse identifier

Monthly Utilization Report: Reports shall be submitted no later than the tenth (10th) business day of each month.

Reports shall include:

• Number of calls

• Call volume by day

• Call volume by hour

• Chief complaints

• Dispositions

• Response times

• Follow-up activity

• Trends

• Significant events

12. Security and Privacy: The Contractor shall comply with:

• HIPAA

• Privacy Act of 1974

• HHS Records Management requirements

• Applicable Federal cybersecurity requirements

• All IHS privacy and security policies

Protected Health Information (PHI) shall be transmitted using secure electronic methods approved by the Government, including:

• Secure portal

• Secure File Transfer Protocol (SFTP)

• Encrypted email

• Encrypted fax (when specifically requested)

13. Quality Control: Within thirty (30) calendar days after contract award, the Contractor shall submit a Quality Control Plan describing procedures for:

• Monitoring performance

• Clinical review

• Corrective actions

• Complaint resolution

• Continuous process improvement

14. Contractor Qualifications: The Contractor shall:

• Maintain current URAC accreditation for Nurse Advice Telephone Line Services or an equivalent nationally recognized accreditation acceptable to the Government.

• Employ licensed Registered Nurses.

• Maintain sufficient staffing.

• Maintain all required business licenses.

• Be actively registered in SAM.

• Comply with all applicable Federal, state, tribal, and local laws.

15. Deliverables:

Deliverable Due Date

Quality Control Plan Within 30 days after award

Daily Encounter Notifications Next business day

Monthly Utilization Report 10th business day

Updated POC Information Within 5 business days of change

Proof of URAC Accreditation Upon request and annually

16. Performance Requirements Summary (PRS)

Performance Objective

Performance Standard Surveillance Method Acceptable Quality

Level (AQL)

Telephone Availability

24 hours/day, 7 days/week COR Review 100%

Toll-Free Service Continuous availability COR Review 100%

Call Answer Time Average ≤30 seconds Monthly Report 95%

Busy Signals None Customer Complaints/COR

Review 100%

Clinical Triage Per approved protocols Record Review 100%

Daily Encounter Reports

Submitted next business day

COR Review 100%

Monthly Reports Submitted by 10th business day COR Review 100%

RN Licensure Current and unrestricted Credential Review 100%

Performance Objective

Performance Standard Surveillance Method Acceptable Quality

Level (AQL)

URAC

Accreditation

Maintained throughout performance

Annual Verification 100%

HIPAA Compliance No unauthorized disclosures Incident Review 100%

17. Period of Performance: The anticipated Period of Performance is:

• Base Period: Twelve (12) months

• Option Period 1: Twelve (12) months

• Option Period 2: Twelve (12) months

• Option Period 3: Twelve (12) months

• Option Period 4: Twelve (12) months

Option periods may be exercised at the sole discretion of the Government in accordance with the terms of the contract.

Appendix A – Facility Information:

Service Unit Estimated Monthly Call Volume Reporting Method

Colorado River Service Unit 150–200 Secure electronic transmission

Uintah & Ouray Service Unit Historical volume Secure electronic transmission

Southern Bands Health Center 10–20 Secure electronic transmission

Appendix B – Acronyms

Acronym Definition

AQL Acceptable Quality Level

CO Contracting Officer

COR Contracting Officer's Representative

CRSU Colorado River Service Unit

HIPAA Health Insurance Portability and Accountability Act

IHS Indian Health Service

NATL Nurse Advice Telephone Line

PHI Protected Health Information

PRS Performance Requirements Summary

PWS Performance Work Statement

RN Registered Nurse

SBHC Southern Bands Health Center

U&O Uintah & Ouray Service Unit

URAC Utilization Review Accreditation Commission