PWS-Orthopedic.pdf

ORTHOPEDIC SURGEON

PERFORMANCE WORK

STATEMENT CRSU

1. PURPOSE OF CONTRACT:

To recruit, credential, and place an Orthopedic Surgeon at the IHS-Cheyenne River Service Unit at

Eagle Butte, SD. The care provided by the Contractor shall be as comprehensive as the Indian Health

Service {IHS) supplied facilities, equipment and support services permit, The Indian Health Service requires Orthopedic Surgeon Physician services continue without interruption during the term of the contract. The continuity of services is vital and must be available during the term of the contract.

Period of Performance

Base year, to include 2 option years.

Base Year: January 1, 2024 through December 31, 2025 Option Year One: January 1, 2025 through December 31, 2026 Option Year Two: January 1, 2026 through December 31, 2027

The contract resulting from this solicitation shall:

1. Be a non-personal health care services contract under which the Contractor is an independent contractor;

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

3. Require the Contractor to indemnify the Government for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance;

4. Require the Contractor to maintain medical liability insurance, in the 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

5. Require the Contractor to ensure its subcontracts for provision of health care services, contain the requirements of the clause at FAR 52.237-7, including the maintenance of medical liability insurance.

6. Contractor will be paid their hourly wage based on hours delivering patient care services.

2. STATEMENT OF WORK

I. Purpose of the Contract

J. Historically, Orthopedic Surgeon clinical services have not been provided at the Cheyenne

River Health Center.

K. The provision of comprehensive direct patient care services.

II. Project Objective

A. Provide 2 days of 8 hours per day per month of Orthopedics direct patient services at the

Cheyenne River IHS Hospital (Monday-Friday). Services will continue until all scheduled patients have been provided care.

B. Improve the coordination of care for Orthopedic patients.

C. Improve the quality of care for Orthopedic patients.

III. Government Furnished Property, Facilities and Services

A. The service unit shall provide a patient examination area and all medical and non-medical equipment and supplies used in the Indian Health Service facility for the care and maintenance of patients.

B. The Orthopedic Surgeon consultant physician shall be provided with an orientation to the Indian Health Service and the Indian community being served. The initial orientation and continuing orientation shall be provided by the Service Unit personnel.

IV. Statement of Work

A. The primary functions of the Orthopedic Surgeon shall include the following:

Adult and/or Pediatric:

1. Regular and Routine Consultation regarding concerns related to Orthopedic disorders on OPD/IPD/ER as needed.

2. Review of care provided to Orthopedic patients

3. Provide services to diagnosis, treat, evaluate orthopedic related illnesses or diseases including referral outside of CRHC, injections, and cast/splint placement.

4. Provide examination, diagnosis, follow-up and recommend treatment plans as part of the patient assessment

a. The Contract physician shall be knowledgeable in all areas that are, as a standard, covered by any Accredited Orthopedic Surgery residency program. The Contract physician shall have sufficient experience to adequately diagnose and treat a full range of orthopedic cases, procedures and surgeries.

5. Specific Orthopedic physician services shall include, but are not limited to:

• Grade I and II ligamentous injuries to the joint.

• Lacerations of the skin without violation of the joint or bone.

• Lacerations of the skin involving bone without fracture.

• Lacerations of the skin including violation of the joint with or without fracture.

• Dislocations of the shoulder glenohumeral joint.

• Dislocations of the acromioclavicular joint, Grade I & IL

• Dislocations of the phalanges of the foot.

• Non-displaced or minimally displaced fractures of the clavicle, distal forearm, proximal humerus, stable thoracolumbar spine, pelvis not including the acetabulum, ankle and foot.

• Displaced and non-displaced fractures of the skeletal system.

• Musculocutaneous wounds and injuries.

• Dislocations of the joints

• Benign and malignant tumors of bone.

• Injections of all commonly injected joints (knee, shoulder, ankle, elbow, hip).

• Evaluation of in-patient patients when necessary

• Evaluation of ER patients when necessary

• Placement of appropriate splints as applicable.

6. The Orthopedic Surgeon will be responsible for all travel and other personal expenses

7. The standards of medical practice and duties of the Contractor Orthopedic Surgeon

Physician shall be determined pursuant to the bylaws of the Cheyenne River Service

Unit, regulations of the facility, applicable provisions of the law, other rules and regulations of any and all governmental authorities relating to licensure and regulations of physicians and hospitals, and the standards and recommendations of

CMS and any other Accrediting Body. Contract physicians shall be required to collaborate with the Outpatient Department Supervisor and Deputy Clinical Director in a quality improvement program, which is consistent with current accrediting requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

8. Medical services shall not be performed by a Contract Physician until professional staff membership and clinical privileges have been granted in writing by the IHS

Governing Body. As a prerequisite to performance under the resultant contract, the contract physician performing the services must be privileged in accordance with

IHS policy. Therefore, compliance with the IHS privileging requirements is essential in the performance of the contract. Any failure to comply with IHS privileging requirements shall be considered to be non-compliance of the contract.

The Governing Body will not grant clinical privileges until it is determined that credential information has been verified.

ii. Exceptions to the IHS credentialing review and clinical privileges process will not be considered. The Contractor's failure to submit successful applicants shall not excuse non-performance of contract requirements. Any contract physician who fails to maintain medical staff appointment and clinical privileges will not be permitted to perform services under the contract and shall be promptly replaced by the contractor.

iii. Contract physician shall generate and maintain proper medical record information on beneficiaries to whom treatment is provided in accordance with Indian

Health Service Regulations.

9. The contract physician shall prepare all medical record documentation to meet or exceed the established standard of the IHS facility to include but not be limited to:

timeliness, legibility, accuracy, content and signature. All medical record information generated in the performance of this contract will remain the property of, and subject to, the exclusive control of the Indian Health Service.

VI. Technical Requirements

A. Possess a Medical Degree from an accredited school of medicine

B. Board Certified in field of specialty

C. A current license to practice medicine.

D. Maintain continuing medical education credits necessary for renewal

V. ORTHOPEDIC PHYSICIAN QUALIFICATIONS

The Contract Orthopedic physician shall be board certified, or board eligible without additional education or training, by the American Board of Orthopedic Surgery. It is a condition of this contract that required certifications in this Statement of Work remain current during the life of this contract.

The Contract Orthopedic physician must hold a current, unrestricted state medical license from any of the 50 United States or the Commonwealth of Puerto Rico.

The Contract Orthopedic physician must meet the CRSU medical staff credentialing and privileging requirements before being allowed to provide medical services at the CRSU IHS facility.

Current Basic Life Support (BLS) and ACLS certification is required of the Contract Orthopedic physician.

Must have a current fee based DEA license.

The Contract Orthopedic physician must have at least three recent (within past year) written letters of professional references from another physician.

The Contract Orthopedic physician must have laboratory titer results showing immunity to

Hepatitis B.

The Contract Orthopedic physician must have had a PPD test performed and read within the past year if not positive in the past. Documentation is required. If the PPD has been positive in the past, then either documentation of completion of treatment (if under age 35 or part of a high risk group) or a negative chest x-ray within the past year (if over age 35 and not in a high risk group) is required. Contract Orthopedic physician must comply with new Executive

Order 14042 for COVID Vaccination requirements as per regulation deadlines.

Cheyenne River Indian Health Service hospital policy requires all staff with direct patient contact, be able to provide proof of PPD and Tdap (Tetanus, Diphtheria, acellular Pertussis).

This includes all permanent employees, volunteers, and contractors (for all contractors in this category, acceptable proof can be in the form of an immunization record or written documentation from a physician). This proof must be provided as part of the application submission process prior to being accepted for a position. Contractor personnel currently serving in a contract position can receive these immunizations from the facility. It is required per IHS policy that the provider receive an influenza vaccine annually prior to providing direct patient care services (The vaccine is available on site).

The Contract Orthopedic Physician must cooperate fully and in a timely fashion to complete all Background Investigation procedures in full prior to starting work, including fingerprinting and the accurate completion of relevant forms.

The Contract Orthopedic Physician shall not have any work or health restrictions which interfere with the performance of orthopedic physician services.

The Contract Orthopedic physician shall speak, understand, read and write English fluently and communicate with sufficient clarity to be understood by Cheyenne River Indian Health Service

Hospital personnel and patients. The Contract Orthopedic physician shall possess sufficient initiative, interpersonal communication skills and social/cultural sensitivity such that he/she can relate appropriately to patients from the local Native American community.

The Contract Orthopedic physician shall maintain standards of personal hygiene/grooming such that his/her image as a physician is compatible with the expectations of the Cheyenne

River Indian Health Service Hospital clinical staff, Cheyenne River Reservation community, and CRSU patients. Complies with CRSU and IHS dress code policy.

The Contract Orthopedic surgeon must be eligible for enrollment in the Service Unit's Medicare

Part B program, so as to enable the hospital to bill for the surgeon's services.

CONTRACTOR'S RESPONSIBILITY:

a. Contractor shall comply that eligible patients under treatment will be rendered services that provide the best medical care within the Contractor's professional training and experience. All services rendered shall be in accordance with current standard medical practices to assure quality care.

b. The Orthopedic Surgeon consultant physician shall attend upon request a Medical

Staff Meeting to detail program highlights, outcomes, and plans for service improvement.

c. Document patient services including all orders, referrals and notes using the Electronic

Health Record (EHR). This includes a diagnosis and treatment plan. EHR exceptions to dictate and have notes uploaded into the EHR will be granted on a case by case basis. Provide case consultation on difficult or problematic cases. Contract physicians shall generate and maintain proper medical record information on beneficiaries to whom treatment is provided, in accordance with Indian Health Service regulations. The

Contract Physician shall prepare all medical records documentation to meet or exceed the established standards of the IHS facility to include, but not limited to: timeliness, accuracy, content and signature. Records must be completed at the end of the work day.

d. All medical record information generated in the performance of this contract will remain the property of, and subject to the exclusive control of the Indian Health Service.

e. BILLING STATEMENT Contract Provider shall complete all proper Purpose of Visit

(POV) and Evaluation and Management (E&M) and Electronic Health Record (EHR) by the end of the shift. Must be registered for Medicare/Medicaid for work completed at CRHC.

f. Contractor shall not bill for any services provided while working at the

I.H.S. facility as I.H.S. is already paying for those services via the contract.

g. The incumbent must possess a specialized knowledge of the concepts, principles and practices of Orthopedic Surgeon such as is obtained through the successful completion of a course of study leading to the Doctor of Medicine or Osteopath degree with specialization in Orthopedic Surgery from an accredited American college or university.

h. Participates in the peer review, focused, and ongoing professional practice (OPPE, FPPE) review process as part of the quality improvement program.

i. Abides by the Cheyenne River Hospital's By-laws, Rules and Regulations, and IHS/HHS policies and procedures.

j. Will submit to a background check.

k. Will certify by signature and by their medical provider documentation on "Statement of Physical and Mental Fitness" as part of medical staff application that he/she is in good physical and mental health and free of any contagious disease. All immunizations are complete and updated.

l. In performing work under this contract in an Indian Health Service facility, the

Contractor shall conform to the specific safety requirements established by the IHS facility. Comply with the safety rules of the Indian Health Service facility that concern related activities not directly addressed this contract. Take all reasonable steps and precautions to prevent accidents and preserve the life and health of

Contractor and Government personnel connected in any way with performance under this contract.

m. Will comply with completing and submitting the timesheets and invoices per Clinical

Directors instructions. Timesheet is to be submitted to the following address within one week of clinical services. Payment will occur only after receipt of timesheet.

Timesheets must be verified by Clinical Director and the HIM department to ensure notes are closed.

n. Contractor will be responsible for bringing specialized support staff to conduct patient care and consultations. This may include an Orthopedic Tech or nurse depending on the schedule/service for that day. The tech/nurse will likewise take charge of caring for the equipment/supplies and shall assume responsibility for the quality of all obtained and completed study results.

CONTACT PERSON:

1. THE CONTRACTOR WILL:

a) Ensure that the Contractor at the Cheyenne River Service Unit under the terms of any resultant delivery order is appropriately covered by Malpractice and Liability Insurance provided by the Contractor.

b) Comply with DHHS, PHS, IHS, IT, CRSU, medical staff, training and certification requirements.

c) Use of RPMS/EHR and Scheduling Software

d) Great Plains Area Indian Health Service will pre-approve all researches, studies, etc., involving the Contractor, the GPAIHS, as well as its patients. No research will be allowed without such prior approval in writing from GP AIHS. All publications and statements of the Contractor and collaborating parties will include clarification that they do not reflect official GPAIHS policy. All parties shall strictly follow GPAIHS patient privacy and right policies and procedures.

f) Must comply with all applicable laws, regulations, and IHS Policy regarding standards of care, patient rights, documentation requirements, conduct, Privacy Act, HIP AA, etc.

g) The standards of medical practice and duties of the Contractor through its Physician(s) shall be determined pursuant to the bylaws of the Service Unit. The regulations of the hospital, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals must be followed. The standards and recommendations of Centers for Medicare and Medicaid

Services (CMS) Accreditation must be adhered to. The Contract Physician(s) shall be required to participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care."

52.224-70 CONFIDENTIALITY OF INFORMATION (APR 1984)

The following clause is covered by the policy set forth in subpart 324.70 and is to be used in accordance with the instructions set forth in 324.7004.

CONFIDENTIALITY OF INFORMATION (APR 1984)

(a) Confidential information, as used in this clause, means (1) information or data of a personal nature about an individual, or (2) proprietary information or data submitted by or pertaining to an institution or organization.

(b) In addition to the types of confidential information described in (a)(I) and (2) above, information which might require special consideration with regard to the timing of its disclosure may derive from studies or research, during which public disclosure of preliminary invalidated findings could create erroneous conclusions which might threaten public health or safety if acted upon.

(c) The Contracting Officer and the Contractor may, by mutual consent, identify elsewhere in this contract specific information and/or categories of information which the Government will furnish to the

Contractor or that the Contractor is expected to generate which is confidential. Similarly, the

Contracting Officer and the Contractor may, by mutual consent, identify such confidential information from time to time during the performance of the contract. Failure to agree will be settled pursuant to the

"Disputes" clause.

(d) If it is established elsewhere in this contract that the information to be utilized under this contract, or a portion thereof, is subject to the Privacy Act, the Contractor will follow the rules and procedures of disclosure set forth in the Privacy Act of 1974, 5 U.S.C. 552a, and implementing regulations and policies, with respect to systems of records determined to be subject to the Privacy Act.

(e) Confidential information, as defined in (a)(l) and (2) above, that is information or data of a personal nature about an individual, or proprietary information or data submitted by or pertaining to an institution or organization, shall not be disclosed without the prior written consent of the individual, institution, or organization.

(f) Written advance notice of at least 45 days will be provided to the Contracting Officer of the

Contractor's intent to release finding of studies or research, which have the possibility of adverse effects on the public or the Federal agency, as described in (b) above. If the Contracting Officer does not pose any objections in writing within the 45-day period, the Contractor may proceed with disclosure.

Disagreements not resolved by the Contractor and the Contracting Officer will be settled pursuant to the

"Disputes" clause.

(g) Whenever the Contractor is uncertain with regard to the proper handling of material under the contract, or if the material in question is subject to the Privacy Act or is confidential information subject to the provision of this clause, the Contractor should obtain a written determination from the Contracting

Officer prior to any release, disclosure, dissemination, or publication.

(h) Contracting Officer determination will reflect the results of internal coordination with appropriate programs and legal officials.

(i) The provisions of paragraph (e) of this clause shall not apply when the information is subject to conflicting or overlapping provisions in other Federal, State or local laws.