Atch D - Supai Radiologist SOW.pdf

SCOPE OF WORK-

08 30 2024

The Colorado River Service Unit (CRSU) intends to acquire the non-personal professional Diagnostic Radiologic Technologist -CT described herein, located in Supai, Arizona.

Contractor is requested to provide non-personal professional Diagnostic Radiologic Technologist-CT Services for a 12-month base period and four (4) 12-month option periods. The intent of this contract is to establish a method whereby the Supai Health Clinic can minimize disruptions in clinical service because of staff changes and shortages over the next 5 years. Also, even when the best plans are laid to hire and retain staff, our remote location makes this difficult and we can have staff shortages despite trying to hire a full-time employee.

Requests for contractor coverage will be based on the consistently changing needs of the clinic. However, the website for the Arizona Directory current has the following hours of operation: Mon, Tue, Wed, Fri 8am-noon & 1pm-5pm; Thu 10am-noon & 1pm-5pm. More information can be found at:

https://www.ihs.gov/phoenix/healthcarefacilities/coloradoriver/ https://theofficialhavasupaitribe.com/

The Colorado River Service Unit includes Parker Indian Health Center, Parker, Arizona, Peach Springs Health Center, Peach Springs, Arizona, Supai Health Station, Grand Canyon, Arizona, Moapa Health Center, Moapa, Nevada, and the Chemehuevi Health Center, Havasu Lake, California and serves approximately 13,000+ active user tribal members/other Native American communities in the Arizona, California, and Nevada area.

Residents to the each respective area are served at each local facility of the Colorado River Service Unit.

Supai Health Station (SHS): This is an ambulatory health station located at the bottom of the Grand Canyon. It is accessible only by helicopter, mule, or on foot. The facility is staffed by one physician. Due to isolation, transportation and communication remain important health care issues for the Havasupai community. SHS operates on an appointment system including walk-in availability and serves approximately 1,110 patients.

The CRSU work site is primarily a Critical Access Hospital (CAH) providing, 24/7 inpatient and emergency service with seventeen in-patient beds. The outpatient clinics provide services to about 58,000 patients per year. The services include general medical, ambulatory, emergency medicine, pediatric, community health, preventative health, and mental health. Dental care is also available. Special ambulatory services are provided on-site by IHS staff based in Phoenix or professional medical locum tenens contractors. Ground and air transport are available for emergency care. CRSU uses a multi-disciplinary team approach to patient care; the Service Unit also provides community-public health programs/services, including public health nursing, social services, health education, environmental health and nutritional services. The CAH is accredited by The Joint Commission.

Supai Health Center: Located in the Grand Canyon, the Supai Health Center is staffed by physicians, registered nurses, and ancillary staff. The Supai Health Center provides ambulatory care, with over 5,400 ambulatory visits for fiscal year 2023, and 1,104 active patients.

All responses to this solicitation and for candidate submission shall contain a complete profile and current work history of the candidate(s) presented, including licensure, certifications and education.

Selected candidate shall undergo the Indian Health Service mandated security clearance requirement prior to commencement of services at the CRSU. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check of candidates through the office of the inspector general's exclusion list at http://exclusions.oig.hhs.gov/.

LOCATION:

All services shall be performed at the following location: Havasupai Health Clinic, P.O Box 129 Main Street, Supai, AZ 86435. Physical Location is: 10 Main St, Supai, AZ 86435

SHIFTS:

Hours of Operation: Mon, Tue, Wed, Fri 8am-noon & 1pm-5pm; Thu 10am-noon & 1pm-5pm.

Shift times and schedules are subject to change based on the medical needs of the patient populace and hospital/clinic operations. The contracted services will augment the current full-time staff.

Contractors will be expected to abide by the facility’s Uniform Code and shift hour assigned, modalities of charting and care delivery and other rules and regulations of the facility. Work within a designated schedule prepared by the Supervisory Designee. Any period of absence or changes in the schedule will be communicated with the Chief Nursing Executive or his/her designee 14 days prior, except for emergency situations.

Contractors who accept long full-time assignments (1 continuous week or more) shall attend meetings and training and participate fully as staff members. Routine Shifts Schedules are: Shifts shall vary with need (8 hours, 10 hours, 12 hours or 16 hours, including call back time, on call, and mandatory overtime).

Schedules may be adjusted but will have a 30-minute unpaid lunch break, depending on the needs of the unit, and timing of peak patient care activity.

* Government does not pay time taken for lunch. Total shifts worked annually shall be in accordance to the total number of work hours allocated for the year by CRSU.

Thirty (30) minute lunch breaks are included in shift hours and Government does not pay time taken for lunch.

The Service Unit shall make every effort to submit a schedule two (2) weeks in advance. Shifts may be cancelled or shortened without time restriction or monetary penalty before the Contractor’s employee arrives for duty.

Unless exempt, medical professionals covered by the Fair Labor Standards Act on a compressed schedule must receive overtime pay for hours worked over 80 in a two week pay period, as defined by the HHS payroll calendar. Contractors may be scheduled in excess of 80 hours in a defined pay period.

HOUSING:

Supai Clinic: Considered very remote and located in the Grand Canyon at Supai, Arizona. The Supai Clinic is staffed with physicians, registered nurses, and ancillary staff. The Supai Clinic provides ambulatory care, with over 5,400 ambulatory visits for fiscal year 2023, and 1,104 active patients. Due to the unique and remote location physicians and nursing staff provide afterhours care when necessary for urgent and emergent cases, which are then transferred via air transport by to the nearest receiving facility for available resources and continuity of care.

Accommodations/Lodging – For all locations except Supai, the Contractor shall provide accommodations or housing allowance for the selected registered nurse(s) for the duration of the period of performance. At Supai, Radiologists will stay in temporary or permanent quarters that are a furnished 2 bedroom with a full kitchen. Quarters are subject to availability and they have a low nightly rate that the Government doesn’t pay;

http://exclusions.oig.hhs.gov/ that will require the contractor’s candidate to be financially responsible for to pay at time of check out via check or money order. There is a small market to purchase basic necessities and food items.

Limited market items available. Limited cellular service. Public wifi is generally available.

Personnel providing services need to ensure they pack all necessities and food for duration of scheduled work.

Transportation by helicopter into Supai is provided by an outside Agency that IHS provides for contractor candidates traveling to Supai. Please note that weather and mechanical situations may affect the schedule that varies for winter and summer. Upon contract award detailed travel information and instructions will be provided to the awardee. If candidates terminate employment during scheduled shift or has to depart Supai early, fees will be assessed to the contractor for these unscheduled departures.

PRICING SCHEDULE:

The unit price paid to the Contractor shall be considered as payment in full for services provided under this award. In no way, unless directed by the IHS, shall any provider attempt to bill or collect from any IHS patient, or from any alternate resource for which the patient may be eligible.

Contractor shall provide an hourly fixed rate. Hourly fixed rate shall be inclusive of all the following rates:

holiday, week nights, weekends, all city, state, federal and local taxes and all associated rates with the provision of services and overtime must be priced out separately. The Government will pay one hourly flat fixed rate. The Contractor shall be paid only for actual time services are performed under the terms of the contract at the hourly fixed rate. Overtime, call back and on-call are projected to be needed for these services.

QUALIFICATION/CERTIFICATION – PROFESSIONAL SERVICES:

Contractor shall provide Radiology professionals with experience in these areas.

1. Years of Experience: Minimum of (1) year of Radiology experience.

2. Minimum Education: All diagnostic radiologic technicians shall be licensed by

American Registry of radiologic Technologist by the appropriate agency.

3. Current certification in BLS (Basic Life Support)

4. Applicants must have active and valid state driver’s license throughout the term of this contract.

MAJOR DUTIES REQUIRED BY POSITION:

The Contractor shall perform diagnostic Radiologic Technologist duties and manage patient’s needs as described, identified by the Service Unit and as directed by Supervisor. Serves as a Diagnostic Radiologic Technologist in the Diagnostic Medical Imaging Departments of the Colorado River Service Unit (Supai clinic with the duties of performing technical operations of Digital Radiography equipment, MDCT, portable x-ray equipment to provide x-ray studies for diagnosis and treatment of patients for medical problems needing special views and similar hard to detect lesions in the body. Use of standardized routine and specialized procedures. Diagnostic Radiologic Technologist will need to be proficient with the hospital information system, RPMS (Resource Patient Management System), which is the main method of processing patient x-ray exam orders and reporting patient x-ray orders results.

A. Shimadzu RAD speed diagnostic room and portable MOBILEART equipment, and Canon Acquillion CT, and operates teleradiology equipment and PACS equipment and all standard diagnostic x-ray procedures.

B. Receives patient, explains methods of procedure, positions patient and makes exposures necessary for requested examination. Independently makes standard examinations.

C. Confers with remote Radiologists to establish requirements of nonstandard examinations and determines technical factors, positioning, number and exposure factors, etc., to satisfy requirements.

Schedules patients for examinations; Evaluates the nature of critical and emergency procedures;

rearranges patient priorities for accommodation purposes; maintains records of patients treated, examinations performed and images taken; maintains permanent record of examinations by entering proper information into Radiology Information System. Performs appropriate clerical filing and maintains orderly records as needed; performs intravenous contrast media injections, records radiation exposure appropriately.

D. Advises radiologist or referring physician of results of examination and provides them with a preliminary diagnostic evaluation; notifies them of significant findings requiring their immediate attention and visualization while patient is undergoing examination.

E. Makes minor adjustments to equipment, performs required QC, operates the Media Writer for the burning of CDS.

FACTORS:

Factor 1 - Knowledge Required by the Position:

Thorough knowledge of radiation protection standards, devices and techniques including concepts of accumulated dosage and genetic changes, effects of radiation on living organisms, and effects of x-ray techniques on patient and operator exposure in order to assure that adequate safeguards are maintained, to recognize when changes of equipment or procedures might result in increased exposure, and to adopt methods to prevent such exposure.

Knowledge of anatomy and physiology, location, appearance and function of various major and minor systems susceptible to radiological exposure and physical abnormalities associated with most disease or lesions which are customarily illustrated by various radiographic exams in order to interpret examination requests accurately, to recognize exams which illustrate the lesion and develop them through control of contrast, density, etc., to optimize the clarity for diagnostic use and to recognize when additional views or different positions are needed to fully illustrate lesions such as recognize an unsuspected mass lesion and taking additional views to fully illustrate the lesion, recognizing when hard to visualize organs have not been properly imaged and changing patient’s position or taking additional views to improve the illustration or recognizing motion artifacts and repeating needed studies.

Knowledge of aspects of basic physics including the concepts of energy, electric power, and types of electrical circuits, construction and use of x-ray tubes and properties of x-rays in order to understand the operation of x- ray equipment, monitor equipment for proper operation, make changes to standard procedures to compensate for equipment aging and determine when maintenance or repair is needed.

Basic knowledge and understanding of computer operation including operation of teletype keyboard input;

purpose of operating digital computerized equipment and operating the R.I.S. system and operating teleradiology and electronic radiology equipment; Knowledge of radiographic exposure techniques such as use of formulae for determining technical factors; knowledge of how to control density, contrast and distortion and use of intensifying screens, buckys, collimators, filters, grids and other accessories to produce images of high diagnostic quality with minimum retakes.

Knowledge and skills to provide care appropriate care to the age specific of patient served; Knowledge of growth principles and development over the life span of patient status; ability to assess data reflective of patient’s status; interprets the appropriate information needed to identify each patient’s requirements relative to age specific needs of neonates, pediatrics, adolescent and geriatric; Provides care needed as described in policies and procedures.

Knowledge of basic nursing practices related to radiography such as emergency cardiac arrest procedures and use of oxygen to assist with breathing difficulties.

Knowledge and skill in the performance of routine and specialized CT examinations to include venipuncture and administration of IV contrast material. Can immediately identify a change in patient condition and intervene appropriately.

Factor 2 - Supervisory Controls:

Incumbent works under general supervision of Supervisory Diagnostic Radiologic Technologist. Assignments are made in the form of work schedules and verbal instructions. On more unusual and complex assignments, incumbent works closely and confers with radiologist and medical officers on special techniques. On most assignments, technologist handles all problems and deviations. Work is evaluated on a spot check basis for achievements of objectives.

Factor 3 - Guidelines:

Standard operating procedures cover the section to be illustrated, number of images to be taken, use of contrast medium, positioning of patient, and technical factors to be used. Textbooks, technical manuals and research papers on various radiographic exam and procedures are available for additional guidance. Many guidelines are not specifically applicable to assignment since radiographic procedures and equipment are rapidly evolving in the field of diagnostic radiology. Incumbent must modify these procedures and guidelines to compensate for observed physiological and anatomical conditions peculiar to patient in order that existing lesions should be most effectively illustrated. Incumbent must maintain up-to-date knowledge of developments in the field of radiology to recommend new methods, examinations and guidelines for adoption. Procedures change frequently due to new developments in the radiology field.

Factor 4 - Complexity:

The work involves independent performance of many types of special examinations such as procedures with injured or seriously ill patients that may require modification of examinations. Incumbent may devise positioning and alter instrumentation set up to minimize further pain and injury. Incumbent must use judgment to deviate from standard procedures to compensate for patients illness or physical disabilities in accordance with established precedent and methods of calculation. The examination process requires incumbent to recognize lesions, masses, or disease related changes to organs that are the object of examination in order to adjust the picture or take additional views to achieve optimum visualization of affected areas.

Factor 5 - Scope and Effect:

Purpose of the work is to provide x-ray studies for diagnosis and treatment of patients for medical problems needing special views and similar hard to detect lesions in the body. The studies affect the accuracy and reliability of physician’s diagnosis and treatment.

Factor 6 - Personal Contacts:

Personal contacts are with patients, department and service unit staff and radiologist, medical providers, nurses and other employees.

Factor 7 - Purpose of Contacts:

Purpose of contacts with patients are to explain procedures being performed by positioning patient to obtain best view of body part and take x-ray studies. Occasionally patients are ill, injured or nervous which requires technologist to exercise tact in providing comfort and reassurance. Contacts with service unit staff are to exchange information and resolve problems with equipment, procedures and scheduling of in patients.

Coordinates work of lower grad technologist when working on procedures that require teamwork. Contacts with professional outside radiology are to demonstrate and explain practical problems in taking specialized x-rays. Contacts with radiologist are to receive instructions and coordinates work efforts or resolve operating problems.

Factor 8 - Physical Demands:

The work requires long periods of standing and walking. There is some bending, lifting and carrying of moderately heavy items. Positioning of patients who are unconscious or disabled requires considerable effort and working in awkward positions; heavy lifting of totally incapacitated patients is performed only with the help of other radiology staff.

Factor 9-Work Environment:

The work area is will lighted, ventilated and temperature controlled. Special safety precautions are required to reduce exposure to x-rays to patients and employees. Safety precautions include using minimum current settings in the x-ray machine and operating machines behind a protective screen by using protective equipment of lead aprons and gloves when needed for patients.

STATEMENT OF WORK:

The overall scope of this contract is to provide qualified and experienced healthcare and medical care providers under a Government service contract. The Contractor(s) will be expected to have the necessary education, training, licensing, previous work experience and competence in being able to provide the services within the department(s). Work performance shall be performed according to the requirements and conditions contained in this Statement of Work. The contract resulting from this solicitation includes:

The Contractors(s) shall be expected to assist and provide services and duties as may be requested for the normal operational requirements for the respective department and personnel. The contractor shall provide work that is consistent with the guidelines and procedures of the IHS. Failure of the contractor to meet these standards can result in cancellation of this contract or at a minimum a request that the Contractor(s) be dismissed and a new Contractor(s) be dispatched. The contractor’s performance and abilities shall be evaluated based upon performance standards that are contained in this statement of work The Contractor(s) shall prepare and complete in a timely manner the required documents, in accordance with the CRSU Medical By-Laws and Service Unit Policy. Chart notes (where applicable) are to be completed on the day services are rendered and specifically, with rare exception, immediately after finishing with the patient. During the performance of their duties, the contractor shall provide for the consistent performance of patient care processes according to the standards for AAAHC accreditation within IHS. The Contractor(s) shall:

1. Be proficient in writing, typing and have a basic working knowledge and understanding of computer hardware and software applications.

2. Have sufficient knowledge, competence and experience in providing these services on a regular schedule at HHCC.

3. Possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that he/she can relate constructively to IHS employees, contractors, vendors and individuals from the Native American community.

4. Have a valid state driver’s license or government issued identification card from any of the 50 United States or the Commonwealth of Puerto Rico.

5. Not have any work or health restrictions, which could directly or indirectly interfere with the performance of providing services.

6. Maintain acceptable standards of personal hygiene, grooming and professional attire such that their image as a Federal contractor is compatible with the expectations of the IHS staff.

7. Be required to utilize the electronic health record for chart documentation (where applicable) after receiving training.

8. Be sensitive to the unique culture factors of the people they serve, which may include use of an interpreter as necessary in communication of services being rendered. Unique cultural factors that may contribute to the patient’s treatment include: use of their language communications; village and tribal customs; use of traditional healers; isolation; housing conditions and lack of resources.

9. Have tact and diplomacy while working in stressful situations.

CONDITIONS FOR REMOVAL/REPLACEMENT OF MEDICAL PERSONNEL:

As mutually agreed between the Contracting Officer and the Contractor there may be grounds for removal and/or replacement of a medical personnel.

The Contractor(s) shall be removed from an IHS facility if services are not performed in accordance with terms and conditions of this award.

The Contractor shall relieve contracted staff within 24 hours of notice and, if a replacement is needed, the replacement should be available within one week of the removal.

CONTRACTOR REQUIREMENTS:

5. CONTRACTOR REQUIREMENTS:

For Medical & Professional Contractors, the contractor shall comply with all IHS facility infection control and safety procedures, and standards. During the performance of this contract, the Contractor shall provide for the consistent performance of patient care process according to the standards of The Joint Commission (TJC) and/or Centers for Medicare Services (CMS) who supplies accreditation to the Phoenix Area Indian Health Service hospitals and health centers. These standards shall include: The Comprehensive Accreditation Manual for Critical Access Hospitals, and the Laboratory Standards as they represent the scope of services of this contract.

For Medical& Professional Contractors, the contractor shall complete in a timely fashion, the medical and other required records for patients he/she admits or in any way provides treatment. Chart notes are to be completed on the day services are rendered. The contractor shall abide by the Service Unit Medical By-laws and rules and regulations and meet all credentialing requirements in accordance with the Service Unit Medical Staff By-laws.

Upon award, the selected professional(s) shall undergo Indian Health Service (IHS) mandated security clearance for work on-site at CRSU. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check through the Office of the Inspector General's exclusion list at http://exclusions.oig.hhs.gov/ and www.sam.gov (best checked through www.verifycomply.com as this checks all exclusion lists). The clearance and credentialing process can take 6 weeks or more.

• Current resume

• OF-306 – Declaration for Federal Employment (all questions must answered and signature with date in 17a is required)

• OF-306 Addendum – Addendum to the OF-306 (Declaration for Federal Employment)

• IHS Provisional Access Memo

• Protecting Children from Sexual Abuse in Health Care Settings; complete the Certificate of Completion http://exclusions.oig.hhs.gov/ http://www.sam.gov/ http://www.verifycomply.com/

• No FEAR Act Training; complete the Certificate of Completion

• OFI-86C form along with two fingerprint cards and applicable state forms

• HHS-745, Section A

• Two IDs (driver’s license and social security card – names must match and be unexpired)

• Educational (college & nursing ) Certification/License

• BLS/ACLS/PALS Certification

NOTE: No photo submission of forms, please have the forms scanned. Wet signature and date is highly recommended. No PDF signatures will be accepted.

MAJOR DUTIES REQUIRED BY POSITION:

Management of Medical Information: The Contractor shall manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols.

Radiology Records and Other Required Documentation: 100% percent of all Radiology records and other required documentation meets established IHS Medical Facility, Joint Commission, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

The Contractor shall ensure adherence to DHHS IT system security policies and procedures. The IT policies and procedures will be made available to the Contractor.

The Contractor shall immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

The Contractor shall wear a government issued contractor identification badge during performance of duty.

All Diagnostic Radiologic technologists providing service under this contract shall attend mandatory orientations and training specified by the government. To include: confidentiality/HIPPA/patient’s Rights and EMTALA Compliance Exam, 2004.

The Government will furnish the Contractor with appropriate PPE other than specified in paragraph 4 of the contract. The Government will be responsible for any repair, cleaning, and inventory required for the PPE.

This does not include any type of uniform or laboratory coat.

The Government will provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 will be charged for lost or destroyed badges.

Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures. Training will be provided ONLY if the subject matter is necessary to improve or enhance the quality of Diagnostic Medical Imaging service or includes mandates made by the IHS Service Units/Health Centers while the Diagnostic Radiologic Technologist is working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

Except for the property specified in paragraph 3 as government furnished, the Contractor shall provide all uniforms and other personal medical instruments subject to the following:

Uniforms and Lab Coats: Uniforms and Lab Coats shall conform to the requirements of the Indian Health

Service Manual, Part 3 Chapter 4 and meet the approval of the Clinical Director at each IHS facility.

Other personal medical instruments: “Other personal medical instruments” are defined as Contractor owned items may include but not limited to scissors, as appropriate to the work unit. The Contractor shall not use unsafe equipment or supplies at any time during performance of this contract. All Contractor furnished equipment and supplies shall be subject to inspection by the Government and must be approved by the COR prior to use by the Contractor. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

SUPERVISORY CONTROLS:

The supervisor of the respective department to which the Contractor(s) is assigned to work or his/her designee, provides primarily administrative supervision. The Supervisor or designee:

1. Sets overall health care objectives and specifies resources available.

2. Provides for clinical supervision during the tour of duty.

3. Assigns work.

4. Reviews work performance on a periodic basis in order to evaluate proficiency in providing health care, discuss deficiencies and problems encountered, outline and/or approve new or changed practices to be employed, and provides consultation on specific cases and related problems.

Work which involves out-of-the-ordinary diagnostic decisions or treatment is discussed with Supervisor or designee who keeps aware of the condition of such patients and all aspects of treatment regimen. Work performance is reviewed for conformance to IHS policy, procedures and accepted professional practices.

Within established guidelines, contractor(s) may exercise latitude in planning and carrying out health care assignments and in undertaking new procedures, practices and approaches to extend both services provided and increase individual proficiency. Overall work performance is reviewed by the Supervisor for effectiveness in meeting requirements for healthcare services.

DELIVERABLES:

The Contractor is required to provide a copy of each Contractor profile to the Contracting Officer Representative (or service unit representative(s)) prior to providing services at CRSU.

Timesheet shall be submitted to the supervisor of the respective department to which the Contractor(s) is assigned to work or his/her designee. The timesheets shall be reviewed for accuracy and certified by signature as accurate and acceptable for payment, then forwarded to the receiving official for further processing of receipt of services through US Treasury utilizing IPP.

CONTRACTING OFFICER REPRESENTATIVE (COR) RESPONSIBILITIES:

The Contracting Officer will designate in writing a COR who shall be responsible for:

1. Monitoring the Contractor’s technical progress, including the surveillance and assessment of performance and recommending to the Contracting Officer, changes in requirements

2. Interpreting scope of work

3. Performing technical evaluations required

4. Performing technical inspections and acceptances required by this contract

5. Monitoring funds available for obligation under this contract

6. The resolution of technical problems encountered during performance of this contract

In no event is the COR empowered to change any of the terms and conditions of the contract. Changes in the scope of work, contract price, quantity, and quality or delivery schedule shall be made only by the Contracting Officer by a properly exercised modification.

The designation of a COR does not authorize or provide a legal right to change any kind of contractual terms regardless of the Contractor’s apparent difficulties in fulfilling contract requirements.

CONTRACTING OFFICER (CO) RESPONSIBILITIES:

The Contracting Officer is the only person delegated the authority to negotiate changes in terms, conditions, or amounts cited in this contract.

PERFORMANCE CONDITIONS:

The COR (or service unit representative(s)) will submit schedules of required coverage a minimum of 15 calendar days prior to the first day of coverage requested.

In the event the Contractor is unable to render service on a previously agreed schedule, the Contractor shall provide a minimum seventy-two (72) hour notification to the COR and service unit representative(s). The Contractor shall then make a full, good-faith effort to provide coverage with a replacement.

Both parties recognize that on occasion there shall be a need to fill coverage requests with less than a 15-day notice. In such an emergency scheduling situation, the Contractor shall make a full, good-faith effort to accommodate the emergency request. If the Contractor is unable to meet the emergency scheduling request, they shall immediately notify the COR and service unit representative(s).

Work Flexibility. As directed by the Supervisor, the Contractor shall rotate into other duty sections as needed to support patient care.

The Contractor shall obtain approval of the department Supervisor or designee prior to any absence from work.

If the length of the absence exceeds eight (8) work hours the Contractor shall request approval at least fifteen (15) days, (the exception is verifiable emergencies) in advance of the desired absence. Approval of leave is contingent upon availability of a qualified replacement.

The Contractor shall provide written documentation from a qualified health care provider for absences of three

(3) or more consecutive days, due to illness, stating: the cause of the current illness or incapacitation AND indicating the Contractor as contagious or non-contagious. The Government reserves the right to examine and or re-examine any Contractor who meets the criteria.

Time and attendance logs or sign-in/sign-out sheets shall be kept on file and verified by the Chief Nursing Executive, Colorado River Service or designee (e.g. ANE) to ensure that services called for under the contract have been rendered.

PAYMENT AND INVOICING INSTRUCTIONS:

Invoices shall be prepared with the following information CLEARLY identified on the invoice:

1. Invoice Date and Number

2. Contract Number

3. Charges for service or products identified BY LINE ITEM Number

4. Brief description of products or services rendered

5. Charges should follow Line Item structure on contract to include Quantity, Unit of Issue, Unit Price, and Total Amount as applicable

6. Dates of Service or Shipment

Invoices shall be prepared and submitted electronically and in accordance with rates and terms as stated in the contract. Invoices shall be submitted electronically in IPP through the US Treasury. Notification and a copy of the Invoice shall be submitted to:

1. Acquisitions: TBD@ihs.gov, A copy of the invoice should be sent electronically to the contract specialist(s) at the address listed above.

2. Service Unit Representatives: A copy of the invoice should be sent electronically to the Service Unit Representative(s) at the address listed above. ADDENDUM:

Pro-Children Act of 1994

The Contractor certifies that it will comply with the provisions of Public Law 103-227, Pro- Children Act of 1994 which imposes restrictions on smoking where federally funded children’s services are provided. The Act requires that smoking should be prohibited in any indoor facility of portion of a facility owned, leased, or contracted for a used for the routine or regular provision of health care, day care, or early childhood development (Head Start) services to children under the age of 18. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 per violation and/or the imposition of an administrative compliance order on the responsible entity. By submitting an offer and entering into a contractual agreement with the Government, Contractors certify that they will comply with the requirements of the Act. Contractors must obtain the same certification from subcontractors.

B. P.L. 101-630, The Indian Child Protection and Family Violence Prevention Act

Contractors whose duties and responsibilities involve regular contact or control over children are subject to a character investigation as required by Public Law 101-630, The Indian Child Protection and Family Violence Act. IHS will conduct these investigations following award of a contract. The character investigation may be waived if, in judgment of the Contracting Officer, in consultation with the Personnel Officer, an investigation has already been conducted and is on file. Until the character investigation has been completed and the Contracting Officer notified of the results, the Contractor must not have unsupervised contact with Indian children.

C. Department of Health and Human Services Tobacco Policy The Contractor’s employee shall comply with the Department of Health & Human Services Tobacco- Free Policy (copy available upon request). Contractor’s employee shall not use tobacco products of any kind (e.g., cigarettes, cigars, pipes, and smokeless tobacco) while on any HHS Property- owned or controlled.

D. Indian Child Protection and Family Violence Prevention Act

No performance under this contract will be allowed without full compliance with the Indian child protection and family violence prevention act, Public Law 101-630 and the Indian Health Service memo dated February 3, 1997, investigations on child care workers. Contractor shall ensure that proposed providers cooperate with and assist the government in the conduction of any necessary background checks.

B. Crime Control Act of 1990

No performance under this contract will be allowed without full compliance with the crime control act of 1990, Public Law 101-647 and the Indian Health Service memo dated February 3, 1997, investigations on child care workers. Contractor shall ensure that proposed providers cooperate with mailto:TBD@ihs.gov and assist the government in the conduction of any necessary background checks.

PERFORMANCE BASED ASSESSMENT:

(a) Introduction – Performance Requirements:

(1) A Quality Assurance Surveillance Plan (QASP) has been developed for in-house operations or to implement a service contract. It is designed to aid the PO in providing effective and systematic surveillance of all aspects of professional nursing services. This plan provides for monitoring the contract requirements

(b) The objective of this surveillance plan is to evaluate how the Contractor is performing in key areas. The government is primarily interested in the final service being provided and not in the details of accomplishment.

(c) The principal method of surveillance will be daily in some cases or by use or periodic inspections. Appropriate indicators are provided for recording observations in this type of surveillance.

(d) How to Use the Performance Based Matrix

(i) Each defect observed will be recorded on the tally report. These documents will then become a formal record for later reference. The tally of defects at the end of each clinic or year (dependent on criteria) will be compared to the acceptable number of defects appearing in the surveillance plan. Errors detected by the PO in the course of surveillance will be transmitted to the Contractor or in-house personnel for correction. Notification of errors will take place within five (5) working days. Specifics concerning any errors should be recorded on the tally checklist. The Contractor or in-house personnel, as applicable, should be asked to initial this record.

(ii) Project Officer shall forward a copy of Contractor’s compliance with performance and non- performance compliance reports.

(e) Quality Assurance Surveillance Plan (QASP):

(i) The Government shall monitor the Contractors’ performance through a Quality Assurance Surveillance Plan (QASP). The QASP is for informational purposes only and not considered part of the contract.

(ii) Surveillance systems will include periodic inspection and acceptance of all deliverables as cited in the contract.

PERFORMANCE-BASED MATRIX

Outcom e

Required AQL Max Allowable

Normal Method of

Incentives and Deduction from

Services Stand ard

Degree of Surveillan ce

Contract Price

Deviation from

Requiremen t/

(AQL)

Radiologist Minimum Contracto r shall

100% Compliant

Government review

Incentive: Government approves

Non- Personal

Qualification for submit of contractors documentation

Services Radiologist supportin g documentatio n for

De-incentive: Government reject

Contract document ation compliance documentation no award, for approval

Radiologist s

Licensure for Radiologist

Contracto r shall

100% Compliant

Government review

Incentive: Government approves

Non- Personal submit of contractors documentation

Services supportin g documentatio n for

De-incentive: Government rejects

Contract document ation compliance documentation, payment may be of Licensure;

withheld licensure shall be in good standing and

Radiologist Background Contracto r shall

100% Compliant

Government review

Incentive: Government approves

Personal Investigation in submit of contractors documentation Services compliance with supportin g documentatio n for De-incentive: Government reject

Contract Indian Child document ation compliance documentation no award, Protection and Family of Backgroun d

Violence Prevention investigati on

Act, Public Law 101-results

Radiologist Immunization Contracto r shall

100% Compliant

Government review

Incentive: Government approves

Non- Compliance submit of contractors documentation Personal supportin g documentatio n for De-incentive: Government reject

Services document ation compliance documentation no award

Contract of

Unaccepta ble

In the event of Contracto r shall

90% Compliant

Government shall

Incentive: No interruption of

Performan ce unacceptable replace notify the performance and positive evaluation performance, lack of personnel contractor in documented in governments’ professionalism, within 5 days writing of non-database.

unacceptable conduct, upon receipt of compliance De-incentive: Two (2) occurrences of the Contractor shall written which the contractor is unable to replace personnel notificatio n replace personnel within the time allowance, a cure notice shall be issued and possible termination of contract. Evaluation documenting performance in the national IHS database.

Long-term shifts

Filled long-term work

Contracto r shall

100% Government’ s

Incentive: No disruption of fulfilled shifts as scheduled by ensure full shift review & written performance; positive evaluation

(Thirteen the Colorado coverage documentatio documented in government’s

(13) River for n/ week travelers)

Service Unit.

Long long term notification to database.

Term shifts contractor nursing needs

Contractor of non-

De-incentive: Two notices to the personnel shall at the Colorado compliance. contractor, a cure notice shall be provide at least a 4

River Service issued and possible termination of week notice so that

Unit contract. Evaluation documented in the position can be national IHS database.

filled prior to vacancy.

Short-term shifts

Filled short-term work

Contracto r shall

85% Same as above

Same as above fulfilled shifts as scheduled by ensure full shift

(Immediat e the Colorado River coverage for staffing needs)

Service Unit. short term needs at the

Colorado River

END OF STATEMENT OF WORK