Performance_Work_Statement.pdf

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Tsaile Health Center

Performance Work Statement (PWS)

For Nonpersonal Services

FAMILY PRACTICE PHYSICIAN SERVICES

Table of Contents

Section Page

1.0 General 1-2

2.0 Definitions 3-5

3.0 Government Furnished Information, Property, & Services 6

4.0 Contractor Furnished Property 7

5.0 Performance-Based Requirements 8-12

6.0 Contractor Qualification Requirements 13-14

7.0 Federal Tort Claims Act 14

8.0 Challenges to Conflicts 14-15

9.0 52.249-12 Termination (Personal Services) (Apr 1984) 15

10.0 Performance-based Matrix 16

11.0 List of Attachments and Exhibits 17

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Tsaile Health Center

Performance Work Statement (PWS)

For Nonpersonal Services

FAMILY PRACTICE PHYSICIAN SERVICES

1.0 General: This performance work statement describes the requirements for Non-Personal services for an Family Practice Physician Service to support the mission of the Indian Health Service (IHS).

1.1 Background: IHS is an agency within the U.S. Department of Health and Human Services and is responsible for providing federal health services to American Indians and Alaska Natives. The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes.

The IHS is the principal federal health care provider and health advocate for the Indian people.

The goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indians and Alaska Natives. The IHS currently provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 34 states.

1.1.1 Navajo Area Indian Health Service (NAIHS) administers health centers and hospitals providing health care to approximately 201,583 members of the Navajo Nation. The Navajo

Nation is the largest Indian tribe in the United States and has the largest reservation, which encompasses more than 25,516 square miles in northern Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico. The NAIHS is the primary provider of inpatient, ambulatory care, preventive and community health, and environmental health services for members of the Navajo Nation and the San Juan Southern

Paiute Tribe.

1.1.2 Tsaile Health Center (THC)

The Tsaile Health Center has 9,031 registered clients. Clinic hours are 8:00 a.m. to 5:00 p.m. Monday through Friday (closed on holidays). Weekend work is limited to two 13 hour emergency room shifts per month at the main hospital (Chinle Comprehensive

Health Care Facility), 25 miles west of the Health Center. The Health Center is adjacent to Dine’ College, the first Indian Tribe-controlled College established in the United

States. Routine outpatient services are provided to a broad range of patients including prenatal and geriatrics.

1.2 Scope: The Contractor shall provide outpatient Family Practice Physician services in accordance with section 5.0, performance based requirements.

1.2.1 Duties and responsibilities will encompass outpatient Family Practice Physician Services to

I.H.S. patients.

1.2.2 Place of Performance: Services are to be performed at Tsaile Health Center within the Outpatient Department. The award pricing schedule will identify the exact place of performance.

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1.2.3 Period of Performance: Will be flexible to allow for short term (13 weeks), long term (1-year to 3-year) and, where feasible, include intermittent support to meet unplanned needs that develop on a frequent basis.

1.3 Applicable Documents: Please see the web link listed unless document is listed as an attachment.

1.3.1 The Joint Commission

http://www.jointcommission.org/

1.3.2 Centers for Medicare and Medicaid Services (CMS) Standards http://www.cms.hhs.gov/

1.3.3 Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaahc.org

1.3.4 Section 231 of Public Law 101-647, the Crime Control Act of 1990.

http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml

1.3.5 Section 4087 of Public Law 101-630, the Indian Child and Family Violence Act.

http://www.nicwa.org/policy/law/protection/index.asp

1.3.6 Health Insurance Portability and Accountability Act (HIPAA) of 1996.

http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf

1.3.7 Privacy Act of 1974.

http://www.usdoj.gov/oip/privstat.htm

1.3.8 IHS Service Unit and Health Center Policies, Procedures and Protocols.

(See section 11.0 for a list of attachments and exhibits)

1.3.9 Computer Security Act of 1987

http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt

1.3.10 Federal Code of Conduct http://www.ihs.gov

1.3.11 IHS General Directives http://www.ihs.gov/adminmggrresouces

1.3.12 IHS Computer Security Directives http://www.ihs.gov/adminmggresources

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2.0 Definitions

2.1 Acceptance: Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart 46.5 and subject to other terms and conditions of the contract.

2.2 Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements. Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

2.3 Area: A defined geographical region for Indian Health Service administrative purposes. Each Area

Office may administer several Service Units.

2.4 Board Eligible: All Internal Medicine or Family Medicine physicians and subspecialist physicians who have met the standards for Board Certification in general Internal Medicine/Family Medicine or any of its subspecialties to be “Board Eligible” in the relevant specialty for a period of 7 years. The 7-year period of Board Eligibility shall begin upon the candidate's successful completion of the initial certification requirements in their field or July 1, 2012, whichever is later. During the period of Board

Eligibility, the candidate may apply for the certifying examination in the relevant specialty. If the candidate does not become Board Certified during the 7-year period of Board Eligibility, the candidate will no longer be deemed “Board Eligible” and may no longer represent himself or herself as “Board

Eligible.”

2.5 Code of Ethics: The Code of Ethics for Family Practice Physician Service as approved by the

American Board for Internal Medicine or American Board for Family Practice.

2.6 Contracting Officer (CO): A Government employee with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.7 Contractor: The organization awarded a legal binding contract to provide supplies and/or services; includes the organization’s employees.

2.8 Contracting Officer’s Representative (COR): A federal employee who assists the ordering/issuing activity contracting officer in the administration of task orders issued under this contract. The COR is primarily responsible for the technical assistance and day-to-day program management of the ordering activity’s task orders. Ordering activities may have different designators for this employee (e.g. GTR –

Government Technical Representative, COTR–Contracting Officer’s Technical Representative, or PO -

Project Officer).

2.9 Cooperative Attitude: Behavior that is positive and displays a willingness to perform assigned patient care tasks and to be a team player.

2.10 Cultural Awareness: Realization and respect for American Indian and Alaska Native practices.

2.11 Customer: Patients, staff and visitors of an IHS service unit and health center.

2.12 Customer Evaluation/Input: Written comments made to the Contracting Officer regarding the

Contractors performance. This is one of the criteria used to evaluate the Contractor’s performance.

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2.13 Dependability: Qualities of being trusted and being able to repeat the same task to yield the same result.

2.14 Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal

Executive agencies in their acquisition of supplies and services with appropriated funds.

2.15 Government Vehicle: An IHS owned motor vehicle or a vehicle leased by IHS through agreements with the General Services Administration (GSA) or through commercial rental agreements.

2.16 Health Center: A facility physically separated from a hospital, with a full range of ambulatory services including at least primary care providers, nursing, laboratory, and x-ray which are available at least 40 hours a week for outpatient care.

2.17 Nonpersonal Services Contract: a contract under which the personnel rendering the services are not subject, either by the contact’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees, as defined in FAR

37.401.

2.18 Ordering Activity: An authorized user of IHS that may issue a task order to obtain required services under this contract.

2.19 Ordering Activity Contracting Officer: A Government employee of IHS authorized and warranted to issue task orders and to make subsequent task order modification(s) under this contract. The

Ordering Activity CO has the authority to make initial determinations on all matters of dispute regarding task orders.

2.20 Orientation: An activity designed to provide basic familiarization of the facility and transition the emergency room physician into the IHS Service Unit and/or Health Center and the nursing unit where the services will be provided.

2.21 Past Performance Information: Relevant information regarding a contractor’s actions under previously awarded contracts. This includes the contractor’s record of conformance to specifications and to standards of good workmanship; the contractor’s record of containing and forecasting costs on any previously performed cost reimbursable contracts; the contractor’s adherence to contract schedules, including the administrative aspects of performance; the contractor’s history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business-like concern for the interest of the customer.

2.22 Patient Outcome: End result of outpatient, family practice physician care.

2.23 Performance based Matrix: Lists the services to be monitored and the standards to be applied.

2.24 Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

2.25 Service Unit: The local administrative unit of IHS.

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2.26 Standards of Practice and Standards of Care: Authoritative statements by which the medical profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for professional medical practice and a framework for the evaluation of practice. The standards of professional medical practice may pertain to general or specialty practice.

2.27 Supervisor. Government employee authorized to provide verbal and written performance direction to the Contractor that the Contractor must follow without exception.

2.28 Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activities written order to obtain services, at a minimum will include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activities task order number.

2.29 Tour of Duty: The time of day the physician is scheduled to perform outpatient duties; also considered the shift of the day, The time can vary according to the needs of each facility and/or clinic, e.g. 12 hour Tour of Duty, 8 hour Tour of Duty, 10 hour Tour of Duty.

2.30 Valid Patient Complaint: Justifiable accusation made by a patient and supported by investigation.

2.31 Verifiable Emergency: An unexpected/unplanned absence by the contractor requiring valid documentation to confirm the occurrence.

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3.0 Government Furnished Information, Property and Services

3.1 Information: Government unique information related to this requirement, which is necessary for

Contractor performance, will be made available to the Contractor. The Contracting Officer or designee will be the point of contact for identification of any required information to be supplied by the

Government.

3.2 Joint Use by the Government and the Contractor: Except for the property and service listed in

3.3 and 4.0, the Government will provide, for joint use by the Government and the Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

3.2.1 Government Vehicle: If required by the position, authorization shall be in accordance with

IHS Chapter 12, Section 13 Motor Vehicle Management.

3.3 Contractor Exclusive Use:

3.3.1 Personal Protective Equipment (PPE). 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.

3.3.2 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.

3.4 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 physician service or includes mandates made by the IHS Service Units/Health Centers while the physician is working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

3.5 Supervisor: The contractor is subject to the supervision and direction of Carolyn Johnson, MD, Chief

Medical Officer (CMO) or her designee for this order.

3.5.1 Contracting Officer Representative (COR): Edith Denny is primarily responsible for monitoring the technical progress including surveillance and assessment of performance for this order.

3.5.2 Point of Contact: Shaunna Tsosie, (928) 724-3710 CMO’s Administrative Assistant is the point of contacts for this requirement.

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4.0 Contractor Furnished Property

4.1 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:

4.1.1 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.

4.1.2 Other personal medical instruments: “Other personal medical instruments” are defined as Contractor owned items may include but not limited to stethoscope, 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.

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5.0 Performance-Based Requirements. The Contractor shall provide uninterrupted outpatient and inpatient Internal Medicine / Family Practice Physician Services in the delivery of patient care to the

Indian Health Service. Specific tasks include the following:

5.1 Primary Care Physician Duties:

5.1.1 Work under the general technical, administrative supervision of the Tsaile Health

Center (THC) Chief Medical Officer or her designee.

5.1.2 The Contractor shall provide professional medical services or direct patient care services under the terms of this contract, appropriate and timely medical services in accordance with the standards of care established by recognized medical care organizations and in accordance with the policies and procedures of Service Unit’s Medical Staff Bylaws and

Rules & Regulations, including attendance at department and medical staff meetings at

Chinle hospital. There is some variability of daily hours based on workload, emergency cases, scheduling of cases and staffing variability.

5.1.3 Provide professional medical services or direct patient care services:

A. Interviews and examines patients, reviews past medical history, and requests and/or performs complex diagnostic tests and examinations deemed necessary to obtain all possible information related to each case. Makes preliminary and comprehensive diagnosis, directs, prescribes or provides treatment, or arranges for specialized care or patient referral as required. Bases decisions upon information obtained, professional medical knowledge and skills and prescribe policies and procedures. Makes note of observations to be incorporated into clinical records. Provide emergency care as required. Provides definitive management in all medical categories for cases that do not require referral. Gives total patient care including prevention, health maintenance, early diagnosis, treatment and follow-up services to patients under his/her care.

B. Conducts outpatient clinics making observations appropriate to the outpatient’s underlying disease and treatment plan, including current symptoms. Reviews the patient’s medications, diet, therapy course, adherence to management plan and patient observations. Modifies regimen as indicated. Instructs and counsels patients and family members as required. Performs or assists other physicians in the performance of minor surgery

C. Coordinates care with specialists both within and outside of the I.H.S.

D. Refers patients to appropriate contracted medical or other government facilities, providing full clinical information for care and diagnostic procedures that cannot be adequately provided at local I.H.S. facilities. Coordinates and integrates information obtained into the ongoing Health Care Program at the Service Unit and assures the provision of timely follow up care as required.

E. Works closely with allied health professional (i.e., Community Health Nurse, Social

Workers, Health Educator, etc.) to utilize and coordinate the services of other health care professional in the management of the families’ medical, psychological and social

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F. Works closely with allied health professional (i.e., Community Health Nurse, Social

Workers, Health Educator, etc.) to utilize and coordinate the services of other health care professional in the management of the families’ medical, psychological and social problems.

G. Provides consultation on difficult cases to practitioners in the same or other specialties. Provides supervision and teaching to medical practitioners, residents and students on the most complex patients.

H. Within specialty area, assumes responsibility for the diagnosis, prevention therapy, maintenance and rehabilitation of family members in the capacity of a senior specialist or expert.

I. Contractor shall provide appropriate documentation regarding care rendered using the Comprehensive Health Care Facility’s (CCHCF) electronic health record system. All documentation by the provider will be entered electronically using the electronic health record system. The provider is responsible for utilizing the CCHCF electronic health record system to obtain pertinent patient information in assisting care. It is the responsibility of the provider to use the training resources provided by the CCHCF to develop competency in utilizing the electronic health record system.

J. Dictates, electronically enters, or writes and assures preparation of appropriate medical records for all patients seen to assure the accumulation and organization of all pertinent clinical data needed to provide comprehensive medical care. Clinical data reports shall be completed in a timely manner and shall be maintained in compliance with JCAHO standards.

5.1.4 Contractor shall be subject to peer review per Joint Commission standards.

5.1.5 Contractor shall meet the Safety management reporting requirements in accordance with the Service Unit Safety Measure Policy.

5.1.6 Contractor shall be responsible for all applicable Federal, State, And Local Taxes, Meals, Travel/Transportation. Lodging is available but must be paid for by the contractor or contract agency. Government quarters are available at prevailing rental rates plus utilities, as applicable, if government quarters are utilized. The contractor shall be responsible and liable for the proper care of government owned or leased property furnished in occupied quarters.

5.2 Work Schedule:

5.2.1 The Supervisor at each IHS facility shall determine specific tour of duty. The contractor shall work 100% of the contracted hours.

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• Tour of Duty: 8:00 am to 5:00 pm, Monday through Friday, Forty (40) hours per week.

If agreed upon on prior to contractor’s tour of duty, contractor shall be subject to work

Weeknight Call, Monday through Friday.

• Call-Back Hours and Overtime Hours after 5 pm.

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

5.2.3 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. Sick/annual leave/compensatory time are not authorized.

5.2.4 Contractor shall provide a qualified replacement to authorize the approval of leave.

5.2.5 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:

A. The cause of the current illness or incapacitation AND

B. 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.

5.3 Conduct: The Contractor shall meet standards as listed in the Federal Code of Conduct.

5.3.1 The contractor shall be subject to character investigation as required by Public Law 101-

360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance of a contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eQIP) system and this shall include all fingerprinting procedures and clearances. The contractor shall provide all requested information necessary to perform Level I and Level II background checks. The contractor shall comply with the requirement to obtain security investigations. The contractor shall work with the I.H.S. to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms will be reviewed by the contractor and forwarded to the government personnel. The contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

5.4 Performance Evaluation:

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5.4.1 The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 10.0.

5.4.2 Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome constitutes a breach of contract and shows cause for termination.

5.5 Identification of Contractor:

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

5.6 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.

5.6.1 Medical Records and Other Required Documentation: 100% percent of all medical records and other required documentation meets established IHS Medical Facility, Joint

Commision, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession. (Note: payment will be withheld for inaccurate or incomplete medical records per paragraph 10.0 of this performance work statement.)

5.6.2 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.

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

5.7 IHS Information Technology Systems:

5.7.1 In performance of this contract, the Contractor shall adapt to and successfully utilize

IHS information technology systems that are deemed by the Supervisor as necessary for acceptable contractor performance.

5.7.2 The Contractor shall ensure that IHS information technology system security policies and procedures are adhered to. The IT policies and procedures will be made available to the

Contractor at each IHS facility.

5.7.3 The contractor shall follow all appropriate federal and locally required Information

Technology security requirements and will be operating under HIPAA and Privacy Act regulations.

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6.0 Contractor Qualification Requirements:

6.1 Experience. The Contractor shall have thirty-six (36) months of Internal Medicine / Family

Practice Physician/ Pediatric services, currently with a minimum of six months (6) in the specialty required by the contract, unless otherwise approved by the Contracting Officer.

6.1.1 Contractor shall have completed residency training and experience in Internal Medicine

/ Family Practice/ Pediatric.

6.2 License/Registration. The Contractor shall be board certified or board eligible with the

American Board of Internal Medicine or American Board of Family Practice or American Board of

Pediatric and shall possess a current, valid, unrestricted physician license in any state, the District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States, throughout the term of this contract. If the contractor is asked to perform outside the normal training parameters of his/her specialty, then the contractor shall provide certification of hospital privileges in those additional field/s of practice.

6.2.1 Motor Vehicle Operator’s License. If required by the position, the Contractor shall possess a valid state driver’s license throughout the term of this contract.

6.2.2 The contractor shall meet the qualifications and credentialing standards.

6.2.3 The contractor shall maintain a valid, current, full and unrestricted DEA license and maintain certification throughout the term of the contract.

6.3 Certifications. Internal Medicine Physicians: Current Basic Life Support (BLS) and Advanced

Cardiac Life Support (ACLS) are mandatory or Family Practice Physicians: Current Basic Life

Support (BLS), Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) are mandatory. The contractor shall maintain valid Cardiopulmonary resuscitation (CPR) certification.

6.4 Health Requirements/Conditions of Employment:

6.4.1 Medical Evaluation. The Contractor shall provide a fitness for duty certificate issued by a licensed physician to perform the proposed job without significant risk to personal health or the health and safety of others.

6.4.2 Immunization. Contractor shall provide evidence of immunization for MMR (Measles, Mumps and Rubella, Diphtheria, Pertussis and Tetanus), Tdap booster, Hepatitis B, PPD status and Influenza or as required by NAIHS immunization policy. Contractor shall also provide the following documentation:

� Immunity to Rubella, Mumps, Measles

� Immunity to Hepatitis B series

� History of chicken pox (varicella) disease or positive titer

� Tetanus Diphtheria (Td) within the last 5 years

� Documentation of receiving a TB Mantoux skin test (PPD) within the past 12 months with documentation of follow-up for a positive test.

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� A signed declination of the Hepatitis B vaccination series will be accepted.

6.5 Language Requirements and Cultural Awareness. The Contractor shall read, understand, speak, and write English to effectively communicate with patients and other health care workers, and shall be respectful of the local, American Indian and Alaska Native culture.

6.6 Information Technology Skills. The Contractor shall possess basic knowledge, skills, and abilities to use a computer.

6.7 Orientation. The contractor shall attend mandatory orientations and training specified by the government.

6.8 Background Checks: As directed by the Contracting Officer, the Contractor shall provide all requested information necessary to perform Level I and Level II background checks. The

Contractor shall comply with the requirement to obtain security investigations. The Contractor shall work with the IHS to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms will be reviewed by the Contractor and forwarded to the Supervisor. The Contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

6.9 General Requirements:

6.9.1 Contractor shall provide at minimum three current letters of reference from other health care providers familiar with the candidate's clinical practice skills within the same discipline. One letter must be from the Chief of Staff/Medical Director or Immediate

Supervisor at the hospital in which the provider either holds or last held staff privileges. If the contractor's provider has just completed a residency program, one of the letters shall be from the program director or service chief.

6.9.2 Contractor/Credentialed medical staff members shall be subject to Medical Staff

Ongoing Professional Practice Evaluation and Focused Provider Performance Evaluation as specified in the Chinle Service Unit Policy & Procedure, Focused Provider Performance

Evaluation & Ongoing Professional Practice Evaluation.

6.9.3 Contractor shall work directly with the Chinle Service Unit Credentials Committee to attain approval of credentials and privileges.

7.0 Federal Tort Claims Act (28 USC 1346 (B), 1946): Independent Contractors: Previously, health care providers working at Indian Health Service or Tribal facilities under non-personal services contracts—such as locums tenens providers—were generally not covered under the Federal Tort Claims

Act and had to secure their own malpractice insurance. However, the recently passed 25 U.S.C. 1680c(e) may extend Federal Tort Claims Act coverage to these “non-Service health care practitioners” who are given clinical privileges and who provide health care services to patients eligible for services from the

Indian Health Service or under an ISDEAA contract.

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8.0 Challenges to Conflicts: For any inconsistency between supervisor directions, this Performance

Work Statement, attachments and exhibits, the following order of precedence will apply:

(a) First Priority: Supervisor’s directions

(b) Second Priority: Position Description (attached)

(c) Third Priority: Performance Work Statement Exhibits

(d) Fourth Priority: Performance Work Statement Narrative

9.0 52.249-12 Termination (Personal Services) (Apr 1984): The Government may terminate this contract at any time upon at least 15 days’ written notice by the Contracting Officer to the Contractor.

The Contractor, with the written consent of the Contracting Officer, may terminate this contract upon at least 15 days’ written notice to the Contracting Officer.

9.1 Any Contractor employee demonstrating impaired judgment shall not be allowed to continue working on the contract. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

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10.0 Performance – Based Matrix

Performance-based Task Indicator Standard Quality Assurance Incentives

State the end results or outputs that you, the customer will formally accept or reject.

For the requirement, state the feature(s) of end result that will be surveilled.

For each “indicator,” state a performance level that, when met, means the task has been performed satisfactorily.

This Standard describes “What Success

Looks Like.”

For each “Standard”, state the method used to check performance (i.e. random sampling, 100% inspection, periodic inspection, customer complaints).

List Positive and Negative

Incentives. Address method of linking payment to quality of service.

Contractor shall provide outpatient in the delivery of patient care to the Navajo

Area Indian Health Service, Tsaile Health Center.

Competency

Compliance

Patient Outcomes

Professionalism

Credentialing

Documentation

Service Quality

Perform 100% required tasks at 100% of the required competencies (refer to 11.0)

100% compliance with IHS Service Units and/or Health Centers published Policies;

Procedures; Standards of Care; and

Hospital and Laboratory Protocols.

No reports of breached patient safety, infection control, and other procedures that might adversely affect patient outcome.

Performance characterized by continual cultural awareness and focus on customer service. 100 % adherence to the Code of

Ethics and Federal Code of Conduct.

Uninterrupted credentialing as defined in

6.0 to 6.8 for period of contract.

100% of all medical records and other required documentation meets established IHS Medical Facility, Joint

Commision, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

Satisfaction with quality of service is evidence by valid customer inputs. 100% adherence to ensure continuity of patient care and to provide replacement on time.

Surveillance systems will include periodic inspections and customer complaints.

Payment of contract price for satisfactory service.

No payment for incomplete work.

Contractor performance will be evaluated using the

Contractor Performance

Assessment Report (CPAR).

The evaluation will be considered when future IHS contract selections are made.

� CPARS evaluation will be forwarded to the

GSA/FSS Contracting

Officer.

PWS No. CSUPWS No. CSUPWS No. CSUPWS No. CSU----14141414----00001111 03 FEB 201603 FEB 201603 FEB 201603 FEB 2016

11.0 List of Attachments and Exhibits. To be provided by the Contracting Officer upon request.

11.1 Attachments

A. Position Description (Service Unit specific) – available upon request.

B. Certification Statement for Performance Work Statement (PWS) No. CSU-14-01

11.2 Written Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

11.2.1 Standard Emergency Codes

11.2.2 Confidentiality: Legal and Ethical Concerns in Healthcare

11.2.3 An Introduction to the Navajo Culture

11.2.4 Verbal and Telephone Orders

11.2.5 Pain Management

11.2.6 Focus Charting

11.2.7 Medical Staff By Laws