SOW_Podiatry.doc

RFQ-WESU-8-109 PODIATRY SERVICES: Indian Health Services

I. PURPOSE OF CONTRACT:

A. To help meet the critical needs of all Wellpinit Indian Health Center (aka David C. Wynecoop Memorial Clinic) patients, placing a high priority on diabetic and other podiatric needs, a contract will be issued to provide podiatry services. Due to limited CHS funding, referrals to external providers is difficult. The services of a Podiatrist on-site will provide the much needed care.

II. OBJECTIVE:

A.

To provide one half (1/2) day of Podiatry services per week. The purpose of the work is to improve the overall health care status of the Native American population served. Most contacts are with patients receiving care and other health care providers at the facility level. The primary purpose of contacts is to provide direct patient care.

III.

PERIOD OF PERFORMANCE AND LOCATION:

A.

Services under this contract will be performed at the following location:

David C. Wynecoop Memorial Clinic

6203 Agency Loop Road

P.O. Box 357

Wellpinit, WA, 99040

In accordance with the statement of work, for the period of TBD in September, 2018 through August 30, 2019.

IV.

STATEMENT OF WORK:

A. Provides Podiatry clinic for ½ day each week – shown as a 4 hour clinic each scheduled day. Clinics will be held on days mutually beneficial to the Wellpinit - Indian Health Clinic, their patients, and the Podiatry services provider. Clinic will be held in the afternoon or morning (as mutually agreed upon) with patients scheduled in a manner necessary to best meet the needs of the patient and the productivity goals as determined by the Clinical Director. If the scheduled clinic falls on a Holiday, the clinic can be rescheduled.

B. Provides Podiatry services for a minimum of eight (8) patients per 4 hour clinic day. This requirement will be considered met, even if patient count is less than this level, if all available patients have been seen for that scheduled clinic day.

C. Services will include, but are not limited to, providing direct care to patients in a responsible, respectful and caring manner. Professional duties include:

· thorough examination, assessment, and treatment of the patient’s foot

· general evaluation of the foot and associated disorders

· nail care to include temporary callous, corn, or wart paring or removal

· treatment of chronic ulceration’s

· individual or group education related to foot care

· patient education will be documented in the patient’s medical record

· all necessary covered services within the medical specialty of Podiatry

· because of the significant diabetic population in the community, special emphasis on the needs of those patients is requested, especially in the prevention of loss of digits or limbs secondary to this condition

D. Community duties include, but are not limited to; normal care and maintenance of Podiatry equipment and supplies; normal care and maintenance of work area; proper processing of all associated patient records. These duties will not take precedence over direct patient care.

E. Provides orientation and in-service training for facility personnel and achieves their own continuing education requirements necessary for licensure.

F. Responsible for recording all patient care examinations and procedures in appropriate electronic and/or paper health records in compliance with clinic standards.

G. Under regulation at 42 CFR 36.24, the IHS must authorize payment for contract health services and may, as party of the authorizing process, refer patients to particular contract providers. In the event a patient is in need of additional Podiatry services which cannot be provided during the clinic (i.e., further work up, etc.), prior approval to refer is required for authorization and payment to be considered.

H. The Contractor shall provide all necessary resources (administrative supplies, transportation, personnel, and shall include applicable state and local sales or other taxes), as required, except as provided by the Government, to provide professional outpatient Podiatry services to eligible beneficiaries. Eligible beneficiaries are defined by the Wellpinit Indian Health Center’s policy and procedures. Specific supplies needed for clinic services are to be conveyed to the service unit management for procurement outside of this contract.

I. The Contractor shall provide Podiatry services in accordance with the Standards of Care established by recognized health care organizations including the Indian Health Service. All services shall be provided within accepted professional standards and be consistent with the Accreditation Association for Ambulatory Health Care (AAAHC) accreditation requirements. The contractor is required to maintain active participation in the Wellpinit Indian Health Center’s professional medical staff.

V.

INDIAN HEALTH SERVICE RESPONSIBILITIES:

A.

The Wellpinit Indian Health Center shall provide a patient examination area, all medical and non-medical equipment and supplies used in the Indian Health Service facility for the care of patients.

B.

The Wellpinit Indian Health Center shall provide nursing services to assist the Contractor as needed within the staff member’s position description and scope of practice.

C.

In partnership with the Contractor, the Wellpinit Indian Health Center will monitor and evaluate the quality and appropriateness of patient care, and identify and correct deficiencies in the quality of care.

D.

The Podiatrist shall be provided with an orientation to the Indian Health Service and the Indian Community being served. This orientation will include, but is not limited to, introduction to the Electronic Health Record (EHR), Resource Patient Management System (RPMS), and other programs and packages necessary to fulfill provider obligations under this contract. The initial orientation and continuing orientation shall be provided by Wellpinit Indian Health Center personnel.

E.

The Medical Secretary or Medical Records office at the Wellpinit Health Center will be responsible for scheduling appointments. At a minimum eight (8) appointments a day will be scheduled per clinic. This requirement will be considered met and attained if all available patients for that clinic day have been scheduled and seen.

F.

The Wellpinit Indian Health Center reserves the right to cancel a Podiatry clinic due to illness, vacation, or emergency of the Contractor or to natural or unforeseen circumstances at the Wellpinit Indian Health Center.

VI.

QUALIFICATIONS:

A.

The contractor shall maintain as a minimum:

· Be a graduate of an accredited Podiatry school.

· Three (3) years experience in the field of Podiatry.

· A current and unrestricted license to practice Podiatry.

· Hold a current and unrestricted license to practice in the State of Washington.

B.

The contractor shall have, at a minimum, the following experience:

- Experience working in a primary care outpatient clinic setting

- Experience providing care to patients within the Regional area

- Experience using an Electronic Health Record System C.

The contractor shall complete, sign and return the attached forms:

· Certification Of Immunization (Attachment I)

· Declaration of Employment (Attachment II)

· Agreement To A Temporary Waiver of Character Investigation (Attachment III)

· Certification of Education, Licensure and Insurance (Attachment IV)

· Representations, Certifications, and Other Statements of Offerors (Attachment V)

· HIPPA Agreement (Attachment VI)

· SF-85 and SF-87, as required.

D.

The Contractor must meet the Wellpinit Indian Health Center’s requirements for Credentialing and Privileging as stated in the Medical Staff By-Laws (attached).

VII.

DELIVERABLE & REPORTING REQUIREMENTS:

A.

TAXES

The contractor will be responsible for all applicable Federal, State, and local taxes and duties. The contractor shall submit quarterly reports due 15 days after the quarter is complete, but no less than on an annual basis, giving evidence that the contractor has made payment of their employment taxes. Internal Revenue Service Forms 941 & 941-V, are the recommended forms. Contractor shall contact local IRS for assistance. The quarter end dates are as follows:

1) 1st quarter – April 15

2) 2nd quarter – June 15

3) 3rd quarter – September 15

4) 4th quarter – January 15

The forms shall be evidence that the contractor has made payment of the contractor’s employment/income taxes and shall be used by the Government to determine contract compliance. Failure to meet this reporting requirement shall constitute non-payment and non-compliance and will be grounds for a cure notice, show cause and possible termination for default cause for suspension of performance or termination under the contract, at no-cost to the Government.

VIII.

ON-SITE CONTACT/SUPERVISION:

A.

The following individual or their designee shall serve as the Project Officer/Supervisor government representative under this contract:

Marcus Martinez – Chief Executive Officer Wellpinit Indian Health Center

P.O. Box 357, Agency Square

Wellpinit, WA 99040

Ph: (509) 258-4517 The Project Officer/Supervisor’s responsibilities will be to coordinate with the provider the technical aspects of this service and the review of performance hereunder. The Project Officer does not have the authority to change or alter the order amount, terms or conditions.

IX.

PAYMENT SCHEDULE:

A.

Payment is made on a per clinic service. No separate travel costs or payments shall be charged or paid for providing services on-site. The contract price includes full compensation for providing all services on-site. For example, the contractor is responsible for travel, lodging, applicable federal / state / local / sales and all other applicable taxes, etc.

B.

The Government is obligated only to the extent of authorized purchases actually made and received under this agreement. Payment for clinics that are not for the full 4 hour clinic duration shall be paid at a pro-rated rate calculated using the actual number of hours services are provided (rounded to the nearest ¼ hour) divided by the 4 hours of the scheduled clinic then multiplied by the per clinic price.

X.

INVOICING:

A.

Invoices shall be submitted to:

Marcus Martinez, Project Officer Wellpinit Indian Health Center

P.O. Box 357, Agency Square

Wellpinit, WA 99040

Ph: (509) 258-4517 ext. 109 Invoices are to be submitted bi-weekly. Payment shall be made only for clinics actually completed at time of invoice submission. Payment will be made by Electronic Funds Transfer. Please fill out the attached E.F.T. Form.

The following information must be included on the invoice as a minimum: Purchase Order Number, Contractor’s Name and Address, Contractor’s Employee Identification Number, DUNS Number, date clinic(s) was held, number of patient(s) encountered during clinic, Total amount due.

XI.

ADDITIONAL TERMS & CONDITIONS:

A.

SUBSTITUTE PROVIDERS

The Contractor may request the right to provide a substitute Podiatrist to cover a scheduled clinic when it is impossible for the Contractor to be in attendance due to illness or vacation. The proposed substitute must meet the qualification, credentialing and privileging requirements of the Wellpinit Indian Health Center and must be approved by the Contracting Officer and the Project Officer.

The proposed substitute must possess the same qualifications as specified in this contract prior to a scheduled clinic. Failure to possess or maintain such qualifications shall deem the offeror ineligible for award and cause the contract to become null and void at no cost to the Government.

B.

FEDERAL TORT CLAIMS ACT

Federal Tort Claims Act coverage for medical claims is extended to personal service contractors only when an incident if negligence is alleged to have occurred during delivery of services as provided by the contract in a facility, owned, operated, or constructed under the jurisdiction of the Indian Health Service, by the contract health care provider. Such tort claims coverage is extended to services provided within the scope of this contract.

C.

CREDENTIALING / CLINICAL PRIVILEGES / TERMINATION

If the contractor fails to meet or maintain the contract required qualifications, licensure, credentialing requirements or clinical privileges of the specific Indian Health Center the contract may be terminated without cost to the Government, and the contractor determined ineligible to contract and thus, the contract shall be void. This contract is valid only so long as the budget within the Wellpinit Health Clinic’s Contract Health Service account can maintain said service. Clinic’s can be cancelled and the contract vacated if the Wellpinit Health Clinic no longer has the financial availability to continue with such.

D.

CONTRACTOR GOVERNMENT FURNISHED EQUIPMENT AND FACILITIES

The Wellpinit Indian Health Center does not anticipate a need for contractor furnished equipment.

E. HIPPA REQUIREMENT

Pursuant to the Health Insurance Portability and Accountability Act (HIPPA) of 1996 and its implementing regulation, the Standards of Privacy of individual Identifiable Health Information at 45 C.F.R. Part 160 and 164, Subpart A and E (“Privacy Rule”), the Indian Health Service is required to enter into an agreement with the Business Associate, pursuant to which the Business Associate shall comply with and appropriately safeguard Protected Health Information (“PHI”) that it will use and disclose when performing functions, activities or services (“Services”) for the Indian Health Service. The Business Associate by signing the contract shall comply with the following terms in addition to other applicable contract terms and conditions relating to the safekeeping, use and discloser of PHI. (See Attachment VI for related HIPPA material and Business Associate Agreement Clause)