SOW - Claremore Cardiology Clinics.doc

STATEMENT OF WORK

CARDIOLOGY CLINIC SERVICES

Purpose:

The purpose of this request is to contract for a Cardiologist to provide cardiology clinic services on-site at the Claremore Indian Hospital, 101 S. Moore, Claremore OK 74017.

Background:

The services of a cardiologist providing an in-house clinic will be beneficial for patients residing in the Claremore Service Unit instead of utilizing the contract health system to an outside vendor.

PROCEDURES:

The contractor shall provide Cardiology services as deemed necessary to evaluate and treat eligible patients residing in the Claremore Service Unit. Clinics will be by appointment only. The Cardiologist will perform an evaluation of cardiovascular diseases, order labs in EHR as necessary and interpretation of EKG’s done in-house. The Cardiologist will, when necessary, recommend referral to in-house specialties or referral for higher level of care or diagnostics. Referrals to outside vendors will be in conjunction with a staff physician and will utilize the contract health system. Documentation of services provided will be in accordance with standard clinic practice and applicable to all regulatory guidelines. Cardiology Clinics will be scheduled as one (1) full day per week to equal 4 days per month based on facility need and Cardiologist availability.

Work Schedule/Period of Performance The period of performance is one year from beginning of award date, with an option for 4 additional years. Actual start date is subject to credentialing and negotiations.

Work Schedule

1. Contractor will schedule in advance full day clinic schedules based on facility needs and the vendor’s availability.

2. Contractor will complete orientation prior to beginning work.

3. Full day clinic hours will be scheduled from 8:00 AM through 4:30 PM.

4. Clinics dates will be scheduled 4 months in advance and if cancelled due to vendor unavailability will be rescheduled within 30 calendar days.

Project Officer:

The Project Officer representing the Government for the purpose of this Contract will be Kimberly Hale, 101 S. Moore Claremore, Oklahoma 74017. Telephone 918-342-6201.

QUALIFICATIONS OF CONTRACTOR PERSONNEL:

The Contractor shall assure that all personnel are appropriately licensed and trained to provide cardiology services. The contractor shall provide Cardiologists that are Board Certified in their field or the appropriate licensed personnel working under the direction of a Cardiologist. Contract is contingent on Cardiologist being contracted, credentialed and privileged by the Claremore Service unit Medical staff through the Claremore Service Unit Medical Staff bylaws.

SPECIAL TERMS AND CONDITIONS:

Contractor shall maintain the security of patient data and comply with the Privacy

Act of 1974.

Minimum Qualifications:

The contractor shall have a permanent, current, full and unrestricted license to practice medicine in a state, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. The providers shall have expertise or experience in cardiology care by practical experience, must have completed an accredited residency training program in Cardiology or board certification in Cardiology, though board certification is not required, the contractor will need to have the ability to order labs, and referrals in EHR.

FAILURE OR INABILITY TO PERFORM SERVICES:

The Contractor shall submit a plan which outlines a course of action, should the vendor be unable to carry out the duties outlined within the contract.

EVALUATION OF TECHNOLOGISTS:

Claremore Indian Hospital shall periodically evaluate the performance and professional quality of services provided through documentation review. The Contractor shall make provision whereby unsatisfactory performance will be addressed in a mutually agreed upon manner. The contractor shall perform quality assurance activities that are acceptable to the Facility’s Accreditation body regarding Cardiology services.

REFERENCE MATERIAL:

The vendor shall be required to develop familiarity and abide by current policies, procedures, by-laws, and regulations of clinical and medical staff of the Claremore Indian Hospital in regards to documentation and safe guarding of patient information. These are available upon request from the Clinical Director at the CIH 101 S. Moore, Claremore, OK 74017.

EXTENT OF OBLIGATION:

The United States Government is obligated only for the authorized services listed in Item

A and B. Any modification to this contract will require prior approval by both parties before any additional obligations of the Government are incurred.

NEGOTIATED AUTHORITY:

The appropriate contract authority is 41 USC 253.

INVOICES:

An original invoice shall be submitted upon completion of services to:

Oklahoma City Area Indian Health Service

Division of Financial Management 701 Market Drive Oklahoma City, OK 73114 With a courtesy copy to:

Claremore Indian Health Center

Attn: Kimberly Hale

101 S. Moore

Claremore, OK 74017

(918) 342-6201 Vendor understands the Government pays only for the actual service performed.

The Vendor agrees to include the following information on each invoice:

1.

Vendor name

2.

Invoice Date

3.

Purchase Order number

4.

Description of services

5.

Quantity of services

6.

Cost

7.

Payment terms

8.

Where practicable, name, title, phone number, and complete mailing address of responsible official to whom payment is to be sent.

INVOICE PAYMENT:

Payment will be made on this contract as close as possible to, but not later than thirty (30) calendar days after an invoice containing the information set forth in the invoice submission article of this contract is received in the payment office designated in this contract. An invoice will be deemed received on the latter of:

The date the invoice is actually received in the designated payment office, or the date on which the government accepts the property or the services required under this contract. Unless a different time period is stated elsewhere in this contract, inspection/acceptance required by this contract will be complete by the government not later than five (5) Government working days after the services are rendered. Payment shall be made within thirty (30) days after the last day of the month during which this invoice covers.

FAR 52.224.2 PRIVACY ACT (APRIL 1984)

(a) The Contractor agrees to:

(1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and regulations issued under the Act in the design, development, or operation of any system of records on individuals to accomplish an agency function when the contract specifically identifies---

The systems of records; and the design, development or operation work that the contractor is to perform.

Include the Privacy Act notification contained in this contract in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract requires the design, development, or operation of a system of records on individuals that is subject to the Act; and

(2) Include this clause, including this subparagraph (3), in all subcontracts warded under this contract which requires the design, development, or operation of such a system of records.

(b) In the event of violations of the Act, a civil action may be brought against the agency involved when the violation concerns the design, development, or operation of a system of records on individuals to accomplish an agency function, and criminal penalties may be imposed upon the officers or employees of the agency when the violation concerns the operation of a system of records on individuals to accomplish an agency function. For purposes of the Act, when the contract is for the operation of a system of records on individuals to accomplish an agency function, the Contractor is considered to be an employee of the agency.

(1) Operation of a system of records, as used in this clause, means performance of any of the activities associated with maintaining the system of records, including the collection, use, and dissemination of records.

(2) “Record,” as used in this clause, means any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and that contains the person’s name, or identifying number, symbol, or other identifying particular assigned to the individual, such as a fingerprint or voiceprint or a photograph.

(3)“System of records on individuals,” as used in this clause, means a group of any records under the control of any agency from which information is retrieved by the name of the individual of by some identifying number, symbol, or other identifying particular assigned to the individual.

CONTACT WITH INDIAN CHILDREN

Individuals providing a service which involves regular contact with, or control over, Indian children, are subject to a character investigation. IHS personnel offices will conduct these investigations following award of non-personal services contract unless in the judgment of the Contracting Officer, in consultation with the Personnel Officer, investigation may be waived based on prior investigations on file. Until the Contracting Officer has been notified of the result of the investigation, such individuals shall not have unsupervised contact with Indian Children.

Kimberly Hale

Inpatient Pharmacy Technician

Chief Executive Officer