SOW - Claremore Pediatric Cardiology.docx

Department of Health and Human Services Indian Health Service Claremore Indian Hospital

Statement of Work (SOW) Pediatric Cardiology Clinic and Monitoring

1. PURPOSE OF THE PROJECT

The Claremore Indian Hospital (CIH), Indian Health Services (IHS) has a requirement for non-personal services to provide Pediatric Cardiology clinics on-site. As set forth in FAR 52.216-21, Requirements (OCT 1995), the services shall be ordered and the funds will be obligated on individual "Purchase-Delivery Order for Health Services" forms. Services include: high risk pediatric patients consultative services, cardiovascular surgical follow-up care, identification of vascular problems, recommendations regarding follow-up care, patient education, pediatric primary care referrals, and all other cardiology care services as seen appropriate by vendor.

2. DETAILED DESCRIPTION OF THE TECHNICAL REQUIREMENTS

2.1. The contractor shall perform work that requires professional medical judgment by a Pediatric Cardiology Physician Specialist to provide medical care to pediatric patients referred to the Pediatric Cardiology Clinic for cardiovascular diseases and related problems of the cardiovascular system. Services include: Pediatric Cardiology consultation services for pediatric cardiology patients, cardiovascular surgical follow-up care, identification of vascular and cardiac problems, with recommendations regarding follow-up care, patient education, pediatric primary care referrals, and all other cardiology care services as seen appropriate by vendor. Services will be provided in half day clinics every other month of contract period (one year) with 10 to 12 patients routinely scheduled.

2.2. CIH will provide space and will schedule patients utilizing the hospital electronic scheduling system. A clinic will consist of between 10 to 12 patients scheduled on half day six times per year (once every other month). Patients will be scheduled appropriately with consideration given for the hours of service and complexity of patient need. Clinic dates and times will be determined and agreed upon by both parties 45 days in advance.

2.3. The contractor shall work closely with hospital providers, nurses, pharmacy and other staff at the facility to provide accurate, quality and timely medical care while performing pediatric cardiology services at the Claremore Indian Hospital on a contractual basis. The physician shall advise and counsel patients on health related issues and assure appropriate medical care is delivered. Performs physical examinations, health assessments, interprets electrocardiograms and provides treatment to patients with varying problems associated with cardiovascular disease. The vendor shall recommend necessary arrangements in concert with active medical staff physicians for admission of patients to the appropriate hospital, which includes authorization for admission to contract facilities for emergency medical care, or any major surgical procedures not provided at the Claremore Indian Hospital. The consultant pediatric cardiology specialist shall also recommend appropriate screening and diagnostic tests and procedures, including but not limited to laboratory, radiographic examinations, echocardiograms, and or ultrasonography exams, and shall record patient - provider encounters in the chart in manner for accurate communication between providers and completes required documentation for accurate billing, ordering of diagnostic tests and referrals. The Contract Consultant shall complete medical records per hospital policy and shall participate in quality assurance measures as appropriate including peer review. The contract physician shall be required to enter patient data, purpose of visit, indication, treatment plan, in the Electronic Health Record system either by direct entry or by dictation using the Claremore Indian Hospital dictation services.

3. PERIOD OF PERFORMANCE

The base year Period of Performance will be 12 months from date of award with four (4) twelve (12) month option years.

Base Year :

Option Year 1:

Option Year 2:

Option Year 3:

Option Year 4:

4. LEVEL OF EFFORT

4.1. The contractor shall be under the supervision of the Clinical Director and the Chief of Pediatrics and will be expected to comply with all hospital policies and procedures.

4.2. The contractor shall read and interpret Holter monitoring reports provided by CIH.

4.3. The contractor shall perform work that requires some physical exertion and stamina including walking, standing, bending, sitting and other activities

4.4. In cases where the contractor has to cancel scheduled clinics, CIH is to be notified at least 14 days in advance in order to notify patients. Cancelled clinics will be rescheduled the following month or an alternate agreed upon time. Patient encounters will be documented in accordance with established hospital policies and procedures.

4.4.1. The contractor shall submit a plan which outlines a course of action, should personnel become ill or be unable to carry out scheduled clinic dates. The Contractor shall reschedule cancelled clinics for the following month to meet patient demand and assure timely patient access to service.

5. SPECIAL REQUIREMENTS

5.1. In accordance with HHSAR 304.1300(b) non-routine contractor employees shall comply with OPDIV DHHS/SE Region – Human Resources, Security Clearance Guidance – Visitors (3/29/12) policy for contract performance period. Contractor employees will be required to obtain a visitor’s pass upon arrival for services from Facilities Management.- (Security Clearance for on-site human services)

5.2. The US PHS Claremore Indian Hospital is a tobacco/smoke free environment (buildings and grounds). No tobacco/smoking use shall be tolerated during service.

5.3. Security Requirements: Contractor personnel will be required to contact the government designated point of contact upon arrival when reporting for service calls or delivery supplies. The contractor shall be responsible for the security of all organizational information. Current rules and regulations applicable to the premises, where the work shall be performed shall apply to the contractor and its employees while working on the premises. These regulations include but are not limited to, escort by Claremore Indian Hospital official, presenting valid identification, smoking restriction and any safety procedures.

5.4. The contractor shall not disclose or cause to disseminate any information concerning operations of Claremore Indian Hospital. Such action(s) could result in violation of the contract and possible legal actions.

5.4.1. All inquiries, comments, or complaints arising from any matter observed, experienced or learned of as a result of or in connection with the performance of the contract, the resolution of which may require the dissemination of official information, shall be directed to the government’s designated representative.

5.5. Termination Amortization Schedule: A termination amortization schedule shall be included as an attachment of the awarded contract. If the Government does not exercise any of the options listed in the price / cost schedule, the Government’s not exercising the options will have the same effect as if the Government terminated for convenience. All remedies afforded to contractor in regards to a termination for convenience shall be available to the contractor.

5.6. Computer Security: Pursuant to the Federal Information Security Management Act of 2002 (FISMA), the contractor will be required to complete a course in Computer Security Awareness Training (CSAT). This training must be completed annually by all employees including contractors, volunteers, students, and summer externs. The Contractor will be required to comply with the Federal Information Processing Standards Publication (FIPS PUB) Number 201, "Personal Identity Verification of Federal Employees and Contractors," and the associated Office of Management and Budget (OMB) implementation guidance for personal identity verification for all affected contractor and subcontractor personnel. Access/clearance to all pertinent computer systems, including completing a Business Partner Interconnection Security Agreement (BPISA), should be coordinated with the Site Manager.

5.7. All hospital safety procedures and infection control policies are to be adhered to by the contractor. Those vendor employees or agents that provide services within this facility working hours are required to develop familiarity with the CIH Safety and Disaster Emergency Policy and Procedures. The information shall be provided to vendors during the pre-performance conference.

5.7.1. This include infection control measures include, but are not limited to:

5.7.1.1. Rubella immunity must be documented either by serologic test or proof of immunization.

5.7.1.2. A Yearly PPD is required for all persons who have had no previous positive tuberculin skin test.

5.7.1.3. Documentation of immunization for Hepatitis B.

5.7.1.4. Meeting Joint Commission requirements.

5.7.1.5. Following universal precautions.

5.8. Contractor shall be required to develop familiarity and abide by current policies, procedures, by-laws, and regulations of clinical and medical staff of Claremore Indian Hospital. These are available upon request from the Clinical Director at CIH, telephone 918-342-6200.

5.9. The vendor shall be required to perform services in compliance with applicable standards of The Joint Commission.

5.10. The contractor shall also comply with all CMS and HIPAA regulations.

5.11. The Privacy Act of 1974 mandates that the Contractor maintain complete confidentiality of all administrative, medical and personnel records, and all other pertinent information that comes to his/her attention or knowledge. The Privacy Act carries both civil and criminal penalties for unlawful disclosure of records. Violation of such confidentiality shall be cause for adverse action. All IHS regulations and policies applicable to these Acts shall be enforced.

5.12. Contractors cannot serve as expert witnesses in any suit against the Federal Government.

5.13. CHILD CARE NATIONAL AGENCY CHECK AND INVESTIGATION (CNACI)

5.13.1. A CNACI must be completed for all Indian Health Service (IHS) contractor personnel within the Billings Area. Public Law (P.L.) 101-630, Indian Child Protection and Family Violence Prevention Act and P.L. 101-647, Crime Control Act of 1990, require the IHS to conduct a character and criminal history background investigation on all contractors performing services in IHS facilities. The Service Unit will conduct the character and background investigation. Fingerprints must also be taken as part of the pre-employment process and must be completed before the physician is allowed to work. The fingerprints and access/clearance to all pertinent computer systems should be coordinated with the Service Unit.

5.14. IHS shall periodically evaluate the performance, professional skills and professional attitude of contractor’s staff both visually and through documentation review via Focused and Ongoing Peer Review by the Chief of Pediatrics as per Medical Staff Credentialing standards. The Contractor shall make provision whereby unsatisfactory performance of contractor staff will be addressed and resolved in a timely manner. If unsatisfactory performance cannot be resolved the contractor will provide replacement personnel and the replacement shall be made within a period mutually agreed upon between the Contractor and IHS.

6. DELIVERABLES AND REPORTING REQUIREMENTS

6.1. Contractor Point of Contact: The contractor shall furnish one designated point of contact (POC) to the government’s designated representative for coordination of supplies, delivery, and/or maintenance. The POC will be empowered to make daily decisions to ensure that the contract implementation and day-to-day maintenance meets the terms and conditions of this contract.

6.2. Contractor’s Phone Numbers: The contractor shall provide a toll-free telephone number for calls, which must be answered during at least eight working hours, between 8:00 am and 4:30 pm, Monday through Friday.

6.3. Personnel Qualifications:

6.3.1. Specialized knowledge and specialized training in the practice of Pediatric Cardiology is required. The Contractor shall provide personnel who are appropriately licensed by any state to provide such service. The contractor shall be expected to provide a copy of appropriate licensure and comply with all hospital policies and procedures while practicing on-site.

6.3.2. The Practitioners must have a D.O. or M.D. degree with a specialty in Pediatric Cardiology and requires Medical Staff Membership (By-Laws) in the consult privileges category.

7. GOVERNMENT FURNISHED PROPERTY, FACILITIES AND SERVICES

7.1. The Government shall supply space and will schedule patients utilizing the hospital electronic scheduling system.

8. CONTRACTOR FURNISHED PROPERTY, FACILITIES AND SERVICES

8.1. Required personnel, materials, supplies and equipment: The contractor shall furnish all personnel, materials, supplies and equipment required to perform work under the contract.

9. CHANGES TO THE STATEMENT OF WORK (SOW)

Any changes to this SOW shall be authorized and approved only through written correspondence from the Contracting Officer. Costs incurred by the contractor through the actions of parties other than the Contracting Officer shall be borne by the contractor.

10. INVOICING AND PAYMENT:

10.1. 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.

10.2. Invoice Submission

10.2.1. The contractor must submit an invoice for services rendered to:

Oklahoma City Area Indian Health Service Office of Financial Management Attn: Denise Karr 701 Market Drive Oklahoma City, OK 73114

With courtesy copy to:

Claremore Indian Hospital Attn: Rebecca Staten 101 Moore Ave Claremore, OK 74017 Phone 918-342-6433 Fax 918-342-6436

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

Vendor Name Invoice Date Purchase Order Number Description of Services Quantity of Services Cost Payment terms Where practicable, name, title, phone number, and complete mailing address of responsible official to whom payment is to be sent.

10.3 The United States Government is obligated only for the authorized services listed in this document. Any modification to this contract shall require prior approval by both parties before any additional obligations of the Government are incurred.

11. ADDITIONAL INFORMATION

11.1. Guidelines available include DHHS, PHS, IHS, Oklahoma Area IHS, CIH and Medical Staff regulations, policies, procedures, and bylaws as well as recognized current published Pediatric Cardiology guidelines. In nearly all cases, however, the medical practitioner's judgment is the key factor in determining whether guidelines are to be adhered to or deviated or whether new guidelines need to be developed to protect the interests of the patient.

11.2. WORK ENVIRONMENT:

The work is performed in a clinical setting and is environmentally controlled.

11.3. The COR shall be responsible for: (1) Monitoring the Contractor's technical progress, including surveillance and assessment of performance and recommending technical changes; (2) Interpreting the Statement of Work; (3) Technical evaluation as required; (4) Technical inspections and acceptance; and (5) Assisting the Contractor in the resolution of technical problems encountered during performance of this contract.

12. PERFORMANCE MATRIX

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