SOW.pdf

Template: Statement of Work (SOW)

1. PROJECT TITLE: Certified Nurse Midwife (CNM) Services at the Northern Cheyenne

Service Unit Lame Deer, MT.

2. BACKGROUND/PURPOSE: The Northern Cheyenne Service Unit is an ambulatory healthcare facility with a 24/7 urgent care department. We are located in southeastern

Montana, 104 miles away from the nearest urban city (Billings, MT). The outpatient department provides services to an average of 150 patients per day, many of which are for Women’s Health services. The volume and complexity of prenatal and women’s health issues exceeds the capacity of our current staff. In an effort to provide our patients with the most comprehensive and timely access to care for these issues we have utilized the services of a Certified Nurse Midwife group. This has allowed our patients, and more specifically our highest risk females, to access the specialty services they require without having to travel to Billings, MT. The purpose of this contract is to continue these specialty services to ensure our patients continue to receive the best care possible.

SCOPE: The overall scope of this contract is to select a Certified Nurse Midwife group(s) to provide direct patient care services at the Northern Cheyenne Service Unit in

Lame Deer, MT. In addition to midwife services the contractor must have the ability to consult/co-manage with an OBGYN or Maternal Fetal Medicine as needed to ensure comprehensive care for high risk patients. Telehealth visits may be used as appropriate.

3. APPLICABLE DOCUMENTS: Guidelines available include PHS, IHS, Billings Area, Service Unit, and Medical Staff regulations, policies, procedures, and by-laws. In addition, traditional and currently accepted medical practices are available in the form of specialty consultation, medical journals, and textbooks. In nearly all cases, however, the

CNM judgment is the key factor in determining whether guidelines are to be adhered to or deviated or whether guidelines need to be developed to protect the interests of the patient.

4. SPECIFIC TASKS: The Certified Nurse Midwife provides healthcare, counseling and education for families of childbearing years, women from menarche through menopause, for women with gynecological problems and also for normal neonates. Performs and/or reviews health histories and performs assessment of the woman during antepartum, intrapartum, and postpartum. Identifies indicators of risk in pregnancy and performs appropriate interventions. Performs routine laboratory, radiology, screening and therapeutic procedures.

Implements the nurse-midwifery plan of care within prescribed nurse-midwifery interventions and procedures as appropriate and in accordance with nurse midwifery care.

Prescribes appropriate medications and instructs patients effectively in their use during antepartum, intrapartum and postpartum. Refers individuals for consultation when appropriate; prescribes and carries out therapy in conformance with approved clinical privileges and Billings Area/IHS policy.

Educates individuals in the nature of health related conditions, recommended therapy, and the general promotion of health and prevention of illness/disease.

Conducts initial and periodic health examinations related to women’s health for finding physical defects in need of correction, and prescribes and implements remedial treatments required to correct these defects. Administers immunizations to patients in compliance with established IHS and Billings Area policy.

Makes necessary arrangements and authorizes admission of patients to the appropriate hospital. This includes authorization for admission to contract facilities for emergency medical care and surgery. Keeps the Service Unit Director, or designee, informed of

PRC (Purchased Referred Care) admissions.

Records patient-provider transactions in the problem oriented medical record format and completes required data collection, referrals, and medical records as required.

Documentation must be completed within 24 hours of the visit.

Assists in the provision of continuing education, on-the-job training, and orientation of

Indian Health Service and Tribal staff as required. Assists in the provision of technical/professional assistance to Tribal and community groups as required.

Refers patients and their families to MD's if necessary and Community Health Services personnel (PHN's, nutritionists, social workers, diabetic counselors, behavioral health and

WIC) as appropriate for their continued care and follow-up.

Participates, as required, in Service Unit/Area meetings to develop new, modify existing, and evaluate medical procedures and processes relative to assurance of quality patient care.

Administrative tasks such as pre-visit planning, charting and ensuring that all necessary updates to the patient’s medical record are completed in a timely manner may require the

CNM to access charts securely through a virtual private network (VPN) off site both before and after services are provided.

5. DELIVERABLES AND DELIVERY SCHEDULE: Contractor(s) will provide clinics once a week for a total of 52 (or 26 if two companies are selected) on site clinics per year.

Clinics will be scheduled from 9:00 to 15:30. If two companies are selected the rotation between which contractor(s) will be on site which weeks will be determined at the beginning of the contract. The weekly staff provided by the contractor will include one

Certified Nurse-Midwife and one support staff. If the volume of patients is such that additional staff are needed to accommodate appointment requests staffing may increase to two Certified Nurse-Midwives and two support staff. Additional staffing needs will be at the discretion of the contractor.

6. GOVERNMENT-FURNISHED EQUIPMENT AND INFORMATION: The department shall provide the contractor with office space including a desk, chair and office supplies.

The contractor will be authorized to use all areas of the facility made available to them.

The contractor must request clearance in order to access restricted areas of the facility, authorization must be granted and is to be used only for official business activities relating to job performance. The contractor will be authorized to use administrative and professional support personnel in carrying out their assigned duties and objectives. The contractor will be allowed to utilize copy machines, facsimile machines, and telephone services for duties that relate to official business activities and job performance. The contractor shall be given an orientation to the IHS role and the Indian community that is being served. The department will provide the contractor with standard and specialized equipment and supplies needed for the performance and delivery of services including the use of a computer. The department will provide the contractor with direction and proper workloads, which are appropriate with the normal day-to-day operations in the department.

7. PLACE OF PERFORMANCE: Services will be provided at:

Northern Cheyenne Service Unit

420 N. Cheyenne Ave

Lame Deer, MT 59043

For consultation with Maternal Fetal Medicine and Telehealth visits services can be provided with a combination of on-site Nurse Midwife and offsite consultation services.

8. SECURITY: Security standards that are required for the position include: Privacy Act

Compliance: Federal Employee Standards of Ethical Conduct Compliance: IHS

Standards of Ethical Conduct: Child care National Agency Check and Investigation

Compliance: Federal Security Identification Badge Request. It is the responsibility for the department to provide the necessary clearances to IHS computer systems as well as other security requirements needed for the contractor to perform their services. All computer security trainings must be completed prior to computer access being provided and must be maintained per IHS standards throughout the contract.