SOW.pdf

STATEMENT OF WORK

Title of Service: Orthopedic Physican/Midlevel Clinic

Location: Northern Cheyenne Service Unit Lame Deer, MT

A. BACKGROUND:

Northern Cheyenne Service Unit (NCSU) is a PHS Indian Health Center that provides healthcare services to the Northern Cheyenne Indian Reservation.

B. OBJECTIVE / DELIVERABLES:

The Northern Cheyenne Service Unit is located in southeastern Montana and has a three year user population of approximatly 6,700. Clinics will be scheduled 3 times a month for 4 hours per clinic.

C. SCOPE OF WORK

Major Duties

The Orthopedic Provider Services shall be provided at the Northern Cheyenne Service Unit, PHS Indian Health Center, Lame Deer, Montana.

The purpose of the services shall be to provide comprehensive clinical medical care (education, prevention, curative, rehabilitative and emergency) at the scheduled Orthopedic Clinics.

Shall examine and diagnosis orthopedic related conditions of individuals presenting themselves for care; refers individuals for consultation when appropriate; prescribes and carries out, therapy, in conformance with approved clinical privileges and Billings Area/Indian Health Service policy.

Shall educate individuals on the nature of health related conditions, recommended therapy, and the general promotion of health and prevention of illness/disease. Assists, as able, in the orthopedic medicine students and other health professionals.

Shall make necessary referrals for further assessment of orthopedic conditions. Shall inform appropriate personnel of Purchased Referred Care (PRC) admissions as it pertains to referrals.

Shall record patient-provider transactions in the problem oriented medical record format and completes required data collection instruments, referrals, third party billing, and medical records as required.

Shall refer patients and their families to NCSU Health Services personnel, as appropriate, for their continued care and follow-up.

D. PERIOD OF PERFORMANCE:

Start Date: 12 months from date of award Option Year One (1): TBD Option Year Two (2): TBD Option Year Three (3): TBD Option Year Four (4): TBD

E. STANDARD REQUIREMENTS

The Contractor must possess a thorough knowledge of the orthopedic medicine. He/she must possess a specialized knowledge of the concepts, principles and practices of emergency medical obtained through the successful completion of a course of study leading to a degree of Doctor of Medicine, Osteopathy,or Family Nurse Practicioner or Physicain Assistant at an approved school, and the successful completion of post graduate training in an approved residency program.

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

The Contractor shall prepare and complete all medical and other required reporting documents as required by IHS procedural guidelines and policies.

The Contractor shall comply with all IHS facility infection control and safety procedures, practices and standards. The Contractor must maintain and demonstrate knowledge of and adhere to hospital and departmental safety regulations. The Contractor shall comply with the following requirements:

infection control, hazardous materials, safety, security, emergency preparedness, life safety, medical equipment and utilities in accordance with established management plans.

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 of 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. IHS shall provide training on the Freedom of Information Act and the Privacy Act. All IHS regulations and policies applicable to these Acts shall be enforced.

During the performance of the contract, the Contractor shall provide for the consistent performance of patient care processes according to the standards of the Accrediting Agency who supplies accreditation to the Northern Cheyenne Service Unit.

Available guidelines include DHHS, 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 providers judgment is the key factor in determining whether guidelines are to be adhered to or deviated from and whether new guides need to be developed to protect the interests of the patient.

F. WORKFORCE REQUIREMENTS

Knowledge of effective patient/family teaching. Knowledge of patient care services provided. Ability to communicate to and interact with persons (staff, health care professionals, community) with different functions, levels of knowledge and requirements to provide optimal health care. Ability to plan and direct the work of others. Knowledge of accreditation standards and safety standards.

Knowledge of, and ability to implement, universal precautions and other principles of infection control and aseptic technique. Knowledge of culture, customs, and health problems of the Native American population, with more specific knowledge of the Northern Cheyenne culture.

G. ASSUMPTIONS

The department supervisor defines the continuing assignment with procedures and methods to be used, priorities and deadlines. The department supervisor consults with the contractor on difficult or controversial aspects of the job requirement. The contractor uses initiative in planning and carrying out the day-to-day workload. Final work is reviewed, as needed, for conformance to policies and regulations, timeliness and satisfaction of the department supervisor. The following IHS employees will assist the project officer in monitoring the contract and will be designated as an alternate in absence of the supervisor.

SUPERVISOR: Physical Therapy Supervisor

ALTERNATE: Service Unit CEO

The responsibility of the Indian Health Service is to monitor and ensure that the contractor is adequately performing the requested services, deliverables, duties and responsibilities in accordance with the Statement of Work and performance standards for which they were hired to accomplish. The department supervisor will monitor work load, completeness of charts, timeliness of contractor, and peer review of the contractor's work output. Failure to maintain a positive working relationship with the NCSU staff and patients, maintain good, readable, records, in a timely fashion, and work within the scope of standard medical practice for an Urgent Care or Outpatient provider may result in termination of the contract.

H. GOVERNMENT-FURNISHED EQUIPMENT AND INFORMATION:

The Government will provide the facility at which the services will be provided. Support staff and assistance with secretarial tasks will be provided if available. Contractor will have access to general office supplies such as phone/fax/copier.

I. GENERAL QUALITY ASSURANCE

As part of the Quality Control and monitoring of the contract, the contractor will be evaluated on their performance and will be conducted in line with permanent IHS employees of similar standing. They will be based upon the review criteria as set forth in the solicitation and contained in their statement of work.