SOW - OCAO Mobile Mammography Version 2.doc

STATEMENT OF WORK

STATEMENT OF WORK (SOW)

Independently, and not as agent of the Government, the Contractor shall provide the personnel and supplies, except as may be otherwise provided herein by the Government, to provide the following services:

a. On-site screening mammography service

b. Diagnostic interpretation

c. Consultation services

d. Continuing Education

e. Reporting

A. On-Site Mammography Services

Contractor shall provide mobile on-site screening mammography services at the respective Indian Health Service (IHS) and tribal facilities, to include:

1. The screening examination shall include at a minimum, cephalocaudal and lateral views of each breast. The mammography procedures and equipment must be state of the art.

2. The film shall be developed in the contractor’s mobile unit while the patient waits in the mobile unit.

B. Written Diagnostic Interpretation

1. The Contractor shall perform interpretation of radiographs taken at the IHS/tribal facilities.

2. The Contractor shall not be required to provide interpretations of any radiograph determined by this judgment not technically satisfactory for definitive mammography study and interpretation.

3. THE IHS WILL NOT PAY FOR ANY EXAMINATION DETERMINED TO

BE UNSATISFACTORY BY THE RADIOLOGIST.

4. The mammography radiographs shall remain the property of the Government. The contractor shall provide the film to the respective IHS/tribal location within seven (7) working days of the examination.

C. Consultative Services

1. The contractor shall provide professional verbal and written consultation as appropriate to the IHS/tribal facilities committees, as may be requested by the respective Standing Committee Chairman in implementing compliance with The Joint Commission (TJC) Standards.

2. The consultation shall be provided within 24 hours upon request of the respective

IHS medical staff and shall include but not limited to:

a. Interpretation of diagnosis

b. Analysis and interpretation of pathological findings

c. Radiological assessment and diagnosis

d. Advisement of additional diagnostic examinations

e. Development of therapeutic plans

D. Continuing Education

The Contractor shall provide an on-going scheduled program or continuing education for medical staff as part of the facility in-service continuing education program.

1. Education shall be directed to the experience of the staff. Topics shall be mutually agreed upon by the contractor and the Contracting Officer’s

Representative.

2. The Contractor shall provide video and printed mammography education materials for patients seen in the mobile van. In-service education shall be performed during regular scheduled clinics.

E. Reporting

The Contractor shall provide interpretation and completed dictation of all mammography examinations for each IHS facility on-site visit.

1. Significant pathological findings and interpretation shall be provided and brought to the attention of the requesting IHS/tribal physician by telephone.

F. Transcription

The Contractor shall provide typed transcription of mammography reports on Government required forms or format.

1. Typed and signed reports shall be available to the medical staff within seven (7) working days of the examination and in compliance with TJC Standards.

G. Consultation and Continuing Education The Contractor shall include brief summary of consultation and continuing education activities provided as a part of the description of services included in the Monthly Report of Services.

H. Invoicing

The Contractor shall provide all of the above services and invoice the IHS using a Unit fee.

1. The “Unit for Payment” shall be the mammography examination. The fee charged for the individual mammography examination is inclusive for all services provided in this contract.

2. The “Unit Fee” shall be the same at each IHS/tribal facility within the respective Price Schedule.

EQUIPMENT SPECIFICATIONS AND PROFESSIONAL QUALIFICATIONS

A. Minimum Equipment Specifications

1. The mobile mammography service and programs shall be accredited by the American College of Radiology.

2. The radiographic mammography equipment shall be registered and inspected by the Radiation Division of the Oklahoma State Department of Health (OSHD).

3. The radiology organization (Contractor) shall be required to: (1) participate in the annual performance testing program conducted by the OSHD and must meet all minimum standards established by the Radiation Division, Consumer Protection Service of the OSHD and (2) shall maintain a stringent Quality Control Program.

4. The on-board X-ray unit shall be designed for and dedicated to low dose mammography examinations.

5. The mobile van shall have an on-board film processor. The processor shall have a three minute processing cycle.

6. The mobile van shall have an on-board electrical generator which supplies all power requirements for the X-Ray unit, film processor, and television.

7. The mobile van shall have a back-up system to provide electrical power that is compatible with the IHS/tribal facilities.

8. The mobile van shall have steps and a ramp for patients to access on-site services. The ramp and steps must be secured to the mobile van and provide adequate safety for patients entering the mobile unit.

B. Personnel Qualifications

A radiologist with the following:

1. A current, valid and unrestricted license to practice medicine in the State of Oklahoma.

2. Maintain certification in diagnostic radiology by the American Board of Radiology during the period of the contractual agreement.

3. Possess unrestricted diagnostic radiology privileges at a TJC accredited facility.

4. Provide documentation within the last 18 months of acquired continuing education specific to mammography and interpretation of a minimum of 800 mammography films.

5. Provide written evidence of mammography Quality Assurance studies and/or activities conducted under his/her direction from a TJC accredited facility.

6. Prior to award of the contract, radiologist must apply for and be granted consultant medical staff privileges in Radiology specific to mammography by the Governing Board of the Oklahoma City Area IHS.

Evidence of all minimum equipment specifications and professional requirements shall be provided to the contracting officer prior to the award of contract.

INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

A.

It is expressed, agreed and understood that this is a non-personal service contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the contractor are rendered in its capacity as independent contractor. The government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of services rendered, including by example, the contractor’s professional medical judgment, diagnosis, or specific medical treatments. The contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts for omissions by it or by its employees or agents. The Contractor shall maintain liability insurance issued by a responsible insurance carrier in the amount of not less than $1,000,000.00 per occurrence during the term of this contract, $3,000,000.00 aggregate.

B.

An apparently successful offeror, upon request by the Contracting Officer shall furnish prior to contract award evidence of its insurability concerning the medical liability insurance required by paragraph (A) of this clause.

GOVERNMENT FURNISHED FACILITIES/EQUIPMENT

The Government will provide the HIS/tribal facilities for use by the Contractor in performance of the contract. The facilities shall include a parking area and, if required, the patient clinic area within the facility. The Government will provide an acceptable back-up power source (electrical receptacle) at all screening locations at no cost to the Contractor. All other mammography services shall be performed in the Contractor mobile unit.

CONTRACTOR FURNISHED FACILITIES/EQUIPMENT/SUPPLIES

A. The Contractor shall provide a mobile unit specifically designed for mammography screening which is completely self-contained with on-board electrical source.

B. The Contractor shall provide educational material necessary for provision of a continuing education program as may be requested by the facility staff.

C. The Contractor shall provide educational materials for use by the mammography patients (i.e. video tapes and limited printed material).

SCHEDULE OR SERVICES AND PRICES/COST

Price Schedule 1

This schedule includes the following Oklahoma City Area (OCA) IHS facilities: El Reno and Watonga, and tribal facilities: Newkirk and Ponca City (White Eagle). The estimated yearly volume is given.

Option Bid Schedule-Year 2

This schedule includes the following OCA IHS facilities: El Reno and Watonga and tribal facilities: Newkirk and Ponca City (White Eagle). The estimated yearly volume is given.

Option Bid Schedule-Year 3

This schedule includes the following OCA IHS facilities: El Reno and Watonga, and tribal facilities: Newkirk and Ponca City (White Eagle). The estimated yearly volume is given.

Option Bid Schedule-Year 4

This schedule includes the following OKC IHS facilities: El Reno and Watonga, tribal facilities Newkirk and Ponca City (White Eagle). The estimated yearly volume is given.

Option Bid Schedule-Year 5

This schedule includes the following OCA IHS facilities: El Reno and Watonga, and tribal facilities: Newkirk and Ponca City (White Eagle). The estimated yearly volume is given.

A. Hours of Operation

The work schedule, exclusive of Federal Holidays, shall be 8:30 A.M. to 4:30 P.M., Monday through Friday.

1. The day, starting time and length of the on-site visits to the IHS/tribal facility shall be established by mutual agreement between the contractor and the IHS Contracting Officers (COR).

2. The contractor shall provide rotating, on-site visits to the IHS/tribal facilities, to ensure that the total estimated number of examinations, by facility, shall be performed during the period of the contract.

B. Rotating Schedule The initial rotating on-site visits to, and from the IHS/tribal facilities, once established, cannot be changed without the IHS COR’s authorization and Contracting Officer’s approval.

C. Mammography Examination The Contractor shall provide on-site mammography examinations utilizing a mobile van at the IHS facilities.

D. Film Interpretation

The Contractor shall provide mammography film interpretations with the interpretative report being returned to the IHS facility within seven (7) working days of the examination.

E. Consultative Services

The Contractor shall provide professional consultation to the respective IHS Medical Staff.

REPORTING REQUIREMENTS

The Contractor shall submit to the COR the following items in the quantities stipulated and within the time frames identified below.

A. Technical Reports

TERM DESCRIPTION

QUANTITY

DATE

1. Monthly Narrative Progress Reports Original plus two (2)

10 days following

In accordance with paragraph ‘a’ copies .

last day of month below.

2. Monthly invoices in accordance Original plus two (2)

10 days following accordance with paragraph ‘a’ copies.

last day of month below.

3. Special Reports as required by

Original plus two (2)

As specified.

the Contracting Officer.

copies.

a. Monthly Narrative Progress Reports shall cover services provided during reporting period and shall briefly present the following information for each service component required in the contract. Reports shall be submitted with monthly invoice and shall include the following:

(1) A comparison of actual services provided with requirements established and the level of services provided that can be readily quantified.

(2) Problems encountered and circumstances, if any, adversely affecting delivery of services.

b. Monthly invoices shall be submitted on Contractor’s stationery and shall reflect signature of dully authorized agent of the Contractor. Invoices shall include itemized listing of all procedures performed, patients name, patient’s chart number, charges, and dates of service.

c. Special reports may be requested by the Contracting Officer during the contract on technical or administrative aspects of contract performance.

Requests for such reports will be provided in writing to the Contractor stipulating information required, time frames for response, and instructions on submissions.

Monthly invoices and Monthly Narrative Progress Reports shall be submitted to the

COR at the respective IHS facility.

OTHER FACTORS

The Contractor shall have adequate staff, facilities and equipment to provide the required mammography services to the IHS.

Performance Conditions

The Contractor shall provide the capacity to perform all services specified herein for the IHS. In any event of the Contractor’s absence, it shall be the responsibility of the Contractor to provide equivalent alternate service at a rate not to exceed the negotiated contracted rate. The Contractor shall notify the IHS facilities at a minimum of 24 hours prior to the absence. The alternate Radiologist must, (1) meet the same professional qualifications, (2) be approved by the IHS Area Board and (3) have staff privileges at the IHS prior to performance of services. The failure of the Contractor to provide such capability may be grounds for termination for default under the default clause of the contract.

The Contractor shall deliver to the Government such reports, items, services as specified in the Reporting Requirements. The Contractor shall also make such reports to the Government as called for by the COR.

Quality of Care

The Contractor shall provide proper and adequate radiology services which shall include compliance by the Contractor with applicable standards of the American

College of Radiology.

Quality of professional services provided shall be at a level commensurate with standards of the medical professional in general and of the American College of Radiology.

The Contractor shall perform the work described in this contract independent of Government supervision. Professional surveillance of services under this contract will be provided by the designated Contracting Officer’s Representative.

Contractor shall be required to participate in regular scheduled activities of the Continuous Quality Improvement Program of the IHS facility in coordination with the IHS facility Radiology Supervisor for services provided under this contract. The Continuous Quality Improvement Program for contracted mammography services shall meet the minimum requirements of The Joint Commission.

Review and Inspection

The OCA IHS Chief Medical Officer (CMO); Area PRC Officer; Director, Laboratory and Radiology Services; designated representatives of the contracting facility; and the Area Contracting Officer shall have the right to, (1) review and inspect the Contractor’s operations prior to award of contract to determine capability of Contractor to provide professional services required by the contract and (2) review and inspect the Contractor’s facility and operations during the performance of this contract.

In preparation of proposal, Contractor may review the contracting IHS facility’s Radiology Department upon not less than three working days prior to telephone request to the Radiology Supervisor at the respective IHS facility.

Pre-Performance Conference

Subsequent to award of contract and prior to beginning of services, the Contractor may be required to attend Pre-Performance Conference to be held at the OCA, IHS, 701 Market Drive, Oklahoma City, OK, 73114 for the purpose of acquainting the Contractor with all technical, administrative aspects and requirements of the contract.

Quality Control

The Contractor shall be responsible for monitoring and evaluating the safety, quality, and appropriateness of mammography services provided and shall maintain the quality control program to maximize the quality of diagnostic information available.

The Contractor must establish and maintain an effective working relationship with the medical and radiology staffs, and facility administration.

As part of the facility’s Continuous Quality Improvement Program, the quality and appropriateness of mammography services provided by the Contractor will be monitored and evaluated, and identified problems will be resolved. (TJC Manual, Diagnostic Radiology Services). The Contractor shall be responsible for cooperating with IHS in assuring that the process is implemented and maintained.

Two (2) radiology audits are required yearly. The Contractor shall perform one of the audits and the Government shall perform one audit, all of which shall be performed in accordance with the following:

1. The audit shall include assessment of the appropriateness of the radiographic examination being ordered by the clinicians. The Contractor shall develop the criteria for the mammography service. The criteria shall be submitted to and approved by the Area Chief Medical Officer within 60 days of ward contract. The results of this study/audit shall perform topics for continuing education for the respective IHS medical staff.

2. The audit shall include as a minimum, an assessment of the quality of clinical interpretation of radiographic film of the contract radiologist.

The complete audits shall become part of the IHS facility’s quality assurance program.

Contract Coordination and Administration

In order to provide continuity of services, the Contractor shall designate someone to be available and responsible for day to day coordination and communication with IHS staff to:

a. Provide administrative and professional consultation,

b. Schedule continuing education for personnel, and

c. Discuss any problems that may arise.

Evidence of designation and description of the Contractor’s delegated authority shall be provided to the Contracting officer prior to award of the contract.

All on-site visits shall be scheduled by mutual agreement of the Field Contracting Officer’s Representative and Contractor.

ACCEPTABLE QUALITY LEVELS (AQL)

1. Required Service

Standard

Acceptable Quality Level

Diagnostic Report

Diagnostic Report

Not more than two Instances availability.

available within per month of late reports.

TJC time frame.

2. Availability of Continuous telephone Not more than two

Radiologist. consultation available. instances per month of inability to consult.

JUSTIFICATION FOR REQUEST FOR OPTION FOR RENEWAL CLAUSE

It is requested that subject contract include an option for renewal clause (for four additional years at one-year intervals) to meet Government’s need for continuity of services, in this case, continuity of pathology services and to prevent any interruption of this specialty type of medical service. Interruption of this service would greatly diminish the ability of the respective IHS facilities to maintain acceptable levels of patient care.

The requesting facilities have contracted for these services over a number of years and will continue to require similar services beyond the first contract period; therefore, follow-up procurement of this type will be required. This can be accomplished through use of an option for renewal clause which will alleviate the potential costs and inconveniences, both administrative and medical, of disrupted services. Further, it will afford the advantages ensuing from familiarity on the part of the provider with local procedures and operations of the respective facilities as a result of performances of the initial contract.

The Government reserves the right to terminate this contract or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work.

The Assistant Area Director for program Services and the CMO have reviewed this request and provided assurance that there is a reasonable certainty that IHS funds will be available after the initial year to permit exercise of an option for renewal subject to approval by the Contracting Officer.

The Contracting Officer is advised that all locations are agreeable to the additional year options. Price schedules for exercise of second, third, fourth, and fifth year pre-priced options are attached.