SOW - RFP 75H70422R00005.pdf

STATEMENT OF WORK

SOLICITATION # 75H70422R00005

Indian Health Service (IHS) Obstetric and Gynecologic Care and Consulting Services, Non-Personal

1 BACKGROUND

The purpose and function of the Indian Health Service (IHS) is to provide comprehensive health care services to American Indians and Alaska Natives (AI/AN) through the IHS hospital and clinic system. IHS seeks professional support to maintain and improve these services through the use of professional consultation site visits and provision of education and hands on training in the disciplines of Obstetrics and Gynecology (OB/GYN), Neonatal, and Women’s Health.

Site and program reviews and consultation are focused on assessing the content and quality of OB/GYN and Women’s Health care in sites under IHS supervision. Areas of need and staff questions identified during the site visits will be addressed by offering educational opportunities on site and at separate trainings and courses.

2 PURPOSE

The purpose of this contract is to obtain the services of a contractor: 1) to provide professional consultation usually in one IHS geographic area or one programmatic area per year to involve 3-5 site visits within that geographic and/or programmatic area and to provide follow-up consultation to at least one area, usually the area reviewed in the previous year; and 2) to develop, provide logistic support, and teach a course in OB/GYN, Neonatal, and Women’s Health, or provide other equivalent educational opportunities annually.

The IHS Chief Clinical Consultant for OB/GYN (CCC), in consultation with the IHS Chief Medical Officer and HQ Maternal Child Health and Women’s Health programs staff, shall determine each year the nature and extent of educational and consultative activities to be supported through this contract based on agency priorities, available funding, and relevant logistic factors.

3 SCOPE OF WORK

3.1 Women’s Health Consultation Site Visits, Follow-up and Reports:

3.1.1 Task 1 - Consultation Site Visits:

a. The contractor shall meet with the Contracting Officer Representative (COR) within 10 business days of contract award. The purpose of this meeting is to review IHS objectives, priorities, initiatives, and IHS program information, including standards to protect the privacy of individually identifiable health information and to maintain strong protections as defined in Privacy Rule’s provisions (such as during Electronic Health Record access and in compliance with the Health Insurance Privacy and Portability Act).

b. The Contractor shall conduct women’s health consultation visits, either in person or virtually or both, within a geographic or programmatic area identified by the IHS Chief Clinical Consultant for OB/GYN, in consultation with the IHS Chief Medical Officer and IHS HQ Maternal Child Health and Women’s Health Program staff. Three or more sites in the same region or programmatic area will be selected for review.

Representatives from the American College of Nurse- Midwives (ACNM), the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN), and the American Academy of Pediatrics (AAP) shall be included as appropriate in the consultative team carrying out the site visits. The practice and educational needs of the site will be considered when selecting an interdisciplinary team for each visit. Logistics, including arrangement of travel for all non-federal consultants to, from, and within the area, lodging, and procurement of meeting sites during the site visit will be supported by the Contractor. All national, state, local, and Tribal infection control guidance will be followed in conducting in person visits. Individual written reports of each site visit and a summary report and recommendations shall be produced by the respective teams. The report will include such areas as the summary of site findings, successes, challenges, and opportunities. The report will be sent to IHS Headquarters, the Area Director of each Area visited, the IHS Chief Clinical Consultant for OB/GYN, and senior leadership at the sites visited. The reports will be due to these officials no more than 8 weeks after the site visits are completed.

A site visit protocol will be developed to guide the visit and will include a review of summary data on deliveries by mode of delivery and outcomes, GYN surgeries, and other descriptive data on women’s health including domestic violence screening and counseling, mental health and substance use disorder services, breast and cervical cancer screening, and lactation services as appropriate to the focus of the review. A typical agenda would include on site or virtual program evaluation, consultation with National, Area, and Local IHS, Tribal, and Urban health facility staff, and a review of the site visit findings from each site with briefing of Area and National staff. Individual patient health records are reviewed to assess quality of care and adherence to national guidelines for evidence-based medicine as well as to assess the functionality of the EHR and/or paper records to support efficient and safe care. Individual demographic information or individually identifiable clinical outcome data will not be retained by the site visit team. The facility will be toured and clinical tools and resources assessed. Community based organizations related to women’s health will be invited to present and describe their linkage with the hospital and the services provided.

c. The Contractor shall arrange follow-up consultation with the Sites/Area visited approximately 6 months after the site visit is conducted. This follow-up may be on site, off-site, or conducted remotely, as appropriate to the issues identified in the original consultation and with direction from the IHS Chief Clinical Consultant for OB/GYN. Additional targeted site visits and/or consultation may be requested by the IHS Chief Clinical Consultant as time and funding allows. These activities will be reflected in the Annual Report supplied by the Contractor. Reports will be due to the offices cited above no more than 3 months after the follow-up is completed.

d. The Contractor shall maintain ongoing liaison relationships with the IHS Chief Clinical Consultant for OB/GYN, the IHS Chief Medical Officer, and IHS HQ Maternal Child Health and Women’s Health staff.

3.1.2 Task 2 - Continuing Education:

The Contractor shall provide continuing medical education in conjunction with the consultation visits to women’s health professionals. The Contractor shall collaborate with the review sites to request continuing education credits (CME & CEU) from the IHS Clinical Support Center and/or other appropriate CME & CEU-granting organization.

3.1.3 Task 3 – National Support for American Indian and Alaska Native Women’s Health:

The Contractor shall provide evidence of efforts to advance American Indian/Alaska Native (AI/AN) women’s health through the preparation of policy statements, publications, and/or presentations and exhibits at national and/or regional meetings. These efforts may include the publicizing of successful strategies being used in AI/AN women’s health programs around the country so that they may be adapted for use elsewhere. Activities may also include publicity of opportunities for employment with IHS, Tribal, and Urban Indian Health programs.

3.2 Educational Opportunities in OB/GYN, Neonatal and Women’s Health

Annual educational priorities will be identified by the Chief Clinical Consultant (CCC) for OB/GYN, in consultation with the IHS Chief Medical Officer and HQ Maternal Child Health and Women’s Health

Program staff. The goals will be to: 1) to assist IHS and Tribal health professionals to better recognize obstetric, neonatal, and gynecologic conditions and health problems, refine patient referral strategies, identify appropriate consultants, and provide comprehensive and culturally appropriate patient care consistent with national guidelines; 2) to enhance patient safety and reduce medical error through improved functioning of interdisciplinary perinatal/women’s health teams; and 3) to better recognize the psychosocial conditions which influence health outcomes and the public health programs which address these risks. The knowledge and expertise are to be gained through a combination of lectures and practical workshops.

The Contractor may conduct or collaborate in a women’s health course, or other educational events that cover knowledge and expertise in obstetric, neonatal, and gynecologic care appropriate for IHS and Tribal physicians, advanced practice nurses, and women’s health and perinatal nurses working at IHS and Tribal clinical care settings. The specific knowledge and expertise taught shall include interdisciplinary obstetric, neonatal, and gynecologic care, patient safety, and psychosocial conditions which influence health and which are especially relevant to the mission of the IHS. The course may include adjunct training such as ALSO (Advanced Life Support in Obstetrics), NRP, (Neonatal Resuscitation Program), and Buprenorphine/Medically Assisted Treatment waiver certification. All national, state, local, and Tribal infection control guidance will be followed in conducting in person training.

In the case of brief educational opportunities or those provided in collaboration with other educational entities at the direction of the CCC, task components may be rescaled or redefined, or responsibility shared with a collaborating entity. Such decisions will be made by the CCC, in collaboration with the contractor and the project officer to fit the circumstances and the funding available for the contract.

3.2.1 Task 1 – Planning Educational Opportunities:

The Contractor shall plan educational opportunities in collaboration with a planning committee including, as appropriate, the IHS Chief Clinical Consultant for OB/GYN, HQ Maternal Child Health and Women’s Health staff, ACNM and AWHONN consultants, and representatives of the Contractor. The planning is to include consideration of the prior courses and, at the discretion of the CCC, is to result in the following:

a. Development of the anticipated course structure and program outline

b. Faculty recruitment and assignment

c. Logistics arrangements

d. Planning for and collaborating in promotion of the course

3.2.2 Task 2 - Register Participants:

The Contractor shall, alone or in collaboration with other educational entities as noted in 3.2.1, develop and distribute the course brochure, which advertises the course and includes registration and tuition/tuition waiver information, to course participants. Register all course participants.

3.2.3 Task 3 - Course Curriculum:

The Contractor shall collaborate in the development of a course curriculum that addresses the unique and special primary care, obstetrics, gynecology, and neonatal needs of physicians, advanced practice nurses, and perinatal and women’s health nurses providing care to AI/AN patients and communities. The course curriculum must provide Category I Physician Continuing Medical Education credits and Nurse Contact hour credits commensurate with instructional time. Responsibility for educational credits may rest with the Contractor or with collaborating educational entities.

The planning committee will identify topics of highest priority to be addressed. These may include the following, as well as others that may be identified in the future as health care needs evolve:

Obstetrics:

a. Routine prenatal care (e.g., diagnosis, gestational age dating criteria, laboratory studies, fetal growth and development, and identification and referral of high-risk patients)

b. Antenatal genetic screening

c. Complications of pregnancy; including maternal, obstetric, and neonatal complications

d. Management of labor (e.g., fetal monitoring, recognition of abnormal labor patterns)

e. Childbirth, including attention to postpartum hemorrhage and other complications

f. Postpartum care

g. Best practices for regionalized care, stabilization, and transfer

h. Nurse-Midwifery and Perinatal Nursing best practices

i. Traditional birthing practices

j. Obstetric and Rural Maternity Safety

k. Lactation Support

Gynecology and Women’s Health:

a. Common problems in gynecology including gynecologic infections, pelvic pain, and cervical and breast cancer screening.

b. Family planning concepts and methods, including infertility services

c. Management of abnormal bleeding, amenorrhea and menopause

d. Management of gynecologic emergencies such as spontaneous abortion and ectopic pregnancy

e. Behavioral health best practices including screening, initial management, and referral

f. Screening and primary care management of chronic diseases common in AI/AN women.

g. Care for survivors of sexual assault and domestic violence

h. Identification and management of substance use disorder.

Neonatology:

a. Newborn assessment.

b. Transport: indications, stabilization, records.

c. Immunization.

d. Problems in the first weeks of life.

Patient Safety:

a. Team building and communication strategies to improve team function

b. Creating a culture of patient safety

c. Strategies to support patient safety and reduce medical errors

3.2.4 Task 4 – Develop and Distribute Course Training Materials:

The Contractor shall develop or procure, as appropriate, training materials for educational offerings. The training materials and training agenda, etc., may be distributed to participants in advance of the course to aid participants’ preparation for the course. Additional relevant literature may be displayed during the course/conference or given to attendees at that time.

3.2.6 Task 5 - Provide and Orient Course Faculty/Consultants:

The Contractor shall provide faculty members/consultants who have nationally recognized expertise in the topics and issues to be presented. When possible, these specialists shall be fully acquainted and familiar with the unique challenges of obstetric, women’s health, and neonatal care in IHS, Tribal, and Urban Indian Health settings. Faculty may include physicians, advanced practice nurses, nurses, and others with appropriate expertise in the subject matter to be taught and/or specialists practicing in regions with a high concentration of IHS and/or tribal facilities.

The Contractor shall arrange all travel and reimbursement for the faculty members/consultants to be supported by the contract; expenses incurred by any additional faculty members/consultants who are specifically provided by IHS or any entity other than the contractor are to be supported by IHS or their sponsoring entity.

The concurrence of the IHS project officer or his/her designee and IHS Chief Clinical Consultant for OB/GYN must be obtained prior to utilization of non-government specialists. The federal government will provide qualified IHS faculty on an as available basis, as deemed appropriate, and the Contractor may coordinate, with the project officer or designee, the selection of IHS faculty. Note: All travel, transportation, and per diem costs of the IHS- provided faculty and course attendees (physicians and nurses) will be reimbursed by the government in accordance with federal travel regulations.

3.2.7 Task 7 - Offer Educational Opportunities:

The Contractor may collaborate in the offering of educational opportunities (e.g. course, conference, or shorter focused educational opportunity) at suitable sites. These may include Advanced Life Support in Obstetrics (ALSO), Neonatal Resuscitation Program (NRP) and Substance Use Disorder/Buprenorphine Waiver training. The Contractor shall, alone or in collaboration with other educational entities, arrange the required lecture hall, the smaller seminar-style rooms for the concurrent workshops, skills practice areas, and the appropriate audiovisual equipment. The Contractor may coordinate availability and use of necessary equipment (i.e. laptops/projectors) with which to conduct and facilitate the course. The Contractor may provide opportunities for active individual participation and practical hands-on experience.

3.2.8 Task 8 - Provide Educational Evaluation Instruments:

As appropriate for each educational event, the Contractor shall prepare a course evaluation instrument, designed to permit the assessment by each attendee, to evaluate the quality of each session presented. The responses of the attendees are to be collected into a summary course evaluation document and included in the final report.

3.2.9 Task 9 - Final Report:

The Contractor shall prepare an annual report, completed in both electronic and hard copy format, encompassing all of the activities performed to prepare, develop and present the educational opportunities.

The report shall be submitted to the project officer within 3 months following completion of the contract year.

INSPECTION AND ACCEPTANCE

The COR, as a duly authorized representative of the Contracting Officer, shall assume the responsibilities for monitoring the Contractor's performance, evaluating the quality of services provided by the Contractor, and performing final inspection and acceptance of all deliverables and services called for by the contract.

Performance Based Quality Assurance Surveillance Plan

The Contractor shall provide services in such a manner as to meet the highest standards of professional ethics and conduct, particularly in regard to confidentiality and patient rights, including standards to protect the privacy of individually identifiable health information and to maintain strong protections as defined in Privacy Rule’s provisions (such as during Electronic Health Record access and in compliance with the Health Insurance Privacy and Portability Act). If at any time during the term of this contract, the Government suspects unprofessional behavior, the Contractor will be contacted and concerns addressed.

Technical Exhibit A – Performance Requirements Summary (PRS)

Performance Objective

Performance Standard Acceptable Quality Levels

(AQL)

Surveillance Method / By Whom

3.1.1 (b) Report(s) provided NLT 8 weeks after each respective site visit.

Report is received late twice during the period of performance.

COR

3.1.1 (c) Arrange follow up consultation with the sites/areas NLT 6 months after site visit is conducted.

Dates of consultation received late three times during the period of the performance.

COR

3.1.2 Provide continuing medical

education to women health professionals.

Continuing education delayed twice during the period of performance.

COR

Technical Exhibit B – Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Medium/Format Submit To

3.1.1 (a) Completed NLT 10 days after award.

Report provided NLT 5 days after Post Award conference.

Electronic and Hard Copy

COR

3.1.1 (b) Report(s) provided NLT 8 weeks after each respective site visit.

Electronic and Hard Copy

COR

3.1.1 (c) Report(s) provided NLT 3 months after consultation has been provided per site/area.

Electronic and Hard Copy

COR

3.1.3 Evidence of policy statements, publications, and/or presentations and exhibits at national and/or regional meetings which may include the publicizing of successful strategies being used in AI/AN women’s health programs around the country so that they may be adapted for use elsewhere must be provided in the final report.

Electronic and Hard Copy

COR

3.2.4 The training materials and training

agenda, and advertisement provided NLT 1 month before the scheduled training.

Electronic and Hard Copy

COR

3.2.8 The course evaluation instrument, designed to permit the assessment by each attendee, to evaluate the quality of each session presented be available NLT 1 month before the training. Report included in the final report.

Electronic and Hard Copy

COR

3.2.9 An annual report encompassing all of the

activities performed to prepare, develop and present the educational opportunities.

The report shall be submitted NLT 3 months following completion of the contract year.

Electronic and Hard Copy

COR