Statement of Work 2024 Podiatry.pdf

STATEMENT OF WORK

It is the intent of the Elko Service Unit, hereafter referred to as ESU, to acquire non-personal professional Podiatry Physician Services for the Southern Bands Health Center, hereafter referred to as the “Service Unit” located in, Elko, NV.

Contractor is requested to provide non-personal professional Podiatry Physician Services for a 12-month base period and four (4) 12-month option periods. The intent of this contract is to establish a method whereby the Elko Service Unit can minimize disruptions in clinical service because of staff changes and shortages projected over the next 5 years. Also, even when the best plans are laid to hire and retain staff, the remote location makes this difficult and staffing shortages happen despite trying to hire a full-time employees. Requests for contractor coverage will be based on the consistently changing needs of the clinic on an on needed basis.

The contractor shall provide the necessary education, training, licensing, previous work experience and competence in being able to provide the services within the department. Work performance shall be performed according to the requirements and conditions contained in this Statement of Work.

All responses to this solicitation and for candidate submission shall contain a complete profile and current work history of the candidate(s) presented, including licensure, certifications and education.

Selected candidate shall undergo the Indian Health Service mandated security clearance requirement prior to commencement of services at the CRSU. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check of candidates through the office of the inspector general's exclusion list at http://exclusions.oig.hhs.gov/.

SCHEDULES/LOCATIONS/SHIFTS/QUALIFICATIONS/CERTIFICATIONS:

SCHEDULE:

Shift times and schedules are subject to change based on the medical needs of the patient populace and hospital/clinic operations. The contracted services will augment the current full-time staff.

Podiatry Physician: Working hours is to be decided between Medical Director and Contractor.

Day Shift: 8:00 A.M. – 5:00 P.M. (0800 - 1700), Monday through Friday

LOCATION: All services shall be performed at the following location;

Southern Bands Health Center 515 Shoshone Circle Elko, NV 89801

WORK WEEK: Work week is defined as Monday through Friday.

SHIFTS: Contractors will be expected to abide by the facility’s Uniform Code and shift hour assigned, modalities of charting and care delivery and other rules and regulations of the facility.

Work within a designated schedule prepared by the Indian Health Service’s Clinical Director or his/her designee. Any period of absence or changes in the schedule will be communicated with the Southern Bands Health Center staff or his/her designee 14 days prior, except for emergency situations.

http://exclusions.oig.hhs.gov/.%20D

Total shifts worked shall be in accordance to the total number of work hours allocated for the year by Southern Bands Health Center. The Service Unit shall make every effort to submit a schedule two (2) weeks in advance. Shifts may be canceled or shortened without time restriction or monetary penalty before the physician arrives for duty.

It is estimated the Southern Bands Health Center will require services 4 hours per week. A total of 16 hours per month is required to provide services.

NOTE: The duration of each shift may vary due to patient load, clinical complexity, weather and other circumstances. An estimated patient volume of 6-8 patients in one 4 hour period.

Contractors shall attend assigned meetings, participate fully as staff members, and actively participate in ongoing quality management activities and any other Southern Bands Health Center or Indian Health Services initiatives deemed applicable to the specialist’s work.

QUALIFICATIONS/CERTIFICATIONS:

Education:

Training:

Experience:

Licensure:

Certification:

Insurance:

Privileges:

Physician shall have four (4) years of accredited medical school leading to DPM doctorate level diploma.

Physicians must have completed a Podiatry medicine residency.

The specialist should have at least two (2) years of current Podiatry specialty medicine experience.

Physician must have an active and unrestricted license to practice medicine in the State of Nevada or one of the other 49 states in the United States or the district of Columbus, or the Commonwealth of Puerto Rico.

BLS (Basic Life Support) is required.

Medical malpractice liability coverage.

All contract physician(s) shall be formally granted clinical privileges in Podiatry Medicine by the ESU and Southern Bands Health Center Governing Body or Executive Committee prior to assuming clinical responsibilities.

1. PRICING SCHEDULE:

The unit price paid to the Contractor shall be considered as payment in full for services provided at the Service Unit under this contract. In no way, unless directed by the IHS, shall any provider attempt to bill or collect from any IHS patient, or from any alternate resource for which the patient may be eligible, any monies for services provided under this contract.

Services shall be inclusive of all other fees (holiday; nights; weekends) including travel expenses, per diem, lodging, all city, state, federal and local taxes, and all miscellaneous costs associated with the provision of services.

Contractor shall be paid only for actual time services are performed under the terms of the contract at the fixed price rate. The quantities are estimated hours and estimated totals not to exceed.

See Attachment A, Rate Schedule, for inputting bid amounts.

2. STATEMENT OF WORK:

The contractor shall be expected to assist and provide services and duties as may be requested for the normal operational requirements for the department and personnel. The contractor shall provide work that is consistent with the guidelines and procedures of the IHS. Failure of the contractor to meet these standards can result in cancellation of this contract. The contractor’s performance and abilities shall be evaluated based upon performance standards that are contained in this statement of work.

The contractor shall prepare and complete in a timely fashion, the medical and other required records for all parties he/she admits or in any way provides care for the hospital or health care facility (Service Unit Medical By-Laws). Documentation in the patient’s health record are to be completed on the day services are rendered. During the performance of their duties, the contractor shall provide for the consistent performance of patient care processes according to the standards for TJC accreditation program within IHS. These standards include: The Comprehensive Accreditation Manuals for Critical Access Hospitals, and the Laboratory Standards as they represent the scope of services of this contract.

The contractor shall possess a professional medical education from a post-secondary academic institution or be licensed in a field of medical study as detailed in Attachment D. The contractor should be proficient in writing, typing and have a basic working knowledge and understanding of computer hardware and software applications. The contractor shall have sufficient knowledge, competence and experience in providing these services on a regular schedule to the Southern Bands Health Center. The contractor shall possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that the contractor can relate constructively to IHS employees, contractors, vendors and individuals from the Native American community. The contractor shall not have any work or health restrictions, which could directly or indirectly interfere with the performance of providing services. The contractor shall maintain acceptable standards of personal hygiene, grooming and professional attire such that their image as a Federal contract employee is compatible with the expectations of the IHS staff.

The contractor shall be required to utilize the electronic health record for chart documentation, after receiving training at Government expense.

The Contractor’s employee(s) shall be sensitive to the unique culture factors of the people they treat, which may include use of an interpreter as necessary in communication of services being rendered. Unique cultural factors that may contribute to the patient’s treatment include: use of their language communications; village and tribal customs; use of traditional healers; isolation;

housing conditions and lack of resources.

3. CONDITIONS FOR REMOVAL/REPLACEMENT OF MEDICAL PERSONNEL:

As mutually agreed between the Contracting Officer and the Contractor there may be grounds for removal and/or replacement of a Contractor employee. The Contractor’s employee shall be removed from an IHS facility if services are not performed in accordance with terms and conditions of this contract.

The Contractor shall request government pre-approval to substitute or replace any of the Contractor’s employee of which it has provided qualifications and resumes under this contract. All Contractor-requested substitutes or replacements’ qualifications, experience and professional certifications must be at least equal to or greater than the original Contractor’s employee provided by the Contractor under this contract.

4. CONTRACTOR REQUIREMENTS:

For Medical & Professional Contractors, the contractor shall comply with all IHS facility infection control and safety procedures, and standards. During the performance of this contract, the Contractor shall provide for the consistent performance of patient care process according to the standards of The Joint Commission (TJC) and/or Centers for Medicare Services (CMS) who supplies accreditation to the Phoenix Area Indian Health Service hospitals and health centers. These standards shall include: The Comprehensive Accreditation Manual for Critical Access Hospitals, and the Laboratory Standards as they represent the scope of services of this contract.

For Medical& Professional Contractors, the contractor shall complete in a timely fashion, the medical and other required records for patients he/she admits or in any way provides treatment. Chart notes are to be completed on the day services are rendered. The contractor shall abide by the Service Unit Medical By-laws and rules and regulations and meet all credentialing requirements in accordance with the Service Unit Medical Staff By-laws. If required by the Service Unit, the IHS will provide training for the Contractor’s employee on Electronic Health Records (EHR). Failure to abide by this requirement is basis for cancellation of this contract. Medical Records will be the property of the U.S. Government and will be placed in each patient’s chart at the health center. The Medical Records shall not leave the premises.

Medical records used for patients treated by the Contractor’s employee shall conform to the Privacy Act and Standards for Patient Confidentiality. An unauthorized disclosure from a person’s record, protected by the Privacy Act, may be subject to a penalty of up to $5,000 per incident.

The Contractor shall be responsible for notifying the Southern Bands Health Center staff in case of an emergency or inclement weather that would prevent him/her from providing his/ her schedule/shift.

The Contractor shall contact the Indian Health Service’s Clinic Director and be responsible for all documentation required for eligibility and temporary staff privileges at Health Center.

The Government will provide all space, equipment, supplies and forms to perform services.

The Contractor shall not be authorized to perform any services for the Government until the IHS Governing body has granted the Contractor such privileges in writing. Federal contract employees do not accrue any form of retirement, social security, insurance or any other form of benefits.

The Contractor shall assist and provide services and duties as may be requested for normal operational requirements for the department and personnel. The Contractor shall provide work that is consistent with the guidelines and procedures of the IHS. Failure of the Contractor to meet these standards can result in the cancellation of the contract.

The Contractor shall have sufficient knowledge, competence and experience in providing these services on a regular scheduled clinic at Southern Bands Health Center. The Contractor shall possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that the Contractor can relate constructively to IHS employees, Contractors, patients, clients and individuals from the Native American Community.

The Contractor shall inform the COR, Contracting Officer or Program Manager or their designated representative of any problems encountered or which may be encountered in connection with meeting the needs of the Contractor’s duties.

The Contractor shall not have any work or health restrictions, which could directly or indirectly interfere with the performance of providing services as there will be some moderate lifting with regard to boxes of office supplies, boxes of medication, and equipment.

The Contractor shall maintain acceptable standards of personal hygiene and grooming such that their image as a Federal contract employee is compatible with the expectations of the IHS staff.

The Contractor shall be required to provide regular report of hours worked to the Designated COR with an invoice. This report shall be verified by the Indian Health Service’s Clinic Director, or, his/her designee, that can confirm the coverage.

If the Contractor is a locum tenens company, the Contractor(s) shall designate an individual who will be the “Project Manager” that will be available to discuss any problems or issues that arise with the COR.

The Contractor shall obtain and maintain, at his/her own expense, all state and/or medical licenses, registrations or certification required in the performance of the contract, and shall comply with all laws, regulations, (Federal, State, Tribal and respective hospital) ordinances in the performance of this contract.

Pursuant to the Federal Information Security Management Act (FISMA) of 2002 the Contractor shall complete the Computer Security Awareness Training (CSAT) course before computer access is provided or within a few days after receiving their access and annually after that. Within the Health and Human Services (HHS), there is a requirement for this training to be completed annually by all employees that includes the Contractor.

MAJOR DUTIES REQUIRED:

Specific work duties and services that the contractor shall provide under this contract shall include, but not be limited to the following:

A. Performs professional work involved in the care and treatment of the feet, ankles and legs, including in the prevention, diagnosis, and treatment of diseases and disorders by physical, medical, and/or minor surgical methods.

B. Non-Surgical:

1. Diagnosis

a) Interpretation of diagnostic imaging studies of the feet, ankles and legs.

b) Interpretation of laboratory studies required for podiatric care.

c) Biomechanical examination lower extremities.

d) Other standard diagnosis including patient history and physical examination.

2. Treatment

a) Non-surgical podiatric care including examination, consultation, and non-invasive procedures (i.e. casting, splinting, taping, manipulation, orthotics, shoes).

b) Injection or aspiration of medication or liquid.

c) Prescription and/or application of topical medications in the treatment of pathology of the feet, ankles and legs.

d) Prescription of oral medications in the treatment of podiatric pathology.

e) Prescription of parenteral medications for the treatment of podiatric pathology.

f) Record pertinent data, enter orders and post-procedure notes in the medical record.

g) Document and sign EHR progress notes and orders in a timely manner.

h) Document ICD and CPT codes in an accurate and timely manner.

i) Completion of scheduled patient care before departing at end of shift.

C. Surgery and Procedures

1. Closed reduction of dislocations and fractures of the foot and ankle.

2. Debride wounds and ulcers of the foot.

3. Treatment of flatfoot including surgical.

4. Treatment of the tendons and ligaments of the foot and ankle.

5. Treatment of foot and ankle fractures including Salter Harris.

6. Completion of procedure permits.

7. Debride toenails and calluses.

8. Toenail removal, total or partial, simple or chemical.

9. Closure of lacerations.

10. Removal of foreign bodies or implanted materials.

11. Performance of procedures as granted in privileges.

D. Contractor(s) serve as a Medical Officer (Podiatry Medicine) which involves performance of Ambulatory Medical Treatment for emergency, surgical and medical care services, at Southern Bands Health Center located in Elko, NV.

E. The contract physician(s) of this position are designated as staff Medical Officer (Podiatry Medicine) who provides direct care and services in the specialty area of Podiatry Medicine.

F. Assignments include providing comprehensive and continuing health and medical care services for adult and pediatric patients. The incumbent is expected to handle the full range of cases and problems in specialty, including the very difficult and complex. Cases are sometimes critical and require immediate decisions. Incumbent also functions as consultant specialist to Southern Bands Health Center medical personnel and to physicians at Indian Health Service field hospitals. Participates in teaching activities as needed.

H. Provides emergency care as required, by interviewing (if possible) and examining any and all patients seeking care. Contract physician(s) review past medical history, and immediately requests and/or performs diagnostic tests and examinations deemed necessary to obtain all possible information related to each case.

I. Contract physician(s) make preliminary diagnosis, directs, prescribes or provides treatment, or arranges for specialized care or patient referral as required. Physician(s) base medical decisions upon information obtained and professional medical knowledge and skills. Contract physician(s) makes notes of observations and incorporates these into clinical records. Contract physician(s) provide definitive management, in all medical categories, for cases that do not require a referral. The provider gives total patient care including prevention, developing patient care plans, health maintenance, early diagnosis, providing instruction/counsel, treatment, and follow-up services to patients under his/her care.

J. The contractor physician(s) shall comply with all ESU and Southern Bands Health Center policies and procedures. The physician(s) shall prepare and complete, in a timely fashion, the medical and other required records for all parties he/she admits or in any way provides care for the hospital or health care facility (Service Unit Medical By-Laws).

During the performance of their duties, the contractor(s) shall provide for the consistent performance of patient care processes in accordance with the CMS Conditions of Participation and EMTALA, and the Joint Commission. The physician(s) shall also adhere to the Comprehensive Accreditation Manuals for Hospitals, The Laboratory Standards and Ambulatory Care Standards as they represent the scope of services of this contract. The Indian Health Service is moving toward a 100% use of the electronic health record (EHR). Once the emergency department is converted over to this electronic health record the contract provider(s) shall use the system for documentation. At that time, Southern Bands Health Center will provide training to all physician providers on the use of the EHR.

K. Provider(s) conducts services, making observations appropriate to the patient’s underlying disease and treatment plan. Physician(s) review the patient’s medications, diet therapy course, and management plan. The provider modifies regimen as indicated.

Physician instructs and counsels patients and family members as required.

L. Contract physician(s) refer patients to appropriate contracted medical (or other) facilities, providing full clinical information for care and diagnostic procedures that cannot be adequately provided at local IHS facilities. Coordinates and integrates information obtained into the ongoing Health Care Program at the Service Unit and assures timely follow-up care as required. Contract physician(s) also complete all necessary paperwork for Contract Health Services for all patients referred.

M. Contract Physician(s) work closely with allied health professionals (i.e., nursing, Community Health Nurse, Social Workers, Health Educator, etc.) to utilize and coordinate the services of Health Care Professionals in the management of the patient’s medical, psychological and social problems.

N. All contract physician(s) shall be formally granted clinical privileges in Podiatry Medicine by the ESU and Southern Bands Health Center Governing Body or Executive Committee prior to assuming clinical responsibilities.

O. Supervision: The contract physician(s) shall provide guidance and instruction to all midlevel providers that work in the podiatry department during each shift worked. The contract physician shall perform his/her professional work independent of Government supervision. However, matters of an administrative and non-technical nature will be referred to the Parker Indian Health Center’s Clinical Director and his/her designee. For the purposes of this order, the Indian Health Service’s Clinic Director is designated as the “Supervisor”.

P. Schedule: The contractor shall record time and attendance which shall be verified by the supervisor and/or his/her designee.

Q. Contractor shall ensure that proposed providers cooperate with and assist the Government in conduction of any necessary background checks.

5. CONTRACTOR MINIMUM REQUIREMENTS:

All Contractors/Contractor Employees working at the Southern Bands Health Center shall adhere to the following:

1. Professional Degree as a Doctor of Podiatry Medicine (DPM).

2. Required Board Certification in Podiatric Primary Care or Podiatric Surgery.

3. Expert knowledge in the area of Podiatry specialty medicine. Provider must be board certified by the American Board of Podiatric Surgery or American Board of Podiatric Primary Medicine.

4. An active and unrestricted license to practice in the state of Nevada or, one of the other 49 states in the USA, in the District of Columbia, or in the Commonwealth of Puerto Rico.

The specialist should have at least two (2) years of current Podiatry specialty medicine experience.

5. The Contractor shall meet the same credentialing/privileging requirements as permanent IHS medical officers before being allowed to provide physician services for the Southern Bands Health Center. Physical and mental health status with sufficient adequacy to demonstrate to the medical staff and the Governing Body that any patient treated by him/her will receive care at the generally recognized professional level established by Southern Bands Health Center.

6. All contractors shall present an original current license when reporting to the Southern Bands Health Center for duty or for orientation whichever comes first. A copy is required for the contract file. No reimbursement will be made for those individuals who report to work with an expired license or a license that is not in good standing.

7. Contractor is subject to a character investigation in the performance of the contract in accordance with P.L. 101-630, Indian Child Protection and Family Violence Act of 1990.

8. All contractors must provide a copy of their resume for file. Contractor file will be kept by the Southern Bands Health Center for verification of license or certificate, also file will contain personal information such as home address, phone number, next of kin, person to notify in case of emergency, health requirements, mandatory in-service and continuing education, competency assessments, and awards or disciplinary action.

9. Contractor is responsible for maintaining satisfactory standard of competence, conduct, appearance and integrity. The quality of work performance of the contractor shall be subject to review.

10. Contractor shall abide by the Service Unit’s Standard of Conduct and policies and procedures. Contractor shall adhere to the guidelines for his/her behavior and action as outlined in Service Excellence Guidelines to enhance relations between employees, departments, patients, patient’s families and visitors. The contractor shall abide by the bylaws, rules and regulations, general conduct of care, and Policy & Procedures set forth at CRSU and Southern Bands Health Center.

11. Contractor shall abide by the lawful ethical principles of his/her profession.

12. Contractor/Contractor Employees is responsible for notifying their immediate supervisor and Project Officer if he/she will be late or will be unable to work due to illness or any other reason.

13. Contractor is compensated only for scheduled hours actually worked at the agreed rate.

Contractors who become sick while on duty will seek medical care from their own private physician, unless contractor is eligible to receive health care from Indian Health Service.

14. Contractor/Contractor Employees is responsible for completing time sheets for actual hours worked which shall be verified by the Indian Health Service’s Clinic Director or his/her designee.

15. Contractor shall subject his/her performance to the hospital’s Quality Improvement Program, in accordance with the requirements of the Joint Commission, the responsible peer review organization and external regulatory agencies.

16. If the performance of a contractor employee is unacceptable, the Federal Government retains the right to restrict further employment of the physician.

17. Clinical privileges are documented in writing, signed and granted by the Chief Executive Officer and Clinical Director, and formally approved by the Governing Body.

18. Contractor shall ensure that proposed providers cooperate with and assist the Government in the conduction of any necessary background checks.

19. The contractor(s) shall attend a Southern Bands Health Center orientation and all Contractors, Students, Volunteers and Temporary Staff are required to provide immunization records as proof of immunity or disease for MMR, Varicella, Hepatitis B or declination form, Hepatitis B titer for staff with potential for contact with blood or body fluids, seasonal influenza vaccine (October-March), Tdap and two TB Skin tests with results administered in the past 12 months, one must be within 30 days prior to the start date. Persons with LTBI are required to complete the TB screening form and will be referred to the Employee Health Provider. Meningococcal is required for microbiology staff who are routinely exposed to isolates of Neisseria meningitides, boosters are needed every 5 years if the risk continues. Volunteers, contractors, students and temporary staff without proof of immunity or vaccination cannot report to duty, be scheduled into orientation, or be issued a badge until the immunization status has been confirmed.

Employee health creates a file for all contractors, students, volunteers, and temporary staff. Contracting Coordinators/Supervisor are responsible to obtain complete immunization records for contractors and fax to the Employee Health Office for clearance.

20. Contractor’s employee is responsible for his/her own reliable transportation, travel, hotel, and per diem expenses in the performance of this contract.

6. CONTRACTOR CREDENTIALS:

Any candidates submitted for credentialing shall undergo Indian Health Service (IHS) mandated security clearance for work on-site at CRSU. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check through the Office of the Inspector General's exclusion list at http://exclusions.oig.hhs.gov/ and www.sam.gov (best checked through www.verifycomply.com as this checks all exclusion lists). The clearance and credentialing process may take six (6) weeks or more.

• Current resume

• OF-306 – Declaration for Federal Employment (all questions must answered and signature with date in 17a is required)

• OF-306 Addendum – Addendum to the OF-306 (Declaration for Federal Employment)

• IHS Provisional Access Memo

• Protecting Children from Sexual Abuse in Health Care Settings; complete the Certificate of Completion

• No FEAR Act Training; complete the Certificate of Completion

• Information Systems Security Awareness (ISSA); complete the Certificate of Completion http://exclusions.oig.hhs.gov/ http://www.sam.gov/ http://www.verifycomply.com/

• OFI-86C form along with two fingerprint cards and applicable state forms

• HHS-745, Section A

• Two IDs (driver’s license and social security card – names must match and be unexpired)

• Educational (college & nursing ) Certification/License

• BLS/ACLS/PALS Certification

NOTE: No photo submission of forms, please have the forms scanned. Wet signature and date is highly recommended. No PDF signatures will be accepted.

7. SECURITY CLEARANCES:

The contractor shall ensure their employees have been properly screened prior to presenting to ESU for employment under this contract. The contractor shall inform their employees to obtain Fingerprint cards or electronically submit their fingerprints through the IHS Human Resources Department and complete the appropriate background investigation form which will be submitted for processing. No performance under this contract shall be allowed until the contractor’s employee is cleared through the IHS Human Resources Department and issued a badge.

8. CREDENTIALING AND PRIVILEGING:

The contractor will participate in the credentialing and privileging process in accordance with existing procedure. Contractor shall provide no services prior to obtaining approval by the Government Medical Executive and Governing Board. The Contractor will be provided copies of current requirements and updates as they are published. Privileges will require renewal at least every one - two years in accordance with Government credentialing privileging policy and AAAHC requirements.

9. SUPERVISORY CONTROLS:

The supervisor of the respective department to which Contractor(s) is assigned to work or his/her designee, provide primarily administrative supervision. The Supervisor or designee:

1. Set overall health care objectives and specifies resources available.

2. Provides for clinical supervision during the tour of duty.

3. Assigns work.

4. Reviews work performance on a periodic basis in order to evaluate proficiency in providing health care, discuss deficiencies and problems encountered, outline and/or approve new or changed practice to be employed and provides consultation on specific cases and related problems.

Work which involves out-of-the-ordinary diagnostic decisions or treatment is discussed with Supervisor or designee who keeps aware of the conditions of such patients and all aspects of treatment regimen. Wok performance is reviewed for conformance to IHS policy, procedures and accepted professional practices.

Within established guidelines, contractor(s) may exercise latitude in planning and carrying out health care assignments and in undertaking new procedures, practices and approaches to extend both services provided and increase individual proficiency. Overall work performance is reviewed by the Supervisor for effectiveness in meeting requirements for healthcare services.

10. DELIVERABLES:

The Contractor is required to provide a copy of each Contractor profile to the Contracting Officer Representative (or service unit representative(s)) prior to providing services at ESU.

Timesheet shall be submitted to the supervisor of the respective department to which the Contractor(s) is assigned to work or his/her designee. The timesheets shall be reviewed for accuracy and certified by signature as accurate and acceptable for payment, then forwarded to the receiving official for further processing of receipt of services through US Treasury utilizing IPP.

11. PERFORMANCE CONDITIONS:

The COR (or service unit representative(s)) will submit schedules of required coverage a minimum of 15 calendar days prior to the first day of coverage requested.

In the event the Contractor is unable to render service on a previously agreed schedule, the Contractor shall provide a minimum seventy-two (72) hour notification to the COR and service unit representative(s). The Contractor shall then make a full, good-faith effort to provide coverage with a replacement.

Both parties recognize that on occasion there shall be a need to fill coverage requests with less than a 15-day notice. In such an emergency scheduling situation, the Contractor shall make a full, good-faith effort to accommodate the emergency request. If the Contractor is unable to meet the emergency scheduling request, they shall immediately notify the COR and service unit representative(s).

12. PERFORMANCE BASED ASSESSMENT:

(a) Introduction – Performance Requirements:

(1) A Quality Assurance Surveillance Plan (QASP) has been developed for in-house operations or to implement a service contract. It is designed to aid the PO in providing effective and systematic surveillance of all aspects of professional nursing services. This plan provides for monitoring the contract requirements

(b) The objective of this surveillance plan is to evaluate how the Contractor is performing in key areas. The government is primarily interested in the final service being provided and not in the details of accomplishment.

(c) The principal method of surveillance will be daily in some cases or by use or periodic inspections. Appropriate indicators are provided for recording observations in this type of surveillance.

(d) How to Use the Performance Based Matrix

(i) Each defect observed will be recorded on the tally report. These documents will then become a formal record for later reference. The tally of defects at the end of each clinic or year (dependent on criteria) will be compared to the acceptable number of defects appearing in the surveillance plan. Errors detected by the PO in the course of surveillance will be transmitted to the Contractor or in-house personnel for correction. Notification of errors will take place within five (5) working days. Specifics concerning any errors should be recorded on the tally checklist. The Contractor or in-house personnel, as applicable, should be asked to initial this record.

(ii) Project Officer shall forward a copy of Contractor’s compliance with performance and non- performance compliance reports.

(e) Quality Assurance Surveillance Plan (QASP):

(i) The Government shall monitor the Contractors’ performance through a Quality Assurance Surveillance Plan (QASP). The QASP is for informational purposes only and not considered part of the contract.

(ii) Surveillance systems will include periodic inspection and acceptance of all deliverables as cited in the contract.

PERFORMANCE-BASED MATRIX

Outcome Required

Services

AQL

Standard Max Allowable Degree of Deviation from Requirement/

(AQL)

Normal Method of Surveillance

Incentives and Deduction from Contract Price

Podiatry Physician Non-Personal Services Contract

Minimum Qualification for Podiatry Physician

Contractor shall submit supporting documentation for approval

100% Compliant Government review of contractors documentation for compliance

Incentive: Government approves documentation De-incentive: Government reject documentation no award, Podiatry Physician Non-Personal Services Contract

Licensure for Podiatry Physician

Contractor shall submit supporting documentation of Licensure;

licensure shall be in good standing and not under investigation.

100% Compliant Government review of contractors documentation for compliance

Incentive: Government approves documentation De-incentive: Government rejects documentation, payment may be withheld

Podiatry Physician Non-personal Services Contract

Background Investigation in compliance with Indian Child Protection and Family Violence Prevention Act, Public Law 101-

Contractor shall submit supporting documentation of Background investigation results

100% Compliant Government review of contractors documentation for compliance

Incentive: Government approves documentation De-incentive: Government reject documentation no award, Podiatry Physician Non- Personal Services Contract

Immunization Compliance

Contractor shall submit supporting documentation of Immunization Compliance

100% Compliant Government review of contractors documentation for compliance

Incentive: Government approves documentation De-incentive: Government reject documentation no award

Unacceptable Performance

In the event of unacceptable performance, lack of professionalism, unacceptable conduct, the Contractor shall replace personnel

Contractor shall replace personnel within 5 days upon receipt of written notification

90% Compliant Government shall notify the contractor in writing of non-compliance

Incentive: No interruption of performance and positive evaluation documented in governments’ database.

De-incentive: Two (2) occurrences of which the contractor is unable to replace personnel within the time allowance, a cure notice shall be issued and possible termination of contract. Evaluation documenting performance in the national IHS database.

Long-term shifts fulfilled (Thirteen (13) week travelers)

Filled long-term work shifts as scheduled by the ESU. Long Term shifts contractor personnel shall provide at least a 4 week notice so that the position can be filled prior to vacancy.

Contractor shall ensure full shift coverage for long term nursing needs at ESU

100% Government’s review & written documentation/ notification to Contractor of non-compliance.

Incentive: No disruption of performance; positive evaluation documented in government’s database.

De-incentive: Two notices to the contractor, a cure notice shall be issued and possible termination of contract. Evaluation documented in national IHS database.

Short-term shifts fulfilled (Immediate staffing needs)

Filled short-term work shifts as scheduled by the ESU.

Contractor shall ensure full shift coverage for short term needs at the E S U

85% Same as above Same as above

END OF STATEMENT OF WORK