Statement of Work - EMG NCV.pdf

STATEMENT OF WORK

SUBJECT

The Federal Bureau of Prisons (BOP), Field Acquisition Office (FAO), in Grand Prairie, Texas, intends to make a single award to a responsible entity of a firm fixed price requirements type contract for the provision of Electromyography and Nerve Conduction Velocity testing for the Adults in Custody (AIC) at the Federal Medical Center (FMC) Lexington, located at 3301 Leestown Road, Lexington, KY 40511. General information regarding the Federal Bureau of Prisons (BOP) facilities can be located at www.bop.gov.

BACKGROUND

The FMC Lexington is a Federal Bureau of Prisons facility that provides a medical mission for federal adults in custody (AIC). In meeting the medical needs of a growing AIC population, FMC Lexington provides essential medical care, which includes electromyography and nerve conduction velocity testing services. The electromyographer will provide Electromyography and Nerve Conduction Velocity testing services to include upper and lower extremities.

PLACE OF PERFORMANCE

Professional EMG/NCV services will be performed within the confines of FMC Lexington’s Rehabilitation and Orthopaedic Department and/or in the medical office of FMC Lexington’s administrative building.

Federal Medical Center (FMC) 3301 Leestown Road Lexington, KY 40511

SCHEDULE

Scheduling of clinics shall be subject to the mutual agreement of FMC Lexington and the contract provider. FMC Lexington anticipates an estimated thirty (30) sessions per year but retains the right to schedule more or less sessions as needed. A session is defined as one nerve study. Multiple AIC nerve studies may be conducted on the same day. The work schedule will be between the hours of 7:30 am and 3:00 pm, Monday through Friday, excluding Federal Holidays.

The work schedule will be mutually determined by the contractor and the FMC Lexington Contracting Officer Representative (COR).

Due to the time-sensitive and patient-centered nature of the EMG and NCV studies, the awarded entity must be available to perform testing on short notice and be able to respond to FMC Lexington within four hours when required.

The Contractor is responsible for completing and maintaining the Session-Based Invoice Verification (SBIV) for each visit.

http://www.bop.gov/

The SBIV form must include:

• Contractor/Service details

• Contract Number

• Date and verification of time-in and time-out for each day services are provided.

• Signature of Health Services Administrator or designee verifying times.

EDUCATION AND EXPERIENCE

The contract provider performing EMG/NCV studies at FMC Lexington must have the ability to work with an inmate population from a variety of cultural, regional, racial, and ethnic backgrounds. The provider shall either be a licensed physician or licensed physical therapist.

Contract providers shall possess a current unrestricted professional license that permits them to perform electromyography and nerve conduction studies in the state of Kentucky.

Documentation of diplomas, certificates and/or national certification must be provided. A resume or curriculum vitae should be included. The contract individual must have at least three (3) years of documented experience performing EMG/NCV studies. The contractor shall provide the name of the candidate(s) that will be providing services for FMC Lexington and photocopies of documents evidencing their own and their candidate(s)’ ability to meet qualifications to perform required services as stated in this statement of work. Examples of evidence include a copy of license or permit, diplomas, internship/residency certifications, letters of recommendation, resumes, etc. Failure to submit this information may result in offeror not being considered for an award.

In evaluating offers, the Government will evaluate the candidate(s) qualification/licensure, in addition to other factors.

DESCRIPTION OF DUTIES

Provide Electromyography and Nerve Conduction Velocity testing services to include upper and/or lower extremity testing, with or without spinal involvement and suspected multi-limb polyneuropathies, which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of healthcare to members of the general public.

The contractor shall provide EMG/NCV services that will be performed that may include but are not limited to the following:

1. EMG/NCV – One extremity EMG/NCV study

2. EMG/NCV – Two extremity EMG/NCV study

3. EMG/NCV – Three extremity EMG/NCV study

4. EMG/NCV – Four extremity EMG/NCV study

The contractor will utilize the EMG/NCV machines located in FMC Lexington’s Rehabilitation and Orthopaedic Department and/or administrative building. FMC Lexington will provide all expendable EMG/NCV supplies to include needles, electrodes, alcohol wipes and conducting gel. At the conclusion of the EMG/NCV study, the contract provider will provide detailed results and recommendations in a written report prior to departing the institution.

PRICING

The contract rate for electromyographer shall be based on required nerve study. Services shall be provided in accordance with commercial practices.

WORK ATTIRE

The Contractor must always wear appropriate professional attire. The Contractor is prohibited from wearing khaki or green clothing of any type as this is the color clothing the AIC population wears.

ADULT IN CUSTODY (AIC) MANAGEMENT

The contractor will not be responsible for the management of the AIC, supervise BOP staff, participate in inmate accountability, requisition, sign for or pick up supplies. The contractor will not formulate policies or procedures, attend recalls or staff functions. The contractor is to constantly be aware of security and always maintain a professional relationship with AICs. Any violation of the institution’s rules and regulations is to be brought immediately to the attention of any Government employee employed at the institution. The Contractor will report any infractions of rules and regulations by any AICs to a health services employee and/or the Contracting Officer’s Representative (COR).

The contract provider is not permitted to discuss examination findings, recommendations, or treatment options with the AIC. Additionally, the contract provider should not guarantee any treatment or discuss future appointment dates with the AIC. All consultant recommendations will be provided in the written report to FMC Lexington staff for review. The Contractor shall not perform any treatment/procedures unrelated to the reason for consultation without receiving prior authorization from FMC Lexington staff.

HEALTH REQUIREMENTS

The contractor shall be free of communicable diseases and physically able to stand for extended periods or walk distances. Any individual who subsequently develops a medical condition which might reasonably be expected to place other workers, AIC, or the public at risk shall be immediately removed from affected activities. In any such case, the contractor shall be responsible, at no additional cost to the institution, for securing the services of any replacement personnel required to perform under the resulting contract. The contractor must provide initial and annual proof of Tuberculosis skin testing or chest x-ray and provide evidence acceptable to the clinical director of test results and proof of Hepatitis B vaccination being offered. If the contractor declines the Hepatitis B vaccination, a signed declination form must be submitted that outlines the potential consequences of declining the vaccine. Failure to submit to testing for or providing acceptable evidence of recent testing for or immunity to selected communicable diseases shall be grounds for denying access to the institution and AICs. Any individual who subsequently develops a medical condition which might reasonably be expected to place other workers, AICs, or the public at risk shall be immediately removed from affected activities.

POLICIES, PROCEDURES, AND REGULATIONS

The contractor shall adhere to all federal, state, and local laws and regulations in effect during the term of this contract. Contract staff shall adhere to all policies and procedures prescribed by the BOP relating to the safety, custody and conduct of the AICs.

SPECIAL CONSIDERATIONS

The contractor shall immediately inform the Contract Officer’s Technical Representative (COR) in writing of any adverse action taken by any local, state, federal, or accrediting agency which affects the contractor’s licenses or certifications.

In the event of the contractor’s choice to seek dissolution of this contract agreement, the contractor will give preferably a six-month notice to the COR so solicitation of an electromyographer to provide Electromyography (EMG) and Nerve Conduction/Velocity (NCV) studies can occur, to provide continuity of medical services to the AIC population at FMC Lexington.

ADDITIONAL INFORMATION

• Manage medical record information and observing restrictions on the release of information.

Upon request, authorized BOP staff shall have access to and obtain copies of all AIC medical records and evaluation and treatment reports prepared and maintained by the contract facility and/or contract providers. Release of information shall only be made in accordance with community standards, Joint Commission regulations, and Privacy Act of 1974. Any requests for copies of an AIC’s medical records by the AIC or a third party shall be directed to the COR for processing. Notwithstanding the above restrictions on the release of information, medical record information shall be provided to FMC Lexington to enhance continuity of care.

• Maintain open avenues of communication.

The Contractor shall provide a Point of Contact (POC) who shall be responsible for facilitating the Contractor’s delivery of EMG/NCV services under this contract. The POC shall have sufficient clinical knowledge to enable preliminary technical consultation, with referral to a specialist if necessary. There shall be an open line of communication between the contractor, its representatives, FMC Lexington, to ensure that only those services ordered by the institution are provided.

Payment shall be based on an end product or the accomplishment of specific results, and the results to be obtained shall be entirely within the contractor’s own unsupervised determination.

To ensure accurate records of billing, the contractor must supply a monthly invoice/statement of service rendered to include the required Session-Based Invoice Verification (SBIV). The contractor is responsible for completing and maintaining the SBIV for each visit. The SBIV must include:

• Contractor/service details

• Contractor number

• Date and verification of time-in and time-out for each day services are provided.

• Signature of Health Services Administrator or designee verifying times.

INSTITUTIONAL SECURITY

The contractor agrees to adhere to all regulations prescribed by the institution for safety, custody and conduct of inmates. The Contractor shall attend an initial and annual four-hour contractor training session prior to assuming institutional involvement. A “refresher” orientation must be completed annually. The date and time for this orientation and annual refresher training shall be mutually agreed upon by both parties, and all costs associated with this orientation shall be at the contractor’s sole expense. The contractor will be required to sign in and out of the institution for accountability purposes. A badge will be issued and worn at all times for proper identification.