TAB 3- PWS.pdf

PWSNo.:CPSU-EDApril14,2025

CrownpointServiceUnit PerformanceBaseWorkStatement(PBWS)

ForPersonalServices

REGISTEREDNURSINGSERVICE—EMERGENCYDEPARTMENT

TableofContents

SectionPage

1.0General1-4

2.0Definitions4-7

3.0GovernmentFurnishedInformation,Property,&Services7-9

4.0ContractorFurnishedProperty9-10

5.0PerformanceBasedRequirements10-14

6.0ContractorQualificationRequirements14-15

7.0FederalTortClaims15

8.0ChallengeofConflict15

9.052.249-12Termination(PersonalServices)(Apr.1984):15

10.0TechnicalDirection15-16

11.0HealthRequirement/ConditionofEmployees16

12.0LanguageRequirementandCulturalAwareness17

13,0PrivacyActNotification17-20

14.0ListofAttachmentsandExhibits21-22

REGISTEREDNURSINGSERVICE—EMERGENCYDEPARTMENT

1.0General:ThisperformancebaseworkstatementdescribestherequirementsforaPersonalService

Contract—RegisteredNursingServicestosupportthemissionoftheIndianHealthService(IHS).

1.1Background:IHSisanagencywithintheU.S.DepartmentofHealthandHumanServices andisresponsibleforprovidingfederalhealthservicestoAmericanIndiansandAlaska

Natives.Theprovisionofhealthservicestomembersoffederallyrecognizedtribesgrew outofthespecialgovernmenttogovernmentrelationshipbetweenthefederal governmentandIndiantribes.TheIHSistheprincipalfederalhealthcareproviderand healthadvocatefortheIndianpeople.Thegoalistoassurethatcomprehensive,culturally acceptablepersonalandpublichealthservicesareavailableandaccessibletoAmerican

IndiansandAlaskaNatives.TheIHScurrentlyprovideshealthservicestoapproximately

1.5millionAmericanIndiansandAlaskaNativeswhobelongtomorethan557federally recognizedtribesin34states.

Thereisanationwideshortageofnurseswhichisamplifiedbytheremoteandruralareas servedbytheIndianHealthService.ThenursingvacancyratewithinIHShasbeen consistentlyat32%.Thesevacanciesarebeingfilledthroughtheuseofcontracts.

1.2Scope:TheContractorshallprovidenursingservicesfortheNavajoAreaIndian

HealthService(NAIHS)inaccordancewithsection5.0,performancebaserequirements.

1.2.1.Dutiesandresponsibilitieswillencompassoutpatient,inpatientandcommunity healthnursingservicestoallpatients.

1.2.2PlaceofPerformance:ServiceswillbeperformedatvariousNAIHSfacilities

(ServiceUnits,HealthCenters)locatedthroughouttheStateofArizona,New

MexicoandUtah.TheNAIHSadministershealthcenters,andhospitals,providing healthcaretoapproximately201,583membersoftheNavajoNation.TheNavajo

NationisthelargestIndiantribeintheUnitedStatesandhasthelargest reservation,whichencompassesmorethan25,516squaremilesinnorthern

Arizona,westernNewMexico,andsouthernUtah,withthreesatellite communitiesincentralNewMexico.TheNAIHSistheprimaryproviderof inpatient,ambulatorycare,preventiveandcommunityhealth,andenvironmental healthservicesformembersoftheNavajoNationandtheSanJuanSouthern

PaiuteTribe.

1.2.3PointofContact:TheContractorshallprovideapointofcontactthatwillbe responsiblefortheperformanceofthework.Thisindividualshallhavefull authoritytoactfortheContractoronallmattersrelatingtothedailyoperationof thecontract.Thepointofcontractmaybeaproviderprovidingcareinaccordance withthisPerformanceBaseWorkStatement.TheContractorshalldesignatethis individualinwritingtotheContractingOfficer(CO)beforethecontractstartdate.

Analternatemaybedesignated,buttheContractorshallidentifythosetimes whenthealternateshallbetheprimarypointofcontact.

1.2.4Availability:Thepointofcontactshallbeavailableviatelephone24hoursaday, sevendaysaweekincludingfederalholidays.

1.2.5ArrangeforReplacementStaff:TheContractorshallarrangeforpre-credentialed replacementstaffwhentheirhealthcareprovider(s)isunabletoprovideservices forone(1)ormoreconsecutivescheduledshifts.

1.2.6WorkRoster:Thepointofcontactshallprovidealistbydate,time,andindividual nurse’snameforthosedaysthecontractorshallbeprovidingservices.Thework rostershallbeprovidedtotheProjectOfficerbythe 20th ofeachmonthofthe precedingmonth.Anyproposedworkschedulechangesshallbesubmittedtothe

ProjectOfficeratleast48hoursinadvance.

1.2.7ContinuityofServices:TheContractorshallensurethatqualifiedbackupnurses areavailabletoprovidecoverageduringscheduledandunscheduledabsencesto primarycontractproviders.Absenceswithoutbackupcoveragewillbesubjectto deductioninaccordancewithFARPart52-212-4(a)

1.3ApplicableDocuments:Pleaseseetheweblinklistedunlessdocumentislistedasan attachment.

1.3.1TheJointCommissiononAccreditationofHealthcareOrganizations.TheJoint Commission(TJC)http://www.jointcommission.org

1.3.2CentersforMedicareandMedicaidServices(CMS)Standards http://www.cms.hhs.gov

1.3.3AccreditationAssociationforAmbulatoryHealthCare(AAAHC) http://www.aaahc.org

1.3.4Section231ofPublicLaw101-647,theCrimeControlActof1990.

http://www.policyalmanac.org/crime/archive/crsfederalcrimepolicy.shtml

1.3.5Section4087ofPublicLaw101-630,theIndianChildandFamilyViolenceAct.

http://www.nicwa.org/policy/law/protection/index.asp

1.3.6HealthInsurancePortabilityandAccountabilityAct(HIPAA)of1996.

http://www.cms.hhs.gov/hipaa

1.3.7PrivacyActof1974.http://www.usdoi.gov/oip/privstat.htm

1.3.8RevisedAmericanNursesAssociationCodeofEthicsandStandardsofPractice andCare(1996)http://www.nursingworld.org

1.3.9StateNursePracticeActfortheContractor’slicensingstate.http://medi-smart.com/practice.htm

1.3.10NavajoAreaIHSServiceUnitandHealthCenterPolicies,Proceduresand Protocols.(Seesection11.0foralistofattachmentsandexhibits)

1.3.11LocationMap(attached)

1.3.12SampleTaskOrder(attached)

1.3.13CustomerEvaluationForm(attached)

1.3.14ComputerSecurityActof1980 http://www.ihs.gov/adminmggrresouces/computersecurityact

1.3.15FederalCodeofConducthttp://www.ihs.gov

1.3.16IHSGeneralDirectiveshttp://www.ihs.gov/adminmggrresouces

1.3.17IHSComputerSecurityDirectiveshttp://www.ihs.gov/adminmggresources

1.3.18NurseLicenseLookuphttp://www.nursys.com

2.0Definitions

2.1.Acceptance:Constitutesacknowledgementthatthesuppliesorservicesconformtothe applicablecontractqualityandquantityrequirements,exceptasprovidedinFARsubpart

46.5andsubjecttoothertermsandconditionsofthecontract.

2.2.Approval:AcknowledgmentbythedesignatedGovernmentofficialthatsubmittals, deliverables,oradministrativedocuments(e.g.,insurancecertificates,installation schedules,plannedutilityinterruptions,etc.)conformtothecontractualrequirements.

GovernmentapprovaldoesnotrelievetheContractorfromresponsibilityforcompliance withcontractrequirements.

2.3.Area:AdefinedgeographicalregionforIndianHealthServiceadministrativepurposes.

EachAreaOfficemayadministerseveralServiceUnits.

2.4.CodeofEthics:TheRevisedAmericanNursesAssociationCodeofEthicsandStandardsof PracticeandCare,publishedin1996bytheAmericanNursesAssociationwhichmakes explicitprimarygoals,valuesandobligationsofthenursingprofession.

2.5.ContractingOfficer(CC):AGovernmentemployeewiththeauthoritytoenterinto, administer,and/orterminatecontractsandmakerelateddeterminationsandfindings.

2.6.Contractor:Theindividualawardedalegalbindingcontracttoprovidesuppliesand services.

2.7.ContractingOfficer’sRepresentative(COR)orProjectOfficer(PC):Afederalemployeewho assiststheordering/issuingactivitycontractingofficerintheadministrationoftaskorders issuedunderthiscontract.TheCORisprimarilyresponsibleforthetechnicalassistance andday-to-dayprogrammanagementoftheorderingactivity’staskorders.Ordering activitiesmayhavedifferentdesignatorsforthisemployee(e.g.GTR—Government

TechnicalRepresentative,COTR—ContractingOfficer’sTechnicalRepresentative,orP0

ProjectOfficer).

2.8.CooperativeAttitude:Behaviorthatispositiveanddisplaysawillingnesstoperform assignedpatientcaretasksandtobeateamplayer.

2.9.CulturalAwareness:RealizationandrespectforAmericanIndianandAlaskaNative practices.

2.10.Customer:Patients,staffandvisitorsofanNAIHSserviceunitandNAIHShealthcenter.

2.11.CustomerEvaluation:WrittencommentsmadetotheContractingOfficerregardingthe

Contractorsperformance.ThisisoneofthecriteriausedtoevaluatetheContractor’s performance.

2.12.Dependability:O.ualitiesofbeingtrustedandbeingabletorepeatthesametasktoyield thesameresult.

2.13.FederalAcquisitionRegulation(FAR):TheFARistheprimaryregulationforusebyallFederal

Executiveagenciesintheiracquisitionofsuppliesandserviceswithappropriatedfunds.

2.14.GovernmentVehicle:ANAIHSownedmotorvehicleoravehicleleasedbyNAIHSthrough agreementswiththeGeneralServicesAdministration(GSA)orthroughcommercialrental agreements.

2.15.PuebloPintadoHealthClinic&ThoreauHealthStation,(THS):Afacilityphysicallyseparated fromahospital,withafullrangeofambulatoryservicesincludingatleastprimarycare physicians,nursing,andlaboratory,andx-raywhichareavailableatleast40hoursaweek foroutpatientcare.

2.16.Non-PersonalServicesContract:Acontractunderwhichthepersonnelrenderingthe servicesarenotsubject,eitherbythecontract’stermsorbythemannerofits administration,tothesupervisionandcontrolusuallyprevailinginrelationshipsbetween theGovernmentanditsemployees,asdefinedinFAR37.

2.17.OrderingActivity:AnauthorizeduserofNAIHSthatmayissueataskordertoobtain requiredservicesunderthiscontract.

2.18.OrderingActivityContractingOfficer:AGovernmentemployeeofNAIHSauthorizedand warrantedtoissuetaskordersandtomakesubsequenttaskordermodification(s)under thiscontract.TheOrderingActivity(CO)hastheauthoritytomakeinitialdeterminations onallmattersofdisputeregardingtaskorders.

2.19.Orientation:Anactivitydesignedtoprovidebasicfamiliarizationofthefacilityand transitionthenurseintotheNAIHSServiceUnitand/orHealthStationandthenursingunit wheretheserviceswillbeprovided.

2.20.PastPerformanceInformation:Relevantinformationregardingacontractor’sactionsunder previouslyawardedcontracts.Thisincludesthecontractor’srecordofconformanceto specificationsandtostandardsofgoodworkmanship;thecontractor’srecordof containingandforecastingcostsonanypreviouslyperformedcostreimbursablecontracts;

thecontractor’sadherencetocontractschedules,includingtheadministrativeaspectsof performance;thecontractor’shistoryforreasonableandcooperativebehaviorand commitmenttocustomersatisfaction;andgenerally,thecontractor’sbusiness-like concernfortheinterestofthecustomer.

2.21.PatientOutcome:Endresultofnursingcare.

2.22.PerformancebasedMatrix:Liststheservicestobemonitoredandthestandardstobe app1ied.

2.23.PersonalProtectiveEquipment(PPE):Theequipmentusedtoprotectmedicalpersonnel fromexposuretobiological,chemical,andradioactivehazards.

2.24.QualityAssuranceSurveillancePlan(OASP):ServiceUnit:Writtendocumentpreparedand usedbythegovernmentforQualityAssurancesurveillanceofthecontractor’s performance.

2.25.QualityControlPlan(QCP):ThoseactionstakenbytheContractortocontrolthequalityof servicesprovided.TheContractor’sQCPmustbeequivalenttotheGovernment’sQuality

AssurancePlan.

2.26.StandardsofPracticeandStandardsofCare:Authoritativestatementsbywhichthenursing professiondescribestheresponsibilitiesforwhichitspractitionersareaccountable.The standardsprovidedirectionforprofessionalnursingpracticeandaframeworkforthe evaluationofpractice.Thestandardsofprofessionalnursingpracticemaypertainto generalorspecialtypractice.

2.27.Supervisor:Governmentemployeeauthorizedtoprovideverbalandwrittenperformance directiontotheContractorthattheContractormustfollowwithoutexception.

2.28.TaskOrder:Anorderissuedinaccordancewiththetermsofthecontractthatdetailsan orderingactivity’sspecificrequirements.Anorderingactivitieswrittenordertoobtain services,ataminimumwillincludethefollowingwhereapplicable:descriptionofservices, skillcategories,hours,price,periodofperformance,contractnumber,andtheordering activitiestaskordernumber.

2.29.TechnicalDirection:AdirectivetotheContractorthatapprovesapproaches,solutions, designs,orrefinements;fillsindetailsorotherwisecompletesthegeneraldescriptionof workordocumentationitems;shiftsemphasisamongworkareasortasks;orfurnishes similarinstructiontotheContractor.Technicaldirectionincludesrequiringstudiesand pursuitofcertainlinesofinquiryregardingmatterswithinthegeneraltasksand requirementsinSection5ofthiscontract.

2.30.TourofDuty:Thetimeofdaythenurseisscheduledtoperformnursingcareduties;also consideredtheshiftoftheday.ThetimecanvaryaccordingtotheneedsofeachNAIHS facilityand/orclinic,e.g.11.5hourTourofDuty,withoneshiftat11hourTourofDuty totaling80hourseverytwoweeks.Theremaybeamid-shiftscheduledfrom1100to2330 or1500to0330.

2.31.ValidPatientComplaint:Justifiableaccusationmadebyapatientandsupportedby investigation.

2.32.VerifiableEmergency:Anunexpected/unplannedabsencebythecontractorrequiringvalid documentationtoconfirmtheoccurrence.

3.0GovernmentFurnishedInformation,PropertyandServices

3.1.Information:Governmentuniqueinformationrelatedtothisrequirement,whichis necessaryforContractorperformance,willbemadeavailabletotheContractor.The

ContractingOfficerordesigneewillbethepointofcontactforidentificationofanyrequired informationtobesuppliedbytheGovernment.

3.2JointUsebytheGovernmentandtheContractor:Exceptforthepropertyandservicelisted in3.3and4.0,theGovernmentwillprovide,forjointusebytheGovernmentandthe Contractor,allnecessaryequipment,supplies,andclinicspacetoperformtheservices underthiscontract.

3.2.1GSAVehicle:Ifrequiredbytheposition,authorizationshallbeinaccordancewith NAIHSChapter12,Section13MotorVehicleManagement.Contractorsmayride inGovernmentvehiclebutnotauthorizedtodriveaGovernmentvehicle.

3.2.2GovernmentHousing:Nogovernmenthousingisavailable,unlessthereisa vacancy.ThiswillbedeterminedbytheHousingCommittee

3.3ContractorExclusiveUse:

3.3.1PersonalProtectiveEquipment(PPE):TheGovernmentwillfurnishtheContractor withappropriatePPEotherthanspecifiedinparagraph4ofthePBSOW.

TheGovernmentwillberesponsibleforanyrepair,cleaning,andinventory requiredforthePPE.Thisdoesnotincludeanytypeofuniformorlaboratorycoat.

3.3.2TheGovernmentwillprovidefacilityspecificcontractoridentificationbadgesfor eachcontractor.Aminimumfeeof$5.00willbechargedforlostordestroyed badges.

3.4Training:Facilityspecificorientation/trainingnecessaryfortheContractortoperformthe requiredduties,e.g.,NAIHSinformationtechnology(IT)systemsandoperational procedures.TrainingwillbeprovidedONLYifthesubjectmatterisnecessarytoimprove orenhancethequalityofnursingservicesorincludesmandatesmadebytheNAIHSService

Units/HealthCenterswhilethenurseisworkingunderthiscontract.Trainingwillnotbe providedforthepurposeofcontinuingeducation,careerdevelopmentorindividual development.

3.5Supervisor:ThecontractorissubjecttothesupervisionanddirectionofDorothina

Francisco,SupervisoryNurse(SN)forEmergencyDepartmentorherdesignee,FernDetsoi, SN,forthisorder.

3.5.1ContractingOfficerRepresentative(COR):JamesTom,HealthSystemSpecialistis primarilyresponsibleformonitoringthetechnicalprogressincludingsurveillance andassessmentofperformanceforthisorder.

3.5.2PointofContact(POC):DorothinaFrancisco,SupervisoryNurse(SN)(505)786-

3.6ProtectionofGovernmentBuilding,Equipment,andVegetation:TheContractorshalluse reasonablecaretoavoiddamagingexistingbuilding,equipment,andvegetationonthe

Governmentinstallation.IftheContractor’sfailuretousereasonablecarecausesdamage toanyofthisproperty,theContractorshallreplaceorrepairthedamageatnoexpenses totheGovernmentastheContractingOfficerdirects.IftheContractorfailsorrefusesto makesuchrepairorreplacement,theContractorshallbeliableforthecost,whichmaybe deductedfromthecontractprice.

4.0ContractorFurnishedProperty

4.1.1.Exceptforthepropertyspecifiedinparagraph3asgovernmentfurnished,the

Contractorshallprovidealluniformsandotherpersonalmedicalinstruments subjecttothefollowing:

4.1.2.UniformsandLabCoats:UniformsandLabCoatsshallconformtothe requirementsoftheIndianHealthServiceManual,Part3Chapter4and meettheapprovaloftheChiefNurseExecutiveateachIHSfacility.

4.1.3.Otherpersonalmedicalinstruments:“Otherpersonalmedicalinstruments”are definedasContractorowneditemsmayincludebutnotlimitedtostethoscope, scissors,asappropriatetotheworkunit.TheContractorshallnotuseunsafe equipmentorsuppliesatanytimeduringperformanceofthiscontract.All

Contractorfurnishedequipmentandsuppliesshallbesubjecttoinspectionbythe

GovernmentandmustbeapprovedbytheCORpriortousebytheContractor.The

Governmentreservestherighttoprohibittheuseofanymaterials,supplies,or equipment.

4.1.4IndemenificationandMedicalLiabilityInsurance:

(a)Itisexpresslyagreedandunderstoodthatthisisapersonalservicescontract, asdefinedinFederalAcquisitionRegulation(FAR)37.101,underwhichthe professionalservicesrenderedbytheContractorarerenderedinitscapacity asanindependentcontractor.TheGovernmentmayevaluatethequalityof professionalandadministrativeservicesprovided,butretainsnocontrolover theprofessionalaspectsoftheservicesrendered,includingbyexample,the

Contractor’sprofessionalmedicaljudgment,diagnosis,orspecificmedical treatments.TheContractorshallbesolelyliableforandexpresslyagreesto indemnifytheGovernmentwithrespecttoanyliabilityproducingactsor omissionsbyitorbyitsemployeesoragents.TheContractorshallmaintain duringthetermofthiscontractliabilityinsuranceissuedbyaresponsible insurancecarrierofnotlessthan$1,000.000perspecialtyperoccurrence, $3,000.000aggregate.

(b)AnapparentlysuccessfulofferoruponrequestbytheContractorOfficer,shall furnishpriortocontractawardevidenceofitsinsurabilityconcerningthe medicalliabilityinsurancerequiredbyparagraph(a)oftheclause.

(c)Liabilityinsurancemaybeoneitheranoccurrencesbasisoronaclaims-made basis.Ifthepolicyisonaclaims-madebasis,anextendedreporting endorsement(tail)foraperiodoflessthan3yearsaftertheendofthe contracttermmustalsobeprovide.

(d)Evidenceofinsurancedocumentingtherequiredcoverageforeachhealth careproviderwhowillperformunderthiscontractshallbeprovidedtothe

ContractingOfficerpriortothecommencementofservicesunderthis contract.Iftheinsuranceisonaclaims-madebasisandevidenceofan extendedreportingendorsementisnotprovidedpriortothecommencement ofservices,evidenceofsuchendorsementshallbeprovidedtothe

ContractingOfficerpriortotheexpirationofthiscontract.Finalpayment underthiscontractshallbewithhelduntilevidenceoftheextendedreporting endorsementisprovidedtotheContractingOfficer.

(e)Thepoliciesevidencingrequiredinsuranceshallalsocontainanendorsement totheeffectthatanycancellationormaterialchangeadverselyaffectingthe

Government’sinterestshallnotbeeffectiveuntil30daysaftertheinsureror theContractorgiveswrittennoticetotheContractingOfficer.If,duringthe performanceperiodofthecontracttheContractorchangesinsurance providers,theContractormustprovideevidencethattheGovernmentwillbe indemnifiedtothelimitsspecifiedinparagraph(a)ofthisclause,fortheentire periodofthecontract,eitherunderthenewpolicy,oracombinationofold andnewpolicies.

(f)TheContractorshallinsertthesubstanceofthisclause,includingthis paragraph(f),inallsubcontractsunderthiscontractforhealthcareservices andshallrequiresuchsubcontractorstoprovideevidenceofanmaintain insuranceinaccordancewithparagraph(a)ofthisclause.Atleast5days beforethecommencementofworkbyanysubcontractor,theContractorshall furnishtotheContractingOfficerevidenceofsuchinsurance.

4.1.3Housing/perdiem/travelandotherassociatedcost:

(a)Contractorshallberesponsibleforhousing,perdiem,travelandother associatedcostfortheiremployee.Governmenthousingwillbeavailable

ONLYifthereisaVacancy.

5.0PerformanceBasedRequirements:TheContractorshallprovidenursingservicesinthedeliveryof patientcaretotheNAIHS.Aspecifictaskincludesthefollowing:

5.1NursingDuties:

5.1.1.TheContractorshallperformnursingdutiesandmanagepatient’sneedsas describedintheattachedPositionDescription(PD)-identifiedbytheServiceUnit andasdirectedbytheSupervisoryNurse.

5.1.2.TheContractorshallperforminaccordancewiththecompetencystandardslisted inExhibits,paragraph11.2.

5.1.3.Thecontractorshallprovideprofessionalnursingserviceindirectpatientcareas follows:

(a)ContractorshallprovidefullrangeofEmergencyservicestopatientsinthe EmergencyDepartment.

(b)Contractorshallexerciseknowledgeofthenursingprocessanditsapplication toclinicalpracticeinordertoprovideindividualized,goal-orientatednursing caretotheadult!pediatricpatient.

Cc)Contractorshallexerciseknowledgeofscientificandpsychosocialnursing theory,principles,practicesandtechniquesinordertoplanandprovide qualitynursingcarewhichmeetsthephysical,spiritual,andsocial-cultural needsoftheIndianpatient.

(d)Contractorshallexerciseknowledgeofbiologicalaspectsofdiseaseprocesses andillnessinordertorecognizecomplicationsandimplementappropriate therapeuticinterventionsrequired.

(e)Contractorshallexerciseknowledgeofthemedicationsanddosagesinorder torecognizetheirdesiredeffects,side-effects,andcomplicationsoftheiruse.

(f)Contractorshallanalyzetheresultsofvariousmedicalproceduresand translatethemintoappropriatenursinginterventions.

(g)Contractorshallworkeffectivelyandharmoniouslywithinthehealthcare teamandwithIndianpatientsandtheirfamilies.

(h)Inter-FacilityTransports.

(i)Provideappropriatedocumentationregardingcarerenderedusing CrownpointServiceUnit(CPSU)ElectronicHealthRecord(EHR)&RPMS system.Alldocumentationbytheprovidershallbeenteredelectronically usingtheElectronicHealthRecordsystem.Theproviderisresponsiblefor utilizingtheEHR/RPMSsystemtoobtainpertinentpatientinformationin assistingcare.Itistheresponsibilityoftheprovidertousethetraining resourcesprovidedtodevelopcompetencyinutilizingtheElectronicHealth

Recordsystem,/RPMS.

(j)Followsfacilitypoliciesandprocedures,TheJointCommission(TJC), OccupationalSafetyandHealthAdministration(OSHA),IndianHealthServices (IHS)andotherfederallicensing,accreditationandregulatingbodystandards.

5.1.4ContractorshallbesubjecttopeerreviewperTheJointCommissionstandards.

5.1.5ContractorshallmeettheSafetymanagementreportingrequirementsin accordancewiththeServiceUnitSafetyMeasurePolicy.

5.1.6ContractorshallberesponsibleforallapplicableFederal,State,AndLocalTaxes, Meals,Travel/Transportation.Lodgingisprovidedbutmustbepaidforbythe contractororcontractagency.Governmentquartersareavailableatprevailing rentalratesplusutilities,asapplicable,ifgovernmentquartersareutilized.The contractorshallberesponsibleandliableforthepropercareofgovernment ownedorleasedpropertyfurnishedinoccupiedquarters.

5.2WorkSchedule:

5.2.1.Workshift:TheSupervisorateachNAIHSfacilitywillprovidetechnicaldirection onthespecifictourofduty.TheContractorshallwork100%ofthecontracted hours.

5.2.2.WorkFlexibility.AsdirectedbytheSupervisor,theContractorshallrotateinto otherdutysectionsasneededtosupportpatientcare.

5.2.3.TheContractorshallobtainapprovalofthedepartmentSupervisorordesignee priortoanyabsencefromwork.Ifthelengthoftheabsenceexceedseight(8) workhourstheContractorshallrequestapprovalatleastfifteen(15)days,(the exceptionisverifiableemergencies)inadvanceofthedesiredabsence.

5.2.4.Approvalofleaveiscontingentuponavailabilityofaqualifiedreplacement.

5.2.5.TheContractorshallprovidewrittendocumentationfromaqualifiedhealthcare providerforabsencesofthree(3)ormoreconsecutivedays,duetoillness,stating:

A.ThecauseofthecurrentillnessorincapacitationAND B.IndicatingtheContractorascontagiousornon-contagious.

TheGovernmentreservestherighttoexamineandorre-examineanyContractor whomeetsthecriteria.

5.3.Conduct:TheContractorshallmeetstandardsaslistedintheFederalCodeofConduct.

5.3.1.ThecontractorshallbesubjecttocharacterinvestigationasrequiredbyPublicLaw 101-360,theIndianHealthChildProtectionandFamilyViolencePreventionAct priortoperformanceofacontractbyutilizingtheUSOfficeofPersonnel Management(OPM),ElectronicQuestionnaireforInvestigationProcessing(eQ.IP) systemandthisshallincludeallfingerprintingproceduresandclearances.The contractorshallprovideallrequestedinformationnecessarytoperformLevelIand LevelIIbackgroundchecks.Thecontractorshallcomplywiththerequirementto obtainsecurityinvestigations.Thecontractorshallworkwiththel.H.S.toensure thatthepre-employmentscreeningprocessincludestheappropriateinvestigation questionnairesandformstobecompleted.Allcompletedformswillbereviewed bythecontractorandforwardedtothegovernmentpersonnel.Thecontractorwill beimmediatelyremovedfromthepositionifatanytimetheinvestigationreceives unfavorableadjudication,or,ifotherunfavorableinformationthatwouldaffect theinvestigationbecomesknown.

5.4.PerformanceEvaluation:

5.4.1.TheContractor’sperformancewillbeevaluatedinaccordancewiththestandards setforthinthecontractandPerformance-basedMatrixofsection11.0.

5.4.2.Substantiatedreportswrittenbyanycustomerdealingwithpatientsafety, infectioncontrol,orotherprocedurethatadverselyaffectspatientoutcome constitutesabreachofcontract.

5.5.IdentificationofContractor:

5.5.1.TheContractorshallwearagovernmentissuedcontractoridentificationbadge duringperformanceofduty.PIVcardsareissuedafter6monthsatServiceUnit.

5.6.ManagementofMedicalInformation:TheContractorshallmanageallpatientinformation inaccordancewithHIPAAstandards,PrivacyAct,andNAIHSServiceUnitand/orHealth Centerspecificpoliciesandprotocols.

5.6.1.TheContractorshallensureadherencetoDHHSITsystemsecuritypoliciesand procedures.TheITpoliciesandprocedureswillbemadeavailabletothe Contractor.

5.6.2.TheContractorshallimmediatelyreporttotheContractingOfficerorCORforany informationorcircumstancesthatmayviolateanystatute,policy,orprocedure.

5.7.IHSInformationTechnologySystems:

5.7.1.Inperformanceofthiscontract,theContractorshalladapttoandsuccessfully utilizeIHSinformationtechnologysystemsthataredeemedbytheSupervisoras necessaryforacceptablecontractorperformance.

5.7.2.TheContractorshallensurethatNAIHSinformationtechnologysystemsecurity policiesandproceduresareadheredto.TheITpoliciesandprocedureswillbe madeavailabletotheContractorateachNAIHSfacility.

5.7.3.TheContractorshallfollowallappropriatefederalandlocallyrequiredinformation TechnologysecurityrequirementsandwillbeoperatingunderHealthInsurance PortabilityandAccountability(HIPAA)andPrivacyActregulations.

5.7.4.InformationTechnologySkills.TheContractorshallpossessbasicknowledge,skills, andabilitiestouseacomputer

6.0ContractorQualificationRequirements:

6.1Experience:TheContractorshallhavethirty-six{36)monthsofnursing experience,withaminimumoftwo(2)yearsinthespecialtyrequiredbythe contract,unlessotherwiseapprovedbytheContractingOfficer.

6.2License/Registration:Allnursesshallpossessacurrent,valid,unrestrictednursing licenseinastate,theDistrictofColumbia,theCommonwealthofPuertoRico,or aTerritoryoftheUnitedStates,throughoutthetermofthiscontract.

6.3MotorVehicleOperator’sLicense.Ifrequiredbytheposition,theContractorshall possessavalidstatedriver’slicensethroughoutthetermofthiscontract.

6.4Certifications:CurrentBasicLifeSupport(BLS)ismandatoryforallspecialties.

PediatricAdvancedLifeSupport(PALS),NewbornLifeSupport(NLS),Advanced TraumaCareNurse(ATCN)orTraumaNurseCriticalCare(TNCC),and AdvancedCardiacLifeSupport(ACLS)arerequiredforeachappropriateduty sectionatthetimeofselectionforcontractaward.Thecontractorshallensurethat thecontractnurse’scertificationsremainvalidthroughoutthetermofthiscontract.

6.5Orientation:Allnursesprovidingserviceunderthiscontractshallattendmandatory orientationsandtrainingspecifiedbythegovernment.

6.6BackgroundChecks:AsdirectedbytheContractingOfficer,theContractorshall provideallrequestedinformationnecessarytoperformLevelIandLevelII backgroundchecks.TheContractorshallcomplywiththerequirementtoobtain securityinvestigations.TheContractorshallworkwiththeNAIHStoensurethat thepre-employmentscreeningprocessincludestheappropriateinvestigation questionnairesandformstobecompleted.Allcompletedformswillbereviewed bytheContractorandforwardedtotheSupervisor.TheContractorwillbe immediatelyremovedfromthepositionifatanytimetheinvestigationreceives unfavorableadjudication,or,ifotherunfavorableinformationthatwouldaffectthe investigationbecomesknown.

AnAgreementtoaTemporaryWaiverofcharacterinvestigationformshallbe signedandusedpendingcompletionofbackgroundinvestigation.

7.0FederalTortClaimsAct(28USC1346(B)I946)jFTCAisnotextendedtoNon-Personal ServiceContractors,refertoclause52.237-7IndemnificationandMedicalLiability Insurance.

8.0ChallengestoConflicts:Foranyinconsistencybetweensupervisordirections,this PerformanceWorkStatement,attachmentsandexhibits,thefollowingorderof precedencewillapply:

(a)FirstPriority:Supervisor’sdirections

(b)SecondPriority:PositionDescription(attached)

(c)ThirdPriority:PerformanceWorkStatementExhibits

(d)FourthPriority:PerformanceWorkStatementNarrative

9.052.249-12Termination(PersonalServices)(Apr1984):

TheGovernmentmayterminatethiscontractatanytimeuponatleast15days’written noticebytheContractingOfficertotheContractor.TheContractor,withthewritten consentoftheContractingOfficer,mayterminatethiscontractuponatleast15days’ writtennoticetotheContractingOfficer.

9.1.AnyContractoremployeedemonstratingimpairedjudgmentshallnotbeallowed tocontinueworkingimmediatelyonthecontract.TheGovernmentreservesthe righttoremovefromthefacilityanyContractoremployeewhointhejudgment ofalicensedhealthcarepractitionerisimpaired.

10.0TechnicalDirection:

10.1Performanceoftheworkunderthiscontractissubjecttothewrittenandverbal technicaldirectionoftheNursingSupervisor.

10.2TheNursingSupervisordoesnothavetheauthorityto,andshallnot,issueany instructionspurportingtobetechnicaldirectionthat:

•Constitutesanassignmentofadditionalworkoutsidetheperformancework statement;

•Constitutesachangeasdefinedinthechanges;

•Inanymannercausesanincreaseordecreaseinthetotalestimatedcontractcost, fixedfee(ifany),orthetimerequiredforcontractperformance;

•Changesanyoftheexpressedterms,conditions,orspecificationsofthecontract;

orthetermsandconditionsofthecontract.

10.3AlltechnicaldirectionshallbeissuedinwritingbytheNursingSupervisor.Allverbal directionwillbeconfirmedinwritingwithin24hours(onebusinessday).The

Contractorshallproceedpromptlywiththeperformanceoftechnicaldirectionduly issuedbytheNursingSupervisorinthemannerprescribedbythisclauseand withintheauthority.If,intheContractor’sopinion,anyinstructionsordirectionby theNursingSupervisorfallswithinanyofthecategoriesdefinedinparagraph above,theContractorshallnotproceedbutshallnotifytheContractingOfficerin writingwithin5workingdaysafterreceivingitandshallrequesttheContracting Officertotakeactionasdescribedinthisclause.Uponreceivingthisnotification, theContractingOfficershalleitherissueanappropriatecontractmodificationwithin areasonabletimeoradvisetheContractorinwritingthattheinstructionordirection iswithintherequirementsofthecontractanddoesnotconstituteachangeunder thechangesclauseofthecontractandthatthecontractorshallproceedpromptly withitsperformance.

10.4AfailureoftheContractorandContractingOfficertoagreethattheinstructionor directionisbothrescindedinitsentirety;orwithintherequirementsofthecontract anddoesnotconstituteachangeunderthechangesclause,orafailuretoagree uponthecontractactiontobetakenwithrespecttotheinstructionordirectionshall besubjecttotheDisputesclauseofthiscontract.

10.5AnyactiontakenbytheContractorinresponsetoanydirectiongivenbyanyperson otherthantheContractingOfficerortheNursingSupervisorshallbeatthe Contractor’srisk

11.0HealthRequirementslConditionsofEmployment:

11.1MedicalEvaluation.TheContractorshallprovideafitnessfordutycertificateissued byalicensedphysiciantoperformtheproposedjobwithoutsignificantriskto personalhealthorthehealthandsafetyofothers.

11.2Immunization.TheContractorshallalsoprovidethefollowingdocumentationprior toRNCandidateselection:ImmunitytoRubella,Mumps,andRubeola(Measles);

•ProofofHepBvaccinationx3ORpositivetiterORasigneddeclinationofthe HepBvaccinationswillalsobeaccepted;•DocumentedhistoryofchickenpoxOR varicellavaccinationx2ORpositivevaricellatiter;•HistoryofTdapvaccination, withsubsequentTdvaccinationifolderthan10years;•Documentationof Tuberculosistesting(TBskintestorIGRA)withinthepast12monthswith documentationofchestx-rayandfollow-upforapositivehistory;12monthswith documentationoffollow-upforapositivetest.Proofofinfluenzavaccinationfrom October-1thruMarch31,perIHSMandatoryInfluenzaVaccinationPolicy.Proof ofVaccinationagainstSARS-COV-2,thevirusthatcausesCOVID19

12.0LanguageRequirementsandCulturalAwareness.

TheContractorshallread,understand,speak,andwriteEnglishtoeffectively communicatewithpatientsandotherhealthcareworkers,andshallberespectfulofthe local,AmericanIndianandAlaskaNativeculture.

13.0PRIVACYACTNOTIFICATION(APR1984)

TheContractorwillberequiredtodesign,develop,oroperateasystemofrecordson individuals,toaccomplishanagencyfunctionsubjecttothePrivacyActof1974,Public Law93-579,December31,1974(5U.S.C.552a)andapplicableagencyregulations.

ViolationoftheActmayinvolvetheimpositionofcriminalpenalties.

13.1PRIVACYACT(APR1984)

(a)TheContractoragreesto—

(1)ComplywiththePrivacyActof1974(theAct)andtheagencyrulesand regulationsissuedundertheActinthedesign,development,oroperationofany systemofrecordsonindividualstoaccomplishanagencyfunctionwhenthe contractspecificallyidentifies—

(i)Thesystemsofrecords;and

(ii)Thedesign,development,oroperationworkthatthecontractoristoperform;

(2)IncludethePrivacyActnotificationcontainedinthiscontractinevery solicitationandresultingsubcontractandineverysubcontractawardedwithouta solicitation,whentheworkstatementintheproposedsubcontractrequiresthe redesign,development,oroperationofasystemofrecordsonindividualsthatis subjecttotheAct;and

(3)Includethisclause,includingthisparagraph(3),inallsubcontractsawarded underthiscontractwhichrequiresthedesign,development,oroperationofsucha systemofrecords.

(b)IntheeventofviolationsoftheAct,acivilactionmaybebroughtagainstthe agencyinvolvedwhentheviolationconcernsthedesign,development,or operationofasystemofrecordsonindividualstoaccomplishanagencyfunction, andcriminalpenaltiesmaybeimposedupontheofficersoremployeesofthe agencywhentheviolationconcernstheoperationofasystemofrecordson individualstoaccomplishanagencyfunction.ForpurposesoftheAct,whenthe contractisfortheoperationofasystemofrecordsonindividualstoaccomplishan agencyfunction,theContractorisconsideredtobeanemployeeoftheagency.

(1)“Operationofasystemofrecords,”asusedinthisclause,meansperformance ofanyoftheactivitiesassociatedwithmaintainingthesystemofrecords,including thecollection,use,anddisseminationofrecords.

(2)“Record,”asusedinthisclause,meansanyitem,collection,orgroupingof informationaboutanindividualthatismaintainedbyanagency,including,butnot limitedto,education,financialtransactions,medicalhistory,andcriminalor employmenthistoryandthatcontainstheperson’sname,ortheidentifying number,symbol,orotheridentifyingparticularassignedtotheindividual,suchasa fingerprintorvoiceprintoraphotograph.

(3)“Systemofrecordsonindividuals,”asusedinthisclause,meansagroupof anyrecordsunderthecontrolofanyagencyfromwhichinformationisretrievedby thenameoftheindividualorbysomeidentifyingnumber,symbol,orother identifyingparticularassignedtotheindividual.

13.2PrivacyorSecuritySafeguards(Aug1996)

(a)TheContractorshallnotpublishordiscloseinanymanner,withoutthe ContractingOfficer’swrittenconsent,thedetailsofanysafeguardseitherdesigned ordevelopedbytheContractorunderthiscontractorotherwiseprovidedbythe Government.

(b)Totheextentrequiredtocarryoutaprogramofinspectiontosafeguard againstthreatsandhazardstothesecurity,integrity,andconfidentialityof Governmentdata,theContractorshallaffordtheGovernmentaccesstothe Contractor’sfacilities,installations,technicalcapabilities,operations, documentation,records,anddatabases.

(c)Ifneworunanticipatedthreatsorhazardsarediscoveredbyeitherthe GovernmentortheContractor,orifexistingsafeguardshaveceasedtofunction, thediscoverershallimmediatelybringthesituationtotheattentionoftheother party.

13.3PrivacyAct(December18,2015)

ThiscontractrequirestheContractortoperformoneormoreofthefollowing:

(a)design;

(b)develop;or(C)operateaFederalagencysystemofrecordstoaccomplishan agencyfunctioninaccordancewiththePrivacyActof1974(Act)(5U.S.C.

552a(m)(1))andapplicableagencyregulations.Thetermsystemofrecordsmeans agroupofanyrecordsunderthecontrolofanyagencyfromwhichinformationis retrievedbythenameoftheindividualorbysomeidentifyingnumber,symbol,or otheridentifyingparticularassignedtotheindividual.ViolationsoftheActbythe Contractorand/oritsemployeesmayresultintheimpositionofcriminalpenalties(5

U.S.C.552a(i)).TheContractorshallensurethateachofitsemployeesknowsthe prescribedrulesofconductin45CFRpart5bandthateachemployeeisawarethat he/sheissubjecttocriminalpenaltiesforviolationoftheActtothesameextentas DepartmentofHealthandHumanServicesemployees.Theseprovisionsalsoapply toallsubcontractstheContractorawardsunderthiscontractwhichrequirethe design,developmentoroperationofthedesignatedsystem(s)ofrecords(5U.S.C.

552a(m)(1)).Thecontractworkstatement:

(a)Identifiesthesystem(s)ofrecordsandthedesign,development,oroperation worktheContractoristoperform;and

(b)Specifiesthedispositiontobemadeofsuchrecordsuponcompletionof contractperformance.

13.4ConfidentialInformation(December18,2015)

(a)ConfidentialInformation,asusedinthisclause,meansinformationordataofa personalnatureaboutanindividual,orproprietaryinformationordatasubmittedby orpertainingtoaninstitutionororganization.

(b)SpecificinformationorcategoriesofinformationthattheGovernmentwill furnishtotheContractor,orthattheContractorisexpectedtogenerate,whichare confidentialmaybeidentifiedelsewhereinthiscontract.TheContractingOfficer maymodifythiscontracttoidentifyConfidentialInformationfromtimetotime duringperformance.

(c)ConfidentialInformationorrecordsshallnotbedisclosedbytheContractor until:

(1)Writtenadvancenoticeofatleast45daysshallbeprovidedtotheContracting OfficeroftheContractor’sintenttoreleasefindingsofstudiesorresearch,towhich anagencyresponsemaybeappropriatetoprotectthepublicinterestorthatofthe agency.

(2)Forinformationprovidedbyoronbehalfofthegovernment, (i)Thepublicationordisseminationofthefollowingtypesofinformationare restrictedunderthiscontract:P11.

(ii)Thereason(s)forrestrictingthetypesofinformationidentifiedinsubparagraph (I)is/are:protectedunderthePrivacyActandHIPAA.

(iii)Writtenadvancenoticeofatleast45daysshallbeprovidedtotheContracting OfficeroftheContractor’sintenttodisseminateorpublishinformationidentifiedin subparagraph(2)(i).Thecontractorshallnotdisseminateorpublishsuch informationwithoutthewrittenconsentoftheContractingOfficer.

(d)WhenevertheContractorisuncertainwithregardtotheconfidentialityofora propertyinterestininformationunderthiscontract,theContractorshouldconsult withtheContractingOfficerpriortoanyrelease,disclosure,dissemination,or publication.

13.5FederalIndemnification

(a)Indemnification,Liability,StatuteofLimitations:AnyprovisionsintheTOS relatedtoindemnificationandfilingdeadlinesareherebywaived,andshallnot applyexcepttotheextentexpresslyauthorizedbylaw.Liabilityforanybreachof theTOSasmodifiedbythisAmendment,oranyclaimarisingfromtheTOSas modifiedbythisAmendment,shallbedeterminedundertheFederalTortClaims Act,orothergoverningfederalauthority.FederalStatuteofLimitationsprovisions shallapplytoanybreachorclaim.

(b)Governinglaw:Anyarbitration,mediationorsimilardisputeresolutionprovision intheTOSisherebydeleted.TheTOSandthisAmendmentshallbegovernedby andinterpretedandenforcedinaccordancewiththelawsoftheUnitedStatesof Americawithoutreferencetoconflictoflaws.Totheextentpermittedbyfederal law,thelawsoftheStateof[Companytoinsertnameofstateifoneismentioned initsTOS](excluding[Company’sstate]choiceoflawrules)willapplyinthe absenceofapplicablefederallaw

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erform ance based

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P erform ance.

based

T ask

Indicator S tandard Q uality A ssurance Incentives

For the

For each

“S tandard”, state the requirem ent, For each

“indicator,” state a perform ance level that, m ethod used to check state the w hen m et, m eans the task has been perform ed perform ance

(i.e.

random

S tate the end results or outputs that feature(s) of end satisfactorily, sam pling, 100% inspection, List Positive and N egative Incentives.

you, the custom er w ill form ally accept result th at w ill be periodic inspection, custom er A ddress m ethod of linking paym ent or reject.

surveilled.

T his

S tandard describes “W hat S uccess L ooks Like.”

com plaints), to quality of service.

C ontractor shall provide

N ursing

C om petency P erform 100% required tasks at 100% of th e required

S ee

Q A

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S urveillance system s P aym ent of contract price for services in th e delivery of patient com petencies (refer to 11.0) w ill include periodic inspections satisfactory service.

care to the

N avajo

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Indian and custom er com plaints

H ealth

Service.

C om pliance

100% com pliance w ith

IH

S S ervice U nits an d /o r H ealth C ontractor perform ance w ill be

C enters published Policies;

P rocedures;

S tandards of evaluated using the

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P rotocols.

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S C ontract control, and o th er procedures th at m ight adversely selections are m ade.

affect patient outcom e.

P rofessionalism

P erform ance characterized by continual cultural aw areness and focus on custom er service.

p ercen t adherence to th e N ursing C ode of

E thics and F ederal C ode of

C onduct.

C redentialing

U ninterrupted credentialing as defined in

6.0 to

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D ocum entation 100% percent of all docum entation m eets established lH S

M edical

Facility, TiC and

C M

S standards to include, but are not lim ited to, tim eliness, legibility, accuracy, content, date, tim e, signature and designated profession.

Service Q uality

S atisfaction w ith quality of service is evidenced by valid custom er inputs.

14.1ListofAttachmentsandExhibits.TobeprovidedbytheContractingOfficeruponrequest.

14.1.1.Attachments

1.PositionDescription(ServiceUnitspecific)

14.1.2ExhibitsApplicabletotheNavajoAreaHIS

14.1.3.WrittenCompetencyAssessments a.Confidentiality/HIPAA/Patient’sRights b.EMTALAComplianceExam,2004 c.AgeSpecificCompetencyVerification d.RNMedicationAdministrationCompetencyExamination e.RNMedicationAdministrationCompetencyVerification f.IntravenousTherapyExam g.VenipunctureProcedureSkillscompetencyVerification h.PainManagementCompetencyVerification i.Restraints j.SoftRestraintApplicationCompetencyVerification k.HardLeatherRestraintApplication

14.1.4.ContractNurseOrientationCheckList

14.1.5.ContractNurseOrientationCompetencyVerificationInstructions

14.1.6.ContractNurseBillingInformation

14.1.7StandardEmergencyCodes

14.1.8.Confidentiality:LegalandEthicalConcernsinHealthcare

14.1.9EMTALA—EmergencyMedicalTreatmentandLaborAct

14.1.10.WhatisAge-SpecificCompetencies?

14.1.11AnIntroductiontotheNavajoCulture

14.1.12VerbalandTelephoneOrders

14.1.13.MedicationAdministration

14.1.14.PainManagement

14.1.15.LatexAllergy

14.1.16.FocusCharting

14.1.15.PatientRestraints

14.1.16.ChargeNurseDuties:ResponsibilityandExpectation

14.1.17.NursingStandards

14.1.18.StandardsofNursingPractice