TAB A - PWS General Surgery Nocturnist REV 06.08.26.pdf

PWS: General Surgery (Nocturnist) 6.8.26

Performance Work Statement (PWS) for Non-PersonaI Services

General Surgery Nocturnist

Table of Contents

Section Page

1.0 General 2-4

2.0 Definitions 4-6

3.0 Government Furnished Information, Property, & Services 6-7

4.0 Contractor Furnished Property 7-8

5.0 Performance Work Statement Requirements 8-11

6.0 Contractor Qualification Requirements 12-13

7.0 Performance Requirements Summary 14

8.0 List of Attachments and Exhibits 15

1.0 General: This performance work statement describes the requirements for non-personal services for a(n) GENERAL SURGERY NOCTUNIST to support the mission of the Indian Health Service (IHS).

1.1. Background: IHS is an agency within the U.S. Department of Health and Human Services and is responsible for providing federal health services to American Indians and Alaska Natives. The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes. The IHS is the principal federal health care provider and health advocate for the Indian people. The goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indians and Alaska Natives. The IHS currently provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 34 states.

1.1.1. Navajo Area Indian Health Service (NAIHS) administers health centers and hospitals providing health care to approximately 201,583 members of the Navajo Nation. The Navajo Nation is the largest Indian tribe in the United States and has the largest reservation, which encompasses more than 25,516 square miles in northern Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico. The NAIHS is the primary provider of inpatient, ambulatory care, preventive and community health, and environmental health services for members of the Navajo Nation and the San Juan Southern Paiute Tribe.

1.2. Scope: The Contractor shall provide GENERAL SURGERY NOCTURNIST care services in accordance with section 5.0, performance-based requirements.

1.2.1. Services shall encompass GENERAL SURGERY NOCTURNIST SERVICES to IHS patients.

1.2.2. Place of Performance: Services are to be performed under the Navajo Area Indian Health Service (NAIHS), Shiprock Service Unit - Northern Navajo Medical Center (NNMC) within the State of New Mexico. The award pricing schedule shall identify the exact place of performance.

1.2.3. Period of Performance: The period of performance for this contract is a base of 6 months with four 6 month option periods.

1.3. Applicable Documents: Please see the web link listed unless document is listed as an attachment.

1.3.1. The Joint Commission http://www.jointcommission.org/

1.3.2. Centers for Medicare and Medicaid Services (CMS) Standards http://www.cms.hhs.gov/

1.3.3. Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaahc.org

1.3.4. Section 231 of Public Law 101-647, the Crime Control Act of 1990, https://www.bia.gov/sites/default/files/dup/ assets/bia/ ois/ois/pdf/idc2- 057852.pdf

1.3.5. Section 4087 of Public Law 101-630, the Indian Child and Family Violence Act.

https://www.ihs.gov/sites/selfgovernance/themes/responsive2017/display_objects /docum ents/OIG_PL_Facts_Sheet.pdf https://www.nicwa.orgl.Q.Qfu:v/1aw/protection/inclex.asp

1.3.6. Health Insurance Portability and Accountability Act (HIPAA) of 1996.

https://aspe.hhs.gov/reports/health-insurance-porta bility-accountabiIity-act-1996

1.3.7. Privacy Act of 1974.

Office of Privacy and Civil Liberties I Privacy Act of 1974

1.3.8. IHS Service Unit and Health Center Policies, Procedures and Protocols. (See section 10.0 for a list of attachments and exhibits)

1.3.9. Computer Security Act of 1987

https://csrc.nist.gov/csrc/media/projects/ispab/ documents/csa 87.txt

1.3.10. Federal Code of Conduct http://www.ihs.gov

http://www.jointcommission.org/ http://www.cms.hhs.gov/ http://www.aaahc.org/ https://www.bia.gov/sites/default/files/dup/assets/bia/ois/ois/pdf/idc2-057852.pdf https://www.bia.gov/sites/default/files/dup/assets/bia/ois/ois/pdf/idc2-057852.pdf https://www.ihs.gov/sites/selfgovernance/themes/responsive2017/display_objects/docum%20ents/OIG_PL_Facts_Sheet.pdf https://www.ihs.gov/sites/selfgovernance/themes/responsive2017/display_objects/docum%20ents/OIG_PL_Facts_Sheet.pdf https://www.nicwa.orgl.Q.Qfu:v/1aw/protection/inclex.asp https://aspe.hhs.gov/reports/health-insurance-porta%20bility-accountabiIity-act-1996 https://csrc.nist.gov/csrc/media/projects/ispab/%20documents/csa%2087.txt http://www.ihs.gov/

1.3.11. IHS General Directives https://www.ihs.gov/ihm/

1.3.12. IHS Computer Security Directives https://www.ihs.gov/lSSA/

2.0 Definitions

2.1. Acceptance: Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart 46.5 and subject to other terms and conditions of the contract.

2.2. Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements.

Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

2.3. Area: A defined geographical region for Indian Health Service administrative purposes.

Each Area Office may administer several Service Units.

2.4. Code of Ethics: The Code ethics as described by the American Medical Association (AM_A) and any code of ethics described by individual specialty organizations.

2.5. Contracting Officer (CO): A Government employee with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.6. Contractor: The individual awarded a legal binding contract to provide supplies and services.

2.7. Contracting Officer's Representative (COR) or Project Officer (PO): The COR is a Federal employee who is primarily responsible for the technical assistance and day-to-day program management of the contract during the award period.

2.8. Contractor Performance Assessment Report: A report that assesses a contractor's performance and provides a record, both positive and negative, on a given contract for specific period of time.

2.9. Cooperative Attitude: Behavior that is positive and displays a willingness to perform assigned patient care tasks and to be a team player.

https://www.ihs.gov/ihm/ https://www.ihs.gov/lSSA/

2.10. Local Awareness: Realization and respect for American Indian and Alaska Native practices.

2.11. Customer: Patients, staff and visitors of an IHS service unit and health center.

2.12. Customer Evaluation/Input: Written comments made to the Contracting Officer regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor's performance.

2.13. Dependability: Qualities of being trusted and being able to repeat the same task to yield the same result.

2.14. Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal Executive agencies in their acquisition of supplies and services with appropriated funds.

2.15. Government Vehicle: An IHS owned motor vehicle or a vehicle leased by IHS through agreements with the General Services Administration (GSA) or through commercial rental agreements.

2.16. Health Center: A facility physically separated from a hospital, with a full range of ambulatory services including at least primary care providers, nursing, laboratory, and x-ray which are available at least 40 hours a week for outpatient care.

2.17. Health Insurance Portability and Accountability Act (HIPAA): A US law designed to provide privacy standards to protect patients' medical records and other health information provided to health plans, doctors, hospitals and other health care providers.

2.18. Nonpersonal Services: A contract under which the personnel rendering the service are not subject, either by the contract's terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees, as defined in FAR 37.

2.19. Orientation: An activity designed to provide basic familiarization of the facility and transition the Contractor into the IHS Service Unit and/or Health Center and the nursing unit where the services shall be provided.

2.20. Past Performance Information: Relevant information regarding a contractor's actions under previously awarded contracts. This includes the contractor's record of conformance to specifications and to standards of good workmanship; the contractor's record of containing and forecasting costs on any previously performed cost reimbursable contracts; the contractor's adherence to contract schedules, including the administrative aspects of performance; the contractor's history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor's business-like concern for the interest of the customer.

2.21. Patient Outcome: End result of outpatient.

2.22. Performance Work Statement Requirements summary: Lists the services to be monitored and the standards to be applied.

2.23. Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

2.24. Service Unit: The local administrative unit of IHS.

2.25. Standards of Practice and Standards of Care: Authoritative statements by which the medical profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for professional medical practice and a framework for the evaluation of practice. The standards of professional medical practice may pertain to general or specialty practice.

2.26. Tour of Duty: The time of day the GENERAL SURGERY NOCTURNIST is scheduled to perform outpatient and inpatient general surgery nocturnist services; also considered the shift of the day. The time can vary according to the needs of each facility and/or clinic, e.g. 12 hour Tour of Duty, 8 hour Tour of Duty, 14 hour Tour of Duty.

2.27. Valid Patient Complaint: Justifiable accusation made by a patient and supported by investigation.

2.28. Verifiable Emergency: An unexpected/unplanned absence by the contractor requiring valid documentation to confirm the occurrence.

3.0 Government Furnished Information, Property and Services

3.1. Information: Government unique information related to this requirement, which is necessary for Contractor performance, shall be made available to the Contractor. The Contracting Officer or designee shall be the point of contact for identification of any required information to be supplied by the Government.

3.2. Joint Use by the Government and the Contractor: Except for the property and service listed in 3.3 and 4.0, the Government shall provide, for joint use by the Government and the Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

3.2.1. Government Vehicle: If required by the position, authorization shall be in accordance with IHS Chapter 12, Section 13 Motor Vehicle Management.

3.3. Contractor Exclusive Use:

3.3.1. Personal Protective Equipment (PPE). The Government shall furnish the Contractor with appropriate PPE other than specified in paragraph 4 of the contract. The Government shall be responsible for any repair, cleaning, and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

3.3.2. The Government shall provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 shall be charged for lost or destroyed badges.

3.4. Facility specific orientation/training necessary for the Contractor to perform General

Surgery Nocturnist Services, e.g., IHS information technology (IT) systems and operational procedures. Training shall be provided ONLY if the subject matter is necessary to improve or enhance the quality of service or includes mandates made by the IHS Service Units/Health Centers while the GENERAL SURGERY NOCTURNIST is working under this contract. Training shall not be provided for the purpose of continuing education, career development or individual development.

4.0 Contractor Furnished Property

4.1. Except for the property specified in paragraph 3 as government furnished, the

Contractor shall provide all uniforms and other personal medical instruments subject to the following:

4.1.1. Uniforms and Lab Coats: Uniforms and Lab Coats shall conform to the requirements of the Indian Health Service Manual, Part 3 Chapter 4 and meet the approval of the Clinical Director at each IHS facility.

4.1.2. Other personal medical instruments: "Other personal medical instruments" are defined as Contractor owned items may include but not limited to stethoscope, scissors, as appropriate to the work unit. The Contractor shall not use unsafe equipment or supplies at any time during performance of this contract. All Contractor furnished equipment and supplies shall be subject to inspection by the Government and must be approved by the COR prior to use by the Contractor. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

5.0 Performance-Based Requirements. The Contractor shall provide outpatient and inpatient

GENERAL SURGERY NOCTURNIST services in the delivery of patient care to the Indian Health Service. Specific tasks include the following:

5.1. GENERAL SURGERY NOCTURNIST SERVICES:

5.1.1. The Contractor shall perform GENERAL SURGERY NOCTURNIST SERVICES as identified by the Service Unit and as directed by the Chief of Surgery or their designee.

5.1.2. The Contractor shall perform in accordance with the competency standards listed in the Shiprock Service Unit Medical Staff By-Laws.

5.1.3. The Contractor shall provide professional medical services or direct patient care services under the terms of this contract, appropriate and timely medical services in accordance with the standards of care established by recognized medical care organizations and in accordance with the policies and procedures of Service Unit's Medical Staff Bylaws and Rules & Regulations at Shiprock hospital.

5.1.4. The contractor shall provide professional GENERAL SURGERY NOCTURNIST

SERVICES as follows:

5.1.4.1. The GENERAL SURGERY NOCTURNIST (hereafter referred to as the contractor) shall provide, but is not limited to, the diagnostic and therapeutic procedures involved in the examination, treatment and care of the full range of general surgical patients at Indian Health Service, Northern Navajo Medical Center, Shiprock, New Mexico.

5.1.4.2. The Contractor will provide care to adults and children over 18 months

(routine & emergencies)

5.1.4.3. Contractor shall obtain consultation with members of the GENERAL

SURGERY staff and other anesthesia staff on matters of patient care when questions arise.

5.1.4.4. The Contractor will cross-cover the inpatient General Surgery service and admit new patients to the hospital as needed while on-call during overnight and weekend shifts. The Contractor will provide on-call (carrying the pager) coverage with call-back hours for any consults/admissions/questions from the ED, the outpatient clinics, and the inpatient services as well as local referral centers. The Contractor will perform emergency general surgical cases and upper/lower endoscopies as needed. The Contractor may be called in to assist in emergency surgical cases with any of the other surgical service providers (e.g. Obstetrics/Gynecology).

5.1.4.5. The contractor shall review clinical records and adhere to records documentation procedures to ensure that records are properly maintained.

5.1.4.6. The contractor shall report to the Chief of GENERAL SURGERY or his/her designee. The contractor's provision of GENERAL SURGERY NOCTURNIST SERVICES will be monitored by the Northern Navajo Medical Center's quality assurance plan.

5.1.4.7. Contractor shall have access to the internet to use the Electronic Health

Record. All documentation on patients shall be completed prior to the contractor's shift is over. Delinquent charts shall be completed prior to the contractor completion of his/her contract at Northern Navajo Medical Center. If the delinquent chart is not completed the contract company shall assume the responsibility of returning the contractor to Northern Navajo Medical Center to complete any outstanding delinquent charts.

5.1.4.8. The contactor may be subject to technical direction and/or guidance of the designated Government official.

5.2. Work Schedule:

5.2.1. The Chief of Surgery or their designee shall determine specific tour of duty. The contractor shall work 100% of the contracted hours.

5.2.2. The Contractor will work five weekly overnight on-call (carrying the pager) shifts, Wednesday through Sunday, from 1700 to 0700. In addition, for 1 to 2 weekends of each month covered by the contract period, the contractor will also cover a full weekend on-call (carrying the pager) (Friday 1700-0700 Monday: the standard overnight Friday 1700-0700 Saturday; then 24hour Saturday 0700-0700Sunday;

24hour Sunday 0700-0700 Monday). During these on-call shifts, the Contractor will be responsible for call-back hours when he/she needs to come into the hospital to cross-cover the inpatient General Surgery service and/or address consults/admissions. from the ED, the outpatient clinics, and the inpatient services as well as local referral centers. The Contractor will perform emergency surgeries/scopes as needed during his/her tour of duty, if the patient cannot be stabilized and managed medically until the next business day. Otherwise, the contractor may admit and stabilize the patient in preparation for surgery by the day-team the following morning. Contractor is expected to cover shifts that occur on holidays that fall during the covered contract period and work schedule.

5.2.3. The Contractor shall provide to the COR planned absences from work. If the length of the absence exceeds eight (8) work hours the Contractor shall request approval at least fifteen (15) days, (the exception is verifiable emergencies) in advance of the desired absence.

5.2.4. Approval of leave is contingent upon availability of a qualified replacement.

5.2.5. The Contractor shall provide written documentation from a qualified health care provider for absences of three (3) or more consecutive days, due to illness, stating the cause of the current illness or incapacitation AND indicating the Contractor as contagious or non-contagious

5.3. Conduct: The Contractor shall meet standards as listed in the Federal Code of Conduct.

5.4. Performance Evaluation:

5.4.1. The Contractor's performance shall be evaluated in accordance with the standards set forth in the contract and Performance Work Statement Requirements summary.

5.4.2. Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome constitutes a breach of contract.

5.5. Identification of Contractor: The Contractor shall wear a government issued contractor identification badge during performance of duty.

5.6. Management of Medical Information: The Contractor shall manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols.

5.6.1. Medical Records and Other Required Documentation: All medical records and other required documentation must meet the established IHS Medical Facility, Joint Commission, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession. (Note:

payment shall be withheld for inaccurate or incomplete medical records per paragraph 10.0 of this performance work statement.)

5.6.2. The Contractor shall ensure adherence to DHHS IT security policies and procedures. The IT policies and procedures shall be made available to the Contractor.

5.6.3. The Contractor shall immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

5.7. IHS Information Technology Systems:

5.7.1. In performance of this contract, the Contractor shall adapt to and successfully utilize IHS information technology systems necessary for acceptable contractor performance.

5.7.2. The Contractor shall ensure that IHS information technology system security policies and procedures are adhered to. The IT policies and procedures shall be made available to the Contractor at each IHS facility.

6.0 Contractor Qualification Requirements:

6.1. Experience: The Contractor shall be a GENERAL SURGEON and must be either Board

Eligible as per the American Board of Surgery (ABS} regulations or ABS certified.

6.2. License/Registration: All GENERAL SURGERY NOCTURNISTS shall possess a current, valid, unrestricted license in any state, the District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States, throughout the term of this contract.

The selected individual is required to obtain and maintain medical staff clinical privileges, including any licensure requirements throughout the term of this contract.

The provider is also required to have a personal or Federal DEA number.

6.2.1. Motor Vehicle Operator's License: If required by the position, the Contractor shall possess a valid state driver's license throughout the term of this contract.

6.3. Certifications: Current Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) is mandatory.

6.4. Health Requirements/Conditions of Employment:

6.4.1. Medical Evaluation: The Contractor shall provide a fitness for duty certificate issued by a licensed physician to perform the proposed job without significant risk to personal health or the health and safety of others.

6.4.2. Immunization: The Contractor shall also provide the following documentation:

6.4.2.1. Immunity to Rubella, Mumps, Measles

6.4.2.2. Immunity to Hepatitis B series

6.4.2.3. History of chicken pox (varicella) disease or positive titer

6.4.2.4. Tetanus Diphtheria (Td) within the last 5 years

6.4.2.5. Documentation of receiving a TB Mantoux skin test (PPD) within the past

12 months with documentation of follow-up for a positive test.

6.4.2.6. A signed declination of the Hepatitis B vaccination series shall be accepted

6.4.2.7. Flu vaccination is REQUIRED

6.4.3. Contractor History: Per the IHS SOP for credentialing for high-risk findings, the contractor cannot have a history of any of the following actions:

6.4.3.1. Suspension, restriction, revocation, denial, probation or involuntary relinquishment of any clinical professional license or registration held by the licensed practitioner

6.4.3.2. Suspension, restriction, revocation, or denial of employment, medical staff membership, or clinical privileges at any place of employment, including, hospitals, clinics or other healthcare settings

6.4.3.3. Subject of civil, criminal, or administrative action regarding sexual misconduct, child abuse, domestic violence, elder abuse, or other violent crimes.

6.4.3.4. Any arrest, charge, conviction, or sentence for the following crimes:

Driving Under the Influence (DUI) or while impaired or intoxicated

6.4.3.5. Any sexual misconduct

6.4.3.6. Illegal drugs forbidden by Federal Law

6.4.3.7. Intimate Partner violence or other violent crimes

6.4.3.8. Not Board Certified

6.5. Language Requirements: The Contractor shall read, understand, speak, and write

English to effectively communicate with patients and other health care workers, and shall be respectful of the local, American Indian and Alaska Native culture.

6.6. Information Technology Skills: The Contractor shall possess basic knowledge, skills, and abilities to use a computer.

6.7. Orientation: All GENERAL SURGERY NOCTURNISTS providing service under this contract shall attend mandatory orientations and training specified by the government.

6.8. Background Checks: As directed by the Contracting Officer, the Contractor shall provide all requested information necessary to perform Level I and Level II background checks.

The Contractor shall comply with the requirement to obtain security investigations. The Contractor shall work with the IHS to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms shall be reviewed by the Contractor and forwarded to the COR and the Chief of Surgery or their designee. The Contractor shall be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

7.0 Performance Requirements Summary

Performance-based Task Indicator Standard Quality Assurance Incentives

State the end results or outputs that you, the customer shall formally accept or reject.

For the requirement, state the feature(s) of end result that shall be surveilled.

For each "indicator," state a performance level that, when met, means the task has been performed satisfactorily.

This Standard describes "What Success Looks Like."

For each "Standard", state the method used to check performance (i.e.

random sampling, 100% inspection, periodic inspection, customer complaints).

List Positive and Negative Incentives. Address method of linking payment to quality of service.

Contractor shall provide GENERAL SURGERY in the delivery of patient care to the Navajo Area Indian Health Service.

Competency

Compliance

Patient Outcomes

Perform 100% required tasks at 100% of the required competencies (refer to 11.0) 100% compliance with IHS Service Units and/or Health Centers published Policies; Procedures;

Standards of Care; and hospital and Laboratory Protocols.

No reports of breached patient safety, infection control, and other procedures that might adversely affect patient outcome.

See requirements summary.

Surveillance systems shall include periodic inspections and customer complaints.

Payment of contract price for satisfactory service.

No payment for incomplete work.

Contractor performance shall be evaluated using the Contractor's Performance Assessment Report (CPAR). The evaluation shall be considered when future IHS contract selections are made.

Professionalism Performance characterized by continual cultural awareness and focus on customer service. 100 % adherence to the Code of Ethics and Federal Code of Conduct.

Credentialing Uninterrupted credentialing as defined in 6.0 to 6.8 for period of contract.

Documentation

All medical records documentation and other required Documentation must meet the established IHS Medical Facility, Joint Commission, and CMS standards to include, but not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

Service Quality Satisfaction with quality of service is evidenced by valid customer inputs.

8.0 List of Attachments and Exhibits to be provided by the contracting officer on request.

8.1. Written Competency Assessments

8.2. Confidentiality/HIPAA/Patient's Rights

8.3. EMTALA Compliance Exam, 2004

8.4. Standard Emergency Codes

8.5. Confidentiality: Legal and Ethical Concerns in Healthcare

8.6. An Introduction to the Navajo Culture

8.7. Verbal and Telephone Orders

8.8. Pain Management

8.9. Focus Charting

8.10. Medical Staff Bylaws