Performance_Work_Statment_Emergency_Physician.rtf

PWS No. CSU-14-01 01 OCT 2014 Chinle Comprehensive Health Care Facility Performance Work Statement (PWS) for Nonpersonal Services

EMERGENCY MEDICINE PHYSICIAN SERVICES

Table of Contents Section

Page

1.0 General 1 - 2

2.0 Definitions 3 - 5

3.0 Government Furnished Information, Property, & Services

4.0 Contractor Furnished Property

5.0 Performance-Based Requirements 8 – 11

6.0 Contractor Qualification Requirements 12-13

7.0 Federal Tort Claims Act

8.0 Challenges to Conflicts

9.0 52.249-12 Termination (Personal Services) (Apr 1984)

10.0 Performance-Based Matrix

11.0 List of Attachments and Exhibits

Chinle Comprehensive Health Care Facility Performance Work Statement (PWS) For Nonpersonal Services

EMERGENCY MEDICINE PHYSICIAN SERVICES

1.0 General: This performance work statement describes the requirements for Non-Personal services for an Emergency Medicine Physician to support the mission of the Indian Health Service (IHS).

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.

1.1.2 Chinle Comprehensive Health Care Facility (CCHCF) provides medical care for approximately 35,000 Navajo. Serving a rural area, many of our patients travel 100 miles round trip to receive care and do not have electricity or running water in their homes. And, most of our elderly patients speak only Navajo, and live according to traditional Navajo cultural practices. The Chinle Comprehensive Health Care Facility and Ambulatory Care Center is a 60 bed inpatient hospital and outpatient facility. Services offered are: Adult inpatient and Pediatric Inpatient Care, Outpatient Primary Care, Adult Intensive Care, Emergency Medicine, General Surgery, Podiatry, OBGYN, Labor & Delivery, Women's Health, Midwifery, Mental Health, Pharmacy, Optometry, Dental, PT, OT, Speech Pathology, Audiology, Lab, Public Health and School Health. THE ARIZONA DEPARMENT OF HEALTH SERVICES DESIGNATES CCHCF AS A LEVEL IV TRAUMA CENTER, SEPTEMBER 9, 2013 TO SEPTEMBER 9, 2016.

Scope: The Contractor shall provide Emergency Medicine Physician Services in accordance with section 5.0, performance based requirements.

1.2.1 Duties and responsibilities will encompass emergency medicine services to IHS patients.

1.2.2 Place of Performance: Services are to be performed at hospitals, clinics and other healthcare facilities in the Navajo IHS Areas within the Chinle Comprehensive Health Care Facility.

1.2.3 Period of Performance: Will be flexible to allow for short term (13 weeks), long term (1-year to 3-year) and, where feasible, include intermittent support to meet unplanned needs that develop on a frequent basis.

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.

http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml" http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.shtml

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

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

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

http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf

1.3.7 Privacy Act of 1974. http://www.usdoj.gov/oip/privstat.htm

1.3.8 IHS Service Unit and Health Center Policies, Procedures and Protocols. (See section 11.0 for a list of attachments and exhibits)

1.3.9 Computer Security Act of 1987

http://csrc.nist.gov/groups/SMA/ispab/documents/csa_87.txt

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

1.3.11 IHS General Directives http://www.ihs.gov/adminmggrresouces

1.3.12 IHS Computer Security Directives http://www.ihs.gov/adminmggresources" http://www.ihs.gov/adminmggresources 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 of Ethics for Emergency Medicine Physicians approved by the American Board of Emergency Medicine.

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 organization awarded a legal binding contract to provide supplies and/or services; includes the organization’s employees.

2.7 Contracting Officer’s Representative (COR) or Project Officer (PO): A federal employee who assists the ordering/issuing activity contracting officer in the administration of task orders issued under this contract. The COR is primarily responsible for the technical assistance and day-to-day program management of the ordering activity’s task orders. Ordering activities may have different designators for this employee (e.g. GTR – Government Technical Representative, COTR–Contracting Officer’s Technical Representative, or PO - Project Officer).

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

2.9 Cultural Awareness: Realization and respect for American Indian and Alaska Native practices.

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

2.11 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.

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

2.13 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.

2.14 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.

2.15 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.

2.16 Non-Personal Services Contract: a contract under which the personnel rendering the services 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 37.401.

2.17 Ordering Activity: An authorized user of IHS that may issue a task order to obtain required services under this contract.

2.18 Ordering Activity Contracting Officer: A Government employee of IHS authorized and warranted to issue task orders and to make subsequent task order modification(s) under this contract. The Ordering Activity CO has the authority to make initial determinations on all matters of dispute regarding task orders.

2.19 Orientation: An activity designed to provide basic familiarization of the facility and transition the emergency room physician into the IHS Service Unit and/or Health Center and the nursing unit where the services will 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, Emergency Medicine physician care.

2.22 Performance Based Matrix: 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 Supervisor. Government employee authorized to provide verbal and written performance direction to the Contractor that the Contractor must follow without exception.

2.27 Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activities written order to obtain services, at a minimum will include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activities task order number.

2.28 Tour of Duty: The time of day the physician is scheduled to perform emergency medicine duties; 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, 10 hour Tour of Duty.

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

2.30 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, will be made available to the Contractor. The Contracting Officer or designee will 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 will 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 will furnish the Contractor with appropriate PPE other than specified in paragraph 4 of the contract. The Government will 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 will provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 will be charged for lost or destroyed badges.

3.4 Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures. Training will be provided ONLY if the subject matter is necessary to improve or enhance the quality of physician service or includes mandates made by the IHS Service Units/Health Centers while the physician is working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

3.5 Supervisor: The contractor is subject to the supervision and direction of Eric Wortmann, MD, Emergency Medicine or his designee for this order.

3.5.1 Contracting Officer Representative (COR): Georgina Nez is primarily responsible for monitoring the technical progress including surveillance and assessment of performance for this order.

3.5.2 Point of Contact: Georgina Nez, (928) 674-7450 and Aurelia Tsosie, (928) 674-7451 are the point of contacts for this requirement.

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 emergency medicine services in the delivery of patient care to the Indian Health Service. Specific tasks include the following:

5.1 Emergency Medicine Physician Duties: Contractor shall perform duties as an emergency department physician. The Chinle Comprehensive Health Care Facility (CCHCF) is recognized and approved as a Level IV trauma center (certification attached). The Chinle Service Unit serves a population of 37,000. Covering an area 3600 square miles, the hospital and clinic are the only medical services in the immediate area. The CCHCF is a 60-bed hospital, which provides medical, surgical, pediatric and obstetric care. The Emergency Department and the Urgent Care department care for approximately 30,000 patients per year. The Emergency Department consists of nine (9) beds and emergency care services are provided on a 24-hour basis for adults, adolescent children and infants. The Urgent Care consists of 6 beds and is staffed by mid-level providers (physician’s assistants or nurse practitioners) who see patients that present for acute care and who have been triaged as lower acuity. The Urgent Care operates form 10am -10 pm. The emergency department also provides care for patients with less acute illnesses who present to the department after 9 pm.

5.1.1 The Contractor shall perform emergency medicine duties and manage patient’s needs as described in the (PD), identified by the Service Unit and as directed by Supervisor.

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

5.1.3 The Contractor shall provide professional medical services or direct patient care service as follows:

Work under the general technical, administrative supervision of the Chinle Comprehensive Health Care Facility, Chief of Emergency Medicine of his/her designee.

Makes preliminary diagnosis, directs, prescribes or provides treatment, or arranges for specialized care of patient referral as required. Evaluates patients, adult/adolescents who come to the emergency room.

Provides patient care as needed and obtains consultants as needed. Patients are often critical and may require immediate decision or are complicated because patient fail to respond to previously tried treatment regimens. Provides primary medical care to patients with wide spectrum of illnesses in the emergency room.

Provides emergency care on a regular and ongoing basis to patients seen in the emergency room. This includes stabilization and transfer of major trauma (penetrating wounds, hemorrhage, traumatic brain injury, significant blunt trauma etc.) Emergency providers should also be competent in the management, stabilization and transfer of pediatric trauma, pediatric advanced life support, adult cardiac life support, psychiatric emergencies such as suicide, and complex/critical medical conditions (septic shock, cardiopulmonary shock, end stage renal disease etc.)

Serves as a first responder for “codes,” that is, ACLS/PALS administration for patients found in life threatening situations for which the “code blue” activation system has been initiated on the CCHCS campus, including the out-patient departments.

Makes appropriate referrals and obtains appropriate consultations after primary complete evaluation and documentation has been completed.

Recognized and gives initial treatment of acute psychiatric problems.

Provides guidance and supervision to the Urgent Care physician’s assistants or nurse practitioners; assisting them with patient care as needed.

Contractor shall provide appropriate documentation regarding care rendered using the Comprehensive Health Care Facility’s (CCHCF) electronic health record system. All documentation by the provider will be entered electronically using the electronic health record system. The provider is responsible for utilizing the CCHCF electronic health record system to obtain pertinent patient information in assisting care. It is the responsibility of the provider to use the training resources provided by the CCHCF to develop competency in utilizing the electronic health record system.

Contractor shall be subject to peer review per Joint Commission standards.

Safety management reporting requirements will be in accordance with the Service Unit Safety Measure Policy.

Contractor shall be responsible for all applicable Federal, State, And Local Taxes, Meals, Travel/Transportation. Lodging is provided but must be paid for by the contractor or contract agency. Government quarters are available at prevailing rental rates plus utilities, as applicable, if government quarters are utilized. The contractor shall be responsible and liable for the proper care of government owned or leased property furnished in occupied quarters.

Contractor shall submit invoices as required for payment of services rendered and hours worked. Contractor shall submit an original invoice. Invoice shall be certified by Contractor that services have been provided and attach daily sign in/sign out sheets that verify the hours worked. Invoices will also include certification statement of services received, which are to be signed by the Supervisor or designee and Project Officer.

5.2 Work Schedule:

5.2.1 The Supervisor at each IHS facility shall determine specific tour of duty. The contractor shall work 100% of the contracted hours. Works shifts as arranged by Chief of Emergency Medicine. Tour of Duty: 8:00 am to 8:00 pm or 8:00 pm to 8:00 am, Sunday through Saturday including holidays, 12 hours per shift. ExcOvertime: additional hours are admissible to a contractor that works more than 12 hours providing direct patient care. A contractor shall be subject to working longer hours in the rare instance patient load demands the contractor remain past their scheduled 12 hours in the Emergency Room. ExcOvertime will not be provided for additional time spent completing written or electronic patient care documentation. All contractors will submit a sign out, or clearance for separation sheet, prior to departure.

5.2.2 Continuity of Patient Care: The contractor shall ensure the continuity of patient care and shall provide a replacement within the time frame specified by the Contracting Officer, or shall be considered grounds for Termination for Default. If the CCHCF staff need to provide patient care coverage for any of the contracted shifts noted herein, the Contractor shall be assessed a penalty fee of $150.00 per hour for each hour of coverage provided. Penalty fee will be deducted from the invoice payment.

5.2.3 Work Flexibility. As directed by the Supervisor, the Contractor shall rotate into other duty sections as needed to support patient care.

5.2.4 The Contractor shall obtain approval of the department Supervisor or designee prior to any absence 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. Sick/annual leave/compensatory time are not authorized.

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

5.2.6 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.

The Government reserves the right to examine and or re-examine any Contractor who meets the criteria.

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

5.3.1 The contractor shall be subject to character investigation as required by Public Law 101-360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance of a contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eQIP) system and this shall include all fingerprinting procedures and clearances. 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 I.H.S. to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms will be reviewed by the contractor and forwarded to the government personnel. 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.

5.4 Performance Evaluation:

5.4.1 The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 10.0.

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:

5.5.1 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: 100% percent of all medical records and other required documentation meets established IHS Medical Facility, Joint Commision, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession. (Note: payment will 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 system security policies and procedures. The IT policies and procedures will 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 that are deemed by the Supervisor as 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 will be made available to the Contractor at each IHS facility

6.0 Contractor Qualification Requirements:

6.1 Experience. The Contractor shall meet the following requirements.

6.1.1 Completed a total of three (3) years equivalent residency training and experience in Emergency Medicine. Must be board certified with the American Board of Emergency Medicine If the provider is to perform outside the normal training parameters of his/her specialty, the provider shall provide certification of hospital privileges in those additional field/s of practice or

6.1.2 Completed a total of three (3) years equivalent residency training and experience in Family Practice must be board certified with the American Board of Family Practice. If the provider is to perform outside the normal training parameters of his/her specialty, the provider shall provide certification of hospital privileges in those additional field/s of practice.

6.2 License/Registration. The contractor's provider shall maintain appropriate licensure (a valid, current, full and unrestricted license to practice Emergency Medicine in any state within the United States, District of Columbia or the Common-Wealth of Puerto Rico) and certification throughout the term of this contract.

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.

6.2.2 The contractor's provider shall meet the qualifications and credentialing standards.

6.2.3 The contractor shall maintain a valid, current, full and unrestricted DEA license and maintain certification throughout the term of the contract.

6.3 Certifications. The Following are Mandatory and any additional certifications as appropriate to each specialty;

Current Basic Life Support (BLS) Cardiopulmonary resuscitation (CPR)

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 provide a current immunization for MMR (Measles, Mumps and Rubella, Diphtheria, Pertussis and Tetanus), Tdap booster, Hepatitis B, PPD status and Influenza or as required by NAIHS immunization policy.

6.5 Language Requirements and Cultural Awareness. 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, skill, and ability to use a computer.

6.7 Orientation. The contractor shall attend mandatory orientations and training specified by the government.

6.7.1 Contractors will complete an orientation check in sheet if they have not had previous employment at the CCHCF. Contractors will be compensated for a minimum of four hours for the orientation process, and will be granted additional hourly compensation for every hour the orientation process exceeds the estimated four hours.

6.7.2 Contractors who have not provided service to the Chinle Comprehensive Health Care Facility (CCHCF) within the last 90 days, are mandated to report to the CCHCF Credentialing Office before 12:00 pm the day prior to their scheduled ER shift if they are working from 8:00 am to 8:00 pm, or before 12:00 pm the day of their shift if they are working the 8:00 pm to 8:00 am shift, for orientation and to gain temporary employee access/privileges.

6.7.3 If the contractor is working either shift on a Sunday, then they are mandated to report to the CCHCF Credentialing Office before 12:00 pm on the subsequent Monday for orientation and to gain temporary employee access/privileges.

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 will be reviewed by the Contractor and forwarded to the Supervisor. 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.

6.9 General Requirements: The Contractor shall meet the following requirements.

6.9.1 The contractor shall provide three current letters of reference from other health care providers familiar with the candidate's clinical practice skills. One letter must be from the Chief of Staff/Medical Director at the hospital in which the provider either holds or last held staff privileges. If the contractor's provider has just completed a residency program, one of the letters shall be from the program director or service chief.

6.9.2 The contractor/credentialed medical staff members will be subject to Medical Staff Ongoing Professional Practice Evaluation and Focused Provider Performance Evaluation as specified in the Chinle Service Unit Policy & Procedure, Focused Provider Performance Evaluation & Ongoing Professional Practice Evaluation.

6.9.3 The contractor shall work directly with the Chinle Service Unit Credentials Committee approval of credentials and privileges.

7.0 Federal Tort Claims Act (28 USC 1346 (B), 1946): According to the Indian Health Care Improvement Act Reauthorizations and Amendments (Section 194) Federal Torts Claim Act (FTCA) (28 U.S.C. 1346 (B), 1946) is extended to Indian Health Service (IHS) Nonpersonal Service Contractors if the health care practitioner is providing services in an IHS facility to IHS beneficiaries.

8.0 Challenges to Conflicts: For any inconsistency between supervisor directions, this Performance Work Statement, attachments and exhibits, the following order of precedence will apply:

9.0 52.249-12 Termination (Personal Services) (Apr 1984): The Government may terminate this contract at any time upon at least 15 days’ written notice by the Contracting Officer to the Contractor. The Contractor, with the written consent of the Contracting Officer, may terminate this contract upon at least 15 days’ written notice to the Contracting Officer.

9.1 Any Contractor employee demonstrating impaired judgment shall not be allowed to continue working on the contract. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

PWS No. CSU-14-01 01 Oct 2014

10.0 Performance – Based Matrix

Performance-based Task Indicator Standard Quality Assurance Incentives State the end results or outputs that you, the customer will formally accept or reject.

For the requirement, state the feature(s) of end result that will 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 outpatient Emergency Medicine in the delivery of patient care to the Navajo Area Indian Health Service.

Competency

Compliance

Patient Outcomes

Professionalism

Credentialing

Documentation

Service Quality 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.

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

Uninterrupted credentialing as defined in

6.0 to 6.8 for period of contract.

100% of all medical records and other required documentation meets established IHS Medical Facility, Joint Commision, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

Satisfaction with quality of service is evidenced by valid customer inputs. 100% adherence to ensure continuity of patient care and to provide replacement on time.

Surveillance systems will include periodic inspections and customer complaints.

Payment of contract price for satisfactory service.

No payment for incomplete work.

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

CPAR evaluation will be forwarded to the GSA/FSS Contracting Officer.

PWS No. CSU-14-01 01 Oct 2014

11.0 List of Attachments and Exhibits. To be provided by the Contracting Officer upon request.

11.1 Attachments

Position Description (Service Unit specific) – available upon requested.

Certification Statement for Performance Work Statement (PWS) No CSU-14-01

11.2 Written Competency Assessments