TG 114 Attachment C_SOW PCMO Physician_March 2025.pdf

March 2025

STATEMENT OF WORK

PEACE CORPS MEDICAL OFFICER (PCMO) in

The services to be performed under this contract will be subject to the ultimate responsibility, authority and medical supervision of the Peace Corps Associate Director for the Office of Health Services (AD/OHS) with assistance from the Country Director (CD).

The required/preferred skill level of the Peace Corps Medical Officer (PCMO) shall be a Physician. The PCMO shall work the schedule found in VI – Work Week.

I. Professional qualifications

A. Physician: The PCMO shall have a valid, current, active license to practice as a Physician in one of the 50 United States, or country where license was obtained.

It shall be the responsibility of the PCMO-Physician to maintain a current valid license to practice medicine in one of the 50 United States, or country where license was obtained, at all times during the performance period of this contract while serving as a PCMO in any country.

II. Scope of Practice

1. PHYSICIAN (MD/DO) SCOPE OF PRACTICE

The PCMO shall:

• Provide diagnostic, therapeutic, and preventative ambulatory healthcare services to Volunteers which includes assessment, diagnosis and management of acute episodic and chronic illness.

• Perform comprehensive physical exams for close of service and health status.

• Order, conduct, and interpret diagnostic and laboratory tests including, but not limited to EKGs, x-rays, spirometry, etc.

• Prescribe pharmacologic agents and non-pharmacologic therapies that comply with the Medical Technical Guidelines. Serve as a medical prescriber for Registered Nurses and advisor to Nurse Practitioners.

• Provide mental health counseling to Trainees and Volunteers.

• Collaborate with peer PCMOs, consultants and OHS to develop and continuously evaluate an integrated Volunteer-centered health care plan to include further testing, specialist referral, medication, therapy, diet or life-style changes.

• Promote health and prevent illness and injury by providing health information and training to Trainees and Volunteers.

• Promote a safe and therapeutic environment through a Quality Improvement (QI) program.

• Acquire and apply critical new knowledge and technologies to the practice domain.

• Accept responsibility for knowing the legal, ethical, and professional parameters of practice, maintain those boundaries and acknowledge when a decision or action has not been in the best interest of a Volunteer while taking corrective action in the Volunteer’s behalf.

III. Services to Be Provided

1. The PCMO shall perform the following clinical care and administrative services in accordance with the policies promulgated in the Peace Corps Manual and the Medical Technical Guidelines. A copy of the Peace Corps Manual and Medical Technical Guidelines shall be provided by the Peace Corps in the country of assignment and are incorporated herein by reference. The PCMO shall provide and perform the clinical and administrative services listed herein, in support of the Peace Corps Volunteers and Trainees in his/her country of assignment. For purposes of this Statement of Work, Peace Corps Volunteers (PCVs) shall include Trainees.

2. The PCMO shall also provide health and medical care to such other persons as required by the Peace Corps, which may include employees/staff and/or contractors of the Peace Corps and other United States Government agencies. If under an agreement with the Department of State, the PCMO, upon request, may be provided a copy of the agreement between the Peace Corps and the Department of State that provides malpractice protection for the PCMO.

3. The PCMO, as delegated by the AD/OHS, is responsible for establishing and managing the in-country Volunteer Health Support Program. The PCMO acts as both program manager and clinician. The PCMO shall perform the following functions:

A. Safety and Security

A.1. With all other Peace Corps staff, the PCMO shall share responsibility for the safety and security of Peace Corps Volunteers by remaining current on safety and security policies and procedures and making safety and security the first priority.

A.2. The PCMO shall provide input for developing and updating safety and security procedures and reporting formats for use by staff, PCVs and counterparts.

B. Prevention and health education

The PCMO shall:

B.1. Plan, coordinate and provide health education to Volunteers, both during formal in-country training programs, and throughout their tour, through the use of newsletters, health handbooks, individual health education sessions, and other activities.

B.2. Provide preventive health services, including immunizations, periodic health evaluations and preventive treatments.

B.3. Establish and maintain a monitoring program in order to ensure 100% Volunteer compliance with Peace Corps health maintenance requirements such as obtaining immunizations on schedule or taking malaria prophylaxis.

B.4. Participate in the process of site selection (living and work sites); provide ongoing site evaluations. Make written professional recommendations for site improvements or changes if indicated.

C. Clinical care

The PCMO shall:

C.1. Provide clinical care, including the assessment and management of health problems.

This includes the provision of primary care for common illnesses and injuries appropriate to the PCMO's training and credentials and as set forth in the Medical Technical Guidelines.

C.2. Arrange for prompt diagnostic consultations with physicians, dentists, specialists, laboratories or other facilities in cases where the provision of health care requires medical skills or facilities beyond the professional capability of the PCMO. The PCMO has oversight and approval responsibilities for referred health care.

C.3. Maintain current, complete and accurate records on all PCV consultations and treatment (including laboratory and x-ray reports) in each PCV’s health record. This includes counseling notes, referrals, individual health education sessions, telephone consultations and correspondence between the Volunteer and the PCMO.

C.4. Establish and maintain an in-country referral network of health care providers – identify and evaluate consultants, facilities and services.

C.5. Coordinate, in collaboration with other Peace Corps staff, the medical evacuation of PCVs requiring treatment not available locally to designated evacuation points. This may include accompanying evacuated PCVs to these points.

C.6. Coordinate, or when PCMO's credentials permit, conduct annual and termination medical and dental evaluations, including laboratory tests, for all Volunteers in accordance with Medical Technical Guidelines.

C.7. Seek consultation with the Regional Medical Officer (RMO) and/or OHS to assist with case management and referrals.

C.8. Seek prompt consultation with OHS for all health conditions that may present a high risk to the Volunteer or others. It shall be the PCMO’s responsibility to ensure that privileged information in medical documents is protected in order to comply with medical confidentiality and Privacy Act provisions. Note that medically confidential information is NOT to be transmitted by non-secure electronic means.

C.9. Adhere to the Medical Technical Guidelines for policy on the management of specific clinical conditions. If there is a compelling reason for non-adherence to the Medical Technical Guidelines, the PCMO must consult OHS for concurrence.

D. Counseling

The PCMO shall:

D.1. Provide emotional support and short-term counseling services in accordance with Medical Technical Guidelines.

D.2. Assess Volunteers for signs and symptoms of emotional disorders and substance abuse, and provide support and referral as set forth in Medical Technical Guidelines.

D.3. Establish a mental health referral network; oversee referral interventions; and document referrals in the medical record.

E. Program management/administration

The PCMO shall:

E.1. Establish and operate a health unit; maintain supplies of medications, health and medical equipment to meet anticipated routine and emergency medical needs. In collaboration with the Peace Corps Country Director and the Director of Management Operation (DMO), order, stock, and inventory medical supplies and equipment. All medicines, medical supplies and equipment provided or paid for by the Peace Corps shall be for the sole and exclusive purpose of treating Trainees and Volunteers and other eligible persons, who may include employees/staff or contractors of the Peace Corps or of other United States Government agencies.

E.2. Maintain regularly scheduled and announced office hours in the Peace Corps health unit. The schedule for regular office hours will be determined with the approval of the Country Director. The PCMO is a fully participating member of the in-country Peace Corps staff.

In this capacity, the PCMO may be called upon to provide health/medical care to Volunteers and other eligible personnel after duty hours and on week-ends and holidays. The PCMO will be "on-call" after hours and on week-ends and holidays for medical and/or mental health emergencies for all personnel eligible for the PCMO's services.

Policy regarding adjustable work schedules and extra time off differs from country-to-country and is developed by each Country Director to meet the specific program needs of each post. The PCMO may adopt or modify an adjustable work schedule, or take extra time off in addition to the annual leave specified in this contract, only after advance written agreement is reached with the Country Director.

E.3. Advise the CD of foreseeable PCMO absences sufficiently in advance to permit arrangement for coverage. In the event the PCMO is sick, on vacation or unavailable due to (a) accompanying a medical evacuation; (b) attendance at a Peace Corps conference; or (c) an authorized field trip away from the office, OHS and the Country Director shall be responsible for arranging adequate coverage. The PCMO will assist OHS and the Country Director in arranging such coverage.

E.4. Participate in staff meetings and assist with the formation of all in-country policies that have potential impact on Volunteer health/safety. Maintain administrative records and planning systems and participate in the budgetary planning process.

E.5. Administer the in-country Volunteer Health Support Program in compliance with Peace Corps policies and procedures as outlined in the Medical Technical Guidelines and Manual Sections.

E.6. Maintain clinical records - referred to as the "Volunteer Health Record" - in accordance with specifications set forth in the Medical Technical Guideline, "Health Records."

Ensure medical confidentiality and compliance with the provisions of the Privacy Act, HIPAA, the Peace Corps Manual Section on Medical Confidentiality and Medical Technical Guideline, "Medical Confidentiality."

E.7. Establish in-country, regional, and long distance medical evacuation plans in collaboration with OHS and the Country Director and other in-country Peace Corps staff.

E.8. Provide the CD and OHS with status reports on health and safety concerns, including objectives of the health care program and identified in-country health risks.

E.9. Keep the CD and OHS informed of major health and safety problems which have programmatic impact. This includes, but is not limited to assaults, illnesses that interfere with Volunteers' activities, or Volunteer medical evacuation and/or hospitalization.

E.10. Advise the CD and OHS of needed clinical and administrative support when applicable.

E.11. Review all proposed medical expenditures and provide professional advice to OHS relative to payment.

E.12. Provide OHS with regular and timely status reports, (i.e., ongoing consultations, hospitalizations, assaults, etc.)

E.13. Submit monthly epidemiological surveillance data to OHS and other reports as appropriate to OHS and the CD.

E.14. Maintain effective, timely and appropriate liaison and cooperation regarding health programming and clinical services called for under this contract with the CD and other members of the in-country staff.

E.15. Ensure, to the best of the PCMO's ability, that all physicians, dentists, laboratories, hospitals or clinics providing services in conjunction with this contract are professionally qualified through guidance by OHS.

E.16. Attend Continuing Medical Education courses and Medical Overseas Staff Training in Washington when invited by OHS.

F. Mentoring and on-the-job training of other PCMOs

The PCMO shall:

F.1. Provide and receive mentoring and on-the-job training, as indicated and appropriate, to other PCMOs assigned to the Peace Corps health unit in-country. Such training should be undertaken with the approval of OHS and in consultation with the CD. “Other PCMOs” may include back- up/coverage and temporary duty (TDY) personnel, as well as colleagues who are under Peace Corps contract to provide health care to Volunteers, and share responsibility for the management of the in-country Volunteer health care system.

F.2. Provide long-term on-the-job training for a PCMO colleague, if program circumstances indicate the need. It is the goal to guide his/her preparation to eventually assume the full roles and responsibilities of the PCMO. This should be undertaken only with the approval of, and in consultation with both OHS and CD.

G. Sexual Assault Prevention and Response

The PCMO shall:

G.1. Provide and/or coordinate the initial and follow-up clinical, forensic (when applicable), and psychosocial care for sexual assault victim/survivors, using the OHS technical guidelines and best practices. This includes conducting a primary and secondary assessment of the Volunteer, protecting the confidentiality of information surrounding the sexual assault, completing the medical component of the serious or imminent threat assessment tool, making referrals to the Behavioral Health and Outreach Unit (BHO) and communicating with the Forensic Nurse Specialist for guidance when required and according to the notification protocol.

G.2. Collaborate with multidisciplinary Designated Staff team to provide quality care to victim/survivors of sexual assault. This includes, but not limited to, sending notification to Office of Victim Advocacy, participating in agency Coordinated Agency Response System (CARS) calls when needed, participating in Designated Staff Quarterly meetings and in the bi-monthly Case Management Review Meetings

G.3. Adhere to sexual assault clinical and Security Incident Management System (SIMS) documentation guidelines.

G.4. Participate in OHS online and in-person skills training sessions related to sexual assault.

Completion of these trainings is essential to ensure medical officers are up to date with the latest protocols and best practices in providing care to sexual assault survivors.

G.5. Pass the annual sexual assault medical-forensic competencies. This may include the following: demonstrating a trauma informed approach and proficiency in evidence collection, physical assessment and findings, photo-documentation, ano-genital exams.

H. Evaluations of PCMOs

At the conclusion of the mentoring period and annually, the Country Director and OHS will jointly evaluate the PCMO’s performance of duties under this contract in accordance with criteria set forth in the Medical Technical Guidelines. The initial evaluation at the conclusion of the mentoring period will include any assessments conducted by Peace Corps during the mentoring period.

I. Travel within Country

All travel will be coordinated with and approved by the Country Director. If indicated by country/program needs, travel will be planned and undertaken in collaboration with other Peace Corps staff.

The PCMO shall:

I.1. Travel to and be prepared to stay at training sites on a regular basis as program needs dictate in order to provide Volunteers with health training, preventive care (e.g.

immunizations), and clinical intervention as needed.

I.2. Undertake routine visits to Volunteer living sites on a schedule developed in collaboration with the CD and other Peace Corps staff.

J. This position may require up to 20% international travel.

K. Must be able to obtain a US Visa.

L. Interpersonal Skills: Shows understanding, respect, courtesy, tact, empathy, concern, and politeness to others; develops and maintains effective relationships with others; may include effectively dealing with individuals who are difficult, hostile, or distressed.

M. Performs other duties as assigned.

N. Other Flexibilities: If there is a time at post, due to a pandemic or for any other reason, when there are limited or no Peace Corps Trainees and/or Volunteers (jointly referred to as “Volunteers”) at Peace Corps/[Country], the PSC may be temporarily assigned during that period, as determined by the Peace Corps Country Director, to carry out additional duties and responsibilities in furtherance of the goals of the Peace Corps in order to enhance the ability of Peace Corps Volunteers to perform functions under the Peace Corps Act, including facilitating a safe environment in order for the successful return or increase of Volunteers.

This temporary assignment may require the PSC to provide services and/or support beyond what is listed in their current Statement of Work (SOW). The services and/or support may take many forms, examples of which may include but are not limited to, training, providing administrative, technical, medical, and/or operational assistance, building on host country programs, etc. This temporary assignment also may require the PSC to provide these services and/or support to individuals/organizations other than those listed in their current SOW such as host country government, partner organization(s), community member(s), staff, and/or contractors.

Text1: [Country]