Family Physician Job Description for Ft. LeonardWood Army Community Hospital aka- General LeonardWood Army Community Hospital
Acronyms Defined:
MTF= Military Treatment Facility
GLWACH- General Leonardwood Army Community Hospital
HCP= Health Care Provider
CHCS= Composite Healthcare Computer Systems
Specific tasks are outlined at 5.0
1.2. Qualifications.
1.2.1. The provider shall be board certified in family practice by the American Board of Family Practice or American Osteopathic Board of Family Practice. The HCP provider may be a new graduate of a family practice program as long as they are board eligible or certified. Board eligible HCPs are acceptable during the base year only and the contractor shall insure all HCPs are board certified in HCP, at contractor expense, for all option years. The HCPs shall have graduated from an accredited educational college or university to include a residency program. Grandfathered board certified HCPs are not acceptable.
1.2.2. The provider shall have a minimum of two years full time (3,600 total hours) experience as a practicing hands-on family practice in the last three years. Residency and fellowship time counts as practicing experience. Internship time does not count as practicing time. Time spent in an administrative capacity as a claims reviewer, internet physician, survey reviewer, medical school instructor, medical director, etc. does not qualify as practicing time.
1.2.3. The providers shall be a Medicine Doctor (M.D). or Doctor of Osteopathy (D.O.) and be capable of treating all ages of patients.
1.2.4. Possess and maintain a valid, unrestricted license to practice medicine in one of the fifty United States, District of Columbia, Commonwealth of Puerto Rico, Guam or U.S. Virgin Islands and be able to obtain privileges at GLWACH through approval of the credentials committee. Also see the Employee Credentialing History clause (Addendum to FAR 52.212-4(y)).
1.2.5. Possess and maintain at all times, at contractor expense, current certification in BCLS, ACLS, PALS and NRP. BCLS is not the same as CPR training. BCLS is only acceptable from the American Heart Association or American Red Cross.
1.2.6. Possess and maintain at all times a current Drug Enforcement Administration (DEA) registration number and BNDD number as required by state agencies where the provider is licensed.
1.2.6. Possess and maintain at all times a current Drug Enforcement Administration (DEA) registration number.
1.2.7. The providers shall be able to read, write, and speak English fluently to be able to communicate effectively with patients and other healthcare providers.
1.2.8. The providers shall be able to type and have had experience using computers. The providers will not be required to type a certain amount of words per minute. GLWACH will provide computer training on the GLWACH computer system. Failure to learn the computer system at GLWACH within 2 weeks of beginning service shall also be grounds for immediate removal of the provider. Lab tests, x-rays, pharmaceuticals, referrals, etc. shall be ordered independently on the computer by the providers. The provider shall order, manage and close consults in CHCS as per MEDDAC Pam 40-9, "Referral and Preauthorization Process". The provider shall dictate any results to a consult. If a special form (i.e. Ophthalmology) is used, then minimum clinical information is still required to be dictated and entered as the consult report. The provider shall verify and close consults within 10 working days of the encounter for routine consults and within 24 hours of the encounter for urgent/emergent time frames. The physician(s) shall be in an ADP sensitive position requiring compliance with AR380-19 and AR280-67.
1.2.9. The following shall disqualify, at any time, any provider from consideration/performing under this contract. If none of these conditions are applicable, the contractor shall provide a letter so stating.
- a provider under probation/revocation/suspension action at any time from any state, the
District of Columbia, Commonwealth of Puerto Rico, Guam or U.S. Virgin Islands where the provider has/had a license;
- a provider who has defective color vision;
- a provider who is chemically (alcohol or drug) dependent or impaired;
- a provider who was previously convicted of any felony;
- a provider who is awaiting possible adverse action administration action by any board of
medicine;
- a provider who has been declined to participate in any Tricare program
- failure of the contractor or provider to disclose any information listed herein.
1.2.10. If certifications should lapse in any area, the provider shall be removed from performance immediately.
1.3. ADMINISTRATIVE.
1.3.1. Neither military nor Government civilian employees shall be used as a consultant or employee in matters related to this contract.
1.3.1.1. Each day that services are performed the contract provider shall be required to sign-in his/her time of arrival and departure on a log sheet to be maintained at a designated area.
1.3.2. Orientation and Training. Newly hired contract providers shall be required to complete new employee orientation which is provided by the MTF. Thereafter, contract providers shall be required to complete quarterly training to meet competency requirements. Orientation and annual/or quarterly training requirements are a condition of employment for which the contractor will be compensated at the hourly rate reflected in the contract.
1.3.2.1. Computer Training: Contract providers who have any interaction with the hospital computer systems must receive training for the applicable system. These systems include but are not limited to:
1.3.2.1.1. Composite Healthcare Computer System (CHCS and CHCS II). CHCS and CHCS II contain the MTF’s appointment scheduling program, pharmacy, lab, and radiology ordering system and are interlinked with other departments in the MTF.
1.3.2.1.2. Ambulatory Data System (ADS). This computer system produces forms on which the providers identify the appropriate billing codes for diagnoses and procedures for each patient.
1.3.2.1.3. Training for CHCS, CHCS II, and other computer training will be scheduled through the Emergency Department. The training will be on-site and during normal duty hours. This training will be at no cost to the contractor.
1.3.3. The contractor shall be reimbursed for work performed by submitting invoices to the COR for processing through Defense Finance and Accounting System (DFAS), therefore, the contractor must be registered in the Central Contractor Registry (CCR).
1.3.4. Government Required Training. The government may elect to provide unique government training to contract HCPs who are performing services under this contract. If the government elects to provide such training, the government will provide such training at no additional expense to the contractor or to the contract HCPs. When directed by the contracting officer, contract HCPs shall attend all such training in a paid status as part of the normal services required and billed under the contract. If determined by the contracting officer, such training may require a performance commitment by the contractor and the contractor shall reimburse the government (by means of a reduction in an invoice) if a contract HCP fails to satisfy the performance commitment after the HCP receives the unique government training. The amount of the reimbursement shall be the prorated cost of the training, calculated based on the total cost of the training and the number of months by which the contract HCP fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first.
1.3.4.1. In accordance with Operations Order 07-34, all HCPs performing under the resulting contract shall complete Behavioral Health training, if required.
1.3.5. The use of non-compete clauses in the contractor’s employment agreements (to prevent loss of personnel by the contractor) effective only during the period of performance is acceptable. However, the use of non-compete clauses in employment agreements which prevent employees of the incumbent from being employed, or accepting offers of employment, by a different contractor on a follow-on contract is unacceptable. It hinders the government’s ability to accomplish the mission of providing medical care to beneficiaries. Inclusion of such clauses in an employment agreement shall result in an offeror’s proposal/bid being unacceptable. Awardees and their subcontractors shall not include such clauses in their respective employment agreements.
1.3.6. REPORTS. The contractor shall provide to the contracting officer reports required to monitor performance on this task order.
1.3.6.1. Monthly Report - Fill/Vacancy Report. The contractor shall provide a monthly report on the fill and vacancy rates on each contract/task order. This report will identify the contract/task order number, the contract effective date, the number of FTE under the contract/task order, the number of filled positions and the number of vacancies. In addition, the contractor shall provide a brief explanation as to why the position is not filled and what is being done to correct the situation. This report shall be submitted on the first of each month after the effective date, or the first Monday of the month should the first fall on a weekend. The report will be accomplished on the provided spread sheet to the contracting officer. (Attachment 3.)
1.4. HOURS OF PERFORMANCE.
1.4.1. Normal duty hours are Monday – Friday (excluding Federal Holidays), from 7:30am – 4:30 pm; however, the provider shall be able to provide services 24 hours per day, 7 days per week, including holidays. Shifts may be 8-12 hours in length. A minimum break of 30 minutes (unpaid) will be given during the shift. Work hours and days will be determined by GLWACH. Schedules are subject to change due to cancellations, hospital staff changes, organization day, emergencies, exodus, training holidays and unexpected events. The Contractor shall only be paid for actual hours worked. Compensatory time off is not authorized.
1.4.2. Call coverage. The provider shall be required to provide telephonic consultations to the attending physician in emergency cases. Carrying a beeper or pager shall not qualify as on-call services. On-call service is defined as actual patient care performed in GLWACH outside of 7:30 a.m.– 4:30 p.m. Monday through Friday and all day on holidays. The contract provider is not required to remain at a place of residence while on call, but shall be available by Government furnished pager during on-call periods. The provider shall respond telephonically within 10 minutes of the page being sent and shall be prepared to return to GLWACH and provide consultation and/or assistance within 30 minutes of the page being sent or as soon as needed. Only hours spent at GLWACH and physically provided patient care shall be paid. GLWACH may use various methods to verify when actual on-call hours were worked in GLWACH, to include but not limited to requiring the use of a time clock or a sign-in sheet.
1.4.3. On-call services shall be on a rotational basis including weeknights, holidays and weekends, one third of the time for the contract period. Call will be shared equitably among all available staff (weeknights 4:30 p.m. to 7:30 a.m. and weekends Friday evening, 4:30 p.m. through Monday morning at 7:30 a.m.). If the provider is on call on a holiday weekend, the on call period will include the holiday, training holiday (if any), and weekend. Call shall end on the next normal business day at 7:30 a.m. The contract physician may or may not be required to work a normal 8 hour day after being on call the previous night(s). It will be determined later what days the contract providers will be on call. The number of military providers is subject to change due to mobilization, ETS, PCS, TDY, deployments, etc. The physician shall perform rounds while on-call.
1.4.4. Scheduled/unscheduled absences: A total of 25 eight-hour work days (200 hours) of scheduled/unscheduled absences will be granted for each full time equivalent provider for each contracting period covering a full 12 months. The provider will also receive 10 federal holidays per year. The days off will include vacation time, sick leave and continuing medical education (CME) purposes, training holidays, funeral leave, weddings, graduations, etc. Clinic or hospital closures caused by emergencies, exodus, training holidays and unexpected events shall count against the 25 days/200 hours. The Government will not pay for the 25 days/200 hours of absence. Scheduled absences shall be requested 30 days in advance and are subject to approval by the division chief. A break of more than one continuous work week is subject to the approval of the Contracting Officer’s Representative, in order to ensure adequate coverage for the department.
1.4.5. Closures and organizational activities: During anticipated closure of the facility due to Command declared training holidays, holiday parties, organization day, staff administrative leave or unplanned closure of the facility due to natural disasters, military emergencies, severe weather or otherwise, the contractor will only be paid for the actual hours that were worked.
1.4.5.1. During training holidays or organizational days contract HCPs shall report to work, and may be required to work in a different department/or clinic of GLWACH if needed.
1.4.6. The provider shall be rested and fully physically and mentally capable for performing the duties required under this contract. The provider shall not have worked the 8 hours before beginning services at GLWACH.
1.5. CONDUCT.
1.5.1. The contract HCP shall record the time worked according to MTF procedures.
1.5.2. The chief of the Emergency Department, or his/her representative, will define the scope of practice. Contract HCPs shall not introduce new procedures or services without prior approval of the Department Chief or representative. In disagreements or deviations from established or new protocols, the Department Chief, or representative, will be the deciding authority.
1.5.3. Contract HCPs shall comply with MTF policies regarding personal appearance and conduct. The HCP shall maintain a neat, well groomed appearance at all times to facilitate credibility with patients. Tank tops, halter tops, clothing with alcohol, drug, tobacco or profane related messages/slogans/trademarks, short, jeans, or T-shirts shall not be worn.
1.5.4. Contract HCPs shall abide by federal and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and the HCP as may be necessary for security and personnel reliability programs. They shall also abide by federal and local MTF regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act of 1996. All regulations referenced are available for review from the COR, MTF, or the Contracting Officer. All medical records and reports will remain the property of the government.
1.5.5. Contract HCPs shall abide by MTF bylaws, Joint Commission, DOD and Medical Department regulations with regard to Utilization Review and Quality Assurance directives, including, but not limited to, in service training, maintenance of records, performance evaluation, and release of medical information.
1.5.6. Contract HCPs shall make use of all appropriate equipment; supplies and services made available by the government and shall make referrals and seek consultations, as deemed necessary, for the optimal care of the patients.
1.5.7. Inquiries. The contractor shall not respond to any media inquiries. Any inquiries from the media, third parties, or public agencies shall be immediately relayed to the COR, who will relay them to the Hospital Public Affairs Officer or, after duty hours, to the Administrative Officer of the Day (AOD). There shall be no interviews, comments, or any other response without the knowledge and approval of the MTF Commander. Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the contract HCP’s government supervisor.
1.6. CONFLICT OF INTEREST.
1.6.1. The Contractor/contract HCPs shall not bill the patient for services rendered under this contract. The Contractor/contract HCPs shall be prohibited from receiving compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract, at the rate specified.
1.6.2. The contractor or contract HCPs shall not, while performing services under this contract, advise, recommend, or suggest to persons eligible to receive medical care at Government expense that such persons should receive care from the contractor or contract HCPs at any place other than as designated under this contract.
1.6.3. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. The contractor shall not release any of the above information without prior written consent of the Contracting Officer. The Contractor/contract HCPs shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication. The HCP shall prepare medical records, forms and documents as required, IAW the regulations and established guidelines listed in the contract.
1.6.4. Contract HCPs are not prohibited by reason of their employment under this contract from conducting private practice provided there is no conflict with the performance of services under this contract. The contracting officer will unilaterally resolve any issues concerning potential conflicts. The HCP shall not make use of any Government facilities or other Government property in connection therewith.
1.6.5. The contractor or contract HCPs shall not use Government facilities or other Government property in connection with conducting a private practice.
1.7. LICENSE AND CREDENTIALS REVIEW OR PRIVILEGING.
1.7.1. All providers providing services under the terms and conditions of the contract shall have their credentials reviewed by the Credentials Committee of the MTF and be granted hospital privileges by the MTF Commander in accordance with AR 40-68 and local MEDDAC regulations prior to commencement of services. Actions to limit, suspend, or revoke clinical privileges shall be in accordance with the procedures of AR 40-68 as pertaining to notice, hearing, and Commander’s decision. The contractor and contract provider do not have the right to appeal the MTF Commander’s decision to the next higher headquarters. If there are adverse actions on the contract provider providing services under this contract which in any way limits his/her privileges, the government reserves the right to require performance by a contract provider who is fully privileged. The failure to meet the privileging requirements does not relieve the contractor from the responsibility of insuring that the services required are performed. Information on the credentialing/privileging process can be printed or read in chapter 4 of Army Regulation 40-68 located on the internet at website http://www.usapa.army.mil/pdffiles/r40_68.pdf. A criminal history background check (CHBC) shall be required for all contract providers under this contract. The contractor shall be responsible for performing and paying for the CHBC on the provider(s). The MTF Commander must grant privileges to contract HCPs for which credentialing is required prior to HCPs providing any services. The privileging process shall be in accordance with all requirements in ARs 40-66 and 40-68, as amended. Any failure to meet these requirements is considered nonperformance and the basis for termination for cause.
1.7.2. Unless otherwise required, applications for clinical privileges shall be submitted not later than ten (10) calendar days prior to the start of health care delivery. The contractor shall submit the required documentation listed below to the Credentials Committee. With the advice of the Chairman of the Credential’s Committee, the MTF Commander will approve or disapprove credentials and delineation of privileges after the Credentials Committee has recommended approval or disapproval. Unless otherwise required, the contractor shall ensure that a provider who has been granted privileges is available to begin performance within 14 calendar days after notification of approval of privileges.
1.7.3. Should the contractor need to add additional or replacement providers during the contract period, the same qualification standards, credentialing and health requirements shall apply.
1.7.4. The Credentials Committee may have questions which they wish to present to the Contractor verbally or in writing. The Contractor shall answer questions presented by the Credential’s Committee either verbally or in writing.
1.7.5. If at time of contract award and subsequent performance, the provider whose credentials have been reviewed by the Credentials Committee is no longer available to provide required contract services, the contractor shall provide a candidate whose credentials are clearly equal or greater than those of the original candidate within 30 days after the contractor receives notification that provider will no longer be available or is no longer available.
1.7.6. The MTF Credentials Committee will maintain control of the credentialing/privileging aspects for all providers who will be providing independent healthcare services at the MTF or under our auspices.
1.7.7. No contract provider shall provide services under this contract without prior approval of the Commander as recommended by the MTF Credentials Committee.
1.7.8. The credentials office at GLWACH will identify documentation required for privileging. The contractor will receive a credentials packet upon award for each provider and complete and return the packet via certified carrier within 10 calendar days of award to GLWACH in accordance with instructions detailed on the “Contractor’s Checklist for Appointment” form. Faxed/scanned documents from the contractor may be accepted, as will American Medical Association Profiles. Credentialing Transfer Briefs from other Army Medical Treatment Facilities will be accepted. The credentials packet returned to GLWACH will include a completed “Contractor's Checklist For Appointment” form; required privileging forms with original signatures; 2 reference letters on letterhead; National Practitioner Data Bank (NPDB) Response to Information Disclosure Request; curriculum vitae; and verified copies of degree(s); residency(ies); internship(s); BLS; board certification as applicable; and active state license(s). The contractor shall provide a listing of all inactive state licenses and verify the provider was in good standing at the date the state license became inactive. The contractor shall perform all primary source verifications and document verifications on verified copies of degree(s); residency(ies); internship(s); BLS; board certification, as applicable; and state license(s). Verification shall include date verified, signature of verifier, and source used for verification. GLWACH will not assist the Contractor in obtaining any needed information. The Contractor shall obtain and complete all paperwork as detailed in the “Contractor’s Checklist for Appointment” form. Failure of the providers to be credentialed will be considered grounds for Termination by Default. The providers shall abide by all the by-laws of GLWACH. The contractor shall provide statements by the provider regarding physical and mental health, to include any history of substance abuse, involvement in malpractice cases and claims, including a brief description of the facts of any case settled on behalf of the provider, and a history of any disciplinary action taken by hospitals, state licensure boards, or other government agencies. At a minimum, DA Form 5754-R will be used for this purpose; it will be completed upon initial application for privileges, and at the time of privilege renewal.
1.7.9. Unless otherwise required, the Contractor shall submit completed credentials packets for any additional providers 45 calendar days prior to projected start date. Renewal Credentials documents shall be submitted to the Credentials Coordinator at least 45 calendar days prior to the expiration of previous privileges. Affiliate privileges are granted for the first year based upon their expiration date and every two years afterwards.
1.7.10. The credentialing documents specified in the above paragraphs will be provided to the Contractor through the COR by the Credentials Coordinator in photocopy-ready state. The Contractor shall reproduce forms as necessary. The Contractor shall submit all completed forms and documentation specified above to the Credentials Coordinator.
1.7.11. Presentation of an HCP to the MTF by the Contractor shall, on a continuous basis, constitute evidence that the contractor has investigated and verified all information presented to the MTF for the purpose of provider credentialing. During the term of the contract, the contractor shall notify the Credentials Coordinator at the MTF within 72 hours upon becoming aware of any information which may compromise a contract provider's credentials at the MTF. This shall include, but is not limited to, information linking a contract provider with chemical dependence, misdemeanor, felony, or medical malpractice. This information shall be reviewed by the MTF Credentialing Committee and may result in the rescinding of credentials. The MTF Credentialing Committee is the sole agency authorized to recommend to the Commander that a particular contract provider be granted privileges. The Commander of the MTF is the final authority for approving/denying clinical privileges to any and all contract providers.
1.7.12. If the credentials of any HCP are revoked, he/she shall not be permitted to continue practicing medicine at the MTF. Such action will not relieve the Contractor from responsibility to perform the services required by this contract. The contractor shall provide a candidate whose credentials are clearly equal to or greater than those of the original candidate within 30 days after the contractor receives notification that a provider’s credentials have been revoked.
1.7.13. All contractor personnel shall attend newcomers training at the start of their employment at the MTF and quarterly training thereafter. All contractor personnel shall participate in orientation to their work area and maintain a competency file (which is different from a credentials file) at the worksite (Joint Commission standards).
1.7.14. Incomplete credentials packets will be returned without action.
1.8. CONTRACTOR PERSONNEL.
1.8.1. All contract HCPs shall abide by Army Regulations and GLWACH policies and rules. All contract HCPs shall maintain and support the standards necessary to meet Joint Commission and CMS certification. When commencing work under this contract, all contract HCPs shall obtain an in-processing checklist from the COR and provide the COR a copy when completed. The contract HCP shall wear a GLWACH identification badge. The COR/ACOR will assist the contract HCP in obtaining the identification badge through the appropriate section. Upon termination of work at this MTF, all contract HCPs are required to return the hospital identification badge and out-process thru the activities identified on the out-processing checklist obtained from the COR.
1.8.2. The contractor shall designate, in writing, at least five working days prior to commencement of services, an on site representative for contract coordination and implementation. This representative may also serve as one of the Family Practice Physicians. Changes in the on site representative, at any time after the contract commencement, shall require the contractor to notify the contracting officer of the new authorized representative five working days prior to said change. This notification shall be in writing and shall state the name of the new on site representative.
1.8.3. The contractor’s representative shall meet with the contracting officer’s representative (COR) at the MTF on a monthly basis or as requested by the COR to discuss any issues or concerns. Problems experienced by either party will be discussed and resolved. Unresolved problems will be referred to the contracting officer for resolution.
1.8.4. Ten days prior to commencement of work under this contract, the contractor shall furnish in writing to the COR the complete name, address, social security number (SSN), date of birth and daytime phone number of each contract provider engaged in performance of this contract. In the event of a change in contract providers, the contractor shall advise the COR of the change and shall furnish in writing, within five working days before the change, the same information as stated above.
1.8.5. MTF Authority: The contractor agrees to abide by Medical Staff Bylaws and all MTF standards, rules, and procedures including requirements for any required credentialing and quality assurance. The MTF Commander will have ultimate authority to review, approve, disapprove, of any contract HCPs supplied by the contractor, pursuant to this agreement, and the decision of the MTF Commander will be final. Further, where the MTF Commander deems appropriate, contract HCPs can be denied access to the MTF. In the event that the MTF Commander decides to deny access of a contract HCP provided pursuant to this agreement, the MTF Commander agrees to give the contractor at least seven (7) days’ advance notice of such decision, during which time contractor will attempt to cure any problems which may exist. During such seven-day period, the MTF Commander may restrict the contract HCP from providing services at the MTF pending the outcome of discussions between the contractor, contracting officer, and the MTF Commander.
1.8.6. COMMENCEMENT OF REQUIRED SERVICES FOR PRIVILEGED PROVIDERS. The contractor shall be required to commence with required services within 60 calendar days of award (date of Contracting Officer signature) of initial requirements (task orders). The contractor shall likewise commence with required services within 60 calendar days for any follow on requirements issued under subsequent task orders based on the date of Contracting Officer signature. In the event the Administrative Contracting Officer issues a modification to an existing task order to add follow-on requirements, the 90 calendar day start up period is applicable. To ensure required commencement of services, the contractor shall submit complete credentials packets within 30 calendar days of award of initial or follow-requirements as identified above.
1.8.7. REPLACEMENT PERSONNEL FOR PRIVILEGED PROVIDERS. The contractor will be required to provide a permanent replacement for any primary provider who has an unscheduled absence in excess of 15 consecutive work days. The replacement shall commence with required services within 45 calendar days of written notification by the designated site representative that the primary provider has exceeded the authorized forbearance period. To ensure required commencement of replacement services, the contractor shall submit complete, credentials packets (based on site requirements) within 30 calendar days of required notification.
1.8.8. Healthcare Provider Compensation. This is a personal services requirement. In no case shall the total amount of compensation paid to an individual in any year under any contract resulting from this solicitation exceed the full time equivalent rate as established under United States Code, Title 3, Section 102 (as referenced in United States Code, Title 10, Section 1091). This amount is currently established as $400,000.00 but may change in the future. In no case should the compensation exceed the amount set by law.
1.9. INSPECTION.
1.9.1. The performance by the HCP, the quality of services rendered, and any documentation or written material in support of same, shall be subject to continuous inspection, surveillance, and review for acceptance by the Contracting Officer or designated representative. Any services rendered by the HCP to patients or interaction with military/civilian personnel deemed unprofessional/threatening/dangerous by the Department Chief will be considered as grounds for immediate removal of the HCP and termination under the Termination for Default clause. Quality Assurance procedures established by the MTF shall be used for continuous monitoring. The COR will maintain a Log to document performance under this contract as established in the Quality Assessment Surveillance Plan (QASP) in Para 6 of this PBWS.
2. DEFINITIONS / ACRYONYMS.
2.1. DEFINITIONS
2.1.1. ANCILLARY PERSONNEL: These personnel are commonly referred to as radiology, pathology and/or medical pharmacy technicians/technologists. Clerks, secretaries and receptionist personnel are commonly considered administrative personnel.
2.1.2. CLINICAL PRIVILEGES: Authorization by GLWACH to provide specific patient care and treatment services in the organization, within well defined limits, based on the individuals license, education, training, experience, competence, judgment, and physical and mental health.
2.1.3. COMPOSITE HEALTH CARE SYSTEM (CHCS): An automated medical information system, which will provide integrated support for the functional work centers of inpatient and outpatient care facilities, patient administration, patient appointments and scheduling, nursing, laboratory, pharmacy, radiology, and clinical dietetics.
2.1.4. CONTINUING EDUCATION. Education beyond initial professional preparation relevant to the type of patient care delivered in the organization provides current knowledge relevant to the field of practice and is related to findings from quality assurance activities.
2.1.5. CONTRACTING OFFICER: A person with the authority to enter into, administers, and/or terminates contracts and makes related determinations and findings. The only person authorized to make changes in the contract on behalf of the Government.
2.1.6. CONTRACTING OFFICER'S REPRESENTATIVE (COR): A government employee selected and designated in writing by the contracting officer to act as his/her designated representative in administering a contract.
2.1.7. CONTROLLED SUBSTANCE: All regulated drugs.
2.1.8. FACILITIES: Building, equipment and supplies necessary for the implementation of services by personnel.
2.1.9. RESERVED.
2.1.10. MILITARY TIME is on a 24 hour clock, e.g.
8:00 a.m. - 0800 9:10 a.m. – 0910 Noon - 1200
9:10 p.m. – 2110 Midnight – 2400 12:01 a.m. - 0001
2.1.11. MILITARY DATES are written as: September 2, 1996 2 Sep 96
2.2.12. PRIVILEGING PROCESS: Process established by the medical activity and AR 40 68 for granting clinical privileges to health care internist.
2.1.13. QUALITY ASSESSMENT AND IMPROVEMENT. Those actions taken by the Government to check services to determine if they meet the requirements of the JCAHO, U.S. Army Medical Command, Dental Activity (DENTAC) quality assurance and risk management program, and ensure that the contract personnel comply with the terms and conditions of the contract.
2.1.14. QUALITY CONTROL: Those actions taken by a contractor to control the performance of services to ensure that they meet the requirements of the contract.
2.1.15. REPLACEMENT PERSONNEL: Contract personnel selected to fill a position for the duration of the contract period, which was previously occupied by other contract personnel.
2.1.16. SCHEDULED ABSENCE: Prearranged absences from performance of contractual services by contract personnel. These absences, whether taken for vacations or continuing medical education, etc. are scheduled/arranged in advance.
2.1.17. TRAINING HOLIDAY: A day off in addition to holidays.
2.1.18. UNSCHEDULED ABSENCE: Absences from performance of contractual services by contract personnel that are not scheduled/arranged in advance, regardless of whether the absences are caused by illness or for other reasons.
2.2. ACRONYMS:
2.2.1. ACLS – Advanced Cardiac Life Support
2.2.2. ATLS – Advanced Trauma Life Support
2.2.3. AR – Army Regulation
2.2.4. BCLS – Basic Cardiac Life Support
2.2.5. CLIN – Contract Line Item Number
2.2.6. COR – Contracting Officer’s Representative
2.2.7. CPR – Cardiopulmonary Resuscitation
2.2.8. DA – Department of the Army
2.2.9. DCCS - Deputy Commander for Clinical Services.
2.2.10. DoD - Department of Defense.
2.2.11. DEA - Drug Enforcement Administration.
2.2.12. EKG - Electrocardiogram.
2.2.13. FTE - Full Time Equivalent.
2.2.14. MEDCOM Medical Command.
2.2.15. IV Intravenous.
2.2.16. JC Joint Commission.
2.2.17. KO Contracting Officer.
2.2.18. MEDDAC Medical Department Activity.
2.2.19. MTF Medical Treatment Facility.
2.2.20. PA Physician Assistant
2.2.21. PAD Patient Administration Division
2.2.22. PALS - Pediatric Advanced Life Support
2.2.23. Pam Pamphlet
2.2.24. PCF – Practitioner’s credentials file
2.2.25. QA&I – Quality Assurance & Improvement
2.2.26. QC – Quality Control
2.2.27. SF Standard Form
2.2.28. SOW Statement of Work
2.2.29. TAB Therapeutic Agents Board
3. GOVERNMENT FURNISHED PROPERTY AND SERVICES.
3.1. The Government will provide use of all available MTF facilities and support services, materials, publications and forms, and equipment required for contract performance (except as designated in the contract). Contract HCPs shall keep government furnished supplies, equipment, and work areas in a safe, orderly and clean condition. The Government shall provide administrative support, dictation, receptionist, scheduling, patient chaperons, etc. Administrative support is a shared function among clinic staff. Contractor personnel shall notify the Government whenever maintenance of equipment is required. The Government will furnish heat, air conditioning, electricity, water and sewer services, Government related telephone service, refuse collection and custodial services. Personal long distance calls are not authorized. The cost of personal long distance calls will be deducted from the Contractor's invoice. Contract HCPs shall notify the Government whenever maintenance of equipment is required.
3.2. Emergency Contract HCP Healthcare. The MTF will provide Emergency healthcare for injuries occurring while on duty. The contractor shall reimburse the government for such services.
3.3. The identification badge described in paragraph 1.8.1. that is to be worn on outer clothing shall be provided by the MTF. The MTF will also provide a Common Access Card (CAC) for use in logging-on to a computer workstation and access to MTF electronic systems. Upon termination of services (voluntarily or involuntarily), both the identification badge and CAC shall be surrendered to the COR or other designee.
3.4. Contract HCPs shall obtain a post decal for entrance onto the Post and comply with the Bases requirements for vehicle security.
4. CONTRACTOR FURNISHED SUPPLIES/SERVICES.
4.1. The contractor shall ensure that each HCP providing medical services under this contract has his/her own stethoscope and white smock.
4.2. The contractor shall provide I.D. badges for all HCPs.
4.3. The contractor shall ensure HCPs providing medical services under this contract has his/her own rubber stamp containing their full name, degree, title, DEA license number and company name (if applicable) or the word, "Contractor." The stamp shall be placed on all forms and documentation having the provider's signature:
EXAMPLES:
John J. Jones, M.D.
Family Practice Provider
DEA #123456
XYZ Healthcare Company
5. SPECIFIC TASKS.
5.1. The Contractor shall provide family practice services to authorized beneficiaries of any age per AR 40 3, AR 40 50 1, and in accordance with established principles, practices and standards of the Joint Commission, and the Army Medical Department. The provider shall perform all tasks in this contract independently. The HCP shall have inpatient admitting responsibilities and perform inpatient rounds. The HCP shall perform hospitalist duties. The HCP shall perform chart reviews and attend medical staff meetings as part of the normal workday.
5.2. If necessary, the HCP shall provide initial emergency medical care required to any civilian, military, or military beneficiary requiring it in life threatening situations. Patients shall be transferred to the appropriate military or civilian hospital when the attending physician determines that the patient is stable enough to make the trip.
5.3. The HCP shall interview patients, diagnose illnesses, prescribe treatments and medicine, perform minor surgery, and refer patients to military or civilian hospitals for more complex medical problems. The HCP shall provide comprehensive and continuing health and medical care services e.g. diagnosis, prevention, therapy, maintenance and rehabilitation. The HCP shall manage the health care needs of patients with serious illnesses through consultation or direct referral to specialty physicians. The HCP shall perform only those services for which privileges have been granted by the GLWACH credentials committee.
5.4. The HCP shall write prescriptions only for medications within the scope of work of the HCP. Medications beyond the scope of work of the HCP require interaction with physicians from other clinics.
5.5. The HCP shall complete medical records, forms and documents. The HCP shall complete all patient documentation within 72 hours after seeing a patient.
5.6. The HCP shall take the patient history and perform medical surveillance physicals on appointed military and Department of Army Civilians. The HCP shall request lab tests, x rays, pharmaceuticals, etc. via the computer system. The HCP shall request consultations and procedures as considered appropriate. The HCP shall study health records and evaluate the significance of total clinical evidence. The HCP shall read and abide by AR 40 3 Medical, Dental, and Veterinary Care, AR 40 66 Medical Records and AR40 68 Quality Assurance Administration.
5.7. The HCP shall make periodic follow up examinations of patients to determine progress and reaction to treatment, review clinical evidence to detect deviation from normal disease course, and determine the patient's progress. When deemed appropriate, the HCP shall consult with other physicians concerning the significance of symptoms and interpretations, prepare clinical reports of each examination, consultation and diagnosis, and record other pertinent data in the appropriate format. The HCP shall review radiological images, lab results, telephone consults, medication requests, etc. as part of the work day. The HCP shall maintain accurate and up to date records, including daily recording of hours worked.
5.8. A M.D. or D.O. shall provide all services. The physician shall be capable of performing the full range of family practice services including diagnosis and treatment of urgent/acute diseases/injuries to include but not limited to:
Skin Pulmonary system
Head Gastrointestinal system
Eyes Musculoskeletal system
Ears Genitourinary system
Nose Reproductive system
Throat Lymphopoietic system
Neck Central nervous system
Cardiovascular system Endocrine system
5.8.1. The physician shall be capable of performing the following tasks as a minimum and request such concomitant privileges:
Manage cardiopulmonary arrests and arrange back up for EMS
Interpret electrocardiograms
Interpret basic radiographic images
Direct medical care through radio communications
Perform arterial punctures
Interpret cardiac monitoring
Infiltration of local anesthesia
I & D of simple abscesses
Suturing of lacerations
Perform closed cardiac massage
Perform needle aspiration of tension pneumothorax
Perform adult lumbar puncture
Splint and immobilize simple fractures
Emergency endotracheal intubations
Emergency cardioversion
Emergency cricothyrotomy airway
Treating a minimum of 25 patients per day
ECG performace and initial interpretation
regional anesthesia
infant/newborn resuscitation
circumcision
moderate sedation
diagnostic thoracentesis with or without biopsy
abdominal pericentesis
reduction of simple fractures of extremities
incision and drainage
nail trephination
sling or swath injuries
General sports/orthopedic medicine
5.8.2. The HCP may attend, participate in, and/or perform uncomplicated vaginal deliveries. The HCP is not permitted to attend, participate in, or perform high risk or C-section deliveries, but will be required to attend to the newborns. The physician shall be responsible for medical oversight and assistance of PA students, special forces members, and students on rotations in the clinic. The physician shall be required to treat patients from other provider panels.
5.9.1. As workload permits during scheduled duty, the HCP shall attend the Emergency Medical Service's monthly staff meetings and the Quality Improvement and Risk Management committee meetings if required by GLWACH. Contract physicians shall also attend such meetings scheduled during their assigned duty shift if required.
5.9.2. If necessary, provide staff teaching, prepare and deliver lectures, attend department grand rounds and other scheduled academic activities on Fort Leonard Wood.
5.10. Quality Control/Assurance. The contractor is required to follow current Quality Control/Assurance plans in place at the medical facility in the performance of this contract.
5.11. Safety. Contractor personnel shall comply with all installation safety and fire prevention regulations. Copies of these regulations are on file in the medical activity safety office or with the COR. The contractor and contractor personnel shall be cognizant of and observe all requirements for handling and storing combustible supplies and materials, and daily disposal of combustible waste, trash, etc.
5.12. GLWACH is part of the Department of Defense HMO program called Tricare and as such, the Contractor staff shall be required to adhere to all Tricare rules. Information on the Tricare program may be obtained at www.tricare.osd.mil.
5.13. The providers under this contract are considered key personnel and mission essential. This means the providers shall make every attempt to be at work on time and work their assigned shift regardless of inclement weather conditions or other circumstances.
6. PUBLICATIONS.
Following is a list of basic publications applicable to this contract. Current issues of many DA publications can be accessed at http://www.usapa.army.mil/gils. Current issues of many forms can be accessed at http://www.usapa.army.mil/forms. Publications and forms not on the internet can be obtained from the MTF.
The Publications have been coded as mandatory or advisory. The Contractor is obligated to follow those coded as mandatory only to the extent that they apply to this contract/task order. Supplements, amendments, or changes to these mandatory publications may be issued during the life of the contract. Advisory publications may be used for information and guidance but are not binding for compliance.
6.1. Mandatory:
Public Law 91 596 29 Dec 70 Occupational Safety and Health Administration
Public Law 104-191 dated 21 Aug 96 Health Insurance Portability and Accountability Act of 1996
Current Edition Joint Commission Manual
AR 40 1 Composition, Mission, and Functions of¬ the Army Medical Department
AR 40 2 Army Medical Treatment Facilities and General Administration
AR 40 3 Medical Services: Medical, Dental, and Veterinary Care
AR 40-4 Army Medical Department Facilities/Activities
AR 40 5 Preventive Medicine
AR 40-48 Non-Physician Healthcare Providers
AR 40 66 Medical Records Administration
AR 40 68 Quality Assurance Administration
AR 40-330 Rates Codes, Expense and Performance Reporting Systems, Centralized Billing,
and Medical Service Accounts.
AR 40-407 Nursing Records and Reports
AR 40-501 Standards of Medical Fitness
AR 40-562 Immunizations and Chemoprophylaxis
AR 340 21 The Army Privacy Program (05 Jul 85)
AR 380-19 Information Systems Security
AR 380-76 The Department of the Army Personnel Security Program
AR 385 40 Accident Reporting and Records and HSC Supplements
AR 600 85 Alcohol & Drug Abuse Prevention and Control Program
