Family Medicine Physician — SAMMC, San Antonio, TX
General Medical Officer Services
JBSA-SAMMC, San Antonio, TX
PERIOD OF PERFORMANCE: 1 Oct 2017 - 30 September 2018
OPTION YEARS: 4
The General Medical Officer shall provide family medicine services to all eligible military and eligible beneficiaries at Brooke Army Medical Center (BAMC) Facilities, Department of Family & Community Medicine (DFCM), JBSA - Fort Sam Houston, Texas. The contract physician shall provide these services along with rendering medical assessment of their condition and taking appropriate medical action. The General Medical Officer shall be performing service under the Department Chief or his/her designated representative.
HCP TRAINING AND IN-PROCESSING: All contract providers are required to complete mandatory in- processing and training prior to being authorized to begin providing professional services. This is billable time for all contract providers privileged to work under the terms of the contract. This time does not count towards shift coverage with regards to the PAP.
QUALIFICATIONS: The contract physicians shall meet the following minimum qualifications:
- Shall be a Doctor of Medicine or Osteopathy who has successfully completed their Doctorate degree from an accredited college approved by the Council in Medical Education and Hospitals of the American Medical Association or Doctor of Osteopathy from a college accredited by the American Osteopathic Association. The contract physician must have successfully completed an approved internship training program.
- Possess and maintain a current valid unrestricted license to practice medicine in one of the 50 states in the U.S, the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands
- The HCP shall not, within 5 years prior to employment:
- Have had his/her clinical privileges limited, suspended, or revoked by any healthcare facility, public or private, anywhere in the world.
- This prohibition does not apply to any individual whose clinical privileges, although originally limited, suspended or revoked by a healthcare facility were subsequently fully reinstated by the healthcare facility.
- Able to obtain and maintain clinical privileges to practice medicine through approval with the applicable MTF Credentials Committee
- Must have or obtain a current valid DEA registration number prior to performing the contract services. Any change to the DEA requirement to obtain a valid DEA registration number is applicable when the incumbent’s existing DEA registration expires
- Possess and maintain BLS & ACLS from the American Heart Association
- CME: Health care providers registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current
- Able to complete favorable Background Check
- Able to read, write, and speak English well enough to effectively communicate with all parties and other health care providers as determined by the MTF Commander or the Contracting Officer’s Representative (COR)
- Shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to a variety of patients from diverse backgrounds
- Able to complete favorable Credentialing
ORIENTATION AND TRAINING
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.
The government reserves the right to verify the hours worked by the contract providers not only by implementing sign-in/sign-out procedures, but by any other means, including requiring the contract provider to utilize a time clock should one be installed.
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.
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:
- Composite Healthcare Computer System (CHCS). CHCS contains the MTF’s appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the MTF
- 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
- Training for CHCS and other computer training will be scheduled through the OIC/NCOIC of the Department. The training will be on-site and during normal duty hours. This training will be at no cost to the contractor.
HOURS OF PERFORMANCE
Duty Hours. Hours of performance shall be determined by the Chief, Department of Family and Community Medicine. Normal work shift is expected to be 40 hours per week, 8 hours per day between the hours of 0600 -2000 Monday through Friday, which includes a one-hour unpaid lunch break. Due to workload requirements, the schedule may include 8, 10, or 12 hour shifts including weekdays, weekends and federal holidays with adjusted starting and ending times, as well as the specific days of the week to be worked. However, the contract physician will not normally be scheduled for more than 40 hours in one week unless by mutual agreement of the contract physician and Chief, Family Medicine Service or his/her designee. Compensatory (Comp) Time and Overtime are not authorized.
The government reserves the right to verify the hours worked by physicians to include implementing sign in/sign out procedures or using a time clock as appropriate. Any attendance sheets are for the sole use of government officials to ensure compliance with FTE hours and will not be provided to the contractor for any reason and/or purpose. In addition, under no circumstances will Government employees sign or verify the contractor's time sheets for the contractor's health care providers.
Contract physicians are not subject to work on holidays.
ABSENCE FROM THE WORKPLACE: The Contractor shall provide qualified and trained personnel for the required hours of performance. The contractor shall ensure that scheduled and unscheduled absences of their employees do not interrupt service performance. All proposed substitutes/replacements shall have qualifications equal to or higher than the qualifications of the person being substituted or replaced and will also be required to meet identical application submission procedures specified in the statement of work prior to per forming services.
SCHEDULED ABSENCES: The contractor will coordinate any scheduled absence with the Department Chief or his/her designated representative and the COR at least 60 days' notice prior to the planned absence. Contractor shall coordinate the absence with the MTF so that it does not hinder the schedule.
UNSCHEDULED ABSENCES: In the event the contractor is unable to perform services on a scheduled duty day due to an emergency absence such as illness, he/she shall notify the Department Chief or his/her designated representative, and the COR, as soon as it is known that the duty day will be missed or at least 2 hours prior to the start of the shift.
All contract providers shall abide by the MTF, policies, rules and ARs. All contract providers shall maintain and support the standards necessary to meet JC and CMS (Centers for Medicare and Medicaid Services) certification. When commencing work under this contract, contract providers shall obtain an in- processing checklist from the hospital personnel office. The contract provider shall wear the MTF identification badge. Upon termination of work at this MTF, all contract providers are required to return the hospital identification badge and out-process through the activities identified on the out-processing checklist obtained from the hospital personnel office.
MTF AUTHORITY: Contractor agrees to abide by all MTF standards, rules, and procedures including requirements for any required credentialing and quality assurance.
SPECIFIC TASKS: The contractor shall be fully aware that, other than ancillary and support personnel, the contract physician shall be fully prepared to provide all of the emergency services required without assistance or supplementation by other MTF physicians. Contract physicians performing services under this contract shall have sufficient experience to be able to adequately diagnose and treat diseases/injuries; perform medical procedures/tasks to include, but not limited, to the following:
Skin, Head, Eyes, Ears, Nose, Nose/Throat, Neck, Cardiovascular System, Gastrointestinal System, Lymphatic System, Musculoskeletal System, Genitourinary System, Reproductive System, Psychiatric Disease, Central Nervous System, Endocrine System, and Peripheral Nervous System.
Specific Tasks: The contract physician providing services under this contract shall perform the same duties as those required of any military or government civil service General Medical Officer of similar experience assigned to the same unit at the MTF. The quality of service shall meet or exceed reasonable standards of professional practice as determined by the same authority that governs services in the same discipline. The contract physician shall provide family medicine services to all eligible military and other healthcare system beneficiaries, render a medical assessment of their condition, and take appropriate medical action. The contract physician shall have sufficient training/experience to be able to perform the required specific tasks which include, but are not limited to the following:
Provide definite medical care to each patient as appropriate to the diagnosed condition, to include review of results of all ancillary diagnostic tests ordered for the patient.
Follow up of abnormal ancillary test reports to assure correct medical follow up and treatment of patients.
All reports shall be reviewed within 3 work days of their receipt by the contract provider.
Attend and treat patients in priority as established by medical triage or assigned by the given clinic.
Provide necessary emergency care and stabilization to patients presenting themselves to the assigned clinic for medical care.
Prepare appropriate patient profile.
Prepare and document appropriate patient history, physical examinations, and preoperative diagnosis. Maintain documentation of all treatment provided in accordance with hospital directives and prepare such records and reports as may be required by the contract. Ensure all documentation and reports are legible and accurate.
Consult with other hospital staff specialties as appropriate to determine referral priorities of patients whose conditions are diagnosed as beyond the capabilities of the healthcare provider, thoroughly documenting the patient's condition, history and reason for referral.
Provide professional advice to clinic personnel and hospital ward personnel with regard to professional management of patients.
Respond to mass casualty situation in accordance with hospital procedures.
Adhere to the Centers for Disease Control guidelines and hospital Infection Control Program concerning universal precautions at all times while providing services under this contract.
Be capable of performing a full range of general medical services to include the ability and experience to adequately diagnose and treat urgent/acute disease and injuries including but not limited to:
Skin, Head, Eyes, Ears, Nose, Throat/Mouth, Neck, System Pulmonary System, Gastrointestinal System, Lymphatic System, Muscular Skeletal System, Genitourinary System, Reproduction System, Psychiatric Disease, Central Nervous System, Endocrine System, Peripheral Nervous System
Have sufficient experience to be able to adequately diagnose and treat diseases and injuries to include, but not limited to, the following:
Upper and Lower Respiratory Infections Ear, Eye, Nasal, and Lung Infections Skin Disorders and Infections
Minor Heart Disorders Minor Allergic Reactions Simple Hay Fever
Have sufficient experience to be able to adequately perform medical procedures to include, but not limited to, the following:
Incision and drainage
Sling or swath injuries
Suture simple laceration Suture removal
Cultures (throat, wound)
Secure and maintain an adequate airway Remove foreign bodies as appropriate Clearing of ears by flush technique
Stabilize dislocations and fractures, when appropriate
Bandaging of sprains, minor bums, and minor lacerations
Perform venous punctures for lab studies and interpret results
Administer intravenous, intramuscular and subcutaneous medications as appropriate
Contract physicians shall become familiar with the hospital formulary. Contract physicians authorized to prescribe pharmaceuticals shall do so according to the availability of drugs listed therein. The pharmacy service will provide instructions to all prescribing practitioners on substitutability of generic drugs for prescribed medication. The contract physician shall use only prescription forms DA 1289, which have been stamped. To be filled only at San Antonio DoD Military Treatment Facilities. The prescriptions shall be valid only at SAMMC pharmacies and only for eligible beneficiaries of the military health care system. Follow the procedures of the hospital when prescribing drugs.
Maintain proper medical records on beneficiaries to whom treatment is provided in accordance with Army Regulation 40-66, Medical Record & Quality Assurance Administration. Provide accurate and timely documentation in electronic medical record, meeting hospital requirement to close patient chart no later than 72 hours after patient appointment. Medical records completed by the contractor's physicians shall be subject to review by the Chief, Family Medicine Service, and the hospital medical records review committee. The contract physician(s) shall be notified of deficiencies in their entries into the medical records and shall be instructed to correct the deficiencies. All records generated in the performance of the contract will remain the property of and subject to exclusive control of the government.
Verify the content and correctness of all prepared and transcribed reports by affixing his/her own signature and stamp to all paper copies of the document and validating its contents.
Attend and participate in patient care reports, patient care conferences, team conferences, professional staff conferences and other appropriate professional activities as required by the supervisor.
The contract physician shall utilize the appropriate/designated electronic medical records and database/information management systems for keeping records, ordering of ancillary procedures, ordering of medications, writing doctor's order, and performing other required patient record functions. BAMC / SAMMC personnel shall furnish instructions to the contract physician in the use of these systems.
Prepares appropriate patient profile Prepare and document appropriate history, physical examinations, and preoperative diagnosis. Maintain documentation of all treatment provided in accordance with hospital directive and prepare such records and reports as may be required.
Contract physician, during scheduled duty, shall attend the required staff meetings and the Quality Improvement Committee meetings as required by the Chief, Department of Medicine. Contract physicians may also attend such meetings scheduled during other than their assigned duty shift.
The contract HCP shall record the time worked according to MTF procedures.
The chief of the department where services are being performed, 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.
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.
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.
Contract HCPs shall abide by MTF bylaws, JC, 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, release of medical information.
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.
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.
CONFLICT OF INTEREST
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.
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.
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 internist shall prepare medical records, forms and documents as required, IAW the regulations and established guidelines listed in the contract.
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 internist shall not make use of any Government facilities or other Government property in connection therewith.
The contractor or contract HCPs shall not use Government facilities or other Government property in connection with conducting a private practice.
QUALITY ASSESSMENT AND IMPROVEMENT (QA&I)
The Government shall monitor the contractor’s performance under this contract using the QA&I procedures established by the MTF and pursuant to addendum 52.212-4. Additionally, the contractor’s performance is subject to scheduled and unscheduled review by the QA&I Committee defined in the MTF’s quality assurance plan and AR 40-68.
The inspection and acceptance point for all services rendered under this contract will be by the Department. 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 CO 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 HCP. Quality Assurance procedures established by the MTF shall be used for continuous monitoring. Other performance evaluation factors will be monitored that are not quantified by numerical measurements which include: prescribing medications not on the hospital formulary; contractor providing personnel not meeting the minimum qualification standards; no inappropriate prescriptions; patient customer service comments; contractor relationship with hospital staff/government contracting personnel; compliance with hospital policy and procedures. Services provided by the physician shall be reviewed and rated in accordance with the MTF by-laws and JCAHO standards. A poor rating shall be grounds for immediate removal of the HCP.
Patient complaints on services provided by the HCP are taken very seriously at the MTF and as such will be considered a part of the inspection process. The Department Chief will review all complaints.
The MTF is a no smoking facility. Smoking is permitted outside in designated areas.
GOVERNMENT FURNISHED PROPERTY AND SERVICES.
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.
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
Freedom of Information Act Program (FOIA and Privacy Act). The contractor shall comply with DOD Regulation 5400.7-R, DOD Freedom of Information Act Program requirements. The Freedom of Information Act sets policy and procedures for the disclosure of records to the public and for marking handling transmitting and safeguarding For Official Use Only materials.
Reporting Requirements. The contractor shall comply with DoD 5200.2-R, January 1987, Personnel Security Program and AR 380-67, 9 September 1988, Department of the Army Personnel Security Program Regulation. Contractor shall report to the SAMMC Security Manager any information or circumstances which may pose a threat to DOD or contractor personnel, resources, or DOD information.
Removal of contract employee. The government reserves the right to require immediate temporary or permanent removal of any individual whose actions raise reasonable suspicion that patient care or services may be compromised in any way or that pose a threat of harm to other contractor/government personnel or self. The employee may be required to submit to drug/alcohol testing. The government reserves the right to require temporary or permanent removal of any individual who refuses testing. Notification of all removals will be made by the Contracting Officer Representative (COR). Removal of any individual does not relieve the contractor of any performance requirement.
Physical Security. The contractor shall comply with all Force Protection Condition (FPCON) procedures, Random Antiterrorism Measures (RAMS) and local search/identification requirements.
Government Computer Access Requirements. If this contract requires contractor personnel to have access to government computers, contractor personnel requiring access to government computers shall successfully complete, a National Agency Check (NAC), before obtaining access to the computer. These investigations shall be submitted by the government at no additional cost to the contractor. Common Access Cards (CACs) for Contractor Personnel are required which is hereby incorporated by reference if not otherwise included. The contractor shall comply with Homeland Security Policy Directive (HSPD)-12, Policy for Common Identification Standard for Federal Employees and Contractors and Federal Information Processing Standard 201 Keys and Lock Combinations. The contractor shall abide by all current key control and lock combination procedures The Contractor shall be responsible for any keys issued contractor. The keys shall not be duplicated. The Contractor shall ensure government-issued keys are not by personnel other than those currently authorized. No unauthorized personnel shall be allowed entry into the locked area. Keys shall not be used to open work areas for personnel other than personnel engaged in performance of their duties, unless authorized by the Government functional area chief. The contractor shall use keys issued to them to secure/open areas only as directed by the COR and/or functional area chief. Lost keys and/or locks shall be reported to the issuing party and COR immediately upon recognition of the loss. The COR shall notify the PMO of the lost key. The contractor shall be responsible for the replacement costs of any lost keys and any associated locks. Reimbursement shall be provided before the Government replaces lost keys or performs re-keying.
ANTI-TERRORISM (AT) REQUIREMENTS
Key Control. The contractor shall safeguard all keys issued by the government and insure they are used only by authorized contractor personnel. The contractor shall not duplicate issued keys and shall report lost keys to the contracting officer immediately the contractor will be charged for lost keys, re-keying, and lock
Security Requirements: Work under this contract is UNCLASSIFIED. The Contractor shall comply with all applicable DoD security regulation and procedures during the performance of this contract. The Contractor shall not disclose and must safeguard procurement sensitive information, computer systems and data, Privacy Act data, and Government personnel work products obtained or generated in the performance of this contract. Contractor will be issued by the Government a Common Access Card (CAC) which is required for access to Government computer databases and entrance to the installation. Additionally, contractor must be issued a special identification card issued by SAMMC PMO Badge and ID Office prior to reporting for duty. The Contractor shall be responsible for the control and safe keeping of all Government issued IDs and ensure all badges are returned to the COR upon termination of the contract. The Contractor shall ensure he or she is aware that in the event either of the Government IDs are lost or stolen that they are to advise the PM or alternate immediately upon discovery. The Contractor shall ensure that the COR is notified the same day the report of an ID lost or stolen.
The Government shall conduct criminal background checks on the contractor in accordance with the procedures set forth in Public Law 100-235, DoD Directive 5200.28, DoD Directive 5200.2-R, DoDI 1402.5. and submit to the PM or the Alternate. The Contractor is responsible for completing the SF86, Authorization for Release of Information form and ensures all background check submittals are initiated in accordance with this PWS prior to employees providing services at BAMC facilities. Background checks shall be based on fingerprints of individuals obtained by qualified Government law enforcement or security personnel, inquiry’s conducted through the Federal Bureau of Investigation (FBI) and the State Criminal History Repository check, and a local Installation Record Check., if required. The procedures for completing the required background check are outlined in the Department of Defense Instruction (DoDI) 1402.5. Government will not allow the contractor to start work until clearance of criminal background check has been completed.
Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use at the end of each business day. The Contractor shall ensure all government facilities, equipment, and materials shall be secured at the close of each duty day.
Antiterrorism (AT) / Operations Security (OPSEC) Requirements: For OPSEC to be effective, all Contractors must be aware of OPSEC and understand how OPSEC complements traditional security programs. All personnel must know how to apply and practice OPSEC in the performance of their daily tasks. OPSEC must become a mindset of all Contractors and be performed as second nature. To accomplish this level of OPSEC vigilance, OPSEC training programs must be action and job-oriented, enabling the workforce to put into practice the knowledge and tactics, techniques, and procedures (TTPs) they learned in training. Training should maximize the use of lessons learned to illustrate OPSEC objectives and requirements. In order to ensure accomplishment of training, the Government will include OPSEC training as a part of their organization’s annual training guidance. Contractor must complete Level I OPSEC and AT Awareness training within 30 calendar days of reporting to duty in according to Army Regulation 530-1 and 525.13. AT Level I awareness training is also available at https://atlevel1.dtic.mil/at.
iWATCH Training: The Government will brief contractor on the local iWATCH program. This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to their COR. Contractor must complete iWATCH training within 30 calendar days of reporting to duty.
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