Two(2) Internal Mediicine Physicians

REQUEST FOR QUOTATIONS (THIS IS NOT AN ORDER) RFQ-13-049 1 05/17/2013 / IHS1202691 1. REQUEST NO. AND/OR DMS REG. 1 , , I d. CITY I e. STATE I f. ZIP CODE I d. STATE I e. ZIP CODE PAGE OF PAGES 1-2 2. DATE ISSUED RATING THIS RFQ IS W IS NOT A SMALL BUSINESS SET-ASIDE 5A. ISSUED BY 1 6. DELIVER BY /Date) 1 Linda.suess@ihs.gov 1 605 1 685-6771 1 3. REQUISITIONIPURCHASE REQUEST NO. 7. DELIVERY OTHER FOB DESTINATION (See Schedule) 9. DESTINATION a. NAME OF CONSIGNEE 5b. FOR INFORMATION CALL (NO COLLECTCALLS) 4. CERT.FOR NAT. DEF. UNDER BDSA REG.2 NAME Linda M. Suess, Contract Specialist b. STREET ADDRESS P.O. Box 1201 c. CITY Pine Ridge, SD TO: SD TELEPHONE NUMBER AREA CODE I NUMBER a. NAME 57770 5a ON OR BEFORE CLOSE OF BUSINESS 05/13@ 12:OO~m MAT b. COMPANY 10. PLEASE FURNISH QIJOTATIONS TO IMPORTANT: This is a request for information, and quotations furnished are not offerors. If you are unable to quote, I THE ISSUING OFFICE IN BLOCK 1 olease so indicate on this form and return it to the address in Block 5a This reauest does not commit the Government 1 to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter. 1 1. SCHEDULE (Include applicable Federal, State and local taxes) Firm Fixed-Price, Non-Personal service contract for Two (2) Internal Medicine Physicians for OPC/IPC at the Pine Ridge Service Unit, Pine Ridge, SD. Period of performance will be fiom 05120120 13 through 09130/20 13. The contractor is to perform as outlined in the attached Statement of Work. The quoted "unit price" must be an allinclusive cost. I c' STREET ADDRESS ITEMNO. I SUPPLIESISERVICES (a) Two (2) Internal Medicine Physicians M-F 8am to 4:30 PM(1ess lunch) QUANTITY I UNIT I UNITPRICE I AMOUNT PAYMENT (b) URGENT & COMPELLING b. STREET ADDRESS 1 (c) I I (d) c. COUNTY a. NAME (Type ofprint) I I I I I I AUTHORIZED FOR LOCAL REPRODUCTION FormFlowDelrina Inc. STANDARD FORM 18 (REV 6-95) Previous edition not usable Prescribed by GSA-FAR (48 CFR) 53-215-I(a) 16. SIGNER b. TELEPHONE AREA CODE (e) (f) d. CITY e. STATE f. ZIP CODE c. TITLE (type orprint) NUMBER CONTINUATION FOR RFQ-013- PAGE 2 OF 2 PAGES ITEM NO. (a) DUNS & BRADSTREET NUMBER: (The Duns & Bradstreet number is required. Provided you do not have it, you may call 866-705-5711 and obtain one.) You will need a DUNS & BRADSTREET NUMBER to be awarded the purchase order. WHAT I S SAM? The System for Award Management (SAM) is a Federal Government owned and operated free web site that consolidates the capabilities in CCRfFedReg, ORCA, and EPLS. FORMER CCR REGISTRANTS If you had an active record in CCR, you have an active record in SAM. You do not need to do anything in SAM at this time, unless a change in your business circumstances requires updates to your Entity record(s) in order for you to be paid or to receive an award or you need to renew your Entity(s) prior to its expiration. SAM will send notifications to the registered user via email 60,30, and 15 days prior to expiration of the Entity. To update or renew your Entity records(s) in SAM you will need to create a SAM User Account and link it to your migrated Entity records. You do not need a user account to search for registered entities in SAM by typing the DUNS number or business name into the search box. FEDERAL TAX ID NUMBER: EMAIL ADDRESS: NET TERMS: QUANTITY (c) UNIT (d) UNIT PRICE (e) AMOUNT (0 SECURITY CLEARANCE Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S. facilities or systems each person must complete a FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System. Contractors shall allow five business dnys for I.H.S. processing of fingerprints taken electronically at an I.H.S. site and thirty business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer. In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Exclucled IndividualslEntities (LEE),h ~~://exclusions.oie;.hhs.govA.s soon ns practicnble prior to the sL1t-t of work, the perforlnance of the work the Contractor shall provide to the Contracting Officer the names of all individunls to be used in performance of work for screening against the LEIE. During the performance of the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening they begin work. The Contractor is responsible for conducting security preclearance investigations sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the LEE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of perfomlance to avoid delays caused by denial of access. If this is a Time and Materials, -hhr-Hou~'mC ost Reimbursement eontraet, the eontractor shatl notehaqe-forerbereimbimsed-fm-labohro urs-or-otherc osts incmed-foremployees who are unable to perform due to denial or access or the excess time required to resolve and clew unfavorable security clearance findings. If this is a Fixed Price contract, denial of access due to security clearonce findings shall not be a basis for excusable delay or an increase to the contract amount. STATEMENT OF WORK Internal Medicine Physician Services (NON-PERSONAL SERVICE) DESCRIPTION OF SERVICES. The Contractor shall provide Internal Medicine Physician services required for the Pine Ridge Comprehensive Health Care Facility. The mission of the Pine Ridge Comprehensive Health care Facility in Pine Ridge, South Dakota is to provide the best possible health care services to the Native American population on the Pine Ridge Indian Reservation. The 35-bed facility is also known as the Pine Ridge Indian Health Service Hospital, The Pine Ridge Service Unit, or the IHS Hospital. The Aberdeen Area Indian Health Service (AAIHS) requires contractor support to assist in the recruitment and placement of emergency room physicians into temporary duty assignments in health centers and hospitals in the AAIHS. The purpose of the contract is for the recruitment, credentialing, and placement of internal medicine physicians into various locations in the Aberdeen Area. This contract is a non-personal health care services contract, as defined at Far Part 37.101 under which the Contractor is an independent contractor and which shall allow the Government to evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of the services rendered, (e.g., professional judgments, diagnosis for specific medical treatment). The Contractor shall indemnify the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance. The Contractor shall maintain medical liability insurance, in the coverage amount acceptable to the Contracting Officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned. The Contractor shall fiunish physicians for internal medicine assignments in Aberdeen Area hospitals. I.H.S. facility in Pine Ridge, South Dakota, will require internal medicine physicians on an ongoing basis. Contract physician care shall cover the range of medicine typically provided in a rural civilian practice of similar size. The Contractor shall provide physicians to perform the necessary medical procedures for patients in both outpatient and inpatient situations, but this position will not involve overnight call, unless emergency condition develops. (See Appendix A for the types of services historically provided.) Upon the receipt of an I.H.S. service unit task order, the Contractor shall locate, credential, and have available sufficient staffing to provide physician coverage for 8 hour shifts, occasionally extra hours may be necessary (up to 55 hourslweek). The work schedule will consist of a Monday - Friday 8:00 am - 4:30 pm.Task Orders shall be issued 2 1 days in advance of the need but some tasks orders may provide the Contractor with a limited time in which to respond. The standards of medical practice and duties of the Contractor through its physicians shall be determined pursuant to Governing Body bylaws, medical staff bylaws, rules and regulations of the appropriated I.H.S. hospital, applicable provisions of law including but not limited to rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals, and standards and recommendations of CMS (Centers for Medicare and Medicaid Services) compliance. The contract resulting from this solicitation shall: 1. be a non-personal health care services contract under the Contractor is an independent contractor: 2. allow the Government to evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of the services rendered, (e.g., professional judgments, diagnosis for specific medical treatment); 3. requires the Contractor to indemnify the government for any liability-producing act or omission by the Contractor, its employees and agents occurring during contract performance; require the Contractor to maintain medical liability insurance, in the coverage amount acceptable the contracting officer, which is not less than the amount normally prevailing within the local community for the specific specialty; and 4. require the Contractor to ensure its subcontracts for provisions of health care service, contain the requirements of the clause at FAR 52.237-7, including the maintenance of medical liability insurance. 1.1. CONTRACTOR RESPONSIBILITY. 1.1.1. Provides internal medicine services to approximately 600 patient visits per month to a patient population ranging in age fiom young adult to geriatric. 1.1.2. The physician's actual clinical duties will be in accordance with hisher credentialed privileges. 1.1.3. The physician shall practice within the Medical Staff By-Laws of the Pine Ridge Comprehensive Health Care Facility. 1.1.4. Primary duty will be to provide outpatient care in our IPC clinic. But may provide direct hands-on patient care in both inpatient and outpatient settings durning the normal duty day. Performs triage, assesses, and re-assesses patients throughout the patient visits. Ensures documentation of medical assessments and observations are documented accurately in the patient's health care record. When necessary completes all transfer forms, writes admittingldischarge orders, daily progress notes and complete H&P and discharge summary according to the Pine Ridge IHS Medical Staff By-laws. Documents consultations in the patient's health care record when called in to assist an emergency room physician. 1.1.6. Implements, evaluates and is consulted on outpatient and inpatient policies, procedures and instructions. 1.1.7. Establishes inter-personal and intra-departmental relationships to enhance optimal patient care. 1.1.8. Demonstrates competent and effective oral and written communication. 1.1.9. Provides appropriate patiendfamily member teaching and education; evaluates effectiveness and level of patiendfamily member understanding of teaching provider. 1.1.10. Utilizes the RPMSEHR computer softwarelprogram for entering and signing of medical orders such as laboratory studies, and directly signing and dating radiological studies, etc. 1.1.11. Obtain necessary information on patients seen in the clinic, such as medical records, x-ray films and reports, and pathology slides and reports and documents pertinent normal and abnormal test results in the patient's medical record. 1.1.12. Maintain familiarity and comply with hospital antiseptic polices and procedures. Maintain familiarity and comply with all Federal, State, Indian Health Service, CMS regulations, and departmental regulation and requirements. 1.1.13. Ensure a safe work environment and employee safe work habits. 1.1.14. REFERRALS AND CONSULTS. The provider shall follow IHS Contract Health regulations and policies when arranging for a referral or consult. The family practice physician shall be required to consult with other specialty practitioners for consultative opinions and continuation of care. The provider shall inform patients of the required referral or consult by indicating the specialty involved. 1.1.15. PRESCRIPTIONS. The provider shall use and follow the IHS formulary for prescriptions for all patients The formulary list is approved and maintained by the Pine Ridge IHS Pharmacy and Therapeutics Committee. Any drug not listed on the formulary must be approved by the Pharmacy and Therapeutics Committee. 1.2. PROCEDURE GUIDANCE. Contractor providers shall perform procedures compatible with the medical facility's operating capacity and equipment. New medical procedures/se~icess hall not be introduced without prior recommendation to, and approval of the Clinical Director or authorized representative. 1.3. PRIVACY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION. The Contract health care providers shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity. The Contractor shall ensure strict compliance to the release of Protected Health Information in accordance with the Code of Federal Regulation, Title 45, Public Welfare, Subtitle A, Department of Health and Human Services, Part 164, Security and Privacy (45 CFR 164) and AFI 41-210, "Patient Administration Functions" paragraph 2.2.3, "Health Insurance Portability and Accountability Act (HIPPA)" and paragraph 2.3, "General Guidelines on Releasing Medical Information". 1.4. COMMUNICATION. The Contractor shall ensure contract providers maintain open and professional communication with members of the Medical Staff. Complaints validated by the Quality Assurance Personnel (QAP) and Clinical Director shall be reported in writing to the Contracting Officer (CO) and the Contractor for action. 1.4.1. ENGLISH LANGUAGE REQUIREMENT. The contractor provider(s) shall read, understand, speak, and write English fluently. 1.5. DOCUMENTATION. Contractor personnel shall prepare all documentation to meet or exceed established CMS standards and Pine Ridge IHS Medical Staff Bylaws. 1.6. AVAILABILITY: 1.6.1. HOURS OF OPERATION: Contractor coverage will be for 8 hour shifts, occasionally additional hours may be required (up to 55 hour work week). The work schedule will consist of a Monday - Friday 8:00 am - 4:30 pm. Routine work hours will be scheduled by the Clinical Director to correspond to the needs of the facility. The physician shall arrive for each scheduled shift in a well-rested condition and shall have had at least six hours rest from all other duties. 1.6.2. FEDERAL HOLIDAYS. When the holiday is on a Saturday, the preceding Friday will be the federal holiday. When the holiday is on a Sunday, the following Monday will be the federal holiday. Asterisk (*) indicates the dates change each year. List of Federal Holidays (a) 1 January New Year's Day (b) 3rd Monday in January * Martin Luther King's Day (c) 31M~o nday in February* President's Day (d) Last Monday in May * Memorial Day (e) 4 July Independence Day (0 1" Monday in September * Labor Day (g) 2nd Monday in October * Columbus Day (h) 11 November Veteran's Day (i) 4th Thursday in November * Thanksgiving (j) 25 December Christmas 1.6.3. ON CALL DUTY. On call duty is not required, although in emergencies, additional hours may be required. 1.6.4. CONTINUITY OF SERVICESIREPLACEMENT STAFF. The Contractor point of contact shall ensure qualified personnel are available to provide coverage at all times even during scheduled absences of primary contract providers. 1.6.5. The IM Physician services are considered vital to the Government and must be continued with minimal interruption. In order to minimize interrupted services, the incumbent contractor shall exercise its best efforts and cooperation to effect an orderly and efficient transition to a successor. 1.6.6. PERFORMANCE OF SERVICES DURING CRISIS DECLARED BY THE NATIONAL COMMAND AUTHORITY. On occasion, services may be required to support an activation or exercise of contingency plans outside the normal duty hours. Emergency situations (i.e., accident and rescue operations, civil disturbances, natural disasters) may necessitate the contractor provide increased or reduced support as determined by the contracting officer. The Government will negotiate an equitable adjustment with the contractor for the cost of these emergency requirements. 1.7. ORIENTATION. The Contractor shall ensure that all new contract providers participate in the Pine Ridge IHS Facility orientation with an overlap of services to include one additional day. Providers must arrive on a Monday - Friday excluding holiday and participate in the orientation prior to providing services at the Hospital. 1.7.1 RECORDS. The contractor shall document all patient encounters legibly in the patient medical record. All documentation shall be timed and dated. Verbal ordered are to be used as infrequently as possible. In the event of a major disaster or code all verbal orders are to be signed off immediately following the code or disaster. All Medical records must be signed by the providers and charge ticket completed at the end of the visit. All Medical records are to be completed by the end of the provider's scheduled shift. All documentation shall meet the current CMS guidelines. 1.7.1.2 Final payment will be withheld until all medical records are completed by the contract physician. 1.8. PERSONNEL REQUIREMENTS 1.8.1. CONTINUING MEDICAL EDUCATION (CME)/ CERTIFIED EDUCATION UNITS (CEU) REQUIREMENTS. Maintain CME and review pertinent journals, books and publications. Health care providers registered or certified by nationavmedical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentials office for tracking by the Clinical Director. 1.8.2. LICENSUREIREGISTRATION. Non-personal services contract personnel providing care at the Pine Ridge facility must maintain a current active and unrestricted license in at least one of the 50 United States or US territories. 1.8.3. CERTIFICATION. The provider must have national andlor state (required) approved and current board certification or board eligible in the American Board of Internal Medicine. 1.8.3.1. Copies of required certification for each Provider shall be furnished to the Contracting Officer prior to performance on this contract. 1.8.4. FORMAL EDUCATION. The provider must have a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited college or university in the specialty area required to complete the FTE. 1.8.5. EXPERIENCE. The provider must have a minimum of 3 years of experience within IM practice to include fellow and residency time within the past 36 months prior to provider beginning performance at Pine Ridge IHS. 1.8.6. Maintain certification in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS). 18.7 LABILITY INSURANCE. The contractor shall maintain current medical liability insurance, in the coverage amount acceptable to the Contracting Officer, which is not less than the amount normally prevailing within the local community for the medial specialty concerned. 1.9. QUALITY CONTROL: The contractor shall develop and maintain a quality program to ensure emergency room services are performed in accordance with commonly accepted commercial practices, manufacturers' recommendations, this contract, and all federal, state, and local laws and regulations. As a minimum, the contractor shall develop quality control procedures addressing the areas identified in the Service Delivery Summary. The contractor shall develop and implement procedures to identify, prevent, correct, and ensure non recurrence of defective services. The contractor shall provide a copy of the quality control plan to the contracting officer no later than the orientation date, and updated copies as changes occur. Records of all inspections conducted by the contractor and corrective action taken shall be made available to the government upon request. 2. SERVICE DELIVERY SUMMARY. INTERNAL MEDICINE - PHYSICIAN. 2.1. The Government shall periodically evaluate the Contractor's performance by appointing a project officers to monitor performance to ensure services are received. The Government project officer along with the PI Coordinator, Clinical Director or her designee shall evaluate the Performance Objective (General) 1. Medical practice must be within the standards of their credentialed specialty 2. Documents medical assessments, History and Physicals, observations, discharge summaries and daily progress notes. 4. Utilizes RPMSIEHR to enter and sign off lab results 6. Complies with safety policies. 7. Consults with other specialty practitioners 8. Maintains patient privacylconfidentiality. 9. Adheres to work duties and scheduled for shifts . 10. Maintains continuing medical education, licensing, registration, and certifications 11. Complaints on quality of care andlor conduct. Performance Measure 100% compliance required. 100% compliance required 90% of labs must be signed off at end of each shift Zero violations 100% compliance required Zero breaches of privacy No more than 2 unplanned absences per quarter 100% compliance required Not more than 2 per quarter. Contractor's performance through inspections of call logslreports and receive and investigate all complaints from base personnel. The Government may inspect each task as completed or increase the number of quality assurance inspections if deemed appropriate because of repeated failures or because of repeated customer complaints. Likewise, the Government may decrease the number of quality assurance inspections if performance dictates. The Government Contracting Officer shall make final determination of the validity of customer complaint(s). 2.2. If any of the services do not conform to contract requirements, the Government may require the Contractor to perform the services again in conformity with contract requirements, at no increase in contract amount. When the defects in services cannot be corrected by reperformance, the Government may - (a) Require the Contractor to take necessary action to ensure that future performance conforms to contract requirements; and (b) Reduce the contract price to reflect the reduced value of the services performed. 3. GOVERNMENT-FURNISHED PROPERTY AND SERVICES. 3.1. EQI-IIPMENT. Contract providers shall have joint use of all available equipment for performing services required by this contract: 3.2. PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish the contract provider(s) with appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE. This does not include any type of uniform or laboratory coat. 3.3. IDENTIFICATION CREDENTIALS. The Pine Ridge IHS will provide each contract provider with the required identification card. 3.4. FORMS. The Pine Ridge IHS will provide required Government forms used in the performance of services. 3.5 SLIPPLIES. The Pine Ridge IHS will provide medical and non-medical supplies commonly used in the facility for the care and management of patients and the performance of the requirements of this contract. 3.6 HOUSING. For the purpose of this contract, the Government will furnish housing for the contractor which can be rented though the IHS Housing Manager. 3.7 UTILITIES. For the purpose of this contract, the government will furnish all required utilities (such as water, telephone, electricity, etc.) at no cost to the contractor. Government phones and computers are not to be used for personal phone calls or e-mails. 3.8 MEALS - are available at the hospital for the contractor at a cost of around $3.00/meal. Meal tickets are available for purchase through the finance office. 3.9. SERVICES. 3.9.1. Administrative support. Pine Ridge will provide normal office administrative support services, to include telephone and utilities. 3.9.2. Patient scheduling. Clinic personnel will assist in patient scheduling. Complete administrative control of the patient shall remain with the facility. 3.9.3. Pine Ridge will provide all other ancillary personnel services required, including personnel to move patients or equipment. 3.9.4. Housekeeping services will be provided by the facility. 3.10. CONTRACTOR FURNISHED ITEMS AND SERVICES 3.10.1. GENERAL. Except for those items or services specifically stated in Section Ill to be Government furnished, the Contractor shall furnish everything required to perform this contract in accordance with all of its terms. 3.10.2. CONTRACTOR OWNED EQUIPMENT. The physician will provide hislher own stethoscope. 3.10.3. INITIAL INSPECTION. Contractor owned equipment will be inspected and approved by the biomedical equipment maintenance section prior to use in the facility. This includes personal items such as coffee makers and radios. 4. GENERAL INFORMATION 4.1. PERSONNEL. 4.1 .I. POINT OF CONTACT. The Contractor shall provide a point of contact who shall be responsible for the performance of the work. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The Contractor shall designate this individual, in writing, to the Contracting Officer (CO) before the contract start date. An alternate may be designated, but the Contractor shall identify those times when the alternate shall be the primary point of contact. 4.1.2. CRIMINAL BACKGROUND CHECK REQUIREMENTICHILD CARE NATIONAL AGENCY CHECK WITH INQUIRIES (CNACI). The Government will conduct at government expense, a CNACI and state criminal history checks on individuals providing direct, unsupervised child care services under this contract. As a minimum, the Contractor shall contact the Pine Ridge Contracting Officer for obtaining all necessary forms and directions for filing background check information in writing and electronically on personnel hired at the beginning of the contract. This action shall take place no later than five (5) working days from contract award date. Contractor shall submit completed personnel background check applications within twenty (20) working days after award date to the Contracting Officer for processing. Contractor personnel will be required to be fingerprinted . Requests for personnel hired subsequent to the contract start date shall be submitted to the Government not later than five (5) workdays from the employee's first duty day. Contractor shall provide a list of substitute contract personnel fulfilling contingency situations (i.e. absences of certified contract personnel). Names of substitutes and credentials shall be provided 30 calendar days in advance to accomplish background checks. Contractor personnel receiving unfavorable CNACls shall not be employed. IHS may employ an individual pending completion of successful background checks. 4.1.2.1. Background checks will be based on fingerprints of individuals obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureau of Investigation (FBI) and state criminal history repositories. 4.1.2.2. Individuals shall have the right to obtain a copy of any background check pertaining to themselves and to challenge the accuracy and completeness of the information contained in the report. 4.1.2.3. lndividuals who have previously received a background check shall provide proof of the check to the Clinical Director or obtain a new one. 4.1.2.4. CONFI-ICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of HHS (Health and Human Services), unless such person seeks and receives approval in accordance with the Department of HHS. 4.1.2.5. APPEARANCE. Employees are expected to comply with reasonable dress, grooming and hygiene standards based on comfort, productivity, health and type of position occupied. Employee attire will be in good repair, and should not be considered offensive, disruptive or unsafe. 4.1.2.6. Contract providers shall display their Identification badge on their outer clothing. 4.1.2.7. PROTECTIVE CLOTHING. When required and supplied by the Government, the provider shall wear special protective clothing and shoe covers. When duties will be performed in specified areas, a disposable protective hood shall be worn to ensure infection control standards are met. The Government will provide this hood. These items shall remain the property of the Government and shall not be removed from the facility. After use, protective clothing shall be turned in or destroyed as directed by the Infection Control Policy. 4.2. PRIVILEGING REQUIREMENTS. The contract providers' credentials shall be reviewed and approved by the Credentialing Specialist and the Credentialing Committee. The Contractor is responsible for ensuring that proposed providers possess the requisite credentials to enable granting of privileges by the Pine Ridge Medical Staff sufficient to allow for performance of all tasks identified. 4.2.1. Initial applications for clinical privileges, to include credentials action history, malpractice history, and certified true copies of the documents listed below, shall be submitted to the Pine Ridge Credentialirlg Committee, through the Credentialing Specialist, no later than 5 calendar days after receipt of notice of contract award. a. Copy of valid, current unrestricted state license and applicable Board Certification. (Submission required with proposal) b. Documentation of continuing education and training. c. Current Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS). (Submission required with proposal) d. A signed consent for release of information. e. Current copy of Drug Enforcement Agency (DEA) certificate.. f. A list of all states in which contract provider currently holds or has held a license to practice related services. g. A current copy of the proposed contract provider's professional resume, accompanied by that individual's sworn affidavit of the truthfulness of same, indicating experience, training, and technical expertise in the type of care to be rendered. . h. Certification of current physical examination. The certification shall contain a statement signed by the examining physician stating that the employee is free of any contagious diseases. The physical examination shall be current as of 12 months prior to application for privileges. 4.2.2. Applications for privileges will be screened through the National Practitioners Data Bank. 4.2.3. Professional staff appointments and clinical privilege actions will be based on review of documents listed in paragraph 4.2.1 above. Re-appointment shall occur not less than every two years, in accordance with Pine Ridge Medical Staff Bylaws. 4.2.4. DENlAL/TERMlNATlON OF PRIVILEGES. Actions to limit, suspend, or revoke clinical privileges will be in accordance with the procedures outlined in the Medical Staff Bylaws. The Cl...