1a Atch 1 PWS.pdf

Attachment 1 for FA520921P0071

PERFORMANCE WORK STATEMENT

FOR

BEHAVIORAL HEALTH OPTIMIZATION

PROGRAM (BHOP) PROVIDER

FOR

374TH MEDICAL GROUP

YOKOTA AIR BASE, JAPAN

374 MDOS/SGOW

16 March 2021

Attachment 1 for FA520921P0071

Table of Contents

Section Number and Title Page Number

SECTION 1. Description of Services/General Information 3

SECTION 2. Services Summary 16

SECTION 3. Government Furnished Property and Services 16

SECTION 4. Contractor Manpower Reporting Requirements 17

PERFORMANCE WORK STATEMENT

FOR

BEHAVIORAL HEALTH OPTIMIZATION PROGRAM (BHOP) PROVIDER

SECTION 1.

1. DESCRIPTION OF SERVICES / GENERAL INFORMATION. The Contractor shall provide one (1) Behavioral Health Optimization Program (BHOP) Provider for 374th Medical Group, Yokota AB, Japan, also referred to as the “medical treatment facility” (MTF) herein. The Contractor care shall cover the range of services for a mental health provider as provided in a civilian medical treatment facility. Performance shall be according to the requirements contained in this Performance Work Statement (PWS), professional standards of the Joint Commission (JC), and Health Services Inspection (HSI). Standards for JC and HSI are available upon request.

1.1. NON-PERSONAL SERVICES: The services to be performed shall be non-personal services and are not inherently governmental. The Contractor is solely liable for the actions of their employees.

1.1.1. Mission Essential Status: Contractor personnel are not designated as mission essential personnel.

1.1.2. Public Health Emergency (PHE) Protective Measures: The observance of protective measures is mandatory for all personnel present on or assigned to Yokota Air Base including but not limited to U.S. military members, U.S. civilian employees, all dependents, DoD retirees, Host- Nation (HN) employees, contractors, mission partner/tenant unit members and any other persons accessing the installation. Any cost/installation to comply with these measures shall be paid or prepared by the Contractor.

1.1.3. The Contractor shall ensure contractor personnel is knowledgeable of the policies and procedures of their specific place of duty and of the medical activity.

1.1.4. The prime contractor‘s staff, including all teaming partners, subcontractors and their staff at corporate level involved in the company’s administration of this contract will hereafter be termed as Contractor. The prime contractor retains responsibility for any teaming partner(s) or subcontractor(s) and shall be accountable for their performance.

1.1.5. Point of Contact: The Contractor shall provide a point of contact that 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 point of contact may be a healthcare worker providing care in accordance with this PWS. The Contractor shall designate this individual, in writing, to the Contracting Officer (KO) upon award.

1.2. PERSONNEL REQUIREMENTS.

1.2.1. English Requirement: TOEIC score of at least 860 or equivalent certificate is required for non-native English speakers.

1.2.2. Formal Education: Must hold a Master of Social Work (M.S.W.) degree from a graduate school of social work fully accredited by the Council on Social Work Education (CSWE).

1.2.3. Licensure: Must have current, unrestricted clinical license to independently practice social work in any one of the 50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands.

1.2.3.1. Contractor personnel must maintain an active license during the course of this contract.

The Contractor is responsible for maintaining/renewing licensure. The contractor personnel shall not perform any service if license is inactive or revoked.

1.2.3.2. Copies of required licensure and board certification shall be furnished to the KO prior to performance on this contract and then provided to the Government Representative (GR=Medical Logistics Representative). Copies of renewals must be submitted ten (10) days before date of expiration.

1.2.4. Experience: Provide a resume stating that the contractor personnel has a minimum of two

(2) years within the past five (5) years in the independent practice of clinical social work in a mental health setting working with an adult population, or with children and teens if specifically working with that population.

1.2.4.1. The contractor personnel should have experience and demonstrated competence with Electronic Medical Records and preferably have experience with Armed Forces Health Longitudinal Technology Application (AHLTA).

1.2.5. Continuing Education: The contractor personnel must maintain currency of continuing medical education, certification(s), health requirements, Basic Life Support (BLS)/Advanced Cardiac Life Support (ACLS ) and initial/annual training completion records.

1.2.6. Identification: All contractor personnel shall be clearly identifiable while on duty. All contractor personnel shall wear a Contractor nametag with the company name, individual’s name, and specialty displayed. The nametag shall be worn on the outermost garment. Facility badges must be worn at all times.

1.2.7. Appearance: While on duty, the contractor personnel shall be neat and clean, well-groomed, and dressed appropriately. The contractor personnel’s clothing shall fit correctly to provide a professional, modest appearance in keeping with the normally accepted community standards of dress for the work being performed. In all cases, clothing shall be neat and clean. This includes being free from visible dirt and stains.

1.2.8. Tier 1 Background Investigations, Fitness and Suitability Adjudications: The contractor shall ensure personnel comply with DoDI 5200.46 before submitting personnel resumes to the Government.

1.3. WORK SCHEDULES.

1.3.1. Workdays will consist of eight (8) hour days. Services are generally required five (5) days each week (Monday through Friday), excluding U.S. Federal holidays. Required services may be scheduled between the hours of 0730 – 1630, Monday through Friday. Contractor personnel should follow command announcements for reporting to work as it relates to inclement weather or base closures. Hours are subject to change based on need and as mutually agreed between the Functional Requirements Evaluator Designee (FRED) / GR and the Contractor. However, the total number of hours will not exceed eighty (80) hours per two (2) week period. The contractor personnel will be given a one (1) hour lunch break each day. A lunch period is not a payable period and will be coordinated with the FRED/GR. Commuting time to and from required place of performance is not compensable by the Government. In no case will overtime be authorized or paid.

1.3.2. Non-Duty Days: Contractor personnel may not be required to perform on Government non-duty days or other times when the MTF may be closed such as Pacific Air Forces (PACAF) family days (approximately 7 - 9 days per year). The FRED/GR at each location shall notify the Contractor five (5) work days prior to the family day if performance will be required. Days in which contractor personnel are not required to perform shall be considered non-paid days and shall be deducted from the contractor’s monthly invoice. The government will not be required to pay for non-duty days, scheduled/unscheduled absences or days where the Contractor does not perform services (i.e. waiting for replacement contractor personnel to arrive). Non-duty/work days beyond the Contractor’s calculated proposal shall be considered non-paid days and shall be deducted from the monthly invoice amount and calculated as follows:

Contract Line Item Number (CLIN) Monthly amount divided by two hundred and forty (240) hours (30 calendar days) = Hourly Rate

**Thirty (30) calendar days shall be used for calculation purposes regardless of the total number of days within the month. (e.g., February) **

1.3.4. Federal Holidays. Federal Holidays are paid days. Contractor personnel may be required to perform duties during the PACAF family days as well as during monthly SRTD (Samurai Readiness Training Days). Any holidays that are declared by Presidential Executive Order shall be observed in the same manner as the holiday listed below.

Federal Holidays listed below:

New Year’s Day 01 January Martin Luther King’s Birthday Third Monday in January President’s Day Third Monday in February Memorial Day Last Monday in May Independence Day 04 July Labor Day First Monday in September Columbus Day Second Monday in October Veteran’s Day 11 November Thanksgiving Day Fourth Thursday in November Christmas Day 25 December

*Holidays falling on a Saturday will be observed on the preceding Friday, and holidays falling on a Sunday will be observed on the following Monday.

1.3.5. The contractor personnel should follow command announcements for reporting to work as it relates to inclement weather or base closures. In the event of real world disasters, all personnel are required to respond to the MTF within 30 minutes and will work until released by the FRED/GR.

1.3.6. The base closure due to the incremental weather will be payable days.

1.3.7. Scheduled and Unscheduled Absences: The contractor personnel is allowed to take up to twenty (20) work days of leave annually. Leave is classified as both annual, vacation or sick leave.

Leave shall be taken in one (1) day increments and shall not exceed ten (10) consecutive work days.

All leave shall be considered non-paid days and shall be deducted from the contractor’s monthly invoice. Timing and details shall be coordinated with the FRED/GR. Scheduled absences shall be scheduled at least thirty (30) calendar days in advance and mutually agreed upon by the FRED/GR.

Unscheduled absences shall be called into the FRED/GR by the contract personnel within the first two (2) hour of each duty day that he/she is unable to report to work.

1.3.8. Replacement of Contractor Personnel: The contractor management staff shall replace permanent contractor personnel at the earliest possible. Contractor personnel must notify the Contractor and the Government staff (FRED, GR and KO) of the intention to vacate the job at least 90 calendar days prior to the last duty day at the requesting location. (e.g. send resignation form/document to the Contractor from contractor personnel). The Contractor must provide candidate package to the Government staff no later than 60 calendar days prior to the date of resignation. The contractor management staff shall ensure that all temporary or permanent replacement staff are fully qualified, meet all pre-placement requirements and are ready to perform within the required timeframe.

1.4. CONTRACTOR MANAGEMENT STAFF RESPONSIBILITIES.

1.4.1. The prime contractor’s staff, including all teaming partners, subcontractors and their staff at corporate level involved in the company’s or team’s administration of this contract will hereafter be termed as contractor management staff. The Contractor retains responsibility for any teaming partner or subcontractor and shall be accountable for their performance.

1.4.2. Communication: The Contractor shall ensure contract healthcare workers under his/her supervision maintain adequate communication with members within the MTF and all patients.

Complaints validated by the GR shall be reported in writing to the KO and the Contractor for action. Failure of the Contractor to correct validated complaints brought by the MTF staff and the KO will warrant administrative action.

1.4.3. The labor category recruited and hired by the contractor management staff to perform the services as described in this contract will be termed hereafter as contractor personnel.

1.4.4. At least fourteen (14) business days prior to the required start date at the MTF, the contractor management staff shall provide to the KO an employee package for that employee as proof the employee meets all experience, training and health requirements of the contract. The package shall consist of a resume or curriculum vitae, a copy of nursing license, a copy of any applicable certification certificate or cards and any other qualifying medical documentation of immune status in accordance with paragraphs 1.8.1. and 1.8.8. of this PWS.

1.5. APPLICABLE PUBLICATION AND FORMS: The Contractor shall comply with Air Force Instruction (AFI) 44-102 and Medical Group Instruction (MDGI/AFI) 44-110. The applicable areas of those instructions will be briefed to the contractor personnel prior to commencement of services. These documents are available in the MTF and maintained by the

Government. Supplements or amendments to instructions or publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes.

1.6. TYPE OF WORK.

1.6.1. Contractor personnel may be required to function in a specialty mental health clinic or in a patient centered medical home (PCMH) location as a behavioral health consultant (BHC) and/or Behavioral Health Care Facilitator (BHCF).

1.6.2. The type of work requires that the contractor personnel shall:

1.6.2.1. Attend and participate in meetings during normal duty hours, professional staff conferences and other appropriate professional activities such as: quality improvement meetings, professional staff meetings, commander's staff meetings, mental health flight meetings, and other meetings required by MTF guidance, or as directed by the GR.

1.6.2.2. Provide Clinical/Counseling Services: Responsible for and applies psychological procedures and techniques, including interviewing, behavioral assessment, and evidenced-based therapies, in the evaluation, diagnosis, and treatment of psychological and neuropsychological disorders using the following skills:

1.6.2.2.1. Individual, family and group psychotherapy, and couples therapy, alcohol and drug treatment evaluations.

1.6.2.2.2. Maintain satisfactory customer service and patient care relationships as assessed in the Services Summary.

1.6.2.2.3. Consult with medical personnel, legal authorities, military commanders and school districts, as required.

1.6.2.2.4. Maintain accurate and current notes in the Mental Health records, inpatient medical records and electronic medical records of all patients seen, as appropriate, and produce reports of evaluation and/or treatment, as required.

1.6.3. Training: Participate in military specific training (e.g., training to perform security clearances, use of the Air Force Guide to Managing Suicidal Behavior, pre-post deployment screening, Post Traumatic Stress Disorder (PTSD) and combat stress) and others as directed by the FRED/GR or AF policy.

1.6.3.1. Participate in and successfully completes Air Force provided Phase I and Phase II BHC training.

1.6.3.2. Attends Phase I BHC training. All course content will be provided by the Government to the contractor personnel upon arrival at the location of the training. Successful completion of Phase I BHC training is required before seeing patients in primary care.

1.6.3.3. Attends Phase II BHC training. Phase II training will require the contractor personnel to demonstrates core competency skills to an expert trainer. The Contractor shall complete this training within 90 days upon completion of Phase I training. This training will be conducted at a military facility within the continental U.S. Scheduling and location of this training will be coordinated by the FRED/GR and provided to the Contractor. The location of this training may be different than the location of the Phase I Training. All course content will be provided by the Government upon arrival of the contractor personnel to the location of the training. The 90-day threshold for demonstration of core competency skills will be extended if the Air Force is unable to provide training opportunities within 90 days.

1.6.3.4. Phase I and Phase II training courses, along with any training materials associated with this course, will be provided by the Government at no additional costs to the contractor.

1.6.3.5. Information on installation access for the contractor personnel will be provided to the Contractor by the FRED/GR or authorized Government representative.

1.6.3.6. The Contractor shall be responsible for ensuring that the contractor personnel become aware of and abide by all policies, rules, and laws for the training location(s) to include, but not limited to, personnel and vehicle installation access, security, and safety.

1.6.4. Provide brief (typically no more than four appointments) cognitive/behavioral interventions in primary care under the Air Force consultation model (i.e., per the Air Force Behavioral Health Optimization Program Practice Manual). Services will mimic the pace of primary care (i.e., patients seen for 15- to 30-minute appointments).

1.6.5. Efficiently manages appointments (e.g. confirms and clarifies consultation issue and obtains initial patient engagement in addressing consultation issue within 60 seconds after completing the introductory script (2 mins or less), completes focused assessment in 15 mins or less for intake appointments, summary and formulation takes 1-3 minutes and occurs between the assessment and intervention phase of appointment).

1.6.6. Uses a biopsychosocial approach to assessment, intervention and primary care team feedback (e.g. how a patient’s physical condition, thoughts, emotions, behaviors, and environment are impacting or influencing the identified problem and functioning).

1.6.7. Uses evidence-based interventions appropriate for a primary care setting (e.g. self-management skills or home-based practice for relaxed breathing and eating behavior changes).

1.6.8. Bases interventions on measurable, functional outcomes and symptoms reduction (e.g.

improved ability to work, improved performance on responsibilities at home, increased frequency or improved quality of social interactions) that are collaboratively developed with the patient.

1.6.9. Teaches patient self-management skills as a primary strategy to decrease symptoms and improve function (e.g. activity pacing to manage chronic pain exacerbation).

1.6.10. Has basic knowledge of psychopharmacological agents (e.g. can name commonly used anxiety and antidepressant medication, appropriate dose and first line recommendations for a specific symptom presentation).

1.6.11. Stays on time when conducting consecutive appointments (e.g. if one appointment runs 5 mins long, shorten future appointments in order to maintain schedule).

1.6.12. Uses follow-up intervals that are appropriate for a primary care setting (e.g. every 2-4 weeks).

1.6.13. Provides interventions for most common mental health and medical conditions in primary care, recommending specialty mental health care only when indicated.

1.6.14. Offer a minimum of one class per quarter with a format appropriate for primary care (e.g.

sleep enhancement class, relaxation class, drop-in stress management class, group medical visit for chronic condition, classes consistent with any of the IBHC clinical pathways).

1.6.15. Clearly and concisely provides assessment results and feedback to PCMs in 3 minutes or less and include specific recommendations for PCM’s course of action with a patient. Provides feedback to the PCM on same day as the patient visit for a majority of appointments when PCM is in the clinic on that day.

1.6.16. Deliver brief presentations/trainings to primary care team members regarding behavioral health issues and BHC services.

1.6.17. Participate in team efforts to develop, implement, evaluate, and revise clinical pathway programs needed in the clinic.

1.6.18. Consults with medical personnel, legal authorities, and military commanders as required.

1.6.19. Contact referred patients to assess treatment adherence.

1.6.20. Use validated symptom inventories to assess current symptom severity. (e.g. Behavioral Health Measure -20)

1.6.20. Assess barriers to treatment adherence and help patient problem-solve solutions to barriers.

1.6.21. Provide patients with education regarding their mental health condition and treatment regimen.

1.6.22. Maintain patient information in a patient registry through AHLTA (Armed Forces Health Longitudinal Technology Application).

1.6.23. Maintain accurate and current notes in the electronic medical records of all patients contacted for review by the managing physician.

1.6.24. Routinely staff difficult cases with the referring provider, behavioral health consultant and/or psychiatry consultant.

1.6.25. Perform case management functions, staffing with other providers, medication referrals and other referrals as needed.

1.6.26. Documentation: All contractor personnel shall prepare all documentation to meet or exceed established standards of the MTF. Provides concise, clear notes in the EMR free of psychological or psychiatric jargon. Focus on referral problem, frequency, duration, functional impact and specific recommendations for change. Documents the majority interactions with or about the patient in the EMR by the end of the clinic day on which the patient is seen or within 24 hours of patient’s appointment. If suicide risk becomes apparent (e.g. positive answer on screening questionnaires or verbal self-report) the IBHC must conduct risk assessment and crisis planning comparable to that which would be accomplished in the specialty mental health clinic and document the encounter on the same day. All notes must be completed, without exception, within 72 hours of the patient appointment in order to meet the established standards of the MTF.

1.6.26.1. Guidelines are as outlined in the “Operating Instructions of the MTF” to include but not limited to: timeliness, legibility, accuracy, content and signature. Only MTF and Air Force approved abbreviations may be used to document care in the health care record. Contractor personnel shall ensure complete patient identifying information is on all documentation that is to become part of a health care record.

1.6.26.2. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment).

1.6.26.3. The contractor personnel should make every attempt to complete all reports for the day by Close of Business (COB). In case some reports are not able to be completed by COB, the contractor personnel shall complete them as quickly as possible, to the maximum extent practicable, but shall not complete them later than 72 hours after each appointment/session. The Government will evaluate the quality and timeliness and notations as stated above.

1.7. TRAINING.

1.7.1. MTF Requirements: The contractor personnel shall complete all MTF-specified orientation program(s), initial and annual training requirements, and comply with all MTF policies, procedures, productivity standards and instructions as provided by the MTF. The Government will provide initial MTF orientation and annual refresher training for contractor personnel. This requirement will be conducted during normal duty hours.

1.7.2. The Contractor shall ensure that the contractor personnel participates in the MTF orientation, training and service/clinic specific orientation, to include any MTF required computer training within thirty (30) days of employment. Such training will include instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training shall be conducted during the scheduled shift of the contractor personnel. Training requirements will be the same as other MTF employees, to include other contractor personnel and civil service employees. Training records must be maintained in compliance with the JC, Occupational Safety and Health Administration (OSHA), and Center for Disease Control (CDC) requirements. All training documentation will be kept by the contractor personnel’s Competency Assessment Folder (CAF). The Contractor shall ensure that the contractor personnel is knowledgeable of the policies and procedures of their specific place of duty and of the medical activity.

1.7.3. Training in CHCS (Composite Health Care System), AHLTA, Essentris and Military Healthcare System Population Health Portal will be available through the Government. Training will be done on military specific needs.

1.8. PERSONNEL HEALTH REQUIREMENTS.

1.8.1. Certification of Current Physical Examination: The certification shall contain a signed statement by the examining physician stating that the employee is free of any contagious diseases.

Physical examination must be current within 12 months prior to application for privileges. It is the Contractor’s responsibility to pay for any medical examinations necessary to ensure this public health compliance requirement is met.

1.8.2. Initial documentation of all health requirements listed in the guidance of paragraphs 1.8.1.

and 1.8.8. of this PWS shall be obtained prior to arrival at the 374th Medical Group.

1.8.3. It is the Contractor’s responsibility to pay for any medical examinations and/or services necessary to ensure medical employee health requirements are met and maintained throughout the contract period to include but not limited to a mandatory annual flu vaccine unless a medical permanent exemption document is included with employee health documents. All healthcare workers (HCW) must in-process through Public Health (PH) within 10 duty days of arrival at the 374th Medical Group. Not later than five (5) working days prior to start of work, certification shall be provided to the FRED/GR that contract physician has completed medical evaluation required above. This certification shall state the date on which the examination was completed, the doctor’s name and complete contact information to include but not limited to phone number, email address, business address that performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: “(name of contract employee) is free from contagious diseases.”

1.8.4. The Centers for Disease Control and Prevention (CDC) Healthcare Infection Control Practices Advisory Committee (HICPAC) and Advisory Committee on Immunization Practices (ACIP) definition for HCW is used here and includes: All paid and unpaid persons working in health-care settings who have the potential for exposure to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air. HCW might include (but are not limited to) physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, volunteers, contractual staff. HCW might also include persons (e.g., clerical, dietary, housekeeping, maintenance, and volunteers) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted to and from HCW.

1.8.5. It is the Contractor’s responsibility to report to the FRED/GR all information necessary to ensure their employees medical records are maintained correctly, and therefore comply with JC, OSHA and CDC health records requirements. Department of Defense Joint Instruction AFJI 48-110 “Immunizations and Chemoprophylaxis” directs immunizations and chemo prophylactic practices follow current national standards as per CDC ACIP.

1.8.6. Specific guidance for healthcare workers is posted on the internet.

http://www.cdc.gov/vaccines/acip/index.html and http://www.cdc.gov/niosh/topics/healthcare/.

For further information on current requirements, please contact PH at DSN 315-225-5311.

1.8.7. HCW will not begin duties until and unless determined to be in compliance with infection/immune status as defined by CDC ACIP and determined by PH.

http://www.cdc.gov/vaccines/acip/index.html http://www.cdc.gov/vaccines/acip/index.html http://www.cdc.gov/niosh/topics/healthcare/

1.8.8. Preventive, Prophylactic and Follow-up Procedures: The Contractor shall ensure that his/her employees are in compliance with preventive, prophylactic and follow-up procedures, as well as infection control and employee health program procedures, as established by the MTF.

Required preventive, prophylactic and follow-up procedures will be paid by the Contractor. If care is received somewhere other than Yokota AB, the Contractor shall provide written verification of treatment.

1.8.9. Pregnant Employees: It is the responsibility of the Contractor to notify the FRED/GR of a pregnant employee. MTF Employee Health Office will provide information concerning any work hazards in that area. The Contractor is to notify their pregnant employee of any work hazards. It will be the employee and the contractor’s joint decision whether the contractor personnel works in the environment.

1.9. HIPAA COMPLIANCE: The Contractor agrees to abide by all the requirements of the Health Insurance Portability and Accountability Act (HIPAA) as codified at 45 CFR Part 160 and Part 164, subparts A and E, and implemented by DoD 6025.18-R regarding the privacy and confidentiality of health records and information being provided and shared under the resulting contract. The Contractor shall also comply with the Business Associate Agreement under Privacy of Protected Health Information.

HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The medical facilities of the military services and the DOD health plans are specifically listed as covered by HIPPA. Currently, HIPAA Privacy and Security Rules, as set forth in the Code of Federal Regulations, are in effect for all MTFs. The specific implementation of HIPPA Privacy for DOD medical facility is set forth in DOD 6025.18-R, and for HIPAA Security, the requirements for AF MTF’s are contained in DOD 8580.02-R and AFI 41-217, which also contains additional Information Assurance requirements for all AF MTF’s . DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. MTRs are responsible to insure overall compliance with HIPAA requirements, which includes incorporation of certain requirements in contracts entered or amended after the respective implementation dates.

IAW these regulations the Contractor and its employees meet the definition of Business Associates.

Therefore, a Business Associate Agreement is required by law to comply with both the HIPAA Privacy and Security regulations. This clause serves as that agreement for each MTF, whereby the Contractor and its employees agree to abide by all HIPAA Privacy and Security requirements regarding health information as defined in this clause, DOD 6025-18-R, DOD 8520.02-R and AFI 41-217. Additional HIPAA requirements will be addressed when implemented.

1.10. Initial documentation is required for: MMR (Measles, Mumps, and Rubella) (immunization or titer levels for Rubella and Rubeola), history of chicken pox disease or positive titer (varicella vaccination must be accomplished if lack of immunity), Hepatitis B, and Tetanus Diphtheria (Td), Tuberculosis (TB) Mantoux skin test (IPPD-Intradermal Purified Protein Derivative) if positive, minimum requirement will be follow-up with the Contractor’s physician and a chest x-ray. A physician must provide documentation of “no active respiratory disease.”. It is the Contractor’s responsibility to pay for any medical examinations necessary to ensure this PH compliance requirement is met. Must obtain annual flu vaccine unless medically unable to do so.

1.11. All non-military healthcare workers (contract, volunteer or student) will receive vaccinations and/or testing for only HIV, Hepatitis B virus (HBV) (if they fall into the appropriate category), TB (frequency determined by MTF policy) and Influenza (if available), per Centers for Disease Control guidance, AFJI 44-110, AFI 44-108, 374 MDGI 48-109 and 374 MDGI 44-111. All other required immunizations/tests, to include mumps, measles, rubella, varicella, and Tdap must be performed prior to starting work at this MTF at contractor’s expense.

1.12. All hospital employees must be immunized annually with the influenza vaccine. This vaccine will be provided by the Government. Unless vaccinated by the Government, the health care worker shall be required to show proof of the vaccination.

1.13. SECURITY REQUIREMENTS.

1.13.1. Computer Security: A National Agency Check must occur for clearance for appropriate security of privacy act information. Contractor is responsible for completing SF-85P (Application for Public Trust Position) and providing fingerprint cards for each employee immediately with the hiring process, complying with regulations, DoD 5200.2-R, Chapter 1 and Appendix A, and AFSSSI 5027, Section 1.8.1.2.1. The above information must be completed and submitted to the MTF prior to seeing patients.

1.13.2. Government Computer Access: The Contractor will ensure that all contractor personnel comply with the requirement to obtain the minimum personnel security investigations as prescribed by DoD 5200.2-R and AFI 31-501, paragraphs 3.27.3.7 to 3.27.3.7.2. The Contractor will work with the MTF to ensure that the pre-employment screening process for each employee classified as Automated Data Processing (ADP) I, II, III (as defined in DoD 5200.2-R) includes the appropriate investigations and that each contractor personnel has the appropriate questionnaires and forms to be completed. All completed forms will be reviewed by the Contractor and forwarded to the MTF for processing prior to the contractor personnel beginning work. The Contractor understands that, while the MTF Commander may allow contractor personnel to temporarily occupy non-critical sensitive positions pending National Agency Check (NAC), the contractor personnel will be immediately removed from the position if at any time the NAC receives unfavorable adjudication, or if other unfavorable information that would affect the NAC becomes known. This must be completed prior to the start of health care delivery. All documents will be submitted to the designated MTF Security Manager.

1.14. AUTOMATED INFORMATION SYSTEMS III SECURITY REQUIREMENTS.

1.14.1. The contractor personnel will have access to and/or process information requiring protection under the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act (HIPAA) of 1996 on unclassified automated information systems (AIS) under this contract. Therefore, contractor personnel working for the Government under this contract are in non-sensitive public trust positions designated as AIS III (formally ADP) positions in accordance with DoD Directive 5200.2-R. In compliance with DoD Directive 5200.2-R a National Agency Check (NAC) is required for all AIS III positions. The contractor management staff shall fully adhere to the provisions in these referenced publications by ensuring all contractor personnel who are performing under this contract are prepared to complete the security requirements in accordance with requesting installation policy and procedures. Contractor personnel shall, for example, submit appropriate security forms that are complete and accurate or schedule and attend scheduled appointments.

1.14.2. The Contractor shall ensure that, as a condition of employment, the contractor personnel providing patient care services under this contract meet the requirements of the Crime Control Act of 1990, as amended. This will be accomplished by successfully completing a Criminal Background Check consisting of a Federal Bureau of Investigation (FBI) fingerprint check and State Criminal History Repository check. The procedures for completing the required background checks are outlined within Department of Defense Regulation 5200.1, The DoD Information Security Program and DoD Instruction 1402.5, Criminal History Background Checks on Individuals in Child Care Services, 19 Jan 93.

1.14.3. The MTF Security Manager will assist and process the security investigation forms in conjunction with the base Information Protection Office. The name of the GR shall be included in each request as the recipient of the results.

1.14.4. Individuals shall have the right to obtain a copy of any background check pertaining to them and to challenge the accuracy and completeness of the information contained in the report.

1.14.5. Individuals who have previously received a background check shall provide proof of the check to the MTF security manager and submitted with the credentialing package, or obtain a new one. A new investigation is required if a break in service to the Department of Defense results in a time lapse of more than two (2) years.

1.15. National Agency Check: The Contractor must submit a SF-85P (Application for Public Trust Position) to designated MTF Security Manager to begin the National Agency Check (NAC).

When contractor personnel arrive Applicant will be fingerprinted using SF-87/FD258 (Fingerprint Card). The documentation will be submitted to the US Office of Personnel Management. Any person who receives an unfavorable NAC or is determined disloyal, untrustworthy, or unreliable shall be removed from employment by the Contractor.

1.15.1. The contractor personnel shall submit security investigation forms per base requirements to the GR at least thirty (30) business days prior to the employee’s required start date in the MTF. The contractor personnel shall complete the Electronic Questionnaires for Investigations Processing (e- QIP) process in accordance with requesting base or MTF policy and procedure. Failure to submit the e-QIP prior to starting performance may result in a “stop work” on the contract until the e-QIP is completed.

1.15.2. The contractor personnel may be employed under the contract pending completion of background checks but will not care for minor children alone until completion of the background checks.

1.15.3. The contractor personnel shall coordinate submission of fingerprints with the responsible base agency (i.e. MTF Security Office, Information Protection Office (IPO), etc.) and in accordance with applicable base procedure. Fingerprints shall be coordinated immediately following the successful submission of the security investigation forms as verified by the MTF Security Manager.

1.15.4. The contractor personnel shall produce proof of citizenship (e.g., original Birth Certificate, passport, Naturalization Certificate) upon request.

1.15.5. The contractor management staff shall advise contractor personnel that a favorable Joint Personnel Adjudication System (JPAS) report is needed as a condition of employment under this contract. The contractor management staff understands the MTF commander may allow contractor personnel temporary or interim access to government systems in non-sensitive positions pending final adjudication of the NACI. Any contractor personnel receiving an “Unfavorable” determination will be immediately removed from the position.

1.16. Medical Health Insurance Coverage: The contractor personnel and his/her dependents residing with them in Japan, if applicable, must have adequate health insurance coverage for overseas medical services. This includes coverage to pay for the cost of medical evacuation from the host country to receive emergency medical treatment when adequate treatment is not available in the host country.

1.16.1. Overseas Medical Services: Contractor personnel should be prepared to use the medical and dental services of the host country. Medical care at overseas military treatment facilities is limited care, when available will be provided on a reimbursable basis, through MTF billing of the patients’ medical insurance. Patients are responsible for paying any copays, deductibles or non-covered services, if applicable, to the MTF. Mental health care professionals are generally not available in the military medical units and host nation mental health professionals usually do not meet the needs of Americans. Individuals or family members with behavior disorders or requiring psychiatric or mental health care should not travel to overseas areas. Internal medicine practitioners and cardiologists are generally not available in military health care units. Military and foreign country pharmacies may not stock medicines or prescription drugs that are available in the U.S.

Contractor personnel must pay for all prescriptions filled at the MTF. The MTFs pharmacy rates are comparable to rates in the United States. The Contractor must determine whether adequate medical care is available in the host country prior to sending personnel or their family members that have medical problems or require medication. Military dental clinics are usually only available to provide emergency services.

1.16.2. Emergency healthcare services, if available, resulting from employment related accidents or injuries will be provided by the Government on a reimbursable basis.

1.16.3. It is the responsibility of the Contractor to ensure the Government and host nation health care providers are paid for medical services rendered to contractor personnel and their dependents.

1.16.4. Under extreme emergency conditions where special circumstances require Government transportation, the Contractor shall be charged at the DoD established movement rate or Full Reimbursement Rate (FRR).

1.17. DEPARTMENT OF DEFENSE SCHOOLS (DoDDS): Education, including special education, to the children of contractor personnel who are eligible for services from DoDDS may attend school on a tuition and space available basis. Students must meet DoDDS criteria for special education. Services are provided based on an Individualized Educational Program. Most schools are not staffed for all disabilities although DoDDS staffs schools in specific locations for a full range of disabilities. Prior to sending a contractor personnel and their child(ren) with significant disabilities (i.e., blindness, deafness, severe mental retardation, serious emotional impairments) to the job location, the contractor personnel shall ensure the child's educational needs can be met.

1.18. PERFORMANCE OF SERVICES DURING CRISIS DECLARED BY THE

NATIONAL COMMAND AUTHORITY OF OVERSEES COMBATEANT COMMANDER:

The Contractor is required to perform essential services in accordance with this PWS in emergency or limited force protection conditions such as natural disaster; however DoDI 1100.22 does not apply to this contract for crisis situations where continuation of essential services by the Contractor is unfeasible.

SECTION 2.

2. SERVICES SUMMARY (SS)

Performance Objective

PWS Para

Performance Threshold

Method of Assessment

SS #1. Must maintain currency of continuing medical education, certification(s), health requirements, BLS and initial/annual training completion records.

1.2.3.

and

1.2.5.

100% Compliance Periodic Inspection

(Annually)

SS #2. Maintain satisfactory customer service and patient care relationships. 1.6.2.2.

thru 1.6.2.2.2.

The contractor personnel will not receive any more than four valid customer complaints per year from patients monthly via Interactive Customer Evaluation Service Delivery Assessments or Comment

Periodic Inspection (Customer Complaints)

SS #3. The Government will evaluate the quality and timeliness of notations of patient appointments/sessions with BHOP Provider. The majority of notes should be completed the same day or within 24 hours.

1.6.26.

thru

1.6.26.3.

Zero (0) instances of incomplete after the 72 hour period, monthly. Zero instances for identified risk of suicide outside of same day of appt.

Periodic Inspection (Daily)

SECTION 3

3. GOVERNMENT FURNISHED PROPERTY AND SERVICES.

3.1. The Government will provide the following equipment, supplies, and services listed below for services performed inside government facilities:

3.1.1. Equipment/Office Furniture: The Contractor will be provided Government-controlled working space to perform services required by this contract.

3.1.2. Forms: The MTF shall provide required Government forms, either hardcopy or computer-generated used in the performance of services.

3.1.3. Supplies: The MTF will provide non-medical supplies commonly used in the facility for administrative, non-clinical services supporting the care and management of patients. Commonly used supplies are those routinely stocked by the MTF.

3.2. Computer Equipment: The MTF will provide computer equipment, software and peripherals as required for accomplishment of duties. The contractor personnel will be required to use Government computer systems in support of the Air Force Medical Service mission.

3.3. Utilities: The government will furnish all required utilities (such as water, telephone, electricity, etc.) at no cost to the Contractor. Long distance and Defense Switched Network (DSN) telephone services will be provided for official use only. The contractor personnel shall participate in government energy conservation programs.

3.4. Housekeeping: Housekeeping services will be provided by the MTF.

3.5. Patient Scheduling: Contractor personnel will assist in patient scheduling. Complete administrative control of the patient shall remain with the Government.

SECTION 4.

4. CONTRACTOR MANPOWER REPORTING REQUIREMENTS.

4.1. IAW FY11 NDAA Section 8108, the Contractor shall report all contractor labor hours (including subcontractor labor hours) required for performance of services provided under this PWS via a secure data collection site. The Contractor is required to completely fill in all required data fields at: https://www.sam.gov/SAM/

4.2. Reporting Period: Reporting inputs will be for the labor executed during the period of performance for each Government Fiscal Year (FY), which runs 1 October through 30 September.

While inputs may be reported any time during the FY, all data shall be reported no later than 31 October of each calendar year. Contractors may direct questions to the Contractor Manpower Reporting Application (CMRA) help desk.

4.3. Uses and Safeguarding of Information. Information from the secure web site is considered to be proprietary in nature when the contract number and contractor identity are associated with the direct labor hours and direct labor dollars. At no time will any data be released to the public with the contractor name and contract number associated with the data.

4.4. User Manuals: Data for Air Force service requirements must be inputted at the https://www.sam.gov/SAM/.

http://www.ecmra.mil/