3 PWS - PT.pdf

Attachment 3 to Solicitation #FA520922Q0006

PERFORMANCE WORK STATEMENT

FOR

PHYSICAL THERAPIST

FOR

374TH MEDICAL GROUP,

YOKOTA AIR BASE, JAPAN

374 OMRS/SGCU

6 Jul 2021

Table of Contents

Section Number and Title Page Number

1.0 Description of Services/General Information 3

2.0. Service Summary 18

3.0. Government Furnished Property and Services 19

PHYSICAL THERAPIST

AT 374TH MEDICAL GROUP YOKOTA AIR BASE, JAPAN

1. DESCRIPTION OF SERVICES/GENERAL INFORMATION. The Contractor shall provide one (1) Physical Therapist (PT) for 374th Medical Group at Yokota AB, Japan, also referred to as the “Medical Treatment Facility” (MTF) herein. The PT shall cover the range of services and labor required to accomplish the performance of PT duties as specified in this Performance Work Statement (PWS). Performance shall be according to the requirements contained in this PWS, professional standards of the Joint Commission (JC), National Committee for Quality Assurance (NCQA), Air Force Pediatric Patient Centered Medical Home (PCMH), Health Services Inspection (HSI), the MTF’s operating instructions and DoD or Air Force guidance.

1.1. NON-PERSONAL SERVICES. The services to be performed shall be non-personal services and are not inherently governmental functions. 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. The Contractor shall ensure the PT is knowledgeable of the policies and procedures of their specific place of duty and of the medical activity.

1.1.3. MTF Requirements. 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.

1.2. PROFESSIONAL QUALIFICATIONS/REQUIREMENTS

1.2.1. Qualifications. The contractor personnel is required to possess Advanced knowledge of Physical Therapy theory, professional medical rehabilitation, therapeutic principles and extensive clinical experience and training to develop individual treatment programs for each patient referred in the areas of physical disabilities, neuromuscular, and psychosocial dysfunction. Knowledge of highly specialized concepts, principles, and practices to assess, diagnose, and treat a broad spectrum of neuro-musculoskeletal disorders of diverse complexity and etiology without direct supervision of a physician. Knowledge of selected pharmaceuticals, their desired effects, side effects, and complications of their use. Must have knowledge of special procedures to be followed for patients with neuromusculoskeletal disorders, such as ordering and reviewing x-rays, MRI, bone scans, and other radiology studies, prescribing medications, requesting routine lab tests, and recommending work and activity restrictions to include physical profiles.

1.2.1.1. English Requirement. The PT shall read, comprehend/understand, speak, and write English fluently.

1.2.1.2. Education. The PT shall have a Masters or Doctoral degree in Physical Therapy from a college of Physical Therapy accredited by the American Council on Pharmaceutical Education

(CAPTE).

1.2.1.3. Licensure/Certification. Must have a valid, current unrestricted state license in any one of the 50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands. Contractor personnel is responsible for maintaining/renewing licensure from a state and if required, a certification or registration when caring for patients within the MTF. The PT shall not perform any service if license is inactive or revoked. Copies of required licensure shall be furnished to the Contracting Officer (KO) prior to performance on this contract and then turned in to the Contracting Officer’s Representative (COR). Copies of renewals must be submitted ten (10) days before date of expiration.

1.2.1.4. Experience. The PT shall have at least one year of Physical Therapy experience within the past two years practicing as a PT.

1.2.2. Position Requirements.

1.2.2.1. Performs the full spectrum of services as a staff PT. The PT shall have knowledge of the full range of professional principles and practices of physical therapy. Deliver comprehensive physical therapy services within the personnel, supply, and equipment capabilities of the facility.

1.2.2.2. The PT shall have a working knowledge of computer systems such as Composite Health Care System (CHCS) and Armed Forces Health Longitudinal Technology Application (AHLTA).

1.2.3. Perform key roles including but not limited to the following:

1.2.3.1. Physician Extender (70%): Performs primary evaluation, diagnosis, and plans/executes treatment programs for patients seeking care of neuromusculoskeletal disorders. Recommends appropriate casts, splints, and/or bracing for these conditions. Orders and reviews x-rays and develops initial impression of x-rays and consults with the orthopedic surgeon or radiologist as indicated. Distinguishes between normal and abnormal physical findings to recognize early potentially serious physical and/or physiological problems. Orders Magnetic Resonance Imaging studies (MRI), bone scans, other radiology as indicated, and routine laboratory studies.

Refers patients to specialty clinics or to their primary care provider when indicated. Prescribes analgesics and non-steroidal anti-inflammatory compounds that have been approved by the therapeutics agent board, the credentials committee, and the Commander. Authenticates temporary profiles not to exceed 30 days, permanent (P2) profiles for various neuromusculoskeketal conditions, and assigns quarters for up to 72 hours.

1.2.3.2. Provision of Physical Therapy Service (20%): Provides physical therapy care in the areas of physical disabilities and neuromusculoskeletal dysfunctions in patients from toddlers to the elderly. Performs comprehensive neurological and musculoskeletal evaluations of patients referred to the department by non-physicians or physicians other than orthopedic surgeons.

Exercises independent professional judgment in planning treatment programs based upon general information in consult and taking into consideration the patient physical and mental conditions and addressing the patient needs. Observes and evaluates patients functioning and interprets range of motion as well as strength, power, and endurance of muscles to assist in the diagnosis and treatment of musculoskeletal disorders. Implements treatment, individually or in groups, and periodically re-evaluates the patient level of functioning to determine if treatment goals are being achieved. Determines changes in treatment method or termination of the treatment programs when appropriate. Must be aware of the hazards and problems inherent in any treatment program so as to prevent occurrence of any injury to the patient. Assists physician in organizing complex treatment plans for complicated cases and modifies standard procedures to meet special problems.

1.2.3.2.1. Develops long-term and short-term patient treatment goals. Administers patient treatment and provides follow-up care. Determines necessity of home programs, instructs patients and their families on home programs to compliment treatment, and establishes that the patient verbalizes understanding of such programs. Consults with physicians and other health care providers on patient treatment plans and strategies. Documents all outpatient care in AHLTA within 24 hours, and reports on patient progress through progress notes and/or oral reports in patient team meetings or rounds. Works in contact with other hospital services to develop an integrated treatment program. Contacts and collaborates with appropriate personnel relative to the individual patient treatment program and provides advice on equipment needs.

1.2.3.2.2. Participates in professional conferences, in-house training, and continuing education meetings. Participates in the hospital patient education activities by developing and presenting appropriate lectures. Contributes to the diagnostic and follow-up evaluations of patients discussed in interdisciplinary meetings. Direct supervision of Physical Therapy Assistants, students, and Red Cross volunteers. Provides technical guidance to Physical Therapist Assistants and physical therapy students providing patient care. Serves as primary clinical instructor for physical therapy students. Reviews and co-signs military physical therapy technician musculoskeletal assessments. Independently develops and provides education programs, inpatient care safety procedures, and treatment techniques. Assesses patient learning style and develops an appropriate patient education program for each patient. Supports use of standardized handout outs and rehabilitative efforts.

1.2.3.3. Administrative Work (10%): Performs essential Officer In-Charge (OIC) level administrative functions and in the absence of the Chief may fill in as acting OIC of the Physical Therapy clinic. Assists in scheduling, planning and conducting in-service training for professional and non-professional personnel. Maintains records of all patients assessed and/or treated and prepares statistical documents as required. Participates in section peer reviews.

Records minutes for weekly meeting. Updates and develops clinic Operating Instructions (OIs) and treatment protocols as needed. Assists in ordering of new equipment and determination of supply needs. Provides input to Non-Commissioned Officer (NCO) and OIC to assist in the performance evaluation and rating of military staff members. Attends any pertinent meetings as requested by the Chief of Physical Therapy. Participates in clinical continuing education functions, quality assurance, risk management activities, special projects, and community educational functions as directed by the Chief of Physical Therapy. Coordinates and prioritizes own time in relation to overlapping demands of administrative and patient care responsibilities.

Constantly vigilant to scheduling conflicts and issues as to minimize rescheduling patients.

Maintains own professional credentials including licensure, CPR certification, and annual continuing medical education (CME). Updates records with credentialing personnel as needed to practice in the MTF.

1.2.3.4. Skill in teaching holistic regional pain classes (back, shoulder, hip, knee etc.) to the standards of the Physical Therapy clinic.

1.2.3.5. General administrative and policy direction is available from the Chief, Physical Therapy. The contractor personnel is expected to work with a high degree of independence, exercising professional judgment in developing, planning, and conducting treatment programs to meet complex treatment objectives. The PT must independently exercise originality in problem solving in areas not covered by written operating procedures and make adaptations and modifications of treatment plans without supervisory guidance or review. Work is reviewed for general professional adequacy through the supervisor periodic observation of work performance and through peer review audits. The contractor personnel evaluates and provides primary care to patients with neuromusculoskeletal disorders in the Physical Therapy section. Patients with serious illnesses or trauma are referred to the orthopedic surgeon or other primary care provider in charge as deemed necessary. Assignments in the clinic evolve from the flow of work. The contractor personnel provides care without detailed instructions, independently determining times for reassessing, counseling, teaching, and treating patients, adjusting schedules according to the patient needs and resources available. An orthopedic surgeon is designated as the supervising physician. Work is evaluated on the basis of demonstrated clinical expertise, professional physical therapy ability, skill and judgment in caring for patients, and effective delivery of physical therapy services.

1.2.3.6. The work requires a wide variety of duties outside the typical realm of Physical Therapy. As a Physician Extender, the PT provides a complete range of rehabilitative services including assessing, planning, evaluating, and modifying the treatments of patients, often with the involvement of family members. The work also involves counseling, teaching, coordinating other services, and participating with other disciplines in interpreting and evaluating the health care plan. The PT also advises patients, physicians, and other ancillary staff on the necessity of special orthotic and/or assistive devices for patients as determined by their professional judgment and experience.

1.2.3.7. The contractor personnel is required patience and the ability to elicit cooperation from patients who may be uncooperative or unmotivated. Work requires sitting, standing, bending, and walking, with long periods of standing during a clinic day. It requires strength, coordination, and stamina to manage physically disabled patients and operate therapy equipment. It involves frequent bending and lifting of a wide variety of equipment. Physical conditioning must be sufficient to demonstrate and perform various physical therapy procedures. The PT must be able to assist in patient transfers from bed to chair and provide support during gait training. Work also requires the ability to perform under stress.

1.2.3.8. Work is performed in an outpatient physical therapy clinic where there are electrical, ultrasound, and thermo-dynamic equipment. Work may also be performed in an office building, fitness center or gym, and pool at Yokota AB. Work involves minimal risks or discomforts and requires normal safety precautions typical of a health clinic setting. PT are required to wear gloves, gown, and mask and use approved sterile technique when working in areas of open wounds or contagious diseases.

1.2.3.9. Performs peer reviews as directed by the Chief of Medical staff (SGH).

1.2.3.10. Ensures compliance of all physical therapy plan of care is executed by technical staff.

1.2.3.11. Provide exercise and physical therapy guidelines to the clinical staff as required.

1.2.3.12. Provide healthcare related in service training to clinical staff on evidenced based practice and other topics as deemed appropriate by the department head.

1.2.3.13. Provide clinical direction of physical therapy technicians and provide input into job performance evaluations.

1.2.3.14. Supervise inventory control of all equipment in the physical therapy. Maintain appropriate records and security of all equipment issued according to applicable regulations.

1.2.3.15. Consult with other specialty practitioners to provide optimal physical therapy care.

1.2.3.16. Participates in physical therapy staff in-service meetings when scheduled within normal duty hours. The PT shall attend meetings and training as directed by the Physical Therapy Element Leader or his/her designee. The PT shall attend any additional special meeting called by the 374 Medical Group Commander or designee as required to discuss the therapist’s credentials, quality control issues or emergency situations.

1.2.3.17. PT must have to decide when and how the patient should return for treatments and follow-up evaluations, change the treatment plan as indicated, refer to other specialty clinics, and recommend termination of treatment.

1.3. PRIVILEGING & CREDENTIALS. PT will be subject to the credentials and privileging requirements of AFI 44-119, Medical Quality Operations as well as adverse actions.

1.3.1. PT shall be able to obtain privileges through the applicable MTF Credentials Committee.

The Contractor shall provide a complete, current and accurate credentialing package for each individual as required in AFI 44-119, Chapter 5.

1.3.2. The Government shall review the credentials of the PT. The MTF must award privileges before the PT may start work at the MTF. The MTF needs a minimum of 30 days after receipt of a complete package to grant privileges.

1.3.3. Any clinical or administrative adverse actions will be handled and processed IAW applicable Air Force instruction(s) (AFI). In the event of an adverse action, the KO will provide a written statement advising the Contractor adverse action. The written statement will detail the basis for the action, provide the Contractor sufficient information in order to make employment/substitution decisions as necessary, and if required, the final outcome of the adverse action process. Per 10 USC 1102, the Government will mark the written notice(s) as Confidential and Privileged. No other information pertaining to the adverse action will be released without MTF permission. Examples of adverse action include loss of credentials or loss of base access and could be the result of innumerable situations (misconduct on base, impaired provider, unsafe patient care, etc…)

1.4. GENERAL INFORMATION

1.4.1. Documentation. HCW shall prepare all documentation to meet or exceed established standards of the MTF 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. HCW shall ensure complete patient identifying information is on all documentation that is to become part of a health care record.

1.4.2. SOFA STATUS. SOFA article I (b) will be provided to United States National(s), who is/are not ordinarily resident in Japan and solely for the purpose of executing this contract as a Physical Therapist.

1.4.3. Evaluation. 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).

1.4.4. Health Requirements.

1.4.4.1. 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:

i. 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.

ii. 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.

iii. 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.

1.4.4.2. Department of Defense Joint Instruction AFJI 48-110 “Immunizations and Chemoprophylaxis” directs immunizations and chemoprophylactic practices follow current national standards as per CDC ACIP. Specific guidance for healthcare workers is posted on the internet.

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

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

1.4.4.3. At least fourteen (14) business days prior to start of work, the Contractor is required to submit to the KO, a complete employee qualification record for the HCW as proof of immunization of contractor personnel working within MTFs for the following diseases: hepatitis B, influenza, measles, mumps, rubella, varicella, TDap, and proof of a negative TB skin test completed within the past twelve (12) months (if positive, proof of negative chest X-ray within the past twelve (12) months), hepatitis A and poliovirus.

1.4.4.4. HCW must in-process through Public Health (PH) within 10 duty days of arrival at the 374 Medical Group.

1.4.4.5. 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.

1.4.4.6. No pre-employment medical tests or procedures required by the contract will be performed by the MTF (with the exception of Tuberculosis testing after start of work and exposure). Expenses for all required tests and/or procedures shall be borne by the Contractor or contractor personnel, not the Government.

1.4.4.7. In those areas where there is a higher risk of transmission of tuberculosis, HCW may be tested as frequently as directed by the MTF policy at the Government’s expense.

1.4.4.8. HCW working in an MTF is required to be immunized annually with the influenza vaccine as recommended by the CDC. This vaccine will be provided by the Government at no cost to the contractor. If the vaccine is obtained at other facilities, the cost will be borne by the Contractor or contractor personnel, not the Government.

1.4.4.9. Immunization information for contractor personnel shall be provided to the respective MTF for government personnel to record and track in DoD computer systems.

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

1.4.4.10. The Government will provide post blood borne exposure protocols according to applicable Air Force Instructions.

1.4.4.11. 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.

1.4.4.12. Pregnant Employees. It is the responsibility of the Contractor to notify the Functional Requirements Evaluator Designee (FRED)/COR 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 contracted employee works in the environment.

1.4.4.13. 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 DoDI 8580.02 and AFI 41- 217, which also contains additional Information Assurance requirements for all AF MTF’s .

DOD 6025.18-R, DOD 8580.02-R 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.

1.4.5. MEDICAL LIABILITY INSURANCE. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor’s professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its issued employees. The Contractor shall maintain during the terms of this contract liability insurance issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrence $1,000,000.00, $3,000,000.00 aggregate. If at any time the Contractor changes insurance providers, the Contractor shall provide evidence to the KO via COR that the Government will be indemnified to the limits specified above per specialty per occurrence. Reference AFI 44-119, Medical Quality Operations, 4.2.5.2. Non-personal services contractor personnel are independent contractors and are required to carry professional liability insurance. The Federal Tort Claims Act does NOT cover this individual.

The Contractor is responsible to ensure that the individual has malpractice liability coverage.

Non-personal services contractor personnel must have an active, valid, current and unrestricted license (with no limitations, stipulations or pending adverse actions) as a physical therapist in any US state/jurisdiction. Contractor personnel is responsible for maintaining/renewing licensure from a state and if required, a certification or registration when caring for patients within the MTF. The PT shall not perform any service if license is inactive or revoked.

1.4.6. MEDICAL HEALTH INSURANCE COVERAGE. Contractor personnel and their 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.

1.4.7. OVERSEAS MEDICAL

1.4.7.1. 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. Emergency 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.

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

1.4.7.3. 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.

1.4.7.4. 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).

1.4.8. 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, provided by the government, must be worn at all times.

1.4.9. Appearance. While on duty, contractor personnel shall be neat and clean, well-groomed, and dressed appropriately. 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

1.4.10. 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 KO upon award.

1.4.11. Hours of Operation. Normal hours of operation of the MTF are 0730-1630hrs, Monday-Friday, with variability depending on patient care needs and mission requirements.

1.4.12. Availability.

1.4.12.1. Workdays can consist of eight (8) to 10 hour days based on mission requirements.

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 0700-1800hrs., Monday through Friday. Hours are subject to change based on need and as mutually agreed between the FRED/COR and the Contractor however; the total number of hours will not exceed forty (40) hours per week period. A lunch period is not a payable period, but will be coordinated with the FRED/COR. Commuting time to and from required place of performance is not compensable by the Government. In no case will overtime be authorized or paid.

1.4.12.2. Scheduled and Unscheduled Absences. 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 is considered non-paid days and shall be deducted from the contractor’s monthly invoice. Timing and details shall be coordinated with the FRED/COR. Scheduled absences shall be scheduled at least 30 days in advance and mutually agreed upon by the FRED/COR and Contractor. Unscheduled absences shall be called into the FRED/COR by the contractor personnel within the first two (2) hours of each duty day that he/she is unable to report to work.

1.4.12.3. 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 10 days per year). The FRED/COR at each location shall notify the contractor personnel 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 personnel 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)**

The base closure due to the incremental weather may not be non-duty days. The rare cases will be determined whether duty or non-duty days by the FRED/COR.

1.4.12.4. If the contractor employee is ill or sick, the Contractor or designee must notify the FRED/COR of anticipated length of absence.

1.4.12.5. 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 contractor personnel are required to respond to the MTF within 30 minutes and will work until released by the FRED/COR.

1.4.13. Federal Holidays. Federal Holidays are paid days. The contractor personnel may be required to perform duties during about 10 PACAF “Family Days” as well as during monthly SRTD (Samurai Readiness Training Days) as stated para 1.4.12.3.

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 Juneteenth Day 19 June 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

Note: If holiday occurs on a Saturday it will be celebrated on the Friday preceding the holiday. If the holiday occurs on a Sunday will be celebrated on the Monday following the holiday. Any holiday that are declared by Presidential Executive Order shall be observed in the same manner as the holidays listed above.

1.4.14. Arrange for Replacement Staff. The Contractor shall have adequate qualified replacement personnel available to provide services when current contractor personnel will be unable to provide services ten (10) or more scheduled shifts. The replacement shall be accomplished based on coordination with the COR. Substitutes shall be as qualified as the contractor personnel being replaced. In the case that an alternate PT is necessary, the Contractor shall notify the COR immediately and shall identify the name of the alternate in two weeks.

1.4.15. Functional Requirements Evaluator Designees (FRED). FRED shall oversee the contractor personnel performance, monitor schedule compliance (days/hours worked), inspect work performance, and submit monthly surveillance documentation to the COR. FRED reports of non-conformance must be forwarded to the COR within three (3) business days of the incident.

1.4.16. Security Requirements.

1.4.16.1. The Contractor Manager or alternate shall complete a Request for Identification Credential (AFMC Form 496) for each employee of the contractor requiring access to Yokota Air Base. The request shall be submitted to Pass and Registration. The Government shall provide a completed Identification Credential (AFMC Form 3876), which shall be issued, displayed and surrendered.

1.4.16.2. Computer Security. A National Agency Check (NAC) must occur for clearance for appropriate security of privacy act information. Contractor is responsible for completing SF85 Worksheet 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 AFSSI 5027, Section 1.8.1.2.1. The above information must be completed and submitted to the MTF prior to seeing patients.

1.4.16.3. 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 contractor personnel classified as 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 employee beginning work. The Contractor understands that, while the MTF Commander may allow contractor personnel to temporarily occupy non-critical sensitive positions pending 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.

1.4.17. Criminal Background Check Requirement.

1.4.17.1. 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 Manual 5200.1, The DoD Information Security Program and DoD Instruction 1402.5, Criminal History Background Checks on Individuals in Child Care Services, 11 Sep 2015. The Contractor is responsible for any costs associated with the Criminal Background Check.

1.4.17.2. 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.

1.4.17.3. All background investigation requests shall be submitted to the designated MTF security manager. The name of the COR shall be included in each request as the recipient of the results.

1.4.17.4. 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.

1.4.17.5. 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 2 years.

1.4.17.6. National Agency Check (NAC). The Contractor must submit a SF-85 (Questionnaire for Non-Sensitive Positions) to designated MTF Security Manager to begin the NAC. When contractor personnel arrives, applicant will be fingerprinted using SF-87/FD258 (Fingerprint Card). The documentation will be submitted to the base Information Protection Office (IPO).

Any person who receives an unfavorable NAC or is determined disloyal, untrustworthy, or unreliable, shall be removed from employment by the Contractor.

1.4.18. Emergency Health Care. The MTF will provide emergency health care for contractor personnel for injuries occurring while on duty in the MTF. These services will be billed to the contractor personnel.

1.4.19. Patient Sensitivity. The contractor personnel shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. Whenever the contractor personnel receives complaints, COR validates those, valid complaints will be forwarded to the KO for further action.

1.4.20. Communication. The Contractor shall ensure contractor personnel under his/her supervision maintain open and professional communication with members of the MTF.

Complaints validated shall be reported in writing to the Contracting Office and the Contractor for action.

1.4.21. Applicable Publication and Forms. The contractor personnel shall comply with Air Force Instruction (AFI) 44-102 and Medical Group Instruction (MDGI) 44-110. The applicable areas of those instructions will be briefed to the contractor’s 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 personnel shall immediately implement those changes.

1.4.22. Automated Information System III Security Requirement.

1.4.22.1. 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.

1.4.22.2. Contractor personnel shall submit security investigation forms per base requirements to the COR at least fourteen (14) business days prior to the employee’s required start date in the MTF. 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.

1.4.22.3. The MTF Security Manager will assist and process the security investigation forms in conjunction with the base Information Protection Office.

1.4.22.4. 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.

1.4.22.5. Contractor personnel shall produce proof of citizenship (e.g., original Birth Certificate, passport, Naturalization Certificate) upon request.

1.4.25.6. The contractor management staff shall advise contractor personnel that a favorable Joint Personnel Adjudication System 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 contract personnel receiving an “Unfavorable” determination will be immediately removed from the position.

1.4.26. Training Requirements.

1.4.26.1. Initial Training.

1.4.26.1.1. The Government will ensure adequate, consistent and available training to all contractor personnel through MTF orientation, computer based training (CBT) and section orientations.

1.4.26.1.2. This program requires utilization of a government-owned training websites. The Government shall use CBTs as the training platform; facilitate, monitor and validate training of contractor personnel; maintain complete and accurate training records for contractor personnel and ensure annual/refresher training is completed within three (3) days of expiration. Contractor personnel will complete all newly introduced mandatory training is completed within timeframes designated by the Air Force.

1.4.27. Other Training Requirements.

1.4.27.1. Continued Education. The contractor management staff, at their own expense, shall ensure contractor personnel continue to meet the minimum standards for Continuing Education Unit (CEU) requirements for all contractor personnel licensed, registered or certified by state, national, or medical associations as prescribed in AFI 44-119, Medical Quality Operations.

CEUs shall be obtained at no additional cost to the government. Contractor personnel CEU maintenance will be validated at least annually for compliance and currency by the COR or his/her designee. Occasionally, no-cost CEUs may be available at the MTF and available to any contractor personnel desiring to attend if space is available.

1.4.27.2. Basic Life Support (BLS) Certification. At a minimum, all contractor personnel working within an MTF must maintain current certification in the American Heart Association Basic Life Support (BLS)-Course C or the American Red Cross CPR/BLS (Heartsaver) Course.

Training shall be obtained at no cost to the Government so that contractor personnel arrive in the position fully qualified. The Government may offer refresher training for contractor personnel on a space available basis. The Government will not pay for initial or recertification training obtained outside the MTF.

1.4.27.3. Health Insurance Portability and Accountability Act (HIPAA) of 1996. All contracted management staff or contractor personnel performing services for the Air Force are required to complete initial and annual refresher HIPAA Privacy and Security Rule training as provided by the MTF for its personnel and will be held accountable for complying with health information privacy and security policies and procedures.

1.4.27.4. Training. Training will be conducted on military specific needs and the DD Form 2792, Exceptional Family Member Medical Summary, completion for overseas clearance. These activities will be a daily part of medical care for active duty military dependents.

1.4.28. Records, Files, Documents, Data, and Work Papers. All records, files, documents, data and work papers provided by the government remain Government property. Contractor personnel will comply with all AFMS requirements for safe keeping, handling, release, and disposal of any of the above information. These AFMS requirements shall include, but are not limited to, limiting access to Government data, tracking information from origin to disposal, removal of personal identifiers and thoroughly destroying information when work is completed according to Federal Law and DoD regulations. If data is used or transmitted outside government facilities, the Contractor shall be responsible for all aspects of physical and operational security. Inside Government facilities, contractor personnel shall be responsible for following DoD and local directives regarding physical and operational security. Under no circumstances may any information or data used under this contract be transferred nor may work under this contract be performed outside the MTF.

1.4.29. Department of Defenses 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.

2. SERVICES SUMMARY (SS).

Performance Objective PWS Paragraph

Performance Threshold

Method of Inspection

SS#1: Licensure/Certification.

Must have a valid, current unrestricted state license in any one of the 50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands.

1.2.1.3. 100% compliance Periodic Inspection (Annually)

SS#2: Performs the full spectrum of services as a staff PT. The PT shall have knowledge of the full range of professional principles and practices of physical therapy.

Deliver comprehensive physical therapy services within the

1.2.2.1. Chief Physical

Therapy will review the submitted reports, patient notes

Periodic Inspection (Monthly) personnel, supply, and equipment capabilities of the facility.

SS#3: Ensures compliance of all physical therapy plan of care is executed by technical staff.

1.2.3.10. Chief Physical

Therapy will review

SS#4: Provide exercise and physical therapy guidelines to the clinical staff as required.

1.2.3.11 Chief Physical

Therapy will review

3. GOVERNMENT FURNISHED PROPERTY AND SERVICES: The Government will provide the following equipment, supplies, and services listed below for services performed inside government facilities unless otherwise stated in the contract.

3.1. OFFICE/WORK/LOCKER AREA. Those areas (office, exam room, etc.,) provided for the use of the contractor personnel will present an orderly appearance. Contractor personnel shall ensure these areas are tidy and any decorative items present a professional, modest appearance in keeping with accepted community standards. Office space will be shared with other members of the medical team. The government will not be responsible for loss or damage of personal items brought into the MTF. Ensure safe work environment and employee safe work habits, reference MTF and base safety programs.

3.2. EQUIPMENT. The healthcare worker shall have joint use of all available equipment for performing services required by this contract.

3.3. PERSONAL PROTECTIVE…