Atch 1 PWS 22P0134.pdf

Attachment 1

FA520922P0134

PERFORMANCE WORK STATEMENT

FOR

REFERRAL MANAGEMENT CENTER (RMC)

ADMINISTRATIVE TECHNICIAN

FOR

374TH MEDICAL GROUP,

YOKOTA AIR BASE, JAPAN

374 MDSS/SGST

26 May 2022

PERFORMANCE WORK STATEMET

FOR

REFERRAL MANAGEMENT CENTER (RMC) ADMINSTRATIVE TECHNICIAN

1. DESCRIPTION OF SERVICES/GENERAL INFORMATION: The Contractor shall provide one (1) Referral Management Center (RMC) Administrative Technician to provide services required for Government beneficiaries. The Contractor shall conduct administrative functions at the 374th Medical Group, Yokota Air Base (AB), Japan, also referred to as the “Medical Treatment Facility” (MTF) herein.

Performance shall be according to the requirements contained in this performance work statement (PWS), professional standards of the Joint Commission (JC), and Unit Effectiveness Inspection (UEI).

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 contract personnel.

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

1.2. SPECIFIC TASKS:

1.2.1. Initial MTF specific training will occur during Orientation. Additional training may be required as guidelines change.

1.2.2. Assists in preparing a wide variety of recurring and some nonrecurring correspondence, reports, and other documents.

1.2.3. Proofreads/edits documents. Ensures coordination procedures are followed.

1.2.4. Assists in preparing patient briefing packets, routing/delivery of correspondences (referrals, CDs, reports, etc.) from RMC staff throughout the MDG.

1.2.5. Provide front desk coverage. Receives telephone calls, greets visitors, and receives/relays messages for RMC staff members. Provides excellent telephone etiquette and communication skills.

1.2.6. Assists with scheduling of patient appointments (MTF appointments at all locations near Yokota AB) and documenting/tracking of the referral in the Referral Management System (RMS) Tracking Database and within the Composite Health Care System (CHCS).

1.2.7. Verifies patients are registered In CHCS and DEERS; updates demographic information as needed.

Obtain current, accurate contact information (i.e. cell/home phone number).

1.2.8. Assists with scheduling of specialty referral appointments to MTF providers using correct CHCS booking procedures, Access-to-Care (ATC) standards and established clinic capability/booking protocols.

1.2.9. Advises patients of the provider, location, time and day of referral appointments or requests the patient to call back for appointment information if not provided appointment prior to leaving MTF for MTF provider initial specialty care appointments.

1.2.10. Assists team members in providing pre-appointment instructions to patients as indicated by the

MTF.

1.2.11. Assists in submitting referrals to the appropriate reviewer when required for medical necessity and appropriateness review.

1.2.12. Assists in tracking initial specialty care and deferred to Network primary care referrals to include obtaining reports from MTF and network providers.

1.2.13. Assists in documenting patient appointments in CHCS and/or RMS Tracking Database.

1.2.14. Assists with the creation of referrals into standard format for submission to request appointments on DD Form 2161, Referral for Civilian Medical Care.

1.2.15. Will track results of referrals received and coordinate documentation with applicable healthcare provider.

1.2.16. Will track open referrals on recurring basis to ensure ATC standards are maintained and notify patient and healthcare provider as applicable.

1.2.17. Will assist in making copies of records for Release of Information as required.

1.2.18. Will assist in coordinating translation services for beneficiaries with translation contract services.

1.2.19. Will be trained on the following systems to assist as needed:

Armed Forces Health Longitudinal Technology Application (AHLTA)

CHCS

Referral Manage System (RMS) Carepoint

1.3. GENERAL INFORMATION:

1.3.1. Personnel Requirements.

1.3.1.1. English Requirement. Contract personnel shall read, understand, speak, and write English.

TOEIC score of at least 730 or equivalent certificate is required for non-native English speakers.

1.3.1.2. Administrative Personnel. Administrative personnel shall possess a high school diploma or General Educational Development (GED) equivalency.

1.3.1.3. Experience. At least 12 months of experience working in a medical office.

1.3.2. Identification Cards. The Government will issue a hospital identification (ID) badge which must be worn at all times within the MTF. The ID badge must be visibly displayed between the shirt collar and the waist. A Common Access Card (CAC) will also be issued to allow the contract personnel access to necessary computer systems and to the base and the MTF during heightened security. The identification card held by the individual will identify them as a contract personnel. Both cards must be carried by the individual at all times while working at the MTF.

1.3.3. Evaluations. Contract services will be reviewed by the Functional Requirements Evaluator

Designees (FRED) and Government Representative (GR) every month.

1.3.4. Appearance. While on duty, contract personnel shall be neat and clean, well-groomed, and dressed appropriately. Contract 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. Contract personnel shall dress in professional business casual attire.

1.3.5. Customer Service Function. The Contractor shall greet patients in a positive and professional manner and provide appropriate patient education and instructions on their referral and the referral process. Maintain positive and professional communication with members of the MTF.

1.3.6. Health Requirements.

1.3.6.1. 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.

1.3.6.2. 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 Public Health (PH) at

DSN 315-225-5311

1.3.6.3. 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 contract 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.

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

1.3.6.5. Contract personnel 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.

1.3.6.6. 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.

1.3.6.7. Contract personnel 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.

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

1.3.6.9. 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.

1.3.6.10. Pregnant Employees. It is the responsibility of the Contractor to notify the Functional Requirements Evaluator Designee (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 contracted employee works in the environment.

1.3.6.11. It is the Contractor’s responsibility to report to the GR all information necessary to ensure contract personnel’s MTF training and medical records are maintained correctly, and therefore comply with JC, OSHA, and Center for Disease Control health records requirements.

1.3.6.12. 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 HIPAA. 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 HIPAA 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.

1.4. WORK SCHEDULE: Workdays can consist of eight (8) hours a days based on mission requirements. Services are generally required five (5) days each week (Monday through Friday), excluding U.S. Federal holidays. Hours are subject to change based on need and as mutually agreed between the FRED/GR and the Contractor however; the total number of hours will not exceed eighty (80) hours per two (2) week period. A lunch period is not a payable period, but 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.

1.4.1. Hours of Operation. Average work day is 0730-1630 Mon-Friday with variability depending on patient care needs. Average work week is 40 hours. The contract personnel will be allowed one (1) hour lunch. The contract personnel should follow command announcements for reporting to work as it relates to inclement weather or base closures.

1.4.2. Federal Holidays. Federal Holidays are paid days. Any Federal Holidays falling on Saturday will be observed on the preceding Friday, holidays falling on a Sunday will be observed the following Monday. Any holidays that are declared by Presidential Executive Order shall be observed in the same manner as the holidays 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 Juneteenth Day 19 June Independence Day 04 July Labor Day First Monday in September Columbus Day Second Monday in October Veterans Day 11 November Thanksgiving Day Fourth Thursday in November Christmas Day 25 December

1.4.3. Scheduled and Unscheduled Absences. Contractor personnel are allowed to take up to ten (10) 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/GR. Scheduled absences shall be scheduled at least 30 days in advance and mutually agreed upon by the FRED/GR and Contractor. Unscheduled absences shall be called into the FRED/GR by the contract personnel within the first two (2) hours of each duty day that he/she is unable to report to work.

1.4.4. Contract 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 12 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. Non-duty days shall be considered non-paid days and shall be deducted from the contractor’s monthly invoice.

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/GR.

1.5. SECURITY REQUIREMENTS.

1.5.1. Computer Security. A National Agency Check must occur for clearance for appropriate security of privacy act information. Contractor is responsible for completing SF85P Worksheet and providing fingerprint cards for each contract personnel immediately with the hiring process, complying with regulations, DoD 5200.2-R. The above information must be completed and submitted to the MTF prior to personnel starting work.

1.5.2. Government Computer Access. The Contractor will ensure that all contract 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 contract personnel classified as Automated Data Processing (ADP) I, II, III (as defined in DoD 5200.2-R) includes the appropriate investigations and that each contract 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 contract personnel beginning work. The Contractor understands that, while the MTF Commander may allow contract personnel to temporarily occupy non-critical sensitive positions pending National Agency Check (NAC), the contract 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.

1.5.3. Criminal Background Check Requirement (MANDATORY).

1.5.3.1. The Contractor shall ensure that, as a condition of employment, the contract 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. DoDI

1402.5 is available on the internet at: http://web7.whs.osd.mil.

1.5.3.2. All background investigation requests shall be submitted IAW the applicable directive of the specific medical treatment facility. The name of the GR shall be included in each request as the recipient of the results.

1.5.3.3. 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.

1.5.3.4. Individuals who have previously received a background check shall provide proof of the check to the GR 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.

1.5.3.5. National Agency Check. It is the Contractor’s responsibility to submit background investigation applications to the US Office of Personnel Management for personnel who require them.

Payment for the conduct of any criminal history background checks is the responsibility of the Contractor.

The Contractor will provide verifications of submission or completion of the appropriate background investigation, on company letterhead. The Contractor shall submit the National Agency Check (NAC) to the US Office of Personnel Management. Applications will include the SF-85P (Application for Public Trust Position), OPM Agency Use Form, and one SF-87/FD258 (Fingerprint Card). Any person who receives an unfavorable NAC or is determined disloyal, untrustworthy, or unreliable, shall be removed from employment by the Contractor.

1.5.3.6. Emergency Health Care. The MTF will provide emergency health care for contract personnel for injuries occurring while on duty in the MTF. Services will be billed to the Contractor at the current full reimbursement rate.

1.6. MEDICAL QUALITY ASSURANCE/RISK MANAGEMENT (QA/RM).

1.6.1. Orientation. The Contractor shall ensure that all contract personnel participate in the MTF orientation, training, and service/clinic specific orientation to include any MTF required computer training, this must occur within 30 days of employment.

1.6.1.1. The Contractor shall be knowledgeable of the policies and procedures of their specific place of duty. The Contractor shall receive any staff training required by the MTF as a recondition/condition to performance. Such training may include instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training shall be conducted during the duty day. Some examples of training are: CHCS/AHLTA patient entry, information awareness, local HIPAA training, etc.

1.6.2. Applicable Publication and Forms. The Contractor shall comply with Air Force Instruction (AFI) 44-176. 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.

1.6.3. Customer Complaints. Any customer complaints will be documented using the ICE comment system or directed to the Patient Advocate.

1.6.4. Performance of Services during Crisis Declared by the National Command Authority of Oversees Combatant 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

3020.37 does not apply to this contract for crisis situations where continuation of essential services by the Contractor is unfeasible.

2. SERVICE SUMMARY.

SS Number

PWS

Para

Performance Threshold Method of Inspection

SS#1: Assists with scheduling of patient appointments (MTF), documents/tracks referrals in the RMS tracking database and in CHCS – 100% of all referrals generated to and from the MTF must be tracked. All referral status updates will be annotated in CHCS and all referrals will be tracked in

RMS

1.2.6. 100% Compliance of tracking of all generated referrals

Periodic Inspection

(Monthly)

SS#2: Assists with scheduling of specialty referral appointments to MTF providers using correct CHCS booking procedures, Access-to-Care (ATC) standards and established clinic capability/booking protocols. The MTF must make every attempt to schedule all referrals for appointment with the Access-to- Care standard within the MTF or outside of the MTF.

1.2.8. 98% Compliance

SS#3: Assists in tracking initial specialty care and deferred to Network primary care referrals to include obtaining reports from MTF and network providers. – 100% of all network reports must be sent to the MTF for continuity of care.

1.2.12. 100% Compliance of network results from providers

Periodic Inspection

(Monthly)

3. GOVERNMENT FURNISHED PROPERTY/SERVICES. The Government will provide the following equipment, supplies, and services listed below:

3.1. Office/Work. The office/work area provided for the use of the contract personnel will present an orderly appearance. Contract 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 within the Referral Management Center. The government will not be responsible for loss or damage of personal items brought into the MTF. Ensure safe work environment and contract personnel 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. Forms. The MTF will provide required Government forms used in the performance of services.

3.4. Supplies. The MTF will provide non-medical supplies commonly used in the facility for administrative functions.

3.5. Computer Equipment. The MTF will provide computer equipment required to schedule, check-in, document, order ancillary services, and maintain appropriate electronic medical information that supports the hard copy medical record. The MTF will provide required training for these systems. The Contractor will be required to use the computer systems that are standard for the support of health care delivery at the

MTF.

3.6. Administrative Support. The contract personnel will be authorized to use all administrative support available to the government employees. This will include, but is not limited to copy machines, fax machines, installation distribution, Class “A” telephone lines and Defense Switching Network (DSN) lines. The same restrictions to limit use of these items for official government business apply.

3.7. Contractor Furnished Property and Services: Except for those items or services specifically stated in paragraphs 3 of Government furnished property/services, the Contractor shall furnish everything required to perform this contract in accordance with all of its terms.