Attach-1_Performance Work Statement PEBLO.pdf

Performance Work Statement (PWS)

Physical Evaluation Board Liaison Officer (PEBLO)

For

The 18th Medical Group

Kadena Air Base, Okinawa Japan

11 Feb 2020

CONTENTS:

Description of Services

1 Scope

1.2 Place of Performance

1.3 Mission Essential Status

1.4 Education and Experience Requirements

1.5 PEBLO Services Task

1.6 Mandatory Knowledge and Skills:

1.7 Orientation and Training:

1.8 Hours of Operation:

2 Facility and Equipment

2.1 Government Provided

3 General Information

3.1 Quality Assurance/Control

3.2 Security Requirements:

3.3 Privacy and Confidentiality:

3.4 Status of Force Agreement (SOFA)

4 Service Summary

5 Appendices

5.1 Appendix 1 – Definitions/Acronyms

5.2 Appendix 2 – Applicable Publications

Description of Services

1. Scope:

1.1. This position serves as the Physical Evaluation Board Liaison Officer (PEBLO) for the Medical Treatment Facility (MTF) and its geographic area of responsibility. Provides Disability Evaluation System (DES) guidance in accordance with established DoD guidelines, data collection, medical coordination, Service member/commander/stakeholder advising, and procedural work related to Medical Evaluation Board (MEB) processing and Temporary Disability Retired List (TDRL) reevaluations in accordance with applicable instructions, regulations and directives. Liaison support is provided to active duty and Reserve Component (RC) members (Air Force Reserve Component (AFRC) and Air National Guard (ANG)) and commanders on program requirements, military benefits, legal rights, and the appeals process. Coordinates Aeromedical evacuation or other patient travel requirements, fitness for duty determinations, line of duty (LOD) and other program requirements related to the DES. Provides Physical Evaluation Board (PEB) findings to service member and medical staff. Tracks each DES case from referral to final disposition. Guides the Service member throughout the DES process. The PEBLO shall furnish all labor, management, supervision, consultations and reports. Performance shall meet the professional standards of the Joint Commission on Accreditation of Healthcare Organization (JCAHO), Accreditation Association for Ambulatory Health Care (AAAHC), Unit Effectiveness Inspection (UEI), and Department of Defense (DoD)/Veterans Administration (VA)/United States Air Force (USAF) Instructions/Regulations. Representative will need to have a working knowledge of the above mentioned.

1.2 Place of Performance:

1.2.1 The Contractor shall provide services at the 18 Medical Group (MDG), Kadena AB, Japan.

1.3 Mission Essential Status:

1.3.1 This service is determined to be non-essential for performance during crisis according to DODI 3020.41, Operational Contract Support, paragraph 2.c. in the event of crisis, the contractor will be notified by the Contracting Officer (CO) of the need to discontinue services due to contingency, base closure or other causes. If notification to discontinue services is not received, the contractor will be expected to continue performance in according with the PWS.

1.4 Education and Experience Requirements:

1.4.1 Education: Associate Degree (AA) in business administration, management or health care organizations from an accredited college or university.

1.4.2 Experience. Two years’ experience as a PEBLO within the DoD military health system in the last 6 years; or five years’ experience working in a civilian disability program; or two years’ experience as a VA Medical Service Coordinator (MSC)

1.5 PEBLO Services Task

1.5.1 Responsible for obtaining, assembling and forwarding all required documents and records for active duty, AFRC and ANG to the Veteran Affairs Medical Service Coordinator, the local MEB, the IPEB, the FPEB and other Integrated Disability Evaluation System (IDES) stakeholders in accordance with regulatory guidance.

1.5.2 Ensures LOD processing is accomplished for each IDES case.

1.5.3 Provides guidance to all ranks of military personnel from all branches of the uniformed services, retirees, and families of those being processed through the IDES program of their rights, benefits, privileges, or obligations.

1.5.4 Coordinates evaluation appointments; schedules follow-up appointments and appropriate referrals related to benefits.

1.5.5 When the Service member is incapacitated or incompetent for pay purposes and unable to manage his/her own legal affairs, the PEBLO provides guidance and assists the legal next-of-kin on the Service member’s rights and benefits.

1.5.6 Serves as a liaison between the Service member, their respective commander and a multi-disciplinary team of primary care managers, other appropriate health care professionals, medical care case managers, non-medical case managers (e.g., Recovery Care Coordinators (RCC)), patient administration personnel, the Office of the Airmen’s Counsel (OAC), the PEB and the Military Department Wounded Warrior Program liaison or advocate.

1.5.7 Processes Review-in-Lieu-of (RILO) MEB cases for assignment limitation codes as directed or required by AFPC/DPANM and in accordance with established AF guidance.

1.5.8 Receives and responds to inquiries from beneficiaries, DoD Components, other agencies, and various interested parties.

1.5.9 Provides guidance on activities with appropriate points of contact throughout the Military Health System (MHS), the line of the Air Force agencies, (i.e. Military Personnel Flights, Comptroller, Air Force Personnel Center (AFPC), Transportation, Aeromedical Evacuation), the Department of Veterans Affairs (i.e. Veterans Benefits Administration [VBA] and Veterans Health Administration [VHA]) to best meet the member’s needs for information or assistance.

1.5.10 Assists in preparing appeals, impartial medical reviews, rebuttals, and coordinates the assignment of Service member’s legal counsel.

1.5.11 Updates local program documentation, i.e., patient handouts, training documents, checklists, operating procedures, etc.

1.5.12 Maintains and safeguards both hard copy and electronic medical information.

1.5.13 Discloses medical information to authorized personnel in accordance with Privacy Act of 1974, and the Health Insurance Portability and Accountability Act (HIPAA) guidelines.

1.5.14 Assists the medical professional staff and other staff members on the regulatory and procedural aspects of profiling and disability processing. Provides MEB orientation program and on the job training for assigned staff personnel as required.

1.5.15 Tracks all assigned cases, analyzes performance against established standards.

1.5.16 Monitors/updates cases in VTA or other tracking tool as the case progresses through the IDES process.

1.5.17 Analyzes available data using various statistical analytic tools, measuring means, trends, statistical deviations, constructs diagrams, histograms, charts, etc., to convey IDES performance to IDES stakeholders.

1.5.18 Provides reports, briefings, training and respond to inquiries from senior leaders.

1.5.19 Coordinates patient travel for members opting to appeal to the FPEB. Assures necessary arrangements are made for members to travel on temporary duty status to and from other locations as required.

1.5.20 Initiates actions to facilitate Emergency Family Member Travel for Very Seriously Ill and Injured Service members.

1.5.21 Advises service member and medical staff on PEB findings and assists in preparing appeals and rebuttals and coordinates the assignment of legal counsel.

1.5.22 Must have the ability to work cooperatively and interact in a positive and professional manner with patients, care giver(s)/support system, case managers, providers, and co-workers; work productively with minimal supervision.

1.5.23 PEBLO shall attend and participate in meetings, staff conferences, and other appropriate activities as directed by QI.

1.5.24 The PEBLO shall ensure that contract personnel maintain open and professional communication with other personnel. Complaints validated by QI and TRICARE Operations and Patient Administration (TOPA) Flight Commander shall be reported in writing to the contract administrator and the PEBLO for action. Failure of the PEBLO to correct validated complaints raise by the MTF staff and the Commander will be considered a failure to perform.

1.5.25 Monitors the effectiveness and efficiency of the local MEB, Line of Duty, and TDRL programs using the TRICARE Operations Self-inspection Checklist and other related AF instructions.

1.5.26 Maintains professional working relationships with all personnel in the work section

1.6 Mandatory Knowledge and Skills:

1.6.1 Ability to plan, organize, and manage functions and staff within an MTF to meet program objects.

Knowledge of the military healthcare organizational structure, major issues, policies, procedures, and operations related to the management of the healthcare delivery systems

1.6.2 In-depth knowledge, experience, and training to handle and solve complex cases that arise when addressing fitness for duty or physical disability evaluation issues.

1.6.3 Tact, diplomacy, and restraint in counseling and explaining entitlements, benefits, and responsibilities to all customers.

1.6.4 Effective interpersonal communication skills to effectively accomplish the IDES process

1.6.5 Excellence customer service principles, methods, practices and techniques analytic methods, to include using research tools and statistical analysis and, interpersonal relations practices.

1.6.6 Ability to communicate effectively both orally and in writing to motivate, train, and work effectively with a diverse workforce. Must be able to draw realistic conclusions and recommend viable solutions.

1.6.7 Ability to gather data from various sources, analyze data, statistical analysis, prepare statistical reports and recommendations for improvements.

1.6.8 Skill in applying fact finding, analytical, and problem solving methods and techniques

1.6.9 Knowledge of DES processing regulations, instructions, procedures, and policies to assure timely case processing.

1.6.10 Practical knowledge and understanding of the TRICARE program.

1.7 Orientation and Training:

1.7.1 The Air Force Medical Readiness Agency (AFMRA) IDES support team will provide ongoing IDES training guidance.

1.7.2 PEBLO training will include: Orientation training, on-the-job training, standardized DES annual refresher or continuing education and training to ensure PEBLOs remain current in their understanding and application of DES procedures. Training will be accomplished via computer-based training, monthly DCS teleconference, and ongoing email communications. May be required to travel to San Antonio for AFMS IDES training workshop at the Government’s discretion every two years.

1.7.3 Training will be in accordance with Warrior Care Policy Training Standards and Performance Objectives Guidebook.

1.7.4 The Government will provide training on the following electronic systems:

1. CHCS (Composite Health Care System)

2. AHLTA (Armed Forces Health Longitudinal Technology Application)

3. DEERS (Defense Enrollment Eligibly reporting System)

4. VTA (Veteran Tracking Application)

Note: The Contractor shall be required to sign and submit a Request for Functional Automated Information Systems Access memorandum for system access.

1.7.5 The Government will provide the following 18 MDG initial and ongoing training:

1. Newcomers Orientation (Initial)

2. Medical Facility/Air Force Unique Training (Ongoing)

3. Security Training (Ongoing)

4. Military Health System (MHS) Access to Care standards (Ongoing)

5. Section Specific Safety Briefings (Ongoing)

6. Clinic Specific Training (Ongoing)

1.7.6 The Government will provide initial and ongoing training on 18 MDG appointing protocols/protocol changes to the Contract personnel. These trainings will be given on an as needed basis.

1.7.6.1 When in-processing the MTF, contractors are required to provide proof of immunizations including, but not limited to: Hepatitis B; Measles, Mumps, and Rubella (MMR); Tetanus, Diphtheria, Pertussis (Tdap); Tuberculosis; Varicella; and Influenza (annual requirement). Any missing immunizations will be required in order to finalize in-processing and will be obtained at the Contractor’s expense.

1.8 Hours Of Operation:

1.8.1 The contractor shall maintain the following service hours to conduct normal day-to-day business:

7:30 a.m. to 4:30 p.m., Monday-Friday with a maximum of 40 hours per week. When necessary for contractor personnel to work hours other than 7:30 a.m. to 4:30 p.m., Monday through Friday, contractor must coordinate with the section chief or Contract Officer Representative (COR). A lunch period is not a payable period, but will be coordinated with the Functional Representative Evaluator Designee (FRED).

Commuting time to and from required place of performance is not compensable by the Government.

There will be no overtime paid on this contract.

1.8.2 The Contractor is required to work during days that have been designated by the Installation Commander or 18 MDG leadership as days of reduced operations (i.e., PACAF/5th Air Force Training Days, Family Days, Exercises, minimally manned or reduced hours of operation). The Contractor is encouraged to conduct in-house training when clinic services are limited. The FRED will notify the Contractor personnel of any changes to the provider staffing schedules due to inclement weather, clinic closures, etc.

1.8.3 Contract personnel are not required to provide services on the observance day for the following Federal Holidays:

New Year’s Day Martin Luther King Day President’s Day Memorial Day Independence Day Labor Day Columbus Day Veteran’s Day Thanksgiving Day Christmas Day

1.8.4 Scheduled and Unscheduled Absences. Contractor personnel are 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. Scheduled absences shall be scheduled at least thirty (30) calendar days in advance and mutually agreed upon by the COR and individual. Unscheduled absences shall be called into the FRED by the contract provider within the first two (2) hours of each duty day that he/she is unable to report to work

1.8.4.1 In case of absences or illness exceeding two weeks, the Contractor shall replace the absent employee with another of equal or exceeding qualifications. The Contractor/Contractor’s personnel shall advise the Functional Representative Evaluator Designee (FRED), supervisor or designee of absences due to illness or incapacitation.

1.8.4.2 If the Contractor is absent for more than two consecutive days due to illness, the Contractor shall provide the Government with a statement that the employee is free from communicable illness before/as the employee returns to work. The Government’s intent is to ensure that illnesses will not be passed to others in the workplace. The Government reserves the right to examine and or re-examine any worker who meets this criterion.

1.8.5 Replacement of contractor personnel. The contractor management staff shall replace permanent contractor personnel at the earliest possible. Contractor personnel must notify to the Contractor and the Government staff (FRED, COR, CA or CO) of the intention to vacate the job at least thirty (30) calendar days prior to the last duty day. (e.g. send resignation form/document to the Contractor). The Contractor must provide candidate package to the Government staff no later than thirty (30) 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.

1.8.6 The Defense Medical Human Resources System Internet (DMHRSi) is the DoD accounting system for financial, personnel, education and training, and workload within the MDG. The Contractor staff is responsible to provide all required information monthly (for example: personal data, work schedule, worked hours, work center, etc.) for all contractor personnel to the Medical Expense and Performace Reporting System (MEPRS) manager or clinic MEPRS monitor for entry into the system by the Air Force.

1.8.6 Contractor will only be allowed to invoice for hours rendered.

Facility and Equipment

2.1 Government Provided:

2.1.1 The Government will provide a room within building 626 for the PEBLO. No alterations to the facilities shall be made without specific written permission and approval. In case of alterations necessary for compliance with OSHA, such permission shall not be unreasonably withheld. The Contractor shall return the facilities to the Government in the same condition as received, except for fair wear and tear and approved modifications. These facilities shall only be used in performance of this contract.

2.1.2 The Government will furnish utilities to include heating, electricity, water, and sewer.

2.1.3 The Government will provide all equipment necessary to accomplish the appointing procedures including telephony equipment, computers, and general office supplies.

2.1.4 The Contractor shall notify COR, in writing, of any equipment that is broken, damaged, or in any way inoperable. The MDG will be responsible for the maintenance and replacement of any damaged or broken equipment.

General Information

3.1 Quality Assurance/Control

3.1.1 The Government will periodically evaluate the contractor’s performance by appointing a FRED to monitor performance to ensure services are received. The COR will complete a monthly surveillance report and submit to the Contracting Officer. The COR may evaluate the Contractor’s performance through intermittent on-site inspections of the Contractor’s performance and receipt of validated complaints. The Government may increase or decrease the number of inspection based on performance.

The COR shall make determination of the validity of customer complaint(s). In the event there is a dispute, the Contracting Officer will make the final determination. Government personnel will record all surveillance observations. The preferred method, when possible, of correcting contract defects is re-performance at no additional contract cost. At a minimum, contractor shall provide documentation of their efforts to preclude repeat deficiencies.

3.1.2 The Contractor shall develop, submit for CO acceptance, and maintain a quality control plan to ensure appointing services are performed in accordance with this statement of work and specifically address the Service Summary (SS) items. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services.

3.1.3 The Contractor’s shall include, as a minimum:

3.1.3.1 Inspection System. A description of the inspection methodology used to cover all tasks and services. The description shall include specifics as to the areas to be inspected on a scheduled and unscheduled basis, frequency of inspections, submission of quality control inspection schedule, and the title and organizational placement of the inspectors.

3.1.3.2 Identification/Prevention Methods. A description of the methods to be used for identifying and preventing defects in the quality of service performed.

3.1.3.3 Documentation. The Contractor shall document inspections and corrective or preventive actions taken. The record of inspections shall be kept and made available to the Government throughout the contract performance period and for the period after contract completion until final settlement of any claims under this contract.

3.1.4 The Contractor shall establish and implement methods of making sure all keys/combinations issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons.

The Contractor shall not duplicate any keys issued by the Government. The Contractor shall immediately report to the COR any occurrences of lost or duplicated keys. In the event keys, other than master keys, are lost or duplicated, the Contractor may be required, upon written direction of the COR, to re-key or replace the affected lock or locks without cost to the Government. The Government may, however, at its option, replace the affected lock or locks or perform re-keying and deduct the cost of such from the monthly payment due the Contractor. In the event a master key is lost or duplicated, the Government shall replace all locks and keys for that system, and deduct total cost from the monthly payment due the Contractor.

3.2 Security Requirements:

3.2.1 All personnel employed by the Contractor in the performance of this contract, or any representative of the Contractor entering the Government installation, shall abide by all security regulations of the installation. All employees shall possess base provided identification cards and Vehicle Registration Certificates for personal vehicles requiring access to Kadena AB. When any employee no longer works for the Contractor at the installation, the Contract Manager shall return any Government-furnished identification to the Government. These passes are at no cost to the contractor. The 18th Contracting Squadron shall coordinate assistance in attaining the proper installation identification.

3.2.2 Contractor employees shall wear visible identification badges on the front of outer clothing, between the neck and waist.

3.2.3 The Contractor’s employees shall have, a background check completed in order to have access to Government systems. Contractor is responsible for completing SF85P Worksheet and providing fingerprint cards for each employee prior to access to the installation. The Contractor shall comply with regulations, DoD 5200.2-R Personnel Security Program. Note: the Contractor may request an interim clearance for access to government systems when the clearance has not been finalized at the time of employment. However, the 18 MDG Commander must approve this interim access, and evidence must be presented that shows the clearance has been initiated, pending favorable final approval. The POC for this will be the 18 MDG Security Officer.

3.2.4 The Contractor shall be responsible for safeguarding all government property provided for contractor use. At the end of each work shift, all government facilities, equipment, and materials shall be secured. The Contractor shall designate a custodian and alternate(s) to receipt for and account for government-provided facilities and equipment.

3.3 Privacy and Confidentiality:

3.3.1 Patient Health Information (PHI). The Contractor shall comply with all Health Insurance Portability and Accountability Act (HIPAA) guidelines. Patient information, lists and/or names of patients shall not be disclosed or revealed in any way for any use outside the MTF without prior written permission by the 18 MDG Commander. Any unauthorized disclosures shall be immediately documented and forwarded to the COR. The Contractor shall maintain, transmit, retain in strictest confidence, and prevent the unauthorized duplication, use, and disclosure of PHI in accordance with Standards for Privacy of Individually Identifiable Health Information, final rule, December 18, 2000 DoD Health Information Privacy Regulation (DoD 6025.18-R), the Privacy Act, and DoD Privacy Program (DoD 5400.11-R). The Contractor shall provide patient information only to employees, contractors, subcontractors, and government personnel having a need to know requirement for such information in the performance of their duties for this tasking. The 18 MDG shall approve the release of any patient information prior to the release.

3.4 Status of Force Agreement (SOFA):

3.4.1 Contract to be performed in Japan. The Status of Forces Agreement between the United States and Japan (SOFA) governs the rights and obligations of the United States armed forces in Japan. Unless a contractor is present in Japan solely to perform under a contract with the United States for the sole benefit of the United States armed forces in Japan and is accorded privileges under SOFA Article XIV, it and its employees shall be subject to all the laws and regulations of Japan. Certain contractor employees and their dependents not accorded privileges under SOFA Article XIV may be accorded privileges under SOFA Article l(b)

3.4.2 The Contractor shall comply with the instruction of the Contracting Officer concerning the entry of its employees, equipment, and supplies into Japan, and shall comply with all applicable Japanese laws and regulations as well as United States Forces Japan (USFJ) and USFJ component policies and regulations during the performance of this contract

3.4.3 SOFA Article l(b) Status:

(A) SOFA Article l(b) status. Contractor employees performing under contracts with the United States for the provision of services in support of U.S. armed forces in Japan, and whose presence is required in Japan to provide such services, may be determined eligible to acquire l(b) does not create a lawful status in Japan for any entity other than individuals (e.g., the company employing the individual does not acquire SOFA status under Article l(b)). To qualify for SOFA status under SOFA Article l(b), such individuals must be:

1. United States nationals

2. Not ordinarily resident in Japan

3. present in Japan at the invitation of, and solely for the purpose of executing contracts with, the United States for the benefit of the United States armed forces, and (iv) not contractors or employees of a contractor whose presence in Japan is solely for the purpose of executing contracts within the definition of SOFA Article XIV

(B) The contracting officer may determine a proposed contractor employee's eligibility for recognition as a Member of the Civilian Component under Article l(b) of the SOFA by documenting on a Letter of Authorization (LOA) that the contractor employee is essential to the mission of the United States armed forces and has a high degree of skill of knowledge for the accomplishment of mission requirements by fulfilling one of the following:

1. Acquiring the skill and knowledge through a process of higher education or specialized training and experience; or

2. Possessing a security clearance recognized by the United States to perform his or her duties;

3. Possessing a license or certification issued by a U.S. Federal Department or Agency, U.S.

State, U.S. Territory, or the District of Columbia to perform his or her duties; or

4. Identified by the United States armed forces as necessary in an emergent situation and will remain in Japan for less than 91 days to fulfill specialized duties; or

5. Specifically authorized by the Joint Committee.

(C) Contractor employees shall present a valid LOA, signed by the Contracting Officer, to Japanese immigration officials upon entry into Japan to receive GOJ recognition as a Member of the Civilian Component under Article l(b) of the SOFA.

(D) SOFA Article 1(b) privileges and benefits. Persons granted authority to enter Japan under SOFA Article l(b) and their dependents (defined as spouse, children under 21 , and, if dependent for over half their support upon an individual having SOFA Article l(b) status, parents and children over 21) may be accorded the following benefits of the SOFA. These privileges are personal to the employee/dependent and do not inure to the employer.

1. Access to and movement between facilities and areas in use by the United States armed forces and between such facilities and areas and the ports or airports of Japan as provided for in SOFA Article V, paragraph 2;

2. Entry into Japan and exemption from Japanese laws and regulations on the registration and control of aliens as provided for in SOFA Article IX;

3. Acceptance as valid by Japan, without a driving test or fee, a U.S. Forces, Japan Operator's Permit for Civilian Vehicle as provided for in SOFA Article X. Issuance of such permit shall be subject to applicable military regulation;

4. Exemption from customs duties and other such charges on materials, supplies, and equipment which are to be incorporated into articles or facilities used by the United States armed forces furniture, household goods for private use imported by person when they first arrive to work in Japan, vehicles and parts imported for private use, and reasonable quantities of clothing and household goods for everyday private use which are mailed into Japan through United States military post offices as provided for in SOFA Article XI, paragraphs 2 and 3;

5. Exemption from the laws and regulations of Japan with respect to terms and conditions of employment as provided for in SOFA Article XII, paragraph 7, except that such exemption shall not apply to the employment of local nationals in Japan;

6. Exemption from Japanese taxes to the Government of Japan or to any other taxing agency in Japan on income received as a result of their service with the United States armed forces as provided for in SOFA Article XIII. The provisions of Article XIII do not exempt such persons from payment of Japanese taxes on income derived from Japanese sources;

7. If authorized by the installation commander or designee, the right to use exchanges, commissaries, messes, social clubs, theaters, newspapers and other non-appropriated fund organizations regulated by United States military authorities as provided for in SOFA Article

XV;

8. The transmission into or outside of Japan of United States dollar or dollar instruments realized as a result of contract performance as provided for in SOFA Article XIX, paragraph 2;

9. The use of postal facilities as provided for in SOFA Article XXI;

10. Exemption from taxation in Japan on the holding, use transfer by death, or transfer to person or agencies entitled to tax exemption under the SOFA, of movable property, tangible or intangible, the presence of which in Japan is due solely to the temporary presence of these persons in Japan, provided such exemption shall not apply to property held for the purpose of investment or the conduct of other business in Japan or to any intangible property registered in

11. Logistic Support. Contractor, contractor personnel, and in the case of personnel granted SOFA Article l(b) status, dependents, shall, subject to availability as determined by the installation commander or designee, be provided logistic support including, but not limited to, the items below.

a. Base Exchange, including exchange service stations, theaters, and commissary (Article l.b personnel/dependents and Article XIV personnel only);

b. Laundry and dry cleaning;

c. Military banking facilities (Article l(b) personnel/dependents and Article XIV personnel only);

d. Transient billeting facilities;

e. Open mess (club) membership, as determined by each respective club;

f. Casualty assistance (mortuary services) on a reimbursable basis;

g. Routine medical care on a reimbursable basis for U.S. citizens and emergency medical care on a reimbursable basis for non-U.S. citizens;

h. Dental care, limited to relief of emergencies on a reimbursable basis;

i. Department of Defense Dependent Schools on a space-available and tuition-paying basis;

j. Postal support, as authorized by military postal regulations

k. Local recreation services on a space-available basis;

l. Issuance of U.S. Forces, Japan Operator's Permit;

m. Issuance of vehicle license plates.

n. Conduct. Civilian personnel supporting the U.S. armed forces in Japan are guests in a foreign country and must at all times conduct themselves in an honorable and credible manner. Criminal conduct and dishonorable personal behavior committed either on or off duty adversely impacts U.S. and Japanese relations, tarnishes the image of the DoD and USFJ, and hampers the Force's military readiness.

4 Service Summary

SS# Performance Objective PWS Paragraph Performance Threshold

1.5 Starts the IDES referral and submits to

VA MSC

1.5.1 Must complete within 7

calendar days

1.5 Processes Medical Evaluation Board

according to the IDES timeline as directed by AFMRA

1.5.1 1.5.24

MEB phase must be completed within 72 calendar days

5 APPENDICES

5.1 Appendix 1 - Definitions/Acronyms

1. General Definitions

Contracting Officer. A person duly appointed with the authority to enter into, administer, and terminate contracts on behalf of the Government Contracting Officer Representative. Government personnel who survey contractor compliance. They are the contractor’s first point of contact for contract issues.

Government. The Federal government of the United States of America.

Government Quality Assurance. Those actions taken by the Government to assure contractor services meet the requirements of the contract.

Medical Group/Medical Treatment Facility. Air Force hospitals or clinics, including all activities providing outpatient and/or in-patient healthcare services for authorized personnel.

Performance Work Statement. A document accurately describes a service in terms of the output requirements.

Quality Control. Those actions taken by a Contractor to control the quality of output and to ensure that they conform to contract requirements and reasonable standards of medical care.

2. Acronyms

AA - Associate of Art AFPC - Air Force Personnel Center AFRC - Air Force Reserve Component AHLTA – Armed Forces Health Longitudinal Technology Application ANG - Air National Guard CA - Contract Administer CHCS – Composite Health Care System CO - Contracting Officer COR - Contract Officer Representative DEERS – Defense Enrollment Eligibly Reporting System DES - Disability Evaluation System DOD - Department of Defense FPEB – Formal Evaluation Board FRED – Functional Representative Evaluator Designee GOJ Government of Japan HIPAA - Health Insurance Portability and Accountability Act IDES – Integrated Disability Evaluation System IPEB – Informal Physical Evaluation Board JCAHO - Accreditation Association for Ambulatory Health Care LOA - Letter of Authorization LOD - Line of Duty MDG - Medical Group MEB - Medical Evaluation Board MHS - Military Health System MSC - Medical Service Coordinator

MTF – Military Treatment Facility OAC - Office of the Airmen’s Counsel PEB - Physical Evaluation Board PEBLO - Physical Evaluation Board Liaison PHI - Patient Health Information PWS - Performance Work Statement RC - Reserve Component RCC - Recovery Care Coordinators RILO - Review-in-Lieu-of SOFA - Status of Force Agreement SS - Service Summary TDRL - Temporary Disability Retired List UEI - Unit Effectiveness Inspection USAF - United States Air Force VA - Veterans Administration VBA - Veterans Benefits Administration VHA - Veterans Health Administration VTA – Veteran Tracking Application

5.2 Appendix 2 – Applicable Publications

Publications and forms applicable to the Performance Work Statement (PWS) are listed below. The Contractor is obligated to follow those publications. These publications are available in the MTF and maintained by the Government. Supplements or amendments to listed publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes in publications, which result in a decrease or no change in the price and notify the CO thru COR in writing of such change. Should a decrease in contract price result; the Contractor shall provide a proposal for reduction in the price to the CO thru COR. Prior to implementing any change that will result in an increase, the Contractor shall submit to the CO thru COR a price proposal within 30 days of receipt of the change by the Contractor. The CO and the Contractor shall negotiate the change into the contract under the provisions of the contract clause entitled “Changes”. Failure of the Contractor to submit a price proposal within 30 days from receipt of the change shall entitle the Government to performance in accordance with such change at no increase in price

Applicable Technical, Regulations, References Manuals, Specifications, and Documentation. This list includes, but is not limited to the following:

Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act of 1992

Privacy Act of 1974

Title VI of the Civil Rights Act of 1964 Section 504 of the Rehabilitation Act of 1973

DoD Directive 5400.11-R, “The Freedom of Information Act of 1967”

Health Insurance Portability and Accountability Act of 1996 (HIPPA)

Electronic and Information Technology Accessibility Standards (36 CFR 1194)

DOD Regulation 5200.2-R, “DoD Personnel Security Program,” January 1987

Standards for Privacy of Individually Identifiable Health Information, Final Rule, December 28, 2000 5 U.S.C. § 552a, as amended

32 CFR 199

Rehabilitative Act of 1973, Section 508

Appointment Standardization Commander’s Guide to Access Success

TRICARE Operations Manual, 6010.51-M, August 1, 2002, Chapter 21, Section 3

TRICARE Systems Manual, 7950.1-M, August 1, 2002, Chapter 1

Accreditation Process (DITSCAP)

DoD Health Information Privacy Regulation (DoD 6025.18-R)

DOD Privacy Program (DoD 5400.1l-R) Title 10, U.S.C., Chapter 55

DOD Directive 5500.7, Standards of Conduct, Mar 87

AIR FORCE REGULATIONS/MANUALS/INSTRUCTIONS

AFI 41-115, Authorized Health Care and Health Care Benefits in the Military Health System

AFI 41-210, Patient Administration Functions

AFI 44-119, Medical Service Quality Improvement and Risk Management, Aug 11

OTHER REFERENCES

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Accreditation Manual for Hospitals, current edition

The Commander’s Guide to Access Success, http://www.tricare.osd.mil/tai/cguide.htm

Access to Care in Preparation for the T-Nex Environment, First Consulting Group Study, Prepared for AF/SG, March 2003