Attach 2a PWS FA8501-23-Q-0002.pdf

Performance Work Statement

Ambulance Services for Robins Air Force Base

15 NOVEMBER 2022

1.0 Description of Services

1.1 The contractor shall provide all labor, management, supervision, vehicles, supplies, equipment, transportation, reports and services for full coverage of 24-hour a day Paramedic emergency ambulance services for patient transport from all of Robins AFB (RAFB), GA— except as provided in Section 3, Government Furnished Property (GFP). The Contractor shall provide two (2) fully equipped ambulances with personnel on base. Their responsibilities include: (1) emergency Paramedic response and patient transport, (2) in-flight emergency response, (3) participation in RAFB and Military Treatment Facility exercises, and (4) provide third party collections forms (DD Form 2569). The Contractor care shall be commensurate to that of Emergency Medical Technicians (EMT) and paramedic/ambulance services provided in the local community. Performance shall be according to the requirements contained in this performance work statement (PWS), and professional standards of The Joint Commission (TJC), AFI 44-119 Medical Quality Operations, the Department of Transportation and the National Registry for Emergency Medical Technicians (NREMT). The contractor shall participate in flight-line hazard and mishap response planning. These services will be paid for by the government; the contractor shall not bill patients. Emergency reporting (Fire Department) telephone numbers are 911 for emergency and (478) 222-2900/DSN: 472-2900 for non-emergency calls.

1.2 Emergency Paramedic Response and Patient Transport: The Contractor shall provide ambulance response to emergencies as requested by RAFB Emergency Dispatch. Patients will be transferred to appropriate medical center facility as directed. The contractor shall respond to primary emergencies within (not to exceed) 7 minutes. For secondary back up calls to the same emergency, the contractor shall respond within (not to exceed) 12 minutes. If two or more calls occur at the same time each ambulances shall meet the 7 minutes response time to each individual emergency call. The contractor shall ensure that this response time standard is achieved 90% of response times. The notification time includes from notification of unit to the time arrived on scene. After the completion of the emergency ambulance run, the contractor shall complete a State of GA run sheet, and/or Robins Air Force Base Fire Emergency Services Patient Care Report (Form CEXF OI 32-69). The contractor shall deliver these forms each Monday from the prior week (showing all activity for Sunday-Saturday), to: 78 AMDS/SGPF, 655 Seventh Street, Building 700, RAFB, GA 31098-2227.

1.2.1 Provide ambulance services 24 hours a day to include all holidays. This contract covers all emergency patient transport from RAFB. The contractor shall establish and maintain a system to ensure that backup support is provided in the event of simultaneous responses, equipment failures, or other unforeseen circumstances. Services must always be available as described in section 1.1.

Attachment 2 - PWS

1.2.2 Contractors shall travel to incident locations in an appropriate medical response vehicle with the appropriate personnel per information received primarily from the RAFB Fire Department.

1.2.2.1 Response time for all calls on RAFB, to include Basic Life Support (BLS) at 7 minutes and Advanced Cardiac Life Support (ACLS) at 7 minutes. This standard must be met 90% of every call. Response time is defined as the time call received from Robins Emergency Dispatch to time arrived on scene. This is in accordance with Georgia State EMS protocols in cooperation with representatives from RAFB Fire Department.

1.2.2.2 Coordinate patient transport with local hospitals.

1.2.2.3 Transport patients to local hospitals from RAFB.

1.2.2.4 Ensure an EMT/Advanced Medical Technician (AEMT)/Paramedic remains with patients until a qualified member (equivalent to contractor or higher) of the receiving hospital properly accepts the patients. Within two hours of a patient being transferred to a hospital/higher level of care, the contractor shall call the RAFB Command Post at 478-327-2612 and provide the following: patient name, time of arrival, and name of the hospital that received the patient.

1.2.2.5 Provide medical care and treatment appropriate to patient’s condition. The contractor shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.

1.2.2.6 Coordinate in-field care, to include EMT/AEMT/Paramedic/BLS Care, in accordance with Georgia State EMS protocols and in cooperation with representatives from local Fire Departments and the closest hospital with capability.

1.3 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 Paramedic providing care in accordance with this PWS. The contractor shall designate this individual, in writing, to the Contracting Officer (CO) and the contracting Officer’s Representative (COR) on the contract start date. An alternate may be designated, but the contractor shall identify those times when the alternate shall be the primary point of contact.

1.4 Education and Certification Requirements: All EMTs, AEMTs, and Paramedics performing work under this contract shall have current certifications and provide the documents listed below. Copies of certifications shall be submitted to the Functional Requirements Evaluator Designees (FREDs) and COR at the start of the contract and whenever a change or update occurs. The Government reserves the right to request copies of these documents on any contractor at any time. The contractor shall produce documents within 24 hours of request. At a minimum, before starting and throughout employment, all EMS contractor personnel working for RAFB shall maintain current EMT, AEMT, Paramedic, American-Heart Association BLS, and Pediatric Advanced Life Support (PALS) certifications. Training must be attained at no cost to the Government.

1.4.1 The applicable contractor personnel shall possess a copy of a valid current unrestricted State of Georgia and NREMT Certification as required by the state of Georgia (Paramedic, AEMT, and EMT).

1.4.2 The applicable contractor personnel shall possess and maintain a valid State of Georgia driver’s license. https://dds.georgia.gov/how-do-i-non-commercial-e-and-f

1.4.3 Experience: All Paramedics shall have provided services in their respective specialties a minimum of six months within the past 12 months.

1.4.4 The contract Paramedic must have completed all courses required to obtain and maintain certification as an EMT/AEMT/Paramedic continuing medical education, emergency vehicle driver education and training files. Additionally, Continuing Medical Education (contractor provided) shall be accomplished as required.

1.4.5 Contractor shall have current certification and or training with the Health Insurance Portability Accountability Act involving handling of patient information.

1.4.6 Contractor shall provide copies of proof of ALL training certifications and licenses before the employees start performing duty of EMT/AEMT/Paramedic as requested by FRED/COR.

1.4.7 Contractor shall maintain files to assure that all EMT/AEMT/Paramedic performing work under this contract shall have current certifications and/or documents for the duration of their employment. Upon request, the contractor shall allow the Government access to review/audit these documents for any EMT/AEMT/Paramedic performing under this contract. The contractor shall provide copies of certification upon request.

1.4.8 Ambulance Operation Service License: Contractor’s Company shall maintain an active service license with Department of Public Health Office of Emergency Medical Services and Trauma DPH OEMS-T and abide by all laws, rules and regulations according to Office Code of Georgia Title 31 Chapter 11 and Georgia Department of Public Health Rule and Regulations 511-9-2. Furthermore, scope of practice is limited to what is legal in the state of Georgia only and is defined by the Georgia Office of EMS and Trauma Form R-P11A. A copy of the ambulance license and the EMS Vehicle Identification shall be provided to the FRED prior to operating on RAFB.

(CDRL A006, AMBULANCE OPERATION SERVICE LICENSE, DI-MGMT-51584/T)

1.5 Documentation: The contractor shall prepare all documentation to meet or exceed established standards of the MTF such as timeliness, legibility, accuracy, content and signature. The contractor shall ensure complete patient identifying information is on all documentation to be provided to the MTF relating to the transport, including third party billing information (DD Form 2569). The FRED will provide guidance for the Paramedic who shall maintain and dispose of those records, files, documents, and work papers if required. All records, files, documents, and related work emergency https://dds.georgia.gov/how-do-i-non-commercial-e-and-f

1.5.1 Contractor shall ensure complete patient identifying information is on all documentation to be provided to the MTF relating to the transport. Contractor shall be required to complete run sheets on each response and forward to the FRED. All documentation and records shall remain property of the Government. The contractor shall be required to complete the DD Form 2569 Third Party Collections (TPC) form for all civilian personnel transported and deliver each Monday for prior week (showing all activity for Sunday-Saturday) IAW PWS para 1.1.

1.5.2 Patient information shall be collected to include the following information:

Date of Transport Patient’s Name Call Location Destination Nature of Call Response Time Run Report/Dispatch # Notes Branch (Active Duty/Civilian/Dependent/Retired Military) Sponsor’s Name Sponsor’s Phone Number#

1.5.3 Patient information, no matter how developed shall be treated as privileged information under the privacy act and applicable release of information guidelines. Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF without prior written permission by the Chief of Medical Staff.

1.5.4 The EMTs/AEMTs/Paramedics shall only release medical information obtained during the course of this contract to other MTF staff involved in the care and treatment of that individual patient. Per the Georgia Department of Health guidelines at https://dph.georgia.gove/ems/gemsis “All Georgia licensed EMS agencies (ground ambulance services, neonatal transport services, air ambulance services, and medical first responder services) must report EMS data using GEMSIS Elite v3.4.0 or any other NEMSIS approved ePCR vendor software in order to be compliant”. Direct all questions regarding this guideline to gemsis@dph.ga.gov.

1.5.5 Contract EMTs/AEMTs/Paramedics shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. Paramedics receiving complaints validated by the FRED, COR and Chief of the Medical Staff shall be subject to counseling and, depending on the nature and severity of the complaint, separation from performing services under this contract.

1.5.6 Contractor shall ensure contract EMTs/AEMTs/Paramedics maintain an open and professional communication with members of the MTF and Fire Department. Complaints validated by the FRED, COR and Chief of the Medical Staff shall be reported in writing to the contract administrator and the contractor for action. Failure of the contractor to correct validated complaints identified by the MTF staff and the CO will be considered a failure to perform. Contractor provided vehicles shall be maintained with MTF provided communication https://dph.georgia.gove/ems/gemsis mailto:gemsis@dph.ga.gov devices including hand held radios that are compatible with other base operations, including, but not limited to control tower, base fire and rescue units, command post, MTF and major civilian referral facilities with mutual aid frequency. The contractor shall be responsible for having radios programed to all RAFB necessary frequencies on all ambulances that respond to base calls.

1.6 In-Flight Emergency Response: The contractor shall be responsible for serving as primary medical response to all in-flight emergencies. The contract ambulance will be notified of the need to respond by the base fire department via the Robins Emergency Dispatch. The responding unit will maintain radio contact with Senior Fire Officer (SFO) at all times while in-transit. RAFB will provide the Emergency Medical Services (EMS) unit on duty at RAFB a land mobile radio (LMR) that has the Fire NET frequency IAW PWS Appendix D. The contractor will not be responsible for the cost of communications equipment necessary to comply with this requirement. The unit will provide medical advice and guidance to SFO for patient care.

Contractor will fall under the authority of the SFO and obey all directives the SFO provides IAW

IEMP 10-2.

1.6.1 The contractor shall ensure all personnel are fully trained and capable of treating aviation personnel experiencing symptoms of decompression sickness during emergencies in coordination with the Robins AFB Chief of Medical Staff (SGH).

1.7 Participation in Exercises and Training: The contractor shall participate in all RAFB exercises. Provide on scene ambulance coverage for 78th Civil Engineering Squadron Live Pit Fire training, assistance with EMT All Refresher courses, Readiness Skills Verification programs, 78th Air Base Wing Level Exercises, special events and semi-annual training with Flight Medicine/Field Response Team personnel. These events mentioned above must be submitted through the FRED and then the FRED will send requests to the contractor for coverage.

1.7.1 Specific responsibilities include:

1.7.1.1 Participate in advance and post exercise meetings.

1.7.1.2 Respond with EMTs to exercise sites and performing mock duties.

1.7.1.3 Coordinate all activities during exercises with the Robins ECC.

1.7.1.4 Provide ambulance support during MTF and Robins AFB exercises and training activities. The participating ambulance and crew must remain on-site for the duration of each event. In the event of a medical necessity elsewhere on the installation the secondary response ambulance will respond according to above time frames in para 1.2.2.1.

1.7.1.4.1 Live structural fire training (approximately four (4) times annually.) In the event of a medical necessity elsewhere on the installation the secondary response ambulance will respond according to above time frames in para 1.2.2.1.

1.7.1.5 Over and Above Work (O&A): This work is to be billed on separate O&A CLIN as identified in the contract. The scope of the O&A consists of providing one stand-by (1) ambulance for special events (i.e. Change of Command and other official ceremonies, Air Shows, etc.) as requested. Contractor will be notified two-day prior to all stand-by special events. This O&A to be submitted under separate Contract Line Item Number (CLIN) for hours worked as stated in the contract.

1.8 Required Air Force Training Exercises: The contractor shall be available to conduct or participate in training in conjunction with the Fire Department. This will include flight line training and special training related to flight line response. Newly assigned personnel will receive flight line training within 30 days of date of hire. Certification of current HAZMAT Awareness training is required for all ambulance response personnel. Personnel shall complete First Responder Awareness Level and Decompression Sickness Training. The contractor is subject to provide proof of training within five duty days upon request. Also, Robins Fire Department will provide initial and quarterly refresher training in the use of 100% Oxygen system via Aviator's mask for treatment of Decompression Sickness (DCS). Robins Fire Department will provide at least one in-house exercise annually on the use of this system. In the event of a medical necessity elsewhere on the installation the secondary response ambulance will respond to above time frames in para 1.2.2.1.

1.8.1 All flight line drivers shall receive proper government provided flight line drivers training or be escorted by authorized government personnel. Contractor shall ensure flight line drivers training annual requirements are meet.

1.9 Work Roster: The contractor’s designated point of contact shall provide a work schedule of individuals scheduled to perform services to the FREDs by the 20th of the preceding month.

Proposed work schedule changes shall be submitted to the FRED at least 48 hours in advance.

The point of contact shall give a minimum of two hours’ notice to FRED for same day changes due to emergencies, sick leave, etc.

1.10 Third Party Collection Forms (DD Form 2569): The contractor shall not bill patient for services associated with this contract to insurance companies. The responsibility for insurance billing and collection is on the 78th Medical Group. The contractor shall ensure complete patient identifying information and patient’s signature is on all third party billing information (DD Form 2569). (CDRL A007, Run sheet and DD Form 2569, DI-MGMT- 51585/T)

2.0 Services Summary

Performance Objective

PWS Para

Performance Threshold

Respond to emergencies

1.2

Respond within 7 minutes for primary and 12 minutes for secondary call (back up) response. This standard must be met 90% of every call (measurement based on monthly PAR period).

Prepare run sheets & DD form 2569.

1.5.1

Run sheet to be delivered each Monday after the week prior.

Transfer Patient to Higher Level of Care

1.2.2.4

Within 2 hours

Contractor Safety Program

4.8

No more than two class C mishaps per contract year and zero class A or B mishaps.

3.0 Government Furnished Property/Equipment and Services

3.1 The Government shall furnish property incidental to the place of performance. The contractor shall ensure use of all government provided equipment/facilities is limited to performance of contract related official Government business. Upon completion or termination of the contract or expiration of employee identification passes, the prime contractor shall ensure that all GFP/GFE is returned to the COR and each individual is processed through the directed Out-processing checklist.

3.2. Government Inventory

3.2.1 The contractor shall perform an inventory of all Government property to include material and equipment not later than 30 calendar days after contract start. After the initial inventory, the contractor shall inventory annually thereafter (if applicable). Physical Inventory reports shall be submitted to the Government Property Administrator (AFSC/PZIO and/or the PMO). The report shall detail the results of the inventory, any items not accounted for and items that are lost, damaged, or destroyed beyond use. (CDRL A008, Inventory, DI-MGMT-51582/T)

3.3 Government Furnished Property (Material/Equipment): The contractor shall maintain records evidencing receipt, accountability, preventative maintenance and disposal as defined within the government property clauses. All furnished government property shall be included in the attached spreadsheet.

3.4 The Government at the direction of Robins AFB Fire Chief shall provide space for two ambulances and personnel located at Fire Station 1 bldg. 377, Fire Station 2 bldg. 85, and their quarters at bldg. 400 (after hours ) Officers Circle, 24- hours a day at no charge to the contractor. The space includes: sleeping quarters and ambulance parking.

3.4 Forms and Maps: The MTF will provide any required Government forms used in the performance of services. The state of Georgia Ambulance Run Sheet will be used to document all responses and patient transports. Also, MTF/Fire Department/ECC shall provide updated maps (Global Information System) to the contractor whenever they become available. The contractor shall limit the copying and or distribution of these maps due to security purposes.

3.5 Communication: The MTF will furnish 5 land mobile radios.

4.0 General Information

4.1 Health Requirements: All health care workers shall follow the methods for controlling and preventing disease as described in the American Public Health Association publication, Control of Communicable Diseases Manual, and the Centers for Disease Control and Prevention (CDC) publication, Morbidity and Mortality Weekly Report (MMWR), and its supplements. Where applicable, the most recent guidelines from these publications are utilized as the standard. The contractor shall adhere to the Medical Group MDGI 48-10, Employee Health, Blood borne Pathogens, and Tuberculosis Exposure Control Plan, Chapter 2, “Employee Health Plan,” and AFI 44-108, Infection Prevention and Control Program, Section 3.2, “Employee Health Program Elements.” In response to a task order award or during contractor performance when replacing or substituting EMTs/AEMTs/Paramedics, the Contractor places qualified EMTs/AEMTs/Paramedics. The contractor verifies EMTs/AEMTs/Paramedics qualifications against health, immunizations, and drug screening submits to MTF.

4.1.1 Vaccination, immunity, or testing is required for the following:

4.1.1.1 Mumps, Rubella, and Rubella (MMR): Contractors without proof of immunity, disease or history of two lifetime MMR vaccinations shall be vaccinated per Advisory Committee on Immunization Practices guidelines (two MMR vaccinations). The MTF will NOT administer the MMR shots or lab work to contract employees unless they are authorized medical care at the MTF. Contract employees that are not authorized must go to their private physician to receive shots/blood work and bring proof to Public Health clinic for documentation.

4.1.1.2 Tuberculin (TB) Skin Test: Contractors shall be screened within the first 10 days of employment, prior to direct patient care. Annual screening is not required; however, screening shall be required for employees that are exposed to TB. The MTF may administer the TB Skin Test to contractors if they have not been tested within the previous 12 months. If not, then they shall go to their private physician to receive a 2-step Purified Protein Derivative (PPD) screening test with reading (if positive, proof of negative chest X-ray within 12 months). Bring proof to Public Health for documentation.

4.1.1.3 Varicella: Contractors shall be screened to determine their varicella immunity status. The MTF will not administer the varicella shots or lab work to contractors unless they are authorized medical care in the MTF. If not, then they shall go to their private physician to receive the vaccine or lab work and bring proof to PH for documentation.

4.1.1.4 Hepatitis B Immunity: Proof of immunity shall be in the form of documentation of previous vaccine administration or an adequate serum antibody titer. Personnel with a history of having received the Hepatitis B vaccine series but no documentation of receiving the vaccine, must provide adequate Hepatitis B serum antibody titer. All Paramedics are considered “High Risk” and are required to be vaccinated for Hepatitis B, as well as provide proof of immunity (MTF will not administer).

4.1.1.5 Tetanus, Diphtheria, Acellular Pertussis (Tdap): Contractor's shall be vaccinated with

Tdap if not previously vaccinated. Those with contact to patients and/or children should be prioritized to receive Tdap as soon as practical. The MTF will not administer the Tdap vaccine to contractors unless they are authorized medical care in the MTF. If not, then they shall go to their private physician to receive the vaccine and bring proof to PH for documentation.

4.1.1.6 Influenza: Yearly requirement. The MTF will not administer the Influenza vaccine to contractors unless they are authorized medical care in the MTF. If not, then they must go to their private physician to receive the vaccine and bring proof to the Immunizations Clinic for documentation.

4.1.1.7 Human Immune deficiency Virus (HIV) Testing: HIV test is required. The MTF will not pay for/test the contractor unless they are authorized medical care in the MTF. If not, then the contractor shall go to their private physician to receive the test and bring proof to the PH clinic for documentation.

4.2 Security Requirements

4.2.1 Government Security Regulations: The Contractor shall ensure personnel, information, system, facility, and international security requirements are met in accordance with DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Air Force Instruction AFI 31-101, Integrated Defense, and Robins Air Force Base Instruction 31-101, Installation Security.

4.2.2 Security Clearance: The contractor shall ensure contract personnel have a valid security clearance appropriate to the access required for proper accomplishment of contract/order requirements. Contractor personnel shall not be authorized access to classified and/or sensitive, but unclassified, information and/or materials or be permitted to work on classified and/or sensitive, but unclassified, projects and/or programs without a proper security clearance and a need-to-know. Contractor personnel whose clearances have been suspended or revoked shall immediately be denied access to classified and/or sensitive, but unclassified, information.

4.2.3 Communications Security (COMSEC): The contractor shall use only secure communications methods and/or equipment to transmit or otherwise transfer classified and/or sensitive, but unclassified, information in accordance with DoD 5220.22-M.

4.2.4 Access to Government System: The Government will not allow contractor personnel access the medical network systems to perform tasks under contract. All patient information will be done on paper and turned into the MTF. The Government will provide all paper forms refer to paragraph 1.10.

4.2.5 Access to Government Facilities

4.2.5.1 The contractor shall ensure contract personnel who require access to RAFB or other Government facilities comply with the security procedures of the facility.

4.2.5.2 Contractor Identification Badges: The contractor shall complete all necessary documents for all contractor personnel requiring access to RAFB. The contractor’s PM will ensure that each employee contacts Trusted Agent for the 78th Medical Group to complete ROBINS AIR FORCE BASE GEORGIA ACCESS AFFIDAVIT. This data will be used to screen individuals who have or are seeking access to US Air Force installations or facilities controlled by the Air Force.

Please answer each question. Access will be denied if this questionnaire is incomplete or missing from the contractor Access Packet. This information will be used to generate state and federal criminal history checks.

4.2.5.2.1 During performance of the contract, the contractor shall be responsible for obtaining required identification for newly assigned personnel and for prompt return of credentials and vehicle passes for any employee who no longer requires access to the work site. Upon completion or termination of the contract or expiration of the identification passes, the prime contractor shall ensure all base identification passes issued to employees and subcontractor employees are returned to the issuing office.

4.2.5.3 All visitation requests will be submitted through the Defense Information System for Security (DISS) to the contract security manager Security Management Office (SMO) code RX1MFN826. Visitations will be made available for review by the Group Security Manager (GSM) of the area where the task will be performed.

4.2.6 Operations Security (OPSEC): The contractor shall ensure compliance with OPSEC requirements including procedures to protect classified and/or sensitive, but unclassified, Government projects and/or programs. The contractor shall ensure contract personnel who perform work at RAFB or another Government facility comply with the OPSEC procedures of the facility.

4.2.7 Security Incident or Violation: The contractor shall immediately notify the Government Security Office of any potential or actual security incidents or violations including potential or actual unauthorized disclosure or compromise of classified and/or sensitive, but unclassified, information.

4.3 Place of Performance: Services shall be performed on Robins Air Force Base.

4.3.1 Building/Facility Access Control. The contractor shall establish and implement methods of making sure all access provided by the government to the contractor are not lost or misplaced and are not used by unauthorized persons. The contractor shall include procedures for immediate reporting to the COR or CO any occurrences of lost, unauthorized uses, or unauthorized duplication of keys, badges or lock combinations.

4.4 Schedule: Contractor shall adhere to 24-hour of on-site Paramedic and emergency ambulance service for patient transport at RAFB GA and schedule personnel to the 24-hours on-site service.

4.4.1 Adverse Weather Conditions: During adverse weather conditions, contractor shall continue to provide services for RAFB.

4.4.2 Appearance: Contractor shall present a professional appearance and be easily recognized as contractor Paramedic employees. Contractor shall not wear clothing items deemed offensive.

The contractor shall wear badges issued from Contractor Office.

4.5 Quality Control: The contractor shall submit a Quality Control Plan (QCP) within 30 days after contract start date. COR will inspect contractor performance in accordance with the Quality Assurance Surveillance Plan (QASP) and other technical guidance and regulations. (CDRL A005, Quality Control Plan, DI-MGMT-51581/T)

4.5.1 The contractor shall maintain an internal Self-Assessment Program (SAP) to evaluate the effectiveness of existing procedures and internal controls, to determine organizational compliance with regulatory requirements and to complement external inspections and assessments. Additionally, the contractor shall provide support, as required, for contingencies, exercises, and surge operations. The FC/FD will notify the contractor of upcoming events as the dates become known. (WR-ALC OI 90-201) (CDRL A009, Self-Assessment Program, DI-

MGMT-51586/T)

4.5.2 The contractor shall support Air Force initiatives and participate in other applicable Quality Control programs and Continuous Process Improvement (CPI) initiatives designed to indicate the appropriate end-state of managed technical orders. The contractor shall comply with resulting changes to existing processes/procedures from these programs/initiatives. (AFMCI 90- 104).

4.6 Green Procurement Program (GPP): The contractor shall comply with the Green Procurement Program in accordance with Under Secretary of Defense (USD) Memorandum, Establishment of the DoD Green Procurement Program, dated August 27 2004, and establishes the requirement for a GPP. The GPP is a mandatory federal acquisition program that focuses on the purchase and use of environmentally-preferable products and services. In accordance with FAR 23.404, Agency Affirmative Procurement Programs, the GPP requires 100% of purchases of Environmental Protection Agency (EPA)-designated products, included in the Comprehensive Procurement Guidelines (CPG) list, contain recovered materials unless the item cannot be acquired competitively within a reasonable timeframe, meet appropriate performance standards, and/or be acquired at a reasonable price. In accordance with FAR 23.101, Sustainable Acquisition Policy / Definition, the GPP requirement applies to all acquisitions, including services, using U.S. Government appropriated funds. The Green Procurement Program (GPP) includes these mandatory components:

4.6.1 Recycled content products, also known as Comprehensive Procurement Guideline (CPG)

Items https://www.epa.gov/smm/comprehensive-procurement-guideline-cpg-program

4.6.2 Energy Star® and energy-efficient products; energy efficient standby power devices https://www.energy.gov/eere/office-energy-efficiency-renewable-energy

4.6.3 Bio-based products

https://www.dm.usda.gov/procurement/programs/biobased/awarenessbrochure_may200 6.pdf

4.6.4 Non-ozone depleting substances https://www.epa.gov/ozone-layer-protection/ozone-depleting-substances https://www.epa.gov/smm/comprehensive-procurement-guideline-cpg-program https://www.energy.gov/eere/office-energy-efficiency-renewable-energy https://www.dm.usda.gov/procurement/programs/biobased/awarenessbrochure_may2006.pdf https://www.dm.usda.gov/procurement/programs/biobased/awarenessbrochure_may2006.pdf https://www.epa.gov/ozone-layer-protection/ozone-depleting-substances https://www.epa.gov/ozone-layer-protection/ozone-depleting-substances

4.7 Environmental Management System (EMS): Any contractor employee working on RAFB shall require EMS training. The prime contractor is responsible for ensuring that all subcontractors comply with this requirement. Computer-based training is provided by the Base Civil Engineering Group Environmental Management Office.

https://geobase.robins.af.mil/emstraining/EMSTrainingOptions.aspx. For questions concerning this training, contact 78 CEG/CEG, 327-8344 for assistance.

4.8 Contractor Safety Program: The contractor shall establish and maintain an acceptable safety program in accordance with their accepted Safety and Health Plan. No more than two Class C mishaps per contract year and Zero Class A or B mishaps will be tolerated. All changes to the plan must also be submitted in writing and approved by the government via the DD 1423 Data Item Number Data Acquisition Document Number DI-ENVR-81375 for contractor's Standard Operating Procedures (SOP) to receive the contractor's Safety and Health Plan Update.

4.8.1 Safety and Health Plan: Within 10 calendar days after contract award, the contractor shall provide a copy of their company Safety Plan that is required to ensure compliance with applicable federal, state, local, and consensus standards (e.g., OSHA (Public Law 91-596), NFPA, National Institute of Occupational Safety and Health (NIOSH), and TJC). The Safety Plan shall be provided to the DHA Safety Office for review. The DHA Safety Office will provide acceptance or non- acceptance within 5 working days of receipt to the government point-of-contact who will notify the CO. (CDRL A001, Safety and Health Plan, DI-MGMT- 51580/T).

4.8.1.2 The contractor Safety Plan shall address the Occupational Safety and Health Act (OSHA) (Public Law 91-596), and all required State and Federal safety standards. The contractor’s internal procedures must be identifiable within the submitted Safety Plan or shall be provided in an amendment or addendum to the company’s Safety Plan. The contractor will have 5 working days to resubmit the Safety Plan, amendment, or addendum to address or correct issues identified for non-acceptance. The Safety Office will provide acceptance or non-acceptance of the resubmission within 5 workings days of receipt to the government POC who will notify the CO.

4.8.2 Safety Mishap/Incident Reporting: The contractor shall report all mishaps/incidents in accordance with DHA-AI 6055.01. The contractor shall immediately secure the mishap scene and damaged property and impound pertinent maintenance and training records until released by the DHA Safety Office. Such release shall be accomplished through the CO. The contractor shall cooperate and assist Government personnel in the investigation of the incident and submit an Accident/Incident Report within 24 hours of the accident/incident. The contractor shall require all subcontractors to comply with required safety, health and fire standards. (CDRL A002, Mishap/Incident Report, DI-SAFT-81563/T)

4.9 Travel: Travel is not required.

4.10 Essential Services During Crisis: The Functional Commander/Director (FC/FD) has determined, by placing in writing their decision, that this requirement is Mission Essential (M-E) in accordance with DFARS 237.76, Continuation of Essential Contractor Services.

4.10.1 Mission Essential Functions: The Government has identified all of the contractor service performed under the contract as essential contractor services in support of mission essential functions. All services and functions provided by the Ambulance Services contract have been determined to be mission essential.

4.10.1.1 Ambulance services is an initial medical response on RAFB to support base response to in-flight and other mission related emergencies, as well as any other on-base incidents.

4.10.2 The contractor shall provide a written plan for continuing the performance of essential contractor services identified in the paragraph above. (CDRL A003, Mission Essential Plan, DI-

MGMT-51583/T)

4.11 Status Report: The contractor shall submit a Status Report quarterly with the number of runs accomplished for each month during the quarter and the response time for each run.

The Status Reports shall be submitted on the 10th calendar day of the first month following the quarter, if the 10th falls on a holiday or weekend the reports are due the next duty day. In addition, the contractor shall provide a complete listing of names and training dates for all paramedics and EMTs assigned. (CDRL A004, Status Report, DI-MGMT-51584/T)

4.12 Service Contract Reporting: In accordance with 10 United States Code 2330(a), and DFARS 252.204-7023 (Reporting Requirements for Contracted Services), the Contractor shall provide a Service Contract Report for each contract that meets the DoD Contract Reporting criteria and is in excess of $3,000,000. The Contractor shall report the total amount invoiced and contractor labor hours expended on the services performed during the previous fiscal year. Prime contractor labor hours, including any required Tier 1 subcontractor information, shall be reported in the System for Award Management (SAM). The Contractor shall report annually, by October 31, on the services performed during the preceding government fiscal year. SAM will only enable reporting for entities with contracts that meet the SCR criteria and thresholds. Additional information and user manuals for government personnel and Contractors is available at https://www.sam.gov. SCR eligibility, reporting rules and criteria is located on the DoD Procurement Toolbox at https://dodprocurementtoolbox.com/site-pages/service-contract-reporting-scr.

4.13 Contractor Identification Badges: The contractor shall complete all necessary documents for all contractor personnel requiring access to RAFB. Common Access Cards (CAC) will be required for all on-site contractor personnel. The contractor’s PM will ensure that each employee contacts Trusted Agent for the 78th Medical Group to be added into Contractor Verification System (CVS) for obtaining CAC. Additional instructions for applications will be sent to the e-mail address provided for the application. Prior to application approval, each individual will be reviewed for eligibility in the JPAS system and checked against the WR-ALC debarment roster.

4.13.1 During performance of the contract, the contractor shall be responsible for obtaining required identification for newly assigned personnel and for prompt return of credentials and vehicle passes for any employee who no longer requires access to the work site. Upon completion or termination of the contract or expiration of the identification passes, the prime contractor shall ensure all base identification passes issued to employees and subcontractor employees are returned to the issuing office.

5.0 APPENDICES

5.1 Appendix A, References

Name of Publication Sections that Apply Date of Publication Title of Publication

IEMP 10-2

ENTIRETY

Updated Annually

Air Force Emergency Management Program Planning & Operations

MDGI 48-10

Chapter 2, “Employee

Health Plan,”

15 November 2015

Employee Health, Blood borne Pathogens, and Tuberculosis Exposure

Control Plan

MDGI 44-108

Section 3.2, “Employee

Health Program Elements.”

4 January 2016 Infection Prevention and Control Program

AFI 44-119 ENTIRETY 16 August 2011 Medical Quality

Operations

5.2 Health Insurance Portability and Accountability Act (HIPAA) Of 1996. HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The AFMS and its components are specifically listed as covered entities (CE) under HIPAA. Currently, HIPAA Privacy and Security Rules, as set forth in the Code of Federal Regulations, are in effect for all AFMS CEs. The specific implementation of HIPAA Privacy for DOD medical facilities is set forth in DOD 6025.18-R, and for HIPAA Security, the requirements for the AFMS are contained in DOD 8580.02-R and AFI 41-217, Health Information Assurance for Military Treatment Facilities, which also contains additional Information Assurance requirements. DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. AFMS organizations are responsible to insure overall compliance with HIPAA requirements, which includes incorporation of certain requirements in contracts entered into or amended after the respective implementation dates.

IAW these regulations, the contractor and its employees meet the definition of Business Associate. 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 this contract, 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 8580.02-R, and AFI 41-217. Additional HIPAA requirements will be addressed when implemented.

Introduction

(a) Definitions: As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DOD 6025.18-R, DOD 8580.02-R or AFI 41-217.

Individual has the same meaning as the term "individual" in 45 CFR 164.50 1 and

164.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR I 64.502(g).

Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160 and part 164, subparts A and E.

Protected Health Information has the same meaning as the term "protected Health information" in 45 CFR 164.501, limited to the information created or received by the contractor from or on behalf of the Government.

Electronic Protected Health Information has the same meaning as the term "electronic protected health information" in 45 CFR 160.103.

Required by Law has the same meaning as the term ''required by law" in 45 CFR 164.501 and 164.103.

Secretary means the Secretary of the Department of Health and Human Services or his/her designee.

Security Rule means the Health Insurance Reform: Security Standards at 45 CFR part 160,162 and part 164 subpart C.

Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103, 160.502, 164.103, 164.304 and 164.501.

(b) The contractor agrees to not use or further disclose Protected Health Information other than as permitted or required by the contract or as Required by Law.

(c) The contractor agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this contract.

(d) The contractor agrees to use administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the electronic protected health information that it creates, receives, maintains, or transmits in the execution of this contract.

(e) The contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the contractor of a use or disclosure of Protected Health Information by the contractor in violation of the requirements of this contract.

(f) The contractor agrees to report to the Government any security incident involving protected health information of which it becomes aware.

(g) The contractor agrees to report to the Government any use or disclosure of the Protected Health Information not provided for by this contract of which the contractor becomes aware of.

(h) The contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the contractor on behalf of the Government, agrees to the same restrictions and conditions that apply through this contract to the contractor with respect to such information.

(i) The contractor agrees to ensure that any agent, including a subcontractor, to whom it provides electronic Protected Health Information, agrees to implement reasonable and appropriate safeguards to protect it.

(j) The contractor agrees to provide access, at the request of the Government, and in the time and manner designated by the Government to Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524.

(k) The contractor agrees to make any amendment(s) to Protected Health Information in a Designated Record Set that the Government directs or agrees to pursuant to 45 CFR

164.526 at the request of the Government or an Individual, and in the time and manner designated by the Government.

(1) The contractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the contractor on behalf of, the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner designated by the 'Government or the Secretary, for purposes of the Secretary determining the Government’s compliance with the Privacy Rule.

(m) The contractor agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CPR 164.528.

(n) The contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45

CFR 164.528.

General Use and Disclosure Provisions

Except as otherwise limited in this Agreement, the contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R if done by the Government.

Specific Use and Disclosure Provisions

(a) Except as otherwise limited in this Agreement, the contractor may use Protected Health Information for the proper management and administration of the contractor or to carry out the legal responsibilities of the contractor.

(b) Except as otherwise limited in this Agreement, the contractor may disclose Protected Health Information for the proper management and administration of the contractor, provided that disclosures are required by law, or the contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the contractor of any instances of which it is aware in which the confidentiality of the information has been breached.

(c) Except as otherwise limited in this Agreement, the contractor may use Protected Health Information to provide Data Aggregation services to the Government as permitted by 45 CFR l 64.504(e)(2)(i)(B).

(d) Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j) (l).

Obligations of the Government

Provisions for the Government to inform the contractor of privacy practices and restrictions

(a) Upon request the Government shall provide the contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice.

(b) The Government shall provide the contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the contractor's permitted or required uses and disclosures.

(c) The Government shall notify the contractor of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to in accordance with 45

CFR 164.522.

Permissible Requests by the Government

The Government shall not request the contractor to use or disclose Protected Health Information in any manner that would not be permissible under the HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R, if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the contractor as otherwise permitted by this clause.

Termination

(a) Termination: A breach by the contractor of this clause, may subject the contractor to termination under any applicable default or termination provision of this contract.

(b) Effect of Termination

(1) If this contract has records management requirements, the records subject to the Clause should be handled in accordance with the records management requirements.