Attachment 1 Performance Work Statement.pdf

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Performance Work Statement For

Clinical Healthcare Services

1.0. Description of Services. The contractor shall provide all transportation, personnel, labor, supervision, and management to provide Clinical Support Services, in the form of health care workers, who will perform a full range of clinical support services in accordance with (IAW) the Medical Position Descriptions described in Appendix 1 of this Performance Work Statement (PWS), the terms and conditions of this contract, PWS, subsequent task orders, all joint commission medical standards, and the Arizona Department of Health Services. The contractor shall provide personal services and non‐personal services for eligible beneficiaries of the 355th Medical Group (355 MDG) referred to as the Military Treatment Facility (MTF) hereafter, at Davis‐Monthan Air Force Base (DMAFB), Arizona. Teleworking in not authorized under this contract.

1.1. Deliverables/Reporting Requirements

Deliverable PWS Para Due to COR/CO

Recruiting Plan 1.2.2.

5 days after award and when updated

Quality Control Plan 1.2.9.1.

5 days after award and when updated

Essential Contractor Services Plan 2.1.1. With award

Mission Essential Employee Identification 2.1.2.

5 days after award and when updated

Task Order Staffing Report 5.3 Weekly

1.2. General Information

1.2.1. Contract Manager. The contractor shall designate a primary on‐site Contract Manager (CM) and at least one alternate CM, who shall be responsible for the performance of contract services. The CM shall have full authority to act for the contractor on all matters relating to the daily operation of the contract, and shall be available on‐site during the hours of 7:30 a.m. to 4:30 p.m., Monday through Friday. The contractor shall submit the names and phone numbers of the primary and alternate(s) CM in writing to the Contracting Officer (CO), at least five (5) calendar days prior to the contract start date. The contractor shall identify, in writing to the CO, when the alternate is acting as the primary CM.

1.2.1.1. Contract Manager Responsibilities. The CM shall ensure all contractor employees are aware of their responsibilities in accordance with the terms and conditions of the contract, and the CO is the only individual that can make any changes to the contract. If a contractor employee is asked to perform services that are not included in the contract, the contractor employee shall inform the CM of the request and the CM shall immediately report the request to the Government Contracting Officer’s Representative (COR).

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1.2.2. Recruiting. Recruiting is the process by which health care workers from outside of the Government are located, contacted, and hired for specific positions. The contractor shall recruit health care workers to fulfill the duties, qualifications, and requirements of the contract, including the PWS and Position Descriptions.

1.2.2.1. Short Term Positions. Contractor employees filling short term positions will normally have a (6) six month minimum performance period. These positions are designed to fill in the gaps created by long term government employee absences and allow the MTFs to continue operations as normal. If a short term position requirement is cancelled prior to the contractor employee start date, this cancellation shall be at no cost to the Government.

1.2.2.2. Screening of Potential Candidates. The contractor shall screen all potential candidates to ensure they possess all required qualifications, including those in the PWS and position descriptions, prior to submitting candidates to the Government.

1.2.2.3. Submission of Candidates. The contractor shall submit potential candidate’s resume for open positions to the CO, within 30 calendar days after contract award and upon vacancy notification. Notification begins upon written notice from the Government (Task Order Award) of a new requirement or upon notification of a vacancy by a current employee.

1.2.2.4. Credentialing and Privileging Package Submission. Upon Government approval of a proposed candidate, the contractor shall submit a complete and accurate credentials package, containing all documents identified in a Government‐provided checklist (provided by the Government upon award) for the respective position. The contractor shall submit credentials packages to the Medical Staff Manager within 45 calendar days of the Government approval notification.

1.2.3. Credentialing and Privileging Decision. The Government shall review all credentialing documents and render a final credentialing and privileging decision within 15 calendar days of receipt of the credentialing documents. If additional documents and/or information are required, the Government will notify the contractor and the contractor shall provide the additional documents/information to the credentials manager within 10 calendar days of the request.

1.2.3.1. Credentialing and Privileging. Professional staff appointment and clinical privileging actions, to include adverse actions, will be based on a review of the documents in the Provider Credentials File (PCF), IAW Air Force Instruction (AFI) 44‐119, Medical Quality Operations, Section 5B – Provider Credentials and Defense Health Agency‐Procedures Manual (DHA‐PM) 6025.13, Clinical Quality Management in the Military Health System, Volume 4: Credentialing and Privileging, 5b – Credentialing Requirements for Privileged and Non‐Privileged Providers. All health care providers must be able to obtain privileges granted through the applicable MTF Credentials Function as outlined in AFI 44‐119. Reappointment (renewal) of contractor’s privileges will occur IAW AFI 44‐119.

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1.2.3.2. Accreditation Requirements. The contractor shall comply with the accreditation standards applicable for the MTF (i.e. Accreditation Association for Ambulatory Health Care (AAAHC), Joint Commission on Accreditation of Health Care Organizations (JCAHO), etc.), applicable provisions of law and the rules and regulations of any and all Governmental authorities pertaining to:

1.2.3.2.1. Licensure and/or regulation of healthcare personnel in treatment facilities.

1.2.3.2.2. The regulations and standards of professional practice of the MTF.

1.2.3.2.3. The bylaws of MTF professional staff.

1.2.4. Clinical Privileges Limitation, Suspension and Revocation. Actions to limit, suspend, or revoke clinical privileges shall be IAW the procedures outlined in AFI 44‐119, Medical Quality Operations, Chapter 9 – Adverse Clinical, Administrative Actions Related to the Provision of Healthcare and Related Professional Staff Issues and DHA‐PM 6025.13, Clinical Quality Management in the Military Health System, Volume 3: Healthcare Risk Management. If an individual’s clinical privileges are summarily suspended pending an investigation into questions of professional ethics or misconduct, the contractor employee’s performance under this contract may be suspended until clinical privileges are reinstated. No reimbursement shall be made and no other compensation shall accrue as long as performance is suspended. The denial, suspension, limitation, or revocation of clinical privileges based upon practitioner impairment or misconduct will be reported to the appropriate authorities.

1.2.4.1. Adverse Actions. In the event of an adverse action, the COR will notify the CO and the contractor as soon as possible when the necessity to exercise such authority becomes apparent. The COR will provide the CO with a written statement advising the CO of adverse actions involving a health care provider, including a brief statement of the basis for the action so the contractor has sufficient information to make immediate employment/substitution decisions and permanent replacement, if necessary, based on the outcomes of the adverse action process. Written notice(s) will be marked by the Government as covered by 10 United States Code (USC) 1102, Confidentiality of Medical Quality Assurance Records: Qualified Immunity for Participants. No other information pertaining to the adverse action will be released without the MTF Commander’s permission.

1.2.5. Contractor Orientation. All contractor employees shall complete the MTF and clinic‐ specific orientation, prior to performing services under this contract. Clinic orientation must occur within five (5) duty days of employment start date. Medical Group orientation must occur within thirty (30) days or first available date of employment start date. All contractor employees shall report to the Commander Support Staff (CSS) to receive an orientation checklist, which includes an identification badge. All required orientation shall be documented by the contract manager and available for review by the COR and CO. All contractor employees unable to attend the Health Insurance Portability and Accountability Act (HIPAA) training

Page | 4 presented during the Medical Group orientation must contact the MTF HIPAA Privacy Official in order to receive “initial training” on local privacy policies as mandated by federal law and military regulations.

1.2.6. Controlled Substances. Healthcare providers authorized to prescribe controlled substances must possess and maintain a controlled substances registration certificate from the Drug Enforcement Agency (DEA), IAW the laws of the state in which health care provider is licensed.

1.2.6.1. Prescriptions. Healthcare providers authorized to prescribe pharmaceuticals shall become familiar with the hospital formulary and prescribe pharmaceuticals according to the drugs listed, and follow MTF procedures when prescribing drugs. The MTF Pharmacy Service will provide instructions to all prescribing healthcare providers on substitutions of generic drugs.

1.2.6.2. Drug Testing. The appropriate MTF Squadron Commander reserves the right to direct drug testing for contractor employees as required, at the Government’s expense.

1.2.7. Medical Evaluation Boards (MEB). Credentialed contractor employees shall perform MEB duties when tasked, including, but not limited to, writing narrative summaries for MEB and/or Deployment/Permanent Change of Station (PCS) waivers, IAW AFI 48‐123, Medical Examinations and Standards and Air Force Manual (AFMAN) 41‐210, TRICARE Operations and Patient Administration.

1.2.7.1. Related Duties. Credentialed contractor employees shall perform medical profiles, sick excuses (quarters and convalescent leaves), Deployment Health Assessments Post Deployment Health Reassessments (PDHRA) as well as Preventive Health Assessments (PHA), participate as a member of the Rapid Response Team, and perform telephone triage according to the MTF’s accepted protocols during duty hours. Credentialed contractor employees shall address, manage, and document medical issues pertaining to the Personnel Reliability Program (PRP), Security Clearances, Overseas Clearances, Pre‐Confinement evaluations, Line of Duty Determinations (LOD), and Occupational and fitness for duty medical evaluations ‐‐ all of which will be performed for active duty, reserve, and National Guard members as well as eligible civilian, Department of Defense (DoD), and dependent beneficiaries

1.2.8. Meeting Attendance. Contractor employees shall attend professional medical/staff meetings and participate in peer review and clinical quality control/performance improvement activities, to include review and evaluation meetings dealing with patient care. Contractor employees shall also attend all meetings deemed mandatory by Squadron Commanders, or a designated representative.

1.2.9. Inspection and Surveillance of Contractor Services. Functional Requirements Evaluator Designees (FRED) are Government employees appointed in writing by each Squadron Commander to carry out inspection duties. FREDs will monitor the days/hours worked by

Page | 5 contractor employees, inspect work performance, and report their findings to the COR. FREDs shall report incidents of non‐conformance to the COR within three (3) business days of the incident or notification of the incident, whichever is earlier.

1.2.9.1. Quality Control Plan (QCP). The contractor shall establish, implement, and maintain a QCP to ensure contract services are provided as specified in this contract. The contractor shall submit the QCP to the CO no later than 5 days after contract award. The contractor shall update the QCP as changes occur and submit changes to the CO for review prior to implementing the changes. As a minimum, the contractor’s QCP shall contain the following items.

a. A description of the inspection system to cover all services. The description shall include specifics as to the areas to be inspected on a scheduled and unscheduled basis, frequency of inspections, and the title and organizational placement of the inspector(s).

b. A description of the methods to be used for identifying and preventing defects in the quality of service performed.

c. A description of how records will be kept. Records must document all inspections and corrective or preventive actions taken.

1.2.9.2. Contractor Inspection Records. The contractor shall maintain inspection records and make the records available to Government personnel throughout the contract performance period, and for the period after contract completion until final settlement of any claims under this contract.

1.2.10. Procedural Guidance. Contractor employees shall perform procedures compatible with the MTF’s operating capacity and equipment, and shall not introduce any new medical procedures or services without the prior approval of the MTF Commander, Executive Committee of the Medical Staff, and/or the Credentials Function.

1.2.11. Patient Sensitivity. Contractor employees shall provide patients with the utmost care and attention, and assure all patients of their privacy and personal dignity. Contractor employees shall ensure proper safeguarding measures and privacy standards are executed to avoid unauthorized use and disclosure of patient information and personally identifiably information, IAW the Privacy Act and the HIPAA. Contractor employees shall immediately report any inadvertent unauthorized uses and disclosures to the MTF’s HIPAA Privacy Officials.

1.2.12. Communication. Contractor employees shall maintain open and professional communication with members of the MTF staff, MTF customers, and other contractor employees. COR will report valid complaints in writing to the CO for action. Valid complaints will be considered a performance failure. The contractor shall resolve all substantiated

Page | 6 complaints immediately upon notification of the complaint, and no later than the suspense date provided by the CO.

1.2.13. Documentation. Contractor employees shall prepare all documentation to meet or exceed established MTF standards, to include, but not limited to: timeliness, accuracy, content, and signature. Contractor employees shall only use MTF and Air Force‐approved abbreviations for documentation in the patient health records and follow the MTF’s Do Not Use Abbreviation List.

1.2.13.1. Medical Records Documentation. Healthcare providers shall complete medical records documentation within 72 business hours of the encounter with the patient.

1.2.13.2. Coding. Contractor employees shall use the proper coding of procedures and treatment, and shall maintain coding accuracy based on the Current Procedural Terminology Evaluation and Management Coding (CPT/E&M/procedure) at the same standard, 90% or higher, as military and civil service healthcare providers engaged in comparable work.

1.2.13.3. Computer Proficiency. Contractor employees must possess proficiency in Microsoft Office Suite applications (i.e. Outlook, Word, Excel, PowerPoint). In addition, contractor employees are required to use the computer systems that are standard for the support of health care delivery at the MTF. Contractor employees will learn, and become proficient in, documenting workload and entering clinical notes into the electronic medical record keeping system utilized by the MTF, currently Armed Forces Health Longitudinal Technology Application (AHLTA) and the data system Composite Health Care System (CHCS). System requirements include: process patient demographic data/document care, identify and correct patient data errors, verify physician and patient care/record location identifiers and work with clinics and other medical personnel to resolve missing or incorrect data appropriately in each patient's medical record.

1.2.14. Contractor Employee Start Date (Credentialed). Credentialed health care worker(s) shall physically begin performance within 90 calendar days after contract award or upon notification of a vacant position. Credentialed healthcare workers may begin performance earlier than 90 calendar days if an earlier start date is mutually agreed upon between the Contracting Officer and the Contractor.

1.2.14.1. Contractor Employee Start Date (Non‐Credentialed). Non‐credentialed health care worker(s) shall physically begin performance within 60 calendar days after contract award or upon notification of a vacant position. Non‐credentialed healthcare workers may begin performance earlier than 60 calendar days if an earlier start date is mutually agreed upon between the Contracting Officer and the Contractor.

1.2.15. Relationship of the Parties

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1.2.15.1. Personal Services. A personal services contract is defined in the Federal Acquisition Regulation (FAR), Subpart 37.104, Personal Services Contracts, as a contract that is characterized by the employer‐employee relationship it creates between the Government and the contractor’s personnel. Healthcare workers providing services under this contract will render personal services to the Government and are subject to the relatively continuous supervision and control of a Government officer or employee. Supervision and control is the process by which the individual healthcare worker receives technical guidance, direction, and approval with regard to a task(s) within the requirements of this contract. All other employer/employee duties and responsibilities (payroll, etc.) remain the responsibility of the prime contractor. Personal services contracts are entered into under the authority of Section Title 10, Section 1091, United States Code (USC), Personal Services Contracts and are identified in the position descriptions.

1.2.15.2. Medical Malpractice for Personal Services. Title 10, Section 1089, USC, Defense of Certain Suits Arising Out of Medical Malpractice, shall apply to personal injury lawsuits filed against health care workers based on negligent or wrongful acts or omissions incident to performance within the scope of this contract. This personal services relationship is solely between the Government and healthcare workers and does not include prime contractors.

Therefore, prime contractors are responsible for their own insurance and liability of any type.

Healthcare workers are not required to maintain medical malpractice liability insurance while performing services under this contract.

1.2.15.3. Personal Injury Claims. Personal injury claims alleging negligence by the contractor within the scope of the contractor’s performance will be processed as claims alleging negligence by DoD military or civilian health care providers.

1.2.15.4. Claims Procedures. If a suit or action is filed, or any claim is made against a contractor employee, which occurred as a result of work performed by a contractor employee identified under a personal‐service position while performing services under this contract, the healthcare provider and/or the contractor shall:

a. Immediately notify the CO and promptly furnish copies of all pertinent paperwork received;

b. Cooperate with the Government, without further compensation, in the processing, review, settlement or defense of the suit, action or claim; and,

c. Authorize Government representatives to settle or defend the claim and to represent the contractor employee in, or take charge of, any litigation involved in such an action.

The contractor may, at its own expense, participate in defense of such claim or litigation.

1.2.15.5. Non‐Personal Services. Non‐personal services contracts are defined in the FAR, Subpart 37.101, Non‐personal Services Contracts, as a contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its

Page | 8 administration, to the supervision and control usually prevailing in relationships between the Government and its employees. Non‐personal services contracts are entered into under the authority of 10 U.S.C. Section 2304, Contracts: Competition Requirements, and 41 U.S.C. Section 253, Competition Requirements. Contractor employees providing non‐personal services to the Government shall be subject to supervision and control by the contractor or the contractor’s CM. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered.

Non‐personal services are identified in the position descriptions.

1.2.15.5.1. Liability Responsibility for Non‐Personal Services. The non‐personal services positions under this contract will not be afforded liability coverage under the Federal Tort Claims Act as provided in the Medical Malpractice Immunity Act, 10 U.S.C. Section 1089.

1.2.16. Health Requirements

1.2.16.1. Medical Evaluation. No contractor employee shall perform health care services under this contract unless a pre‐assignment medical evaluation, including drug screening, has been performed not more than thirty (30) calendar days prior to submission of credentials. The purpose of this medical evaluation is to determine if the individual, from a medical standpoint, possesses the minimum physical abilities needed to perform the proposed job without significant risk to personal health or the health and safety of others. As a minimum, the individual shall be free of any medical conditions which might reasonably be expected to place other workers, patients, or the public at risk. Not later than five (5) days prior to the commencement of performance of health care services under this contract by any employee, the contractor shall provide certification to the Public Health (Employee Health) Flight that such employees have completed the medical evaluation requirements identified below. This certification shall state the date on which the examination was completed, the doctor’s name that performed the examination, and a statement concerning the physical health of the individual. Initial documentation is required for: Mumps, Measles, Rubella (MMR) immunization or titer levels for Mumps, Rubella and Rubeola, history of varicella disease or positive varicella titer (varicella vaccination must be accomplished if lack of immunity), two‐step Tuberculosis (TB) Mantoux skin test Intradermal Purified Protein Derivative (IPPD). If skin test is positive, the minimum requirement will be to follow‐up with contractor’s physician and a chest x‐ray. The contractor must provide documentation of “no active respiratory disease”. The Hepatitis B vaccination series is required for all personnel with occupational risk of exposure (declination are not acceptable, this is a condition of employment) and if the employee will be involved in exposure‐prone procedures (e.g. dentist, dental hygienist, surgeon) they must have their Hepatitis B immunity status determined. This is to be done by providing documentation of the Hepatitis B Surface Antigen (HbsAg), HbsAg and Hepatitis B Surface Antibody (HbsAb) titers (if HbsAg titer is positive they will be referred to the MTF Credentials Committee to determine scope of practice). If, in the opinion of the evaluating medical practitioner, the individual is found to be qualified for duty, the medical statement shall include the following wording:

“(NAME OF EMPLOYEE) possesses the minimum physical abilities to perform the proposed duties of a (insert job title). He/she has documented proof of immunization against/immunity

Page | 9 to rubeola, rubella, and hepatitis B and does not have an active infectious condition which might place others at risk.” If, in the opinion of the evaluating medical practitioner, the individual does not possess the minimum capabilities needed to perform the proposed job or does not meet the conditions of employment or will pose a risk to others, the medical statement shall contain the following wording: “For medical reasons, (NAME OF EMPLOYEE) is not qualified for employment as a (insert job title).” Certification shall be provided to the CM and COR. CM will track and forward to the MTF Occupational Health Office.

1.2.16.2. Preventive, Prophylactic, and Follow‐up Procedures. The contractor shall ensure that contractor employees are in compliance with preventive, prophylactic and follow‐up procedures, as well as infection control, drug demand reduction and employee health program procedures, as established by the MTF. The required preventive, prophylactic and follow‐up procedures will be provided by the Government to contractor employees in the MTF. If care is received elsewhere, the contractor shall provide written verification of treatment. The contractor shall report all information necessary to the Squadron Commander, to ensure hospital employee records are maintained correctly, and in compliance with the Joint Commission, Occupational Safety and Health Administration (OSHA), and Center for Disease Control (CDC) health records requirements.

1.2.16.3. Flu Vaccinations. Contractor employees are required to receive the flu vaccination every year on their own time and at their own expense, unless a contractor employee presents a valid medical waiver (e.g. adverse effects) to CM. The CM will track and forward the certificate to the MTF Occupational Health Office.

1.2.16.4. Pregnant Employees. The contractor or CM shall notify the COR of contractor employee pregnancies. The MTF Occupational Health Office will provide information concerning any work hazards in the area. The contractor shall notify pregnant contractor employees of any work hazards. It is the employee’s and the contractor’s joint decision whether the contractor employee will work in the environment.

1.2.17. Life Support Certification. All contractor employees shall be certified in Basic Life Support through the American Heart Association prior to performing duties. Advanced Cardiac Life Support (ACLS) certification requirements are identified in the individual position descriptions. All Family Medicine Providers & Pediatricians (PA/NP and MD/DO) are required to have Pediatric Advanced Life Support (PALS). All certifications required under the PWS or PDs will be at the contractor’s expense.

1.2.18. Clinical Performance Improvement (CPI). Contractor employees shall participate in CPI activities to the extent required by AFI 44‐119, Medical Quality Operations, and the individual MTF CPI plan or regulation. The contractor employee will receive instructions on CPI programs during the contractor employee’s in‐processing, and periodically as necessary.

1.2.19. Medical Quality Assurance/Risk Management (QA/RM). The contractor shall participate in Quality Assurance/Risk Management (QA/RM) activities to the extent required by

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AFI 44‐119, Chapters 8, 9, and 10/DHA PM Vol. 3 and the individual MTF QA/RM plan or regulation.

1.2.19.1. The Government will evaluate the contractor’s professional licensing using quality assurance standards specified in AFI 44‐119 and DHA PM Vol. 4. The Government may also conduct inspections under the Inspection of Services clause of this contract.

1.2.20. Annual Ongoing Competency Requirements. All contractor employees are required to attend any training deemed mandatory by the Squadron Commander, Chief of the Medical Staff, Clinic Supervisor, and/or MTF regulating agencies. Training requirements mirror the military active duty specialty working in the same patient care setting. The following are examples, but not limited to: medical group/unit specific orientation, Health Insurance Portability and Accountability Act (HIPAA), Patient Safety, Customer Service, Computer Security, and Pain Management training. Any training deemed necessary must be completed within normal duty hours and overtime will not be granted to complete the training.

1.2.21. Continuing Medical Education (CME) Requirements. Healthcare providers registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current as prescribed in AFI 41‐117, Medical Service Officer Education;

paragraph 5.6., Individual Requirements for Continuing Health Education (CHE). CME shall be obtained at no additional cost to the Government and reported to the COR or designee annually on the first normal duty day in January for the previous calendar year. Periodic CME may be available at the MTF, at no cost to the contractor, to any healthcare provider desiring to attend.

1.2.22. Exercises/Drills Participation. Contractor employees shall participate in Emergency Management Exercises/Drills (e.g. fire, natural disaster, code procedures). Contractor employees may participate in readiness training on a volunteer basis during duty hours, with the approval of COR and CM.

1.2.22.1. Records Maintenance. It is the contractor’s responsibility to report to the section supervisor all information necessary to assure hospital records can be maintained correctly, and therefore comply with the civilian accreditation authorities, OSHA, and Center for Disease Control (CDC) health records requirements.

1.2.22.2. Controlled Unclassified Information (CUI). CUI is information that requires safeguarding or dissemination controls consistent with applicable laws, regulations, and Government‐wide policies, but is not classified. The contractor shall create, mark, handle, and maintain CUI material IAW Department of Defense Instruction (DoDI)5200.48, Controlled Unclassified Information (CUI). When CUI material are authorized for destruction, including in electronic form, destruction must be accomplished in a manner making it unreadable, indecipherable, and irrecoverable.

1.2.22.3. Patient Lists. Patient lists, no matter how developed, shall be treated as privileged information. The contractor shall add the following to the bottom of all patient lists: “FOR

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OFFICIAL USE ONLY”. This document contains information exempt from mandatory disclosure under the Freedom of Information Act (FOIA), Title 5 U.S.C. 552(b)(2) High and (b)(6) apply.”

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 Chief of the Medical Staff.

1.2.22.4. Release of Medical Information. The contractor shall “use and/or disclose” patient information and personally identifiable information as authorized IAW privacy regulations only.

All uses and disclosures require verification of the “identity and authority” of the recipient. The following are examples, but not limited to: use of patient information amongst staff members is for official use only; disclosure of patient information to a third party requires valid HIPAA Authorization or Alcohol and Drug Abuse Prevention & Treatment (ADAPT); disclosure of patient information to law enforcement officials requires official written request/case number;

disclosures to military command authorities is for “military mission essential” and pertains to armed force personnel only.

1.2.22.5. Privacy Act Program. The contractor shall create and maintain Privacy Act data IAW AFI 33‐332, Air Force Privacy and Civil Liberties Program, systems of records notice(s) and AFMAN17‐1302‐O, Communications Security (COMSEC) Operations. The contractor shall not create or maintain a Privacy Act system of records prior to public notice. If the contractor receives a Privacy Act request, the contractor is responsible for searching for the records and providing those records to a Government official who, as the authorized official, will make the decision on releasing the Government records.

(http://www.defenselink.mil/privacy/notices/usaf).

1.2.22.5.1. Functional Requests. A functional request is a written request for DoD records that does not cite the FOIA or Privacy Act, received from any person, including a member of the public, an organization, or a business. The contractor is responsible for searching for the records and providing those records to a Government official who, as the authorized official, will make the decision on releasing the Government records. This does not include requests from Government employees with a need to know to perform official Government business

1.2.23. Contractor Employee Restrictions. The contractor shall not employ persons for work on this contract if such employee is identified to the contractor by the CO as a potential threat to the health, safety, security, general wellbeing, or operational mission of the installation and its population.

1.2.23.1. Conflict of Interest. The contractor shall not employ any individual who is an employee of the United States Government if the employment of that individual would create a conflict of interest, nor shall the contractor employ any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval of the employment IAW Department of Defense Directive (DoDD) 5500‐07, Standards of Conduct. In addition, the contractor shall not employ any person who is an employee of the Department of the Air Force if such employment would be contrary to the policies contained in AFI 64‐106, Air Force Industrial Labor Relations Activities. Utilize the following link to access

Page | 12 documents listed above: https://www.esd.whs.mil/Directives/issuances/dodi/ and http://www.e-publishing.af.mil/.

1.2.23.2. Military Personnel. The contractor is cautioned that off‐duty active duty military personnel hired under this contract may be subject to permanent change of station (PCS), change in duty hours, or deployment. Military reservists and National Guard members may be subject to recall to active duty. The abrupt absence of these personnel could adversely affect the contractor’s ability to perform. Their absence at any time shall not constitute an excuse for non‐performance under this contract.

1.2.23.3. Illegal Aliens. IAW Air Combat Command (ACC) supplement to AFI 31‐101, Integrated Defense (FOUO), illegal aliens are not authorized on DMAFB. The contractor shall not hire illegal aliens to perform contract services on DMAFB, nor attempt to bring illegal aliens on the installation. Corrective/punitive action will be taken against the contractor and the illegal alien(s), if the contractor hires illegal alien(s) to perform contract services on DMAFB.

1.3. Security Requirements

1.3.1. Criminal Background Checks. The Government will conduct criminal background checks on individuals providing services under this contract, using the procedures set forth in Department of Defense Directive (DoDD) 5200.1, The DoD Information Security Program, and Department of Defense Instruction (DoDI) 1402.5, Criminal History Background Checks on Individuals in Child Care Services. Utilize below link to access documents mentioned above:

https://www.esd.whs.mil/Directives/issuances/dodi/

1.3.1.1. Background checks will be based on fingerprints of individuals obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureau of Investigation (FBI) and state criminal history repositories.

1.3.1.2. Contractor employees may be permitted to work before completion of background checks with the consent of the Squadron Commander, provided the employee is within sight of an individual who has successfully completed a background check.

1.3.1.3. Contractor employees 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. Contractor employees shall contact the 355th Medical Group Security Manager for a copy of the background check and for procedures to challenge the accuracy and completeness of the information in the report.

1.3.1.4. Individuals who have previously received a background check shall provide proof of the check to the CO and Medical Group Security Manager, or obtain a new one. Documents required for proof of recently received background check include FBI fingerprint check and state criminal history check.

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1.3.1.5. Procedures for Criminal Background Checks. On or about the first day of employment the contract employee will meet with one of the MDG Security Managers to initiate the Government background check (National Agency Check). The contract employee shall bring a completed SF85P along with two forms of identification in order to begin the process. Utilize below link to access document mentioned above: https://wwwpm.gov/forms.

The contract employee must have a favorable background/fingerprint check in order to receive a Common Access Card (CAC). If employee is unable to obtain a CAC employment will not be authorized.

1.3.2. Government Issued Access Badges. The Government will issue contractor employees with a DoD Common Access Card (CAC) for access to the installation. The CAC must be under the control of the contractor employee at all times. Upon completion of contract performance or as otherwise directed by the Government, the contractor employee shall return the badge to the MTF Security Point of Contact. Failure to do so could result in withholding of payment to the contractor.

2.0 Special Requirements.

2.1. Continuation of Essential Contractor Services. The Government has determined that the Position Descriptions providing services marked by an asterisk (*) in Attachment #5 titled “Position Description Pricing Worksheet” are mission essential, in accordance with the Defense Federal Acquisition Regulation Supplement (DFARS), Subpart 237.76, Continuation of Essential Contractor Services. The contractor providing essential services shall be prepared to continue providing such services, in accordance with the terms and conditions of their contract, during periods of crisis, as determined by Government personnel.

2.1.1. Essential Contractor Services Plan. In accordance with DFARS 252.237‐7024 provision, Notice of Continuation of Essential Contractor Services, offerors shall provide upon award a written plan describing how it will continue to perform the essential contractor services listed in the PWS during periods of crisis. The required contents of the mission essential plan can be found in the DFARS provision 252.237‐7024.

2.1.2. Contractor Mission Essential Employee Identification. Upon contract award, the contractor shall provide the name, address, and telephone number of a point of contact for purposes of continuation of essential DoD contractor services during crisis. The contractor shall also provide the names of contractor employees having military mobilization recall commitments, and have adequate plans for replacing those employees in the event of mobilization, in accordance with DoDD 1200.7., Screening the Ready Reserve, and DoDD 1352.1, Management of Regular Reserve Retired Military Members, which the contractor shall provide with their offer. Utilize below link to access documents mentioned above:

https://www.esd.whs.mil/Directives/issuances/dodi/

2.2. Contractor Travel. The contractor employees identified for possible travel in Attachment #2, Position Descriptions, maybe required at times to travel for the purpose of attending

Page | 14 conferences, various meetings, and training outside of the assigned place of performance with prior approval. All Government funded contractor travel will be for official business only and will be conducted in accordance with applicable laws and regulatory requirements. All Government funded contractor travel shall be coordinated with the COR and the CO and require prior Government approval/authorization. The contractor will invoice for the cost of any Government directed travel requirements for healthcare workers. The contractor is responsible for obtaining all healthcare worker transportation, lodging, and subsistence. The contractor will invoice travel expenses consistent with the substantive provisions of the Federal Travel Regulation per FAR 31.205‐46 and the limitation of funds specified in this contract. The contractor’s travel shall be in accordance with the Joint Travel Regulation (JTR) and shall be invoiced for the actual travel costs using the lowest cost mode of transportation commensurate with mission requirements. When necessary to use air travel, the contractor shall use the tourist class, economy class, or similar accommodations to the extent they are available. Travel will be invoiced based on costs predetermined with the Government and the contractor prior to travel; no profit or additional fees shall be paid.

3.0. Services Summary.

Performance Objective

PWS

Reference Performance Threshold

1. Recruit qualified personnel to fill all positions identified in awarded task orders.

1.2.2.

Notify the Government of non‐availability of qualified candidates for identified positions no more than 1 time per calendar year per position.

2. Ensure low staff turnover 1.2.2.

Staff turnover per task order position not to exceed 1 replacement, per year.

3. Submit potential candidate for open positions to the CO, within 30 calendar days of vacancy notification.

1.2.2.3. 100%

4. Submit complete and accurate credentials packages within 45 calendar days of the acceptance/selection of the candidate.

1.2.2.4.

No more than 1 credentials package submitted either inaccurate or later than 45 calendar days of the acceptance/selection of the candidate per calendar year.

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5. Provide patients with the utmost care and attention, and assure all patients of their privacy and personal dignity.

1.2.11.

No more than two valid MTF patient complaints per employee, per year.

6. Maintain open and professional communication with members of the MTF staff, MTF customers, and other contractor employees

1.2.12.

No more than two valid MTF complaints per employee, per year.

7. Prepare all documentation to meet or exceed established MTF standards.

1.2.13.

No more than 1 instance of non‐ compliance per employee, per month.

8. Submission of accurate invoices in WAWF

5.26.

95% of invoices shall be accurate for hours worked.

9. Provide the Government a minimum of 30 calendar days written notification prior to credentialed employees departure, and a minimum written notification of 15 calendar days prior to departure of non‐credentialed employees.

5.28.4. 95%

4.0. APPENDIXES

4.1. Appendix 1 – Position Descriptions

4.2. Appendix 2 – Provider Privilege Lists – Will be provided upon contract award.

4.3. Appendix 3 ‐ Applicable Publications

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4.3.1. Publications applicable to the PWS are listed below. The contractor is obligated to follow these publications. These publications are available online and are 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 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. Prior to implementing any change that will result in an increase; the contractor shall submit to the CO a price proposal within 30 calendar days of receipt of the change by the contractor. The CO and the contractor will 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 calendar days from receipt of the change shall entitle the Government to performance IAW such change at no increase in price.

AFI 31‐101, Integrated Defense (FOUO) AFI 16‐1404, Air Force Information Security Program AFMAN17‐1302‐O, Communications Security (COMSEC) Operations AFI 17‐130, Cybersecurity Program Management AFI 33‐322, Records Management and Information Governance Program AFI 33‐332, Privacy Act and Civil Liberties Program AFMAN 41‐210, TRICARE Operations and Patient Administration AFI 44‐119, Medical Quality Operations AFI 48‐123, Medical Examination and Standards AFI 64‐106, Contractor Labor Relations Activities DHA‐PM 6025.13, Clinical Quality Management DoD Instruction 1402.5, Background Checks on Individuals in DoD Child Care Services Programs DoD Manual 5200.1, (3 Volumes) DoD Information Security Program DOD Manual 5200.02, Procedures for the DoD Personnel Security Program (PSP) DoD Manual 5400.07, DoD Freedom of Information Act (FOIA) Program

4.3.2. Publications and forms are available electronically through the internet. For example, http://www.e‐publishing.af.mil/ is the Air Force’s e‐Publishing site and one way to obtain Air Force Instructions. DoD Directives can be found at https://www.esd.whs.mil/Directives/issuances/dodi/Regulations are followed by a “‐R” (e.g., DoD 6025.18‐R) and can be located on the website by clicking on “Publications” instead of “Directives.”

5.0. General Information

5.1. Data. The Government has unlimited rights to all deliverables of this contract to include intellectual property rights.

5.2. Government Training. The contractor shall provide fully qualified site personnel.

Government training will be provided to the contractor when the training is unique and

Page | 17 available only to Government personnel. The Government will provide workplace orientation, mission/system familiarization, and standard operational procedures training to the contractor at the place of performance.

5.3. Listing of Employees. The contractor shall provide a weekly status report of all positions, according to Task Order, to the CO and the COR. Any contract employee that is terminated during the period of the contract must be reported to the CO in writing within one workday of the employee’s termination.

5.4. Security Training. All contractor employees shall receive initial and recurring security education training from the Government sponsoring agency’s security manager. Training must be conducted in accordance with DoDM 5200.01 V1‐V3 DoD Information Security Program, and AFI 16‐1404, Air Force Information Security Program. Contractor personnel who work in Air Force controlled/restricted areas must be trained IAW AFI 31‐ 101, Integrated Defense (FOUO).

Utilize below links to access documents mentioned above:

https://www.esd.whs.mil/Directives/issuances/dodi/ and http://www.e-publishing.af.mil/

5.5. Antiterrorism Awareness Training. Level I – Antiterrorism (AT) Awareness Training is available to all contractor employees. Non‐Common Access Card (CAC) holders can accomplish Level 1 ‐ AT Awareness Training at https://jkodirect.jten.mil. Additionally, contractor employees may contact the Government sponsoring agency’s Unit Antiterrorism Representative (UATR) to request Antiterrorism Awareness Training material.

5.6. Reporting Requirements. Contractor personnel shall immediately report to an appropriate Government authority any information or circumstances of which they are aware may pose a threat to the security of Department of Defense personnel, contractor personnel, resources, and classified or unclassified defense information. Contractor personnel are required to review suspicious activity reporting procedures. Contact the Government sponsoring agency’s Unit Antiterrorism Representative (UATR) to request Suspicious Activity Reporting training material.

Contact the Base Defense Operation Center (BDOC) to report actual suspicious activity at 520‐ 228‐3200.

5.7. Incident Notification. Contractor personnel with access to a government computer shall update their AtHoc profile with current contact information to ensure receipt of incident notification. Contractor personnel without computer access should be alert for notifications from the base public address system (i.e. Giant Voice). Additional notifications can be received via the Davis Monthan AFB Facebook Page. In the event of an incident, contractor personnel should adhere to the guidance provided in the Antiterrorism Awareness Training.

5.8. Pass and Identification Items. The contractor shall ensure that all necessary pass and identification items required for contract performance are obtained for contractor employees and non‐Government owned vehicles.

5.9. Retrieving Identification Media. The contractor shall retrieve all identification media, Page | 18 including vehicle passes from contractor employees that depart for any reason before the contract expires (e.g. terminated for cause, retirement, etc.) and turn them in to the issuing office. Once contractor employees are no longer employed, the contractor office shall notify the issuing office of the termination immediately.

5.10. Traffic Laws. Contractor employees shall comply with all base traffic regulations.

Contractor employees are subject to random vehicle speed control checks. Contractor personnel cited for speeding on the installation may suffer loss of base driving privileges, debarment from the base, or other administrative action. The use of seat belts is mandatory for all vehicle occupants. The use of cell phones is prohibited while driving on base, unless the phone is a hands‐free cell phone.

5.11. Random Personnel and Vehicle Searches. Contractor personnel are subject to random personnel and vehicle searches. If contractor personnel refuse to be searched, they will be denied entry to the base, and may result in loss of base driving privileges, debarment from the base, or other administrative action.

5.12. Weapons, Firearms, and Ammunition. Contractor employees are prohibited from possessing weapons, firearms, or ammunition, on themselves or within their contractor owned vehicle or…