Attachment 1-PWS Phlebotomists.pdf

PERFORMANCE WORK STATEMENT (PWS)

(PERSONAL SERVICE)

FOR

PHLEBOTOMISTS

4 August 2020

1. Description of Services.

1.1. Requirement with Background. The Department of Defense (DoD) Military Treatment Facilities (MTF) on Joint Base San Antonio (JBSA), Texas, has a requirement for 21 full time equivalent (FTE) Phlebotomists as described in this PWS. This is a follow-on requirement for services currently being performed. Phlebotomists support donor blood drives, meet donor quotas set by the Defense Health Agency (DHA), support laboratory specimen collection, basic military trainee (BMT) medical processing, and/or specimen processing and shipping operations. Contract personnel (CP) shall work within the Government provided facility and use Government provided equipment and perform services and support compatible with the medical facility’s operating capacity and equipment.

1.2. Regulations and Guidance

1.2.1 All services shall be provided in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations, The Joint Commission standards, Accreditation Association for Ambulatory Health Care (AAAHC), applicable DoD, military specific regulations, directives, and policies, and MTF specific policies and procedures. CP shall give the highest regard to donor and patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for Patients.

1.3. Relationship of the Parties and Professional Liability.

1.3.1. This is a personal services contract (as defined by Federal Acquisition Regulation[FAR] Subpart 37.104) and is intended to create an employer-employee relationship between the Government and the CP only to the extent necessary for providing the health care services required under the contract. The performance of the CP under this contract is subject to day-to-day supervision, clinical oversight and control by health care facility personnel comparable to that exercised over military and civil service personnel engaged in comparable work. The personal services contract does not create an employer-employee relationship between the Government and any corporation, partnership, business association, or other party or legal entity with which the CP may be associated.

1.3.2. Any personal injury claims alleging negligence by the CP within the scope of the CP performance of the personal services contract shall be processed by DoD in the same manner as claims alleging negligence by DoD military or civil service personnel. The authority for this contract is 10 United States Code 1089 and 10 United States Code 1091.

1.3.3. If any suit or action is filed or any claim is made against the CP, which occurred as a result of work performed by the CP under this contract, the CP shall immediately notify the Contracting Officer (CO) and furnish copies of all pertinent correspondence received.

1.3.4. The CP shall also cooperate with the Government, without further compensation, in the processing, review, settlement, or defense of the suit, action, or claim; and authorize Government representatives to settle or defend the claim and to represent the CP in, or take charge of, any litigation involved in such an action. The CP may, at the CP's own expense, participate in defense of such claim or litigation.

1.4. Specific Tasks. CP shall perform tasks in support of the assigned medical facility to include the following:

1.4.1.1 Shall perform all administrative and technical tasks consistent with blood donor center operations.

These tasks include, but are not limited to, donor registration, physical screening, routine and donor phlebotomy and post-donation care.

1.4.1.2. Perform component processing/manufacturing and blood product shipments. Maintain supply levels and perform quality control and equipment preventive maintenance and properly document results.

1.4.1.3. Shall be able to work independently with attention to detail and full knowledge of all aspects of the daily operations without deviating from established procedures. Comply with safety, policies, procedures, and universal precautions in the work area. Complete training and competency checklists within scheduled timeframes. Shall initiate and complete occurrence reports and root cause analysis for errors, accidents, and procedural deviations of which the CP is involved.

1.4.1.4. Receive donors and interact with staff in a courteous and professional manner. Explain donor screening and collection procedures to all potential donors and their families, instruct donors on necessary physical requirements, and post donation information.

1.4.1.5. Perform all tasks in compliance with local operating instructions, AAAHC and/or Joint Commission on Accreditation of Health Care Organizations (JCAHO), Enterprise Blood Management System - Donor (EBMS-D) Technical Guidance documents, Air Force Blood Program Memorandums (AFBPM), Code of Federal Regulations for the Food and Drug Administration (FDA), American Association of Blood Banks (AABB), Joint Commission (TJC) and College of American Pathologist (CAP) regulations and policies and all other Federal, State, and local laws.

1.4.1.6. Ensure whole blood units are collected in the proper amount and pilot tubes are collected to perform necessary donor screening tests. Enter data into EBMS-D.

1.4.1.7. Brief and assist donors in the preparation of blood donor record.

1.4.1.8. Perform donor deferral check and enter donor demographics into EBMS-D.

1.4.1.9. Prepare and label blood collection bags and pilot tubes prior to in-house and mobile blood drives ensuring all materials are unexpired and acceptable for use.

1.4.1.10. Obtain complete donor history and make corrections before releasing donors.

1.4.1.11. Perform donor weight checks, assess donor temperature, pulse, and blood pressure manually or automated and annotate on blood donor record.

1.4.1.12. Perform finger stick to obtain blood sample for hemoglobin and/or hematocrit determination using proper technique.

1.4.1.13. Perform donor interview and correctly determine donor eligibility.

1.4.1.14. Perform phlebotomy using donor collection bags.

1.4.1.15. Provide donors with post donation instructions. Assess donor status before departure and initiate appropriate measures in emergency situations (e.g. donor reactions).

1.4.1.16. Weigh, segment and prepare units after collection for component processing.

1.4.1.17. Manufacture components. Perform component processing to include preparation of red blood cells, fresh frozen plasma, recovered plasma, liquid plasma, convalescent plasma.

1.4.1.18. Assist in the set up and breakdown of mobile blood drives.

1.4.1.19. Inspects products for suitability.

1.4.1.20. Perform basic organizing, filing, and housekeeping tasks that support the scope of work and that improve efficiency and effectiveness of operations as well as answering phones, filing paperwork, and preparing donor materials.

1.4.1.21. When time and mission permits, donor center CP may be temporarily assigned to Wilford Hall Ambulatory Surgical Center and Reid Clinic for phlebotomy and medical processing support.

1.4.1.22. Shall perform all tasks consistent with basic military trainee medical processing at Reid Clinic, specimen collection area operations and laboratory specimen processing and shipping area operations.

These tasks include, but are not limited to, patient registration, age-specific phlebotomy to include pediatric, geriatric, and processing samples for shipping and/or testing.

1.4.1.23. Shall perform phlebotomy using standards collection techniques using and vacutainers, syringes, lancets, and/or butterflies as required for collection from patients.

1.4.1.24. Shall perform processing to prepare samples for testing and/or shipping.

1.4.1.25. Greet patients in a courteous and professional manner. Promote a positive professional image.

Explain collection procedures to all patients and/or their families.

1.4.1.26. Perform operation of basic instrumentation. Instruments may include but not limited to centrifuges, incubators, point of care testing instruments and scales.

1.5. Special Qualifications.

1.5.1. The CP shall meet the following education requirements:

1.5.2. The CP shall have and maintain a current basic Life Support (BLS) certification through hospital approved association such as American Red Cross (ARC) or American Heart Association (AHA).

1.5.3. The CP shall meet licensure or certification of Phlebotomist training or Texas certified Phlebotomist.

1.5.4. Shall have completed a phlebotomy course or equivalent On-the-Job-Training (OJT).

1.5.5. The contract personnel shall complete the initial profile package requirements.

1.5.6. CP shall have a high school diploma or equivalent.

1.5.7. CP shall have at least six (6) months phlebotomy experience with in the past five (5) years.

1.5.8. Knowledge of standard phlebotomy and capillary specimen collection techniques required to collect blood specimens.

1.5.9. Knowledge of the techniques and instrumentations used to prepare a blood specimen for testing or shipping.

1.6. General Information.

1.6.1. Quality Assurance: The Government will evaluate the Contractor’s performance under this contract IAW a separate Quality Assurance Surveillance Plan (QASP). This Government-only plan is primarily focused on what the Government will do to ensure that the Contractor has performed IAW contract performance standards. The contract QASP provides a systematic method to evaluate performance to include how the performance standards will be applied, the frequency of surveillance, and the acceptable quality levels for each of the metrics identified in the Exhibit 1 “Performance Requirements Summary.” The QASP is created with the premise that the Contractor is responsible for management and quality control actions to meet the terms of the contract while the Government is responsible for quality assurance actions.

1.6.1.1. Contracting Officer’s Representative (COR): The following individual is designated as the COR for this TO:

Name of COR: See COR Designation Memorandum, to be provided after award.

COR Email Address: See COR Designation Memorandum, to be provided after award.

COR Telephone Number: See COR Designation Memorandum, to be provided after award.

1.6.2. Hours of Performance.

1.6.2.1. Contract performance requirements are governed by the contract. Personnel working in these areas may be scheduled for any shift (day, evening, and night) to include rotating shifts and weekends.

Sample of shifts are 0400-1300, 0600-1500, 0730-1630, 0900-1800, 1100-2000, 1400-2300 and 2200- 0700 to include a one (1) hour unpaid lunch but not to exceed 40 hours per week. These shifts are not all inclusive and subject to change. Any deviation will be authorized by the COR.

1.6.2.2. The CP is advised that special activities including but not limited to commander’s calls, sports days, employee quality of life meetings, late reporting, staggered reporting times, early release, physical fitness time, office picnics, and holiday parties are for Government personnel only and do not apply to the CP unless expressly stated otherwise in the contract. If any special activity occurs, the CP will continue to perform contract requirements unless expressly excused by the Contracting Officer. In the event that the Contracting Officer excuses performance, the contractor understands that its employees’ participation in such event will not be at government expense. The CP is further advised that any special time off granted by the President or other competent authority is for Government personnel only and does not apply to the CP.

1.6.2.3. Absences. The CP shall ensure that scheduled absences do not interrupt service performance.

Scheduled absences shall be scheduled at least thirty (30) calendar days in advance and mutually agreed upon by the Contracting Officer Representative (COR). Unscheduled absences shall be limited to no more than twice per month and be reported to the COR by the CP no later than two (2) hours prior to the start of the shift.

1.6.2.4. If the CP is prevented from performing due to acts beyond the CP’s control including emergency base closure the standards in contract terms and conditions will be applied to determine if the non-performance is excusable. In the event of an emergency base closure due to weather or other contingency situation the COR will notify the CP of any changes in performance requirements. Under no circumstances will the contractor be paid for services not delivered.

1.6.2.5. Federal Holidays: The MTF will observe the ten federal holidays listed below.

Holiday Projected Date

New Year's Day January 1 Martin Luther King Jr's Birthday

3rd Monday in January

President’s Day 3rd Monday in February Memorial Day Last Monday in May Independence Day July 4 Labor Day 1st Monday in September Columbus Day 2nd Monday in October Veterans' Day November 11 Thanksgiving Day 4th Thursday in November Christmas Day December 25

Should the official holiday fall on Saturday then the observed holiday is the previous Friday.

Should the official holiday fall on Sunday then the observed holiday is the following Monday.

1.6.2.6. Place of Performance. The work to be performed under this contract will be at JBSA-Lackland, JBSA-Fort Sam Houston, JBSA-Randolph. CP shall receive notification two weeks prior to the reassignment to another location with a 40-mile commuting radius of their assigned MTF. CP shall be expected to provide their own means of transportation to alternate locations within a 40-mile commuting radius of their assigned MTF.1.6.2.7. CP performing under this contract shall abide by the provisions of MDWI 41-101 Medical Expense and Performance Reporting System (MEPRS), (Paragraph 2.1.3.). The contractor shall provide documentation or records of units worked through Wide Area Work Flow (WAWF) under inspector extension code: F2MTW7

1.6.2.7. With the exception of donor center operations, services performed under this contract have been determined not to be essential for performance during crisis declared by the National Command Authority.

1.6.3. Compliance.

1.6.3.1. The CP shall comply with all applicable Air Force Instructions (AFI), Department of Defense (DoD) Regulations, and Medical Wing Instructions (MDWI) as outlined in Appendix A.

1.6.3.2. MTF Orientation. The CP shall attend the MTF Orientation at the outset of their working at the MTF. The MTF Orientation will familiarize the CPs with the policies and procedures of the MTF and will be scheduled by the COR within two (2) months of employment. Orientation attendance shall be required of the CP during Government paid working hours.

1.6.3.3. In/Out processing. All personnel performing service under this contract shall be required to in-process through the 59 MDW Medical Logistics Contract Personnel Office upon reporting for duty. At this time, the CP shall initiate the process to receive a Common Access Card (CAC), Base Identification Passes, Restricted Area Badges, and keys. Upon termination or expiration of the contract, contract personnel shall be required to out-process through the same office and turn in the CAC, Base Identification Passes, Restricted Area Badges, and keys.

1.6.4. Conduct Requirements.

1.6.4.1. The Government will restrict the performance on this contract by any individual who is identified as a potential threat to the health, safety, security, general well-being, or operational mission of the MTF and its population.

1.6.4.2. The CP shall not advise, recommend, or suggest to persons eligible to receive medical care at Government expense that such person should receive care at an outside agency or provider at any place other than as designated under this contract.

1.6.4.3. The CP shall not use Government facilities or other Government property for personal use or other business not related to this contract.

1.6.4.4. CP shall not respond to any media inquiries nor provide interviews, comments, or any other responses to the media regarding any subject related to this contract. All inquiries or complaints from the media or other sources shall be immediately relayed to the COR.

1.6.4.5. The contractor shall ensure that its employees conduct themselves in a professional manner while on the installation and refrain from disruptive, offensive, or otherwise improper behavior that undermines order and discipline. The CO may direct the contractor to remove from performance of this contract on this installation any CP engaging in such misconduct.

1.6.4.6. Abide by federal and local MTF regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act of 1996. All medical records and reports will remain the property of the Government.

All financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the CP during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. The CP shall not release any of the above information without prior written consent of the Contracting Officer.

1.6.4.7. Smoking in AF Facilities. CP are advised that the Air Force has placed restrictions on the smoking of tobacco products in AF facilities. AFI 40-102, Tobacco Free Living, outlines the procedures used by the commander to control smoking in our facilities. CP and visitors are subject to the same restrictions as government personnel. Smoking is permitted only in designated smoking areas.

1.6.4.8. Base Fire Prevention Program. The CP will be required to comply with the applicable Fire Prevention Program, for JBSA-Lackland the applicable directive is AFI 91-203.

1.6.5. Security.

1.6.5.1. General Security Requirements. The CP shall follow all Security Requirements referenced in the solicitation and contract clauses.

1.6.5.2. Internal Operating Instructions (OI). The CP shall abide by the MTFs current OIs for internal circulation control, the protection of resources, and the regulated entry into AF controlled areas during normal, simulated, and actual emergency operations.

1.6.5.3. Reporting Requirements. The CP shall comply with AFI 71-101, Volume 1, Criminal Investigations Program (Chapter 2, paragraph 2.7) and Volume-2, Protective Service Matters, (Paragraph 1.2). CP shall report to Security Forces any information or circumstances which may pose a threat to DoD or CP, resources, or DoD information.

1.6.5.4. Removal of CP. The Government, through the CO, reserves the right to require immediate removal from contract performance on the installation or any Government facility, any individual whose actions raise reasonable suspicion that donor or patient care or services may be compromised in any way, or that pose a threat of harm to other CP/Government personnel or self. Removal under other circumstances will be subsequent to and at the direction of the CO only.

1.6.5.4.1. If a situation meriting removal occurs as outlined in the previous paragraph, the COR will contact the CO and the contractor’s representative within twenty-four (24) hours. A meeting may be required with the CO, COR and contractor representative to discuss further action.

1.6.5.4.2. The CO will notify the Contractor if and when permanent removal is required. In the event of a disagreement between the Government and the Contractor, the decision of the CO will be final. During the period of time between the removal and the final decision of the CO, the Contractor agrees to provide backup/replacement CP in accordance with the terms of this contract.

1.6.5.4.3. The CP may be required to submit to drug/alcohol testing. The Government may require temporary or permanent removal from contract performance any individual who refuses or fails testing.

1.6.5.5. Government Computer Access Requirements. If this contract requires contractor personnel to have access to government computers, contractor personnel requiring access to government computers shall successfully complete, a National Agency Check with Inquiries (NACI) request, before obtaining access to the computer. These investigations shall be submitted by the government at no additional cost to the contractor. All contractor employees affected by this requirement must have completed an acceptable submission that complies with all directions for completion of the investigation request through the government security office within 30 calendar days of contract award or notice of award. To begin this process, all affected contractor employees must complete within 15 calendar days after contract award or notice of award Standard Form 85P worksheet that can be downloaded from http://www.opm.gov/forms/pdf_fill/SF85P.pdf . The contractor shall notify the COR or Government personnel when the worksheet is complete. The affected employee will then be scheduled by the government for two or more appointments to complete the security package. If at any point after submission of the security worksheet, disqualifying information is discovered or developed, the government reserves the right to deny computer access. In this instance the Contracting Officer will notify the contractor of the denial. That individual will no longer be allowed to perform duties requiring computer access. After submission of the complete security package through the security office and completion of an adjudicated NACI, contractor employees may obtain their CAC for the duration of their contract, unless disqualifying information is subsequently discovered. In this instance access will be revoked. The NACI adjudication process normally takes 2 to 5 months after submission of the package.

The CP shall comply with DODD 5200.08R Physical Security Program, (Chapter 3, Section C.3) requirements.

1.6.5.6. Installation Access. Criminal History Check will be conducted on all prime/subcontractor employees requiring base access. The contractor shall provide the Contracting Officer and the http://www.opm.gov/forms/pdf_fill/SF85P.pdf

Information Protection Office a current list of employees needing access within 3 working days after receiving award or notice of award. The list shall include employee’s name, date of birth, social security number, state driver’s license/state ID number and state of issue. Notifications of contract employee additions and deletions shall be provided with the same information listed above and within 3 working days. Within 10 business days after receipt of the list the government will notify the CP that installation access passes are available for those employees clearing the criminal history check. The duration of any pass issued will not exceed one year or the duration of the contract, whichever is shorter. This process will be repeated at the exercise of any option period.

1.6.5.7. Government Data. The CP shall manage all data created for government use or legally controlled by the government, in support of the functional activity or required by AF publication, IAW with the records management procedures in Air Force Instruction (AFI) 33-322, Records Management Program, Air Force Manual (AFMAN) 33-363, Management of Records, and the Air Force Records Disposition Schedule (AFRDS) located at https://www.my.af.mil/gcss-af61a/afrims/afrims/rims.cfm

1.6.5.8. Freedom of Information. The CP shall not respond to any Freedom of Information Act request or release any information in response to a Freedom of Information request. Any request for information received by the CP under the Freedom of Information Act (FOIA) will be referred to the Contracting Officer.

1.6.5.9. Physical Security. The CP shall comply with Force Protection Condition (FPCON) procedures, Random Antiterrorism Measures (RAMS) and local search/identification requirements.

The CP shall safeguard all government property, including controlled forms, provided for CP use. At the close of each work period, government training equipment, ground aerospace vehicles, facilities, support equipment, and other valuable materials shall be secured.

1.6.5.10. Key Control. The CP shall safeguard all keys issued by the government and ensure they are used only by authorized contract personnel. The CP shall not duplicate issued keys and shall report lost keys to the Contracting Officer immediately. The CP will be charged for lost keys, re-keying, and lock replacement as applicable.

1.6.5.11. Additional Security Requirements. NACIs will be IAW Homeland Security Presidential Directive 12 (HSPD-12).

1.6.5.12. Unescorted Entry to Restricted/Controlled Areas. If this contract requires unescorted entry to controlled or restricted areas, the CP shall comply with DOD 5200.2-R, Appendix 1, and AFI 31-501, Personnel Security Program Management (Paragraph 3.24). If the performance of this contract requires unescorted entry to a restricted/controlled area, personnel must have a favorably adjudicated NACI investigation.

1.6.5.13. Weapons, Firearms, and Ammunition. Contractor employees are prohibited from possessing weapons, firearms, or ammunition, on themselves or within their contractor-owned vehicle or privately-owned vehicle while on any location within JBSA, TX..

1.6.6. Health Requirements and Immunizations.

1.6.6.1. Prior to contract performance, the CP shall provide proof of immunization or immunity from or screening for the following diseases according to Air Force guidelines equivalent to that provided to active work Armed Forces: Hepatitis B, MMR (Measles, Mumps, and Rubella), Varicella, Tdap (Tetanus, Diphtheria, and Pertussis), Tuberculosis (TB), HIV (CP who has direct patient care) and influenza for all personnel. CP shall control and prevent disease in accordance with AFI 48-105 Surveillance Prevention https://www.my.af.mil/gcss-af61a/afrims/afrims/rims.cfm and Control of Diseases and Conditions of Public Health or Military Significance, and 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, Air Force Policy (as applicable) and its supplements. For the TB screening, the CP shall provide proof of negative TB 2-step skin testing IAW CDC. If an individual has a past positive TB skin test, the CP shall provide proof of a negative chest X-ray within twelve (12) months prior to personnel performing. The Government reserves the right to require more frequent TB testing of personnel based on the facility annual TB risk assessment. Additional vaccines as they are made mandatory for health care workers may also be required in unusual circumstances. In summary, CP should have and maintain all requirements.

See Appendix B.

1.6.6.2. Medical Tests. The CP shall not obtain medical tests or procedures at the MTF. The CP shall be responsible for the cost of any emergency medical services received.

1.6.6.3. Influenza Immunization. CP shall receive the current influenza immunization, at contractor’s expense, unless contraindicated by allergy; as an example, to eggs as evidenced by hives, difficulty breathing, itching, and other symptoms of anaphylactic hypersensitivity, this exemption requires a Physicians diagnosis. Proof of vaccination will be required.

1.6.7. Reports. The CP shall submit reports to the COR and/or credentials office (as applicable) for use in monitoring performance. Such reports may include:

1.6.7.1. Initial – Effective date of award

Quarterly – 1st Qtr (October 1), 2nd Qtr (January 1), 3rd Qtr (April 1), and 4th Qtr (July 1) Annual – September 5

Report Timeline

Health and Immunization requirements Initially Personnel Changes Quarterly Basic Life Support (BLS) as accepted by American Heart Association (AHA) or American Red Cross

Initially and upon expiration date *

Continuing Education Units Initially and upon expiration date *

Competency and currency of licensure/ registration

Initially and upon expiration date*

Security requirements Initially Invoices submitted in WAWF Monthly

*Note: In accordance with Military Training Bulletin NO. 07-003 (7 Feb 07), this training will not be provided by the Government.

1.6.7.2. Contractor Manpower Reporting Application (CMRA):

The Contractor shall report ALL Contractor labor hours (including Sub-Contractor labor hours) required for performance of services provided under this contract via a secure data collection site. The contractor is required to completely fill in all required data fields at http://www.ecmra.mil.

http://www.ecmra.mil/

1.6.7.2.1. Reporting inputs will be for the labor executed during the period of performance for each Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported any time during the FY, all data shall be reported no later than 31 October of each calendar year.

Contractors may direct questions to the CMRA help desk.

1.6.7.2.2. Uses and Safeguarding of Information: Information from the secure web site is considered to be proprietary in nature when the contract number and Contractor identity are associated with the direct labor hours and direct labor dollars. At no time will any data be released to the public with the Contractor name and contract number associated with the data.

1.6.7.2.3. User Manual: Data for Air Force service requirements must be input at the Air Force CMRA link. However, user manuals for Government personnel and Contractor are available at the Army CMRA link at http://www.ecmra.mil. Once you get to this site, click the Department of Air Force CMRA link, to log-in or to initially set-up a user account.

2. Government-Furnished Property and Services.

2.1. The Government will provide use of all available MTF facility’s and support services, materials, publications and forms, use of equipment, and specialty clothing required for contract performance (except as designated in the contract). The CP shall keep Government furnished supplies, equipment, and work areas in a safe, orderly and clean condition.

2.2. The Government will schedule and furnish initial and annual training which may include but shall not be limited to various applicable software, data base systems, quality assurance policies, radiation safety, local in-service, safety briefings, compliance, patient safety, performance improvement, risk management, infection control, fire protection, security, Operations Security (OPSEC) and patient sensitivity training. The classes may be scheduled as required throughout the life of the contract.

2.2.1. Specialty Training. The Government may provide voluntary specialty training to the CP.

2.3. Any space used by CP in performance of this contract may be used for other purposes during their absence. Items of clothing, personal effects, or equipment may not be able to be secured at the MTF. The Government will not incur any liability for theft, damage to, or loss of such personal items.

2.4. The Government will provide local telephone service, Class-A telephone lines and Defense Switching Network lines limited to matters related to the performance of this contract. Personal long distance calls are not authorized.

2.5. The MTF will provide emergency healthcare for injuries occurring while working. The CP shall reimburse the Government for such services. This includes blood borne exposure protocols after start of work. The Government will provide initial testing at no cost, but the CP shall provide follow-up testing or reimburse the Government for such services performed within the MTF. The CP will provide the MTF with documentation for follow-ups performed outside the MTF as required by MTF policy. The Government will provide post-exposure tuberculosis testing at no charge to the CP when required (ex.

following exposure to active TB case with in MTF) to avoid testing delays.

2.6. The Government will provide MTF ID badges which will be worn/displayed at all times when in the MTF while at work. Upon favorable clearance, the CP will be issued a CAC in order to access donor and patient records. Items will remain Government property and will be returned to MTF upon completion of use.

http://www.ecmra.mil/

3. Attachments/Exhibits.

EXHIBIT 1

PERFORMANCE REQUIREMENTS SUMMARY (PRS)

P.0. # Performance Objective

(PO)

PWS

Paragraph

Performance Threshold (Per FTE)

Method of Surveillance

The Contractor shall provide personnel that accurately registers, screens, draws, and cares for donors and patients

1.4.1.1 1.4.1.11 1.4.1.15

No more than one (1) discrepancy per month

Customer Complaint

Periodic Surveillance

Shall perform donor deferral checks, interview donors, and enter data into the computer system

1.4.1.7 1.4.1.8

1.4.1.10 1.4.1.13

No more than one (1) discrepancy per month

Customer Complaint

Periodic Surveillance

Shall perform phlebotomy using standard collection techniques and/or donor phlebotomy techniques

1.4.1.14

No more than one (1) discrepancy per month and no more than 3 unsuccessful donor phlebotomies per day unless environmental factors

Customer Complaint

Periodic Surveillance

Shall perform component processing accurately

1.4.1.2.

1.4.1.16 1.4.1.17

No more than one (1) discrepancy per month

Customer Complaint

Periodic Surveillance

Shall inspect blood products for suitability and process samples for testing and/or shipping

1.4.1.12 1.4.1.19

No more than one (1) discrepancy per month

Customer Complaint

Periodic Surveillance

Shall ensure that the contract personnel comply with tasks IAW local OI’s, AFBPM, Code of Federal regulations, AABB, FDA, AAAHC, JCAHO, CAP and all federal, state and local laws.

1.4.1.5. No more than one (1)

discrepancy per month

Customer Complaint

Period Surveillance

Shall provide contract personnel that demonstrate public relations and a professional image.

1.4.1.4.

1.4.1.6.

1.4.2.4.

No more than one (1) discrepancy per month

Customer Complaint

Periodic Surveillance

Shall provide contract personnel who comply with the Hours of Performance.

1.6.2.1 95% compliance with staffing requirements, no interruption in service. No more than two (2) incidents of being more than ten (10) minutes late for work per month. No more than 3 unscheduled absences per month.

Periodic Surveillance

Shall comply with all initial and annual reports.

1.6.7. 100% Compliance Periodic Surveillance

Shall work independently and safely without deviating from established procedures.

1.4.1.3. No more than one (1)

unintentional deviation per month

Customer Complaint

Period Surveillance

Shall complete occurrence reports and root cause analysis for errors, accidents, and procedural deviations.

1.4.1.3 Complete within 7 duty days

of discovery

Periodic

Shall support and prepare for blood drives by preparing and utilizing unexpired bags and supplies.

1.4.1.9.

1.4.1.18

100% Compliance Periodic

4. List of Appendices.

Appendix A: Referenced Department of Defense, Air Force, and 59th Medical Wing Publications Appendix B: Contract Specific Requirements Prior to Performance

APPENDIX A

REFERENCED DEPARTMENT OF DEFENSE, AIR FORCE, AND 59TH MEDICAL WING

PUBLICATIONS

In all instances, current version applies. Publications can be found electronically at http://www.e-publishing.af.mil and http://www.e-publishing.af.mil/otherpublishingsites.asp. Medical Wing Instructions and Operating Instructions will be furnished upon request.

AFI 31-218, Motor Vehicle Traffic Supervision in its entirety) AFI 31-501, Personnel Security Program Management AFI 31-401, Information Security Program Management AFI 33-322, Records Management Program AFMAN 33-363, Management of Records AFI 40-102, Tobacco Free Living (in its entirety) AFI 48-105, Surveillance, Prevention and Control of Diseases and Conditions of Public Health or Military Significance. (Paragraph 1.10.10.)

AFI 71-101, Volume I, Criminal Investigations. (IAW 802 CONS & 802 SFS MOA) AFI 71-101, Volume 2, Protective Service Matters. (IAW 802 CONS & 802 SFS MOA) DoD Directive 5200.28, Security Requirements for Automatic Data Processing (ADP) Systems (Paragraph E6.4.1.2) AFI 91-203, Air Force Consolidated Occupational Safety Instruction DoD Directive 5200.2-R, DoD Personnel Security Program (Chapter 5) DoDI 1402.5 Criminal History Background Checks on Individuals in Child Care Services (Enclosure 5) MDWI 36-2601, Human Resource Development (in its entirety) MDWI 41-101, Medical Expense and Performance Reporting Systems (MEPRS) (Paragraph 2.1.3.)

APPENDIX B

CONTRACT SPECIFIC REQUIREMENTS PRIOR TO PERFORMANCE

WILFORD HALL AMBULATORY SURGICAL CENTER/59 MDW

FAXED TO:__________________________FAX:__________________DATE:_____________

Contract Position: __________________________________________ Name:____________________________________________________

All personnel performing service under this contract shall be required to in-process through the 59th Medical Wing Contract Services Section upon reporting for duty.

The following contract specific required items are to be provided to the Contract Services Section by the contractor prior to performance:

_______Pre-employment medical exam (no earlier than 45 days before start date)

_______Immunization Record

_______Varicella (Serologic evidence of immunity or documentation of 2-shot series)

_______Tdap(Documentation of tetanus/diphtheria vaccination within two (2) years or current Tdap vaccine.)

_______TB- 2 Step Testing or Neg. Chest X-Ray for Past Positive Tests (see screening criteria below) Screening Criteria Required Testing No Previous Documented TST result Two-step baseline TST Previous documented Neg TST >12 months before new employment Two-step baseline TST Previous documented Neg TST < 12 months before new employment Single TST > 2 previous documented Neg TST but most recent TST >12 months Single TST Previous documented Positive TST Chest X-Ray (negative)

_______MMR (Serologic evidence of immunity or documentation of 2-shot series)

_______Hepatitis B (Serologic evidence of immunity or documentation of 3-shot series)

_______HIV (direct contact with patients or body fluids) (Frequency shall be based on exposure risk per hospital employee program)

_______Influenza (current series)

_______Drug Testing

_______Security Background Check ____SF 86 (If applicable) ____ State ____NAC ____LFC Affidavit signed and dated by the Contractor. Copy of signed AF FM 2583 or Sentinel Key verification printout from a Security Manager.

_______Copy of non-disclosure statement

_______Copy of license (if applicable)

_______Copy of certifications (if applicable)

_______Credentials package (if applicable)

Report Timeline