Attachment 4_Performance Work Statement (PWS)_Nurse Case Managers (NCMs)_23R0005.pdf

Performance Work Statement

Department of Quality Service

Nurse Case Manager

22 December 2022

1. GENERAL INFORMATION. This is a personal services contract (as defined by FAR Subpart 37.l04) and is intended to create an employer- employee relationship between the Government and the individual health care providers (HCP) only to the extent necessary for providing the health care services required under the contract. The performance of health care services by the individual HCPs under a personal services contract are subject to government oversight to ensure compliance with governing directives by health care facility personnel comparable to that exercised over military and civil service HCPs engaged in comparable health care services. The 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 HCP may be associated. The authority for this contract is l0 United States Code l089 and l0 United States Code l09l. Throughout this performance work statement, the Health Care Providers is used interchangeably with Nurse Case Manager. Both references mean the procuring requirement of Nurse Case Managers (NCMs). The DHAPM references them as HCPs, referring to all health care providers. Nurse Case Managers (NCMs) are Health Care Providers (HCPs).

1.1. Professional Liability. The performance of health care services by the individual Nurse Case Managers (NCM) under a personal services contracts are subject to day-to-day supervision and control by health care facility personnel comparable to that exercised over military and civil service Nurse Case Managers (NCM) engaged in comparable health care services.

Any personal injury claims alleging negligence by the individual Nurse Case Managers within the scope of the NCMs 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 HCPs. Pursuant to 10 USC 1089(a), DoD shall process any personal injury claim alleging negligence by the HCP within the scope of the HCP’s performance under this contract as claims alleging negligence by DoD military or civil service HCP.

1.1.1 Contract workers shall have and maintain a current, valid, unrestricted license specific to the position (with no limitations, stipulations or pending adverse actions). Additional licenses held by a provider must be in good standing whether they are inactive, expired, or limit the provider’s practice to a military setting. The healthcare provider’s license(s) must remain current, valid and unrestricted throughout the duration of the contract worker performance on the TO. The

DHAPM 6025.13, Clinical Quality Management in the Military Health System, volume 4, is the governing directive for all licensure, registration, and certification. Adherence to the outlined requirements within the DHAPM 6025.13, vol. 4, shall be met.

1.1.2 Certification. When required, documentation demonstrating candidates meet the certification requirements outlined in DHAPM 6025.13, vol. 4. Certifications could include, but not limited to, Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), or Neonatal Resuscitation Program (NRP), or other certifications as required for one’s specialty.

1.1.3. Primary Source Verification. The Contractor shall perform all primary source verifications and include all verifications with the credentials package or competency assessment folder information for non-privileged staff IAW

DHAPM 6025.13, volume 4. All current professional licenses, certifications or registrations, including those the healthcare provider previously held that are now inactive, expired, or suspended, must undergo initial Prime Source Verification (PSV).

The Contractor shall obtain all paperwork, letters of reference, approvals, work history, etc. required by the MTF credentialing/licensure verification processes. The MTF staff will not assist the Contractor in obtaining any needed information for initial credentialing. The Contractor is responsible for the current competence of healthcare provider used to provide health care services under the Training Officer. Credentialing documents shall be submitted within 14 days of contract award or 21 days after notification of departing contract personnel.

1.1.4. Education. Documentation demonstrating candidates meet the minimum education requirements outlined in the

DHAPM 6025.13, vol 4.

1.1.5. Experience. A minimum of 3 years of full-time experience providing services as an independently licensed registered nurse in an in-patient environment as well as a certified nurse case manager with at least 3 years’ experience within the last 4 years with an emphasize in patient case management and discharging services.

Documentation demonstrating candidates meet the minimum experience level outlined in the DHAPM 6025.13, vol.

1.1.6. If any suit or action is filed or any claim is made against the Nurse Case Manager, which occurred as a result of work performed by the Nurse Case Manager (NCM) under this contract, the NCM shall immediately notify the contractor who will in turn notify the contracting officer’s representative (COR) and the contracting officer (KO) and promptly furnish them copies of all pertinent documents received.

1.1.7. The contractor NCM shall 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 NCM in, or take charge of, any litigation involved in such an action. The contract NCMs may, at the contract NCM’s own expense, participate in defense of such claim or litigation.

1.1.8. The contractor or Nurse Case Manager is not required to maintain medical malpractice liability insurance, and the

Government will not reimburse or otherwise pay for such insurance should any be purchased.

1.2. Background. The contractor shall provide the services for twenty (20) nursing support requirements, Certified Nurse

Case Managers (NCM) at Brooke Army Medical Center (BAMC), in San Antonio, Texas or any of its outlying clinics located within a 20-mile radius of the main facility, to include Fort Sam Houston BAMC will hereafter be referred to as the medical treatment facility (MTF).

1.3. Scope of Work. The contractor shall provide the personal services of a Nurse Case Manager (NCM) for Department of Quality Services, (DCQS) and Department of Surgery, (DOS), Brooke Army Medical Center, Fort Sam Houston, Texas.

The NCM shall be provided as required in accordance with this performance work statement (PWS) and the terms and conditions of any resulting contract.

1.3.1 Orientation and Training.

1.3.2. As part of their in-processing, Healthcare Provider will be provided orientation to familiarize CP with the policies and procedures of the MTF. Orientation attendance is required and will be conducted during normal duty hours for which contractor can invoice.

1.3.3. The Contractor shall ensure that each HCP is knowledgeable of the policies and procedures of his/her specific place of duty and of the medical activity. The Contractor shall ensure HCPs receive any staff training required by the MTF as a precondition/condition to performance. Such training may include instruction on MTF information systems, quality assurance policies, and local in-service and safety briefings. This training shall be conducted during the scheduled shift of the HCP.

1.3.4. Government unique training. The MTF may elect to provide unique government training to HCPs who are performing services under this contract. If the MTF elects to provide such training, it will be at no additional expense to the Contractor or to the NCM. When directed by the Contracting Officer, NCMs shall attend all such training in a paid status as part of the normal services required and billed under the contract. Such training shall require a performance commitment by the Contractor and the Contractor shall reimburse the Government (by means of a reduction in an invoice) if a NCM fails to satisfy the performance commitment after the NCM receives the unique Government training. The amount of the reimbursement shall be the prorated cost of training, calculated based on the total cost of the training and the number of months by which the NCM fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first. Details of any subsequent training agreement will be agreed upon by all parties, and such training agreements will be designated by modification to the contract.

1.3.5. Electronic Medical Record Keeping Systems. The Government will provide training to NCMs in the

Electronic Medical Record Keeping Systems and other procedures that the medical activity's staff is required to use.

Access to such patient data systems is an "Automated Data Processing Sensitive" position requiring compliance with

AR 25-2 and AR 380-67. Refer to the Additional Information section “ADP Security Requirements” in this contract for further guidance. Training on information systems and other computer training will be scheduled through the

COR prior to the HCPs providing direct patient care. The training will be on-site and during normal duty hours. This training will be at no cost to the contractor and may include but is not limited to Medical Health System -MHS Genesis.

1.3.6. Basic Life Support (BLS) Certification Contract workers shall maintain current certification in Basic Life Support

(BLS) from the American Heart Association, or the American Red Cross. Certification cards must display the American

Heart Association, the American Red Cross or other approved certifying body emblem. Web-based (on-line) classes are not acceptable by the Government.

1.3.7. Continuing Education. The Contractor shall ensure that contract workers who are licensed, registered or certified by state bodies, professional organizations or national/medical associations continue to meet the minimum, standards for continuing education to remain current as prescribed by their professional agency and applicable regulatory guidelines and policies. The Contractor shall ensure contract workers obtain continuing education at no additional cost to the

Government. The Government may approve contract workers to attend continuing education courses at the place of performance on a space available basis; however, that time shall not be billable to the Government.

1.4. Hours of Performance

1.4.1. The contractor and NCM will support the MTF’s seven-day a week, 365 days a year operation that includes an in-patient population and 24-hours a day. Normal hours of operation for out-patient clinics are 7:30 a.m. to 4:30 p.m., Monday through Friday, but duty hours may also include 9 consecutive hours per day/40-hour work week, routinely scheduled between the hours of 0700 to 2100 hours, Sunday through Saturday excluding federal holidays with 1 hour unpaid lunch and some command-directed training holidays.

1.4.2. Shift lengths for NCM assigned to out-patient clinics are 8 hours in duration with an unpaid lunch break of approximately one hour in duration. Shift lengths for NCM assigned to in-patient wards may vary by work area and can consist of 8, 10, and 12-hour shifts that will be combined so as to not to exceed 80-hours of work per 2-week period per each full-time requirement.

1.4.3. NCM shall arrive for each scheduled shift in a well-rested condition and shall have had at least eight hours of rest from all other duties prior to reporting for the shift. Full-time nurses shall normally work no more than 80 hours in a two-week period. If engaged in direct in-patient care, it may become necessary for the NCM to stay beyond the end of their scheduled shift until such time that the patient’s care is stabilized or officially transferred to another provider. Such occasions should be the exception and not a regular occurrence and compensation will be at the same rate as regularly scheduled hours. Compensatory time is not authorized.

1.4.4. The Government will not provide compensation for contractor employee travel time involved in reaching the

MTF, or for scheduled lunch/dinner break times during scheduled shifts. Each shift utilizes a minimum of a 30-minute meal break, with the exception of outpatient clinics that commonly close for a one (1) hour lunch break.

Meal breaks/times for night shift will be coordinated with the night supervisor. These meal breaks are not paid.

1.4.5. The COR may place oral orders for shift coverage on behalf of the MTF with written confirmation provided to the contractor by the next regular workday. The Nursing Supervisor may submit emergency staffing requests on behalf of the MTF after normal duty hours, weekends and holidays, or in the absence of the COR. Such emergency staffing requests will be made no later than 4 hours prior to the start of the shift. In such cases, the COR shall confirm the action the next duty day. The Contractor shall make a good faith effort to fill all emergency staffing requests up until the time the requested shift is to start. If no replacement can be found, the Contractor shall notify the COR/Nursing Supervisor at the start of the requested shift. Negative assessments do not apply to emergency staffing requirements.

1.4.6. Contractor personnel will not be turned away from a shift fill due to a lesser need for their services (i.e., during a lower patient census). The Government will utilize such instances to instead release military and/or civil service employees. The government further reserves the right to utilize Nurse Case Managers in another unit in which they are qualified to work if there is a greater need than in the originally assigned unit. The Contractor will advise their personnel that if it appears the unit will not be fully occupied, the Government has the option to utilize them in another area/unit. The Contractor will provide a list of nurses who possess the skill qualifications required to work in areas other than where usually scheduled, and shall provide each nurse’s qualifications with their credentials at the time of hire in order for the COR to know how to best utilize the Contractor’s staff. In the event that the Government decides to utilize Nurse Case Managers in an area other than the one to which they have originally been scheduled, the Contractor shall be reimbursed at the contract price for the ward where the healthcare worker was originally scheduled to work. Assignments to other areas in excess of three consecutive occasions shall require the MTF to review the continued need for Nurse Case Managers to be assigned in the area where the low census is being experienced.

1.4.7. The Contractor shall not make any change to the required scheduled shifts unless the change is approved by the COR or the Chief, Nursing Operations. After normal duty hours or in the absence of the COR, the Nursing

Supervisor and/or his/her representative may approve these changes. The Contractor will not guarantee any NCM a specific shift to work unless mutually agreed upon by the Chief, Nursing Operations, and the contractor. Any such mutual agreement shall be expressed in writing by both parties.

1.4.8 Requests for Time-Off.

1.4.8.1. Requests for time off will be made in writing no less than twenty-one (21) calendar days prior to the first day of the anticipated leave. The Nurse Case Manager shall coordinate requests for time off with the MTF’s Nurse Unit

Manager before submitting the request to the contractor for approval. Such coordination will be made in writing and will accompany the timesheets submitted with contractor’s invoice.

1.4.8.2. The government reserves the right to verify the hours worked by contractor personnel not only by implementing sign-in/sign-out procedures, but by any other means available or deemed necessary.

1.4.8.3. In the event of sudden illness or unforeseeable event necessitating the Nurse Case Manager (NCM) miss his/her scheduled shift, the NCM shall notify the contractor as soon as possible so that an appropriate replacement can be found.

The contractor’s representative will notify the head nurse of the clinic/ward of the replacement or absence no later than at the start of the scheduled shift. Any pattern of recurring missed shifts will be sufficient grounds to request permanent replacement of the offending NCM.

1.4.8.4. Closures. During anticipated closure of the facility due to command declared training holidays or during unplanned closure of the facility due to natural disasters, military emergencies, severe weather, or otherwise, the contractor shall not invoice the government for services not performed and the government will not be liable to the contractor for any such closures.

1.4.8.5. The contractor shall maintain a 95% fill rate of all required hours of service and shall not exceed a turnover rate of more than once per NCM per 12-month period of performance.

1.4.9. Federal Holidays

New Year’s Day – 1 January

• Martin Luther King’s Birthday – 17 January

• President’s Day – 3rd. Monday in February

• Memorial Day – Last Monday in May

• Juneteenth Day- 19 June

• Independence Day – 4 July

• Labor Day – 1st Monday in September

• Columbus Day – 2nd. Monday in October

• Veteran’s Day – 11 November

• Thanksgiving Day – 4th Thursday in November

• Christmas Day – 25 December

NOTE: Any of the above holidays falling on a Saturday will be observed on the preceding Friday; holidays falling on a Sunday will be observed on the following Monday. Any holidays that are declared by Presidential Executive

Order shall be observed in the same manner as the holidays listed above. If the area in which a contract employee is scheduled to work is closed due to the holiday declared by an Executive Order and the employee is not required to report in, payment will not be made for those hours. Closures of the installation due to inclement weather or other such acts of God shall be handled in the same manner.

2. DEFINITIONS & ACRONYMS

2.1. ACRONYMS/ABBREVIATIONS. Following is a list of basic acronyms/abbreviations used in this contract.

ADP - Automated Data Processing

AR - Army Regulation

BCLS - Basic Cardiac Life Support.

BAMC -Brooke Army Medical Center

CFR -Code of Federal Regulations

CHCS - Composite Health Care System

CLIN - Contract Line Item Number

CME - Continuing Medical Education

CMR - Contract Manpower Report

COR - Contracting Officer’s Representative

CPARS - Contractor Performance Assessment Reporting System

CPR - Cardiopulmonary Resuscitation

DA - Department of the Army

DEA - Drug Enforcement Administration

DoD - Department of Defense

DODI - Department of Defense Instruction

DMHRSi - Defense Medical Human Resource System – Internet

DQS - Department of Quality Service

FAR - Federal Acquisition Regulation

HCAA - Health Care Acquisition Activity

HCP - Healthcare Provider (s)

HHS - Health and Human Services

HIPAA - Health Insurance Portability & Accountability Act of 1996

KO - Contracting Officer

KS Contract Specialist

TJC - The Joint Commission

MEDCOM - Medical Command

MHS GENESIS- Military Health System’s electronic medical record system of use

MTF - Medical Treatment Facility

NACI - National Agency Check with Inquiries

NCM Nurse Case Manager (s)

OSHA - Occupational Safety and Health Administration or Act

PAD - Patient Administration Division

PALS - Pediatric Advance Life Support

Pam - Pamphlet

PAR - Performance Assessment Report

PL - Public Law

POC - Point of Contact

PWS - Performance Work Statement

QA - Quality Assurance

QA&I - Quality Assessment & Improvement

QC - Quality Control

USC - United States Code

2.2. DEFINITIONS. Following is a list of definitions used in this contract.

BENEFICIARY: An individual eligible for medical care in a medical or dental facility as outlined in 10 U.S.C. Part 55.

CERTIFICATION: In accordance with DHAPM, 6025.13, volume 4. A process by which a nationally recognized organization confirms that an individual healthcare organization has met certain predetermined standards or procedures required for certification.

CLINICAL PRIVILEGES: Permission granted by the Privileging Authority to provide medical and other patient care services. Clinical privileges define the scope and limits of practice for privileged providers and are based on the capability of the healthcare facility, licensure, relevant training and experience, current competence, health status, judgment, and peer and department head recommendations.

CLINICAL QUALITY IMPROVEMENT: The integrated processes, both clinical and administrative, that provide the framework to objectively define, measure, assure, and improve the quality and safety of care received by beneficiaries. The CQM functional capability includes the following programs: Patient Safety, Healthcare Risk

Management, Credentialing and Privileging, Accreditation and Compliance, Clinical Measurement, and Clinical

Quality Improvement.

COMPETENCY ASSESSMENT: As outlined in the DHAPM. Assessment of a healthcare provider’s knowledge, skills, and ability to deliver high quality, safe patient care.

CONTRACTING OFFICER (KO). A person with the authority to enter into, administer, and/or terminate contracts/task orders and make related determinations and findings.

CONTRACTING OFFICER’S REPRESENTATIVE (COR). A Government employee selected and designated in writing by the KO to act as his/her designated representative in administering a contract. A COR has no authority to change or modify the terms of a contract.

CREDENTIALS: As outlined in the DHAPM, 6025.13, volume 4. The documents that constitute evidence of appropriate education, training, licensure, experience, and expertise of a healthcare provider.

CREDENTIALED HEALTHCARE PROVIDER(HCP): As outlined in the DHAPM, 6025-13 volume 4. Any individual identified by the DHA as credentialed. This may include an individual who maintains professional qualifications such as education, internship/fellowship, licensure, registration, and/or certification to practice in a clinical discipline.

CREDENTIALS PACKAGE: The documents that provide the necessary information for the Government to validate credentials on a credentialed contract worker prior to performance at a place of performance. The type of information in a credentials package includes, but is not limited to, qualifying degrees, education, professional experience, licensure/registration, and certification requirements. Additional requirements for credentialed contract workers will be outlined in the DHAPM 6025-13 and regulatory guidelines. A credentials package for privileged contract workers also provides the necessary information for the Government to grant clinical privileges at a place of performance. The type of information in a credentials package for a privileged contract worker also includes verification of current clinical competency. Additional requirements for privileged contract workers are outlined in the performance work statement and regulatory guidelines.

CREDENTIALS REVIEW: As outlined in the DHAPM 6025-13 volume 4. The credentials inspection and verification process conducted for healthcare providers before selection for military service, employment, and procurement. The credentials review process is also conducted for healthcare providers before medical staff appointment and granting of clinical privileges and is repeated at the time of reappointment and renewal of privileges.

DEFENSE MEDICAL HUMAN RESOURCE SYSTEM - Internet (DMHRSi). A system that allows time keeping for all employees.

GOVERNMENT SUPERVISOR: Government individual who provides professional oversight of the clinical activities of a contract worker in a personal services arrangement. For personal services contract arrangements, this may be the individual who establishes the work schedule and directs the work of the contract worker. For purposes of evaluating performance and recommending clinical privileges, the clinical supervisor is a peer (if practicable) who is an appointed member of the medical staff and is the individual best qualified, on the basis of background and training, to judge the practice of the provider under review.

LICENSE: A grant of permission by an official agency of a State, the District of Columbia, or a Commonwealth, territory, or possession of the United States to provide health care within the scope of practice of a specified discipline. Licenses shall be current, active, valid and unrestricted. Additional licenses held by a provider must be in good standing whether they are inactive, expired, or limit the provider’s practice to a military setting. Providers in the MHS may not have one active license and another currently suspended or probationary license.

LICENSED INDEPENDENT PRACTITIONER (LIP): Any individual permitted by law and by the organization to provide care, treatment and services, without direction or supervision, and within the scope of the individual's license and consistent with individually granted clinical privileges

MHS GENESIS- Military Health System (MHS) GENESIS is the most current integrated electronic health record used by

DoD.

MILITARY HEALTH SYSTEM (MHS): The combination of military and civilian medical systems used to provide health care to DoD medical beneficiaries. The MHS incorporates all aspects of health care services for DoD.

MILITARY OR MEDICAL TREATMENT FACILITY (MTF): A military hospital or clinic. An MTF includes satellite areas such as standalone clinics and medical operations (i.e., health and wellness centers). The MTF may be a clinic, hospital, or medical center. Clinics are outpatient facilities offering primary care or simple specialty care (i.e., routine exams, tests, treatments). A clinic may be a stand-alone site or a satellite of a larger clinic, hospital, or medical center, to include patient centered medical homes. Hospitals offer more complex, resource-intensive secondary care (i.e., inpatient care, surgery under anesthesia) and primary care. Medical centers offer tertiary (i.e., sophisticated diagnosis/treatment of any ailment), secondary, and primary care, hospital services, preventive services, blood bank, and other services. An MTF is often referred to as a Medical Treatment Facility.

NATIONAL AGENCY CHECK WITH WRITTEN INQUIRIES (NACI): (see definition for Tier 1 investigations).

NATIONAL PRACTITIONER DATA BANK (NPDB): The NPDB is a web-based repository of reports containing information on medical malpractice payments and certain adverse actions related to healthcare practitioners, providers, and suppliers. The NPDB is managed by the Department of Health and Human Services in accordance with Section

11101 of Title 42, United States Code.

NON-PRIVILEGED HEALTHCARE PROVIDER: An individual who possesses a license, certification, or registration by a state, commonwealth, territory, or possession of the United States, and is only permitted to engage in the delivery of healthcare as defined in their granted scope of practice. Examples include registered nurse (RN), licensed vocational nurse

(LVN), registered dental hygienist (RDH), and medical technician.

PEER REVIEW: Any assessment of the quality of medical care carried out by a healthcare provider, including any such assessment of professional performance, any patient safety program Comprehensive Systematic Analysis (CSA) or report, or any other such assessment carried out by a healthcare provider under provisions of this manual.

PERFORMANCE IMPROVEMENT: Continuous study and improvement of processes with the intent to achieve better services or outcomes, and prevent or decrease the likelihood of problems, by identifying areas of opportunity and testing new approaches to fix underlying causes of persistent/systemic problems or barriers to improvement.

PERFORMANCE MEASURE: A method or instrument to estimate or monitor the extent to which the actions of a healthcare provider or personnel conform to clinical practice guidelines.

PRIMARY SOURCE VERIFICATION: As outlined in the DHAPM, 6025-13 volume 4. Validation that a document is true and valid through contact with the issuing institution or its authorized agent.

PRIVILEGED PROVIDER: An individual who possesses appropriate credentials and is granted authorized clinical privileges to diagnose, initiate, alter, or terminate regimens of healthcare with defined scope of practice.

PRIVILEGING. The process whereby the privileging authority, upon recommendation from the credentials committee, grants to individuals the authority and responsibility for making independent decisions to diagnosis, initiate, alter, or terminate a regimen of medical or dental care within their defined scope of practice..

QUALIFYING DOCUMENTATION: The documents that provide the necessary information for the Government to ensure contract workers meet the minimum requirements prior to performance at a place of performance.

QUALIFYING PACKAGE: The documents that provide the necessary information for the Government to validate non-credentialed contract worker minimum requirements prior to performance at a place of performance. The type of information in a qualifying package includes, but is not limited to, education, experience, licensure, certification, health and immunization requirements. Additional requirements will be outlined in the TOPR.

QUALITY: The degree of adherence to generally recognize contemporary standards of good practice and the achievement of anticipated outcome for a particular service, procedure, diagnosis, or clinical problem.

QUALITY ASSURANCE (QA): The Government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP): An organized written document specifying the surveillance methodology the Government uses for surveillance of contractor performance.

QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

REPLACEMENT PERSONNEL Contractor Personnel (CP) selected to fill a position for the duration of the contract period that was previously occupied by another CP.

TRICARE. A regionalized, tri-service, Contractor-supported, DoD-managed healthcare system.

3. GOVERNMENT FURNISHED ITEMS AND SERVICES.

3.1. Services: The Government will provide may include personnel to assist with production set-up.

3.2. Facilities: The Government will provide the necessary workspace for the contractor staff to provide the support outlined in the PWS to include desk space, telephones, computers, and other items necessary to maintain an office environment.

3.3. Utilities: The Government will provide all utilities in the facility will be available for the contractor’s use in performance of tasks outlined in this PWS. The Contractor shall instruct employees in utilities conservation practices. The contractor shall be responsible for operating under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount to accomplish cleaning vehicles and equipment.

3.4. Equipment The Government will provide access to, scanners fax machines, printers, shipping crates, lighting and sound.

3.5. Materials The Government will provide Standard Operating Procedures and Policies.

3.6. CAC Card: The CAC will be issued to eligible DoD contractor personnel. Assistance in obtaining the

CAC will be provided by DQS.

3.7. The government will provide training in MHS GENESIS, inpatient electronic health record, and other hospital computer information systems that the medical activity's staff is required to use.

4. CONTRACTOR FURNISHED ITEMS, SERVICES AND RESPONSIBILITIES.

4.1. Supplies/Materials. The Contractor shall furnish all supplies/materials, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this statement.

4.2. Facility Clearance: Work under this contract is Unclassified. The contractor shall comply with all applicable Department of Defense (DoD) security regulations and procedures during the performance of this task order. The contractor shall not disclose and must safeguard procurement sensitive information, computer systems and data, privacy act data, and Government personnel work products that are obtained or generated in the performance of this task order. If necessary, the contractor will be required to provide clearances for personnel requiring access to Government computers and workstations.

4.3. The Contractor shall be responsible for any keys issued by the Government to NCMs for use in the MTF. The keys shall not be duplicated. The Contractor shall be financially responsible for the replacement of any lost or duplicated keys and any associated locks. Lost or duplicated keys and/or locks shall be reported to the issuing party, Department Chief, or

COR immediately upon recognition of the loss or duplication. No unauthorized personnel shall be allowed entry into the locked area. The Contractor shall ensure that its CPs lock all areas for which they possess a key when they are not using the area and at the close of the work period.

4.4. The Contractor shall ensure that all NCMs comply with the local installation requirements for vehicle registration and operation in the military facility. Any vehicle operated by the Contractor or its employees in performance of this contract must have the minimum liability coverage required by the state in which the performance is located. The Contractor shall ensure that it’s NCMs comply with installation and MTF personnel identification and access requirements. The Contractor is responsible for absences of NCMs due to expired identification and access documents.

4.5. Safeguarding Material. The Contractor shall be responsible for safeguarding all Government property provided for

Contractor use. The Contractor shall safeguard information of a confidential or sensitive nature. Neither the Contractor nor any of its HCPs shall disclose or cause to be disseminated any information concerning the operation of the MTF that could result in or increase the likelihood of the possibility of breach of security or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974. The Contractor may be required to provide testimony or deposition in lawsuits or other administrative, civil, or criminal proceedings.

4.6. Antiterrorism (AT) Level I Training. AR 525-13 (Anti-terrorism), Chapter 5, Para 5-26(3)(b) states that AT awareness training for defense contractor employees shall be offered. As such, this training is available in the Swank HealthCare site and is a mandatory requirement.

4.7. The Contractor upon award of the contract shall ensure that a fill rate- 95%, employee turnover rate not more than 1 employee per year; substantiated complaints: - maximum two per year per position, are filled by the effective start date of the contract. Other performance evaluation factors will be monitored that are not qualified by numerical measurements which include contactor providing personnel meeting the minimum qualifications standards; customer service comments.

4.8. The Contractor will provide temporary personnel backfill, in coordination with the respective

Contracting Officers Representative (COR), in cases where a contract employee performing under this contract will be absent from their normally assigned place of work more than 10 workdays.

4.9. The contractor's representative shall meet with the COR at the DQS on a monthly basis or when requested by the COR to discuss any problems that the contractor's personnel may be experiencing during the performance of this contract. Problems experienced by the Government with the contractor's performance will be discussed and resolved. Unresolved problems will be referred to the contracting officer for resolution.

4.10. The Contractor shall provide the DQS with required contract employee information in order for hospital departments to process contract employee system access requests for use of government information systems required for the performance of contracted services.

4.11. Computer Training. Contract personnel who have any interaction with the Organization's computer systems must receive training for the applicable system. These systems include but are not limited to:

a. Military Health System GENESIS contains the MTF’s appointment scheduling program, pharmacy, lab, and radiology ordering system and are interlinked with RHC-C. Incumbent must have a working knowledge of this process.

b. Training for MHS GENESIS and other computer training will be scheduled through the COR/Department. The training will be on-site and during normal duty hours. This training will be at no cost to the contract.

4.8 Recruitment and Filling of Vacant Positions. The Contractor will recruit and fill a vacant requirement within thirty (30) calendar days of a position being vacated by the incumbent or been established as a new position requirement. The government will annotate on a Contract Performance Assessment Report

(CPARS) and position that remains vacant for more than 30 days, and possibly assign a “Marginal” rating.

5. DESCRIPTION OF WORK: The NCM shall provide patient-centered, individual and family level case management services for all eligible beneficiaries of the Military Health System, as well as non-beneficiary civilian emergency patient during the inpatient episode of care. The case manager will work collaboratively with multidisciplinary hospital staff to coordinate and procure all necessary equipment and supplies for the patient's discharge.

5.1. Manage patient care effectively through collaboration with the multidisciplinary team to develop a plan of care that would minimize medically unnecessary hospital admissions, re-admissions, emergency room and urgent care visits, ancillary care, and discharge planning. Achieve beneficiary and staff satisfaction at the highest-level possible with services provided. Timely transfers of patients to appropriate levels of care to reduce avoidable bed days. Reduction in healthcare expenditures through proactive coordination of post-hospitalization medical needs in concert with the multidisciplinary plan of care to facilitate medically appropriate length of stay and appropriate level of care.

5.2. Provide NCM and discharge/disposition planning in inpatient and ambulatory care settings for beneficiaries as needed, with early identification and interventions focused on outcomes as defined herein.

5.3. Accept referrals for NCM from all sources and perform initial assessment of each patient referred.

5.4. Identify care options that are acceptable to the patient and family that lead to increased adherence to treatment plans, and improved healthcare outcomes.

5.5. Monitor care delivery to the patient across the care continuum (for example sub-acute, long-term, home health, and hospice care) and document assessments of patient progress in reaching healthcare outcome goals.

5.6. Collaborate with direct and purchased care systems to ensure a smooth transition for patients from one level of care or care setting to another, such as rehab, residential or other care institution.

5.7. Ensure coordination of care delivery processes to enhance patient's health and wellness, safety, productivity, and quality of life, to include alternate care settings and the home environment.

5.8. Coordinate discharge/disposition plans to meet the patient's post-hospitalization and post-acute care requirements, to include:

Level of care

Follow-up, and services determined by the physician

Types of medical equipment needed for in home and post-hospitalization use

Rehabilitation/ extended care placement

Other care arrangements, as necessary

5.9. The NCM shall complete a thorough community assessment of available healthcare systems to include medical specialty services to identify agencies for the placement of patents for required medical support services.

5.10. The NCM shall appropriately manage all patients selected for case management across the care continuum, following the CMSA Case Management Standards of Practice, Defense Health Agency (DHA) policies and MTF policies and procedures. Legal and ethical processes will be followed to ensure the patient's clinical, bio-psychosocial, safety, financial, cultural, and environmental healthcare needs are appropriately fulfilled in the most timely manner within the clinical setting where they are treated.

5.11. The NCM shall expect surges in patient caseloads to occur during or following contingency operations. The increased caseload may be for short durations to provide care coordination in the way of discharge/disposition planning and possibly case management for Active-Duty Service Members (ADSMs) and, or to meet family needs of service members. Examples of unique military case management needs include, but are not limited to:

Cases complicated by psychosocial/environmental factors (for example military personnel who reside in a barracks).

Cases impacted by family/military circumstances (for example patient whose spouse is deployed, other children at home, and no other family support).

Cases which require extensive monitoring and coordination (for example foreign military injured, those soldiers injured with no family, and requires assistance with DME and transportation to and from appointments, Physical

Therapy (PT) daily, Coumadin clinic, or an elderly person who lives alone).

All cases for ADSMs in an inpatient status in a civilian hospital.

5.12. The NCM shall use available standardized forms, paper-based or electronic, for documentation of provision of services. Telephone call logs and files may be required to keep detailed documentation.

5.13. Coding of ambulatory case management encounters is required at MTFs as a method of collecting specific population healthcare data and/or NCM interventions. The contract NCM shall use approved codes for all NCM encounters.

5.14. The NCM shall provide NCM data and reports of workload as requested.

6. PUBLICATIONS.

Following is a list of basic publications applicable to this contract/task order. Current issues of many DA publications can be accessed at http://www.usapa.army.mil/gils. Current issues of many forms can be accessed at http://www.usapa.army.mil/forms. Publications and forms not on the internet can be obtained from the MTF. The

Publications have been coded as mandatory or advisory. The Contractor is obligated to follow those coded as mandatory only to the extent that they apply to this contract/task order. Supplements, amendments, or changes to these mandatory publications may be issued during the life of the contract. Advisory publications may be used for information and guidance but are not binding for compliance.

6.1. Mandatory:

Public Law:

• Public Law 91-596 Occupational Safety and Health Act of 1970

• Public Law 104-191 Health Insurance Portability and Accountability Act of 1996

Accreditation Manuals:

• TJC Manual The Joint Commission (TJC) Manual (Current Edition)

Defense Health Agency:

• DHA-AI 001 Telework Program

• DHA-AI 003 Physical Security Program

• DHA-AI 034 Drug-Free Workplace Program

• DHA-AI 050 Accounting of Disclosures of Personally Identifiable Information (PII) and Protected Health

Information (PHI)

• DHA-AI 5015.01 Records Management

• DHA-AI 5200.02 Information Security Program

• DHA-AI 5200.03 Operations Security (OPSEC) Program

• DHAPI 6000.03 Life Support Training Certification Requirements and Guidance

• DHAPI 6010.02 MHS Prescription Drug Monitoring Program

• DHAPI 6015.02 Beneficiary Counseling and Assistance Coordinator (BCAC) and Debt Collection

Assistance Officer (DCAO)

• DHAPI 6025.04 Pain Management and Opioid Safety in the MHS

• DHAPI 6025.06 Standardized Templates for Primary Care Clinical Encounter Documentation

• DHAPI 6025.10 Standard Processes, Guidelines, and Responsibilities of the DoD Patient Bill of Rights and

Responsibilities in the Military Health System (MHS) Military Medical Treatment Facilities (MTFs)

• DHAPI 6025.20 Medical Management (MM) Program within the Military Health System (MHS)

• DHAPI 6025.26 Standard Processes for the Military Health System (MHS) Nurse Advice Line (NAL)

• DHAPI 6025.27 Integration of Primary Care Behavioral Health (PCBH) Services into Patient-Centered

Medical Home (PCMH) and Other Primary Care Service Settings within the Military Health System (MHS)

• DHAPI 6025.28 Standard Processes and Procedures for Communication of Laboratory and Radiology

Results

• DHAPI 6025.29 Provision of Human Immunodeficiency Virus (HIV) Pre-Exposure Prophylaxis (PrEP) for

Persons at High Risk of Acquiring HIV Infection

• DHAPI 6025.33 Acupuncture Practice in Military Treatment Facilities

• DHAPI 6025.39 Medical Ethics in the Military Health System

• DHAPI 6025.42 Routine Adult Transthoracic Echocardiogram (TTE) Standards for all Military Medical

Treatment Facilities (MTFs)

• DHAPI 6040.07 Medical Coding of the DOD Health Record

• DHAPI 6401.01 Dental Sedation Medical Management

• DHAPI 6490.02 Behavioral Health (BH) Treatment and Outcomes Monitoring

• DHAPM 6025.01 Primary Care Behavioral Health (PCBH) Standards

• DHAPM 6025.13, Volumes 1-7 Clinical Quality Management in the Military Health System

Department of Defense (DoD):

• DoD 5200.1-R Information Security Program

• DoD 5200.2 Personnel Security Program

• DoDI 5200.46 DoD Investigative and Adjudicative Guidance for Issuing the Common Access Card

• DoD 5210.42-R Nuclear Weapons Personnel Reliability Program (PRP) Regulation

• DoD 5400.7-R DoD Freedom of Information Act

• DoD 5400.11-R Department of Defense Privacy Program

• DoD 6010.13-M Medical Expense and Performance reporting System for Fixed Military Medical And

Dental Treatment Facilities Manual

• DoD 6010.15-M Military Treatment Facility Uniform Business Office (UBO) Manual

• DoD 6015.1-M Glossary of Healthcare Terminology

• DoD 6025.18-R DoD Health Information Privacy Regulation

• DoD 6055.5-M Occupational Medical Examinations and Surveillance Manual

• DoD 8580.02-R HIPAA Security Rule

• DoDD 5144.02 Information Technology Standards in the DoD

• DoDD 5205.2 DoD Operations Security (OPSEC) Program

• DoDD 5400.11 DoD Privacy Program

• DoDD 5500.07 Standards of Conduct

• DoDD 6000.14 Patient Bill of Rights and Responsibilities in the Military Health System (MHS)

• DODM 6025.13 Medical Quality Assurance (MQA) in the Military Health System (MHS)

• DoDD 6040.41 Medical Records Retention and Coding at Military Treatment Facilities

• DoDD 6205.02E Policy and Program for Immunizations to Protect the Health of Service Members and

Military Beneficiaries

• DoDD 8190.3 Smart Card Technology

• DoDD 8500.01E Information Assurance

• DoDI 1100.22 Policy and Procedures for Determining Workforce Mix

• DoDI 1402.5 Criminal History Background Checks on Individuals in Child Care Services

• DoDI 3020.37 Continuation of Essential DoD Contractor Services During a Crises

• DoDI 5200.02 DoD Personnel Security Program (PSP)

• DoDI 6000.11 Patient Movement

• DoDI 6015.23 Delivery of Healthcare at Military Treatment Facilities: Foreign Service Care; Third Party

Collection; Beneficiary Counseling and Assistance Coordinators (BCACs)

• DoDI 6025.8 Ambulatory Procedure Visit (APV)

• DoDM 6025.13 Medical Quality Assurance (MQA) and Clinical Quality Management in the Military Health

System (MHS)

• DoDI 6025.18 Privacy of Individual Identifiable Health Information in DoD Health Care Programs

• DoDI 6040.40 Military Health System Data Quality Management Control Procedures

• DoDI 6040.42 Medical Encounter and Coding at Military Treatment Facilities

• DoDI 6040.43 Custody and Control of Outpatient Medical Records

• DoDI 6205.2 Immunization Requirements

• 10 USC 1089 - Defense of Certain Suits Arising Out of Medical Malpractice

• 10 USC 1091 - Personal Services Contracts

• PL 91-596 - Occupational Safety and Health Act 0f 1970

• PL 101-647, Section 231 - Crime Control Act of 1990

• PL 102-190, Section 1094 - National Defense Authorization Act

• PL 104-191k - Health Insurance Portability and Accountability Act of 1996

• DoD Directive 5200.28 - Security Requirements for Automated Information Systems (AISs)

• DoD 5200.2-R - Personnel Security Program

• DoD 6025.18-R - Department of Defense Health Information Privacy Regulation

• DoD 8580.02-R - DoD Health Information Security Regulation

• DoDI 1402.5 - Criminal History Background Checks on Individuals In Child

• Care Services Applicable MTF Standard Operating Procedures (SOPs) and Policies

• AR 25-2 - Information Assurance

• AR 40-1 - Composition, Mission, and Functions of the Army Medical Department

• AR 40-3 - Medical Services: Medical, Dental, and Seterinary Care

• AR 40-4 - Army Medical Department Facilities/Activities

• AR 40-5 - Preventive Medicine

• AR 40-48 - Non-Physician CPs

• AR 40-66 - Medical Records Administration and Health Care Documentation

• AR 40-68 - Clinical Quality Management

• AR 40-501 - Standards of Medical Fitness

• AR 40-562 - Immunizations and Chemoprophylaxis

• AR 340-21 - The Army Privacy Program (05 Jul 85)

• AR 351-3 - Professional Education and Training Programs of the Army Medical Department

• AR 380-19 - Information Systems Security

• AR 380-67 - The Department of the Army Personnel Security Program

• AR 385-40 - Army Accident Investigations and Reporting

• AR 600-85 - Army Substance Abuse Program Civilian Services

• MEDCOM Reg 715-3 - Contractor/Contractor's Employees and MEDCOM Personnel Relationships

6.2. Advisory.

• AR 310-25 - Dictionary of United States Army Terms

• MEDCOM Pam 25-31 - Index of Command Administrative Publications (16 Sep 02)

• 6.3. The following is a listing of forms that may be required, and may customarily be used by a CP performing

• services. A complete list of forms can be accessed at http://www.apd.army.mil/AdminPubs/ProductMap.asp.

6.3.1. Standard Forms.

• SF 85-P - Questionnaire for Public Trust Positions

• SF 88 - Medical Record – Report of Medical Examination