Draft PWS.docx

PERFORMANCE WORK STATEMENT

Licensed Vocational Nursing and Certified Nursing Assistant Services

1.0. INTRODUCTION.

1.1. The contractor shall provide the personal services of technically proficient licensed vocational nurses (LVNs), and certified nurse assistants (CNA’s) for the San Antonio Military Healthcare System (SAMHS) which is compriised of the San Antonio Miliatry Medical Center (SAMMC) and their outlying clinics throughout the San Antonio area. SAMMC provides a broad scope of services including a level one trauma center, the Burn Unit, Amputee Center, multiple Critical Care/Intensive Care Units, Step Down Units, Medical-Surgical Units, Pediatrics, Maternal Child, Surgical Services, extensive specialty/subspecialty services supported by Graduate Medical Education program, and ambulatory clinics.

1.2. 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, applicable Department of Defense (DoD), Army specific regulations, directives, and policies, and military treatment facility (MTF) specific policies, procedures, and job descriptions. Contract health care providers shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for Patients.

1.3. The contract health care providers shall provide services in conjunction with other non-contract providers to include physicians, nurse practitioners, physician assistants, registered and licensed practical nurses, and support personnel. All contract health care providers shall perform essentially the same functions, within the scope of acceptable practice for the specific specialty or position, as those required by the MTFs or government service health care professionals of similar experience and in similar duty assignments. The scope of services provided at SAMMC cover the same range of services as those that are provided in civilian hospitals of similar size and scope of services.

1. 4. Relationship of the Parties, Professional Liability Responsibility and Procedures.

1.4.1. This is a personal services contract (as defined by FAR Subpart 37.104) and is intended to create an employer-employee relationship between the Government and the individual health care providers only to the extent necessary for providing the health care services required under the contract. The performance of health care services by the individual health care providers (HCPs) under a personal services contract are subject to day-to-day supervision and control by health care facility personnel comparable to that exercised over military and civil service HCPs engaged in comparable health care services. Any personal injury claims alleging negligence by the individual HCPs within the scope of the HCP’s 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. 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 10 United States Code 1089 and 10 United States Code 1091.

1.4.2 Professional Liability.

1.4.2.1. 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. The contractor or HCP 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.

0. Responsibility and Procedures.

1.4.3.1. If any suit or action is filed or any claim is made against the contract HCP, which occurred as a result of work performed by the HCP under this contract, the HCP shall immediately notify the contractor, the contracting officer and the chief of the appropriate services and promptly furnish them copies of all pertinent documents received.

1.4.3.2. The contractor and contract HCP 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 HCP in, or take charge of, any litigation involved in such an action. The contract HCP may, at the contract HCP’s own expense, participate in defense of such claim or litigation.

2.0 BACKGROUND.

2.1. The mission of the military healthcare system (MHS) is to enhance our Nation’s security by ensuring the nation has a healthy military force capable of providing the full range of military operations supported by a combat ready healthcare system sustaining the health of DoD beneficiaries. Health care services for eligible MHS beneficiaries are provided at Military Treatment Facilities (MTFs) located on or near military installations or posts. The MTF may be a clinic, hospital, or medical center. Clinics are outpatient facilities offering primary care or simple specialty care (routine exams, tests, treatments). The clinic may be a stand-alone site or a satellite of a larger clinic, hospital, or medical center. Hospitals offer more complex, resource-intensive secondary care (e.g. inpatient care, surgery under anesthesia) and primary care at outpatient clinics inside and outside the hospital. Medical Centers offer tertiary (sophisticated diagnosis/treatment of any ailment), secondary, and primary care, hospital services, preventive services, blood bank, and outpatient services. In addition, Medical Centers offer graduate medical education programs for physicians and other training programs for nursing and ancillary personnel.

2.2. Currently, the San Antonio MHS is supported by the following military treatment facilities located at Fort Sam Houston (SAMMC),and Camp Bullis. The Camp Bullis clinic operates as a satellite clinic for SAMMC. In addition, the North Central Federal Clinic is a joint venture between the Veterans Affairs and the Department of Defense. SAMMC and has a level one trauma center and currently providing trauma support for 50% of San Antonio’s trauma care. SAMMC has the Institute of Research Burn Center and the Amputee Center to support America’s Wounded Warriors. In addition, this site provides training for multiple medical training programs for enlisted and officer medical specialties.

3.0. SCOPE OF WORK.

3.1. Administrative.

3.1.1. This is an indefinite delivery/ indefinite quantity contract; this Performance Work Statement applies to all positions encompassed within this contract.

3.1.2. Contractor point of contact. The contractor shall notify the contracting officer (KO) of a primary point of contact for contract implementation, coordination and administration not later than five (5) business days after receiving notice of contract award. The contractor shall notify the KO of changes in the primary point of contact at least five business days prior to the change. All notifications shall be in writing and shall state the name and contact information for the point of contact. In addition, task orders may require a program manager or local point of contact.

3.1.3. Contractor Program Manager. The contractor shall provide a full time program manager in the San Antonio area within 10 business days of contract award. The KO shall be notified in writing and the contractor shall state the name and contact information for the program manager. The Program Manager shall not be one of the contract health care providers providing services.

3.1.3.1. The Program Manager responsibilities include coordinating work schedule requests, filling the requests, resolving staffing problems or other issues requiring immediate attention, and the handling the day-to-day functioning of the contract. The Program Manager shall respond to telephone calls from the Contracting Officer’s Representative (COR)/Quality Assurance Evaluator (QAE) or nursing supervisors within thirty (30) minutes on a twenty four (24) hour a day, seven days a week basis.

3.1.3.2. The Program Manager shall meet with the COR/QAEs monthly during the contract period to discuss any concerns regarding the contract/task order execution.

3.1.4. The contracting officer’s representatives will be the KO’s authorized representatives in administering the contract at the MTF or department level. The contractor’s Program Manager shall be available 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 KO for resolution.

3.1.5. Full performance is critical and shall begin upon issuance of the task order. Credentialling shall be completed no later than forty-five calendar (45) days after receiving the task order.

3.1.5.1. The profile application packet shall be sent to COR/QAE 10 days prior to inprocessing and provide the following below. Depending on the individual position, the profile packages may be reviewed by Department Chiefs, supervisors, flight commanders, etc as determined by the organizational structure of the department to which the contract support provider would be assigned. The COR/QAE will notify the contractor within five (5) business days if the proposed contract service provider has been approved or disapproved.

1. completed centralized credentials quality assurance system (CCQAS) data entry form,

1. primary source verification of state licenses with expiration date, license number, name and contact information for individual performing primary source verification attesting to direct state verification and the method of verification,

1. criminal background check,

1. education history with primary source verification of college attended/degree,

1. certifications (basic life support {BLS}, advanced cardiac life support {ACLS}, Pediatric Advanced Life Support {PALS}, Trauma Nursing Critical Care {TNCC}, professional certifications, etc.

1. employment history, resume

1. immunization status, health examination date

1. skills assessment checklists, competency assessments, medication examinations, or any other skills verification necessary for specialty and location (specifics will be outlined in the task orders)

3.1.5.2. The contractor shall monitor licensure, certifications, health and immunization status and provide updated information on a monthly basis. The monthly report provided to the COR/QAEs shall be include expiration dates and renewals of mandatory requirements including licensure, certifications, life support courses, annual training requirements, and health requirements (TB tine, influenza).

3.1.6. The contractor and contract HCPs shall abide by all MTF standards, rules, and procedures including requirements for any licensure, credentialing and quality assurance requirements. Such regulations include, but are not limited to, general safety, fire prevention, waste disposal, infection control, the Joint Commission, and patient safety initiatives.

3.1.7. Media and Other Inquiries. The contractor or contract service provider shall not respond to any media inquiries. Any inquiries from the media, third parties, or public agencies shall be immediately relayed to the COR/QAE, who will relay them to the MTF Public Affairs Officer or, after duty hours, to the Administrative Officer of the Day (AOD). There shall be no interviews, comments, or any other response without the prior knowledge and approval of the MTF Commander. Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the COR/QAE.

3.1.8. Emergency health care for contract HCPs. The MTF will provide emergency health care for injuries or life threatening medical emergencies occurring while on duty. The contractor shall reimburse the government for such services as billed by the MTF.

3.1.9. Reports. On a monthly basis, the contractor shall submit a written report to the KO identifying all current task orders and the distribution of performance between the prime and subcontractors. The contractor shall submit additional reports to the KO or COR/QAE as requested for use in monitoring contractor performance. Such reports include, but are not limited to, personnel recruitment/credential status, projected losses, HCP locations, etc. Regularly recurring reports will be specified on the task order; however, the KO or COR/QAE may request additional information at any time.

3.1.10. The use of non-compete conditions in employment agreements (to prevent loss of personnel by the contractor) effective only during the period of the contract performance is acceptable. However, the use of non-compete conditions in employment agreements that prevent employees of the incumbent from being employed, or accepting offers of employment by the new contractor on the follow-on contracts is unacceptable. It hinders the government’s ability to accomplish the mission of providing medical care to beneficiaries. Inclusion of such conditions in an employer’s employment agreement will result in an offeror’s proposal being unacceptable. Awardee, and their subcontractors, shall not include such conditions in employment agreements while performing under this contract.

3.2. Conflict of Interest

3.2.1. The contractor or contract HCPs shall not bill the patient for services rendered under this contract. The contractor or contract HCPs shall not request or accept compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract, at the rate specified.

3.2.2. The contractor or contract HCPs shall not, while performing services under this contract, advise, recommend, or suggest to persons eligible to receive medical care at Government expense that such persons should receive care from the contractor or contract HCPs or from any third party at any place other than as designated under this contract.

3.2.3. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of health care services under this contract. The contractor shall not release any of the above information without prior written consent of the KO. The contractor/contract HCPs shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication. The contract HCPs shall prepare medical records, forms and documents as required, in accordance with the regulations and established guidelines listed in the contract.

3.2.3.1. Contract HCPs shall abide by federal and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and the HCP as may be necessary for security and personnel reliability programs. They shall also 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 (HIPAA) of 1996. All regulations referenced are available for review from the MTF, COR/QAE, or the KO. All medical records and reports will remain the property of the government.

3.2.4. The contractor shall not employ active duty military or government civilian employees to perform services under this contract.

3.2.5. The contractor or contract HCPs shall not use Government facilities, supplies, or equipment in private practice or for any purpose other than providing the health care services required under this contract.

3.2.6. Each contract service provider shall have proof of U.S. Citizenship (certified copy of birth certificate or naturalization papers required.)

3.3. Security

3.3.1. Army Trusted Associated Sponsorship System (TASS)

3.3.2. The contractor shall comply with agency personal identity verification procedures that implement Homeland Security Presidential Directive-12 (HSPD-12), Office of Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

3.3.3. The contractor shall comply with agency personal identity verification procedures in all subcontracts when the subcontractor is required to have physical access to a federally controlled facility or access to a Federal information system.

3.3.4. The contractor shall ensure compliance with the provisions set forth below. For purposes of the Federal Acquisition Regulation (FAR) Clause 52.204-9, the government will designate a Trusted Agent (TA) for this contract. The government reserves the right to amend or supplement these provisions pursuant to the Changes clause in the contract.

3.3.5. The contractor is responsible for absences of HCPs due to expired identification and access documents. Such absences shall not relieve the contractor of its obligation to perform the services required under this contract.

3.3.6. In-processing Requirements. The HCPs are prohibited from performing services under this contract absent compliance with the in-processing requirements set forth below.

3.3.7. The government will sponsor the contract HCPs for an Army Knowledge Online (AKO) account. All HCP e-mail addresses will identify them as a contractor and use the format firstname.lastname.ctr@us.army.mil. The AKO will be discontinued by the government when the HCPs no longer require access.

3.3.8. The government TA will send a notice through the TASS to the AKO e-mail address provided IAW the above requirement. The HCP’s user ID and password will be provided in the e-mail and will be require a change at first log-in. In the event the e-mail message is not received, the contractor may request the username and password from the TA and proceed to the website https://www.dmdc.osd.mil/tass to complete the process.

3.3.9. The HCP shall log into the TASS and complete the verification process by submitting the application back to the TA for approval.

3.3.10.. The application will be accepted, returned, or rejected by the TA. Notice as to whether the application has been accepted, returned, or rejected will be provided to the HCP’s e-mail address within 48 hours after submission. If the application is returned or rejected, the HCP shall contact the TA and comply with the TA’s guidance to attempt to correct and resolve the issue(s).

3.3.11. Upon approval of the application, the HCP will receive an e-mail stating the CAC application was approved. The applicant must then go to a RAPIDS Issuing Facility to have the government credential issued. Effective 1 December 2011, Fort Sam Houston, ID section require an appointment. To make an appointment, the HCP will follow the instructions provided by the TA and contact the COR for instructions. If the HCP chooses Randolph or Lackland AFB, the supervisor or government task manager must send a visitor message prior to the HCPs arrival on-site. The HCP must present two acceptable forms of ID which may include: Driver's License, Military ID, Contractor Company ID with picture and expiration date, charge card with picture imprinted, or passport.

3.3.12. Revalidation Requirements. The TA is required to revalidate all HCPs, in the TASS, every 6 months. In the event revalidation is denied, the CAC credentials shall be revoked and the CAC will not be useable to log in.

3.3.13. Out-processing Requirements. When a HCP’s performance under this contract ceases, the HCP shall personally bring the CAC to the TA and complete the DA Form 2962. The TA will revoke the CAC from the TASS.

3.4. Orientation and Training.

3.4.1. MTF in-processing checklist. When commencing work under this contract, the contract HCPs shall obtain in-processing checklist(s) from the COR/QAE or designated office. All contract HCPs are required to complete the applicable items on the checklist and turn it in to the designated office. Upon completion of the duty assignment, the contract HCPs shall complete an out-processing checklist and return it to the designated office.

3.4.2. MTF and Unit Orientation. The expectation of a contract health care provider is that they are fully trained, therefore the contract HCPs will be provided with a Government paid orientation to familiarize the contract HCPs with the policies and procedures of the MTF, assigned department and specific unit.

3.4.2.1. Unit orientation will be scheduled and accomplished by the appropriate department and will be tailored to the needs of the unit and the individual HCPs. The first two shifts a new employee works will be orientation shifts. Pool personnel will be scheduled for two consecutive days on the same unit. Operating Room LVNs shall have a five (5) day orientation. Orientation for the burn unit HCPs varies depending on their experience with burn patients. The unit orientation is eight hours a day and normally provided during the day shift.

3.4.2.2. The unit orientation consists of but is not limited to familiarization with the work-center, uses of ESSENTRIS (automated documentation), Pyxis, military time, military hospital protocol, unit level quality assurance program, and location of emergency equipment. If the supervisors, department COR/QAE, or the agency deem additional orientation is necessary it will be at the government’s expense.

3.4.3. Annual training requirements. The contractor shall ensure that contract HCPs complete any mandatory annual Government or medically unique training requirements in accordance with MTF procedures. All contract HCPs shall meet continuing education requirements. The government will not reimburse for these costs. The COR/QAE may approve contractor HCPs to attend, in an unpaid status, MTF continuing education classes on a space available basis.

3.4.4. Government unique training. The government may elect to provide unique government training to contract HCPs who are performing services under this contract. If the government elects to provide such training, the government will provide such training at no additional expense to the contractor or to the contract HCP. When directed by the KO, contract HCPs 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 contract HCP and the contractor shall reimburse the government (by means of a credit on the next invoice) if a contract HCP fails to satisfy the performance commitment after the contract HCP 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 contract HCP fails to complete the performance commitment. The length of the performance commitment will be stated in the task order.

3.4.5. Computer Training. Contract HCPs who have any interaction with the MTF computer systems must receive training for the applicable system(s). The COR/QAE will coordinate the necessary computer training. The training will be on-site and during normal duty hours. This training will be at no cost to the contractor. These systems include but are not limited to:

3.4.5.1. Composite Healthcare Computer System (CHCS) is the military’s world-wide automated medical information system that interfaces with 40 plus external clinical and administrative systems.

3.4.5.2. Armed Forces Health Longitudinal Technology Application (AHLTA) contains the MTF’s appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the MTF. In addition, it contains the electronic medical records for MHS beneficiaries.

3.4.5.3. Ambulatory Data System (ADS). This computer system produces forms on which the providers identify the appropriate billing codes for diagnoses and procedures for each patient. In addition, contract HCPs working in Labor and Delivery will be trained on the Labor and Delivery Statistics System (LADS).

3.4.6. The contractor shall ensure contract HCPs have received Occupational Safety and Health Administration (OSHA) required training for the position in which they will perform, and that training currency is maintained. Documentation of such training shall be provided to the COR/QAE.

3.4.7. AT Level I Training. This provision/contract text is for contractor employees with an area of performance within an Army controlled installation, facility or area. All contractor employees, to include subcontractor employees, requiring access to Army installations, facilities and controlled access areas shall complete AT Level I awareness training within XX calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting Officer, if a COR is not assigned, within XX calendar days after completion of training by all employees and subcontractor personnel. AT Level I awareness training is available at the following website: https://atlevel1.dtic.mil/at.

3.4.7.1. Access and General Protection/Security Policy and Procedures. This standard language text is for contractor employees with an area of performance within an Army controlled installation, facility or area. Contractor and all associated sub-contractors employees shall comply with applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

3.4.7.2. Contractor Employees Who Require Access to Government Information Systems. All contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DOD Information Assurance Awareness prior to access to the information systems and then annually thereafter.

3.4.7.3. For Information assurance (IA)/information technology (IT) training. All contractor employees and associated sub-contractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoDD 8570.01 dated 14 Mar 2014, DoD 8570.01-M dated 10 Nov 2015 and AR 25-2 dated 24 Oct 2007 place dates within six months of employment.

3.4.8. Operational Security (OPSEC) Requirement

3.4.8.1 Investigation Requirements. The contractor providing service under this contract is required to initiate and document the new employee’s Electronic-Questionnaires for Investigations Processing (e-QIP) and coordinate, or validate through the SAMMC Security Manager’s Office all background investigation requirements needed for employment at SAMMC, or in SAMMC organizations. Clearances will be validated using the Joint Personnel Adjudication System (JPAS) when a new employee begins in-processing after contract is awarded. The SF 85P Questionnaire for Public Trust Positions is to be completed and printed and electronic copies (downloaded from internet program) are to be hand carried to the SAMMC Security Manager prior to performance. The Contractor shall have proof of U.S. citizenship (certified copy of birth certificate or naturalization papers) or a valid U.S. Immigration Form 1-151 and Alien Registration Card ("Green Card"). As a minimum, the contractor providing service requiring operating government-furnished workstations that have access to Department of Defense e-mail and requiring unescorted entry to a restricted area/Controlled Areas, must successfully complete a National Agency Check (NAC). The contractor shall coordinate and schedule appointments with the SAMMC Security Manager prior to performance. The SAMMC security manager will initiate the Request for Personnel Security Action, review the security questionnaire and request a Local File Check from the Provost Marshall prior to scheduling an appointment with the Security Specialists to submit the e-QIP for processing. This security questionnaire must be completed and processed by the SAMMC Personnel Security Office prior to contract performance. The contractor is responsible for monitoring the coordination and completion of the scheduled appointment date and time with the Security Manager.

3.4.8.2. Freedom of Information Act Program (FOIA and Privacy Act). The contractor shall comply with DOD Regulation 5400.7-R, DOD Freedom of Information Act Program requirements. The Freedom of Information Act sets policy and procedures for the disclosure of records to the public and for marking handling transmitting and safeguarding For Official Use Only materials.

3.4.8.3. Reporting Requirements. The contractor shall comply with DoD 5200.2-R, January 1987, Personnel Security Program and AR 380-67, 24 Jan 2014, Department of the Army Personnel Security Program Regulation. Contractor shall report to the SAMMC Security Manager any information or circumstances which may pose a threat to DOD or contractor personnel, resources, or DOD information.

3.4.8.4. Removal of contract employee. The government reserves the right to require immediate temporary or permanent removal of any individual whose actions raise reasonable suspicion that patient care or services may be compromised in any way or that pose a threat of harm to other contractor/government personnel or self. The employee may be required to submit to drug/alcohol testing. The government reserves the right to require temporary or permanent removal of any individual who refuses testing. Notification of all removals will be made by the Contracting Officer Representative (COR). Removal of any individual does not relieve the contractor of any performance requirement.

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

3.4.8.6 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 (NAC), before obtaining access to the computer. These investigations shall be submitted by the government at no additional cost to the contractor. Common Access Cards (CACs) for Contractor Personnel are required which is hereby incorporated by reference if not otherwise included. The contractor shall comply with Homeland Security Policy Directive (HSPD)-12, Policy for Common Identification Standard for Federal Employees and Contractors and Federal Information Processing Standard 201

3.4.8.7. Keys and Lock Combinations. The contractor shall abide by all current SAMMC key control and lock combination procedures The Contractor shall be responsible for any keys issued to the employee. The keys shall not be duplicated. The Contractor shall ensure that its employee’s not allow government-issued keys be used by personnel other than those currently authorized. No unauthorized personnel shall be allowed entry into the locked area. Keys shall not be used to open work areas for personnel other than personnel engaged in performance of their duties, unless authorized by the Government functional area chief. The employee shall use keys issued to them to secure/open areas only as directed by the COR and/or functional area chief. Lost keys and/or locks shall be reported to the issuing party and COR immediately upon recognition of the loss. The COR shall notify the PMO of the lost key. The employee shall be responsible for the replacement costs of any lost keys and any associated locks. Reimbursement shall be provided before the Government replaces lost keys or performs re-keying.

3.4.8.8. Reserved

3.4.9. Key Control. The contractor shall safeguard all keys issued by the government and insure they are used only by authorized contractor personnel. The contractor shall not duplicate issued keys and shall report lost keys to the contracting officer immediately the contractor will be charged for lost keys, re-keying, and lock 1.1.1 Security Requirements: Work under this contract is UNCLASSIFIED. The Contractor shall comply with all applicable DoD security regulation and procedures during the performance of this contract. The Contractor shall not disclose and must safeguard procurement sensitive information, computer systems and data, Privacy Act data, and Government personnel work products obtained or generated in the performance of this contract.

3.4.10. Government a Common Access Card (CAC). Contractor employees will be issued by the Government a CAC which is required for access to Government computer databases and entrance to the installation. Additionally, all Contractor employees must be issued a special identification card issued by SAMMC PMO Badge and ID Office prior to reporting for duty. The Contractor shall be responsible for the control and safe keeping of all Government issued IDs and ensure all badges are returned to the COR upon termination of an employee or the contract end date. The Contractor shall ensure all contractor employees are aware that in the event either of the Government IDs are lost or stolen that they are to advise the PM or alternate immediately upon discovery. The Contractor shall ensure that the COR is notified the same day the employee reports an ID lost or stolen. The Government shall conduct criminal background checks on all Contractor employees in accordance with the procedures set forth in Public Law 100-235, DoD Directive 5200.28, DoD Directive 5200.2-R, DoDI 1402.5. and submit to the PM or the Alternate. The Contractor is responsible for ensuring all Contractor employees must complete the SF86, Authorization for Release of Information form and ensure all background check submittals are initiated in accordance with this PWS prior to employees providing services at SAMMC facilities. Background checks shall be based on fingerprints of individuals obtained by qualified Government law enforcement or security personnel, inquiry’s conducted through the Federal Bureau of Investigation (FBI) and the State Criminal History Repository check, and a local Installation Record Check., if required. The procedures for completing the required background check are outlined in the Department of Defense Instruction (DoDI) 1402.5. Government will not allow any employees to start work until clearance of criminal background check has been completed.

3.4.11. Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use at the end of each business day. The Contractor shall ensure all government facilities, equipment, and materials shall be secured at the close of each duty day.

3.4.12. Antiterrorism (AT) / Operations Security (OPSEC) Requirements: For OPSEC to be effective, all Contractors must be aware of OPSEC and understand how OPSEC complements traditional security programs. All personnel must know how to apply and practice OPSEC in the performance of their daily tasks. OPSEC must become a mindset of all Contractor employees and be performed as second nature. To accomplish this level of OPSEC vigilance, OPSEC training programs must be action and job-oriented, enabling the workforce to put into practice the knowledge and tactics, techniques, and procedures (TTPs) they learned in training. Training should maximize the use of lessons learned to illustrate OPSEC objectives and requirements. In order to ensure accomplishment of training, the Government will include OPSEC training as a part of their organization’s annual training guidance. Contractor employees must complete Level I OPSEC and AT Awareness training within 30 calendar days of reporting to duty in according to Army Regulation 530-1 and 525.13. AT Level I awareness training is also available at https://atlevel1.dtic.mil/at.

3.4.13. iWATCH Training: The Government will brief all Contractor personnel on the local iWATCH program. This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to their COR. Contractor employees must complete iWATCH training within 30 calendar days of reporting to duty.

3.4.14. SHARP: The contractor shall ensure all service providers receive Sexual Harassment/Assault Response and Prevention (SHARP) training not later than 60 calendar days after contractor personnel begin performance under this contract. Training can be obtained either online or in person. Contractor personnel can attend SHARP training provided by MEDCOM on an every other month basis by contacting (210) 221-8361 for class date/time and availability. If contract individuals have an AKO account, they can access online the Team Bound Self Study course through Army Learning Management System (ALMS) at http://www.atsc.army.mil/tadlp/delivery/alms.asp

3.4.14.1. The contractor shall comply with OTSG/MEDCOM Policy Memo 19-019, Policy for Reporting Incidents of Sexual Assault and Sexual Harassment under the Sexual Harassment/Assault Response and Prevention (SHARP) Program, 21 March 2019. The SHARP reporting requirements apply only to knowledge obtained by contractor personnel while performing services under this contract.

3.4.14.2. The contractor shall require all Contract Service Providers (CSP) with knowledge of an incident of sexual assault occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours of gaining knowledge of the incident) report the incident in writing to the government's COR. This reporting policy also applies to sexual assault incidents involving MEDCOM personnel that occur on the contractor's owned or leased facility under this contract. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals, when the incidents occur on a Government facility or a Government leased facility.

3.4.14.3. The contractor shall require all CSPs with knowledge of an incident of sexual harassment occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours of gaining knowledge of the incident) report the incident in writing to the government's COR. This reporting policy also applies to sexual harassment incidents involving MEDCOM personnel that occur on the contractor's owned or leased facility under this contract. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals, when the incidents occur on a Government facility or a Government leased facility.

3.5. MTF Hours of Operation

3.5.1. Hospitals and medical centers provide services 24 hours a day, 365 days a year (366 days during leap years) including holidays. Clinics have designated operating hours. Hours of operation will be outlined in the task orders.

3.5.2. Holidays. The following is a list of legal federal holidays. Any of the federal holidays falling on a Saturday will be observed on the preceding Friday, holidays falling on a Sunday will be observed on the following Monday. Contract employees may be required to work on legal holidays as determined by the department chief and stated on the task order.

New Year’s Day, January 1st Martin Luther King’s Birthday, 3rd Monday in January President’s Day, 3rd Monday in February Memorial Day, Last Monday in May Independence Day, July 4th Labor Day, 1st Monday in September Columbus Day, 2nd Monday in October Veteran’s Day, November 11th Thanksgiving Day, 4th Thursday in November Christmas Day, December 25th

3.5.3. Contract HCPs may be required to report to work as scheduled during emergencies, disasters or during adverse weather conditions. Contract services will still be required during these situations if stated on the task order.

3.5.4. Closures. During anticipated closure of the facility due to Command declared training holidays or unplanned closure of the facility due to natural disasters, military emergencies, severe weather, or otherwise, the contractor will only be paid for the actual hours that were worked.

3.6. Hours of Performance

3.6.1. Task orders will identify the hours performance is required along with the scheduling process.

3.6.1.2. The contractor shall provide employees to support a seven (7) day/week, 24 hour/day operation to include holidays. Below is an example of common shift times which consist of eight (8) work hours with a non-paid 30 minute lunch or dinner break, and a 12 hour shift with a 30 minute non-paid lunch or dinner break. The maximum number of shift hours to be scheduled in a twenty-four hour period is twelve.

*Any eight- (8) hour day shift may begin between the hours of 0600 to 1300.

The contractor will provide employees with written instructions on how to properly fill out time sheets. If an employee does not write “no lunch” on the time slip when the employee did not take the 30 minute lunch, 30 minutes of time is automatically deducted from the hours worked.

3.6.1.3. Full Time Personnel (FTE)(FTE=1920 hours): Employees will normally work 32-40 hours per week on rotating shifts Sunday through Saturday, including Federal holidays. Nurses may be required to work over 40 hours in a one week period resulting in overtime. Overtime must be approved by the Section Supervisor or Eve/Night Supervisor. Any employee may be “floated” to work within their scope of practice in another unit if patient census requires this measure.

3.6.1.4. Pool Personnel: Employees who will be requested to work in the absence of the full time employee, or during periods of increased patient census. Pool nurses will not be guaranteed a specific number of hours per pay period. Pool nurses must work a minimum of three (3) shifts per month to ensure competency and maintain employment.

3.6.2. Scheduling. The COR/QAE or their designee will be responsible for communicating with the program manager regarding scheduling issues. The shift supervisor may act as point of contact after normal duty hours, weekends, and holidays. In such cases, the COR/QAE will confirm all actions on the next normal working day.

3.6.3. Absences and leave.

3.6.3.1. The contractor shall notify the COR/QAE when a scheduled contract HCP cannot fill a shift due to illness or emergency. Employees who cancel a shift do so by contacting the contractor who then notifies the COR/QAE or Nursing Supervisor (after hours) 2 hours prior to the scheduled shift.

3.6.3.2. If required by the task order, the contractor shall have sufficient qualified personnel available so that all services are provided in the event an HCP scheduled to work becomes ill, resigns, is terminated, or is otherwise unavailable to work. All proposed substitutes/replacements (no matter when they are proposed during the performance period) shall have qualifications equal to or higher than the qualifications of the person being substituted or replaced. All proposed substitutes/replacements shall meet the identical application submission procedures specified in 3.1.5.1. prior to performing services.

3.6.3.3. Full Time Nurses (FTE) - The contractor shall provide a replacement nurse for any nurse who is absent from duty, whether scheduled or unscheduled upon request of COR/QAE, Head Nurse or Nursing Supervisor.

3.6.3.4. Pool Nurses - If pool nurses, for whatever reason, become unavailable for their scheduled shift the contractor shall provide a substitution within 2 hours upon notification of absenteeism of such personnel.

3.6.3.5. When the contractor experiences delays in recruiting or submitting credentials or profile packages, the contractor shall notify the ordering KO immediately. The ordering KO will evaluate the situation to determine if an extension of the dates is appropriate. If an extension is not approved, the Government may terminate the task order for default or seek other remedies as appropriate.

3.6.3.6. Scheduled absences of contract HCPs shall be coordinated with the COR/QAE at least 30 calendar days in advance.

3.7. PATIENT INCREASE. In addition to the monthly schedule from the COR/QAE, any additional requirements will be projected as far in advance as possible; however, for situations such as increases in patient acuity or census, the government reserves the right to request additional shifts.

3.8. PATIENT DECREASE. In the event that patient acuity or census decreases, the COR/QAE or the on-duty supervisor will provide the following alternatives; float the contracted nursing personnel to other appropriate patient care units to administer nursing care or cancel any scheduled shift or shifts for the pool nurses. If a contract nurse refuses to float to another area although the work required is within their scope of practice, disciplinary action or termination may result. The Deputy Commander for Nursing or the COR/QAE will notify the contractor’s point of contact at least two (2) hours prior to the start of the shift to cancel any pool nurse. If the two (2) hour cancellation option is not implemented by the government, and the pool nurse is referred to work, the government will pay for the first two hours of the shift. Should a pool nurse be cancelled prior to completion of any shift, the government will pay for actual time worked.

3.9. License Verification and Credentials Review or Privileging (If Applicable).

3.9.1. The contractor shall follow Army Regulation (AR) 40-68. Army Regulation 40-68 is located at http://www.usapa.army.mil/pdffiles/r40_68.pdf. Air Force Instruction is located at http://www.e-publishing.af.mil/. Complete credentials or profile packages shall be submitted within the time frames stated in the task orders.

3.9.1.1. 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 in accordance with guidance. The contractor shall obtain all paperwork, letters of reference, approvals, work history, etc. required by the MTF credentialing or 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 HCPs used to provide health care services under this contract.

3.9.1.2. Licensure, certification, registration, or authorizing documents. All contract HCPs under a personal services task order must maintain a current, active, valid and unrestricted license or authorizing document from any U.S. state, District of Columbia or U.S. territory or jurisdiction to provide healthcare within the scope of practice for a specific health care discipline. In addition, contract HCPs who write prescriptions for controlled substances must have a current Drug Enforcement Agency (DEA) certificate or Controlled Drug Substance number as appropriate. The contractor shall ensure that renewal actions are accomplished well before expiration of the provider’s license and/or DEA certification to ensure compliance with the contract. DEA certificates are not necessary at overseas location. The licenses and certificates shall be renewed and maintained in a current status during the life of the task order. All licensure and renewals shall be submitted to the appropriate MTF office as appropriate, failure to do so is grounds for dismissal.

3.9.2. If the contractor adds additional/or replacement HCPs during the contract period, the same qualification standards, and health requirements shall apply.

3.9.3. The contractor shall not use any individual to provide direct health care services under this contract if that individual, within the past 5 years.

3.9.3.1. Has had his/her clinical privileges limited, suspended, or revoked by any healthcare facility, public or private, anywhere in the world.

3.9.3.2. Is the subject of a current or pending hearing or appeal brought by any health care facility, public or private, anywhere in the world, which may result in the limitation, suspension, or revocation of the individual’s clinical privileges.

3.9.3.3. This prohibition does not apply to any individual whose clinical privileges, although originally limited, suspended or revoked by a health care facility, were subsequently fully reinstated by the health care facility.

3.9.3.4. Limitation of clinical privileges, as used in this paragraph, refers to a partial…