Draft PWS for Sources Sought Notice (911-EMS Fort Irwin) 08132026.pdf

DRAFT

PERFORMANCE WORK STATEMENT (PWS)

911 EMERGENCY MEDICAL SERVICES (EMS)

WEED ARMY COMMUNITY HOSPITAL

U.S. ARMY MEDICAL DEPARTMENT ACTIVITY (MEDDAC)

FORT IRWIN OPERATIONAL AREA-RANGES, FORT IRWIN CALIFORNIA

PART 1

GENERAL INFORMATION

1. GENERAL: This is a non-personal services contract as defined by Federal Acquisition

Regulation (FAR) 37.101. It is expressly understood that the services rendered under this contract shall be performed by the Contractor as an independent contractor and not as an employee or agent of the Government. The Government shall not exercise supervision or control over the

Contractor’s employees in the performance of services required under this contract. The

Contractor shall be solely responsible for the management, supervision, training, conduct, and performance of its personnel.

The purpose of this contract is to provide comprehensive 911 Emergency Medical Services (EMS) for the Fort Irwin military installation and supported communities. The Contractor shall furnish all personnel, supervision, management, ambulances, vehicles, medical equipment, communications equipment, contractor-furnished operational supplies, maintenance, certifications, training, logistics support, and all other resources necessary to perform the requirements of this Performance Work Statement. Pharmaceuticals, medications, controlled substances, and routine medical supplies required for EMS operations shall be provided through the Medical Treatment Facility (MTF).

The Contractor shall remain fully responsible for contract performance and mission accomplishment at all times. Any action taken by Government personnel during an emergency, contingency, or operational disruption shall not relieve the Contractor of responsibility for meeting the requirements of this contract.

1.1. DESCRIPTION OF SERVICES/INTRODUCTION: The Contractor shall include all functions, tasks and responsibilities normally performed by a ground ambulance emergency response and transport organization for (2) ground ambulances 24 hours a day, 7 days a week, 365 or 366 days a year providing Emergency Medical Technicians (EMT), Paramedics, and a Senior Level

Paramedic that shall serve as an On-Site Program Manager in support of U.S. Army Medical

Department Activity (MEDDAC) Fort Irwin Operational Area-Ranges, NASA Goldstone Deep

Space Communications Complex, Fort Irwin, California as outlined in the Performance Work

Statement (PWS). Government-furnished pharmaceuticals and medical supplies shall be utilized in support of EMS operations when provided through the MTF.

1.2. SCOPE: The Contractor shall provide, operate, manage, and maintain a fully functional, comprehensive Emergency Medical Services (EMS) program in support of Fort Irwin, California, including the National Training Center (NTC) operational areas and the NASA Goldstone Deep

Space Communications Complex.

1.3. OBJECTIVES: The Government’s objective is to obtain a fully operational, reliable, responsive, and professionally managed Emergency Medical Services (EMS) capability for Fort

Irwin without personal-services supervision of Contractor employees.

The Contractor shall provide continuous pre-hospital emergency medical care, Advanced Life

Support (ALS), Basic Life Support (BLS), patient assessment, stabilization, treatment, transportation, and related EMS services throughout the designated operational area.

The Contractor shall provide and maintain a qualified EMS Medical Director throughout the period of performance. The Contractor-provided EMS Medical Director shall serve as the clinical authority for EMS operations and shall provide medical oversight, clinical protocols, standing orders, quality assurance guidance, scope of practice oversight, and other medical direction functions in accordance with applicable Federal, State of California, local EMS authority, DoD, DHA, Army, and contract requirements.

1.4. PERIOD OF PERFORMANCE:

12-month base plus two (2) 12-month option periods.

1.5. GENERAL INFORMATION:

1.5.1. Quality Control Plan (QCP): The Contractor shall develop, maintain, and execute a comprehensive Quality Control Plan (QCP) to ensure all services are performed in accordance with this Performance Work Statement (PWS). The Contractor shall establish procedures to identify, prevent, correct, and prevent recurrence of performance deficiencies.

The Contractor shall submit the initial QCP to the Contracting Officer (KO) and Contracting

Officer’s Representative (COR) within thirty (30) calendar days after contract award. Updates to the QCP shall be submitted whenever significant operational changes occur or as requested by the KO.

At a minimum, the QCP shall address procedures for monitoring and ensuring compliance with all contract requirements, including staffing levels, personnel qualifications, vehicle readiness, ambulance availability, medical equipment readiness, Government-furnished pharmaceutical and medical supply accountability, inventory control, training compliance, response times, documentation accuracy, infection control practices, patient care reporting, and corrective action processes.

The QCP shall include performance monitoring methods, internal inspection procedures, deficiency tracking mechanisms, root cause analysis procedures, corrective action timelines, and management review processes necessary to ensure continuous contract compliance and operational readiness.

1.5.2. Quality Assurance: The Government shall evaluate the Contractor’s performance in accordance with the Quality Assurance Surveillance Plan (QASP). Government surveillance may include inspections, observations, audits, records reviews, response-time monitoring, equipment inspections, personnel credential verification, vehicle readiness assessments, and other methods deemed necessary to verify compliance with contract requirements.

Government surveillance activities do not relieve the Contractor of responsibility for quality control, operational readiness, or performance of the requirements contained in this Performance

Work Statement (PWS).

When performance deficiencies are identified, the Government may require corrective action. The

Contractor shall investigate the deficiency, identify the root cause, implement corrective measures, and provide a written corrective action plan within the timeframe specified by the

Contracting Officer (KO) or Contracting Officer’s Representative (COR).

The Contractor shall cooperate fully with Government quality assurance personnel and shall provide access to records, reports, facilities, vehicles, equipment, inventories, certifications, training records, and other documentation necessary to verify contract compliance.

1.5.3. Recognized Holidays: The Contractor shall provide uninterrupted EMS services during all federally recognized holidays, weekends, training holidays, emergency conditions, and other non-duty periods throughout the period of performance.

1.5.3.1. U.S. Holidays: Work shall be performed on U.S. federally recognized holidays occurring during the normal work week unless otherwise directed by the Contracting Officer.

NOTE: U.S. holiday occurs on a Saturday or a Sunday, the holiday is observed on the preceding

Friday; holidays falling on a Sunday shall be observed on the following Monday.

New Year’s Day (Observed 1 January)

Martin Luther King Jr’s Birthday (Observed the third Monday in January)

Presidents' Day (Observed the third Monday in February)

Memorial Day (Observed the last Monday in May)

Juneteenth (Observed 19 June)

Independence Day (Observed 4 July)

Labor Day (Observed the first Monday in September)

Columbus Day (Observed the second Monday in October)

Veterans Day (Observed 11 November)

Thanksgiving Day (Observed the fourth Thursday in November)

Christmas Day (Observed 25 December)

1.5.4. Operating Hours: The contractor shall provide services 24 hours a day, 7 days a week, 365 days a year, to include Federal holidays, regardless of national emergencies. The Contractor shall at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS. When hiring or terminating personnel, the contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.5.4.1. Government Facility Office Hours: Government administrative offices are generally open Monday through Friday during normal business hours, excluding federal holidays and

Government-directed closures.

Government office closures shall not relieve the Contractor of responsibility to provide uninterrupted EMS services in accordance with this PWS.

1.5.4.2. Government Facility Closures: Government facilities may be closed due to local emergencies, national emergencies, severe weather, force protection conditions, administrative closures, or other Government-directed actions.

Unless specifically directed otherwise by the Contracting Officer, such closures shall not suspend, interrupt, or reduce the Contractor’s responsibility to provide required EMS services.

1.5.4.3 Contractor Support Hours: The Contractor shall maintain sufficient staffing and operational support capability to sustain continuous EMS operations during all periods of performance, including weekends, federal holidays, training holidays, military exercises, surge operations, mass casualty incidents, and emergency conditions.

The Contractor shall provide supervisory, administrative, logistical, maintenance, and operational support necessary to maintain mission readiness and uninterrupted EMS

1.5.4.3.1 Contract Work Plan: The Contractor shall develop and maintain a staffing and operational work plan sufficient to support all EMS requirements identified in this contract.

The work plan shall demonstrate how the Contractor will maintain continuous operational readiness, qualified staffing levels, supervisory coverage, vehicle availability, medical equipment readiness, Government-furnished pharmaceutical accountability procedures, and contingency capabilities necessary to meet mission requirements throughout the period of performance.

1.5.5. Place of Performance: The primary area of performance includes Fort Irwin, California, the National Training Center (NTC) operational and training areas, and the NASA Goldstone Deep

Space Communications Complex.

PENDING GOVERNMENT DETERMINATION OF CONTRACTOR WORKSPACE/FACILITY

SUPPORT.

1.5.6. Field Hours and Special Event Support: The Contractor shall provide EMS coverage for

Government-directed training events, exercises, community events, emergency preparedness activities, mass casualty exercises, and other special events as identified by the Government.

1.6. SECURITY REQUIREMENTS: The following information is provided on security related matters.

1.6.1 Security Program: Fort Irwin is a restricted-access military installation. Contractor personnel shall obtain and maintain all installation access credentials, identification badges, background investigations, vehicle registration requirements, and approvals necessary to perform under this contract. Personnel denied installation access shall not perform work under this contract.

Upon award of the contract, the Contractor shall immediately contact the COR for processing procedures to meet the security requirements, for information needed to access the installation/MTF initially, as well as in-processing forms.

1.6.2 Personnel Security Requirements: The Contractor shall ensure all personnel assigned to perform under this contract meet applicable Federal, Department of Defense (DoD), Department of the Army, Defense Health Agency (DHA), and Fort Irwin installation security and access requirements throughout the period of performance. Documentation demonstrating compliance shall be maintained and provided to the Government upon request.

Failure of Contractor personnel to obtain or maintain required security, credentialing, licensing, certification, or access requirements shall not relieve the Contractor of responsibility for uninterrupted contract performance.

1.6.3 Installation Access: The Contractor shall be responsible for obtaining and maintaining all installation access credentials, badges, permits, registrations, vehicle authorizations, and approvals required for personnel, subcontractors, vehicles, and equipment performing under this contract. Access to Fort Irwin installations, buildings, and controlled areas is limited to authorized personnel who meet applicable security requirements.

Failure to obtain or maintain required installation access authorizations shall not relieve the

Contractor of responsibility for contract performance. The Government shall not be responsible for delays, increased costs, or performance impacts resulting from the Contractor’s failure to obtain or maintain required installation access.

1.6.3.1 Emergency Access Requirements: The Contractor shall establish and maintain procedures necessary to ensure uninterrupted Emergency Medical Services (EMS) operations during installation access restrictions, force protection conditions, gate closures, security measures, emergency situations, and other access limitations.

1.6.3.2. Common Access Cards (CAC) and CAC Accountability: The Contractor shall provide all information required by the Government to process Common Access Cards (CACs), installation access credentials, vehicle registrations, and other access authorizations necessary for contract performance.

The Contractor shall ensure all Personally Identifiable Information (PII) is collected, transmitted, stored, protected, and disposed of in accordance with applicable Federal, Department of Defense

(DoD), Department of the Army, Defense Health Agency (DHA), cybersecurity, privacy, and information assurance requirements.

The Contractor shall establish accountability procedures for all Government-issued CACs, identification badges, installation access credentials, vehicle passes, and access devices issued to Contractor personnel.

The Contractor shall immediately report lost, stolen, compromised, or unaccounted-for credentials to the COR, Contracting Officer (KO), and appropriate installation security officials.

Upon employee separation, reassignment, contract completion, or when access is no longer required, the Contractor shall ensure all Government-issued credentials are returned in accordance with installation procedures.

1.6.4 Background Investigations and Suitability Determinations: Contractor personnel shall meet all applicable background investigation, suitability, and installation access requirements in accordance with applicable Federal, DoD, Army, DHA, and Fort Irwin requirements prior to performing services under this contract. Personnel determined ineligible to perform duties under this contract shall be removed and replaced by the Contractor without interruption of contract performance. Documentation supporting compliance shall be maintained and provided upon

Government request.

1.6.4.1. Personnel Eligibility and Replacement Requirements: The Contractor shall ensure personnel assigned to this contract maintain all qualifications, licenses, certifications, registrations, and suitability requirements necessary to perform assigned duties. Personnel determined ineligible to perform contract duties shall be promptly replaced without interruption of contract performance.

1.6.5 Physical Security: The Contractor shall safeguard Government-furnished property and information provided for contract performance. Government facilities, equipment, materials, and other Government properties shall be secured in accordance with applicable Army, DoD, DHA, and Fort Irwin physical security requirements.

All Government facilities, equipment, materials, records, Government-furnished pharmaceuticals, controlled substances, and operational assets shall be secured in accordance with applicable

Federal, Department of Defense (DoD), Department of the Army, Defense Health Agency (DHA), Fort Irwin, and Army Regulation (AR) 190-5 Physical Security Program requirements.

1.6.6 Operations Security (OPSEC): The Contractor shall comply with all applicable Operations

Security (OPSEC), force protection, information security, cybersecurity, and installation security requirements throughout the period of performance.

The Contractor shall ensure all personnel receive required OPSEC training and understand their responsibilities for protecting sensitive operational information, emergency response capabilities, staffing information, communications systems, facility locations, emergency response plans, and mission-critical information.

1.7. KEY CONTROL: The Contractor shall maintain accountability and control of all Government-issued keys, key cards, Common Access Cards (CACs), access devices, and other access credentials provided for contract performance. Lost, stolen, duplicated, compromised, or unaccounted-for items shall be reported immediately to the COR, KO, and appropriate

Government authorities. All Government-issued items shall be returned upon employee separation, reassignment, contract completion, or when access is no longer required.

1.8 Post-Award Conference/Periodic Progress Meetings: The Contractor shall attend any post award conference convened by the contracting activity or contract administration office in accordance with FAR Subpart 42.5. The Contracting Officer, COR, and other Government personnel, as appropriate, may meet periodically with the Contractor to review the Contractor's performance. At these meetings the Contracting Officer will appraise the Contractor of how the

Government views the Contractor's performance and the Contractor shall appraise the

Government of problems, if any, being experienced. Appropriate action should be taken to resolve outstanding issues. These meetings shall be at no additional cost to the Government.

1.8.1 Contractor Participation: The Contractor shall attend, participate in, and furnish input to scheduled and unscheduled meetings, conferences, and briefings that relate to the functions and services herein as required by the Government to provide effective communication and impart necessary information. The Contract Manager or designated representative shall attend meetings as requested by the Government. Meeting attendees shall at times include Contractor managerial, supervisory, and other personnel knowledgeable of the subject matter. Meetings may start or end outside of regular duty hours

1.9 Contracting Officer’s Representative (COR): A COR will be appointed in writing by the

Contracting Officer (KO) in accordance with FAR, DFARS, and applicable Army acquisition policies. The COR shall monitor technical performance and contract compliance but is not authorized to modify contract terms, authorize changes, obligate Government funds, direct additional work, or alter the scope of the contract.

The Contractor shall comply with all written direction issued by the KO and shall recognize that only the KO possesses authority to modify the contract.

1.10 Key Personnel: The Contractor shall provide and maintain qualified key personnel necessary to perform all requirements of this contract, including but not limited to the Program

Manager, Operations Manager, Medical Director, Lead Paramedics, EMTs, Quality Control personnel, Training personnel, and other positions necessary to maintain uninterrupted EMS operations.

Key personnel shall possess all licenses, certifications, credentials, and qualifications required by

Federal, State of California, ICEMA, DHA, Army, and local regulatory authorities.

The Contractor shall notify the KO and COR in writing prior to replacing any designated key personnel and shall ensure replacement personnel meet or exceed the qualifications of the individual being replaced.

1.11 Identification of Contractor Personnel: Contractor personnel shall be clearly identifiable at all times while performing duties under this contract.

The Contractor shall provide identification badges for all personnel. At a minimum, badges shall display the employee’s name, photograph, employer, certification level, and functional position.

Contractor personnel shall identify themselves as contractor employees and shall not represent themselves as Government employees.

The Contractor shall maintain accountability for all identification credentials and immediately recover such credentials upon employee separation, reassignment, suspension, or termination.

1.11.1 EMS Provider Identification: EMTs, Advanced EMTs, Paramedics, Supervisors, and other licensed medical personnel shall display credentials reflecting their current certification level and scope of practice.

1.12 Data Rights: All reports, patient care documentation, operational records, quality assurance records, performance metrics, training records, inventories, deliverables, databases, electronic records, and other contract-generated materials produced under this contract shall become

Government property unless otherwise specified by law.

The Contractor shall maintain all records in accordance with HIPAA, DHA policies, DoD requirements, Federal records management requirements, and applicable privacy laws.

1.13 Non-Disclosure Requirements: Performance under this contract may require the

Contractor to access data and information proprietary to a Government agency, another

Government Contractor, or of such nature that its dissemination or use other than as specified in this work statement would be adverse to the interests of the Government or others. The Contractor and Contractor personnel shall not divulge or release data or information developed, or obtained under performance of this PWS, except to authorized Government personnel or upon written approval of the Contracting Officer. The Contractor shall not use, disclose, or reproduce proprietary data, which bears a restrictive legend, other than as specified in this PWS. All documentation showing individual names or other personal information shall be controlled and protected under the provisions of the Privacy Act of 1974, Public Law 93-579, 5 United States

Code (U.S.C.) Section 552a.

1.14 Protection of Government and Contract Information: The Contractor shall not release, publish, distribute, market, advertise, photograph, record, disclose, or otherwise use Government information, patient information, operational information, facility information, emergency response information, imagery, logos, mission data, or contract-related information without prior written approval from the KO.

This prohibition includes websites, social media platforms, promotional materials, advertisements, recruiting materials, public presentations, and media communications.

1.15 Organizational Conflict of Interest (OCI): Contractor and subcontractor personnel performing work under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCI as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting

Officer to avoid or mitigate any such OCI. The Contractor’s OCI Mitigation Plan will be determined to be acceptable solely at the discretion of the Contracting Officer. In the event the Contracting

Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may affect other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the OCI. The Contractor shall immediately disclose any actual, apparent, or potential Organizational Conflict of Interest (OCI) and shall submit a written mitigation plan within five (5) business days of identification. Failure to disclose an OCI may constitute grounds for contract remedies, including termination.

1.16 Phase-In/Phase-Out Period: The Contractor shall accomplish an orderly transition sufficient to ensure uninterrupted EMS services at contract start and contract completion. The Phase-In period shall include activities necessary to achieve operational readiness prior to the start of performance. Phase-In and Phase-Out activities shall be performed at no additional cost to the

Government.

1.17 Safety: The Contractor shall establish, implement, maintain, and enforce a comprehensive safety and occupational health program for all personnel performing under this contract. The program shall comply with all applicable Federal, State of California, DoD, DHA, Army, OSHA, Fort Irwin, ICEMA, and local safety regulations, standards, directives, policies, and procedures.

The Contractor shall be responsible for protecting its employees from workplace hazards and shall provide all safety equipment, personal protective equipment (PPE), training, medical surveillance, exposure control measures, immunizations, and safety resources necessary to safely perform all contract requirements.

1.17.1 Contractor Employee Medical Care and Occupational Injuries: The Contractor shall be solely responsible for providing, arranging, coordinating, and funding all medical evaluation, treatment, transportation, workers’ compensation benefits, occupational health services, disability management, follow-up care, and related expenses associated with injuries, illnesses, exposures, or medical conditions sustained by Contractor personnel during contract performance.

Government medical facilities, Occupational Health Clinics, Troop Medical Clinics, Emergency

Departments, or other Government healthcare resources are not intended to provide routine occupational healthcare services for Contractor personnel.

In the event of a medical emergency involving Contractor personnel occurring on Government property, Government personnel may provide immediate lifesaving measures, first aid, emergency stabilization, or emergency medical response necessary to prevent loss of life, limb, or eyesight until appropriate medical care is available.

Provision of emergency assistance by the Government shall not create any Government liability for medical treatment costs, workers’ compensation claims, disability claims, transportation costs, follow-up care, occupational health services, or any other associated expenses.

The Contractor shall remain fully responsible for all costs and obligations associated with care of its employees.

1.18 Required Training: The following provides information on training requirements.

1.18.1 Anti-Terrorism (AT) Level I Training: All Contractor personnel requiring access to Fort

Irwin facilities, installations, or controlled areas shall complete Anti-Terrorism Level I Awareness

Training prior to receiving unescorted installation access and thereafter as required by current

DoD and Army policy.

The Contractor shall maintain training records and provide proof of completion upon Government request.

1.18.2 Operations Security (OPSEC) Training: All Contractor personnel shall complete OPSEC training prior to performing duties under this contract and shall complete recurring refresher training as required by applicable Army and DoD regulations.

Personnel shall protect operational information, mission information, emergency response information, deployment information, communications information, and any other information designated as sensitive.

1.18.3 iWATCH Training: The Contractor shall ensure personnel receive iWATCH Army awareness training and understand procedures for recognizing, documenting, and reporting suspicious activities, security concerns, insider threats, or activities that may impact installation security.

1.18.4 Information Assurance and Cybersecurity Training: Contractor personnel requiring access to Government networks, systems, applications, databases, electronic health records, communications systems, or information systems shall complete all required cybersecurity, information assurance, and cyber awareness training in accordance with DoD, DHA, Army, and local installation requirements.

1.18.5 HIPAA, Privacy Act, and PII Training: All Contractor personnel shall complete training related to HIPAA, the Privacy Act, Protected Health Information (PHI), Personally Identifiable

Information (PII), cybersecurity awareness, patient confidentiality, records protection, and information safeguarding prior to performing duties and annually thereafter.

1.18.6 Combatting Trafficking in Persons: The Contractor shall comply with Federal Acquisition

Regulation (FAR) 52.222-50, Combating Trafficking in Persons, and all applicable Federal laws, regulations, and Department of Defense policies related to the prevention of human trafficking.

The Contractor shall not engage in, support, or permit trafficking in persons, procurement of commercial sex acts, use of forced labor, or any activity prohibited by FAR 52.222-50.

The Contractor shall immediately notify the Contracting Officer and COR of any credible information regarding violations of trafficking in persons requirements involving Contractor personnel, subcontractors, or agents performing under this contract.

The Contractor shall ensure all employees performing under this contract are informed of the requirements of FAR 52.222-50 and shall cooperate fully with any Government investigation related to alleged violations.

1.19 Government Property and Services: Government-furnished property, facilities, services, equipment, medications, medical supplies, and other Government support provided for contract performance are identified in Part 3 of this Performance Work Statement (PWS). The Contractor shall use all Government-furnished resources only for the performance of this contract and shall maintain accountability, security, protection, and proper stewardship of all Government property in accordance with applicable Federal, Department of Defense (DoD), Defense Health Agency

(DHA), Army, and local installation requirements.

1.20 Safeguarding Material, Confidential Information, PHI, PII, and Cybersecurity: The contractor shall be responsible for safeguarding all Government property provided or obtained in connection with this contract. The Contractor shall safeguard information of a confidential or sensitive nature. Neither the Contractor nor any of its contract HCPs shall disclose or cause to be disseminated any information concerning the operation of the MTF that could result in or increase the possibility of a breach in security or interrupt the continuity of operations or which breaches the requirements of the Federal Privacy Act of 1974. However, the Contractor and/or Contractor

HCPs may be required to provide testimony in legal or administrative procedures. Such participation shall be consistent with the disclosure requirements imposed in this contract and coordinated with the contracting officer.

a. The contract HCP under this contract shall have access to and/or process information requiring protection under the Privacy Act of 1974. These positions are considered "Automated

Data Processing (ADP) Sensitive" positions. Compliance with applicable regulations is mandatory for ADP Sensitive positions.

b. Unless otherwise specified, all financial, statistical, personnel, and/or technical data, which is furnished, produced or otherwise available to the Contractor and/or Contractor HCPs 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 and/or contractor HCPs shall not release any of the above information without prior written consent of the KO. The contractor and contract HCPs shall prepare medical records, forms and documents as required, in accordance with the regulations and guidelines established in the contract and those established by the MTF Director.

c. The Contractor and contract HCPs shall abide by federal and local MTF regulations and requirements concerning the nature of 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, to include but not limited to the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act

(HIPAA) of 1996. All regulations referenced are available for review from the COR, MTF, or the

KO. All medical records and reports will remain the property of the Government.

1.20.1 Medical Records and Patient Information:

The Contractor shall prepare, maintain, secure, and transfer all patient care documentation in accordance with DHA, Army, State of California EMS requirements, ICEMA requirements, HIPAA, and applicable medical records management regulations.

Patient records, PCRs, ePCRs, quality review documents, and related medical documentation generated under this contract shall remain Government property and shall be made available to the Government upon request.

1.20.2 STANDARDS OF PERFORMANCE: The Government requires that the Contractor shall provide technically competent certified personnel requirements identified in Technical Exhibit B.

a. The Contractor shall follow the State of California EMS requirements and remain in good standing throughout the life of this contract.

b. Other performance evaluation factors will be monitored that are not quantified by numerical measurements which include: Contractor providing personnel exceeding the minimum qualification standards; patient customer service comments; provider relationship with consultants; and Contractor relationship with hospital staff/government contracting personnel;

compliance with hospital policy and procedures.

c. Performance Reports will be provided by the COR monthly to the Contracting Officer to ensure acceptable performance of the contract. The Contractor can request copies also be forwarded to the assigned Contractor POC. The Contractor POC will receive notice of UNACCEPTABLE

PERFORMANCE within 7 days of the COR becoming aware of any unacceptable performance and will report it to the Contracting Officer.

d. The Contractor shall be responsible for the security of all patient information.

e. Neither the Contractor nor any of its contract service providers shall disclose or cause to disseminate any information concerning operations of military activities. Such action(s) could result in violation of the contract and possible legal actions.

f. All inquiries, comments or complaints arising from any matter observed, experienced, or learned of as a result of or in connection with the performance of this contract, the resolution of which may require the dissemination of official information, shall be directed to the contracting officer representative (COR) and the contracting officer.

g. The Contractor shall only conduct business with designated government personnel listed as points of contact (POCs). Names of authorized personnel shall be provided to the Contractor by the Government, in writing, and updated as necessary throughout the contract period. The

Contractor shall designate the point of contact prior to the start of contract performance.

h. U.S. Government records, copies of original results and reports, verified original data, corrected data, and corrected supporting final reports are maintained by the Contractor, but remain the property of the U.S. Government. These files/results shall be surrendered to the COR.

i. Outcome: The Government requires that the Contractor provide qualified personnel who shall fulfill the performance requirements at a standard that meet DoD benchmarks for the MEDDAC to provide a high level of quality health care.

1.21. Professional Conduct: Contractor personnel shall demonstrate professional conduct, customer service, clinical competence, and ethical behavior while interacting with patients, Government personnel, visitors, and the public.

1.21.1 Performance Deficiencies: The Government may identify performance deficiencies through inspections, complaints, investigations, audits, QA reviews, response-time monitoring, documentation reviews, credentialing reviews, or direct observation.

The Contractor shall develop and implement corrective action plans when directed by the

Government.

1.22 Government Quality Assurance and Improvement (QA/QI): The Government will monitor the Contractor's performance under this contract using the quality improvement/assessment procedures established by MTF. Additionally, the Contractor's performance is subject to scheduled and unscheduled review by a Quality Assurance Evaluator as defined by the DHAPM

6025.13 and contract QASP specifics

1.23 Corrective Action Plans (CAP): The Contractor shall develop and submit a written

Corrective Action Plan (CAP) within five (5) business days, or within a timeframe specified by the

Contracting Officer, after notification of a performance deficiency.

The CAP shall include:

a. Description of the deficiency.

b. Root cause analysis.

c. Immediate corrective actions implemented.

d. Long-term preventive measures.

e. Responsible management personnel.

f. Completion milestones and timelines.

g. Verification methods to ensure recurrence prevention.

Implementation of a CAP does not relieve the Contractor of responsibility for meeting contract requirements.

1.23.2 Clinical Quality Improvement: The Contractor shall maintain an internal Continuous

Quality Improvement (CQI) program for all EMS operations performed under this contract.

The CQI program shall include review of:

• Response times.

• Clinical documentation.

• Medication administration.

• Airway management.

• Cardiac arrest care.

• Trauma care.

• Patient refusals.

• Sentinel events.

• Patient complaints.

• Equipment failures.

• Vehicle readiness.

• Infection prevention and control compliance.

The Contractor shall make CQI records available to the Government upon request.

1.23.3 Government Right to Remove Personnel: The Government may require removal of

Contractor personnel whose performance, conduct, professional qualifications, clinical competence, certification status, safety practices, security status, or behavior is determined to be unacceptable or detrimental to mission accomplishment.

The Contractor shall provide qualified replacement personnel within the timeframe established by the Contracting Officer or COR at no additional cost to the Government.

1.23.4 Performance Deficiency Documentation: Performance deficiencies may be documented through:

• QASP surveillance.

• COR observations.

• Government inspections.

• Patient complaints.

• Incident reports.

• Safety investigations.

• Clinical reviews.

• Security violations.

• Credentialing deficiencies.

• Staffing shortages.

• Vehicle inspections.

• Equipment inspections.

• Regulatory compliance reviews.

Repeated deficiencies may result in contractual remedies in accordance with applicable contract clauses and Federal acquisition regulations.

1.24 PRODUCTIVITY STANDARDS

The Contractor shall maintain staffing, operational readiness, vehicle availability, response capability, and workforce continuity sufficient to provide uninterrupted EMS services twenty-four

(24) hours per day, seven (7) days per week, including weekends, Federal holidays, training periods, leave periods, and emergency contingencies.

Performance standards include, but are not limited to, the following:

1.24.1 Staffing Continuity and Vacancy Coverage

The Contractor shall maintain sufficient qualified staffing to provide uninterrupted Emergency

Medical Services (EMS) coverage twenty-four (24) hours per day, seven (7) days per week throughout the period of performance. The Contractor shall maintain 100 percent staffing coverage for all required ambulance operations identified in this contract.

The Contractor shall provide qualified replacement personnel for vacancies, illnesses, injuries, resignations, disciplinary removals, military obligations, leave periods, credentialing delays, and other staffing shortages at no additional cost to the Government.

Failure to maintain required staffing levels or provide timely replacement personnel may result in performance deficiencies and contractual remedies in accordance with the Quality Assurance

Surveillance Plan (QASP) and applicable contract provisions.

1.24.3 Patient Complaints

The Contractor shall maintain professional conduct standards that minimize substantiated patient complaints.

All complaints shall be investigated by Contractor management and reported to the COR upon request.

Corrective actions shall be implemented when deficiencies are identified.

1.24.4 Operational Readiness

The Contractor shall maintain ambulances, medical equipment, communications equipment, staffing, and operational resources necessary to meet all contract requirements at all times.

1.24.5 Credentialed Personnel Documentation

SUBMITTING CREDENTIALS PACKAGES.

a. Submit Credentials Package on Credentialed Contract Workers. The Contractor shall provide a complete and accurate credentials package on credentialed contract workers as outlined DHAPM 6025.13, Volume 4. No start date will be established until credentials are verified by the credentials department. For healthcare providers on this contract that are privileged providers, privileges will be granted to meet the contract requirements by the commencement date. The credentials packages will be given to the COR to be routed to the MTF Quality team. Concurrently, the Contractor will ensure that Army EMS receives a copy of the credentials of the EMT/Paramedic healthcare providers.

b. The Contractor shall provide credentialing packages withing 30 days in advance of the anticipated start date to allow Government review, verification, and approval. Delays resulting from incomplete, inaccurate, missing, expired, or deficient credentialing documentation shall be the sole responsibility of the Contractor and shall not relieve the

Contractor of contract performance requirements.

c. 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.

d. All educational items, 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 verification processes. The MTF staff will not assist the Contractor in obtaining any needed information for initial credentialing. The Contractor is responsible for submission of evidence of current competency for the healthcare provider that is used to provide health care services under the PWS. Contractors will ensure that credentials are provided to the MTF each year after the initial credentialing. Healthcare workers that do not maintain the professionals certifications and licensures to remained credentialed and/or privileged, will not remain on the contract.

e. Primary Source Verification by one of the following accepted methods:

-Written confirmation directly from the issuing authority.

-Verbal telephone confirmation from the issuing authority. A detailed record of the telephone interaction will be documented, which will include the names of the organization and the individual contacted, date/time, phone number, signature, and title of the person responsible for verification.

-Via the internet. Such verification is acceptable if the information is obtained directly from the professional organization's website. Identification of the individual making the website contact, and the date will be annotated on the web page printout

-If the contractor adds additional or replacement healthcare providers during the contract period, the replacement shall meet the same qualification and credentialing/privileging standards as outlined in the DHAPM 6025.13, vol. 4 as well as the health requirements as stated in this PWS.

e. When there are concerns about suspected misconduct, impairment, incompetence, or any conduct which adversely affects, or could adversely affect, the health or welfare of a patient, or staff member, this will be reported immediately to the COR/KO. If there is a imminent concern for patient, staff or contract worker safety, a stop work will be immediately directed, involving the KO, COR and Contractor. The Contractor will cooperate with the USG if further investigation is required.

1.25 Personal Appearance

The Contractor shall ensure all personnel maintain a professional appearance consistent with the standards expected of emergency medical services personnel operating within a Department of

Defense medical environment. Personnel shall present a clean, professional, and military-compatible appearance that promotes public confidence, patient trust, safety, infection prevention, and mission readiness.

Contractor personnel shall comply with applicable Medical Treatment Facility (MTF) appearance standards, infection prevention requirements, occupational safety requirements, and local installation policies. The Government reserves the right to require correction of any appearance deficiency determined to negatively impact patient care, safety, professional standards, or mission effectiveness.

a. Uniform Standards The Contractor shall provide and maintain uniforms for all personnel assigned under this contract. Uniforms shall be clean, serviceable, properly fitted, free from excessive wear, and professionally maintained at all times while performing official duties.

b. Footwear Requirements Personnel shall wear closed-toe, closed-heel footwear appropriate for emergency medical operations. Footwear shall provide protection against bloodborne pathogens, bodily fluids, sharps hazards, slips, trips, and falls, consistent with

OSHA requirements and CDC infection control guidance.

c. Fingernails and Hand Hygiene Personnel shall maintain fingernails in a manner consistent with CDC Infection Prevention Guidelines, DHA infection control requirements, and MTF policies. Artificial fingernails, acrylic nails, nail enhancements, overlays, or excessive nail length that may interfere with hand hygiene practices, glove integrity, patient safety, or infection prevention measures are prohibited while performing clinical duties.

d. Hair and Grooming Standards Personnel shall maintain hair in a clean, neat, professional, and safe manner. Hair shall not interfere with patient care, personal protective equipment (PPE), respiratory protection devices, visual acuity, communication equipment, or operational readiness requirements.

e. Professional Conduct and Appearance Compliance The Contractor shall ensure personnel maintain professional appearance standards throughout the period of performance. Personnel whose appearance fails to meet established standards may be removed from duty until deficiencies are corrected.

Failure to comply with appearance requirements may be considered a performance deficiency subject to corrective action under the contract Quality Assurance Surveillance Plan (QASP).

1.26 Health and Immunization Requirements

All Contractor HCP performing health care services under this contract assigned to a medical treatment facility are required to be screened for applicable immunizations or pre-existing immunity based on occupational risk, regardless of job series. The expense for all physical examinations to comply with the health requirements shall be borne by the contractor at no additional cost to the Government. All HCP shall comply with the Health and Immunization requirements identified below at the time of initial request for clinical privileges and annually thereafter.

a. All Contractor service performing direct health care services under this contract shall receive a general physical examination prior to commencement of services. The

Contractor shall provide the Contracting Officer's Representative, 10 calendar days before beginning services under this contract, a physical examination certificate for each individual direct health care provider who will provide services. The certification shall state the date on which the physical examination was completed and the name of the physician who performed the examination. This certification shall be signed by the physician performing the examination. For the purposes of this paragraph, a physical examination administered more than 45 days prior to performance of the contract will not be considered adequate. The physical examination shall include the following:

(1) A history to show that Direct Health Care provider has completed a primary series of immunization with tetanus and diphtheria toxoids and that a booster dose containing tetanus, diphtheria and pertussis is current (within the past 10 years).

(2) A test for the hepatitis (Type B) virus with documentation of the results. A profile shall be established to show immune status to hepatitis. Non-immune Health Care Workers (lacking anti-

HB(c) or anti-HB(s)) shall be required to complete an immunization series with a Hepatitis-B vaccine (e.g., Recombivax, Engerix).

(3) The physical examination shall also document serologic evidence of immunity to measles and rubella or to provide documentation of immunization with measles, mumps and rubella (MMR) vaccine using the following guidelines:

(a) Health care personnel born before 1957 without documentation of previous vaccination with MMR should receive one dose.

(b) Health care personnel born in or after 1957 who have received one dose of MMR previously shall receive one booster dose.

(c) Health care personnel born in or after 1957, without documentation of any previous vaccination with MMR, should receive two doses of vaccine, separated by no less than one month.

(4) Contractor's health care providers shall be screened…