Draft Requirements Document - GMSS.pdf

U.S. Department of State Draft Requirements Document

Bureau of Medical Services Global Medical Support Services (GMSS)

SECTION C – DESCRIPTIONS/SPECIFICATIONS/STATEMENT OF WORK

Disclaimer: The nature of projects to be awarded under this contract is broad. Specific requirements will be conveyed at the task order level. The Government expects awardees to remain flexible and adaptive to meeting Department requirements. Contractors are reminded that this is a multiple-award IDIQ contract. As such, Contractors will be required to compete, unless an exception to fair opportunity procedures is approved, for each task order over the micro-purchase threshold (i.e., currently $10,000 USD). Awardees are not guaranteed anything other than the minimum contract quantity described in Section B. Due to budgetary and program uncertainties, the size or number of orders to be issued under these contracts cannot be reliably estimated.

C.1 INTRODUCTION

Mission of the U.S. Department of State: The U.S. Department of State (hereinafter referred to as “DOS”, “State”, or “the Department”) is the lead institution for the conduct of American diplomacy and the Secretary of State is the President’s principal foreign policy advisor. The

Department of State’s mission is to advance U.S. national security interests, fight terrorism, protect

U.S. interests abroad, and implement foreign policy initiatives that build a freer, prosperous, and secure world.

Mission of the Bureau of Medical Services (MED): MED’s global mission to provide preventive, primary, and emergency medical care to Chief of Mission (COM) personnel is accomplished through global programs and echelons of care, from health unit medical providers and regional medical centers, to resources in the United States. The Washington-based MED team works closely with overseas counterparts to ensure the safety of America’s diplomatic community of 75,000 people including employees, interagency partners, and family members assigned to U.S.

missions abroad. Further, MED provides initial occupational health services to the diplomatic community and the locally employed staff population of over 150,000. MED’s combined Civil and Foreign Service, domestic, overseas, and contractor workforce, providing professionalism, expertise, and agility to meet the Department’s medical needs.

Mission of the Operational Medicine Program (OpMED): The essential functions of the

OpMED Program are planning, developing, resourcing, and executing medical contingency plans to enhance the security of COM personnel engaged in high-risk environments worldwide, providing senior decision-makers with flexible response options to identify and mitigate emerging medical risks and employing professionals trained, experienced, and equipped to operate in high-risk environments. Activities of the OpMED Program complement the Department’s medical program abroad by supporting mission medical health unit staff and assisting missions in emergency medical preparedness in all environments.

General Scope: This non-personal services contract is designed to support MED’s and OpMED’s global missions through the provision of a broad range of medical services and equipment supply support including but not limited to those services listed in Section C of the contract. This Global

Medical Support Services (GMSS) contract provides a full range of medical services, equipment and supplies to the U.S. Department of State and other U.S. Government agencies under COM authority and, under special circumstances, non-COM activities around the globe. There are no geographic limitations to where work may be performed in support of efforts undertaken through this contract vehicle.

C.2 VISION

The GMSS Indefinite-Delivery, Indefinite-Quantity (IDIQ) contract aims to:

a) Establish a streamlined approach to successfully meeting the Government’s acquisition requirements, while maintaining the public’s trust and fulfilling public policy objectives.

b) Create opportunities for DOS to augment U.S. Government staff in the continental United

States and in regions overseas, where demand for services exceeds U.S. Mission capacity to support, as well as capture significant savings, achieve economies of scale, and promote efficiencies in back-office operations.

c) Acquire medical support services and supplies under a broad global contract to sustain diplomatic platforms and provide flexibility to support the Department and its missions around the world.

d) Remove duplicative and unnecessary variations in U.S. Government requirements and inefficient processes to realize cost savings. This includes reduced costs for contracts that would otherwise have to provide such services to U.S. missions through a disparate framework of support efforts.

e) Develop a group of highly reliable medical service and supply support contractors capable of supporting current and future needs of the Department and U.S. Government agencies and offices in the United States and overseas.

f) Provide for increased safety and improved health for COM personnel and others as designated by the Secretary of State. This includes the reduced likelihood of serious injury, impairment or death resulting from inadequate, incomplete, or non-immediate care and treatment.

g) Provide for advancements in the field of medicine through innovative performance and information technology approaches to the provision of support services.

h) Provide IDIQ holders the ability to offer cost-effective solutions and the opportunity to propose innovative alternatives for meeting the objectives of each task or delivery order.

C.3 SCOPE

Task and delivery order requirements to be procured against this contract vehicle include and are not limited to the following:

a) Procurement of medical, emergency medical, and surgical support services in locations around the world, including but not limited to locations deemed high-threat, high-risk

(HTHR) and in areas that the Department of Defense has designated as overseas contingency operations, as defined in 10 U.S.C. 101(a)(13).

b) Procurement of medical, emergency medical, and surgical equipment to enable MED and

OpMED to provide optimal quality of care to designated patient populations worldwide.

The Contractor shall assemble, integrate, test, and deliver the equipment and provide transportation, installation, on-site training, warranty, technical support, maintenance, and all miscellaneous requirements necessary to accomplish the efforts described within each task or delivery order.

Additional supplies and services, within the general scope of the contract, will be added at the task order level. In addition to the areas described in this document, the Government considers services and supplies covered under the following North American Industry Classification System

(NAICS) codes to be within the scope of this contract:

NAICS Description

622110

(Primary)

General Medical and Surgical Hospitals

423450 Medical, Dental, and Hospital Equipment and

Supplies Merchant Wholesalers

621511 Medical Laboratories

621512 Diagnostic Imaging Centers

621910 Ambulance Services

621991 Blood and Organ Banks

621999 All Other Miscellaneous Ambulatory Health Care

Services

624221 Temporary Shelters

624230 Emergency and Other Relief Services

334516 Analytical Laboratory Instrument Manufacturing

334517 Irradiation Apparatus Manufacturing

334519 Other Measuring and Controlling Device

Manufacturing

481211 Nonscheduled Chartered Passenger Air

Transportation

C.3.1 Other Government Agencies

The Department of State works with a large number of partner agencies to execute its worldwide medical and contingency medical mission. This contract vehicle can be used to support DOS and its partners.

C.3.2 Services Not In Scope

The Contractor shall not accept or perform work for a task order involving:

a) Inherently Government Functions as defined in FAR 2.101(b)

b) Personal Services as defined in FAR 2.101(b)

C.4 OVERARCHING REQUIREMENTS

C.4.1 Program Management

a) Robust program management is critical to the ability of the Contractor and Department to meet its objectives. The Contractor shall be able to effectively coordinate operations across a number of U.S. Governmental, non-governmental, and host nation organizations to achieve the overall goals of each task and delivery order.

b) The Contractor’s corporate management structure shall guarantee senior, high-level program management of this program. The Contractor shall provide management support for performance requirements including, but not limited to: oversight of Government-established quality control/assurance procedures, safety, environmental, project management, leases, storage, contractor communications, travel, visas, and taxes.

c) Contractor Program Management will be dynamic throughout the entire period of performance. The Contractor will be expected to provide frequent briefings to different stakeholders to apprise them of program objectives, plans, activities, and status updates.

d) The Contractor must be flexible if there is a disruption to the schedule and be able to re-prioritize, re-order, and re-schedule necessary elements with guidance and concurrence provided by the Contracting Officer (CO) and/or Contracting Officer’s Representative

(COR) and Government Technical Monitors (GTMs).

e) The Contractor’s program management shall work consistently to bridge any divides between the various stakeholders, technical teams, and management.

f) The Contractor shall obtain all necessary host country licenses, visas, and permits to operate within the place(s) of performance for each task order, and meet all applicable tax and fee requirements. The Contractor shall comply with all applicable current and future

U.S. federal, state, local, and host country laws, rules, and regulations.

g) The Contractor shall provide trained and certified health care professionals and administrative service support as required at the task order level.

h) The Contractor shall staff, operate, equip, and supply health care facilities in locations prescribed by the Department of State as required at the task order level.

i) The Contractor shall subcontract for support services and supplies as needed to meet the needs of the Department under this contract.

j) The Contractor will be relied upon by the Department to scale and augment its existing capabilities to support its global medical missions.

k) The Contractor shall ensure staff members receive (as applicable) cultural sensitivity and host nation familiarization courses, Foreign Affairs Counterthreat Training, High Threat

Post training, and other required courses based on DOS standards regulations.

C.4.2 Customer Service and Support

The Contractor is expected to maintain a customer-focused approach to the work, ensuring a high level of customer satisfaction while operating within the terms and conditions of the contract. The

Contractor will also need to work with a wide variety of customers to successfully perform this work. The Contractor shall:

a) Meet the customer’s requirements for timeliness, quality, and cost efficiency. This will include the design and development of appropriate, mutually agreed upon quality assurance surveillance plans with viable metrics for performance.

b) Proactively identify risks, issues, and problems and recommend plans for mitigation, whether under Contractor or DOS control.

c) Implement and oversee Government-established quality control/assurance measures and procedures.

d) Work with customers to resolve issues or problems dealing with any products or services provided under this contract. The Contractor shall resolve problems to the satisfaction of the customers and with minimal impact on the mission.

e) Refer issues and problems immediately to the COR or the appropriate Alternate

Contracting Officer’s Representative (ACOR) and GTMs.

f) The Contractor will be responsible for seeking innovative solutions to perform the medical mission.

g) Develop a Customer Satisfaction Survey to use in soliciting customer feedback and gauging customer satisfaction for areas of service performed under this contract, at the task order level. Customer Satisfaction Surveys shall be integrated into the Contractor’s quality control/assurance measures and procedures.

C.4.3 Standard Operating Procedures

As required at the task order level, the Contractor shall develop Standard Operating Procedure

(SOP) documents to define ongoing services to be provided in quantitative and qualitative terms while at the same time providing descriptive instructions on how to achieve/complete specific operational functions (one SOP for each required operational function). The SOP is a living document and can be changed at any time in response to innovative performance improvements.

The SOP shall specifically detail the roles/responsibilities of the “provider” (Contractor) and the

“client” (U.S. Government), clearly defining and describing where (when applicable) one provides a service to another. The SOP document will utilize a combination of text and diagrams (swim lane and flow chart) to clearly illustrate processes. SOP development will be further defined at the task order level but will generally consist of two drafts submitted for Government review and comment followed by a final draft, which is subject to approval by the Government.

In developing the SOPs, the Contractor shall incorporate process improvements and industry best practices. The Contractor shall review, maintain, and update SOPs annually to ensure documentation is reflective of the current processes employed. The Contractor shall ensure that

SOPs include:

a) Performance Standards

b) Acceptable Quality Level (AQL)

c) Definitions

d) Required Procedures

e) Diagrams, if necessary

f) Organizational Structure/Key Personnel

g) Performance Measures/Metrics

h) Quality Control/Assurance Procedures

i) References

Additionally, a joint Government and Contractor annual review of all SOPs will be conducted 30 calendar days prior to exercising any contract option year to determine if SOPs remain valid or require updating.

C.4.4 Corporate Program Manager (CPM) (IDIQ Level)

The Contractor’s corporate management structure shall guarantee senior, high-level program management of the GMSS Program. The contractor shall provide management support for performance requirements including, but not limited to, oversight of quality control, safety, environmental, project management, freight, leases, storage, contractor communications, travel, visas, and taxes. The Contractor shall assume total performance responsibility for work performed and data delivered under each task order and shall ensure proper management of all subcontractors.

The Contractor shall coordinate management efforts with Government personnel as required. The

Contractor shall identify issues and formulate and provide alternatives for issue resolution.

The Contractor shall assign a Corporate Program Manager (CPM) to represent the company on all program and contract related matters.

The CPM duties include, but are not limited to:

a) Verifying that the CO soliciting and/or awarding task orders under this contract is authorized to do so. Verification may be obtained by contacting the Administrative

Contracting Officer (ACO) identified in Section G of this contract;

b) Ensuring administrative functions are performed in a timely manner and in compliance with contract and task order requirements;

c) Being ultimately responsible for ensuring that all reporting information required under this contract and resultant task orders is provided accurately, thoroughly, and timely;

d) Being ultimately responsible for all performance issues related to this contract and task orders awarded under it;

e) Being ultimately responsible for ensuring that all contractual agreements, including modifications, are negotiated and executed expeditiously; and

f) Being ultimately responsible for ensuring that all invoicing is accurate and timely.

The CPM shall have sufficient corporate authority to direct, execute, and control all elements of this contract and resultant task orders. If the CPM does not have contractual authority to bind the

Contractor, the Contractor shall ensure an individual with authority to bind the Contractor is readily available at the request of the COR and the CO.

The CPM need not be a full-time employee. Such individual shall be on-call during normal duty days. For the purpose of this requirement, a “normal duty day” is defined as Monday through

Friday (excluding Federal Holidays) from 8:00 am until 5:00 pm Eastern Time.

The Contractor shall assign, with the concurrence of the CO or COR, temporary replacements to cover for the CPM during periods of CPM paid-time off. Such replacements must be delegated the same authority and responsibilities as the CPM.

The Contractor shall provide, no later than one business day after award of the IDIQ contract, point of contact (POC) information (address, email, telephone, and cell phone) for the CPM, and if applicable, for the individual authorized to bind the Contractor. The Contractor shall provide updated POC information to the Government as required to ensure timely communications.

During task order performance, the CPM shall respond within one (1) business day to all emails sent by the CO and/or COR.

The CPM shall ensure timely, compliant, and complete résumés, security packages, and language certifications are provided to the Government.

The CPM shall ensure that all invoices submitted under resultant task orders: 1) comply with the requirements of the contract and task order; 2) are complete and correct; and 3) include all necessary back-up documentation. All invoices shall be submitted on a timely basis, and any issue identified by the Government shall be promptly corrected by the Contractor.

The CPM shall ensure that all records required under the contract and task orders are properly maintained, safeguarded from unauthorized disclosure, and backed-up. The CPM shall promptly make such records available to the COR and CO upon request.

C.4.5 Program Manager (Task Order Level)

Certain task orders may require a Program Manager at the level. That information will be conveyed at the task order level.

C.4.6 Asset Management

The Contractor shall possess an expert knowledge and understanding of asset management to successfully perform the workload requirements of this contract. The Contractor will be responsible for instituting asset management industry best practices in order to document and monitor all asset changes, updates, and modifications. The Contractor shall abide by the conditions and reporting requirements of FAR Clause 52.245-1 (Government Property) and DOSAR Clause

652.245-71 (Special Reports of Government Property) found in Section I of the contract.

C.4.7 Contractor Safety Programs

The Contractor shall develop and implement a Project Safety Program Plan based on U.S. codes and regulations, Occupational Safety and Health Administration (OSHA) standards, and DOS

Overseas Buildings Operations (OBO) facilities guidelines and Safety and Health

Environmental Management (OBO/SHEM) requirements.

The Contractor must submit a draft Project Safety Program Plan within 15 days of contract award. The Contractor must submit a final Project Safety Program Plan within 15 days of receiving Government comments on the draft. If a task order requires a Project Safety Program

Plan the Project Safety Plan will be reviewed by the Facility Manager (FM), RSO, and Post

Occupational Safety and Health Officer (POSHO), identified for a given site or country and accepted by the COR. The Project Safety Plan shall then be distributed as needed, and used as part of the training for all Contractor personnel arriving at Post. A draft Project Safety Plan will be due to the CO thirty (30) calendar days after Task Order award. The final plan will be due sixty (60) calendar days after Task Order start and shall be reviewed and updated by the

COR, Facility Manager, RSO, and POSHO and approved by the CO, annually. The Contractor shall develop and implement Safety Plans for each country and worksite in which work is performed.

C.4.8 Reporting Requirements

C.4.8.1 Communications

a) The Contractor shall establish reliable communications between work parties, headquarters, Program Office, host nation counterparts (as approved by the Program

Office), and others as appropriate to ensure activities are well coordinated and that results are efficiently achieved.

b) The Contractor shall be knowledgeable in local languages or provide interpreters to ensure effective communications with and between teams in the field.

C.4.8.2 Monthly Progress Reports

The Contractor shall provide monthly progress reports after the issuance of the first task order.

These reports shall be in sufficient detail to allow the Government to clearly understand progress achieved and the reasonableness of costs incurred. It shall also include performance metrics and monitoring in accordance with the Quality Assurance Surveillance Plan (QASP) approved under this contract. Individual task orders will specify reporting requirements.

C.4.8.3 Lessons Learned Report

Within two weeks after the completion of each task order, the Contractor shall provide a lessons learned report and seek disposition instructions of any equipment remaining under said task order.

One copy should be delivered to the cognizant COR or GTM.

C.4.8.4 Serious Incident Reporting (SIR)

The Contractor shall provide a Serious Incident Report (SIR) for any and each serious incident.

For the purposes of this section, “serious incident” means any incident that results or is likely to result in:

a) Embarrassment or harm to the reputation of the U.S. Government, host country, and or

DOS;

b) Negative impact to program performance;

c) Serious injury or bodily harm to self or others;

d) Property damage, U.S. Government Furnished Equipment (GFE) or otherwise; or

e) Policy and legal violations, either programmatic, federal, host country, or contract/task order stipulated.

The SIR shall contain and identify in executive summary format (1 page or less), the “Who, What, Where, When, and How” of the incident. It shall be objective (i.e., without any type of interpretation, emotion, or motive).

The SIR shall be provided to the COR no later than four (4) hours after occurrence of a serious incident. The Contractor shall use the following subject line format when submitting SIRs.

SIR (Initial, Follow-up, or Final), Task Order Number, Contractor, and Location

The body of the email notification shall contain the synopsis of the action and the full report shall be attached.

C.4.8.5 Special Reports

Special reports may be requested as the circumstances dictate or as identified in individual task orders.

C.4.9 Ethics, Code of Conduct, and Personnel Policies

The Contractor shall develop and implement project personnel policies, a code of conduct program, and an ethics program that conform to U. S. Government, host country laws, and DOS policies. The Contractor shall ensure that, at a minimum, the project personnel policies, code of conduct program, and ethics program clearly explain the terms of employment, project compensation structures, expectations of project employees, project discipline procedures, and employee termination procedures. The Contractor shall ensure the project personnel policies, code of conduct program, and ethics program include any employee rights to mediation or recourse. The Contractor shall provide a Project Personnel Policy Handbook (in the native language of the employee) including the project code of conduct and the project ethics standards to their project staff no later than 10 days after date of hire. The Contractor must submit a draft Project Personnel Policy Handbook within 15 days of contract award.

The Contractor shall follow up promptly on any personnel or discipline matters and shall communicate regularly and promptly with the COR regarding any matters affecting contract performance including discipline, breach of code of conduct or ethics standards, or health-related conditions.

C.4.10 Threat Environment Security Plans

Work under this contract may be performed in countries that experience security contingencies due to civil unrest, terrorism, political violence, and crime. For certain places of performance (i.e., Critical Threat Environments), the task order will specify a Risk Mitigation Plan that must be adhered to by the Contractor – see Section C.4.10.1 below.

For other places of performance, the Contractor will be responsible for developing and implementing a comprehensive security program to protect their employees, and the employees from each subcontract, regardless of their country of origin, from such contingencies; and must develop a means to monitor, assess, and communicate changes in the security environment to their employees throughout the region.

The Contractor should seek professional advice in developing a security program tailored to the region where the work will be performed, or where an activity is undertaken to facilitate that work, to ensure the security program adequately mitigates the risks specific to that locale.

The security program shall, at a minimum, address physical, personal, and procedural security for employee housing/residences, transportation from housing to and from work venues, an action plan for medical/security-related emergencies, and the contractor’s security policy for employees for off duty recreational activities and those areas of the host nation that are deemed off limits due to the security environment. The comprehensive security program shall be documented in writing and submitted to the CO within 30 days after award. The Contractor will provide plan updates as necessary.

Adherence to this clause is considered integral to the performance of this contract, and failure to submit a plan consistent with these requirements or implement the plan may provide adequate ground for termination of the contract for default. This clause is to be read in agreement with FAR

52.225-19, which is incorporated into this contract, and nothing in this clause shall be read or construed as limiting the responsibilities of the contractor or its subcontractors as set out in that clause.

C.4.10.1 Critical Threat Environment Risk Mitigation Plans

Work under this contract may be required in critical threat environments. In these locations, the

Government will incorporate a DOS-approved Risk Mitigation Plan that the Contractor shall be responsible for developing and implementing.

C.4.10.2 Security Training for Contractors Abroad at High Threat/High Risk Locations

FAR Clause 52.225-19 "Contractor Personnel in a Designated Operational Area or Supporting a

Diplomatic or Consular Mission Outside the United States" paragraph (e)(2)(v) requires that all contractor personnel receive personal security training. The High Threat Security Overseas

Seminar for Contractors (HTSOS-C) course described below meets this requirement unless the contract requires more intensive security courses.

The Government is providing a High Threat, High Risk (HT/HR) security training course to the contractor for use in training all U.S. citizens and Third Country National (TCN) personnel assigned to a location on the Department of State's HT/HR list. The Contractor shall provide this training course to U.S. Citizens and TCN employees expected to be at that location for more than one (1) day (see exceptions below). The training is available in several languages and maybe conducted individually or in a classroom setting. The CO will advise the contractor on how to obtain the electronic course at time of award. The training must be taken by the employee in pre-deployment or within 15 days of being assigned to the HT/HR location and every five years thereafter, or upon transfer to a new contract.

Exceptions: Personnel who have taken a more intensive State Department approved security course such as the FSI course CT650, Foreign Affairs Counter Threat (FACT) course or a

Contractor-obtained equivalent FACT course, (if the course is approved by the CO in writing)will be considered to have met this requirement.

The Contractor shall file proof of each person trained in their Contractor-maintained personnel record and it must be available for inspection by the CO or COR upon demand. Since the training is good for five years, a training certificate should be provided to each trainee to use as proof of training for future positions.

Applicable locations will be specified at the task order level.

C.4.11 Post-Award Conference

The Contractor shall participate in a mandatory post-award conference that will be held at a time and place to be determined by the CO. The Government expects to conduct the post-award conference within two (2) weeks of contract award in the Washington, D.C. area. Time and place are subject to change.

C.5 DESCRIPTIONS OF SERVICES

MED’s patient population’s medical needs range across the lifespan, including pediatrics, obstetrics, adults, and geriatrics. MED encounters almost every disease Americans have. Health care staff support patients worldwide, and as such, must be sensitive to language barriers and cultural differences. The Contractor will be required to provide a comprehensive list of services and staff augmentation on a worldwide basis. The list below is just a sample of the types of services that may be required under this contract. Some of these services have been further defined in subsequent sub-sections, but individual task orders will be issued that will identify the specific tasks to be performed throughout the contract period of performance.

When providing services at medical clinics, health units, hospitals, or other locations, the

Contractor shall have the capability to provide any/all of the services listed below.

a) Primary care and specialty care services

b) Urgent, emergency, surgical, and trauma care

c) Post-operative and intensive care

d) Public health assessments, inspections, and education

e) Routine and emergency dental care

f) Physicals and drug testing support

g) Medical skills verification services

h) Supply and equipment maintenance and repair (biomedical and other)

i) Medical communications and automation support

j) Mortuary affairs-related services

k) Mass casualty planning, exercises, and training

l) Emergency care for USG service animals

m) Behavioral health services

n) Pharmaceutical Services

o) Radiology and/or tele-radiology services and Medical imaging services

p) X-ray and diagnostic ultrasound

q) Medical Laboratory services

r) General medical support services

s) Medical gases including tank refill/replacement

t) Routine and specialized patient examination services

u) Occupational health and wellness advisory support

v) Full spectrum of immunizations services

w) Clinical services including operation, support, and patient care

x) Medical/laboratory testing, patient examination and screening services

y) Life support services including medical evacuations

z) Medical/health related staff augmentation

aa) Sourcing and procurement of medical equipment and supplies, collection of biological samples and laboratory processing and analysis

bb) Design, fabrication, and deployment of modular health clinics (“Doc-In-A-Box”) solutions

cc) Coordination of medevac services with all interlocutors

dd) Other related services and support needed to enable MED and OpMED to achieve its global mission.

Individual task orders will specify what services are required at each location.

C.5.1 Primary and Specialty Care

Primary care shall be provided by trained personnel, skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern not limited by problem origin, organ system, or diagnosis. Primary care includes health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis, and treatment of acute and chronic illnesses in a variety of health care settings. This includes providing and coordinating day-to-day broad spectrum preventive and curative health care over an extended period of time.

For purposes of this contract, chronic care will be limited to preexisting, diagnosed, and treated chronic conditions as appropriate to accepted standards of care provided by a generalist physician or mid-level provider in the United States. Common chronic illnesses treated in primary care include: hypertension, angina, diabetes, asthma, chronic obstructive pulmonary disease, depression and anxiety, back pain, arthritis, and thyroid dysfunction. Continuity is a key characteristic of primary care. Primary care will be performed and managed by a provider at each site and when required, will collaborate with other health professionals utilizing consultation or referral as appropriate.

Specialty care includes advanced medically necessary care and treatment of specific physical, mental, or behavioral health conditions or those health conditions that require treatment of a specialist including but not limited to orthopedic, gynecologic, cardiac, testicular, deep vein thrombosis, etc.

C.5.2 Urgent, Emergency, Surgical and Trauma Care

The Contractor shall have the capability to provide urgent, initial emergency, surgical, and trauma care including overnight bed capability as required with the ability to provide triage, stabilization, and prepare patients for medical evacuation. The Contractor shall have operating room capability with anesthesia and supplies. The Contractor may be required to respond to emergency medical situations within the barriers of designated in the applicable task order. The contractor shall have the capability to provide emergency medical services on the scene, perform triage, initial resuscitation, and any advanced services required by medical necessity.

C.5.3 Post-Operative and Intensive Care

The Contractor shall have the capability to provide post-operative and intensive care for patients to be stabilized for up to 96 hours until medically evacuated.

C.5.4 Public Health Assessments, Inspections, and Education

In an effort to provide a safe and sanitary work and living environment, the Contractor must be capable of providing public health oversight. This includes conducting random and non-random public health sanitation inspections of common areas such as but not limited to: cafeterias, gymnasiums and local vendor food and bottled water deliveries. The Contractor shall monitor any instances of foodborne illness outbreaks, gastrointestinal cases and other vulnerability assessments that could impact the population of each location. The Contractor must be able to remain objective in order to analyze and report on other Contractor’s performance objectives.

The Contractor must be able to track and report occupational injuries, disease trends (e.g.

influenza-like illness), blood-borne pathogen and needle stick exposure programs, periodic health education and disease prevention programs and other services in accordance with industry standards. The Contractor may be required to highlight to the Department any significant threats to public health uncovered in inspections immediately. The Contractor must be able to implement and conduct robust health awareness classes and events to include but not limited to: smoking cessation, hypertension awareness and supporting other healthy lifestyle activities such as “fun runs.”

C.5.5 Dental Care

The Contractor shall have the capability to provide routine and emergency dental care services.

C.5.6 Physicals and Drug Testing Support

The Contractor shall have the capability to perform physicals, random and non-random drug testing for other third party contractors operating in support of Department operations.

C.5.7 Medical Skills Verification Activities

In the event other third party contractors supporting the Department require Emergency Medical

Technicians (EMTs) and paramedics, the Contractor may be required to assist with medic validation and verification to ensure the verification and maintenance of credentials for EMTs and paramedics. This includes providing assistance in training, skills testing, and validation.

C.5.8 Supply and Equipment Maintenance and Repair

The Contractor may be required to be responsible for supply chain management processes to support the operations of health care facilities or operations. This includes monitoring inventory and usage to determine what pharmaceuticals, medical supplies, and medical equipment are required to sustain patient care operations. The Contractor shall use industry standard best practices for asset management under this contract.

The Contractor may be required to identify the necessary equipment to outfit the health care facilities with the equipment and supplies required to provide health care support and maintain basic operations. The Contractor may be required to provide all communications systems and equipment.

The Contractor must be able to find sources for material ordered and ensure all material meets

U.S. FDA, European Medicines Agency (EMA) or other standards for approved-use.

The Contractor may be responsible for maintaining a supply chain and storage center for medical supplies and consumables in support of contract operations. A warehouse/storage center may be required to serve as the distribution hub in designated locations for medical materials to fulfill routine and emergent requirements from outlying sites. The Contractor shall ensure that the appropriate level of medical supplies, equipment, basic formulary, vaccines, laboratory and other supplies are adequate for the required services on the individual task orders.

The Contractor shall have the capability to receive, store and provide personnel with recurring medical prescriptions being shipping through various means including Diplomatic Post Offices

(DPO).

C.5.9 Medical Communications and Automation Support

The Contractor must be able to provide computers, peripherals, and automation support required to meet the health care requirements described in the individual task order. Internet connectivity for the purposes of conducting work under this contract is the responsibility of the Contractor.

Anything that maintains patient data becomes the property of the Government. The Contractor may be required to provide a solution for transmission of Computerized tomography (CT) and other digital images across locations for “real time” emergency and non-emergency readings.

C.5.10 Mortuary Affairs

The Contractor shall have the capability to provide limited mortuary affairs services in accordance with the requirements outlined in the individual task order. The Contractor shall have the capability to handle remains for 24-48 hours.

C.5.11 Mass Casualty Planning, Exercises, and Training

The Contractor may be required to work closely with representatives from the Department and

U.S. Government staff on mass casualty planning, exercises, and training. At designated site locations, the Contractor may be responsible for ensuring health unit and/or support hospital readiness. The Contractor shall ensure that the same level of standards and readiness is applied at each health unit and support hospital served.

The Contractor shall have the capability to establish and maintain a contingency medical treatment center. For example, a contingency treatment center may need to be equipped with the appropriate medical supplies capable to sustain two critically ill or injured patients and 50 minor injuries for up to 48 hours.

In case of an emergency immediately requiring blood and blood products, the Contractor shall have the capacity to perform fresh whole blood collection and transfusion. This capacity, often referred to as a “walking blood bank”, should include the solicitation of potential volunteers well in advance of an emergency; appropriate screening at the time of solicitation; rapid HIV, HBV, and HCV donor screening at the time of collection; necessary collection bags and filters; and adherence to a well-defined protocol. It is understood that such a program would constitute an extraordinary measure to be used only under extraordinary circumstances.

C.5.12 Emergency Care for USG Service Animals

The Contractor shall have the capability to provide emergency care for COM service animals. This is limited to providing care to the U.S. working dogs but only under emergency conditions that threaten life, limb, or eyesight. All treatment will require the approval of the COR.

The Contractor shall not be liable for damages for injuries alleged to have been sustained by such animal or for damages for the death of such animal alleged to have occurred by reason of an act or omission in the rendering of emergency treatment. Contractor is required to exercise due and reasonable emergency treatment care.

C.5.13 Behavioral Health Services

The Contractor shall have the capability to provide behavioral health services supporting the mental health needs of covered personnel, to include providing: brief supportive counseling, emergency consultation, and individual and group psychoeducational programs.

C.5.14 Pharmaceutical Services

The Contractor shall have the capability to provide pharmacy services, to include: developing medical formularies inclusive of pharmaceuticals, over-the-counter medications and other medical supplies that are dispensed to patients and clinical staff. Initial and amended formulary lists must be approved by the RMO and COR.

Controlled medicines shall be stored in a secure, locked location, as detailed by U.S. Drug

Enforcement Agency (DEA) guidelines as found at: www.deadiversion.usdoj.gov. The Contractor shall maintain an inventory that provides an audit trail from receipt of the drug by the vendor to dispensing to individual patients. If an electronic system is not utilized, a non-loose leaf inventory log is required.

C.5.15 Radiology and Tele-Radiology Services

The Contractor shall have the capability to provide the following diagnostic radiologic services at all locations of performance if required: basic x-ray and diagnostic ultrasound (to include Focused

Abdominal Sonogram for Trauma (FAST) Right Upper Quadrant (RUQ), renal, OB (tubal pregnancy), GYN, testicular, and Deep Vein Thrombosis (DVT) evaluations). The contractor may also be required to provide the following additional service: Computerized Tomography (CT) scanning with the capability to conduct non-contrast, contrast (oral and IV), and the ability to do

PA-grams (ideally with venous run-off).

The Contractor shall have the capability to make tele-radiology service available at all facilities where diagnostic radiology services other than bedside ultrasound are offered. The tele-radiology service should be of a quality and nature such that all radiographic images (including basic x-rays, http://www.deadiversion.usdoj.gov/

CT scans, and duplex ultrasound studies) will be emergently read by a licensed Radiologist at a remote location within 30 minutes, and that final interpretations and review of routine studies are available within 24 hours.

C.5.16 Medical Laboratory Services

For medical laboratory services, the Contractor may be required to operate according to all Clinical

Laboratory Improvement Amendment (CLIA) regulations, including mandatory participation in a proficiency testing program.

C.5.17 Life Support and Medical Evacuation Capabilities

The Contractor shall have the capability to perform medical evacuation aviation support services for the emergency deployment of personnel and equipment, and retrieval of eligible personnel, including personnel that are critically ill and may or may not be infected with unique and highly communicable pathogens.

C.5.18 Design and Fabrication Support Services

The Contractor shall have the capability to design, fabricate, deploy, and staff a wide variety of both permanent and non-permanent medical units. An example of such a unit would be the development of a portable medical module that can be emplaced in a fixed location to provide mobile clinic, trauma, and surgery capabilities. This includes development, modification, and revision of engineering and design, as well as fabrication, testing, and validation of these modules designed to meet a wide spectrum of medical needs. Additional information will be required at the task order level.