PWS.doc

Air Force Medical Operations Agency

Performance Work Statement

For

Seeking Safety

(Post Traumatic Stress Disorder/Substance Abuse) 14 may 2009

TABLE OF CONTENTS

Page

1.0 DESCRIPTION OF SERVICES

1.1 Background 3

1.2 Scope 3

1.3 Acronyms 4

2.0 SUMMARY OF REQUIREMENTS

2.1 Description of Duties Seeking Safety PTSD/Substance Abuse

2.2 General Contractor Personnel Requirements

2.3 Services Summary

2.4 Government Furnished Support

2.5 Travel 11

2.6 Deliverables 11

3.0 QUALITY ASSURANCE PLAN

4.0 NON PERSONAL SERVICES

5.0 CONTRACTOR IDENTIFICATION

6.0 HOURS OF OPERATION

7.0 APPENDICES

7.1 APPENDIX A: Health Insurance Portability & Accountability Act (HIPAA) of 14

7.2 APPENDIX B: HQ AF/SG Organizational Conflict of Interest (OCoI) 19

7.3 APPENDIX C: HQ AF/SG Non-Disclosure Agreement 22

7.4 APPENDIX D: Customer Feedback Form 25

1.0. DESCRIPTION OF SERVICES.

1.1 BACKGROUND: The mission of the Air Force Medical Operations Agency (AFMOA) is to support Department of Defense (DoD) health professionals in optimizing the health and wellness of their populations through appropriate, effective and efficient healthcare practices and service delivery. The United States Air Force (USAF) is committed to taking care of its own. Our Air Force (AF) members and their families deserve the best support possible. AF readiness targets combat stress reactions such as Post Traumatic Stress Disorder (PTSD), deployment environment and deployment-related stress reactions such as substance abuse. Tailored support of the base helping agencies targets deployment challenges and engages the services of base helping agencies. AFMOA Mental Health Division provides military readiness support through management of various programs engaged in individual, family and community mental health initiatives. These programs include Family Advocacy; Alcohol and Drug Abuse Prevention and Treatment/Demand Reduction; Education and Development Intervention Services/ Special Needs; and Suicide Prevention. The objective of these programs is to address intervention and prevention strategies for common modifiable behavioral risk factors. The challenge is recognizing the stressful situations of military members, specifically behaviors and concerns related to deployment stress. Congress has provided funding through the Department of Defense to the USAF to make available tailored support for pre-deployment, deployment, post-deployment, integration and combat stress reactions. There is an ongoing and urgent need to provide early psychological intervention as part of the first response to the traumatic events of pre- and post- deployment. In an effort to continue the success of these programs, AFMOA is seeking implementation of supplemental one day clinical training workshops for military Mental Health Providers (MHPs).

1.2 SCOPE: This non-personal professional requirement provides for implementation of one-day clinical training workshops Outside the Continental United States(OCONUS) and one-day clinical training workshops, Continental United States (CONUS) for military Mental Health Providers (MHPs), which include psychologists, psychiatrists, social workers, mental health nurses, and mental health technicians. The goal of these workshops is to train military mental health providers, Federal Civil Service providers and contractors to provide an evidence based treatment for those dealing with symptoms of Post Traumatic Stress Disorder (PTSD) and substance abuse. This training should be appropriate for active duty military members and their significant others with combat-related stress disorders such as PTSD and substance abuse. In addition, the programs will be evaluated to monitor training effectiveness (e.g., pre/post testing for knowledge). The contractor will provide their own equipment for the presentations, including a laptop and projector for running slides, as well as audio support, wires and cables as needed to put on a workshop as described above. The contractors chosen for the delivery of these services will have had experience treating Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans and their families.

1.3 ACRONYMS

ACRONYMS

2.0. SUMMARY OF REQUIREMENTS.

2.1. DESCRIPTION OF DUTIES SEEKING SAFETY PTSD/SUBSTANCE ABUSE. Contractor personnel shall accomplish the following:

2.1.1. Workshop Materials: Workshop materials shall be specifically tailored to trauma focused substance abuse treatment for United States Air Force (USAF) military personnel. This shall include the creation and updates of workshop handouts, reprints of scientific publications, clinical assessment materials, psychological assessment measures and a provider’s treatment manual or book. The contractor will provide relevant clinical training workshop and consultation materials in anticipation of or during training to each attendee in hard copy and/or electronic media form.

2.1.2. CONUS Clinical Training Workshops: The contractor shall conduct seven (7) one-day CONUS clinical training workshops. All costs associated with travel, food, lodging, creating and transporting the manual or handouts, and miscellaneous expenditures are to be borne by the contractor and are assumed to be covered in the agreed upon cost per workshop. The workshops shall include a review of evidence-based interventions for conjoint PTSD therapy with a specific emphasis on combat stress disorders. Approximately fifty military providers and technicians will attend each workshop and all attendees shall receive workshop type training in the assessment of couple distress and cognitive behavioral conjoint treatment of combat stress disorders including PTSD. Clinical case examples, including audiotapes and video of treatment sessions of active-duty military patients with couple distress and combat stress related disorders shall be reviewed. Attendees will be provided copies of assessment tools and a treatment manual for Cognitive Behavioral Therapy (CBT) Conjoint Therapy. The Government reserves the right to readjust the workshop dates in accordance with military and ops tempo demands.

2.1.3. OCONUS Clinical Training Workshop: The contractor shall conduct 2 CBT Conjoint one-day OCONUS clinical training workshops at the following locations and dates. All costs associated with travel, food, lodging, creating and transporting the manual or handouts, and miscellaneous expenditures are to be borne by the contractor and are assumed to be covered in the agreed upon cost per workshop. The contractor shall be compensated for one rest day prior to the start of the OCONUS workshops to allow for jet lag. The workshops shall include the same components as described above in the CONUS section. The Government reserves the right to readjust the workshop dates in accordance with military and ops tempo demands.

2.1.4. Training Evaluation: The contractor shall implement a training evaluation for all attendees. Demographic evaluation shall be collected on each participant including but not limited to training location, training dates, name, and rank, branch of service, duty station, MAJCOM, professional discipline, and email address. A pre/post knowledge assessment shall be conducted with each workshop participant in order to evaluate learning, motivation, and confidence for using the techniques.

2.1.5. Telephone Consultation for Seeking Safety Trainees. The Contractor will provide ongoing clinical consultation for all Seeking Safety workshop participants, including psychologists, psychiatrists, social workers, and mental health technicians and nurses upon completion of the one-day training workshop. Telephone consultation will be used and a military call-in line will be provided when requested (e.g., Meet Me Line). The contractor will regularly send out notification emails of the phone number and times available for consultation in order to facilitate as much participation as possible. Consultation will be provided for the military clinicians as they begin to see cases (patients) at their assigned MTF, whether they are located within CONUS or OCONUS. For all consultation activities, guidelines will be followed to ensure privacy and confidentiality of all patient information. Proper guidance and procedures will be followed in accordance with Communications and Information Management Guidance and Responsibilities (CIMGR), Air Force Instruction (AFI) 33-101 and Communications Security (COMSEC), AFI 33-201, Volume (V) 1, in its entirety. Consultation times will be available for up to two hours per month and will be arranged at times that are convenient to the clinicians and contractor/consultant. This teleconsultation format will allow for both individual, as well as, small group consultation.

2.1.6. Provide A Seeking Safety training manual and handouts that are specifically tailored to AD mental health providers.

2.1.7. Provide contractor owned equipment for all presentations both CONUS and OCONUS.

2.1.8. Provide Audio and or video case examples demonstrating the principles of Seeking Safety.

2.1.9. Provide the latest version of the book “Seeking Safety”, author Lisa Najavits, to each training participant.

2.1.10. Provide Follow-up teleconsultation services for 1 hr; 2xs per month.

2.1.11. Provide Training on the tracking of client outcomes.

2.1.12. Provide web based measures of satisfaction and the tracking of clinician outcomes.

2.1.13. Travel to multiple CONUS and OCONUS locations.

2.1.14. Deliver one-day trainings.

2.1.15. Present workshops in a format relevant for many different disciplines including psychiatry, psychology, social work, nurses, and mental health technicians.

2.1.16. Conduct a program evaluation including pre/post knowledge test.

2.1.17. Keep track of demographic information for all training participants.

2.2. GENERAL CONTRACTOR PERSONNEL REQUIREMENTS. The contractor shall meet the following requirements:

2.2.1. Experience in training Air Force mental health providers.

2.2.2. Experience in training the treatments for PTSD including Seeking Safety.

2.2.3. Ability to demonstrate at least 5-years of personal experience in training others to use the principals of Seeking Safety.

2.2.4. Contractor’s resume shall exhibit experience in developing protocols or conducting research in the area of trauma and substance abuse with evidence of clinical work with patients who have PTSD or combat related stress symptoms and comorbid substance abuse disorders.

2.2.5. The trainers must have a Doctoral Degree in Clinical Psychology with appropriate licensure in his/her state.

2.2.6. Contractor personnel shall be knowledgeable with standard AFMS software programs such as the Microsoft Office 2007 Professional Suite.

2.2.7Contractor personnel, who read, understand, speak, and write English language.

2.2.8 Contractor shall be responsible for Personnel Security. Documentation required for security certification shall be the responsibility of the contractor and the client organization. Contract personnel must have a National Agency Check (NAC) investigation accomplished prior to beginning work. The contractor shall provide documentation received from the appropriate Government agency as to the verification of contract personnel’s NAC certification. In case the certification has been requested but not received, the contractor may provide documentation on any contractor employee where certification has been requested. In this instance, the contractor employee shall be able to begin work in areas that would not conflict with Government security issues.

2.2.9 Work performed under the contract is unclassified. However, the technical and medical privacy data used within the scope of this contract requires adherence to security/privacy requirements imposed by the Government, DoD, AF and other applicable security clearance requirements as applicable to this contract. The contractor shall handle and protect all data as directed and implemented by the AFMSA enterprise and its implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). (Appendix A)

2.2.10 Contractor shall treat information IAW the following:

2.2.10.1 The Privacy Act of 1974 (5 U.S.C. § 552a), which includes Public Law 100-503, Department of Defense Directive (DoDD) 5400.11, and DoD 5400.11-R and must be treated as FOR OFFICIAL USE ONLY.

2.2.10.2 The Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191), which includes DoD 6025.18-R and is FOR OFFICIAL USE ONLY. (Appendix A)

2.2.10.3 Other Military Health Services, AFMOA, Federal and State laws may also be applicable.

2.2.10.4 Contractor shall provide signed Non-disclosure agreements to the QAP for each contract employee. (Appendix C)

2.2.10.5 Contractor shall provide attendee/registration information only to Government employees, Government Contractor, and subcontractors having a need-to-know such information in the performance of their duties for this project.

2.2.10.6 Contractor shall keep the QAP abreast of issues dealing with the security clearances and/or certifications. No foreign national candidates shall be utilized within the scope of this contract without prior approval of the Government.

2.2.11 Contractor shall comply with DoD Directive 8570.1M, Information Assurance Workforce Improvement Program-May 15,2008 Change 1, DoD Instruction 8500.2, Privacy Act Program Requirements (DoD 5400.11), and Personnel Security Program Requirements (5200.2-R).

2.2.12 Contractor shall be responsible for ensuring personnel security to include, but not limited to, meeting the following requirements:

Initiate, maintain, and document minimum personnel security investigations appropriate to the individual’s responsibilities and access to DoD Sensitive Information (SI).

Immediately report to the appropriate government representative if any contractor employee filling a sensitive position receives an unfavorable National Agency Check (NAC) adjudication, or if information that would result in an unfavorable NAC becomes available. Notify the Privacy Office within five working days if at any time a contractor employee has privileges revoked to a DoD data or system data because of security concerns.

2.2.13 Physical Security: The Contractor shall be accountable for control of Government property IAW AFJI 31-102. The Contractor is also responsible for the protection of any contractor-owned equipment or supplies brought onto the installation IAW AFJI 31-102. Further, the Contractor shall not remove any Government property from the installation.

2.2.14 Installation Entry: The Contractor shall comply with established security procedures for entering the installation and its facilities to include any special security procedures that may be established for entry to Restricted Areas or mission essential or vulnerable areas.

2.2.15 Denial of Entry: Government reserves the right to terminate entry of any contractor employee upon disclosure of information that indicates the individual’s continued entry to the installation is not in the best interest of the national security. Additionally, violation of or deviation from established security procedures by contractor employees may result in confiscation of identification media and denial of future entry to the installation.

2.2.16 Conduct of Contractor Personnel:

Contractor personnel shall be required to observe all base and facility parking, safety and traffic regulations that apply to all facility employees.

Alcoholic beverages on the job shall not be tolerated.

There shall be no loud, profane or abusive language used on the job.

Respect for and the welfare of the visitors shall be mandatory at all times.

Contract personnel shall present a neat well-groomed appearance. Neat, clean, casual business attire clothing shall be worn.

2.3. SERVICES SUMMARY (SS).

The Government will periodically evaluate the contractor’s performance by appointing a representative(s) to monitor performance to ensure services are received. The Government representative will evaluate the contractor’s performance through inspection of deliverables and receipt of all complaints from customers. The Government may inspect each task as completed or increase the number of quality control inspections if deemed appropriate because of repeated failures discovered during quality control inspections or because of repeated customer complaints. Likewise, the Government may decrease the number of quality control inspections if performance dictates. The Government representative shall make final determination of the validity of customer complaints(s). See Table 1 – Services Summary below:

2.3.1. Measurable Terms

Periodic Surveillance Monthly

Table 1 – Services Summary

2.4. GOVERNMENT FURNISHED SUPPORT. The Government will provide the location and space at the medical treatment facilities. If space is not available at the MTF then alternate locations will be provided by the Government.

2.5. TRAVEL

2.5.1. Travel is required during the performance period of this contract. Dates and destinations are written in the contract but may be subject to change based on the military operational tempo and the needs of the Government. Prior to travel the contractor shall coordinate with and receive Government authorization from the office they support for all travel. If and when travel occurs, the contractor shall be required to arrange transportation and other travel-related requirements to ensure attendance by appropriate contract personnel at the best value for the Government and in accordance with Federal Acquisition Regulations (FAR) 31.205-46. The contractor shall travel using the lowest cost mode transportation commensurate with the mission requirements. When necessary to use air travel, the contractor shall use the tourist class, economy class, or similar lodging accommodations to the extent they are available and commensurate with the mission requirements.

2.5.1.1. Travel throughout CONUS/OCONUS infrastructure MTF will be required.

2.5.1.2 The contractor shall prepare and provide administrative documents sufficient to accomplish Government travel when required.

2.6. DELIVERABLES. Any papers, recommendations, etc. that the contractor submits are drafts, not final copies. The Government reserves the right to make changes on delivery dates.

2.6.1. Deliverables.

2.6.1.1. Criteria for Acceptance. All deliverables shall be submitted in a draft format mutually agreed upon by the contractor and the Government.

2.6.2. DATA REPORTING REQUIREMENTS

2.6.2.1. Quarterly Performance Status Report. The contractor shall prepare and submit a Quarterly performance, status report identifying all tasks performed, training status, issues, and anticipated actions consistent with the performance work statement (PWS). (CDRL 0001).

2.6.2.1.1. The first quarterly report shall be submitted to the Program Manager PM/QAP and the CO no later than the tenth (10th) day of the month following the first three months of the contract period of performance. Subsequent reports shall be due no later than the 10th day of the month following the next reporting period.

2.6.2.1.2. Specific format of the report shall be coordinated with the PM/QAP and delivered in an electronic format mutually agreed upon by the contractor and the Government.

2.6.2.1.3. The report shall include the following items:

2.6.2.1.3.1. Highlights of the previous quarter’s activities along with the running demographics for all trained across the course of the contract.

2.6.2.1.3.2. Any issues or anticipated/current problems or barriers to completing each task.

2.6.2.1.3.3. Planned work for the next period; deliverable status information on all active tasks.

2.6.2.1.3.4. Status of QAP-generated action items, if any, from previous report and the resultant impact and schedule changes, if any.

2.6.2.2. Final Summary Report. In addition to the monthly and quarterly report, the contractor shall prepare and submit a final summary report describing all activities conducted including the number of trainings (where and when), numbers trained, demographics of all trained (i.e., service, duty station, MAJCOM, profession, email address, type of training attended, and date trained), pre/post test scores across trainings, and a summary of evaluation feedback. The final summary report shall be submitted fifteen (15) working days prior to the end of the contract period of performance (CDRL 0002).

2.6.2.3. Develop and maintain a complete Quality Control Plan (QCP). Initial QCP shall be provided during the proposal phase and any updates as they become final during the entire performance period.

3.0. QUALITY ASSURANCE PLAN. The Contractor is responsible for Contract Management and Quality Control, not The Government.

3.1. The Contractor shall be responsible for quality control (QC) for all work accomplished during the performance of this contract. All work shall be accomplished using the best commercial practices and be within the Government guidelines. Work and documentation produced by contract personnel shall be regularly reviewed by the Quality Assurance Personnel (QAP) Representative.

3.2. Quality Control (QC) Plan. The contractor shall provide to the government a Quality Control Plan at time of proposal and any updates after contract awarded. Any update to the QC Plan must be accepted by the Government (CDRL 0003).

3.3. Positive incentives as a result of performance that continually exceeds the performance objectives as outlined in the PWS may result in reduced surveillance and favorable Contractor Performance Assessment Reports (CPAR). Negative performance incentives include re-performance of the defective service in accordance with the Inspection of Services clause, reduction of fee/price, negative CPAR reporting and/or increased surveillance.

4.0. NON PERSONAL SERVICES: The Government will neither supervise contractor employees nor control the method by which the contractor performs the required tasks. Under no circumstances shall the Government assign tasks to, or prepare work schedules for, individual contractor employees. It shall be the responsibility of the contractor to manage its employees and to guard against any actions that are of the nature of personal services, or give the perception of personal services. If the contractor feels that any actions constitute, or are perceived to constitute personal services, it shall be the contractor’s responsibility to notify the CO immediately. These services shall not be used to perform work of a policy/decision making or management nature, i.e., inherently Governmental functions. All decisions relative to programs supported by the contractor shall be the sole responsibility of the Government.

5.0. CONTRACTOR IDENTIFICATION: All contractor/subcontractor personnel shall wear a Government identification badge at all times while performing under this effort. When attending meetings and/or answering phones or via electronic mail, the contractor/subcontractor personnel shall identify themselves as a contractor employee to avoid situations arising where sensitive topics might be better discussed solely between Government employees. Contractors/subcontractors shall identify themselves on any attendance sheet or any coordination documents they may review. Electronic mail signature blocks shall identify their company affiliation. Where practicable, contractor/subcontractors occupying collocated space with their Government program customer should identify their work space area with their name and company affiliation or as a minimum “Contractor” after name.

6.0 HOURS OF OPERATION: Normal duty hours are 7:30 A.M. to 4:30 P.M, Monday thru Friday (excluding Federal Holidays), unless mutually agreed upon by Government and contractor personnel. Due to mission need or due to unforeseen acts of nature or emergency, the Government and contractor may agree to different duty hour/work days. Overtime is not authorized.

6.1 Place of Performance. Work shall be conducted on-site at the medical treatment facilities and at identified conference locations.

6.2 Scheduled Holidays: New Year’s Day; Dr Martin Luther King, Jr Birthday; President’s Day; Memorial Day; Independence Day; Labor Day; Columbus Day; Veteran’s Day; Thanksgiving Day; Christmas Day.

7.0. APPENDICES:

7.1. APPENDIX A. Health Insurance Portability and Accountability Act (HIPPA) of 1996

7.2. APPENDIX B. HQ USAF/SGR Organizational Conflict of Interest

7.3. APPENDIX C. HQ USAF/SG Non-Disclosure Agreement

7.4. APPENDIX D. Customer Feedback Form

APPENDIX A: HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996

HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The medical facilities of the military services and the DOD health plans are specifically listed as covered by HIPAA. Currently, HIPAA Privacy and Security Rules, as set forth in the Code of Federal Regulations, are in effect for all MTFs. The specific implementation of HIPAA Privacy for DOD medical facilities is set forth in DOD 6025.18-R, and for HIPAA Security, the requirements for AF MTFs are contained in DOD 8580.02-R and AFI 41-217, which also contains additional Information Assurance requirements for all AF MTFs. DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. MTFs are responsible to insure overall compliance with HIPAA requirements, which includes incorporation of certain requirements in contracts entered or amended after the respective implementation dates.

IAW these regulations, the Contractor and its employees meet the definition of Business Associates. Therefore, a Business Associate Agreement is required by law to comply with both the HIPAA Privacy and Security regulations. This clause serves as that agreement for each MTF, whereby the Contractor and its employees agree to abide by all HIPAA Privacy and Security requirements regarding health information as defined in this clause, DoD 6025-18-R, DOD 8520.02-R and AFI 41-217. Additional HIPAA requirements will be addressed when implemented.

Introduction

(a) Definitions. As used in this clause generally refer to the Code of

Federal Regulations (CFR) definition unless a more specific provision exists in

DOD 6025.18-R, DOD 8520.02-R or AFI 41-217.

Individual has the same meaning as the term “individual” in 45 CFR

164.50 1 and 164.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g).

Privacy Rule means the Standards for Privacy of Individually Identifiable

Health Information at 45 CFR part 160 and part 164, subparts A and E.

Protected Health Information has the same meaning as the term

“protected health information” in 45 CFR 164.501, limited to the information created or received by The Contractor from or on behalf of the Government.

Electronic Protected Health Information has the same meaning as the term

“electronic protected health information” in 45 CFR 160.103.

Required by Law has the same meaning as the term “required by law” in

45 CFR 164.501 and 164.103.

Secretary means the Secretary of the Department of Health and Human

Services or his/her designee.

Security Rule means the Health Insurance Reform: Security Standards at

45 CFR part 160,162 and part 164, subpart C.

Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103, 160.502, 164.103, 164.304 and 164.501.

(b) The Contractor agrees to not use or further disclose Protected Health

Information other than as permitted or required by the Contract or as Required by

Law.

c) The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this

Contract.

(d) The Contractor agrees to use administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the electronic protected health information that it creates, receives, maintains, or transmits in the execution of this Contract.

(e) The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected

Health Information by the Contractor in violation of the requirements of this

Contract.

(f) The Contractor agrees to report to the Government any security incident involving protected health information of which it becomes aware.

(g) The Contractor agrees to report to the Government any use or disclosure of the Protected Health Information not provided for by this Contract of which the Contractor becomes aware of.

(h) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the Contractor on behalf of the Government agrees to the same restrictions and conditions that apply through this Contract to the

Contractor with respect to such information.

(i) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides electronic Protected Health Information, agrees to implement reasonable and appropriate safeguards to protect it.

(j) The Contractor agrees to provide access, at the request of the

Government, and in the time and manner designated by the Government to

Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524.

(k) The Contractor agrees to make any amendment(s) to Protected Health

Information in a Designated Record Set that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or an Individual, and in the time and manner designated by the Government.

(1) The Contractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Contractor on behalf of, the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner designated by the 'Government or the Secretary, for purposes of the

Secretary determining the Government's compliance with the Privacy Rule.

(m) The Contractor agrees to document such disclosures of Protected

Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45

CFR 164.528.

(n) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health

Information in accordance with 45 CFR 164.528.

General Use and Disclosure Provisions

Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the

Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R if done by the Government.

Specific Use and Disclosure Provisions

(a) Except as otherwise limited in this Agreement, the Contractor may use

Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

(b) Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of the information has been breached.

(c) Except as otherwise limited in this Agreement, the Contractor may use

Protected Health Information to provide Data Aggregation services to the

Government as permitted by 45 CFR 164.504(e)(2)(i)(B).

(d) Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR

164.502(j)(1).

Obligations of the Government

Provisions for the Government to Inform the Contractor of Privacy Practices and

Restrictions

(a) Upon request the Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45

CFR 164.520, as well as any changes to such notice.

(b) The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health

Information, if such changes affect the Contractor's permitted or required uses and disclosures.

(c) The Government shall notify the Contractor of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to in accordance with 45 CFR 164.522.

Permissible Requests by the Government

The Government shall not request the Contractor to use or disclose

Protected Health Information in any manner that would not be permissible under the HIPAA Privacy Rule, DOD 6025.18R, the HIPAA Security Rule, or DOD 8580.02-R, if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause.

Termination

(a) Termination. A breach by the Contractor of this clause, may subject the

Contractor to termination under any applicable default or termination provision of this Contract.

(b) Effect of Termination.

(1) If this contract has records management requirements, the records subject to the Clause should be handled in accordance with the records management requirements. If this contract does not have records management requirements, the records should be handled in accordance with paragraphs (2) and (3) below.

(2) If this contract does not have records management requirements, except as provided in paragraph (3) of this section, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of the Contractor. The Contractor shall retain no copies of the Protected

Health Information.

(3) If this contract does not have records management provisions and the Contractor determines that returning or destroying the Protected Health

Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected Health Information.

Miscellaneous

(a) Regulatory References. A reference in this Clause to a section in DOD

6025.18-R, HIPAA Privacy Regulation or DOD 6025.18-R, HIPAA Security Regulation, or any CFR or AFI provision means the section as currently in effect or as amended, and for which compliance is required.

(b) Survival. The respective rights and obligations of Business Associate under the "Effect of Termination" provision of this Clause shall survive the termination of this Contract.

(c) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with DOD 6025.18-R, the CFR HIPAA Privacy Rule, DOD 8520.02-R, the CFR HIPAA Security Rule and AFI 41-217.

appendix B. hq usaf/sgr organizational conflict of interest

Organizational Conflict of Interest

Revised: 30 Aug 2007

The purpose of this clause is to accomplish the following three objectives: (1) to inform prospective Offerors that AF/SGR presumes that award of this contract or task order may give rise to real or apparent OCIs with respect to other requirements or contracts within AF/SGR or the AFMS; (2) to assist current contractors and prospective Offerors in developing their own business strategies regarding participation in AF/SGR or AFMS requirements and in identifying and, where possible, avoiding or mitigating against OCIs; and (3) to ensure that all current contractors and prospective Offerors are afforded the maximum practicable opportunity to compete for all AF/SGR and AFMS requirements consistent with the restrictions required under FAR Subpart 9.5, Government Accountability Office (GAO) or Court of Federal Claims (COFC) decisions, and sound business practices.

The Contractor and all of its agents (including officers, managers, employees, consultants, and subcontractors) will fully comply with the Special Terms and Conditions Organizational Conflict of interest (OCI) required for efforts in support of AF/SGR activities. Contractor will ensure that all confidential and sensitive information will be fully protected. Such information will include, but not be limited to, all source selection sensitive information, government plans or strategies, and all proprietary information of other companies during contract performance. The disclosure of information shall not constitute a grant of any species of right, title, interest, or property in or to said information.

The Contractor understands and appreciates the absolute need to prevent conflicting roles that could or may bias its support to the AF/SGR office and its AF-wide responsibilities. To ensure that any support provided by the Contractor, its personnel, or its agents, is free of any bias in judgment or objectivity and to preclude the Contractor, its personnel, or its agents, from any unfair competitive advantage in current or future acquisitions, the Contractor will implement the following:

· Organizational Isolation

· Company Wide Policy Implementation

· Non-Disclosure Agreements

Contractor participation in a requirement or contract with AF/SGR programs may give rise to an unfair competitive advantage in other AF/SGR procurement actions because of access to advance acquisition planning, source selection sensitive or proprietary information. Furthermore, contractor participation in one area may give rise to a real or apparent loss of contractor impartiality and objectivity where its advisory or planning assistance in one area potentially affects its present or future participation in another area.

For purposes of identifying, avoiding and/or mitigating against OCIs, AF/SGR will examine all its requirements and acquisitions for potential OCI or ethical problems, regardless of the cognizant contracting activity (e.g., AFDW, VA, GSA, other agency Multiple Award Schedules, etc.) or the type of contract vehicle used (e.g., FSS order, Multiple Award ID/IQ Contracts, BPAs, FAR Part 15 competitively awards, etc.).

An Offeror/Contractor wishing to submit an offer for this procurement, or any Offeror/Contractor which provides or previously has provided support to AF/SGR, must include the following as pan of its offer:

· Perform a comparative analysis of the potential new work against all current and previous work performed in support of AF/SGR. The comparative analysis must be included in the proposal for the new work, and must include a statement certifying whether the contractor believes that its performance of the proposed new work would create a real or apparent OCI. If the contractor believes that no real or perceived OCI will result from an award of the proposed work, no additional action by the contractor is required.

· If the Offeror/Contractor believes that a real or apparent OCI may exist as a result of an award, the contractor shall also submit an OCI Avoidance or Mitigation Plan with its proposal.

Inclusion of the comparative analysis and OCI Avoidance or Mitigation Plan will not be counted against any offer page limitations otherwise stated in the solicitation.

The Contracting Officer (and when applicable the appropriate program office, acquisition manager, and legal counsel) will review the comparative analysis and, if provided, the Avoidance or Mitigation Plan, in accordance with the requirements of FAR Subpart 9.5 (Organizational Conflict of Interest) to make an independent determination of whether award to that Offeror would be consistent with those requirements. If it is unilaterally determined by the Contracting Officer that no OCI would arise or that the OCI Avoidance or Mitigation Plan adequately protects the interests of the government in the event of award to that Offeror, the Offeror will be determined, for purposes of this clause, to be eligible for award.

If the Offeror/Contractor knows of no OCI in accepting work under this contract, it shall certify its OCI status and submit the certification at the end of this clause with its proposal and any later award, if awarded the contract. The Contractor shall also obtain a similar certification of OCI status from all subcontractors, teaming partners or consultants prior to tasking any such party under this contract. The Contractor shall appropriately modify and include this clause, including this paragraph, in all consulting agreements and subcontracts of any tier to preserve the rights of the Government.

For breach of any of the above restrictions or for nondisclosure or misrepresentation of any relevant facts required to be disclosed concerning this contract, the Government may terminate this contract, disqualify the Contractor from subsequent related contractual efforts, and pursue any remedies as may be permitted by law or this contract.

Prior to a contract modification involving a change to the Performance Work Statement, or an increase in the level of effort or extension of the term of the contract, the Contractor shall submit any applicable organizational conflict of interest disclosure or an update of the previously submitted disclosure or representation.

The Offeror/Contractor should review the considerations below in determining whether or not a conflict of interest exists.

· Does the Offeror or any intended subcontractors, teaming partners, proposed employees, or affiliates have Unequal Access to Information? Would award to the Offeror result in the Offeror having the opportunity to access nonpublic information that may give the Offeror a competitive advantage in a later competition for a government contract? Specifically, will the Offeror/Contractor have access to any of the following information:

· Budget(s), or Budget Information?

· Acquisition Sensitive Information related to the procurement process to include, but not limited to Acquisition Plans, Requirements, Statements of Work, or Evaluation Criteria?

· Does the Offeror or any intended subcontractors, teaming partners, proposed employees, or affiliates have “impaired objectivity” because the Offeror’s ability to render impartial judgments may be compromised because of its conflicting role(s) on this effort and other government contracts?

· Do “biased ground rules” exist? Most commonly, this would include a situation where the Offeror has, as a government contractor, written specifications or a statement of work for this effort, which could skew competition in favor of itself?

· Is the Offeror aware of any other information relating to this proposed contract/order, which could reasonably be construed as creating an OCI?

The Offeror/Contractor hereby certifies to the best of its knowledge its OCI status below:

(Offeror: Choose one of the following two statements. Delete the statement that does not apply.)

No real or perceived OCI, as defined in FAR 2.1 and discussed in FAR 9.5, will result from an award of the proposed work (there are no ‘Yes’ responses to the questions above).

A real or apparent OCI may exist as a result of an award and therefore an appropriate OCI Avoidance or Mitigation Plan is attached (Offeror shall include an appropriate OCI Avoidance or Mitigation Plan, as required by this clause, with its proposal to the Contracting Officer. [NOTE: Either delete statement #2, or delete the last phrase allowing them to submit it, or include following statement re Mitigation Plan f related to the AFDW BAA: Mitigation Plans are not permitted in order to resolve OCI issues involving contracts awarded under the AFDW A&AS contract and the AFDW BAA.).

_________________________________ (Signature) ________________________ (Date)

(Authorized Official / Sr. Mgr / Officer)

_________________________________(Printed Name) ________________________ (Title)

APPENDIX C: HQ USAF/SG NON-DISCLOSURE AGREEMENT

Revised: 30 Aug 2007 Purpose: The purpose of this Non-Disclosure Agreement (NDA) is to confirm in writing that the undersigned understands his/her responsibilities regarding protection of information and/or material that he/she may come in contact with in the course of work performed under this agreement. This NDA covers all forms of information made available as Government Furnished Information (GFI) or information/material developed under this agreement, whether in the form of working materials or as deliverable product. This NDA applies to unclassified Government information/material, proprietary information/material supplied by other vendors for use by the Government, and classified Government information/material and is intended to supplement, not replace, the DD Form 254. All information/material released to the contractor remains the property of the US Government and may be withdrawn at any time.

Responsibility: As a condition of acceptability for work under this agreement with 311HSW/PK on behalf of AF/SGR, individuals are required to the attached NDA:

NON-DISCLOSURE AGREEMENT

FOR

CONTRACTORJSUBCONTRACTOR EMPLOYEES, SENIOR MANAGERS OR

CORPORATE OFFICERS

(Agreement)

I, ___________________________________________________________ (clearly print or type name), an employee, senior manager, or corporate officer of either _________________________ or a subcontractor to _____________________ under Prime Contract number ______________________; Task Order _____________________ awarded to ______________________ by the AF/SGR office (Customer) agree not to disclose to any third party or anyone who is not performing work for…