Attachment_1 _PWS.pdf

Attachment 1

FA3010-16-R-0015

11 April 16

PERFORMANCE WORK STATEMENT

For

REGISTERED NURSE III - DISCHARGE PLANNER

Personal Services

1. DESCRIPTION OF SERVICES AND GENERAL INFORMATION. The Contractor shall provide one Full-Time Equivalent (FTE) for the following position: Department of Defense (DOD)/Veteran Affairs (VA) Medical Resource Sharing - Discharge Planner Registered Nurse III (RN) on a personal services basis, under the administrative oversight of the Resource Management Office (RMO), 81st Medical Group (81 MDG), 81st Training Wing (81 TRW), Keesler Air Force Base (KAFB), Mississippi (MS). The Contractor shall perform services in accordance with (IAW) the ethical, professional, and technical standards of the health care industry and the Air Force (AF) medical department. Contractor services shall cover the range of services provided in a civilian medical treatment facility (MTF).

1.1. CONTRACTOR MANAGMEMENT STAFF RESPONSIBILITIES.

1.1.1. Verification and Validation of Candidate Qualifications. The Contractor shall verify and validate candidate qualifications against Government minimum requirements prior to submission of qualifying documents.

1.1.2. Placement of Contractor Personnel. The Contractor shall recruit and place contractor personnel in a timely manner. The non-credentialed contractor personnel shall physically start work no later than 30 calendar days from the initial date on the period of performance.

1.1.3. Replacement of Contractor Personnel. The Contractor shall replace permanent contractor personnel such that vacancies will not exceed 30 consecutive calendar days for non-credentialed positions. When replacing a contractor personnel, the consecutive calendar days begin when the contractor personnel terminates employment. For non-credentialed positions, the replacement contractor personnel must begin work within 30 consecutive calendar days after the previous non-credentialed contractor personnel departed the position.

1.1.4. Substitute or Temporary Coverage. The Contractor shall substitute permanent contractor personnel whenever a temporary absence is expected to exceed 30 consecutive calendar days.

The Contractor shall promptly notify the contracting officer representative (COR) and Government supervisor of any projected absences exceeding 30 consecutive calendar days and ensure no temporary absence exceeds 30 consecutive calendar days through the use of a qualified substitute.

1.1.5. Resolve Performance Issues. The Contractor shall adequately resolve MTF and patient complaints regarding contractor personnel which satisfy Government concerns.

1.2. SPECIFIC PROCEDURES FOR WHICH THE CONTRACTOR SHALL BE

RESPONSIBLE.

1.2.1. The Contractor shall provide all labor, management, supervision, consultations, and reports necessary to ensure all tasks meet the requirements in this performace work statement (PWS) and Services Summary (SS).

1.2.2. The Contractor personnel shall develop and execute the following discharge planning activities:

1.2.2.1. Provide discharge planning services to all individuals admitted to the medical treatment facility as inpatients or same day surgery outpatients.

1.2.2.2. Accomplish, either before or at the time of the patient’s admission, a focused, early identification of services that will be required during the post-hospitalization treatment and recovery period.

1.2.2.3. Facilitate the transition to the appropriate level of care through coordination with the patient, the patient’s family/caregiver and the multi-disciplinary healthcare team. This includes consideration for, but is not limited to, acute, chronic, multiple, complex, catastrophic, or life-threatening illnesses; combat stress, residuals of traumatic brain injury; community adjustment;

addictions and other health problems.

1.2.2.4. Work collaboratively with utilization management, case management, disease management and the healthcare team to achieve a timely, appropriate discharge that meets the patient’s needs and is per local facility/AF/DoD and national utilization and discharge standards.

1.2.2.5. Evaluate care and outcomes to ensure the most appropriate and effective care and services.

1.3. QUALIFICATIONS.

1.3.1. Must be knowledgable in medical privacy and confidentiality (Health Insurance Portability and Accountability Act [HIPAA]), and accreditation standards of Accreditation Association for Ambulatory Health Care (AAAHC) and The Joint Commission (TJC); computer applications/software to include Microsoft Office programs, MS Outlook (e-mail), and internet;

problem-solving skills to articulate medical requirements to patients, families/care givers, medical and non-medical staff in a professional and courteous way; DRGs, ICD-10, CPT-4, HCPCS coding; and concepts Length of Stay (LOS) and Avoidable Bed Days.

1.3.2. Must have the ability to communicate effectively both orally and in writing; apply critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations.

1.3.3. Education. Shall be a graduate from an associate’s (ADN) or baccalaureate degree (BSN) program in nursing accredited by a national nursing accrediting agency recognized by the US Department of Education.

1.3.4. License. Maintain an active, valid, current, and unrestricted license (with no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction.

1.3.5. Experience. Have a minimum of 3 years for ADN/2 years for BSN full-time experience in clinical case management or discharge planning functions (assessment, referral, formulation, implementation, and monitoring) for adults, children, families, seniors, and groups.

1.3.6. Certification. Be a Certified Professional in Healthcare Management (CPHM) By McKesson or a clinical specialty recognized by American Credentialing Center –OR-certification eligible with 3 years for ADN or 2 years for BSN experience in broad based clinical nursing. Must maintain current Basic Life Support (BLS) certification.

1.4. TYPE OF WORK. The duties include but are not limited to the following:

1.4.1. Assessment. Proactively identifies and evaluates patients for discharge planning within 24 hours of identification or notification, or by close of the first business day after a weekend or holiday. Conducts systematic, on-going, thorough collection of patient’s physical, emotional, psychological, social, and medical status and information via direct patient contact, family/caregiver, and other relevant sources such as professional and non-professional caregivers.

Reviews the patient’s medical record against McKesson (InterQual) discharge planning criteria, Milliman Care Guidelines (MCG) on demand and clinical decision support tools to determine readiness for discharge.

1.4.2. Planning. Collorborataly develops an appropriate patient-specific discharge plan of care within 72 hours. Coordinates, collaborates, and obtains approval of the plan among the patient, family/caregiver, primary provider and other members of the healthcare team. Documents review of the plan in the patient’s medical record. Develops a proactive process for patients undergoing same day surgeries, anticipating actual and potential needs for post-operative services.

1.4.3. Implementation. Coordinates and executes the discharge plan with the patient and family/caregiver, optimizing access to appropriate services. Consults Case Management services as appropriate for post-discharge care needs. Ensures necessary referrals are ordered by the appropriate discipline and coordinated as needed. Serves as an advocate for, and ensures education is provided to the patient and family/caregiver as required. Promotes adherence to the discharge plan for improved healthcare outcomes.

1.4.4. Coordination. Ensures coordination of care delivery processes, to include alternate healthcare settings and the home environment, for the purposes of enhancing the patient's health and wellness, safety, productivity, and quality of life, and for providing the most beneficial, cost-effective health care. Develops, utilizes, and maintains a variety of military and community resources to optimize access to services and medical care. Ensures timely and appropriate provision of services.

1.5.5. Monitoring. Re-evaluates the patient and the plan every 72 hours until discharged per Mc Kesson (InterQual) guidelines, MCG on demand and clinical decision support tools, aligning the plan with TRICARE/VA benefits and policies. Documents in accordance with existing local facility/AF/DoD and other agency guidelines. Maintains data collection in accordance with local facility/AF/DoD and other specified agency guidelines. Such data includes but is not limited to resource utilization and patient outcomes, and Length of Stay (LOS) and Avoidable Bed Days, analyzing for variance, appropriate interventions, and cost containment.

1.5.6. Evaluation. Actions may include timeliness of completion of the discharge plan, patient’s adherence and response to the plan, identification of variances, patterns or trends from established practice guidelines and/or standards, established outcome measurements, results of interventions, treatment delivery and timeliness of care, and utilization of resources. Monitors and evaluates the facility’s discharge planning program per local facility/AF/DoD policies and guidelines.

1.5.7. Coordinates and participates in interdisciplinary team meetings, designated facility meetings, and discharge planning meetings. Shares knowledge and experiences gained from own clinical nursing practice and education relevant to nursing, discharge planning and case management, disease management, and utilization management.

1.5.8. Participates in the orientation and training of other staff. May serve on committees, work groups, and task forces at the facility.

1.5.9. Must maintain a level of productivity and quality consistent with: complexity of the assignment; facility policies and guidelines; established principles, ethics and standards of practice of professional nursing; the Case Management Society of America (CMSA); American Accreditation Healthcare Commission/Utilization Review Accreditation Commission (URAC);

CAMH; (AAAHC); Health Services Inspection (HSI); and other applicable DoD and Service specific guidance and policies. Must also comply with the Equal Employment Opportunity (EEO) Program, infection control and safety policies and procedures.

1.5.10. Completes medical record documentation and coding, and designated tracking logs and data reporting as required by local facility/AF/DoD/VA instructions, policies and guidance.

1.5.11. Completes all required electronic medical record training, facility-specific orientation and training programs, and any AF/DoD mandated training.

1.5.12. Follows applicable local facility/AF/DoD instructions, policies and guidelines.

1.6.. PERSONNEL REQUIREMENTS.

1.6.1. ENGLISH LANGUAGE REQUIREMENT. Contractor personnel shall read, understand, speak, and write English fluently.

1.6.2. APPEARANCE AND CONDUCT. Contractor personnel shall present a professional, conservative, and neat appearance. Contractor personnel shall report for duty in appropriate attire befitting a health care setting and having complied with socially acceptable standards of personal hygiene expected of health care workers. The Contractor personnel shall display a professional, positive, and cooperative attitude while in the workplace.

1.6.2.1. While on duty, the Contractor personnel shall be neat and clean, free from visible dirt and stains, well groomed, and appropriately dressed. The Contractor personnel’s clothing shall fit correctly to provide a professional, modest appearance, in keeping with normally accepted community standards of dress for the work being performed.

1.6.2.2. Facial hair (including beards, mustaches, and sideburns) shall be controlled (restrained) or trimmed. It shall not interfere with safe work practices, look unkempt, or be unclean. Facial hair shall not interfere with the face seal if a tight-fitting respirator (e.g., N95) is required to be worn for normal duties.

1.6.2.3. The Contractor personnel shall display legible MTF-provided identification media on his/her outer clothing.

1.6.2.4. Protective Clothing. When required and supplied by the Government, Contractor personnel shall wear special protective clothing and shoe covers. When duties will be performed in specified areas, a disposable protective suit with other appropriate personal protective equipment (PPE) (for example, gloves, boots, etc.) shall be worn to ensure universal precautions are observed. The Government will provide ALL PPE. These items shall remain the property of the Government and shall not be removed from the MTF. After use, protective clothing shall be turned in or destroyed as directed by the Chief of Service.

1.7. Referrals and Consults. Contractor personnel shall follow DoD, AF, and MTF regulations and policies when arranging for a referral or consult. Contractor personnel shall inform patients of the required referral or consult by indicating the specialty involved. All consults and referrals will adhere to the MTF/VA approved Consult Management process.

1.8. Prescriptions. Contractor personnel shall use and follow the MTF formulary for prescriptions for all patients that received care at the MTF. The formulary list is approved and maintained by the MTF Pharmacy and Therapeutics Committee. Any drug not listed on the formulary must be approved by the Pharmacy and Therapeutics Committee.

1.8. PROCEDURE GUIDANCE. Contractor personnel shall perform procedures compatible with the MTF’s operating capacity and equipment. New medical procedures/services shall not be introduced without prior recommendation to, and approval of, the MTF Commander or authorized representative.

1.9. PATIENT SENSITIVITY. Contractor personnel shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity.

1.10. COMMUNICATION. Contractor personnel shall maintain open and professional communication with members of the MTF staff. Complaints validated by the Health Care Integrator (HCI)/Medical Director shall be reported in writing to the Contract Administrator and the Contractor for action. Failure of the Contractor to correct validated complaints raised by the MTF staff and the Contracting Officer (CO) will be considered a failure to perform.

1.11. DOCUMENTATION. Contractor personnel shall prepare all documentation (to include patient records) to meet or exceed established standards of the MTF, to include but not limited to, timeliness, accuracy, content, and signature. Only MTF and Air Force-approved abbreviations shall be used for documentation of the patient health record.

1.12. CERTIFIED EDUCATION UNITS (CEU) REQUIREMENTS. Contractor personnel registered or certified by American Nurse’s Association or his or her respective state board must maintiain CEUs in accordance with their state board requirements for liscensure and or certification renewal.

1.13. PERSONNEL.

1.13.1. POINT OF CONTACT (POC). The Contractor shall provide a POC who shall be responsible for the performance of the work. The POC shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The POC may be Contractor personnel providing care IAW this PWS. The Contractor shall designate this individual, in writing, to the CO before the contract start date. An alternate may be designated, but the Contractor shall identify those times when the alternate shall be the primary POC.

1.13.2. AVAILABILITY. The Contractor’s designated project manager shall notify the HCI/Director of Medical Management, as early as possible of programmed absences of the Contractor personnel to allow for planning of service coverage and workload distribution.

1.13.3. Hours of Operation/Work Schedule/Duty Hours. KAFB and the MTF operates on a 24/7 basis. Regular duty hours are 0630 to 1530, Monday thru Friday; and will not exceed 80 hours in two weeks.

1.13.4. Contractor staff shall be required to log in time worked in both the Defense Medical Human Resource System – internet (DMHRSi), as well as any locally established duty tracking system as established by the duty section.

1.13.5. Holidays. The Contractor shall not be required to provide services on the following Federal holidays (or the actual day set aside for observation): New Year’s Day, Martin Luther King Jr. Day, Presidents’ Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans’ Day, Thanksgiving Day, and/or Christmas Day.

1.13.6. Air Education and Training Command (AETC) Family Days. The Discharge Planner will be required to work on designated Family Days.

2016: 27 May 16, 5 Jul 16, 2 Sep 16, 25 Nov 16, 27 Dec 16

2017: 26 May 17, 3 July 17, 1 Sep 17, 24 Nov 17, 26 Dec 17 2018: 25 May 18, 5 July 18, 31 Aug 18, 23 Nov 18, 24 Dec 18, 31 Dec 18

The Contractor shall be given prior notice for Family Days of subsequent years.

1.13.7. Vacation/Absences. Contractor personnel are authorized excused absences for vacation, sick leave, Continued Health Education/Continued Education Units (CHE/CEUs) and miscellaneous reasons. Absences are to be coordinated at a minimum two weeks in advance with, and at the discretion of, the Director of Medical Management/ Chief Health Care Integrator.

1.13.8. Unplanned Closures. In the event of an unplanned closure of the facility due to natural disasters, military emergency, or severe weather, Contractor personnel shall be allowed to account for those hours as billable to the Government if the following two conditions exist: (1) local base policy and base access procedures prevented the Contractor personnel from performing duties at the place of performance; and, (2) the Contractor personnel was scheduled to work, but unable to work because of the unplanned closure. If any of these conditions do not exist (e.g., the Contractor personnel was on leave), the Contractor cannot bill the Government for hours during the unplanned closure.

1.13.9. Emergency Situations. In the instance where the Government Supervisor directs the Contractor personnel to remain on duty in excess of the scheduled shift due to an unforeseen emergency or to complete patient treatment where lack of continuity of care would otherwise jeopardize patient health, the Contractor personnel shall remain on duty. This provision is not intended to apply to the time required to complete routine tasks (e.g., completion of paperwork or routine administrative tasks at the end of a shift) which are to be completed as part of the shift. If the contract includes overage hours, the Government Supervisor may use those overage hours. If the contract does not include overage hours, the Government Supervisor shall adjust the Contractor personnel’s work schedule for the additional hours such that the number of duty hours on the contract is not exceeded.

1.14.. CONTRACTOR MANPOWER REPORTING. The Contractor shall report ALL Contractor labor hours (including subcontractor labor hours) for performance of services under this contract via a secure data collection site. The Contractor is required to completely fill in all required data fields at http://www.ecmra.mil. Reporting inputs will be for all labor executed during the performance for each Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported at any time during the FY, all data shall be reported no later than 31 October of each calendar year. Contractors may direct questions to the Contractor Manpower Reporting Application (CMRA) help desk.

1.15. CRIMINAL HISTORY BACKGROUND CHECKS. Contractors shall perform criminal history background checks IAW Chapter 4, Addendum B, DoDI 1402.5, Criminal History Background Checks on Individuals in Child Care Services, 19 Jan 93, for resource sharing and clinical support agreement personnel working in an MTF involved on a frequent and regular basis in the provision of care and services to children under the age 18. The background checks are required by Criminal Control Act, P.L. 101-647, Section 231 (CC Act 1990, 42 U.S.C. Section 13041). The Contractor shall assemble all necessary documentation required by Chapter 4, http://www.ecmra.mil/

Addendum B for the background checks and forward the documentation to the office designated by the Administrative CO (ACO) or to the office designated in the Memorandum of Understanding (see Chapter 16, Addendum A).

1.15.1. Background checks will be based on fingerprints of individuals obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureau of Investigation (FBI) and state criminal history repositories.

1.15.2. With the consent of the CO, the Contractor personnel may provide contract services prior to completion of background checks. However, at all times while children are in the care of that individual, the Contractor personnel shall be within sight and continuous supervision of a staff person whose background check has been completed.

1.15.3. Individuals shall have the right to obtain a copy of any background check pertaining to themselves and to challenge the accuracy and completeness of the information contained in the report.

1.15.4. Individuals who have previously received a background check shall provide proof of the check to the Chief of Service or obtain a new one.

1.16. CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval IAW DoD Directive (DoDD) 5500.7, Standards of Conduct, 29 Nov 07, and AF policy.

1.17. HEALTH REQUIREMENTS.

1.17.1. Contractor personnel shall receive a pre-employment physical examination prior to commencement of work and annually thereafter. The Contractor personnel shall report to a civilian physician to receive a pre-employment examination and immunizations prescribed by the MTF, IAW Center for Disease (CDC) guidelines.

1.17.2. Not later than five working days prior to commencement of work, certification shall be provided to the Functional Commander/Director (FC/D) that the Contractor personnel has completed the medical evaluation required above. This certification shall state the date on which the examination was completed, the name of the doctor who performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: “(Name of Contractor personnel) is suffering from no contagious diseases to include, but not limited to, Tuberculosis, Hepatitis, and Venereal Disease.”

1.17.3. The Occupational Safety & Health Administration (OSHA) requires that all Contractor personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity to Hepatitis B infection. Contractor personnel who sign declinations may change their minds at any time and receive the Hepatitis B vaccine without penalty.

1.17.4. The Contractor is responsible for reporting to the Chief Health Care Integrator/Medical Director, all information necessary to assure hospital records can be maintained correctly, and therefore comply with the TJC, OSHA, and CDC health record requirements.

1.18. EMERGENCY HEALTH CARE. The MTF will provide emergency health care for the Contractor personnel for injuries incurred while on duty in the MTF. These services will be billed to the Contractor at the current full reimbursement rate.

1.19. MEDICAL TESTS. Contractors are solely responsible for compliance with Occupational Safety and Health Administration (OSHA) standards and the protection of their employees unless otherwise provided by law or regulation to be specified in the contract. Thermoluminescent Dosimetry (TLD) monitoring will be provided to contractor personnel who are a part of a clinic enrolled in the TLD program. No medical tests or procedures required by the contract will be performed by the Government, with the exception of Tuberculosis testing; post blood borne exposure protocols after start of work or exposure. Expenses for all required tests and/or procedures identified in the contract (e.g., N95 particulate respirator duckbill mask fitting) shall be borne by the Contractor or Contractor personnel at no additional expense to the Government.

1.20. MEDICAL QUALITY IMPROVEMENT/RISK MANAGEMENT (QI/RM).

1.20.1. Contractor personnel shall participate in QI/RM activities to the extent required by Section 2C, AFI 44-119, Medical Quality Operations, 16 Aug 11, and the individual MTF QI/RM plan or regulation.

1.20.2. The Government will evaluate the Contractor personnel’s professional, as differentiated from administrative, performance under this contract using Quality Improvement standards specified in AFI 44-119 paragraphs 2.12 and 2.13. Nothing in this paragraph precludes the Government from also conducting inspections under the Inspection/Acceptance requirement of FAR clause 52.212-4.

1.21. PERFORMANCE EVALUATION MEETINGS. The CO will require the Contractor to meet with the CO, Contract Administrator, FC/D, and other Government personnel as often as deemed necessary to discuss performance discrepancies. The contractor may request a meeting with the CO when deemed necessary.

1.22. ORIENTATION. The Contractor shall ensure that all Contractor personnel participate in the MTF orientation procedures for newly assigned personnel to include regulations specific to their professional specialty and hospital and Air Force policy and procedures.

1.23. RECORDS. The Contractor shall create, maintain, and provide Government-owned/Contractor-held records, regardless of media, in performance of this contract IAW the following directives:

AFI 33-322, Records Management Program, 4 Jun 12, Incorporating Change 1, 18 Dec AFMAN 33-363, Management of Records, 1 Mar 08; Incorporating Change 1, 28 Jan 15, and Keesler Supplement, 23 Apr 14 AFI 33-364, Records Disposition—Procedures and Responsibilities, 22 Dec 06 and AFGM2014-01, 28 May 14 Air Force Information Management System database (AFRIMS) (access through the Air Force Portal at https://www.my.af.mil/afrims/afrims/afrims/rims.cfm

Air Force Electronic Records Management Solution

1.23.1. The Contractor shall segregate the Government-owned records from the Contractor-owned records and identify all records required to be created by the PWS on the AFRIMS file plans. The Contractor shall create and maintain paper and electronic records (\\52mahg-fs-106) as appropriate. The Contractor shall maintain the software and background data to retrieve official electronic Government records throughout the lifecycle of the records.

1.23.2. The Contractor maintains and disposes of records IAW the AF records disposition schedules.

1.23.3. Electronically Stored Information (ESI). The Contractor shall maintain Government owned electronic non-official records on the organizational shared network drive according the subjective categories (example: template, common, reference material, and working files). Grant the base records manager access to all files located on the organizational shared network drive.

The Contractor shall maintain the official electronic records on the base designated shared network drive (\\52mahg-fs-106) IAW the Air Force Electronic Records Management System and AFMAN 33-363, Chapter 6.

1.23.4. Upon completion of this contract, all Government-owned/Contractor-held records (regardless of media) received, created, maintained, or provided in the performance of the PWS shall be turned over to the Government. Background electronic data and records specified for delivery to the contracting agency must be accompanied by sufficient technical documentation and software to permit the Air Force to use the data. In the event of default or non-performance, the Government will have access to all records in order to ensure mission support is not interrupted.

1.23.5. Contractor-Owned Records. Maintain records that relate exclusively to the Contractor’s internal business or are of a general nature not specifically related the performance of work under the contract separately from the Government-owned records.

1.23.6. Freedom of Information Act (FOIA) Program. The Contractor shall comply with the requirements of DOD 5400.7-R/AFMAN 33-302, Freedom of Information Act Program, 21 Oct 10, and incorporating through Change 2, 22 January 2015.. If the Contractor receives a FOIA request, the Contractor shall ensure it is delivered immediately to the base FOIA manager (81 CS/SCOK) for processing. The FOIA manager will task a Government official who, as the authorized official, will make the decision on releasing Government records.

http://www.e-publishing.af.mil/shared/media/epubs/AFI33-322.pdf http://www.e-publishing.af.mil/shared/media/epubs/AFMAN33-363.pdf http://www.e-publishing.af.mil/shared/media/epubs/AFMAN33-363.pdf https://www.my.af.mil/afrims/afrims/afrims/rims.cfm

1.23.7. Privacy Act Program. The Contractor shall create, maintain, and destroy Privacy Act data IAW AFI 33-332, The Air Force Privacy and Civil Liberties Program, 12 Jan 15; and Privacy Act systems of records notice(s) (http://dpcld.defense.gov/Privacy/SORNs.aspx). The Contractor shall not create or maintain a Privacy Act system of records prior to public notice. If the Contractor receives a Privacy Act request, the Contractor shall be responsible for searching for the records and providing those records to a Government official who, as the authorized official, will make the decision on releasing the Government records.

1.23.8. Functional Requests. A functional request is a written request for DOD records received from any person (including a member of the public), or a business that does not cite either the FOIA or Privacy Act. The Contractor shall be responsible for searching for the records and providing those records to a Government official who, as the authorized official, will make the decision on releasing the Government records.

1.24. SECURITY.

1.24.1. Security Clearance: As a minimum, Contractor personnel shall successfully complete a NACI before operating Government-furnished workstations that have access to AF automated information systems. Requests for Contractor personnel hired at the beginning of the contract shall be submitted to the Government not later than 45 workdays from the contract start date.

Requests for Contractor personnel hired subsequent to contract start date shall be submitted to the Government not later than ten workdays from the Contractor personnel’s first duty day.

Contractor personnel receiving unfavorable NACIs shall not be employed. The Government will submit requests for investigations on AF 2583, Request for Personnel Security Action, at no additional cost to the Contractor. Any personnel with access to classified material will be submitted by the Contractor’s Facility Security Officer (FSO) for a Secret security clearance.

The Contractor shall comply with the requirements of DoD 5200.2-R, Personnel Security Program, 1 Jan 87, (Incorporating Through Change 3, 23 Feb 96); AFI 31-501, Personnel Security Program Management, 27 Jan 05; and Air Force Manual (AFMAN) 33-152, User Responsibilities and Guidance for Information Systems, 1 Jun 12.

1.24.1.1. Contractor personnel shall comply with the requirements of AFI 71-101, Volume 1, Criminal Investigations, 4 Feb 15 and AFI 71-101, Volume 2, Protective Service Matters, 23 Jan

15. These regulations require Contractor personnel to report any information or circumstances of which they are aware that may pose a threat to the security of DoD personnel, Contractor personnel, resources, and classified or unclassified Defense information to their immediate supervisor. The immediate supervisor of Contractor personnel shall brief on this requirement during initial on-base assignment and as required thereafter.

1.24.1.2. The Unit Security Manager will assist the Contractor with any Joint Personnel Adjudication System (JPAS) Joint Clearance and Access Verification System (JCAVS) and eQIP by Design information for inputting NACIs with assistance from 81 SFS/IP.

1.24.2. Security Monitoring. The Contractor shall comply with all security requirements.

Submit reports, classified if appropriate, of any information coming to their attention concerning any of their employees who have been cleared or are in the process of being cleared for access to http://dpcld.defense.gov/Privacy/SORNs.aspx classified information, which indicates that such access or determination may not be clearly consistent with the national interest. Reports shall be submitted to the Defense Industrial Security Clearance Office (DISCO) immediately upon notification of any adverse information, change in employee’s status, official investigation, or any other reason. In addition, a copy of this report shall be furnished to the Contracting Officer’s Representative(s) (COR(s)) and 81 TRW Installation Commander (81 TRW/CC).

1.24.3. Listing of Employees. The Contractor shall maintain a current listing of all Contractor personnel. The list shall include Contractor personnel’s names, Social Security numbers, and level of security clearance. The list will be validated and signed by the FSO and provided to the CO, COR, Base Visual Information Manager (BVIM), 81 SFS/IP, Unit Security Manager, and FSO prior to the contract start date. Updated listings shall be provided when a Contractor personnel’s status or information changes. Documents will be marked as FOUO as a minimum.

1.25. PHYSICAL SECURITY. The Contractor shall safeguard all Government property, including controlled forms provided for Contractor use. At the close of each work period, Government equipment, facilities, and other valuable materials shall be secured.

1.25.1. Entry Procedures to Controlled/Restricted Areas. The Contractor shall implement local base procedures for entry to AF controlled/restricted areas where Contractor will work.

1.26. OPERATIONAL SECURITY (OPSEC).

1.26.1. OPSEC Training.

1.26.1.1. Contractor personnel shall complete unit OPSEC in-processing training provided by the 81st Medical Group OPSEC Coordinator within 30 calendar days of reporting for duty.

1.26.1.2. All Contractor personnel shall complete annual refresher OPSEC awareness training provided by the Unit OPSEC Coordinator.

1.26.2. Disclosure of Information.

1.26.2.1. The Contractor shall not release to anyone outside the Contractor’s organization any unclassified information, regardless of medium (e.g., film, tape, document, etc.), pertaining to or execution of any part of this contract or any program related to this contract, unless:

1.26.2.2. The CO, the squadron Commander, or OPSEC Coordinator has given prior written approval; or

1.26.2.3. The information is otherwise in the public domain before the date of release.

1.26.2.4. Requests for approval shall identify the specific information to be released, the medium to be used, and the purpose for the release. The Contractor shall submit the request to the CO, the squadron Commander, or OPSEC Coordinator at least 45 days before the proposed date for release.

1.26.2.5. The Contractor agrees to include a similar requirement in each subcontract under this contract. Subcontractors shall submit requests for authorization to release through the prime Contractor to the CO, the squadron Commander, or OPSEC Coordinator.

1.26.3. LEVEL I ANTI-TERRORISM (AT) AWARENESS. Level I Anti-Terrorism (AT) Awareness Training is available upon request and will be conducted by the Installation Anti- Terrorism Officer (ATO). Contact the 81st Security Forces Squadron (81 SFS/S5X), at 228-376- 6623.

1.27. SAFETY.

1.27.1. Obligations. Contractors shall comply with the Occupational Safety and Health Act (OSHA, Public Law 91-596) and the resulting standards, OSHA Standards 29 CFR 1910 and 1926. The detailed provisions of the act for accident prevention are directly applicable to all Contractor operations. Prime Contractors are also responsible for ensuring any sub-contractors also adhere to OSHA Guidance. OSHA compliance officers visit Contractor worksites on the installation.

1.27.2. Responsibilities. Following is a list of responsibilities for Contracting, Contractor, and Wing Safety personnel.

a. Contractor Responsibilities.

(1) Contractors are responsible for ensuring all industrial safety provisions are followed.

(2) Contractors must report all accidents involving Air Force people, property, or equipment damage, and any Contractor personnel injured in the performance of the Air Force contract to the CO.

(3) Take immediate corrective action to comply with safety regulations if informed of a violation by the CO.

b. Contracting Officer (CO) Responsibilities.

(1) Inform Contractor of non-compliance with safety regulations, which may cause injury to Air Force personnel or property.

(2) Notify Wing Safety of any injuries or damage to AF property reported by the Contractor, in performance of an Air Force contract.

c. Wing Safety Responsibilities.

(1) 81st Training Wing Safety Personnel will periodically monitor Contractor operations to ensure safety regulation compliance as it applies to Air Force personnel and equipment.

(2) Wing Safety personnel are available to the CO for technical assistance on matters pertaining to accident prevention.

(3) Notify the CO if a safety procedure or condition exists which requires correction by the Contractor.

1.27.3. Safety Rules. Contractors shall pay particular attention to the following safety rules and ensure strict compliance while on the installation.

a. General Safety Rules While on the Installation.

(1) Ensure adequate lighting and barricading is available and used for day and night operations.

(2) Use proper shoring during trenching operations.

(3) Post proper warning signs at indoor and outdoor operations.

(4) Secure materials when doing high work, during high winds, or when high winds are forecasted.

(5) Use warning signs, barricades, or flagmen when operations present a hazard to drivers, pedestrians, or workers.

b. Traffic Rules While on the Installation. All drivers, mobile equipment, and vehicles must comply with applicable federal, state, and local laws.

(1) Seat belts are mandatory for all passengers as well as drivers

(2) An approved bicycle helmet is required to be properly worn while riding bicycles on the installation.

(3) Drive the speed limit:

(a) Base proper speed limit is 25 mph or as posted.

(b) Housing area speed limit is 15 mph.

(c) Parking lot speed limit is 5 mph.

(4) Give full attention to the operation of the vehicle. Avoid operator distractions, such as using cellular phones, text messaging, etc. while operating a vehicle.

(5) Park in designated areas and IAW Keesler AFB Instruction (KAFI) 31-218, Installation Traffic.

(6) No riding in the beds of trucks, buckets of front end loaders, or tandem riding on vehicles designed for one-person operation.

(7) Use safety chains in addition to towing hooks when towing equipment.

(8) Place a light on the rear of equipment being towed during the hours of darkness.

(9) Mark overhanging portions of loads with warning flags or lights.

(10) When driving or using a crane or cherry picker, be cautious around power lines crossing the road and don't position booms closer than 10 feet to overhead high voltage lines.

(11) Ensure electrical work is IAW the National Electric Code.

(12) Upon encountering troop formations on the installation:

(a) Maintain 50-foot distance behind formations until signaled to pass by the troop commander. When signed to pass troop formation, do not exceed 10 mph while passing.

(b) When passing from the front, proceed without stopping, but slow to 10 mph while passing.

1.28. SMOKING IN AETC FACILITIES. Contractors are advised that the Commander has placed restrictions on the smoking of tobacco products in AETC facilities. AFI 40-102, Tobacco Free Living, 4 Mar 15, outline the procedures used by the commander to control smoking in our facilities. Contractors and visitors are subject to the same restrictions as Government personnel.

Smoking is permitted only in designated smoking areas.

1.29. ENVIRONMENTAL MANAGEMENT SYSTEM (EMS). All Contractor personnel shall complete Environmental Management System (EMS) Awareness training prior to commencement of any activities. Training is available through the Air Force Advanced Distributed Learning Service (ADLS), the Environmental, Safety and Occupational Health Training Network (ESOHTN), or through the Environmental Office (KBOS/CEV).

1.30. HAZARDOUS MATERIALS. In the event that hazardous materials will be used in the execution of this contract, the Contractor shall be required to obtain authorization from the Installation Hazardous Materials Management Program before ordering or purchasing the hazardous product, IAW AFI 32-7086, Hazardous Materials Management, 2 Feb 15. This authorization process may take up to two weeks, which should be considered in the performance period of this contract.

1.31. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996

(HIPAA). HIPAA is comprised of several different sections, each to be implemented by the Department 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 MTF. The specific implementation of HIPAA Privacy for DoD MTFs is set forth in DOD 6025.18-R, DoD Health Information Privacy Regulation, 24 Jan 03, and for HIPAA Security, the requirements for AF MTFs are contained in DOD 8580.02-R, DoD Health Information Security Regulation, 12 Jul

07. DOD 6025.18-R and DOD 8580.02-R are incorporated herein by reference. MTFs are responsible to ensure 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 and DoD 8520.02-R. Additional HIPAA requirements will be addressed when implemented.

a. Introduction.

(1) 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 or DOD 8520.02-R.

(a) HITECH Act shall mean the Health Information Technology for Economic and Clinical Health Act included in the American Recovery and Reinvestment Act of 2009.

(b) Individual has the same meaning as the term “individual” in 45 CFR 164.501 and 164.103 and shall include a person who qualifies as a personal representative IAW 45 CFR 164.502(g).

(c) Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160 and part 164, subparts A and E.

(d) 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.

(e) Electronic Protected Health Information has the same meaning as the term “electronic protected health information” in 45 CFR 160.103.

(f) Required by Law has the same meaning as the term “required by law” in 45 CFR 164.501 and 164.103.

(g) Secretary means the Secretary of the Department of Health and Human Services or his/her designee.

(h) Security Incident shall have the same meaning as the term “security incident” in 45 CFR 164.304, limited to the information created or received by Contractor from or on behalf of the Covered Entity.

(i) Security Rule means the Health Insurance Reform: Security Standards at 45 CFR part 160,162 and part 164, subpart C.

(2) 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.

(a) 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.

(b) The Contractor agrees to use appropriate safeguards to maintain the privacy of the Protected Health Information and to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract.

(c) The HIPAA Security administrative, physical, and technical safeguards in 45 CFR 164.308, 164.310, and 164.312, and the requirements for policies, procedures, and documentation in 45 CFR 164.316 shall apply to the Contractor. The additional requirements of Title XIII of the HITECH Act that relate to security and that are made applicable with respect to covered entities shall also be applicable to the Contractor. 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.

(d) 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.

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

(f) 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.

(g) 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.

(h) 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.

(i) 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.

(j) 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.

(k) 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.

(l) 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 IAW 45 CFR 164.528.

(m) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected IAW 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 IAW 45 CFR 164.528.

b. 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, IAW 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. The additional requirements of Title XIII of the HITECH Act that relate to privacy and that are made applicable with respect to covered entities shall also be applicable to the Contractor.

c. Specific Use and Disclosure Provisions.

(1) 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.

(2) 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…