Attachment_1_-_Rehab_Specialist_PWS_-_19_Oct_17.pdf

Performance Work Statement

Sport Rehabilitation Specialist Service Contract

Robins AFB

19 October 2017

1.0 Description of Services: The contractor shall provide all labor, management, supervision, teaching, consultations and reports for the outpatient health care services required for Government beneficiaries for the 78th Medical Group (MDG), Robins AFB, GA for “Medical Treatment Facility” (MTF). The contractor shall provide three Sport Rehabilitation Specialists and one Medical Administrative Clerk who shall follow the professional standards of the Accreditation Association for Ambulatory Health Care and The Joint Commission.

1.1 Sport Rehabilitation Specialist

1.1.1 Qualifications

1.1.1.1 Completion of a Bachelor’s degree or higher in a health related discipline such as pre-medical sciences, kinesiology, exercise physiology, biology, exercise science, athletic training, or physical education.

1.1.1.2 Athletic trainer certification from an agency accredited by the National Commission for Certifying Agencies or American National Standards Institute and a current, unrestricted Athletic Trainer’s license in any one of the fifty States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands.

1.1.1.3 Contractors shall provide three Certified Industrial Rehabilitation Specialists; two of which must be Certified Functional Capacity Evaluators. Contractors shall obtain certifications at no cost to the government.

1.1.1.4 Contractors shall submit employee resumes demonstrating at least two years employment experience, within the past three years, performing injury rehabilitation in an industrial setting.

1.1.1.5 Proficiency in Microsoft office programs of Word, Excel and PowerPoint.

1.1.1.6 Submit all certifications and training documentation prior to contract award.

Training documentation shall include the following: Conducting functional capacity evaluations, performing job demand analysis, providing work hardening/word flow, work conditioning, making functional progress notes, and writing functional discharge summaries.

1.1.1.7 Contractors will conduct and certify Primary Source Verification for all employee certifications prior to contract award.

1.1.2 Specific Tasks

1.1.2.1 Perform a full range of physical rehabilitative services in accordance with the scope of clinical privileges granted by the MTF, to include initial assessment, immediate care, and rehabilitative management of injuries for employees referred from the 78 MDG’s Occupational Medicine Services (OMS). Obtain access to initial evaluation following OMS referral is w/in 5 working days.

1.1.2.2 Serve as the subject matter experts concerning injury evaluation/assessment, injury prevention, rehabilitation, physical accommodation, ergonomic assessment and implementation, injury prevention, and work conditioning/work hardening.

1.1.2.3 Provide appropriate therapeutic procedures while providing a full range of rehabilitative services in support of patient referrals. Implement a program of corrective exercise and treatment for assigned patients, with the advice and consent of the OMS provider. Treat patients with physical modalities, such as heat, light, sound, cold, electricity, or mechanical devices. Instruct patients on segments of the rehabilitation program including appropriate exercises and proper use of exercise equipment.

1.1.2.4 All patient contact and care shall be safe, timely, result in achievement of realistic and documented treatment goals, and comply with or satisfy the intent of the referring medical staff.

1.1.2.5 Test and measure the patient's strength, motor development, sensory perception, functional capacity, and range of motion. Record findings to develop or revise treatment programs.

1.1.2.6 Plan and prepare written treatment programs based on an evaluation of the patient.

1.1.2.7 Administer manual exercises to improve and maintain function.

1.1.2.8 Instruct, motivate, and assist patients in performing various physical activities, such as non-manual exercises, ambulatory functional activities, daily-living activities, and in use of assistive and supportive devices, such as crutches, canes, and prostheses.

1.1.2.9 Administer treatments involving application of physical agents, using equipment such as a pulsed lavage unit and/or whirlpool bath, moist packs, ultraviolet and infrared lamps, and ultrasound machines. Evaluate effects of treatment at various stages and adjust treatments to achieve maximum benefit.

1.1.2.10 Administer soft tissue mobilization, applying knowledge of mobilization techniques and body physiology.

1.1.2.11 Administer traction to relieve pain, using traction equipment.

1.1.2.12 Record treatment, response, and progress in patient's chart and/or automated systems.

1.1.2.13 Instruct patient and family in treatment procedures to be continued at home. Inform patient and family to create aftercare treatment plan.

1.1.2.14 Evaluate, fit, and adjust prosthetic and orthotic devices and recommend modification as required.

1.1.2.15 Coordinate treatment with the OMS provider and other staff members to obtain additional patient information, suggest revisions in treatment program and integrate rehabilitative therapy treatment with other aspects of the patient's health care. Contact referring OMS provider regarding patient care concerns, as required.

1.1.2.16 Provide thorough documentation of initial evaluations, treatment visits, functional goal based biweekly progress notes and discharge summaries using the SOAP (subjective, objective, assessment, and plan) note format. Documentation is to include the following elements:

1.1.2.16.1 Initial evaluation, including plan of treatment and goals (SOAP note format).

1.1.2.16.2 Appropriate patient medical history.

1.1.2.16.3 Patient examination results.

1.1.2.16.4 Functional assessment.

1.1.2.16.5 Type of treatment and body part(s) to be treated.

1.1.2.16.6 Expected frequency and number of treatments.

1.1.2.16.7 Prognosis.

1.1.2.16.8 Goals (should be functional, measurable and time-based).

1.1.2.16.9 Precautions and contraindications should be noted.

1.1.2.16.10 Statement that the treatment plan and goals were discussed and understood by the patient (can use patient rehab services agreement form).

1.1.2.16.11 Daily treatment records.

1.1.2.16.12 Record any changes in physical status, provider orders or treatment plan or goals.

1.1.2.16.13 Record biweekly progress notes, especially on goal progress (SOAP note format).

1.1.2.17 Provide input and attend OMS rehabilitation team/case management meetings, seminars, and quality assurance meetings.

1.1.2.18 Participate in peer review activities to evaluate for No More than 2% of patients referred to an inappropriate level of care.

1.1.2.19 Provides work hardening and work conditioning services, along with functional progress notes and functional discharge summaries.

1.1.2.20 Provides industrial rehabilitation consultation at various worksites within the Warner Robins Air Logistics Complex consisting of:

1.1.2.20.1 Identification of specific risk factors (e.g. excessive forces, awkward postures, unnecessary repetitive/vibratory motion) for injuries and options available to mitigate

1.1.2.20.2 Provision of quantitative job demand analysis that focuses on anthropometric factors at the human-machine interface

1.1.2.20.3 Participate as musculoskeletal consultant in processes that strive to match the physical work activities to the functional abilities of the employees.

1.1.2.21 Provide injury prevention education and training.

1.1.2.21.1 Educate supervisors and employees how to identify the early signs and symptoms of musculoskeletal disorders, and ways to mitigate.

1.1.2.21.2 Provide safe body mechanics training involving back, upper extremity, and lower extremity safety.

1.1.2.21.3 Promote musculoskeletal wellness.

1.1.2.22 Provide Functional Capacity Evaluation reports to help ascertain the employees’ ability to perform work and to assess an employee’s potential work limitations for use in pre-placement/pre-employment examinations, fitness for duty examinations, reasonable accommodation consideration, and in post work hardening/work conditioning achievement.

1.1.2.23 Additional duties may be assigned.

1.2 Medical Administrative Technician

1.2.1 Qualifications

1.2.1.1 A minimum of 60 words-per-minute.

1.2.1.2 Provide knowledge of preparing and editing written correspondence, using correct grammar and mechanics. Proper word apply to 1.1.1.5.

1.2.1.3 Proficient in Microsoft Office software. Able to use various programs, such as Word, Excel, Access, PowerPoint, and Project to generate various products.

1.2.1.4 Operate standard office equipment, such as computers, scanners, copiers, fax machines, telephone systems and office automation systems, to perform a substantial range of office support.

1.2.1.5 Provide excellent customer service skills, telephone etiquette, and exhibit general medical ethics.

1.2.1.6 Education: High School Diploma or General Educational Development (GED) equivalency.

1.2.2 Specific Tasks

1.2.2.1 Prepare recurring and nonrecurring correspondence, reports, minutes, and other documents.

1.2.2.2 Proofreads/edits documents. Ensures procedural and grammatical accuracy, conformance with general policy, and factual correctness. Ensures coordination procedures are followed.

1.2.2.3 Screen incoming mail and distributes to appropriate staff member or offices.

1.2.2.4 Requisitions office supplies, printing support, and related materials and services. Update the tracker or suspense files as required.

1.2.2.5 General medical ethics, telephone etiquette, and excellent communication and customer service skills.

1.2.2.5 Initiate and maintain medical records in accordance with prescribed directives.

1.2.2.6 File government forms documenting patient care into patient medical records.

1.2.2.7 Review records to ensure proper and complete documentation.

1.2.2.8 Greet patients/visitors at a front desk, information center, or office setting.

1.2.2.9 Answer main office phone line, direct calls to appropriate section, and take messages as required.

1.2.2.10 Prepare weekly metric reports for the Fast Forward Medical Service Clinic to include rehabilitative specialist utilization.

1.2.2.11 Contact the Facility Manager, Building 49, of any environmental, housekeeping, or facility related issues that may affect daily operations of the Fast Forward Medical Service Clinic.

1.2.2.12 Notifies OMS Flight Commander and OMS Administrator of any issues that may affect clinical operations.

1.2.2.13 Monthly Time report: Collect and submit monthly time report for each employees’ working hours for the previous month to OMS Administrator on 1st working day of each month. If services are rendered at building 207, employee must submit a seperate employee time report via Defense Medical Human Resource System internet (DMHRSi) bi-weekly as directed by the OMS Administrator.

1.2.2.14 Additional duties may be assigned.

2.0 Services Summary

Performance Objective PWS Para

Performance Threshold

Provide Peer Review 1.1.2.18 No More than 2% of patients referred to an inappropriate level of care

Provide initial evaluation 1.1.2.1 within 5 working days

3.0 Government Furnished Equipment.

3.1 Government Inventory

3.1.1 The Government shall provide administrative space, (desk, chair, desktop computer, copier (access), fax and a networked printer). In addition, the Government shall provide telephone service consisting of Class 3 (formerly referred to as class C) and Class 1 (formerly referred to as Class A) service, to include the Defense Switched Network. Telephone service classes are defined in Air Force Instruction (AFI) 33-111, 24 Mar 05, Voice Systems Management, Section B, Chap. 31. The contractor shall ensure use of all government provided equipment/facilities is limited to performance of contract related official Government business. Upon completion or termination of the contract or expiration of employee identification passes, the prime contractor shall ensure that all Government Furnished Equipment to include base ID passes, desktop computer, laptop computers, peripherals, and other software/hardware is returned to the Contracting Officer Representative (COR) and each individual is processed through the directed Out-processing checklist.

3.1.2 The CHCS and the newest version, AHLTA, ICD-B, Fax Forward and HAIMS programs shall be utilized for referral management services. Access will be granted by MTF connectivity and the contractor shall comply with MHS communications and Government IT security standards and policies. The military facility will provide system accounts for Joint Personnel Adjudication System (JPAS) personnel after required training and security procedures have been completed by the contractor.

3.2 Medical equipment and supplies: The Government will provide medical equipment and supplies at no cost to the contractor.

4.0 General Information

4.1 Credentialing/Privileging of Providers (Rehabilitation Specialists)

4.1.1 Providers will be subject to the credentialing and privileging requirements of AFI 44-119, Medical Quality Operations, to include adverse actions.

1080537162A Sticky Note This services summary must match the QASP.

4.1.2 The chief of the medical staff, or his/her representative, will define the scope of practice for providers.

4.1.3 The Contractor shall make proposed providers available for interview by the MTF during the credentialing process.

4.1.4 The credentials of providers shall be reviewed and privileges granted as outlined in AFI 44-119, Medical Quality Operations.

4.1.5 In the event of an adverse action, the Contracting Officer (CO) shall be notified by the COR when the necessity to exercise such authority becomes apparent. The COR will also provide the CO with a written statement advising the Contractor of an adverse action involving a health care provider, a brief statement of the basis for the action to provide the Contractor sufficient information in order to make employment/substitution decisions as necessary, and if required, the final outcome of the adverse action process. The written notice(s) will be marked by the government as covered by 10 USC 1102. No other information pertaining to the adverse action will be released without MTF/CC permission.

4.2 Continuing Education Unit Requirements

4.2.1 Health care workers, licensed, registered or certified by national/medical associations shall continue to meet the minimum standards for Continuing Medical Education (CME) to remain current as prescribed in AFI 41-117, Medical Service Officer Education. CME shall be obtained at no additional cost to the Government and shall be reported to the COR and MTF Credentials Committee annually on the first normal duty day in January for the previous calendar year.

Periodic CME may be conducted at the MTF and will be available, at no cost, to any healthcare provider desiring to attend.

4.2.2 Health care providers shall be in good standing, and under no clinical restrictions, with the state licensure board in any state in which a license is held or has been held within the last 10 years.

4.2.3 Health care providers shall maintain current certification in required training as stated in individual task orders

4.3 MTF Requirements: The health care workers shall complete all MTF-specified orientation program(s), initial and annual training requirements, and comply with all MTF policies, procedures, productivity standards and instructions as provided by the MTF. Orientation shall include training to regulations specific to position, and hospital and Air Force policy and procedures, instructions on automation processing, quality assurance policies, CHCS/AHLTA (obtain password) and other information systems, local in-service and safety briefings.

4.3.1 Life Support Certification: All health care workers shall maintain current certification in either the American Heart Association Basic Life Support (BLS) (Course C) or the American Red Cross CPR/BLS Course at no cost to the government.

4.3.2 Health Insurance Portability and Accountability Act (HIPAA): All individuals performing services at an Air Force MTF are required to complete initial and annual refresher HIPAA

Privacy training as provided by the MTF for its personnel and will be held accountable for complying with health information privacy and security policies and procedures

4.4 Personnel Requirements

4.4.1 Communication: Personnel should demonstrate effective communication skills with patients and medical staff regarding treatment plans, directives or policies. Effective communication ensures patient understanding and comprehension of simple or complex medical conditions.

4.4.2 Professional Conduct: Employees shall dress professionally and comply with reasonable grooming standards. Hospital badges will be issued to all Contractor personnel and must be worn while working inside the MTF during duty hours. The contractor shall use appropriate courtesies, including military customs (addressing people by rank and name).

(Contractor shall comply with Customer Service (Medical Group Instruction (MDGI) 44-32).

4.4.3 Customer Service: Contract employees shall respect and maintain the basic rights of staff members, demonstrating concern for personal dignity and human relationships. Employees receiving complaints validated by the COR and Chief of the Medical Staff, shall be subject to and, depending on the nature and severity of the complaint, separation from performing services.

All complaints must be resolved within 30 days. The healthcare worker shall not receive more than two validated complaints per year.

4.5 Medical Recordkeeping: Medical records and files will be initiated and maintained in accordance with facility policies (MDGI 48-20, MDGI 44-16, MDGI 44-30) and AFI 41-210, Patient Administration Functions, and AFI 41-211, Management of Medical Information Services. Contractor shall have no more than one validated administrative complaint with a 3 month period.

4.6 Health Requirements

4.6.1 In accordance with AFI 48-105, Surveillance, Prevention, and Control of Diseases and Conditions of Public Health or Military Significance, all health care workers shall follow the methods for controlling and preventing disease as described in the American Public Health Association publication, Control of Communicable Diseases Manual, and the Centers for Disease Control and Prevention (CDC) publication, Morbidity and Mortality Weekly Report, and its supplements. Where applicable, the most recent guidelines from these publications are utilized as the standard.

4.6.2 Before start of work, the Contractor’s employee shall provide proof of immunization from the following diseases according to CDC guidelines: Hepatitis B, measles, mumps, rubella, varicella, and influenza. The health care worker shall also provide proof of a negative Tuberculosis Skin Test within 12 months (if positive, proof of negative chest X-ray within 12 months) prior to start of work. After start of work, the Government will provide post blood borne exposure protocols according to applicable AFIs.

4.6.3 In those areas where a higher risk of transmission of tuberculosis exists, health care workers will be tested as frequently as directed by the MTF policy. This test will be provided by the MTF. The Contractor’s employee does have direct patient care, but not involved in the clinical aspect of case, just the administrative process.

4.6.4 Immunization information will be tracked in DoD computer systems for all health care workers.

4.6.5 Medical Tests: No medical tests or procedures required by the contract may be performed at the MTF (with the exception of Tuberculosis testing after start of work). Expenses for all required tests and/or procedures shall be borne by the health care workers at no additional expense to the Government.

4.6.6 Health care workers must be immunized annually with the influenza vaccine. This vaccine will be provided by the Government, if available as determined by the MTF. Although this vaccine may be provided by the Government, it may be obtained at other facilities with the cost being borne by the health care worker or the Contractor. Unless vaccinated by the Government, the health care worker shall be required to show proof of the vaccination.

4.7 Procedure Guidance: Health care workers shall perform procedures compatible with the medical facility’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.

4.8 Security Requirements

4.8.1 Government Security Regulations: The contractor shall ensure personnel, information, system, facility, and international security requirements are met in accordance with DoD 5220.2, DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), AFI 31- 101, Integrated Defense, and Robins Air Force Base Instruction 31-101, Installation Security.

4.8.2 Security Clearance: The Contractor shall ensure Contractor personnel have a valid security clearance appropriate to the access required for proper accomplishment of contract/order requirements. Contractor personnel shall not be authorized access to classified and/or sensitive, but unclassified, information and/or materials or be permitted to work on classified and/or sensitive, but unclassified, projects and/or programs without a proper security clearance and a need-to-know. Contractor personnel whose clearances have been suspended or revoked shall immediately be denied access to classified and/or sensitive, but unclassified, information.

4.8.3 Communications Security: The contractor shall use only secure communications methods and/or equipment to transmit or otherwise transfer classified and/or sensitive, but unclassified, information in accordance with DoD 5220.22-M.

4.8.4 Access to Government System: The government will provide contractor personnel access to systems required to perform tasks under the contract/order. The contractor shall ensure Contractor personnel who require access to a government information system have a Defense National Agency Check with Inquiries conducted in accordance with DoD 5220.2. The government will provide system access subject to approval of the DD Form 2875. Upon completion/termination of the contract/order or transfer/termination of Contractor personnel, the system account will be closed.

4.9 Access to Government Facilities

4.9.1 The Contractor shall ensure Contractor personnel who require access to Robins AFB or other Government facilities comply with the security procedures of the facility.

4.9.2 If Contractor personnel require repeated access to Robins AFB or another government facility over the life of the contract/order, the Contractor shall ensure they complete, as applicable, a DD Form 1172-2 (Application for Department of Defense Common Access Card – DEERS Enrollment) to obtain a Common Access Card, an Air Force Materiel Command (AFMC) Form 496 (Application for AFMC Identification Card) to obtain an AFMC Identification Card, or an AFMC Form 387 (Contractor ID Card/Badge) to obtain a Contractor Identification (ID) Card/Badge.

4.9.3 All visitation requests will be submitted through the JPAS to the contract security manager Security Management Office code RX1MFN826. Visitations will be made available for review by the Group Security Manager of the area where the task will be performed.

4.10 Operations Security (OPSEC): The Contractor shall ensure compliance with OPSEC requirements including procedures to protect classified and/or sensitive, but unclassified, Government projects and/or programs. The Contractor shall ensure Contractor personnel who perform work at Robins AFB or another Government facility comply with the OPSEC procedures of the facility.

4.11 Security Incident or Violation: The Contractor shall immediately notify the Government Security Office of any potential or actual security incidents or violations including potential or actual unauthorized disclosure or compromise of classified and/or sensitive, but unclassified, information.

4.12 Place of Performance:

4.12.1 Services shall be performed in Building 49, Building 207 or as at determined by the OMS Flight Commander.

4.13 Schedule

4.13.1 The contractor shall conform to Government approved work schedules between the hours of 7:30 am to 9:30 pm. The contractor must maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS. Each position shall be full-time equivalent of 1920 hours per year. Hours of operation exclude federal holidays and specific days the MTF is closed by order of the Commander.

4.14 Absences and Leave

4.14.1 The contractor shall not be compensated during periods of absences and leave to include both personal and sick leave.

4.14.2 In case of absences or illness (more than 80 consecutive hours), the contractor shall replace the absent employee with another person of equal qualifications. The identified substitute must be acceptable to the MTF. (The contractor will be allowed recruitment time if appropriate under the circumstances).

4.14.3 The contractor shall advise the 78 MDG Service Contract Evaluator and supervisor about absences due to illness or incapacitation. If the contractor is absent for three or more consecutive days due to illness, the contractor shall provide written documentation from a qualified health care provider that he or she is free from communicable disease. The Government reserves the right to examine and or re-examine any worker who meets this criterion.

4.14.4 The contractor shall notify the MTF 30 days in advance of scheduled leave and accommodate the MTF schedule for leave periods of two weeks or more.

4.14.5 The Government supervisor may direct the health care worker to remain on duty in excess of their scheduled shift due to an unforeseen emergency or to complete patient treatment where lack of continuity of care would otherwise jeopardize patient health, the health care worker 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.

4.14.6 During anticipated closure of the facility, (i.e., training holidays, administrative leave granted to the entire staff, or other closure) the contracted staff (for leave and pay purposes) will be treated in the same manner as non-essential DoD civilian employees. If the DoD civilian employees must take annual leave, the health care workers’ MTF supervisor will determine whether the contractor staff must take vacation time or be allowed to provide services elsewhere within the MTF. In the event of unplanned closure of the facility due to natural disasters, military emergency, or severe weather, contract employees will be treated (for leave and pay purposes) in the same manner as DoD civilian employees.

4.15 Performance / Recruitment: When the contractor experiences any delays in accomplishing the specific tasks identified below, the contractor shall notify the 78 MDG Service Contract Evaluator immediately.

4.15.1 Submit resumes of qualified individuals considered for employment to the Services Contract Evaluator within 10 business days of contract award. The Government reserves the right to interview, approve or disapprove all candidates.

4.15.2 Upon award, a DD Form 1155 will be transmitted to the contractor. Complete and accurate security and credentialing packages shall be submitted to the MTF no later than 30 calendar days before start of work.

4.16 Records: The contractor shall be responsible for creating, maintaining, and disposing of only those Government required records which are specifically cited in this PWS or as may be required by the provisions of a mandatory directive listed in this PWS. If requested by the Government, the contractor shall provide the original record or a reproducible copy of any such records within five working days of receipt of the request.

4.17 Patient Lists: Patient lists, no matter how developed shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF without prior written permission by the Chief of the Medical Staff.

4.18 Release of Medical Information: The provider shall only release medical information obtained during the course of this contract to other MTF staff involved in the care and treatment of that individual patient.

4.19 Green Procurement Program (GPP)

4.19.1 The contractor shall comply with the Green Procurement Program in accordance with Federal (EO 13423) and DoD and AF GPP policy. Green Procurement is the purchase of environmentally preferable products and services. These products are preferred because they conserve resources, create less pollution and waste, or eliminate health and safety risks. The GPP includes these mandatory components:

4.19.1.1 Recycled content products, also known as Comprehensive Procurement Guideline (CPG) Items (http://www.epa.gov/cpg/products.htm)

4.19.1.2 Energy Star® and energy-efficient products; energy efficient standby power devices (http://www.eere.energy.gov/)

4.19.1.3 Bio-based products (http://www.biobased.oce.usda.gov/fb4p/)

4.19.1.4 Non-ozone depleting substances (http://www.epa.gov/ozone/snap/lists/index.html)

4.20 Environmental Management System (EMS): Any contractor employee working on Robins Air Force Base will require EMS training. The prime contractor is responsible for ensuring that all subcontractors comply with this requirement. Computer-based training is provided by the Base Civil Engineering Group Environmental Management Office.

https://geobase.robins.af.mil/emstraining/EMSTrainingOptions.aspx. For questions concerning this training, contact 78 CEG/CEVP, 926-1197 Ext 134 for assistance.

4.21 Contractor’s Safety Requirement: The Air Force is part of the OSHA Voluntary Protection Program (VPP). All shall familiarize themselves with the requirements of VPP. Information on the VPP can be accessed at http://www.osha.gov/dcsp/vpp/index.html. Additionally, the contractor is responsible for the safety and health of all subcontractor employees. (Contract Data Requirements List (CDRL) A001, Safety Plan, DI-MGMT-51580/T)

4.22 Mishap/Incident Reporting: The contractor shall report all mishaps/incidents in accordance with the contract Appendix C. The contractor shall immediately secure the mishap scene, damaged property, and impound pertinent maintenance and training records until released by the http://www.epa.gov/cpg/products.htm http://www.biobased.oce.usda.gov/fb4p/ http://www.epa.gov/ozone/snap/lists/index.html https://geobase.robins.af.mil/emstraining/EMSTrainingOptions.aspx

Government’s Safety Office. Such release shall be accomplished through the CO. The contractor shall cooperate and assist Government personnel in the investigation of the incident and submit an Accident/Incident Report within 24 hours of the accident/incident. The Contractor shall require all subcontractors to comply with required safety, health and fire standards. (CDRL A002, Mishap/Incident Reporting, DI-SAFT-81563/T)

4.23 ADP III Security Requirements

4.13.1 Since the health care workers have access to and/or process information requiring protection under the Privacy Act of 1974, these positions are considered “ADP III” positions.

Compliance with DoD Directive 8500.1, DoD Directive 5200.2, AFI 31-501 and AFI 33-202 is mandatory for ADP III positions. Therefore, a National Agency Check with Inquiries (NACI) is required for each health care worker under this contract. The contractor shall fully adhere with the provisions of referenced publications by having each of their employees who are performing under this contract make an appointment (through the COR) with the appropriate security organization at the installation where service is provided. Each individual will be fingerprinted and required to complete the appropriate forms, Standard Form 85-P, Questionnaire for Public Trust Positions. The contractor shall advise their employees that a positive report is needed as a condition of employment under this contract. The Contractor shall apply for the NACI prior to the start of performance for each health care worker.

4.24.2 The contractor understands, while the MTF commander may allow health care workers to temporarily occupy non-critical sensitive positions pending NACI, the health care worker will be immediately removed from the position if at any time the NACI receives unfavorable adjudication, and/or information that would affect the NACI.

4.24.3 The contractor shall ensure the following forms reach the MTF Unit Security Manager NLT 2 weeks (14 calendar days) prior to the employee’s start date in the MTF:

SF-85P, Questionnaire for Public Trust Positions accessed at http://www.dtic.mil/whs/directives/infomgt/forms/sfofforms.htm . The contractor is to provide the MTF Unit Security Manager with two (2) printed and signed (original signatures) hardcopies of the SF-85P. Two (2) sets of FD-258, FBI Fingerprint Cards for each employee.

4.25 Essential Services During Crisis: The Functional Commander/Director has determined, by placing in writing their decision, that this requirement is not mission essential in accordance with DFARS 237.76, Continuation of Essential Contractor Services.

4.26 Travel: In the event contractor travel is required in support of these services, it shall be authorized in advance by the CO. Costs shall be reimbursed in accordance with the Joint Travel Regulation. Receipts must be presented with the invoice for reimbursement of actual travel costs.

4.27 Contractor Manpower Reporting Requirements

4.27.1 Per reference SAF/AQ Memo, 13 Nov 12, “The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided http://www.dtic.mil/whs/directives/infomgt/forms/sfofforms.htm https://cs.eis.af.mil/airforcecontracting/knowledge_center/Documents/AFFARS_Library/5337/2012-11-13_saf-aq-memo.pdf under this contract for the USAF via a secure data collection site. The contractor is required to completely fill in all required data fields at http://www.ecmra.mil (select Dept of the Air Force option if you you’re working an AF requirement). Reporting inputs will be for the labor executed for each Government Fiscal Year (FY), which runs 1 October through 30 September. While inputs may be reported 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 CMRA help desk.” (CDRL A003, Manpower Reporting, DI-MGMT-51581/T)

4.27.2 Reporting Period: Contractors are required to input data by 31 October of each year.

However, due to the delayed implementation, input of FY12 data is required by 31 Mar 13.

4.27.3 Uses and Safeguarding of Information: Information from the secure web site is considered to be proprietary in nature when the contract number and contractor identity are associated with the direct labor hours and direct labor dollars. At no time will any data be released to the public with the contractor name and contract number associated with the data.

4.27.4 User Manuals: Data for Air Force service requirements must be input at the Air Force CMRA link. However, user manuals for government personnel and contractors are available at the CMRA link at http://www.ecmra.mil (select Dept of the Air Force option if you you’re working an AF requirement).

4.28 Network Access

4.28.1 Network access is a privilege extended to contractor employees. It will be granted only after all criteria have been met and may be suspended for cause as defined in AFI 33-115 Vol 2, Section 5.6. Network access will be approved IAW AFI 31-501, AFI 31-601, AFI 33-115 Vols I and II, AFI 33-200, AFSSI 8530, AFSSI 5027, DoD 5200.40, and DoD 5220.22. Per AFI 33- 115V2, “every individual who has access to the Air Force network (af.mil) domain, specialized systems and mission systems is a network user. Before becoming an AF network user, an individual must be trained and licensed. This process of training and licensing ensures that every Air Force network user is trained and aware of the basic principles of network security and their role in Information Assurance (IA).” Every AF network user must possess a current and favorable National Agency Check (NAC) and Local Files Check (LFC). The NAC is a requirement for working on Government installations and any costs associated with obtaining the NAC shall be the responsibility of the contractor. In addition, contractors performing in an IT-I position (DoD 5200.2R, Appendix K, Para 7) require a current and favorable Limited Background Investigation (LBI).

4.28.2 Foreign Nationals must meet the requirements of AF 31-501 prior to access. Access by Foreign Nationals must be processed and approved by the Foreign Disclosure Office in accordance with AFSSI 8522 Para 3.2.1 and 3.2.3.

http://www.ecmra.mil/ http://www.ecmra.mil/

4.29 Contractor Identification Badges

4.29.1 The contractor shall complete all necessary documents for all contractor personnel requiring access to Robins AFB. Common Access Cards (CAC) will be required for all on-site contractor personnel. The contractor will ensure that each employee contacts the Trusted Agent for the 78 MDG to be added into Contractor Verification System for obtaining CAC. Additional instructions for applications will be sent to the e-mail address provided for the application. Prior to application approval, each individual will be reviewed for eligibility in the JPAS system and checked against the Warner Robins Air Logistics Complex barment roster.

4.29.2 During performance of the contract, the contractor shall be responsible for obtaining required identification for newly assigned personnel, prompt return of credentials, and vehicle passes for any employee who no longer requires access to the work site. Upon completion termination of the contract or expiration of the identification passes, the prime contractor shall ensure all base identification passes issued to employees and subcontractor employees are returned to the issuing office.

5.0 Appendices

Publication Name Date Reference AFI 41-115 Authorized Health Care and Benefits

Dec 01 IAW AFI 41-115, 1.4.10, 1.412, 1.412.1-1.412.10

Accreditation for Ambulatory Healthcare (AAAHC) Standards Manual and the Joint Commission (JCAHO) Accreditation Manual

Copyrighted 2008 L.D.3.4.8(09) AAAHC Quality of Care 0.4.M (04.M(09)

TRICARE Operations Manual

Aug 02 ALL

Personnel Security Program Apr 99 DoDD 5200.2 Standards of Conduct Aug 93 DoDD 5500.7, Ch.1, Nov 94 Health Information Privacy Jan 03 DoD 6025.18-R Information Assurance Oct 02 DoDD 8500.1 Criminal History Background Checks on Individuals in Child Care Services

Jan 93 DoDI 1402.5

Network and Computer Security

Jan 05 AFI 33-202

Medical Service Officer Education

Apr 01 AFI 41-117

Clinical Performance Improvement

Jun 01 AFI 44-119

Surveillance, Prevention, and Control of Diseases and Conditions of Public Health or Military Significance

Mar 05 AFI 48-105

Medical Examinations and Standards

May 01 AFI 48-123