Neuro PWS.doc

ATTACHMENT 2

PERFORMANCE WORK STATEMENT

FOR

NEUROPSYCHOLOGIST

Objective: The 82d Medical Group Sheppard AFB, TX, has a requirement to provide a neuropsychologist to furnish outpatient health care to Government beneficiaries. The contractor shall furnish all labor, management, supervision, teaching, consultations, preceptoring and reports, except as provided in paragraph 3. The contractor care shall cover the range of services provided in a civilian medical treatment facility. Performance shall be in accordance with this Performance Work Statement (PWS), healthcare standards of practice, Accreditation Association for Ambulatory Health Care (AAAHC), College of American Pathologists (CAP), Health Insurance Portability and Accountability Act (HIPAA), Infection Control, National Fire Protection Association (NFPA), Health Service Inspection (HSI) standards, and all local 82 TRW and MDG policies.

1. Description of Services

1.1 Recruit. Recruiting is the process by which health care workers from outside of the Government are located, contacted and hired for specific positions. The contractor shall recruit health care workers to fulfill the duties, qualifications and requirements of the position descriptions listed in this PWS. The contractor shall make all proposed health care providers available for interview by the clinics (via telephone or in person) as needed.

1.2 Qualify. Qualifying is the process by which the contractor screens potential applicants to ensure all health care workers possess the qualifications required by this PWS and meet any additional qualification requirements specified in the position descriptions.

1.3 Retain. The continuity of high quality health care workers is a vitally important component in maintaining quality of care to Air Force beneficiaries. The Contractor shall design and manage a retention program that ensures low turnover and customer satisfaction with performance of health care workers.

1.4 GENERAL DEFINITIONS. The following terms shall have the meaning set forth in accordance with the terms of this PWS and the contract.

1.4.1 GOVERNMENT. The federal government of the United States of America.

1.4.2 COMMANDER. MTF Commander, Flight Commander or other activity head, or a designated representative.

1.4.3 CONTRACTING OFFICER REPRESENTATIVE (COR). ). Individual designated and authorized in writing by the Contracting Officer to perform specific technical or administrative functions related to monitoring a contract. The COR must be a Government employee, military or civilian, qualified by training and experience commensurate with responsibilities to be delegated in accordance with department or agency guidelines, and designated in writing. The COR has no authority to make any commitments or changes that affect price, quality, quantity, delivery, or other terms and conditions of the contract." And if you need this additional verbiage, please add this version without QAE reference: “Personnel in this area may have many titles, such as Quality Assurance Specialist, Contracting Officer Technical Representative (COTR), Quality Assurance Personnel (COR), Service Contract Manager; however, their duties are essentially the same.”

1.4.4 CONTRACTING OFFICER (CO). A person duly appointed with the authority to enter into, administer, and terminate contracts on behalf of the government.

1.4.5 CONTRACTOR. The offeror identified in block 17a of Standard Form 1449. The Contractor is an independent contractor and responsible for its own liability.

1.4.6 HEALTH CARE PROVIDER (HCP). Any health care provider recruited by the Contractor, who, under regulations of a Military Department, is granted clinical practice privileges in a military MTF and/or who is licensed or certified to perform healthcare services by a Governmental board or Agency or professional health care society or organization.

1.4.7 HEALTH CARE WORKERS (HCW). All health care personnel, including healthcare providers, recruited by the Contractor who provides healthcare services in a military MTF. HCWs have a personal services relationship with the government.

1.4.8 MEDICAL TREATMENT FACILITY (MTF). Air Force hospitals or clinics, including all activities providing outpatient and/or in-patient healthcare services for authorized personnel.

1.4.9 QUALITY ASSURANCE PROGRAM. A systematic program designed to provide insight into the service provider’s processes. The program focuses on existing data/systems to obtain process improvement and enhance performance.

1.4.10 QUALITY CONTROL (QC). Those actions taken by a Contractor to control the quality of output and to ensure that they conform to contract requirements and reasonable standards of medical care.

1.4.11 SERVICES SUMMARY (SS). Prescribes how the Government plans to (1) assess contractor performance and, (2) manage the contract to obtain efficiencies, improved performance, and cost savings throughout its life cycle.

1.4.12 COMPOSITE HEALTH CARE SYSTEM (CHCS). Computer system, which stores clinical and administrative data. This system provides on-line communication for users in any supported location.

1.4.13 FEDERAL HOLIDAYS. There are ten (10) federal holidays each year.

New Year’s Day - 1 January

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

President’s Day (observed the third Monday in February)

Memorial Day (observed the fourth Monday in May)

Independence Day - 4 July

Labor Day (observed the first Monday in September)

Columbus Day (observed the second Monday in October)

Veterans Day - 11 November

Thanksgiving Day (observed the fourth Thursday in November)

Christmas Day - 25 December

1.4.14 MEDICAL TREATMENT FACILITY (MTF) DOWN TIME. Medical Treatment Facility (MTF) down time usually occurs when the Secretary of Defense issues a down day or the wing/group commander has scheduled an event for all Medical Treatment Facility (MTF) staff and has directed that all patient appointments be blocked. Standard down time usually includes the day after Thanksgiving, a Day in conjunction with Christmas and New Year’s Day. The 82d Medical Group reserves the right to schedule down days as needed.

1.5 SPECIFIC CLINICAL SUPPORT SERVICES REQUIRED.

1.5.1 GENERAL. The Contractor shall apply neuropsychological principles and techniques to problems of human effectiveness, maladjustment, and psychological disturbances. Evaluates, diagnoses, and treats neuropsychological disorders. Teaches, supervises, and directs clinical psychology and related mental health programs.

1.5.2 DUTIES AND RESPONSIBILITIES. The Contractor shall administer clinical format paragraph neuropsychology programs by performing mental health evaluations and therapy. The Contractor shall apply and supervise the application of psychological procedures and techniques in evaluating, diagnosing, and treating psychological and neuropsychological disorders. The Contractor shall provide individual and group therapy, behavior modification paradigms, and biofeedback procedures in treating psychological disorders to include behavioral airsickness management. Assist individuals to achieve more effective personal and interpersonal adjustment, especially regarding the human performance in the aerospace environment for active duty patients from Sheppard AFB TX.

1.5.3 SPECIFIC PROCEDURES FOR WHICH THE CONTRACTOR SHALL BE RESPONSIBLE. The contractor shall:

1.5.3.1 Provide services 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 medical treatment facility (MTF) Commander or authorized representative.

1.5.3.2 Apply psychological and neuropsychological principles and techniques to problems of human effectiveness, maladjustment, and psychological disturbances, especially those associated with behavioral airsickness management and with performance in the aerospace environment.

1.5.3.3 Provide evaluation, diagnosis, and treatment of psychological and neuropsychological disorders.

1.5.3.4 Conduct clinical interviews and interpret psychological and neuropsychological tests/assessments.

1.5.3.5 Diagnose mental disorders and formulate treatment plans.

1.5.3.6 Provide individual and group psychotherapy.

1.5.3.7 Recommend administrative and medical dispositions.

1.5.3.8 Perform neuropsychological screening.

15.3.9 Perform comprehensive neuropsychological evaluations.

1.5.3.10 Serve as members of, and/or make recommendations to medical evaluation boards.

1.5.3.11 Determine the degree of impairment for military service and for civilian social and industrial adaptability due to mental disorders.

1.5.3.12 Assess dangerousness, i.e., suicidal thinking.

1.5.3.13 Serve and/or advise on competency and sanity boards.

1.5.3.14 Certify stability for the sensitive duty programs such as PRP, security clearances, and special access.

1.5.3.15 Certify mental competency when administrative or legal matters arise.

1.5.3.16 CLINIC SUPPORT. The contractor shall provide outpatient services for patients as scheduled by the Government.

1.5.3.17 REFERRALS AND CONSULTS. The physicians shall follow DoD, Air Force, and MTF regulations/policies when arranging for a referral or consult. The contract neuropsychologist shall inform patients of the required referral or consult by indicating the specialty involved. The neuropsychologist shall not recommend to the patient that he/she consult a specific practitioner or use a specific practice.

1.5.3.18 PRECEPTORING. The contract neuropsychologist shall preceptor a military psychologist who is not yet licensed or experienced in Aerospace Psychology.

1.5.3.19 CONDUCTS TRAINING. The contract neuropsychologist shall serve in an advisory and teaching capacity.

2. SERVICES SUMMARY (SS)

REF

Acceptable Quality Level

PWS 1.1

Notifies Government of non-availability of qualified candidates for identified positions no more often than 1 time per calendar year

PWS 1.2

No more than 1 complete and accurate package submitted later than 30 calendar days before start of work with no packages incomplete, inaccurate or submitted later than 25 calendar days before start of work.

All MTF substantiated complaints resolved within 30 calendar days from receipt of complaint from COR

Turnover ratio NTE 1.2 per year

Invoice hours submitted by contractor match MEPRS* data to within 2 hours per month

Any health care worker receives no more than two substantiated patient complaints per year

*Medical Expense Performance Rating System (MEPRS)

3. Government Furnished Property/Contractor Furnished Items and Services.

Property and services are only authorized for government official business that relates to the performance of this contract. The Government will provide the following equipment, supplies, and services listed below:

3.1 EQUIPMENT/OFFICE FURNITURE.

3.1.1 The health care workers shall have joint use of all available equipment for performing services required by this contract.

3.1.2 PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish the health care workers with appropriate PPE. The Government will be responsible for any repair, cleaning, and inventory required for the PPE. The Government will furnish laboratory coats. This does not include any type of uniform or respirator devices or items listed in 4.1.5.

3.1.3 SUPPLIES. The MTF will provide medical and non-medical supplies (except stethoscopes) commonly used in the facility for the care and management of patients. Commonly used supplies are those routinely stocked by the MTF.

3.1.3.1 FORMS AND PUBLICATIONS. The MTF will provide required government forms and publications used in the performance of services.

3.1.4 COMPUTER EQUIPMENT. The MTF will provide computer equipment required to schedule, check in, document, order ancillary services, and maintain appropriate electronic medical information that support the hard copy medical record. The MTF will provide required training for these systems. The health care workers will be required to use the computer systems that are standard for the support of health care delivery at the MTF.

3.1.4.1 The health care worker will be required to sign a Network User License Agreement (NULA) before they can be allowed access to such computer systems.

3.1.5 UTILITIES. For the purpose of this contract, the government will furnish all required utilities (such as water, telephone, electricity, etc.) at no cost to the health care workers. Long distance and Defense Switched Network (DSN) telephone services will be provided for official use only. The health care workers shall participate in government energy conservation programs.

3.1.6 PATIENT SCHEDULING. Clinic personnel will assist in patient scheduling. Complete administrative control of the patient shall remain with the Government.

3.1.7 HOUSEKEEPING. Housekeeping services will be provided by the MTF.

3.2 The Contractor will provide the following equipment, supplies, and services listed below:

3.2.1 UNIFORMS. Healthcare providers shall furnish their own uniforms/scrubs per paragraph 4.13.3 of this PWS.

3.2.2 REPORTS. The Contractor shall submit reports to the FC and CO as requested for use in monitoring the healthcare providers’ performance. Such reports shall include, but are not limited to, personnel recruitment and projected losses.

3.2.3 Healthcare providers requiring stethoscopes will provide their own.

4. GENERAL INFORMATION

4.1 HEALTH REQUIREMENTS

4.1.1 In accordance with AFI 48-105, 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 (MMWR), and its supplements. Where applicable, the most recent guidelines from these publications are utilized as the standard. Contract personnel will be responsible for providing all information necessary to public health to assure personnel occupation health records are maintain correctly.

4.1.2 Before start of work, health care workers shall provide proof of immunization from the following diseases according to Center for Disease Control (CDC) guidelines: Hepatitis B, measles, mumps, rubella, varicella, and influenza. The health care worker shall also provide proof of a negative TB 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. In addition, random drug screens may be done at government request and expense. Contract personnel shall report to a contractor’s physician to receive a pre-employment examination and immunizations/shots prescribed by the MDG.

4.1.3 In those areas where there is a higher risk of transmission of tuberculosis, health care workers will be tested as frequently as directed by the MTF policy. This test will be provided by the MTF.

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

4.1.5 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 (e.g., respirator fit testing where required) shall be borne by the health care workers at no additional expense to the Government.

4.1.6 Health care workers shall be immunized annually with the seasonal influenza vaccine and any other vaccine recommended by the Advisory Committee on Immunization Practices (ACIP) of the CDC for HCW. 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.

4.1.7 LIFE SUPPORT CERTIFICATION. At a minimum, all health care workers must maintain current certification in either the American Heart Association Basic Life Support (BLS) (Course C) or the American Red Cross CPR/BLS Course. In addition, Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS) and Neonatal Resuscitation Program (NRP) certifications shall be as required by AFI 44-102, Community Health Management or local policy.

4.2 PREGNANT EMPLOYEES. Health care workers should report their pregnancy to the Contractor and Government Contracting Officer Representative. The MTF Employee Health Office will provide information concerning any work hazards in her work area inherent to gestational females. The Government is to notify the pregnant health care worker of any work hazards. It will be the Government, Contractor, and health care worker’s joint decision whether she continues work in the environment.

4.3 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996: All individuals performing services at an Air Force MTF are required to complete initial and annual refresher HIPAA Privacy and Security Rule 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. Reference Local Information Clause SAFB-0018 for detailed HIPPA language.

4.4 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. When their services are not required, or the healthcare provider’s services are more urgently required elsewhere, the health care provider may be assigned by the Chief of Clinical Services (SGH) or Chief Nurse (SGN) to provide support in other sections or departments of the MTF commensurate with their experience/competency.

4.4.1 EQUIPMENT. Operator error and improper use of equipment can lead to the injury or death of a patient or staff member. To prevent such occurrences, providers shall ensure they are thoroughly trained on the operation of any equipment before they use the equipment in the performance of their duties. Proper operation includes features unique to the particular manufacturer or model of equipment, safety precautions for operators and patients, user preventative maintenance, cleanliness, and operational verification procedures, recognition and correction of common operational problems, recognition of defective equipment and potential hazards, and proper reporting procedures for maintenance requests. Providers shall assure sterile supplies, other supplies, and required equipment is present and ready for use.

4.4.2 SUPERVISION AND TRAINING. Health care providers may issue medical care instructions/assignments to various skill levels of personnel assigned to various areas of the clinic. The health care provider shall provide supervision and training to newly assigned health care providers.

4.4.3 DOCUMENTATION. Healthcare providers shall prepare all documentation to meet or exceed established standards of the MDG to include but not limited to: timeliness, legibility, accuracy, content, format, and signature and security. The healthcare providers will ensure complete patient identifying information is on all documentation and that it is medically consistent and error free. Encounters must be coded within 24 hours, no later than 72 hours. Ambulatory procedure visits (APVs) will be written/typed documented for coding before the 15 day coding mark. All original encounter documentation will be inserted and maintained in the patients permanent medical record of care and returned to the Outpatient record room or designated location within 24 hours of encounter. No original encounter documentation should be removed from the facility.

4.4.3.1 PATIENT LISTS/RELEASE OF MEDICAL INFORMATION. Patient lists, no matter how developed will 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 MDG. Healthcare providers shall only release medical information obtained during the course of this contract to other MDG staff involved in the care and treatment of that individual patient. Any other releases will be coordinated and accomplished by the appropriate MDG staff member(s).

4.4.3.2 PATIENT SENSITIVITY. Healthcare providers will respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.

4.4.3.3 PHYSICAL SECURITY. Healthcare providers will be responsible for safeguarding all medical information provided for contractor use. At the close of each work period, information will be secured.

4.4.3.4 Healthcare providers have a responsibility to complete and submit an 82 MDG Event Statement, IAW MTF instructions, when they identify potentially serious patient care problems, safety concerns, infection control issues, equipment malfunctions, and defective products whether or not there was a resulting injury. An 82 MDG Event Statement is also completed when a sentinel event occurs. A sentinel event is an unexpected occurrence involving death, serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. 82 MDG Event Statement is written within 24 hours or next duty day of the incident and the original hand carried to the Performance Improvement (PI) office. *82MDG Event Statements are considered confidential and privileged information which may not be copied nor placed in an individual’s medical record. Medical equipment involved in an incident should be immediately reported to the Medical Equipment Repair Center (MERC) with all settings and controls unchanged after the incident. Portable equipment will be moved to the MERC shop and investigated by MERC personnel. Fixed equipment will be locked out and tagged until the MERC investigation is complete. Before the equipment is moved, annotate dial setting at the time of incident and other pertinent information, i.e., location, method of use, and other equipment in use to complete the Event Statement.

4.4.4 POINT OF CONTACT. The contractor will provide a point of contact that will be responsible for the performance of the work. The point of contact will have full authority to act for the contractor on all matters relating to the daily operation of this contract. The contractor will designate this individual, in writing, to the Contracting Officer (CO) and the MDG before the contract start date. An alternate may be designated, but the contractor will identify those times when the alternate will be the primary point of contact. The point of contact shall be available via telephone during normal MTF hours of 0730 hours until 1630 hours, excluding federal holidays and/or Medical Treatment Facility (MTF) down time.

4.4.5 LOCATION/HOURS OF OPERATION. The contractor shall provide services during the normal duty hours of the MTF, Monday-Friday excluding federal holidays and Medical Treatment Facility (MTF) down days. See paragraph 1.4.13 for a list of federal holidays and paragraph 1.4.14 for instances of Medical Treatment Facility (MTF) down times. Duty hours vary anywhere between 0600 – 1930 hours, Monday through Friday. Healthcare personnel will be able to work a 9 hour shift with a one-hour lunch. All personnel should be flexible enough to rotate shifts or location depending on MTF’s need. Changes shall be coordinated and approved by the contractor.

4.4.6 ABSENCES AND LEAVE.

4.4.6.1 In case of prolonged absences or illness, the contractor will replace the absent personnel with another person of equal qualifications. The identified substitute will be acceptable to the MTF. The contractor will be allowed recruitment time if appropriate under the circumstances.

4.4.6.2 The contractor will notify the MTF in advance of scheduled leave and obtain approval of MTF personnel in advance of leave taken.

4.4.6.3 NOTICE TO GOVERNMENT. The contractor employee will give a minimum of two hours’ notice to supervisor staff within their clinic of specialty, when calling for personal/annual/sick leave (same day) when they are scheduled for duty.

4.5 WORK SCHEDULES/ROSTERS. The health care worker shall record the time worked and report time in accordance with MTF policy. The point of contact shall provide a list by date and time with individual provider names for those days the Contractor shall provide services. This list shall be provided to Flight Commander, 82 AMDS/SGPF by the 20th of each month prior to the scheduled month. The Contractor shall submit work schedule changes/vacation in writing to the Flight Commander, 82 AMDS/SGPF at least 72 hours in advance of the proposed change. Contractor shall only be compensated for actual hours worked.

4.6 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. Health care workers shall be flexible to the needs of the clinic and any additional duties as assigned.

4.7 ENGLISH LANGUAGE REQUIREMENT. The health care workers(s) shall read, understand, speak, and write English fluently. Documentation needs to be legible and easy to follow.

4.8 ADP III SECURITY REQUIREMENTS

4.8.1 Since the health care workers under this contract 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 8500.01E, DoD Directive 5200.2 and AFI 31-501 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 and the unit Security manager) 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 and possible criminal History check if required, 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.

4.8.2 The contractor understands that, 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, or if other unfavorable information that would affect the NACI becomes known.

4.9 CONTINUING MEDICAL(CME) REQUIREMENTS. Health care providers registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current as prescribed in AFI 41-117. CME shall be obtained at no additional cost to the Government and shall be reported to the Flight Commander, 82 AMDS/SGPF, annually on the first normal duty day in January for the previous calendar year. Periodic CME may be conducted at the MTF and shall be available, at no cost, to any health care provider desiring to attend. Copies of CMI certificates will be placed in the health care worker’s competency assessment folder.

4.9.1 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.

4.9.2 Health care providers shall maintain current certification in required training, shall be current with, and have completed all continuing education requirements specified by their professional licensure or certification.

4.10 HEALTH CARE PROVIDER

4.10.1 CREDENTIALS/PRIVILEGING

4.10.1.1 Health care providers will be subject to the credentialing and privileging requirements of AFI 41-117, Medical Services Officer Education, AFI 44-119, Clinical Performance Improvement, to include adverse actions and other Air Force and AAAHC requirements.

4.10.1.2 The chief of the medical staff, or his/her representative, will define the scope of practice for health care workers.

4.10.1.3 All health care providers shall be able to obtain privileges through the applicable MTF Credentials Committee. The Contractor shall provide a complete, current and accurate credentialing package for each health care provider as required in 44-119, Chapter 4.

4.10.1.4 The Contractor shall make all proposed health care providers available for interview (via telephone) by the MTF during the credentialing process.

4.10.1.5 The credentials of all health care providers shall be reviewed and privileges granted as outlined in AFI 44-119, Clinical Performance Improvement.

4.10.1.6 In the event of an adverse action, the Contracting Officer (CO) and the Contractor, shall be notified by the COR as soon as possible when the necessity to exercise such authority becomes apparent. The COR will also provide the Contracting Officer and the Contractor 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.

4.10.1.7 The Contractor is required to begin full performance of the contract requirements within 90 days (credentialed positions) after the contract is awarded. It is absolutely critical that privileges be granted to a sufficient number of contract providers to meet the contract requirements by the commencement date.

4.10.2 REVIEW OF CREDENTIALS PACKAGES. The Government reserves the right to limit the number of credentialing packages it shall evaluate.

4.10.3 DENIAL/TERMINATION OF PRIVILEGES.

4.10.3.1 Actions to limit, suspend, or revoke clinical privileges shall be in accordance with the procedures outlined in AFI 44-119.

4.10.3.2 The Contracting Officer and the Contractor shall be notified by the Functional Commander (FC) as soon as possible when the necessity to exercise such authority becomes apparent. The FC shall also provide the Contracting Officer and the Contractor with copies of documentation initiating the revocation process if such actions become apparent.

4.10.3 CRIMINAL HISTORY BACKGROUND CHECK

4.10.3.1 The MTF will conduct criminal background checks on all health care workers involved in the delivery of healthcare to children, under the age of 18 on a frequent and regular basis, as stated in DODI 1402.5, Enclosure 5. The Contractor is responsible for ensuring the completed Standard Form 85 (Questionnaire for Public Trust Positions) is submitted to the 82 MDG Security Officer or the Contract Manager for privileged health care providers and for non-privileged health care workers prior to providing services at the MTF. The contractor shall ensure that the health care worker follows local MTF policy to provide fingerprints on a properly completed FD Form 258 (FBI US Department of Justice Fingerprint Card). The procedures for completing the required background check are outlined in the Department of Defense Instruction (DODI) 1402.5.

4.10.3.2 Process in AFI 44-119, paragraphs 5.4.7.6 and 5.4.7.6.1 is slightly different. Health care workers may be employed under the contract pending completion of the background checks provided they meet the following criteria pending completion of background checks. The MTF Commander shall require close clinical supervision and full compliance with existing DoD Directives, Instructions, and other guidance on quality assurance, risk management, licensure, employee orientation, and credentials verification. These policies rely on process and judgment, and meet the intent of the ‘direct sight supervision’ provision, affording local commanders a flexible and reasonable alternative. Therefore, the Commander will determine what constitutes “close clinical supervision” for individuals whose CHBCs are pending--either supervised privileges ensuring protection of patients under the age of 18 or line-of-sight supervision (i.e., chaperoned by an individual whose background check has been successfully completed) at all times when caring for these patients.

4.10.3.3 The name and address of the MTF security section representative or the COR shall be included in the request as the recipient of the results in accordance with MTF procedures. If neither position exists, the MTF Commander shall be designated to receive a copy of the results.

4.10.3.4 Health care workers have the right to obtain a copy of the background check report. Health care workers should contact the individuals identified in the previous paragraph for a copy of the results. Health care workers may challenge the accuracy and completeness of the information in the report by contacting the individual identified in the previous paragraph.

4.10.3.5 If the health care worker has previously received a background check, proof of the check shall be provided or a new one obtained. A new investigation is required if a break in service to the Department of Defense results in a time lapse of more than 2 years. Re-verification shall be accomplished every 5 years.

4.10.3.6 Payment of fees incurred in the conduct of any criminal history background check will be the responsibility of the Government.

4.10.4 Providers must regularly attend Pro Staff meetings.

4.10.5 Contractors may serve and participate on the following committees and/or functions: Pharmacy and Therapeutics Function, Population Health Function, Medical Records Function, Executive Committee of Medical Staff Function, Credentials Function, Care Review Function, Biomedical Ethics Function, Professional Staff Function, Emergency Response Function, Environment of Care Committee, Aerospace Medicine Council, Data Quality Assurance Function, Patient Safety Committee, Surgical Review Function, Infection Control Review Function, Patient Education Function, serve as Medical Review Officers, and other similar committees required by the MDG/CC, AFIs, and local Medical Group policies.

4.10.6 EDUCATION AND TRAINING REQUIREMENTS.

4.10.6.1 FORMAL EDUCATION. The Contractor shall have obtained a doctoral degree from an approved school of clinical psychology from a regionally accredited university or graduate school. The program shall be accredited by the American Psychological Association (APA). The Contractor shall have completed an APA accredited predoctoral internship in professional psychology. The Contractor shall have completed a two-year fellowship in clinical neuropsychology.

4.10.7 LICENSE/REGISTRATION. The contract provider shall possess a valid unrestricted license to practice psychology from the state of Texas.

4.10.8 EXPERIENCE. The provider shall have a background in application of principals of clinical psychology to a wide variety of mental disorders associated with patients who serve in the United States military, hold security clearances, Personal Reliability Program (PRP) status, or other sensitive duty positions. The provider shall have provided neuropsychology services a minimum of 48 months. Two years of this experience should include, but not limited to, the treatment of air-sickness and other disorders associated with patients who perform in the aerospace environment.

4.11 PROFESSIONAL LIABILITY, RESPONSIBILITY AND PROCEDURES

4.11.1 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE. The Contractor shall provide and maintain adequate liability insurance coverage consistent with the risks associated with the performance of all services required by this PWS. Refer to Federal Acquisition Regulation (FAR) Clause 52.237-7, "INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE", of this contract.

4.11.2 APPEARANCE. Contractor personnel shall present a neat appearance and be easily recognized as Contractor employees. The MTF shall provide an identification badge, which shall be worn by the Contractor while at the MTF.

4.11.3 CONTRACTOR IDENTIFICATION. IAW DFARS 211.106 Contractor employees shall identify themselves as contractor personnel by introducing themselves or being introduced as contractor personnel and displaying distinguishing badges or other visible identification for meetings with Government personnel. In addition, the contractor shall require contractor personnel to appropriately identify themselves as contractor employees in telephone conversations and in formal and informal written correspondence.

4.11.4 CONFLICT OF INTEREST. The contractor will 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.

4.11.5 EMERGENCY HEALTH CARE. The MDG will provide immediate health care or transfer for emergency treatment for contract personnel for injuries occurring while on duty. These services will be billed to the contractor at the full reimbursement rate.

4.11.6 PERFORMANCE IMPROVEMENT Contract personnel will participate in performance improvement activities as required by AFI 44-119, chapter 2 and AFI 44-102, chapter 1, para. 1 and section 1B.

4.11.7 MULTIFUNCTIONAL TEAM (MFT) MEETINGS. The contracting officer (CO) will require the contractor or his representative to meet with the CO, contract administrator, FC, COR, and other government personnel as often as deemed necessary. The contractor may request a meeting with the CO when deemed necessary. Meetings will be documented in the contract file and copies forwarded to the FC and the contractor.

4.11.8 NUISANCE AND POLLUTING ACTIVITY PROHIBITED. Polluting, dumping, or discharging of any harmful, nuisance, or regulated materials into building drains, site drains, streams, waterways, holding ponds or to the ground surface will not be permitted. The contractor will be held responsible for any damages that may result. Further, the contractor will conduct activities in such a fashion to avoid creating any legal nuisance, including but not limited to, suppressing noise and dust, controlling erosion, and implementing other measures as necessary to minimize off-site impacts of work activities.

4.12 QUALITY CONTROL Contracts for commercial items shall rely on contractors' existing quality assurance systems as a substitute for Government inspection and testing before tender for acceptance unless customary market practices (as indicated by market research) for the commercial item being acquired include in-process inspection. Any in-process inspection by the Government shall be conducted in a manner consistent with commercial practice (FAR 12.208 & 46.202-1)."

4.13 Conformance with Environmental, Safety, and Occupational Health Management System (ESOHMS). The contractor shall perform all work under this contract consistent with the relevant policy and objectives identified within Sheppard AFB. The contractor shall perform all work in a manner that conforms to all operational controls as identified within the Sheppard AFB ESOHMS Management Plan. The contractor shall provide any required monitoring and measurement information as necessary for Sheppard AFB to address environmental performance relative to the environmental, safety, occupational health, energy management, green procurement, and transportation management goals. In the event of a nonconformance with the installation ESOH management system, the contractor shall provide the Contracting Officer a written plan of corrective action to include the estimated completion date of all corrective actions.

4.13.1. Compliance with Environmental Laws. The contractor shall comply, and assure that all subcontractors comply, with all applicable federal, state, and local laws, regulations, ordinances, policies, and standards related to environmental matters. The contractor shall also comply, and assure that all subcontractors comply, with all applicable specific instructions, policies, or references contained herein. Copies of local policies and procedures can be reviewed at the Base Environmental Coordinators office, Bldg 1402, phone 676-6840

4.14 Force Protection

4.14.1 Contractors shall obtain base access passes used to gain access to Sheppard AFB during the performance period. Prior to the issuing of a base access pass, all contractor personnel will go through a background check to ensure there are no disqualifying factors. Upon contract award, the necessary applications for passes can be obtained by contacting the Base Contracting Office at (940) 676-5180. The completed applications are then processed through the Base Security Forces, building 1405, Sheppard AFB.

4.14.2 If an employee is dismissed from employment, resigns, or if there is no longer a contractual requirement for the employee to enter Sheppard AFB, the Contractor Project Superintendent shall ensure that the employee identification cards and any other identification, i.e., vehicle passes, issued to the employee are expeditiously returned to the Contracting Officer prior to final invoicing and payment. If all identification is not provided, a portion of the final payment (to be determined by the Contracting Officer) will be withheld pending its submission.

4.14.3 Contractor identification cards may be issued for the performance period of the contract only. Contractor personnel will be made aware of the necessity for safeguarding identification cards issued and the requirement for reporting any identification cards lost.

4.14.4 All contactor personnel will comply with all Antiterrorism/Force Protection measures in the event there is a threat to the installation. Although not required for contractor personnel they shall be afforded the opportunity to complete the Antiterrorism (AT) Level I awareness training. For personnel who do not have access to the Air Force's Advance Distance Learning System (ADLS) they can receiving this training from the following web site: https://atlevel1.dtic.mil/at/.

4.15 PUBLICATIONS AND FORMS.

4.15.1 Access Air Force publications on an approved military web site (www.e-publishing.af.mil <http://www.e-publishing.af.mil> ) or MDG Operating Instructions at \\vnvm-fs-001\82MDG\All_MDG\MDGOI to maintain currency in technical publications. Government publications and forms have been listed in Appendix A . The Contractor shall follow those publications/directives/forms without deviation. Any reference to a publication is meant to include the basic and supplements and amendments. Supplements or amendments to listed publications from any organizational level may be issued during the life of the contract. Publication on an approved military website of a “final” supplement or amendment to a publication or form listed in the PWS appendices shall be construed as a CO’s written order.

4.15.2 Immediate compliance with no-cost published supplements or amendments, as well as the initial 60 days compliance with published supplements or amendments which impact cost, shall be considered included in the contract price. The Contractor shall not continue compliance with a cost-impacting published supplement or amendment beyond the 60 day initial support priced into the contract unless the CO has been given written notice by the Contractor asserting a right to a contract adjustment under the “Changes” clause and the CO has confirmed by written order directing the Contractor to proceed. Negotiation and/or increased cost approval may take place during or after implementation at the discretion of the CO. Failure of the Contractor to submit written notice to the CO within 30 calendar days from the date of receipt of any change shall entitle the Government to performance IAW such change with no increase in contract price.

APPENDIX A

APPLICABLE PUBLICATIONS AND FORMS

PUBLICATIONS

PUB No. TITLE DATE CHAPTERS

DoD Instruction 1402.5, Criminal History Jan 93 All

Background Checks on Individuals in Child Care Services

DoD Directive 8500.01E Information Assurance (IA) Oct 02 All

DoD Directive 5200.2 DOD Personnel Security Program Apr 99 All AFI 31-501, Personal Security Program Management Mar 2005 All AFI 41-117, Medical Service Officer Education

Oct 11 All

PUB No. TITLE DATE CHAPTERS

AFI 44-102, Medical Care Management Jan 12

All AFI 44-119, Medical Quality Operations

Aug 11 All AFI 48-105, Surveillance, Prevention and Control Mar 05 All of Diseases and Conditions of Public Health or

Military Significance FAR Clause 52.237.7

DFARS Clause 211.106