PWS_(2).doc

PERFORMANCE WORK STATEMENT

TO PICK UP AND DESTROY PATIENT DATA

IN SUPPORT OF THE 72 MEDICAL GROUP, TINKER AFB, OK

Non-Personal Services

1. DESCRIPTION OF SERVICES. The contractor shall provide all personnel, equipment, tools, materials, containers, supervision, transportation, vehicles and other incidentals necessary to pickup and destroy confidential patient data. Points of collection shall be from the 72 Medical Group, Building 1094 and Occupational Medicine, Building 3334.

1.1.2. Contractor shall provide all containers to collect and store patient information within the 72 Medical Group, Building 1094 and Occupational Medicine, Bldg 3334. These containers shall be designed and maintained to safeguard all patient information IAW the Health Insurance Portability and Accountability Act (HIPAA).

1.1.3. Contractor shall pick up and destroy all patient information on site at the 72 Medical Group, Tinker AFB Oklahoma, Building 1094 and Building 3334.

1.2. POINT OF CONTACT: The contractor shall provide a point of contact that shall be responsible for the performance of the work. The point of contact shall have full authority to act for the contractor on all matters relating to the daily operation of this PWS. The contractor shall designate this individual, in writing, to the Contracting Officer (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 point of contact.

1.3. CERTIFICATION OF DESTRUCTION. The contractor is required to provide the 72 Medical Group a certification of destruction for all data collected and destroyed on site.

1.4. HOURS OF OPERATION: The contractor shall provide on site collection once every two weeks during the operational hours of Monday – Friday from 0700 to 1600 hours. Federal holidays are excluded.

1.5. FEDERAL HOLIDAYS: The contractor is not required to provide service on the following days: New Year’s Day, Martin Luther King Day, President’s Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day and Christmas Day. If day of pickup falls on a recognized federal holiday, the contractor shall pickup contents of containers on the next normal workday. Work days are Monday through Friday.

1.6. ENGLISH LANGUAGE REQUIREMENT: The contract employee shall be able to fluently read, understand, speak and write English.

1.7. DRIVERS LICENSE. All contract employees providing the on site services must maintain a valid state drivers license.

1.8. SECURITY REQUIREMENT. Contract personnel shall obtain a DOD vehicle registration from the Tinker AFB Security Police and comply with all Tinker Air Force Base Regulations regarding the operation of contract vehicles.

1.9. IDENTIFICATION BADGE: Contract personnel shall be easily recognized as a contract employee by wearing an identification badge at all times while on duty. This identification badge shall be worn on the outer clothing, above the waist, and shall be visible at all times while the contract employee is performing collection duties while in the Medical Treatment Facilities at both Building 1094 and Building 3334.

1.10. 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 in accordance with DoD Directive 5500.7 and Air Force policy.

1.11. QUALITY ASSURANCE. The Government will evaluate the contractor’s performance under this contract through inspections. When an observation indicates defective performance, the Contract Monitor will notify the Contracting Officer and the Contractor. When an observation indicates defective performance, the Quality Assurance Monitor will inform the contract manager or alternate and require them to initial/sign and date the observation. The initialing of the observation does not necessarily constitute the contractor’s concurrence with the observation, only acknowledgement that the contractor has been made aware of the defective performance. Any action taken by the Contracting Officer as a result of surveillance will be according to the terms of this contract. Any matter concerning a change to the scope, prices, terms or conditions of this contract shall be referred to the Contracting Officer and not to the Quality Assurance Monitor. The services to be performed by the Contractor during the period of this contract will at all times and places be subject to review by the Contracting Officer or authorized representative(s). Other Government personnel may from time-to-time observe Contractor operations. These personnel shall not interfere with Contractor performance.

1.12 Performance of Services During Crisis Declared by the National Command Authority or Overseas Combatant Commander. In the state of emergency, if the Government deems necessary, the contractor shall provide all services necessary to ensure mission accomplishment. On occasion, services may be required to support an activation or exercise of contingency plans outside the normal duty hours described above. The contractor’s responsibilities for emergency support are described in paragraphs the Performance Work Statement.

1.13. HIPAA Privacy and Security Business Associate Contract Language

(August 2005)

The following clause may be included in contracts which involve the handling of protected health information by MHS business associates that are modified or initiated after April 21, 2005.

PRIVACY AND SECURITY OF PROTECTED HEALTH INFORMATION

Introduction

IAW DOD 6025.18R “Department of Defense Health Information Privacy Regulation” the Contractor meets the definition of Business Associate. Therefore, a Business Associate Agreement is required to comply with both the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security regulations. This clause serves as that agreement whereby the Contractor agrees to abide by all applicable HIPAA Privacy and Security requirements regarding health information as defined in this clause, and DOD 6025.18R, as amended. Additional requirements will be addressed when implemented.

(a) Definitions. As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DOD 6025.18R.

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 in accordance with 45 CFR 164.502(g).

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

Protected Health Information has the same meaning as the term “protected health information” in 45 CFR 164.501, limited to the information created or received by The Contractor from or on behalf of The Government.

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

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

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

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

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

(b) The Contractor agrees to not use or further disclose Protected Health Information other than as permitted or required by the Contract or as Required by Law.

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

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

(e) The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Contract.

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

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

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

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

(j) The Contractor agrees to provide access, at the request of the Government, and in the time and manner designated by the Government to Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524.

(k) The Contractor agrees to make any amendment(s) to Protected Health Information in a Designated Record Set that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or an Individual, and in the time and manner designated by the Government.

(l) The Contractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Contractor on behalf of, the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner designated by the Government or the Secretary, for purposes of the Secretary determining the Government’s compliance with the Privacy Rule.

(m) The Contractor agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

(n) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

General Use and Disclosure Provisions

Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the Privacy Rule, the Security Rule or DOD 6025.18R if done by the Government.

Specific Use and Disclosure Provisions

(a) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

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

(c) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information to provide Data Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B).

(d) Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j)(1).

Obligations of the Government

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

(a) Upon request the Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice.

(b) The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the Contractor's permitted or required uses and disclosures.

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

Permissible Requests by the Government

The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the Privacy Rule if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause.

Termination

(a) Termination. A breach by the Contractor of this clause, may subject the Contractor to termination under any applicable default or termination provision of this Contract.

(b) Effect of Termination.

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

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

(3) If this contract does not have records management provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected Health Information.

Miscellaneous

(a) Regulatory References. A reference in this Clause to a section in DOD 6025.18R, Privacy Rule or Security Rule means the section as in effect or as amended, and for which compliance is required.

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

(c) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with DOD 6025.18R, Privacy Rule or Security Rule.

2. SERVICE DELIVERY SUMMARY

Para

Mandatory HIPPA Privacy Act to ensure the protection and destruction of patient information.

3.3. GOVERNMENT FURNISHED SERVICES.

3.3.1. The 72 Medical Group will provide the contractor a list of locations that will be considered collection sites for clinical areas located within Building 1094 and Building 3334.

3.3.2. The 72 Medical Group personnel will assist the contract employee to have access to the vendors collection containers as needed in order to perform pick up and destruction services.

Appendix A – Historical Workload (Containers, Locations) Short Containers are 20”x20”x20” & Tall Containers are 20”x20”x30: and all are emptied every two weeks

Tinker AFB, OK

BLDG 1094

TOTAL RECEPTACLES:

Tinker AFB, OK

BLDG 3334

TOTAL RECEPTACLES:

APPENDIX "C"

DOCUMENT DESTRUCTION SERVICES FOR THE 72d MEDICAL GROUP.

SECTION I- GENERAL REQUIREMENTS

A.

Safety Program Requirements. The contractor will implement a safety program that ensures protection of Government personnel and property. The program will consist of, as a minimum:

1.

Mishap notification/reporting as defined in paragraph I.B. below.

2.

A Safety Program that addresses, as a minimum, the subjects listed in Safety Program Elements, Section II and to be used during performance of the work described in the contract.

B.

Mishap Notification.

1.

The contractor shall notify the procuring Safety Office or a designated Government Representative (GR) within one (1) hour of all mishaps or incidents. A written report of the mishap/incident shall be sent within three calendar days to the GR, who will forward it to the Contracting Representative Officer (COR). For information not available at the time of initial written report, the contractor shall provide the remaining information no later than 20 calendar days after the mishap, unless extended by the Safety Office.

2.

Mishap notifications shall contain, as a minimum, the following information:

a.) Contract, Contract Number, Name and Title of Person(s) Reporting b.) Date, Time and exact location of accident/incident c.) Brief Narrative of accident/incident (Events leading to accident/incident) d.) Cause of accident/incident, if known e.) Estimated cost of accident/incident (material and labor to repair/replace) f.) Nomenclature of equipment and personnel involved in accident/incident g.) Corrective actions (taken or proposed) h.) Other pertinent information

3.

If requested by the designated government representative, the contractor shall immediately secure the mishap scene/damaged property and impound pertinent maintenance and training records, until released by the Procuring Safety Office.

C.

The safety provisions of this contract, shall apply to any subcontracts/subcontractors.

D.

Safety requirements listed herein that do not concern contractor’s operations or services shall be considered self-deleting as mutually agreed by the contractor and the procuring office.

SECTION II- SAFETY PROGRAM ELEMENTS

The contractor’s Safety Program shall clearly define procedures, personnel qualifications, facilities and required equipment necessary to fulfill the following elements

Element/Requirement

Referenced Benchmark

Mishap Notification/Reporting

AFI 91-204

Housekeeping

AFOSH Std 91-501

Material Handling Equipment (MHE)

AFOSH Std 91-46 and AFOSH Std 91-501

Handling, Storage and Use of Flammable/Combustible Liquid

AFOSH Std 91-501

Tool Control

AFI 21-101, AFMC Sup

Foreign Object Damage (FOD)

AFI 21-101, AFMC Sup

Hazardous Energy Control

AFOSH Std 91-501

Confined Spaces

AFOSH Std 91-25

SECTION III - BIBLIOGRAPHY OF PUBLICATIONS/DIRECTIVES

These publications/directives and all supplements/changes thereto apply to the extent required by the provisions of Sections I, and II.

AFI 91-204

Feb 06

Safety Investigations and Reports

AFOSH Std 91-66 Oct 97

General Industrial Operations

AFOSH Std 91-501 Jul 04

Air Force Consolidated Occupational Safety Standard

AFI 21-122

Aug 04

Foreign Object Damage (FOD) Prevention Program and

Dropped Object Prevention (DOP) Program

AFMCI 21-107

May 01 Tool Control