EAS_PWS_16_July_2015.pdf

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PERFORMANCE WORK STATEMENT

FOR

EMERGENCY MEDICAL SERVICES

AT

SCHRIEVER AIR FORCE BASE

COLORADO

16 July 2015

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TABLE OF CONTENTS

SECTION 1 – Description of Services/General Information 3

SECTION 2 – Services Summary 18

SECTION 3 - Government-Furnished Property and Services 18

SECTION 4 – Appendices

Appendix 1 – Reference Documents 20 Appendix 2 – Government Furnished Facility and Equipment 22 Appendix 3 – Acronyms 23 Appendix 4 – Definitions 25 Attachment 1 – CDRL # 1 25 Attachment 2 – CDRL # 2 34 Attachment 3 – CDRL # 3 38

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1. DESCRIPTION OF SERVICES/GENERAL INFORMATION

The Contractor shall provide full emergency patient transport services at Schriever Air Force Base, including the housing area on Schriever AFB (hereafter referred to as SAFB). This emergency transport service will consist of one dedicated ambulance on SAFB, with backfill.

The Contractor shall participate in Schriever AFB and 21st Medical Group/Schriever Medical Dental Clinic (referred to as MTF hereafter) exercises, special events, sports events, and specialized training. The Contractor shall furnish all labor, management, supervision, vehicle, supplies, equipment, transportation, and reports, except as provided in appendix 2, Government- Furnished Facility and Equipment. The Contractor shall cover the full range of Emergency Medical Technician (EMT), paramedic and ambulance services provided in the local community to include local protocols or standing orders and staffing minimums in accordance with the most current Colorado applicable regulations and protocols. Performance shall be in accordance with the requirements contained in this Performance Work Statement (PWS) and professional standards of the Accreditation Association for Ambulatory Health Care (AAAHC), and the Colorado State Department of Health’s Division of Emergency Medical Services.

1.1 EMERGENCY MEDICAL RESPONSE AND PATIENT TRANSPORT

The Contractor shall provide ambulance response to emergencies as requested by the SAFB Fire Department. Patients will be transferred to nearest appropriate medical facility, hereafter referred to as local hospitals. Actual work involved in performance of this contract shall include:

1.1.1 Provide ambulance services 24 hours per day every day of the year to include all holidays.

This contract is the sole avenue for SAFB emergency patient transport. The Contractor shall establish and maintain a system to ensure that backup support is provided in the event of simultaneous responses, equipment failures, or other unforeseen circumstances. Services must always be available.

1.1.2 Travel to response sites in an appropriate medical response vehicle per information received primarily from the SAFB Fire Department.

1.1.2.1 Response time for all calls on SAFB, to include Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS), will be within 8 minutes. Response time is defined as the time of receipt of call from SAFB Fire Department to the time of arrival at the emergency location identified.

1.1.3 Respond to calls with, at a minimum, one State of Colorado certified Emergency Medical Technician (EMT) and one State of Colorado certified Emergency Medical Technician- Paramedic/Advanced Cardiac Life Support (EMT-P/ACLS).

1.1.4 Provide medical care and treatment appropriate to patient’s condition. The Contractor will respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.

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1.1.5 Coordinate in-field care, to include EMT-P/ACLS Care, in accordance with protocols developed by the Contractor’s physician advisor in cooperation with representatives from local Fire Departments and the closest hospital with capability.

1.1.6 Coordinate patient transport with local hospitals.

1.1.7 Transport patients to local hospitals from SAFB.

1.1.8 Ensure an EMT or Paramedic remains with patients until a qualified member of the receiving hospital properly accepts patients.

1.1.9 Notify Command Post, via telephone, (719-567-2180), for any on base response. This notification must be provided not later than one (1) hour after receiving hospital properly accepts patient: name of patient, status (military, civilian, contractor, dependent, etc), and name of hospital. If notification is delayed due to response to another emergency call, then notification must be made as soon as possible (ASAP).

1.2 SAFB AND MTF EXERCISE/SPECIAL EVENTS/SPORTS EVENTS/

SPECIALIZED TRAINING.

The Contractor shall be responsible for participating in SAFB and Medical Treatment Facility (MTF) exercises, events, and training, as required/requested.

Specific responsibilities include:

1.2.1 Participate in advance and post exercise meetings.

1.2.2 Respond with EMTs to exercise sites and performing mock duties.

1.2.3 Coordinate all activities during exercises with the Incident Commander. Coordination can be through the On-Scene Medical Director when the FRT is activated and on-scene.

1.2.4 Provide ambulance support during live-structural live fire training and confined space hazardous materials exercises.

1.2.5 Provide one (1) ambulance stand-by special events (i.e. Change of Command and other official ceremonies) as requested. Contractor will be notified one day prior to all stand-by special events. It’s estimated that there will be approximately 60-80 special events per year.

1.2.6 Provide support to sports events.

1.3 QUALITY REQUIREMENTS

1.3.1 The Government will periodically evaluate the Contractor’s performance by appointing a Contracting Officer Represantive (COR) to monitor performance to ensure services are received.

The COR will evaluate the Contractor’s performance through inspections of call logs/reports and

Page | 5 receive and investigate all complaints from base personnel. The Government may inspect each task as completed or increase the number of surveillances if deemed appropriate because of repeated failures discovered during quality control inspection or because of repeated customer complaints. Likewise, the Government may decrease the number of quality control inspections if performance dictates. The Government COR shall make final determination of the validity of customer complaint(s). The Contractor shall not be held responsible for being unable to meet response time due to factors beyond their control. This will include, but is not limited to, road construction or road closures, inclement weather, communications problems, employee incapacitation, responding to one call when being called for a second, etc.

1.4 DATA

1.4.1 The Contractor’s Quality Program Plan (QPP) shall be provided to the Contracting Officer, for approval (CDRL #001).

1.4.1.1 The Contractor’s QPP should address risk management to include processes are in place to evaluate and ensure the standard of care is met in all cases, per Contractor’s current audit procedures.

1.4.2 The Government will provide access to the MTF on a periodic basis that is agreed upon by the two parties involved relating to all transports. This will be accomplished according to relevant Health Insurance Portability and Accountability Act (HIPAA) of 1996 guidelines. This information will include date, response time, type of run (BLS or ALS), whatever available patient information (full name, military last 4 of SSN or civilian, patient condition, address responded to, the name of the hospital transported to) and an explanation of any exceptions to response time contained in Section 2, Service Summary. All refusals should also be documented to the same level, notwithstanding hospital transport.

1.4.2.1 Patient information shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to or revealed in any way for use outside the MTF without prior written permission by the MTF Commander, except as required by paragraph 1.1.9. All patient information shall be handled in accordance with all applicable HIPAA regulations and guidelines.

1.4.3 The Contractor will provide documentation to the MTF relating to vehicle maintenance records of vehicles responding to SAFB. (CDRL#002)

1.5 GENERAL INFORMATION

1.5.1 Contract Manager: The Contractor shall provide a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate(s) who shall act for the Contractor when the manager is absent shall be designated in writing to the contracting officer and the COR prior to contract start date.

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1.5.1.1 The Contract Manager or alternate shall have full authority to act for the Contractor on all contract matters relating to daily operation of this contract and be available during normal business hours (0730-1630).

1.5.2 Education and Training requirements. The Contract Manager and alternate(s) must be able to read, write, speak, and understand English.

1.5.2.1 The Contractor shall ensure that all employees involved in activities that require certification or licensing shall meet all such requirements:

(a) Operate an emergency ambulance in the State of Colorado and possessing a valid Class “C” Colorado driver’s license. Drivers must not have any reckless or dangerous driving citations within the previous 24-month period and have no Driving While Intoxicated (DWI) or Driving Under the Influence (DUI) convictions in the previous three years. Drivers can have a maximum of six points per year assessed under the State of Colorado driving infractions system.

(b) Maintain a current license to perform EMT and Paramedic services in the State of Colorado. Maintain current CPR certification from a Colorado Department of Public Health and Environment CPR- approved provider.

(c) Contractor shall maintain files to assure that all EMTs performing work under this contract shall have current certifications and/or documents for the duration of their employment.

Upon request, the Contractor shall allow the Government access to review/audit these documents for any EMT/Paramedic performing under this contract. The Contractor shall provide copies of certification upon request.

(d) All EMT’s/Paramedics responding on SAFB will have a State of Colorado background check, which includes a Criminal Record Check. NO Contractor employees shall be assigned to the SAFB site until their background check comes back with ‘No Felony’ conviction.

1.5.3 The Contractor is solely responsible for compliance with the Occupational Safety and Health Act (OSHA), Public Law 91-596, and the resulting standards, OSHA, Standard 29 CFR 1910, 1926, and the protection of their employees. It is the Contractor’s sole responsibility to make certain that all safety requirements are met. Additionally, the Contractor is responsible for the safety and health of all sub-Contractor employees.

1.6 HEALTH REQUIREMENTS

1.6.1 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. The contractor shall adhere to the Medical Group MDGI 44-50, Infection Control, Chapter 8, Clinic Employee Health Program.

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1.6.2 Vaccination, immunity, or testing is required for the following:

(a) Mumps, Rubella, and Rubeola (MMR): If born after 1956 without proof of immunity, disease or history of two lifetime MMR vaccinations will be vaccinated per Advisory Committee on Immunization Practices (ACIP) guidelines (two MMR vaccinations). Those born prior to 1957 do not require vaccination and will be offered MMR, if desired. The MTF will not administer the MMR shots or lab work to contract employees unless they are authorized medical care at the MTF. Contract employees that are not authorized, must go to their private physician to receive shots/blood work and bring proof to Public Health (PH) clinic for documentation.

(b) Tuberculin (TB) Skin Test: Contractor must be screened within the first 10 days of employment, prior to direct patient care. No annual tests are required. The MTF may administer the TB Skin Test to Contractor s if they have not been tested within the previous 12 months. If not, then they must go to their private physician to receive a Purified Protein Derivative (PPD) screening test with reading (if positive, proof of negative chest X-ray within 12 months). Bring proof to Public Health (PH) for documentation.

(c) Varicella: Contractors will be screened to determine their varicella immunity status.

The MTF will not administer the varicella shots or lab work to Contractors unless they are authorized medical care in the MTF. If not, then they must go to their private physician to receive the vaccine or lab work and bring proof to PH for documentation.

(d) Hepatitis B Immunity: Proof of immunity will be in the form of documentation of previous vaccine administration or an adequate serum antibody titer. Personnel with a history of having received the Hepatitis B vaccine series but no documentation of receiving the vaccine, must be sent to a lab to have a Hepatitis B serum antibody titer. PH will determine at the time of in-processing the employee’s blood borne pathogen risk category. Contractors having duties involving direct patient contact and hired/beginning work activity after 1 Jan 97, will be vaccinated and must have serological proof of immunity. Other contractor employees, who are not high-risk, or exposure-prone, will be encouraged to receive the vaccine. Low-risk contract employees do not require starting the Hepatitis B series.

(e) Tetanus, Diphtheria, Acellular Pertussis (Tdap): Contractors will be vaccinated with Tdap when it has been at least 2 years since their last Tetanus (Td) vaccination. Those with contact to patients and/or children should be prioritized to receive Tdap as soon as practical. The MTF will not administer the Tdap vaccine to Contractors unless they are authorized medical care in the MTF. If not, then they must go to their private physician to receive the vaccine and bring proof to PH for documentation.

(f) Influenza: Yearly requirement. The MTF will not administer the Influenza vaccine to Contractors unless they are authorized medical care in the MTF. If not, then they must go to their private physician to receive the vaccine and bring proof to the Immunizations Clinic for documentation.

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(g) Polio: Original series. The MTF will not administer the Polio vaccine to Contractors unless they are authorized medical care in the MTF. If not, then they must go to their private physician to receive the vaccine and bring proof to the Immunizations Clinic for documentation.

(h) Human Immune deficiency Virus (HIV) Testing: HIV test is required. The MTF will not pay for/test the contractors unless they are authorized medical care in the MTF. If not, then the contractor must go to their private physician to receive the test and bring proof to the PH clinic for documentation?

1.6.3 PREGNANT EMPLOYEES The Public Health Office will provide information concerning work hazards in the work area for gestational females. This is provided to the contractor at the beginning of the contract and if requested throughout the contract if requested.

1.7 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

OF 1996

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

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

1.7.1 Requirements

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

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

(c) The Contractor shall 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.

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

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

(f) The Contractor shall 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.

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

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

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

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

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

(l) The Contractor shall 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.

(m) The Contractor shall 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.

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

1.7.2 General Use and Disclosure Provisions

Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R if done by the Government.

1.7.3 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).

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

(a) Upon request the Government will 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.

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(b) The Government will 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 will 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.

1.7.5. Permissible Requests by the Government

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

1.7.6. Miscellaneous

(a) Regulatory References. A reference in this Clause to a section in DOD 6025.18-R, HIPAA Privacy Regulation or DOD 8580.02-R, HIPAA Security Regulation, or any CFR or AFI provision means the section as currently in effect or as amended, and for which compliance is required.

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

1.8 PRIVACY ACT PROGRAM

The Contractor shall adhere to AFI 33-332, Privacy Act Program.

1.9 TOBACCO USE

The Contractor shall adhere to AFI 40-102, Tobacco Free Living.

1.10 SAFETY

The contractor shall ensure conformance with standards developed under United States Public Law 91-596, the Occupational Safety and Health Act (OSHA) of 1970, and State Occupational Safety and Health (OSH) Standards, and American National Standards Institute (ANSI), and National Fire Protection Association (NFPA) standards. If a conflict occurs, the contractor shall apply the more stringent standards. The contractor shall ensure that the 50 SW Safety Office (50 SW/SE) is notified of any mishaps within one (1) hour. Phone numbers for reporting mishaps to the 50 SW/SE are: (719) 567-SAFE, (719) 567-5617, or via the Wing Command Post at (719) 567-2180. The contractor shall allow the 50 SW/SE to monitor all operations to ensure the safety of Government property. While on SAFB, the contractor shall follow Air Force traffic regulations according to Air Force Instruction (AFI) 91-207 – The US Air Force Traffic Safety Program and AFI 31-218 IP, Motor Vehicle Traffic Supervision_ 1.11 FACILITIES SAFETY

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The Government has the authority to conduct facility safety inspections in Government facilities occupied by the contractor.

1.12 MISHAP REPORTING

Report all mishaps involving personal injury or illness and damage to Government property resulting from contractor operations to the 50 SW Safety Office (50 SW/SE), Quality Assurance Manager, and the Contracting Officer (CO) no later than the end of the next duty day.

Regulatory Constraint: AFPAM 91-210, Contract Safety, DODI 6055 & AFI 91-204 Safety Investigations and Reports

1.12.1 Mishap Investigation. The Government retains authority to conduct mishap investigations in Government facilities managed by contractors or to participate in the contractor’s investigation of contractor mishaps. As required by the Government, the contractor shall participate in, and cooperate with, mishap investigations. The 50 SW/SE will govern the investigation and reporting of mishaps involving damage to Government property.

1.13 SECURITY

1.13.1 The Contractor shall comply with all Schriever AFB (SAFB) security requirements.

SAFB has a controlled/restricted area and special security procedures are utilized to deter espionage, sabotage, and theft of Air Force resources. The Contractor shall be responsible for security of their work areas in cooperation with applicable base agencies.

1.13.2 Security Clearances. The contractor shall appoint, in writing to the CO, a security Officer to arrange all needed security support for the PWS. The COR will assist the Contractor to coordinate security matters with the 21 MDG and other base agencies, as needed. Training and assistance from the 21 MDG Security Manager and 50th Security Forces Squadron (SFS) personnel will be provided to the Contractor’s Security Officer when coordinated through the COR. The Contractor shall initiate National Agency Check with Incidentals (NACI) prior to contract start. The Contractor shall direct each employee, assigned to SAFB, to personally report to 21 MDG Security Manager for completion of the AF Form 2583, initiating the NACI. The NACI requires the employee to enter personal data in EQIP (Electronic Questionnaire for Investigation Processing), and authorize an employment, residence, credit, and criminal history records check. The employee must also submit to fingerprinting. Access to the internet is required for EQIP entry and submission. Upon return of a “favorable” check, employee must personally report to the 21 MDG Security Manager for completion of the AF Form 2586, Unescorted Entry Authorization Certificate. Contractor employees will not be allowed unescorted entry to SAFB secured buildings until these procedures have been completed.

1.13.3 The Contractor shall request, obtain, and properly use vehicle passes for all vehicles used in the performance of this contract, in accordance with AFI 31-218 IP, Motor Vehicle Traffic Supervision.A restricted area vehicle pass will be issued for the primary response vehicle assigned to Schriever AFB. A temporary vehicle pass will be issued for temporary vehicles assigned during maintenance of the primary vehicle. Personal vehicles (POVs) will also require registration with the 50 SFS, but will not have access to the restricted area.

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1.13.4 Integrated Visitor Group Agreement. The contractor shall comply with the installation contractor long term Integrated Visitor Group Agreement (IVGA). The contractor will complete the Visitor Group Security Agreement (VGSA) with the CO upon contract award.

1.13.5 Security Training. The Government will provide initial and follow-up security procedures training to contractor personnel who work in controlled and restricted areas.

1.13.6 Communications Security (COMSEC). Contractor employees shall complete government provided COMSEC training and comply with COMSEC user requirements IAW AFMAN 33-283, Communications Security (COMSEC) Operations and AFMAN 33-282, Computer Security.

1.13.7 Installation Security Requirements. The Contractor shall direct each eligible employee to personally report to the COR and the 21 MDG Security Manager for completion of the AF Form 2586, Unescorted Entry Authorization Certificate. Contractor employees will not be allowed unescorted entry to SAFB secured buildings until these procedures have been completed. Unescorted entry based on a favorable records check will be limited to Area 7 (Restricted Area portion of SAFB). The restricted/controlled area badge shall only be valid for the term of employment or for the duration of the contract, whichever is shorter. Upon employee termination, the Contractor shall surrender the restricted/controlled area badge to 50 SFS Building 15, Visitor Control Center, no later than 4:00 p.m. on the following workday. When inside restricted area, Contractor personnel shall, at all times, display restricted/controlled area badges on their outer garments above the waist. Remove and secure the restricted/controlled area badges immediately upon departure from the restricted area to prevent loss. Incidents of a person not properly displaying badges or violating escort procedures (e.g. working out of view of escort) shall be treated as a breach of security and that person shall be susceptible to apprehension, search and detainment. Any person inside a restricted area without a restricted/controlled area badge will be detained or apprehended, searched, removed, and turned over to appropriate authorities for disposition.

1.13.7.1 Access to classified information by Contractor personnel during performance of this contract is prohibited. However, Contractor performance shall be within controlled areas that shall require Contractor compliance with various levels of security and require certain established personnel security entry control procedures. The violation of, or deviation from established security procedures by any Contractor employee may result in the confiscation of restricted/controlled area badges and denial of future entry to SAFB. Restricted/Controlled Area badges issued to Contractor personnel are subject to recall for inventory and verification purposes. Contractor personnel shall surrender restricted/controlled area badges to government personnel conducting such inventory and/or verification immediately upon notification.

1.13.7.2 The Contractor shall provide an Entry Authorization List (EAL) to the CO and the COR by the second workday of each month, or as requested. The EAL shall be maintained current and correct at all times and shall include the name of each employee and their restricted/controlled area badge number, and vehicle listing with description. COR will forward list to the 50 SFS.

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1.13.7.3 50 SFS personnel will verify the identity through Common Access Card (CAC) or Contractor ID cards and entry authorization of each Contractor employee and vehicle, and may conduct a search of any baggage, articles, or vehicles on SAFB.

1.13.7.4 Contractor employees requiring entry, but not requiring unescorted entry, will be issued a visitor badge and will be under direct surveillance, at all times, of a Contractor employee possessing a restricted/controlled area badge with escort authority. Contractor employees entering SAFB shall obtain their visitor badge from the 50 SFS, Visitor Control Center, Building

15. The visitor badge will be returned to the entry controller each time the employee departs the SAFB controlled area. While within the SAFB controlled area, Contractor personnel will display the visitor badge on their outer garment above the waist and shall remain at all times within view of the escort official.

1.13.7.5 The Contractor shall report the occurrence of lost badge(s) to the COR, who will in turn report to 50 SFS. If the COR is not available, the loss shall be reported directly to 50 SFS within one duty day of the loss. Replacement badge will not be issued until reporting procedures are satisfactorily completed.

1.13.7.6 The contractor shall adhere to the installation security requirements as provided for in AFI 31-601, Industrial Security Program Management, Chapters 1, 2, 7, and 8. When work under this contract requires unescorted entry to controlled or restricted areas, the contractor shall comply with AFI 31-101Integrated Defense, and AFI 31-501, Personnel Security Program Management, Section 3.24.

1.13.8 Physical Security. The contractor shall safeguard all government property and any controlled forms or products. At the close of each work day/period, facilities, support equipment, and materials shall be secured. The contractor shall designate a custodian(s) and alternate(s) to receipt and account for government-furnished facilities and equipment five (5) days prior to contract start date and as changes occur. Contractor shall immediately report all thefts, vandalism, or destruction of property and/or equipment (government or contractor owned) to the Security Forces upon discovery.

1.13.9 Building/Facility Access Control. The contractor shall establish and implement methods of making sure all access provided by the government to the contractor are not lost or misplaced and are not used by unauthorized persons. The contractor shall include procedures for immediate reporting to the COR or CO any occurrences of lost, unauthorized uses, or unauthorized duplication of keys, badges or lock combinations.

1.13.9.1 Corrective Action(s). In the event keys or badges are lost or duplicated, the contractor shall be required, upon written direction of the CO to re-key or replace the affected lock(s) or badges. Coordination for any combination changes shall be made through the facility manager.

1.14 ENVIRONMENTAL AND HAZARDOUS MATERIAL (HAZMAT)

1.14.1 Environmental. The contractor shall ensure their operations and procedures do not result in acts or omissions that will violate environmental laws, or fail to exercise due care concerning

Page | 15 human health and the environment. The contractor shall comply with all federal, state, and local environmental laws and regulations. The contractor shall report acts or omissions in violation of environmental law to 50 CES/CEV, (719) 567-4030 within 12 hours of discovery.

1.14.2 AF FORM 3952 Chemical Hazardous Material Request Authorization. The contractor shall furnish an AF Form 3952 – Chemical/Hazardous Material Request Authorization, electronic worksheet and or any future Environmental Management System document available to include Materials Safety Data Sheet (MSDS) or Safety Data Sheet (SDS) to the Base Hazardous Materials Pharmacy (HAZMART), through the QAP, anticipated quantities, application, personal protective equipment, and method of disposal for all materials to be used under this contract. The listing shall include, but not be limited to, lubricants, spray cleaning solvents, and any known hazardous materials (HAZMAT). The contractor shall manage HAZMAT IAW AFI 32-7086 – Hazardous Materials Management. The contractor shall purchase materials/products in compliance with Section 6002 of the Resource Conservation and Recovery Act (RCRA) and Executive Order (EO) 13423 – Strengthening Federal Environmental, Energy, and Transportation Management. Regulatory Constraints: AFI 32-7086 and AFSPC 32-7086 Supplement 1 – Hazardous Materials Management.

1.14.3 Hazardous Materials. All HAZMAT must be registered with the Base HAZMART prior to introduction and use at SAFB. The contractor shall comply with the HAZMAT determination and authorization process as outlined in AFI 32-7086 – Hazardous Materials Management, and AFSPC 32-7086 Supplement 1. Contact 50 CES/CEIE, (719) 567-4242 or 4030 for additional guidance.

1.14.4 Hazardous Chemical Reporting. The contractor shall comply with 40 CFR Part 370 – Hazardous Chemical Reporting, and 40 CFR Part 372 – Toxic Chemical Release Reporting Community Right to Know, that includes the following: Chemicals with special characteristics which in the opinion of the manufacturer can cause harm to people, plants and or animals when released by spilling, leaking, pouring, emitting, emptying, discharging, injecting, escaping, leaching, dumping or disposing into the environment (including the abandonment or discarding of barrels, containers, and other receptacles).

Regulatory Constraints: AFI 32-7086 – Hazardous Materials Management, and AFSPC 32- 7086 Supplement 1 – Hazardous Materials Management.

1.14.5 Hazardous Waste (HAZWASTE). The contractor shall coordinate all HAZWASTE disposals with the installation environmental office. If there is any question about whether or not a substance is classified as hazardous, the contractor shall contact the installation environmental office. It shall be the responsibility of the contractor to pay for the disposal of HAZWASTE unless otherwise specified. The contractor shall handle, accumulate, and manage HAZWASTE IAW all regulatory requirements. Questions regarding the proper storage, handling and disposal will be directed to the environmental office through the CO. HAZWASTE manifested for disposal must be reviewed and authorized through the environmental office.

1.14.6 Transporting HAZMAT Notification. The contractor shall notify the Base HAZMART in writing prior to transporting HAZMAT onto the installation under this contract. The contractor shall comply with 29 CFR 1910.1200 – Hazard Communication Program, and 29

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CFR 1910.120 – Hazardous Waste Operations and Emergency Response. The contractor shall contact 50 CES/CEV, (719) 567-4242 or 4030 for additional guidance. Regulatory Constraints:

AFI 32-7086 – Hazardous Materials Management, and AFSPC 32-7086 Supplement 1 – Hazardous Materials Management.

1.14.7 Environmental Act Violation. The contractor shall ensure their operations and procedures do not result in acts or omissions that will violate environmental laws, or fail to exercise due care concerning human health and the environment. The contractor shall report acts or omissions in violation of environmental law to the 50 CES/CEIE within 12 hours of discovery.

1.14.8 Reporting of Recyclable Content. The contractor shall report any products/materials purchased that contain recyclable content to the SAFB Recycling Manager (50 CES/CEIE),

(719) 567-4242 or 4030 through the CO or the Contract Specialist (50 CONS).

1.14.9 Federal, State, and Local Laws. The contractor shall perform the requirements of this contract in such a manner as not to violate any federal, state, or local laws, to include all Code of Federal Regulations (CFR). The contractor shall be solely responsible for any reporting requirements and repercussions resulting from violations.

1.15 ADVERSE WEATHER CONDITIONS

During adverse weather conditions, contractor personnel shall continue to provide services for

SAFB.

1.16 SERVICE SUPPORT DURING AN EMERGENCY

In addition to routine operational support, the contractor shall respond to emergency work requests in support of contingency operations.

1.17 CONTINUATION OF MISSION ESSENTIAL SERVICES. The contractor shall provide ambulance services which are designated as essential contractor services by the government and shall be prepared to continue providing such services, in accordance with the terms and conditions of the PWS, during periods of crisis. The contractor shall have a written plan to ensure the continuation of these services in crisis situations. The contractor will activate such plans only during periods of crisis, as directed by the CO. The contractor shall participate in base level exercises in support of ambulance services during duty hours.

1.17 PERFORMANCE OF SERVICES DURING CRISIS DECLARED BY THE NATIONAL

COMMAND AUTHORITY (NCA)

The contractor shall perform services during a crisis declared by the National Command Authority (NCA) per contractual requirements. The contractor shall supply a list of employees including name, address and phone number of those who shall perform the services as required.

All services shall continue unless otherwise directed by the CO.

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1.17.1 Contingency Operations Plan. The contractor shall establish and maintain a complete contingency plan to ensure continuation of services during periods of emergency, such as a national wartime mobilization IAW DODI 1100.22, Policy and Procedures for Determining Workforce Mix. The Contractor shall submit a Contingency Operations Plan by contract start date. Contractor shall submit revised Contingency Operations Plans within (5) working days after changes occur. (CDRL#003)

1.18 CONTRACTOR LIABILITY

The contractor shall provide insurance IAW FAR 28.307-2. The contractor shall, at its own expense, provide and maintain during the entire performance period, at least the kinds and minimum amounts of insurance as follows:

Worker’s Compensation and Employees Liability $100,000 General Liability $500,000 per occurrence Automobile Liability $200,000 per person $500,000 per occurrence of bodily injury $20,000 per occurrence of property damage

The contractor shall provide written notification to the CO, prior to contract start, that the required insurance has been obtained.

2. SERVICES SUMMARY

Performance Objectives SOW Para. Performance Threshold Eight Minutes Response Time for all calls

1.1.2.2 90% of calls per month

Patient Care Documentation 1.4.2 Provide patient care documentation by end of month 100% of the time.

3. GOVERNMENT-FURNISHED PROPERTY AND SERVICES

3.1 The Contractor will be provided a copy of SAFB’s grid-map prior to start of performance.

3.2 The Government will provide a train-the-trainer course for access to the Secured Area.

3.3 The Government will provide a location on SAFB to house the ambulance and for the ambulance crews to stand-by.

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3.4 Government Furnished Facilities. The government will furnish or make available facilities as described in Appendix 3, Government Furnished Facilities. The government retains the authority to modify or realign facilities and space provided to the contractor based on current Air Force (AF) guidelines for space utilization, mission, and personnel requirements of the service provider. All facilities and personnel shall only be used in performance of this contract.

Government facilities have been inspected for compliance with Occupational Safety and Health Administration (OSHA) and environmental regulations and are provided “as is”. No hazards have been identified which would prevent normal use of the facilities. The fact that no such conditions have been identified does not warrant or guarantee that no possible hazard exists, or that work-around procedures will not be necessary. Prior to contract start, the contractor shall perform a survey and environmental site assessment of government-furnished facilities and storage locations. Assess and document OSHA and environmental conditions. (Refer to AFI 32- 7066, Environmental Baseline Surveys in Real Estate Transactions; 42 U.S.C. Section 9601, et seq. Provide a copy of any identified deficiencies to the COR NLT five (5) days after contract start date. Should a hazard be identified, the government will correct the OSHA or environmental hazard(s) according to base-wide developed and government approved plans. A higher priority for correction will not be assigned to the facilities provided merely because of this contracting initiative. Should the contractor cause the OSHA or environmental hazard (negligence, misuse of space, non-compliance, disturbing of materials includes asbestos, lead based paint) the service provider, at their expense, shall remediate the hazard and any other consequences of such action. Compliance with OSHA and other applicable laws and regulations for the protection of employees is exclusively the obligation of the service provider. Further, the government will assume no liability or responsibility for the service provider's compliance or noncompliance with such requirements, except, for the aforementioned requirement to make corrections according to approved plans of abatement subject to base-wide priorities. Before any modification of any government provided facility is performed, the contractor shall, at the contractor’s expense, furnish the COR documentation describing, in detail, the modification requested. The contractor shall return the facilities to the government in the same condition as received less fair wear and tear and approved modifications. The government will accomplish a survey and site assessment at the completion of this contract. The contractor shall be liable for all corrective actions arising from deficiencies not documented in their initial survey.

Appendix 1 - Government Furnished Facility and Equipment

Bldg Description Sq. Footage

The following facilities are provided in order to facilitate the performance of requirements under this PWS. The square footage below indicates that space allotted for the performance of the AMR requirements.

500 Office Space 680

Equipment Provided Quantity

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The following pieces of equipment are provided to the contractor by the government in order to assist the contractor in performing the requirements in this PWS.

Land Mobile Radios 2

Appendix 2 – Reference Documents

DOD REGULATIONS/MANUAL/INSTRUCTIONS/DIRECTIVES

Publications Date of

Document Title D/G PWS

Paragraph DoD 6025.18 Jan 2003 DoD Health Information Privacy

Regulation D

DoD 8580.02-R 12 Jul 2007 DoD Health Information Security Regulation

D 1.7

DoDI 1100.22 6 Nov 1990 Continuation of Essential DoD Contractor Services During Crises

D 1.17.1

AIR FORCE REGULATIONS/MANUALS

Publications Date of

Document Title D/G Paragraph

AFI 33-129 16 Sep 14 Air Force Information Technology (IT) Service Management

D

AFMAN 33-152 1 Jun 12 User Responsibilities and Guidance for Information Systems

D Ch 3.1 – 3.4

AFMAN 33-283 3 Sep 14 Communications Security (COMSEC) Operations (FOUO)

D

AFMAN 33-282 27 Mar 12 Computer Security D Ch 3 and 4

AFI 33-332

29 Jan 2004 Privacy Act Program D 1.8

AFI 40-102 4 Mar 15 Tobacco Free Living D 3.1 AFI 91-207 12 Sep 13 The US Air Force Traffic Safety

Program D 2.3.1

AFI 91-204 12 Feb 14 Safety investigations and Reports

D 4.9

AFPAM 91-210 14 Feb 15 Contract Safety D Ch. 6

AFI 31-601

Chapters 1.2.7 and 8

29 Jun 2005 Industrial Security Program Management

D 1.13.5

AFI 31-101 8 Oct 2009 Integrated Defense (FOUO) D

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AFSPC Supplement

AFI 31-501

Section 3.24

27 Jan 2005 Personnel Security Program Management

D 1.13.5

AFI 32-7086 1 Nov 2004 Hazardous Material Management

D 1.14.2

AFI 32-7086

AFSPC Supplement

1 Aug 2006 Hazardous Material Management

D 1.14.2

21st MEDICAL GROUP REGULATIONS

Publications Date of

Document Title D/G Paragraph

MDGI 44-50 31 Jan 14 Infection Control D Ch 8

50th SPACE WING REGULATIONS

50 SWVA91-1 25 Sep 2007 50th Space Wing Ground Mishap

Reporting Procedures D 1.10

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Appendix 3– Acronyms

AAAHC Accreditation Association for Ambulatory Health Care ACIP Advisory committee on Immunization Practices ACLS Advanced Cardiac Life Support AFI Air Force Instruction AFSPC Air Force Space Command ANSI American National Standards Institute ASAP As soon as possible BCLS Basic Life Support CDC Centers for Disease Control (CDC) CFR Code of Federal Regulation CO Contracting Officer COMSEC Communication Security COR Contracting Officer Representative DoD Department of Defense DoDI Department of Defense Instruction DSN Defense Switching Network DUI Driving Under the Influence DWI Driving While Intoxicated EMT Emergency Medical Technician

EMT-P/ACLS

Emergency Medical Technician-Paramedic/Advanced Cardiac Life Support

EO Executive Order FAR Federal Acquisition Regulation FOUO For Official Use Only HAZMAT Hazardous Material HAZMART Hazardous Materials Pharmacy HIPAA Health Insurance Portability and Accountability Act of 1996 HIV Human Immune deficiency Virus IAW In Accordance With IVGA Integrated Visitor Group Agreement MDG Medical Group MTF Medical Treatment Facility MMR Mumps, Rubella and Rubeola MSDS Material Safety Data Sheets NFPA National Fire Protection Association NLT No Later Than OI Operating Instructions OSH Occupational Safety and Health OSHA Occupational Safety and Health Act PH Public Health PPD Purified Protein Derivative PWS Performance-Based Work Statement QAP Quality Assessment Program

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QPP Quality Program Plan RA Restricted Area RCRA Resource Conversation Recovery Act SAFB Schriever Air Force Base SS Service Summary SSAN Social Security Number SW Space Wing TB…