Attachment_1_PWS.pdf

Attachment 1

Performance Work Statement (PWS)

(Non-Personal Service)

WHASC Laundry Services

17 June 2016

1. GENERAL REQUIREMENTS

1.1. Scope of Work. It is expressly agreed and understood that this contract is for non-personal services. The

Contractor shall furnish all personnel, equipment, transportation, supplies, and supervision, except as specified herein as government-furnished, to provide bulk laundry services as specified herein, including pick-up and delivery. This contract includes all functions, tasks, and responsibilities normally inherent in a hospital laundry facility. The

Contractor shall establish and maintain a system of records to control and account for work performed. All work under this contract shall be accomplished in accordance with current (a) Joint Commission standards, (b) the Center for Disease Control and Prevention’s Guidelines for Environmental Infection Control in Health-Care Facilities, (c)

Occupational Safety and Health Administration standards, and (d) any other applicable federal, state and local regulations and guidelines. Performance shall be in accordance with the scope of this Performance Work Statement

(PWS), other specifications or provisions of the contract in support of Wilford Hall Ambulatory Surgical Center

Building 4550, 2200 Bergquist Drive, Joint Base San Antonio (JBSA) Lackland, Texas 78236, and other clinics within the WHASC area of responsibility.

1.2. Contractor Representative. The Contractor shall provide a point of contact that shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the Contractor when the primary is absent shall be designated in writing to the contracting officer no later than the start of the contract.

1.2.1. The point of contact and the alternate shall have full authority to act on behalf of the Contractor on all contract matters relating to the daily operation of this contract.

1.2.2. The point of contact and alternate must be able to read, write, speak, and understand English well enough to satisfy all contract performance requirements.

1.2.3. The contract point of contact and alternate shall be available during normal duty hours within 60 minutes to meet on the installation with Government personnel designated by the contracting officer to discuss problem areas.

1.2.4. Contractor personnel shall present a neat appearance and must be recognizable as an employee of the

Contractor. This may be accomplished by wearing distinctive clothing bearing the name of the company, or by wearing appropriate badges or identification tags, which contain the company name.

1.3. Security Requirements. General Security Requirements. The Contractor shall follow all guidelines found in the Security Requirements for Solicitation and Contract clause AFFARS 5352.242-9000 “Contractor Access to Air

Force Installations”.

1.3.1. Installation Access. Criminal History Check will be conducted on all prime/subcontractor employees requiring base access. The contractor shall provide the Contracting Officer and the Information Protection Office a current list of employees needing access within 3 working days after receiving award or Notice of Award. The list shall include employee’s name, date of birth, state driver’s license/state ID number and state of issue. Notifications of contractor employee additions and deletions shall be provided with the same information listed above and within

3 working days of adding or removing an employee. Within 10 business days after receipt of the list, the

Government will notify the Contractor that installation access passes are available for those employees clearing the criminal history check. The duration of any pass issued will not exceed one year or the duration of the contract, whichever is shorter. This process will be repeated at the exercise of any option or ordering period.

1.3.2. Physical Security. The contractor shall comply with Force Protection Condition (FPCON) procedures, Random Antiterrorism Measures (RAMS) and local search/identification requirements.

1.3.3. The contractor shall safeguard all government property, including the scales for linen weights, provided for contractor use.

1.3.4. Government Data. The Contractor shall manage all data created for Government use or legally controlled by the Government, in support of the functional activity or required by AF publication, IAW with the records management procedures in Air Force Instruction (AFI) 33-322, Records Management Program, Air Force Manual

(AFMAN) 33-363, Management of Records, and the Air Force Records Disposition Schedule (AFRDS).

1.3.5. Freedom of Information. The contractor shall not respond to any Freedom of Information Act request or release any information in response to a Freedom of Information request. Any request for information received by the contractor under the Freedom of Information Act will be referred to the Contracting Officer.

1.3.6. Contingency Plans. The Contractor shall maintain a current Contingency Plan and notify the Contracting

Officer of any proposed modifications. The Contractor shall notify the Contracting Officer of any event that jeopardizes performance under this contract. The plan shall include contingency operations for:

1.3.7. Mobilization. In the event of mobilization, which may require services beyond the Contractor’s capability, the

Contractor shall advise the Contracting Officer immediately of the capability and additional volume which the

Contractor can obtain from the local civilian community. In the event the Contractor is not able to meet the government’s requirements, the Government reserves the right to obtain services from military laundry units, other

Department of Defense agencies or other commercial sources.

1.3.8. Disaster. In the event of a disaster, to include but not limited to destruction of the facility, sabotage, or an act of God or nature, that renders the Contractor’s facility unsafe, the Contractor shall determine a feasible alternative method of providing services and make recommendations to the Contracting Officer immediately, as directed by the

Contracting Officer. The Government reserves the right to obtain services from other sources in the absence of such action.

1.3.9. Labor Disputes. In the event of a labor dispute, the Contractor’s responsibility to provide the service shall not be terminated. The Contractor shall provide the Contracting Officer his strike or other employee job action contingency plan to continue performance of service without interruption or degradation in the quality of service. In the event a labor dispute is threatened, the Contractor shall immediately notify the Contracting Officer. In case of a strike or other labor dispute interferes with timely contract performance, the Contractor shall immediately notify the

Contracting Officer and initiate action under the Contingency Plan.

1.4. Performance Evaluation Meetings. The Contractor or designated alternate, CO, Contract Administrator, COR/Functional Requirements Evaluator Designees (FRED), and other appropriate staff shall meet during the performance of this contract as required by any party. Written minutes will be kept as arranged by the CO and will be signed by the Contractor or designated alternate, COR/FRED and CO.

1.4.1. Additional coordination is at the discretion of the local participants.

1.4.2. Distribution of minutes. There shall be one copy to each coordinating party. Should the Contractor not concur with the minutes, the Contractor(s) shall state, in writing, any areas of non-concurrence to the Contracting Officer within seven (7) calendar days of receipt of the signed minutes.

1.5. Transition Period. The new Contractor shall assume complete responsibility for all operations required by this contract as of the first day of the contract period. Therefore, on the initial day of performance, the Contractor shall provide a workforce who is fully qualified and capable of performing all work required under this contract.

1.6. Hours of Operation.

1.6.1. Normal Hours. The Contractor shall be available to meet with Government personnel during normal duty hours of 6:30 A.M. to 4:00 P.M, Monday through Friday and 7:00 A.M to 8:00 AM, Saturday and Sunday, except federal holidays, family/goal days and any planned closure days as indicated in PWS paragraph 1.7.2. Specific pick-up and delivery schedules will be in accordance with PWS Technical Exhibit (TE) 2.

1.6.2. All clinics within the MTF will observe the following federal holidays in addition to any family/goals/planned closure days.

New Year's Day January 1

Martin Luther King Jr's Birthday 3rd Monday in January

President’s Day 3rd Monday in February

Memorial Day Last Monday in May

Independence Day July 4

Labor Day 1st Monday in September

Columbus Day 2nd Monday in October

Veterans' Day November 11

Thanksgiving Day 4th Thursday in November

Christmas Day December 25

1.6.3. Should the official holiday fall on Saturday then the observed holiday is the previous Friday. Should the official holiday fall on Sunday then the observed holiday is the following Monday.

1.6.4. The Contractor shall not be required to pick-up and deliver on all officially recognized federal holidays (see paragraph 1.7.2. above).

1.6.5. Furthermore, any day so designated by Presidential Executive Order as a holiday will also be observed.

2. DEFINITIONS

2.1. Definitions of special terms and phrases used in this Performance Work Statement (PWS) are as follows:

2.1.1.1. Clean. Finished articles are dry and free of visible soil, lint, and objectionable odors, such as cleaning chemicals, mold, mildew, body bacteria, and other unclean elements. Spots and stains are removed without damaging the fabric. Tape and other adhesives shall be removed prior to or during the laundering process.

2.1.1.2. Clean Weight. The total weight of clean laundered items that were not processed through individual counts

(e.g., special items as defined below) delivered to and accepted by the Government.

2.1.1.3. Contaminated Laundry. All soiled laundry originating from the MTF is categorized as contaminated in accordance with the "Infection Control" section (Laundry and Laundry subsection) of the Joint Commission Manual;

the Contractor is responsible for properly handling contaminated laundry.

2.1.1.4. Contingency Plan. Contingency Plan is a document describing actions to be implemented or taken in the event of unforeseen circumstances.

2.1.1.5. Contracting Officer. A person with the authority to enter into, administers, and/or terminates contracts and makes related determinations and findings. The only person authorized to make changes in the contract on behalf of the Government.

2.1.1.6. Contracting Officer’s Representative (COR) and Functional Requirements Evaluation Designee (FRED).

COR/FREDs are MTF personnel responsible for assisting in administration of the Government's quality assurance portion of the contract. These personnel are designated in writing to be responsible for quality assurance inspection, surveillance documentation and periodic (monthly) acceptance of Contractor's performance. A copy of the appointment letter will be provided to the Contractor. Each task order issued under the basic contract may have a separately appointed COR/FRED.

2.1.1.7. Dry Weight. Dry weight is the weight of cleaned, processed laundry that is dry to the touch

2.1.1.8. Dyed Towels. These are white towels that are sent to the Contractor to be dyed brown.

2.1.1.9. Government Quality Assurance. Those actions taken by the Government to assure services meet the requirements of the PWS and to contract clauses relating to quality and performance.

2.1.1.10. Maximum Shrinkage Factor. The permissible weight variance between the total weights of soiled laundry picked up on any given day and the total weight of that same laundry when it is cleaned and returned 24 hours later per Technical Exhibit 1. This weight difference shall not exceed 7.0 percent.

2.1.1.11. Microfiber. These items are used for cleaning purposes, as they can hold an enormous amount of water and absorb dirt and oil, but are soft enough that they won't scratch or damage surfaces. Microfiber cloths are used for dusting because they are electrostatic and naturally attract the dust. Proper washing techniques are necessary to make sure that microfiber cloths are kept clean. Examples of microfiber items include rags (blue, gray, green, and orange), dusters, mops (blue and orange), and dust mops.

2.1.1.12. Military Time. Military time is on a 24-hour clock, e.g.

8:00 a.m. – 0800 9:10 a.m. – 0910 Noon - 1200

9:10 p.m. – 2110 Midnight – 2400 12:01 a.m. - 0001

2.1.1.13. Mix. This refers to the variety of soiled laundry turned over each day to the Contractor for cleaning. It is essential that the mix of clean laundry returned be comparable to the soiled laundry. (e.g., Sheets, bed pads, blankets, scrubs, bath robes, and towels go out soiled the next day we receive clean sheets, bed pads, blankets, scrubs, bath robes, and towels.)

3. CONTRACT MANPOWER REPORTING

3.1. Contractor Manpower Reporting (eCMRA) Application:

3.1.1. The Contractor shall report ALL Contractor labor hours (including Sub-Contractor 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 at http://www.ecmra.mil.

3.1.2. Reporting inputs will be for the labor executed during the period of performance for each Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported any time during the FY, all data shall be reported no later than 31 October of each calendar year. Contractors may direct questions to the CMRA help desk.

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

3.1.4. User Manual: Data for Air Force service requirements must be input at the Air Force CMRA link. However, user manuals for Government personnel and Contractor are available at the CMRA link at http://www.ecmra.mil.

Once you get to this site, click the Department of Air Force CMRA link, to log-in or to initially set-up a user account.

3.2. Quality Control. The Contractor shall be responsible for quality control for all work accomplished during the performance of the contract. The Contractor shall maintain a Quality Control Plan (QCP) which ensures the requirements in this PWS are met. As a minimum, the Contractor shall develop quality control procedures that address the areas identified in section 5, Service Delivery Summary. The QCP shall be submitted with the contractor’s proposal for evaluation and acceptance.

3.3. Quality Assurance. The government will periodically evaluate the Contractor's performance by appointing a

Contracting Officer Representative(s) (COR) to monitor performance to ensure services are received and are http://www.ecmra.mil/ http://www.ecmra.mil/ acceptable. The COR will correspond with an assigned Functional Requirements Evaluator Designee (FRED) to assist in monitoring schedule compliance (days/hours worked) and inspecting work performance. The COR will evaluate the contractor’s performance in accordance with the government's Quality Assurance Surveillance Plan

(QASP) developed for this requirement.

3.4. Contractor Laundry Facilities. The laundry facility shall be designed, equipped and ventilated (a) for efficient production of hygienically cleaned textiles and (b) to minimize the potential dissemination of microbial contaminants that are external (e.g., dust and dirt) and internal (e.g., soiled laundry, contaminated lint) to the facility.

3.4.1. Functional separation of clean and soiled laundry areas shall be maintained at all times.

3.4.2. The ventilation system shall include adequate intake, filtration, exchange rate, and exhaust in accordance with local, state, and federal regulations.

3.4.3. In the event laundering services do not conform to this contract, re-performance of the services shall apply. Any items that do not meet the requirements in the Performance Work Statement shall be re-cleaned, repaired or replaced at no additional costs to the Government. Such items (found by WHASC employees as packages are opened) will be identified to the Contractor’s representative at the next scheduled pick-up after the unsatisfactory condition is discovered. After the items are re-cleaned, the Contractor shall pack these items separately and identify by marking

“Attention COR.”

3.4.4. The WHASC Infection Control Nurse, COR and/or FRED shall conduct a separate inspection (announced or unannounced) of the Contractor’s facility and operations to ensure compliance with CDC and Joint Commission infection control standards.

4. DESCRIPTION OF SERVICES

4.1. Bulk Laundry Service.

4.1.1. Laundry Services. Twenty-four (24) hour turn-around laundry service shall be provided to WHASC and all outlying buildings in accordance with TE 2. The soiled laundry shall be picked-up, processed, cleaned, dried, packaged and returned the next business day in accordance TE 1 and 2. For example, if the soiled laundry were picked-up Monday 0830, the soiled laundry shall then be processed, cleaned, dried, packaged, and returned by

Tuesday 0830.

4.1.2. Discrepancies. Any discrepancy in weight, 93% return of clean versus soiled laundry and 45% return of clean versus soiled microfiber product, shall be annotated at the time of delivery (e.g. for laundry, if 100 pounds of soiled laundry are picked up, then at least 93 pounds of clean laundry shall be returned; for microfiber products, if 100 pounds of soiled microfiber items are picked up, then at least 45 pounds of clean microfiber items shall be returned).

Shortages shall be rectified within 24 hours of being identified.

4.1.2.1. All Government owned laundry or microfiber products that are lost or missing while in the Contractor’s possession shall be replaced at the Contractor’s expense at the actual cost of replacement, less 10.0% per pound. All personal or Government property, to include money that is found in the laundry shall be returned to the Government.

4.1.2.2. Unresolved shortages will be identified in writing to the Contracting Officer for appropriate action.

4.1.3. Process of Receiving and Returning Laundry. Laundry shall be received, processed by the Contractor, and returned to the Government as follows:

4.1.3.1. Soiled laundry, to include microfiber, shall be weighed at the medical facility on Government-owned scales

(weight capacity: 2,000 pounds). The weight will be recorded on a laundry tracking sheet supplied by the

Government prior to the Contractor loading the laundry onto their vehicle.

4.1.3.2. Separate tracking sheets shall be used for soiled laundry and microfiber per facility. The cart number, soiled cart weight (identified separately), and the total weight shall be entered on the tracking sheet. The Government and

Contractor shall verify the weights and countersign the tracking sheet to indicate agreement with those weights at time of pick-up.

4.1.3.3. A copy of each completed laundry tracking sheet shall be furnished to the Contractor and a copy shall be maintained by the Government. Contractor personnel shall be responsible for physically transferring soiled laundry into the Contractor's vehicle.

4.1.3.4. The Contractor shall pick up unsorted and contaminated laundry in Government provided laundry bags and unsorted and contaminated microfiber items in Government provided plastic bags. All soiled/contaminated laundry and microfiber products shall be cleaned, sanitized, and processed in strict accordance with federal, state and local laws as well as healthcare industry standards. Washing formulas shall be strictly adhered to so as to assure proper cleaning of all articles without damage to the article.

4.1.3.5. The Contractor shall ensure that all operators of Contractor-owned vehicles possess evidence of insurance and a valid state permit to operate the vehicles under their control. Soiled and clean articles shall not be transported in the same vehicle and dropped off/picked-up in accordance with TE 2.

4.1.3.6. The Contractor shall provide each month a summary to the Contracting Officer Representative of all processed soiled and clean laundry weights and all clean and soiled microfiber products weights. Disparities between the weights of the soiled and clean laundry that are beyond the healthcare industry standards or range shall be investigated and corrected. Any disagreements that cannot be resolved shall be directed to the Contracting Officer for resolution.

4.1.4. Service Response Time. The Contractor’s response times shall be monitored by the Government. The

Contractor shall receive, process, and return laundry and/or articles in accordance with the service response times as specified in this contract. Failure to adhere to this requirement will be considered a deficiency in the Contractor’s performance.

4.1.4.1. Service response times shall be computed from the time laundry is received by the Contractor at the government site until the time it is returned to the Government.

4.1.5. Corrective Action. The Contractor shall take prompt actions to correct any services or products provided to the

Government that does not conform to the requirements of this contract.

4.1.6. Finished Work. The Contractor shall assemble completed work into bundles and wrap the bundles for return to

WHASC accordance with the Technical Exhibit 1. No trace of wash supplies (e.g., soap, bleach, et al.) shall be left on the fabrics.

4.1.7. Piece laundry and dry cleaning.

4.1.7.1. Pick Up and Delivery. The contractor shall pick up soiled laundry and items for laundering or dry cleaning and deliver clean laundry and dry cleaned items in accordance with Technical Exhibit 2. The turnaround time for all items shall be no longer than 24 hours, (e.g. Items picked up Monday shall be returned Tuesday.)

4.1.7.1.1. Pick-Up. Soiled laundry is processed by piece and will be accounted for by Government personnel who will record the counts on a laundry ticket supplied by the contractor, this will be accomplished prior to pick up by the contractor. The Contractor shall verify the counts and countersign the ticket to indicate agreement. Contractor personnel shall be responsible for physically transforming soiled linen into the contractor’s vehicle. A copy of each completed laundry ticket shall be furnished to the Government.

4.1.7.1.2. Delivery. Laundry items processed by count will be counted by government personnel at the time of delivery to the MTF and recorded on a laundry ticket provided by the contractor. The contractor shall verify counts and sign the ticket to indicate agreement. A copy of each completed laundry ticket shall be furnished to the

Government.

4.1.7.2. Vehicle Interior. Soiled items and clean items shall not be transported in the same vehicle at the same time.

All clean items are to be protected from contamination and soiling during transit to the MTF. After transporting dirty/soiled/contaminated laundry, the vehicle interior shall be cleaned and sanitized before loading the clean articles. Interior of vehicle shall be free of any holes to prevent dust and dirt during transportation.

4.1.7.3. Workmanship and Sanitation. Delivered finished articles shall conform to the generally accepted industry standards for quality of cleanliness, finish, and appearance. All work performed shall be done under sanitary conditions. The items shall be clean not only in the sense of being free from soil, stains and objectionable odors, but also free from excess cleaning chemicals, bacteria, fungi, and other microorganisms, including pathogens or disease-producing organisms.

4.1.7.3.1. Each item shall be clean and dry, and free of lint, scorch marks, and other damage to the fabric.

4.1.7.3.2. White fabrics shall be white and free of yellow or gray tints. Colors shall be bright and clear.

4.1.7.3.3. Articles shall smell fresh and clean and be free of objectionable odors, such as cleaning chemicals, mold, mildew, body bacteria, and other unclean elements.

4.1.7.3.4. Fabrics shall be free of excess soap, bleach, etc.

4.1.7.3.5. All linen shall be completely dry and soft.

4.1.7.3.6. Items processed on flat work and irons, such as tablecloths and napkins shall be machine-finished

(ironed) so that the surfaces are smooth and without “rough-dry spots, wrinkles, or tears. Flat work shall be free of creases when received by the customer.

4.1.7.4. Finished Work. The Contractor shall be responsible for all finish operations as prescribed in this PWS. The

Contractor shall assemble completed work into bundles and wrap the bundles (to include hanger work) for return to

MTF as indicated in TE 3.

4.1.7.5. Re-performance of Laundering and Dry Cleaning. In the event services do not conform to this contract, re-performance of the services shall apply. Any items that do not meet the requirements in the Performance Work

Statement shall be re-cleaned, repaired or replaced at no additional costs to the Government. Such items (found by the MTF personnel as opened packages) will be identified by the FRED and relayed to the Contractor’s representative immediately after the unsatisfactory condition is discovered. After items are re-cleaned, the contractor shall pack these items separately and identify by marking, “Attention FRED”.

4.1.7.6. Packaging. The packaging will be as indicated in TE 3.

4.1.7.7. Doctor/PA Coats. Shall be lightly starched and hung by individual coat on hangers and covered individually with plastic film bags not to exceed the bottom of the coat.

4.1.7.8. Hangers. Hangers shall be of a type not to stain garments.

4.1.7.9. Hospital Duty Uniforms. Shall be lightly starched and hung by individual ticket on hangers and covered individually with plastic film bags.

4.1.7.10. Color Coded and Sized Items. All items such as, but not limited to, napkins and table clothes, etc. which is different colors shall be folded and bundled in accordance with TE 3. Items coming in varied color size shall be bundled by color and size respectively. EXAMPLE: Small cranberry table clothes shall be bundled together; small purple table clothes shall be bundled together, but not mixed with small cranberry table clothes.

4.1.7.11. Receiving, Marking, and Classifying. The Contractor shall provide a completed laundry ticket for laundry items picked up from the MTF at the time of pick-up. Obtain completed laundry ticket receipt for laundered items delivered at the time of delivery.

4.1.7.12. Each form will be completely filled out with nomenclature, size and quantity, date, time of pickup or delivery, with original maintained by the Government and a copy provided to the Contractor at time of pickup or delivery.

4.1.7.13. Contractor and Government personnel shall both sign laundry ticket verifying the count. All disagreements in the count will be directed to the Contracting Officer for resolution.

5. SERVICE DELIVERY SUMMARY

SDS

Item # Performance Objective PWS Paragraph Monthly Performance

Threshold

Method of

Surveillance

1 Provide Contingency Plan PWS Paragraph 1.3.6

Submit any updates to the

Contracting Officer and COR

100% of the time annually.

COR maintain log / Annual review.

2 Comply with security requirements.

PWS Paragraph 1.3.

Comply initially and as required

100% of the time.

COR maintain log (100%

Inspection)

Comply with turn-around

(pick-up and delivery) times listed herein.

PWS Paragraph 4.1.1. /

Technical Exhibit (TE) 2

Shall meet turn-around times at least 95% of the time each month.

FRED

maintain log

(100% inspection)

Delivery of finished articles shall conform to the quality of cleanliness, finish, and appearance requirements listed herein.

PWS Paragraph 4.1.7.3.

At least 95% of the articles processed each month shall be completed as prescribed. (No more than 5% of the articles processed each month shall require re-work.)

Random

Sampling /

Customer

Complaint

Delivery of finished articles shall conform to the packaging and transporting requirements listed herein.

PWS Paragraph 4.1.3. /

Technical Exhibit (TE) 1.

At least 95% of the articles processed each month shall be returned to the MTF in the prescribed manner.

Random

Sampling /

Customer

Complaint

Comply with submitting

Manpower Report.

PWS Paragraph 3. Comply 100% of the time.

COR maintain log.

7 Turnaround time must not exceed 24 hours PWS Paragraph 4.1.7.1.

Laundry items processed by count will be counted by government personnel at the time of delivery. The CP shall verify counts and sign the ticket to indicate agreement. A copy of completed laundry ticket shall be furnished to the government.

At least 95% of the time unless otherwise specified.

FRED

maintain log

(100% inspection)

6. GOVERNMENT FURNISHED PROPERTY

6.1. The Government will provide use of all available MTF facility’s and support services, materials, publications and forms, and use of equipment, (except as designated in the contract). The Contractor shall keep Government furnished supplies, equipment, and work areas in a safe, orderly and clean condition.

7. LIST OF TECHNICAL EXHIBITS & APPENDICES

Technical Exhibit 1: Identification, Standard Packaging, and Method of Finish for Bulk Laundry, WHASC

Technical Exhibit 2: Locations

Technical Exhibit 3: Identification, Standard Packaging, and Method of Finish for Piece Work and Dry

Cleaning Services

Appendix A: Referenced Department of Defense, Air Force, and 59th Medical Wing Publications

Appendix B: HIPAA Business Associate Agreement (BAA)

TECHNICAL EXHIBIT (TE) 1

IDENTIFICATION, STANDARD PACKAGING, AND METHOD OF

FINISH FOR BULK LAUNDRY, WHASC

The following are the routine requirements for packaging of laundry and method of finish for this contract. Any other special packaging requirements or methods of finish will be specified in writing at the time that service is requested.

Definitions of abbreviations for methods of finish are as follows:

B Bundled

F Folded P Pressed

S Sort by Color, Size

W Shrink-Wrapped

The items listed in Technical Exhibit 1 will be included in the yearly laundry service. Weights are listed in pounds.

Additional Instructions: Packaged amounts less than the quantities specified will be identified on the bundle.

BULK LAUNDRY

ITEM WT PER PIECE # PER

BUNDLE

SPECIAL

HANDLING

Bag, Nylon, Light Blue 0.60 10's F, B, W

Bag, Soiled Linen 1.00 10's F, B, W

Blanket, Green or White 2.50 3's F, B, W

Glove, Pocket, Double 0.15 20’s F, B, W

Glove, Pocket, Single 0.15 20’s F, B, W

Gown, Exam, X-Ray (3-Arm Hole)(L, XL, 3X) 1.00 10’s F, S, B, W

Gown, Mammography 0.20 10’s F, S, B, W

Gown, OR, Green 0.65 10's F, B, W

Pad, Bed 0.15 10’s F, S, B, W

Pant, OR, Green (S, M, L, XL, 2XL, 3XL, 4XL, 5XL) 0.65 10’s F, B, W

Pillow Case, Green 0.90 5's F, B, W

Pillow Case, White 1.00 5's F, B, W

Sheet, Crib 0.50 10’s P, F, S, B, W

Sheet, Draw 0.40 20’s P, F, B, W

Sheet, Eye 0.40 20's P, F, B ,W

Sheet, Fitted 0.15 10’s F, B, W

Sheet, Green .50 10’s F, B, W

Sheet, White 0.36 20's F, B, W

Shirt, OR, Green (S, M, L, XL, 2XL, 3XL, 4XL, 5XL) 1.00 5's P, F, B, W

Smock, Green, Long-Sleeve 1.75 10's P, F, B, W

Towel, Bath (White) 1.25 10’s P, F, B, W

Towel, Hand, Green (Surgical) 0.40 10’s P, F, S, B, W

Trousers, OR, Green (S, M, L, XL, 2XL, 3XL, 4XL, 5XL)

0.41 10’s F, B, W

Wrapper 12” 0.24 20's P, F, B, W

Wrapper 18” 0.50 – 0.75 10’s P, F, S, B, W

Wrapper 24” 0.40 10’s P, F, S, B, W

Wrapper 36” 0.80 10's P, F, S, B, W

Wrapper 54” 0.40 10’s F, S, B ,W

Miscellaneous 0.10 10’s F, B, W

0.07 20’s F, B, W

0.15 20’s F, B, W

0.25 20’s F, B, W

0.50 10’s F, B, W

1.50 10’s F, B, W

0.15 – 1.50 1’s F, W

DYED TOWELS

Towel, Bath (Brown) 0.46 10's P, F, B, W

MICROFIBER

ITEM WT PER PIECE # PER

BUNDLE

SPECIAL

HANDLING

Cloth, Microfiber, Blue, 12 x 12 0.06 50's F, B, W

Cloth, Microfiber, Gray, 16 x 16 0.12 50's F, B, W

Cloth, Microfiber, Orange, 12 x 12 0.06 50's F, B, W

Duster, Microfiber, Blue 0.06 50's F, B, W

Mop, Microfiber, Blue, 20 x 5 0.18 50's F, B, W

Mop, Microfiber, Orange, 11 x 5 0.06 50's F, B, W

Dust Mop, Microfiber, Blue, 18 x 5 0.18 50's F, B, W

Dust Mop, Microfiber, Blue, 36 x 5 0.33 50's F, B, W

SPECIAL ITEMS

ITEM WT PER PIECE # PER

BUNDLE

SPECIAL

HANDLING

Coats, Laboratory (Blue, Light and Blue, Dark), Long

Sleeve

1.00 1 Pressed, Hanger, Plastic-

Covered

Pillow Case, White * Sleep Lab * 0.40 20’s P, F, B ,W

Sheet, Fitted * Sleep Lab * 1.00 10’s P, F, B ,W

Sheet, White * Sleep Lab * 1.75 10’s P, F, B ,W

Curtains, Cubicle/Exam Room 5.00 1 W, B, F, S

Some special items cannot be defined ahead of time, as this definition includes special handling items (such as those requiring re-wash or the occasional personal item). Specific instructions for items not herein defined will be provided at the time such items are given to the Contractor for laundering.

TECHNICAL EXHIBIT (TE) 2

LOCATIONS

WILFORD HALL AMBULATORY SURGICAL CENTER (WHASC)

The following pick-up and delivery chart specifies regular pick-up and delivery points for this contract. All pick-ups and deliveries shall be accomplished as stated below (military time):

Delivery / Pick Up Location Pick Up / Delivery Day Delivery Time Pick Up Time

Bldg 4550, WHASC Sunday 0700 0730

Bldg 4550, WHASC Monday 0630 & 1030 0700

Bldg 4550, WHASC Tuesday 0630 & 1030 0700

Bldg 4550, WHASC Wednesday 0630 & 1030 0700

Bldg 4550, WHASC Thursday 0630 & 1030 0700

Bldg 4550, WHASC Friday 0630 & 1030 0700

Bldg 4550, WHASC Saturday 0700 0730

Soiled laundry for Bldg. 4550 will be picked up after the first delivery of clean laundry is delivered. It will be weighed first at the time specified for pick up above (0700 or 0730, depending on the day).

Next, soiled laundry will be picked up from the locations below and brought directly to the linen dock at WHASC prior to 1030 hrs., where it will be weighed and added to the soiled laundry weight’s tracking sheet for that day.

Soiled laundry from these locations shall be segregated from WHASC’s soiled laundry. Clean laundry shall be delivered 24 hours later to WHASC, regardless of pick-up location. There are two separate weigh-ins. The contractor may elect to return the first weigh-in’s laundry to their facility prior to picking up the laundry from the outlying buildings, but they are not required to do so.

Pick Up Location Pick Up

Day

Pick Up

Time

Delivery

Location

Delivery

Day

Delivery

Time

Bldg 4430 Thursday 0730 Bldg 4550 Friday 0630

Bldg 3352 Monday 0730 Bldg 4550 Tuesday 0630

Bldg 3352 Wednesday 0730 Bldg 4550 Thursday 0630

Bldg 6418 Monday 0730 Bldg 4550 Tuesday 0630

Bldg 6612 Wednesday 0730 Bldg 4550 Thursday 0630

Bldg 7602 Thursday 0730 Bldg 4550 Friday 0630

TECHNICAL EXHIBIT (TE) 3

IDENTIFICATION, STANDARD PACKAGING, AND METHOD OF

FINISH FOR PIECE WORK AND DRY CLEANING SERVICES

The following are the routine requirements for packaging of laundry/dry cleaning and method of finish for this contract.

Definitions of abbreviations for methods of finish are as follows:

A Air Dried (No Heat) H Hung on Hanger

B Bagged L Light Starch

BU Bundled P Press

D Dry Clean P/H Press and Hang

F Fold S Sort by Color, Size

Bldg. 4430, Clinic research , 1255 Wilford Hall Loop, Lackland AFB, Texas 78236

Bldg. 3352, Graduate Dental School, 2133 Pepperrell Street, Lackland AFB, Texas 78236

Bldg. 6418, Dunn Dental Clinic, 1515 Truemper Street, Lackland AFB, Texas, 78236

Bldg. 6612, Reid Clinic 1515 Truemper Street, Lackland AFB, Texas 78236

Bldg. 7602, Holland Military Working Dogs Hospital, Lackland AFB, Texas, 78236

W Wash

The items listed in Technical Exhibit 2 will be included in the yearly laundry service.

These figures are based on an estimate; it may vary either higher or lower.

SPECIAL ITEMS ESTIMATED

QUANTITY PER

YEAR

# PER

BUNDLE

SPECIAL

HANDLING

Coat, Doctor/PA, Various Sizes 1,400 1’s L,H,B

Table clothes, Various Colors/Sizes 1,100 5’s L,S,H,B

Table Skirts, Various Colors/Sizes 400 1’s D,P/H,B

Vest 48 1’s L,H,B

The following pick-up and delivery chart specifies regular pickup and delivery points for this contract. All pick-ups and deliveries shall be accomplished as stated below (military time):

Delivery Location Delivery

Days

Delivery

Time

Pick Up

Location

Pick Up Day Pick Up

Bldg. 4550 WHASC Monday-

Thursday

0800 Bldg. 4550 Monday 0830

APPENDIX A

REFERENCED AIR FORCE INSTRUCTIONS, DEPARTMENT OF DEFENSE

REGULATIONS, AND MEDICAL WING INSTRUCTIONS

(Note: In all instances, most current version applies. Publications can be found electronically at http://www.epublishing.af.mil)

AFI 16-1404, Air Force Information Security Program (Entire instruction applies)

AFI 31-501, Personnel Security Program Management (Entire instruction applies)

AFI 33-332, Air Force Privacy Act Program. (Entire instruction applies)

AFI 44-119, Medical Quality Operations. (Entire instruction applies)

AFI 48-105, Surveillance, Prevention and Control of Diseases and Conditions of Public Health or Military

Significance. (Paragraph 1.10.10.)

AFI 71-101, Vol. 2, Protective Service Matters. (Para 1.2) (IAW 502 CONS & 502 SFS MOA)

MDWI, 41-214, Codes and Alarms. (Entire instruction applies)

MDWI 32-2003, Fire Safety Management Response Program. (Entire instruction applies)

MDWI 32-7001 Hazardous Materials, Waste Management and Spill Response Program (Entire instruction applies)

MDWI 44-157, Infection Control Program. (Entire instruction applies)

DoD Directive 5400.7, DOD Freedom of Information Act (FOIA) Program. (Para 2 & 3)

APPENDIX B

HIPAA BUSINESS ASSOCIATE AGREEMENT (BAA)

In accordance with 45 CFR 164.502(e) (2) and 164.504(e) and paragraph C.3.4.1.3 of DoD 6025.18-R, “DoD Health

Information Privacy Regulation,” January 24, 2003, this document serves as a business associate agreement (BAA) between the signatory parties for purposes of the Health Insurance Portability and Accountability Act (HIPAA) and the “HITECH Act” amendments thereof, as implemented by the HIPAA Rules and DoD HIPAA Issuances (both defined below). The parties are a DoD Military Health System (MHS) component, acting as a HIPAA covered entity, and a DoD contractor, acting as a HIPAA business associate. The HIPAA Rules require BAAs between covered entities and business associates. Implementing this BAA requirement, the applicable DoD HIPAA Issuance

(DoD 6025.18-R, paragraph C3.4.1.3) provides that requirements applicable to business associates must be incorporated (or incorporated by reference) into the contract or agreement between the parties.

(a) Catchall Definition. Except as provided otherwise in this BAA, the following terms used in this BAA shall have the same meaning as those terms in the DoD HIPAA Rules: Data Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices (NoPP), Protected Health

Information (PHI), Required By Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health

Information, and Use.

Breach means actual or possible loss of control, unauthorized disclosure of or unauthorized access to PHI or other

PII (which may include, but is not limited to PHI), where persons other than authorized users gain access or potential access to such information for any purpose other than authorized purposes, where one or more individuals will be adversely affected. The foregoing definition is based on the definition of breach in DoD Privacy Act

Issuances as defined herein.

Business Associate shall generally have the same meaning as the term “business associate” in the DoD HIPAA

Issuances, and in reference to this BAA, shall mean the Contractor.

Agreement means this BAA together with the documents and/or other arrangements under which the Business

Associate signatory performs services involving access to PHI on behalf of the MHS component signatory to this

BAA.

Covered Entity shall generally have the same meaning as the term “covered entity” in the DoD HIPAA Issuances, and in reference to this BAA, shall mean the 59th Medical Wing Wilford Hall Ambulatory Surgical Center.

DHA Privacy Office means the DHA Privacy and Civil Liberties Office. The DHA Privacy Office Director is the

HIPAA Privacy and Security Officer for DHA, including the National Capital Region Medical Directorate

(NCRMD).

DoD HIPAA Issuances means the DoD issuances implementing the HIPAA Rules in the DoD Military Health

System (MHS). These issuances are DoD 6025.18-R (2003), DoDI 6025.18 (2009), and DoD 8580.02-R (2007).

DoD Privacy Act Issuances means the DoD issuances implementing the Privacy Act, which are DoDD 5400.11

(2007) and DoD 5400.11-R (2007).

HHS Breach means a breach that satisfies the HIPAA Breach Rule definition of breach in 45 CFR 164.402.

HIPAA Rules means, collectively, the HIPAA Privacy, Security, Breach and Enforcement Rules, issued by the U.S.

Department of Health and Human Services (HHS) and codified at 45 CFR Part 160 and Part 164, Subpart E

(Privacy), Subpart C (Security), Subpart D (Breach) and Part 160, Subparts C-D (Enforcement), as amended by the

2013 modifications to those Rules, implementing the “HITECH Act” provisions of Pub. L. 111-5. See 78 FR 5566-

5702 (Jan. 25, 2013) (with corrections at 78 FR 32464 (June 7, 2013)). Additional HIPAA rules regarding electronic transactions and code sets (45 CFR Part 162) are not addressed in this BAA and are not included in the term HIPAA

Rules.

Service-Level Privacy Office means one or more offices within the military services (Army, Navy, or Air Force) with oversight authority over Privacy Act and/or HIPAA privacy compliance.

I. Obligations and Activities of Business Associate

(a) The Business Associate shall not use or disclose PHI other than as permitted or required by this Agreement or as required by law.

(b) The Business Associate shall use appropriate safeguards, and comply with the DoD HIPAA Rules with respect to electronic PHI, to prevent use or disclosure of PHI other than as provided for by this Agreement.

(c) The Business Associate shall report to Covered Entity any Breach of which it becomes aware, and shall proceed with breach response steps as required by Part V of this BAA. With respect to electronic PHI, the Business

Associate shall also respond to any security incident of which it becomes aware in accordance with any Information

Assurance provisions of this Agreement. If at any point the Business Associate becomes aware that a security incident involves a Breach, the Business Associate shall immediately initiate breach response as required by part V of this BAA.

(d) In accordance with 45 CFR 164.502(e) (1) (ii)) and 164.308(b) (2), respectively, and corresponding DoD HIPAA

Issuances, as applicable, the Business Associate shall ensure that any subcontractors that create, receive, maintain, or transmit PHI on behalf of the Business Associate agree to the same restrictions, conditions, and requirements that apply to the Business Associate with respect to such PHI.

(e) The Business Associate shall make available PHI in a Designated Record Set, to the Covered Entity or, as directed by the Covered Entity, to an Individual, as necessary to satisfy the Covered Entity obligations under 45

CFR 164.524 and corresponding DoD HIPAA Issuances.

(f) The Business Associate shall make any amendment(s) to PHI in a Designated Record Set as directed or agreed to by the Covered Entity pursuant to 45 CFR 164.526, or take other measures as necessary to satisfy Covered Entity’s obligations under 45 CFR 164.526, and corresponding DoD HIPAA Issuances.

(g) The Business Associate shall maintain and make available the information required to provide an accounting of disclosures to the Covered Entity or an individual as necessary to satisfy the Covered Entity’s obligations under 45

CFR 164.528 and corresponding DoD HIPAA Issuances.

(h) To the extent the Business Associate is to carry out one or more of Covered Entity's obligation(s) under the

HIPAA Privacy Rule, the Business Associate shall comply with the requirements of the HIPAA Privacy Rule that apply to the Covered Entity in the performance of such obligation(s); and

(i) The Business Associate shall make its internal practices, books, and records available to the Secretary for purposes of determining compliance with the HIPAA Rules.

II. Permitted Uses and Disclosures by Business Associate

(a) The Business Associate may only use or disclose PHI as necessary to perform the services set forth in this

Agreement or as required by law. The Business Associate is not permitted to de-identify PHI under DoD HIPAA issuances or the corresponding 45 CFR 164.514(a)-(c), nor is it permitted to use or disclose de-identified PHI, except as provided by this Agreement or directed by the Covered Entity.

(b) The Business Associate agrees to use, disclose and request PHI only in accordance with the HIPAA Privacy Rule

“minimum necessary” standard and corresponding DHA policies and procedures as stated in the DoD HIPAA

Issuances.

(c) The Business Associate shall not use or disclose PHI in a manner that would violate the DoD HIPAA Issuances or HIPAA Privacy Rules if done by the Covered Entity, except uses and disclosures for the Business Associate’s own management and administration and legal responsibilities or for data aggregation services as set forth in the following three paragraphs.

(d) Except as otherwise limited in this Agreement, the Business Associate may use PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate. The foregoing authority to use PHI does not apply to disclosure of PHI, which is covered in the next paragraph.

(e) Except as otherwise limited in this Agreement, the Business Associate may disclose PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business

Associate, provided that disclosures are required by law, or the Business Associate obtains reasonable assurances from the person to whom the PHI is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purposes for which it was disclosed to the person, and the person notifies the Business

Associate of any instances of which it is aware in which the confidentiality of the information has been breached.

(f) Except as otherwise limited in this Agreement, the Business Associate may use PHI to provide Data Aggregation services relating to the Covered Entity’s health care operations.

III. Provisions for Covered Entity to Inform Business Associate of Privacy Practices and Restrictions

(a) The Covered Entity shall notify the Business Associate of any limitation(s) in the notice of privacy practices of the Covered Entity under 45 CFR 164.520 and the corresponding provision of the DoD HIPAA Issuances, to the extent that such limitation may affect Business Associate’s use or disclosure of PHI.

(b) The Covered Entity shall notify the Business Associate of any changes in, or revocation of, the permission by an

Individual to use or disclose his or her PHI, to the extent that such changes affect the Business Associate’s use or disclosure of PHI.

(c) The Covered Entity shall notify the Business Associate of any restriction on the use or disclosure of PHI that the

Covered Entity has agreed to or is required to abide by 45 CFR 164.522 and the corresponding DoD HIPAA

Issuances, to the extent that such changes may affect the Business Associate’s use or disclosure of PHI.

IV. Permissible Requests by Covered Entity

The Covered Entity shall not request the Business Associate to use or disclose PHI in any manner that would not be permissible under the HIPAA Privacy Rule or any applicable Government regulations (including without limitation, DoD HIPAA Issuances) if done by the Covered Entity, except for providing Data Aggregation services to the

Covered Entity and for management and administrative activities of the Business Associate as otherwise permitted by this BAA.

V. Breach Response

(A) In general.

(1) In the event of a breach of PII/PHI held by the Business Associate, the Business Associate shall report the breach to the Covered Entity in accordance with Section VII, assess the breach incident, take mitigation actions as applicable, and notify affected individuals, as directed by the Covered Entity.

(2) The Business Associate shall coordinate all investigation actions with the Covered Entity, and at a minimum, follow the breach response requirements set forth in this Part V, which is designed to satisfy both the Privacy Act and HIPAA as applicable. If a breach involves PII without PHI, then the Business Associate shall comply with DoD

Privacy Act Issuance breach response requirements only; if a breach involves PHI (a subset of PII), then the

Business Associate shall comply with both Privacy Act and HIPAA breach response requirements. A breach involving PHI may or may not constitute an HHS Breach. If a breach is not an HHS Breach, then the Business

Associate has no HIPAA breach response obligations. In such cases, the Business Associate must still comply with breach response requirements under the DoD Privacy Act Issuances.

(3) The Business Associate shall, at no cost to the government, bear any costs associated with a breach of PII/PHI that the Business Associate has caused or is otherwise responsible for addressing.

(b) Government Reporting Provisions

(1) If the Covered Entity determines that a breach is an HHS Breach, then the Business Associate shall comply with both the HIPAA Breach Rule and DoD Privacy Act Issuances, as directed by the Covered Entity, regardless of where the breach occurs. If the Covered Entity determines that the breach does not constitute an HHS Breach, then the Business Associate shall comply with DoD Privacy Act Issuances, as directed by the applicable Service-Level

Privacy Office.

(2) This Part V is designed to satisfy the DoD Privacy Act Issuances and the HIPAA Breach Rule as implemented by the DoD HIPAA Issuances. In general, for breach response, the Business Associate shall report the breach to the

Covered Entity, assess the breach incident, notify affected individuals, and take mitigation actions as…