FA3047-15-B-0001.pdf

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until 10:00 AM local time 18 Dec 2014

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X H 49 rachael.avery .2@us.af.mil

RATING PAGE OF PAGES

7. ISSUED BY

(Date)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

Previous Edition is Unusable 33-134 STANDARD FORM 33 (REV. 9-97)

Prescribed by GSA

FAR (48 CFR) 53.214(c)

1 49

(If other than Item 7)

15A. NAME 16. NAME AND TITLE OF PERSON AUTHORIZED TO

AND

ADDRESS

SIGN OFFER (Type or print)

OF

OFFEROR

AMENDMENT NO. DATE

15B. TELEPHONE NO (Include area code) 17. SIGNATURE15C. CHECK IF REMITTANCE ADDRESS

IS DIFFERENT FROM ABOVE - ENTER

SUCH ADDRESS IN SCHEDULE.

18. OFFER DATE

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 700)

2. CONTRACT NO.

FA3047 8. ADDRESS OFFER TO

See Item 7

9. Sealed offers in original and 0 copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if handcarried, in the depository located in

CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and

Flight JBKAC conditions contained in this solicitation.

10. FOR INFORMATION

CALL:

A. NAME (NO COLLECT CALLS)

RACHAEL E. AVERY 210-671-4882

11. TABLE OF CONTENTS

SOLICITATION/ CONTRACT FORM

SUPPLIES OR SERVICES AND PRICES/ COSTS

2 - 6

X I CONTRACT CLAUSES

DESCRIPTION/ SPECS./ WORK STATEMENT

PACKAGING AND MARKING

7 - 18 J LIST OF ATTACHMENTS

INSPECTION AND ACCEPTANCE

DELIVERIES OR PERFORMANCE

20 - 21 X K

REPRESENTATIONS, CERTIFICATIONS AND

OTHER STATEMENTS OF OFFERORS

CONTRACT ADMINISTRATION DATA 22 - 23 X

SPECIAL CONTRACT REQUIREMENTS

OFFER (Must be fully completed by offeror) 24 - 34 X M

L INSTRS., CONDS., AND NOTICES TO OFFERORS

EVALUATION FACTORS FOR AWARD

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

is inserted by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT

(See Section I, Clause No. 52.232-8)

14. ACKNOWLEDGMENT OF AMENDMENTS

(The offeror acknowledges receipt of amendments

AMENDMENT NO. DATE

to the SOLICITATION for offerors and related documents numbered and dated):

FACILITY

12. In compliance with the above, the undersigned agrees, if this offer is accepted within calendar days (60 calendar days unless a different period

SOLICITATION, OFFER AND AWARD

X

(X) SEC. DESCRIPTION (X) SEC. DESCRIPTION PAGE(S)

PART I - THE SCHEDULE

26. NAME OF CONTRACTING OFFICER (Type or print) 27. UNITED STATES OF AMERICA 28. AWARD DATE

EMAIL:TEL: (Signature of Contracting Officer)

CODE CODE

B. TELEPHONE (Include area code) C. E-MAIL ADDRESS

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEMS NUMBERED 20. AMOUNT 21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

10 U.S.C. 2304(c)( ) 41 U.S.C. 253(c)( ) (4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN ITEM

24. ADMINISTERED BY (If other than Item 7) CODE 25. PAYMENT WILL BE MADE BY CODE

PART IV - REPRESENTATIO NS AND INSTRUCTIO NS

PART III - LIST O F DO CUMENTS, EXHIBITS AND O THER ATTACHMENTS

35 - 39

PART II - CO NTRACT CLAUSES

502D CONTRACTING SQUADRON

1655 SELFRIDGE AVE

JBSA LACKLAND TX 78236-5253

210-671-1700

210-671-3360FAX:

TEL:

FAX:

TEL:

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

SOLICITATION

6. REQUISITION/PURCHASE NO.

F2MTW44275A001

5. DATE ISSUED

18 Nov 2014

4. TYPE OF SOLICITATION

SEALED BID (IFB)

NEGOTIATED (RFP)

[ X ]

3. SOLICITATION NO.

FA3047-15-B-0001

Section B - Supplies or Services and Prices

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 8 Months Womens' Health Nurse Providers

FFP

IAW the Performance Work Statement

FOB: Destination

PURCHASE REQUEST NUMBER: F2MTW44275A001

SIGNAL CODE: A

NET AMT

0002 1 Lot Travel CLIN

COST

Line Item is cost reimbursable for Travel Expenses IAW Performance Work

Statement Paragraph 3.12 not to exceed $4,000.00.

FOB: Destination

ESTIMATED COST

1001 12 Months OPTION Womens' Health Nurse Providers

FFP

IAW the Performance Work Statement

FOB: Destination

1002 1 Lot OPTION Travel CLIN

COST

Line Item is cost reimbursable for Travel Expenses IAW Performance Work

Statement Paragraph 3.12 not to exceed $4,000.00.

FOB: Destination

2001 12 Months OPTION Womens' Health Nurse Providers

FFP

IAW the Performance Work Statement

FOB: Destination

2002 1 Lot OPTION Travel CLIN

COST

Line Item is cost reimbursable for Travel Expenses IAW Performance Work

Statement Paragraph 3.12 not to exceed $4,000.00.

FOB: Destination

3001 12 Months OPTION Womens' Health Nurse Providers

FFP

IAW the Performance Work Statement

FOB: Destination

3002 1 Lot OPTION Travel CLIN

COST

Line Item is cost reimbursable for Travel Expenses IAW Performance Work

Statement Paragraph 3.12 not to exceed $4,000.00.

FOB: Destination

4001 12 Months OPTION Womens' Health Nurse Providers

FFP

IAW the Performance Work Statement

FOB: Destination

4002 1 Lot OPTION Travel CLIN

COST

Line Item is cost reimbursable for Travel Expenses IAW Performance Work

Statement Paragraph 3.12 not to exceed $4,000.00.

FOB: Destination

Section C - Descriptions and Specifications

PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT

FOR

Women's Health Nurse Provider

July 18, 2014

1. DESCRIPTION OF SERVICES/GENERAL INFORMATION.

1.1. The Contract Personnel (CP) shall provide personal services as a Women's Health Nurse Provider at San

Antonio, Texas Department of Defense Military Treatment Facilities (MTF) to be filled by Women’s Health Nurse

Practitioners and/or Certified Nurse Midwives. Services shall be performed in the OB/GYN Clinic of Wilford Hall

Ambulatory Surgical Center (WHASC). The CP will not be required to travel to other locations. However, transfer to another San Antonio MTF may be required in the unlikely event that the OB/GYN Clinic of WHASC is permanently closed. The CP shall perform services and support compatible with the medical facility’s operating capacity and equipment.

1.2. All services shall be provided in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations, The Joint Commission standards, Accreditation Association for

Ambulatory Health Care, applicable Department of Defense (DoD), military specific regulations, directives, and policies, and MTF specific policies and procedures. CP shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for Patients.

1.3. Relationship of the Parties and Professional Liability.

1.3.1. This is a personal services contract (as defined by Federal Acquisition Regulation [FAR] Subpart

37.104) and is intended to create an employer-employee relationship between the Government and the CP only to the extent necessary for providing the health care services required under the contract. The performance of the CP under this contract is subject to day-to-day supervision, clinical oversight and control by healthcare facility personnel.

1.3.2. Any personal injury claims alleging negligence by the CP within the scope of the CP’s performance of the personal services contract shall be processed by DoD in the same manner as claims alleging negligence by DoD military or civil service personnel. The authority for this contract is 10 United States Code 1089 and 10 United

States Code 1091.

1.3.3. If any suit or action is filed or any claim is made against the CP, which occurred as a result of work performed by the CP under this contract, the CP shall immediately notify the Contracting Officer (CO) and furnish copies of all pertinent correspondence received.

1.3.4. The CP shall also cooperate with the Government, without further compensation, in the processing, review, settlement, or defense of the suit, action, or claim; and authorize Government representatives to settle or defend the claim and to represent the CP in, or take charge of, any litigation involved in such an action. The CP may, at the

CP’s own expense; participate in defense of such claim or litigation.

1.4. Specific Duties. The CP duties shall include, but are not limited to:

1.4.1 Treat/evaluate all scheduled patients not to exceed 1,280 patients per month (average 320 patients per week /

64 patients per day). It is the contractor’s responsibility to ensure all appointments are rescheduled or transferred to another CP during scheduled and unscheduled absences. The contractor shall include in their planning a 7 – 30 calendar day credentialing and security clearance process. Missed patients due to this process exceeding 30 days for a complete package shall constitute a Government Delay. Missed appointments due to incomplete credentialing and security packages that have been returned to the contractor shall constitute a contractor delay. Treat patients with common acute and chronic conditions, illnesses, or minor trauma within accepted protocols, national and clinical guidelines, Nurse Practice Acts, and/or in collaboration with a physician, as well as, request consultation or referral as appropriate. The contractor is required to satisfy the requirement with Women’s Health Nurse Practitioners and/or

Certified Nurse Midwives. For example, the contractor shall provide all Women’s Health Nurse Practitioners, all

Certified Nurse Midwives, or any combination of the two.

1.4.2. Participates in the orientation, training, and evaluation of duty performance of assigned personnel to include

Graduate Medical Education (GME) program and other health care programs.

1.4.3. The CP shall provide a full range of Gynecological and Obstetrical services in accordance with privileges granted by the Commanding Officer (e.g. provide general screening and medical care and examinations of patients for routine, acute and chronic conditions involving any and all organ systems; order immunizations; diagnose, treat, and counsel patients as indicated). This does not include the scheduled delivery of infants as all deliveries are scheduled at other MTF locations.

1.4.4. The CP must complete all patient care documentation within 3 business days of the patient encounter.

1.4.5 The Contractor shall have on staff a CP capable of providing Fetal Ultrasound Procedures. The contractor may either hire a CP with this certification or utilize the Travel CLIN to obtain this certification. Please see Paragraph

3.12.

1.5. Special Qualifications.

1.5.1. The CP shall meet the following education requirements for either the Women’s Health Nurse Practitioner or the Certified Nurse Midwife:

1.5.1.1. Continuing Medical Education (CME) and/or Continuing Nursing Education (CNE). The CP shall provide appropriate CME documentation and/or Continuing Nursing Education (CNE) to the Functional Requirements

Evaluator Designee (FRED) on an annual basis.

1.5.1.2. Shall have completed at least twenty (20) hours in continuing medical/nursing education in the past twelve

(12) months.

1.5.2. License and Certification Verification. Air Force Instructional (AFI) 44-119, Medical Quality Operation

(Chapter 4 Paragraph 4.6)

1.5.2.1. The CP shall have and maintain a current Basic Life Support (BLS) certification.

1.5.2.2. The CP must be eligible to be granted “fee exempt” Drug Enforcement Administration (DEA) registration number (certificate).

1.5.2.3. The CP shall perform through the MTF all primary and annual licensure or certification document verifications. The CP shall maintain these certifications in a current status throughout the life of this contract.

1.5.2.4. The CP shall confirm that the clinical licenses or certifications have not been suspended or revoked by any healthcare facility, public or private, anywhere in the world. This does not preclude any CP whose licensure or certification, although originally suspended or revoked by a healthcare facility, were subsequently fully reinstated by the same.

1.5.2.5. Healthcare professionals who fail to maintain a license, registration or certification will be removed from patient care until the license, registration or certification is renewed. Issuing agency grace periods are not honored by the Air Force Medical Service (AFMS) when renewing a license, certification, or registration.

1.5.3. Education Requirements:

1.5.3.1. Graduation from an accredited baccalaureate degree program in nursing (BSN) acceptable to the USAF

Surgeon General.

1.5.3.2. Hold a minimum of a Master’s degree fulfilling requirements for either Women’s Health Nurse Practitioner or Certified Nurse Midwife.

1.5.3.2.1. Women’s Health Nurse Practitioner: from an approved OB/GYN or women’s health nurse practitioner program or Advance Certification (Certificate of Authority) acceptable to the USAF Surgeon General as found at http://www.afms.af.mil/shared/media/document/AFD-130320-063.pdf.

1.5.3.2.2. Certified Nurse Midwife; from an approved nurse midwifery program acceptable to the USAF Surgeon

General as found at http://www.afms.af.mil/shared/media/document/AFD-130320-056.pdf.

1.5.4. Licensure.

1.5.4.1. The CP must have a current, unrestricted Nurse Practitioner's license and a current, unrestricted Nursing license.

1.5.5. Certification.

1.5.5.1. The Women’s Health Nurse Practitioner must hold a current women’s health nurse practitioner certification by the National Certification Corporation for Obstetrics, Gynecologic, and Neonatal Nursing Specialties.

1.5.5.2. The Certified Nurse Midwife must hold a current certification by the American Midwifery Certification

Board.

1.5.5.3. CP shall have a minimum of 18 months Obstetrical and Gynecological Advance Practice Nurse clinical experience within the past 36 months.

1.6. Privileging Requirements. The credentials of the CP shall meet the privileging requirements as outlined in the most current version of AFI 44-119, Medical Quality Operations (entire instruction applies).

1.6.1. The CP shall furnish the MTF Credentialing Office with copies of valid, current, active, unrestricted nursing licenses, registrations, education training certificates, and/or certifications in accordance with AFI 44-119, Medical

Quality Operations (entire instruction applies). In addition, copies of board certifications are required, if applicable.

The CP shall continuously maintain at least one active licensure or authorizing document from any U.S. jurisdiction throughout the life of this Contract. The CP shall be responsible for primary source verifications of all licenses and documents.

1.6.2. Applications for privileges shall be screened through the National Practitioners Data Bank (NPDB), Healthcare Integrity and Protection Data Bank (HIPDB) by the CP.

1.6.3. The CP shall also screen through The Department of Health and Human Services (DHHS) at http://exclusions.oig.hhs.gov/ and TRICARE sanction listing at www.tricare.osd.mil/. The listings must be reviewed prior to entering into Contract or hiring CP for the position.

1.6.4. Professional staff appointments and clinical privileges are specific to the facility and the provider. An Initial

Medical Staff appointment will be granted to all newly accessed CP for a period of twelve (12) months. During this period, the CP performance will be under close review by their assigned clinical supervisor for clinical competence as well as for compliance with the facility’s policies, procedures, bylaws, and code of professional conduct.

Thereafter, the CP privileges will be reviewed/ evaluated for an Active Medical Staff appointment, which is granted for a period of two (2) years.

http://www.afms.af.mil/shared/media/document/AFD-130320-063.pdf http://www.afms.af.mil/shared/media/document/AFD-130320-056.pdf http://exclusions.oig.hhs.gov/ http://www.tricare.osd.mil/

1.7. General Information.

1.7.1. MTF Orientation. The CP shall attend the MTF Orientation at the outset of their working at MTF. The MTF

Orientation will familiarize the CP with the policies and procedures of the MTF and will be scheduled by the

Contracting Officer’s Representative (COR) within two months of employment. Orientation attendance shall be required of the CP during Government paid duty hours.

1.7.2. In-Process. The CP performing service under this Contract shall be required to in-process through the 59

MDW Medical Logistics Contract Personnel Office upon reporting. At this time, the CP shall initiate the process to receive Common Access Card (CAC), Base Identification Passes, Restricted Area Badges, and keys.

1.7.3. Out-Process. Upon termination or expiration of the Contract, the CP shall be required to out-process through the same office. Upon completion of performance, termination of the Contract, or termination of performance, the

CP shall out-process and turn in Common Access Card (CAC), Base Identification Passes, Restricted Area Badges, and keys.

1.7.4. Conduct Requirements.

1.7.4.1. The Government reserves the right to restrict the performance on this contract by any individual who is identified as a potential threat to the health, safety, security, general well-being, or operational mission of the MTF and its population.

1.7.4.2. The CP shall not advise, recommend, or suggest to persons eligible to receive medical care at Government expense that such person should receive care at an outside agency or provider at any place other than as designated under this contract.

1.7.4.3. The CP shall not use Government facilities or other Government property for personal or other business not related to this contract.

1.7.4.4. The CP shall not respond to any media inquiries nor provide interviews, comments, or any other responses to the media with respect to this contract. All inquiries or complaints from the media or other sources shall be immediately relayed to the COR.

1.7.5 Health Requirements and Immunizations.

1.7.5.1. Prior to contract performance, the Contractor shall provide proof of immunization or immunity from or screening for the following diseases according to Air Force guidelines equivalent to that provided to active work

Armed Forces: Hepatitis B, MMR (Measles, Mumps, and Rubella), Varicella, Tdap (Tetanus, Diphtheria, and

Pertussis), Tuberculosis (TB), HIV (Contractor who has direct patient care) and influenza for all personnel.

Contractor shall control and prevent disease in accordance with AFI 48-105, Surveillance Prevention and Control of

Diseases and Conditions of Public Health or Military Significance (Paragraph 1.10.10.) and 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, Air Force Policy (as applicable) and its supplements. For the TB screening, the Contractor shall provide proof of negative TB 2-step skin testing IAW CDC recommendations outlined in Appendix B of this document. If an individual has a past positive TB skin test, the

Contractor shall provide proof of a negative chest X-ray within twelve (12) months prior to personnel performing.

The Government reserves the right to require more frequent TB testing of personnel based on the facility annual TB risk assessment. Additional vaccines as they are made mandatory for health care workers may also be required in unusual circumstances. In summary, contractors should have and maintain, at their own expense, all requirements.

See Appendix B.

1.7.5.2. Medical Tests. The CP shall not obtain medical tests or procedures at the MTF, unless identified in Section three (3). The CP shall be responsible for the cost of any emergency medical services received.

1.7.5.3. Influenza Immunization. CP shall receive the current influenza immunization, at CP’s expense, unless contraindicated by allergy; as an example, to eggs as evidenced by hives, difficulty breathing, itching, and other symptoms of anaphylactic hypersensitivity, this exemption requires a Physicians diagnosis. Proof of vaccination will be required.

1.7.6. Hazardous Materials. This PWS does not call for any hazardous material to be provided by the CP.

1.7.7. Reports. The CP shall submit reports to the COR and/or credentials office (as applicable) for use in monitoring performance. Such reports may include, but are not limited to:

Initial – Effective date of award

Quarterly – 1 st Qtr (October 1), 2 nd Qtr (January 1), 3 rd Qtr (April 1), and 4 th Qtr (July 1)

Annual – Anniversary date of award

Report Timeline

Health and Immunization requirements Initially

Personnel Changes Quarterly

Basic Life Support (BLS) As accepted by American

Heart Association (AHA)

(Heart Savers, Admin) (Providers course) or

American Red Cross Initially and upon expiration date *

Security requirements Initially

Invoices submitted in WAWF Monthly

*Note: In accordance with Military Training Bulletin NO. 07-003 (7 Feb 07), this training will not be provided by the Government.

1.7.8. Quality Assurance. The Government will periodically evaluate the CP’s performance by appointing a

Functional Requirements Evaluator Designee (FRED) to monitor performance to ensure services are received. The

FRED will evaluate the CP’s performance in accordance with the Quality Assurance Surveillance Plan (QASP) for this requirement.

1.7.9. Hours of Operation. Clinic operating hours are from 0630 to 1730. Patient care hours are from 0730 to 1630.

CP performing under this contract shall abide by the provisions of MDWI 41-101, Medical Expense and

Performance Reporting Systems (MEPRS) (Paragraph 2.1.3). The contractor shall provide documentation through

Wide Area Work Flow (WAWF) under inspector extension code: F9MMNP.

1.7.9.1. The CP shall ensure that scheduled and unscheduled absences do not interrupt service performance.

1.7.10. Holidays Observed. The following federal holidays will be observed:

Holiday Projected Date

New Year's Day January 1

Martin Luther King Jr.'s Birthday 3 rd

Monday in January

President’s Day 3 rd

Monday in February

Memorial Day Last Monday in May

Independence Day July 4

Labor Day 1 st Monday in September

Columbus Day 2 nd

Monday in October

Veterans' Day November 11

Thanksgiving Day 4th Thursday in November

Christmas Day December 25

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.

1.7.10.1. Family/Down Days. Typically, a "Family Day/Down Day” is associated with, but not limited to, the following holidays: New Year’s Day, July 4th, Thanksgiving, and Christmas. The clinic may or may not be open on these days. The Contractor shall not work on a Family Day/Down Day unless the clinic is open.

1.7.11. Security Requirements.

1.7.11.1. General Security Requirements. The CP shall follow all guidelines found in the Security Requirements for

Solicitations and Contracts clause.

1.7.11.2. Security Training. The CP shall be trained in accordance with AFI 31-501, Personnel Security Program

Management, AFI 31-401A FGM2, Information Security Program Management, AFI 33-200, Information

Assurance Management, AFI 31-101, Integrated Defense (FOUO), AFI 33-203V1, Emission Security (EMSEC), and AFI 33-200, Information Assurance Management.

1.7.11.3. Internal Operating Instructions (OI). The CP shall abide by the MTF’s current OIs for internal circulation control, the protection of resources, and the regulated entry into Air Force controlled areas during normal, simulated, and actual emergency operations.

1.7.11.4. Reporting Requirements. The CP shall comply with AFI 71-101, Volume 1, Special Investigations

Criminal Investigations (Chapter 2, paragraph 2.7) and Volume-2, Special Investigations Protective Service Matters, (Paragraph 1.2). The CP shall report to Security Forces any information or circumstances which may pose a threat to

DoD or CP, resources, or DoD information.

1.7.11.5. Removal of CP. The Government, through the CO, may require immediate removal from contract performance on the installation or any Government facility, any individual whose actions raise reasonable suspicion that patient care or services may be compromised in any way, or that pose a threat of harm to other

Contractors/Government personnel or self. Removal under other circumstances will be subsequent to, and at the direction of the CO only.

1.7.11.6. If a situation meriting removal occurs as outlined in the previous paragraph, the COR will contact the CO and the CP. A meeting may be required with the CO, and CP to discuss further action.

1.7.11.7. The CO will notify the CP if and when permanent removal is required. In the event of a disagreement between the Government and the CP, the decision of the CO will be final.

1.7.11.8. The CP may be required to submit to drug/alcohol testing. The Government reserves the right to require temporary or permanent removal from contract performance any individual who refuses or fails testing.

1.7.11.9. The CP shall conduct themselves in a professional manner while on the installation and refrain from disruptive, offensive, or otherwise improper behavior that undermines order and discipline. Dress code shall be professional attire or clean scrub attire. The wearing of open toed shoes shall not be allowed. The CO may direct the

CP to remove from performance of this contract on this installation engaging in such misconduct.

1.7.12. Performance of Services During Crisis Declared by the National Command Authority or Overseas Combatant

Commander. The services provided under the terms of this PWS have been determined not to be essential as outlined in the provisions of DoDI 3020.37, Continuation of Essential DoD Contractor Services During Crises.

1.7.13. Records Management. The CP 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 AF records management procedures in AFI 33-322, Records Management Program, Paragraph 10, Air Force Manual (AFMAN)

37-123, Paragraph 7.4, Air Force Manual (AFMAN) 37-138, Paragraph 2.13, and the Air Force Records Disposition

Schedule (AF RDS) located at https://afrims.amc.af.mil/rds_series.cfm or http://www.amc.af.mil/shared/media/document/AFD-060803-003.pdf

1.7.14. Air Force Antiterrorism (AT) Program. The AT program seeks to deter or limit the effects of terrorist acts against the AF by giving guidance on collecting and disseminating timely threat information, providing training to all

AF members, developing comprehensive plans to deter and counter terrorist incidents, allocating funds and personnel and implementing AT measures. In accordance with AFI 10-245, Antiterrorism (AT), Paragraphs 2.18 and

Paragraph 2.25, DoD Contractors and sub-contracts personnel shall be offered Level 1 – AT Awareness Training.

Compliance with the training will be monitored by the CORs.

1.7.15. Contractor Full-Time Equivalent Reporting. The CP shall report ALL CP labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Women's Health

Nurse Practitioner (WHMP) or Certified Nurse Midwife (CNM) via a secure data collection site. The CP is required to completely fill in all required data fields at https://afcmra.hqda.pentagon.mil/login.aspx.

1.7.15.1. 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. CP may direct questions to the CMRA help desk.

1.7.15.2. Reporting Period:

CP is required to input data by 31 October of each year.

Uses and Safeguarding of Information: Information from the secure web site is considered to be proprietary in nature when the contract number and CP 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 CP name and contract number associated with the data.

1.7.15.3. User Manuals: Data for Air Force service requirements must be input at the Air Force CMRA link.

However, user manuals for government personnel and CP are available at the Army CMRA link at http://www.ecmra.mil.

2. SERVICE DELIVERY SUMMARY.

P.

0.

Performance Objective (PO)

WOMEN’S HEALTH NURSE PROVIDER

PWS

Paragraph Performance Threshold

1.

Evaluate/treat all scheduled patients not to exceed 1,280 patients per month 1.4.1.

No more than 5% of appointments rescheduled or transferred to

Government Providers per month

2.

Treat patients with common acute and chronic conditions, illnesses, or minor trauma within accepted protocols, national, and clinical guidelines, Nurse Practice Acts, and/or in collaboration with a physician, as well as, request consultation or referral as appropriate.

1.4.1.

No more than one (1) discrepancy per month

3.

Participates in the orientation, training, and evaluation of duty performance of assigned personnel to include Graduate Medical Education

(GME) program and other health care programs.

1.4.2.

No more than one (1) discrepancy per month https://afrims.amc.af.mil/rds_series.cfm http://www.amc.af.mil/shared/media/document/AFD-060803-003.pdf https://afcmra.hqda.pentagon.mil/login.aspx http://www.ecmra.mil/

4.

The CP must complete all patient care documentation within 3 business days of the patient encounter.

1.4.4.

No more than one (1) discrepancy per month

5.

Healthcare professionals who fail to maintain a license, registration or certification will be removed from patient care until the license, registration or certification is renewed.

1.5.2.5.

Zero (0) discrepancies per month

3. GOVERNMENT FURNISHED PROPERTY AND SERVICES.

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

3.2. The Government will schedule and furnish initial and annual training which may include but shall not be limited to various applicable software, data base systems, quality assurance policies, radiation safety, local in-service, safety briefings, compliance, patient safety, performance improvement, risk management, infection control, fire protection, security, and patient sensitivity training. The classes may be scheduled during the MTF’s normal operating hours as required throughout the life of the contract.

3.3. Any space used by CP in performance of this contract may be used for other purposes during their absence.

Items of clothing, personal effects, or equipment may not be able to be secured at the MTF. The Government will not incur any liability for theft, damage to, or loss of such personal items.

3.4. The Government will provide local telephone service, Class-A telephone lines and Defense Switching Network lines limited to matters related to the performance of this contract. Personal long distance calls are not authorized.

3.5. The MTF will provide emergency healthcare for injuries occurring while on duty. The CP shall reimburse the

Government for such services. This includes blood borne exposure protocols after start of work. The Government will provide initial testing at no cost, but the CP shall provide follow-up testing or reimburse the Government for such services performed within the MTF. The CP shall provide the MTF with documentation for follow-ups performed outside the MTF as required by MTF policy. The Government will provide post-exposure tuberculosis testing at no charge to the CP when required (ex. following exposure to active TB case with in MTF) to avoid testing delays.

3.6. The Government will provide MTF ID badges which will be worn/displayed at all times while on duty.

3.7. The Government will furnish the CP with appropriate common use Personal Protective Equipment (PPE). The

Government will be responsible for any repair, cleaning, and inventory required for the PPE. Items shall be used and returned as directed by the MTF.

3.8. The government will provide MTF/WHMC identification badges which will be worn/displayed at all times when in the MTF while on duty.

3.9. In-house pager. The CP shall use the communication device (pager) or other electronic device issued by MTF.

The contractor shall be charged for negligent loss/damage of any such device by the CP.

3.10. The MTF shall furnish surgical scrubs and a physician’s coat if required by the position. These items will be cleaned at the MTF’s expense.

3.11. The MTF shall provide self-inking stamps in accordance with MTF policy, as required by the position.

3.12. Travel: Travel shall be IAW FAR 31.205-46.

3.12.1 CONTRACT PERSONNEL may be required to travel to locations or installations other than San Antonio, TX DoD MTF. The Government will schedule TDY requirements as far in advance as possible to allow the

Contractor to obtain the best travel rates. Whenever possible, TDY will be planned at least thirty (30) days in advance of the travel.

3.12.2. There is no required training that all CP must attend. However, the contractor may use the Travel CLIN to certify a CP in Fetal Ultrasound Procedures, if no other CP are certified.

3.12.3. The Government will reimburse authorized travel in accordance with the terms and conditions of this

Contract. The Joint Travel Regulation is not applicable to Contractor travel. However, the not-to-exceed travel costs identified by the JTR will be used as a cost ceiling that the Government will not exceed.

3.12.4. The Contractor will invoice the Government for the travel costs along with documentation to verify the expenses. This documentation will be similar to DoD requirements for reimbursing mileage or TDY.

4. APPENDICES.

APPENDIX A. Referenced Air Force Instructions, DoD Regulations, & Medical Wing Instructions

APPENDIX B. Contract Specific Requirements Prior to Performance

APPENDIX C. Historical Data from FY 2013 and 2014

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.dtic.mil or www.tricare.mil

AFI 10-245, Antiterrorism, (Paragraphs 2.18 and Paragraph 2.25.)

AFI 31-101, Integrated Defense (FOUO) (Entire instruction applies)

AFI 31-401AFGM2, Information Security Program Management (Entire instruction applies)

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

AFI 33-200, Information Assurance Management, (Entire instruction applies)

AFI 33-203V1, Emission Security (EMSEC) (Entire instruction applies)

AFI 33-322, Records Management Program. (Paragraphs 1, 2 & 10)

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. I, Criminal Investigations. (Chapter 2, Paragraph 2.7.) (IAW 802 CONS & 802 SFS MOA)

AFI 71-101, Vol. 2, Protective Service Matters. (Paragraph 1.2) (IAW 802 CONS & 802 SFS MOA)

AFMAN 37-123, Management of Records, (Paragraph 7.4)

AFMAN 37-138, Records Disposition—Procedures and Responsibilities, (Paragraph 2.13)

DoDI 3020.37, Continuation of Essential DoD Contractor Services During Crises (Entire instruction applies)

Air Force Records Disposition Schedule. On the portal https://www.my.af.mil/gcss-af61a/afrims/afrims

MDWI 41-101, Medical Expense & Performance Reporting System (MEPRS) for Fixed Military Medical & Dental

Treatment Facilities. (Paragraph 1.12) http://www.dtic.mil/ http://www.tricare.mil/ https://www.my.af.mil/gcss-af61a/afrims/afrims

APPENDIX B

CONTRACT SPECIFIC REQUIREMENTS

PRIOR TO PERFORMANCE

WILFORD HALL AMBULATORY SURGICAL CENTER/59

TH

MDW

FAXED TO:__________________________FAX:__________________DATE:_____________

Contract Position: __________________________________________

Name:____________________________________________________

The following items are Contract Specific requirements provided by the CP prior to performance:

_______Pre-employment medical exam (no earlier than 45 days before start date)

_______Immunization Record

_______Varicella (Serologic evidence of immunity or documentation of 2-shot series)

_______Tdap (Documentation of tetanus/diphtheria vaccination within two (2) years or current Tdap vaccine.)

_______TB- 2 Step Testing or Neg. Chest X-Ray for Past Positive Tests (see screening criteria below)

Screening Criteria Required Testing

No Previous Documented TST result Two-step baseline TST

Previous documented Neg TST >12 months before new employment Two-step baseline TST

Previous documented Neg TST < 12 months before new employment Single TST

> 2 previous documented Neg TST but most recent TST >12 months Single TST

Previous documented Positive TST Chest X-Ray (negative)

_______MMR (Serologic evidence of immunity or documentation of 2-shot series)

_______Hepatitis B (Serologic evidence of immunity or documentation of 3-shot series)

_______HIV (direct contact with patients or body fluids) (Frequency shall be based on exposure risk per hospital employee program)

_______Influenza (current series)

_______Drug Testing

_______Security Background Check ____SF 86 (If applicable) ____ State ____NAC ____LFC

Affidavit signed and dated by the CP. Copy of signed AF FM 2583 or Sentinel Key verification printout from a

Security Manager.

_______Copy of license

_______Copy of certifications

_______Credentials package

All personnel performing service under this contract shall be required to in-process through the 59 th

MDW Medical

Logistics Contract Personnel Office upon reporting for duty.

APPENDIX C

HISTORICAL DATA

FY13

Month October November December January February March

Number of

Providers 4 4 4 4 4 4

Patients Seen 774 811 737 913 862 866

Month April May June July August September

Number of

Providers 4 4 4 4 4 4

Patients Seen 928 990 963 953 911 702

FY14

Month October November December January February March

Number of

Providers 4 3 2 2.5* 3.5* 3

Patients Seen 802 749 830 843 764 1003

Month April May June July August September

Number of

Providers 3.5* 2.5 2.5 3 3.5 3.5

Patients Seen 1075 656 592 644 860 802

*see explanation below.

Timeline

October 2013 – All positions filled

November 2013 – One vacant position

December 2013 – Two vacant positions

January 2013 – One vacant position, One filled 13 Jan

February 2014 – Last open position filled 25 Feb

March 2014 – One provider on emergency leave

April 2014 – Provider returns as part time, sees patients twice a week

May 2014 - One vacancy, one part time

June 2014 - One vacancy, one part time

July 2014 - One part time, vacancy filled late in month.

Aug 2014 - One part time

Sep 2014 - One part time

The current contract was for 4 Full Time Equivalents (FTE). When there was contractor personnel turnover, the contractor had to advertise, interview, and submit a new candidate for credentialing and security clearance. The credentialing and security clearance process takes between 7 and 30 days. The clinic was not able to operate at maximum capacity and the historical appointments above are based on the number of providers available. In a monthly contract, the performance objective will be the number of patients seen, the actual need of the clinic. The contractor is able to staff however many FTEs they deem necessary without running out of hours on the contract.

The contractor is responsible for staffing to meet the scheduled patient load, not to exceed 1,280 patients per month, even in the event of unexpected turnover. The monthly CLIN gives the contractor the flexibility to decide how best to do this, in any way that meets the requirement.

Section E - Inspection and Acceptance

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government

0002 Destination Government Destination Government

1001 Destination Government Destination Government

1002 Destination Government Destination Government

2001 Destination Government Destination Government

2002 Destination Government Destination Government

3001 Destination Government Destination Government

3002 Destination Government Destination Government

4001 Destination Government Destination Government

4002 Destination Government Destination Government

Section F - Deliveries or Performance

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC

0001 POP 01-FEB-2015 TO

30-SEP-2015

N/A 59 MDWL/MSLE F2MTW4

JOSEPH LYNCH

2200 BERQUIST DR

LACKLAND AFB TX 78236

210-292-8363

FOB: Destination

F2MTW4

0002 POP 01-FEB-2015 TO

30-SEP-2015

N/A (SAME AS PREVIOUS LOCATION)

1001 POP 01-OCT-2015 TO

30-SEP-2016

N/A (SAME AS PREVIOUS LOCATION)

1002 POP 01-OCT-2015 TO

30-SEP-2016

N/A (SAME AS PREVIOUS LOCATION)

2001 POP 01-OCT-2016 TO

30-SEP-2017

N/A (SAME AS PREVIOUS LOCATION)

2002 POP 01-OCT-2016 TO

30-SEP-2017

N/A (SAME AS PREVIOUS LOCATION)

3001 POP 01-OCT-2017 TO

30-SEP-2018

N/A (SAME AS PREVIOUS LOCATION)

3002 POP 01-OCT-2017 TO

30-SEP-2018

N/A (SAME AS PREVIOUS LOCATION)

4001 POP 01-OCT-2018 TO

30-SEP-2019

N/A (SAME AS PREVIOUS LOCATION)

4002 POP 01-OCT-2018 TO

30-SEP-2019

N/A (SAME AS PREVIOUS LOCATION)

CLAUSES INCORPORATED BY REFERENCE

52.242-15 Stop-Work Order AUG 1989

Section G - Contract Administration Data

CLAUSES INCORPORATED BY FULL TEXT

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (MAY 2013)

(a) Definitions. As used in this clause--

Department of Defense Activity Address Code (DoDAAC) is a six position code that uniquely identifies a unit, activity, or organization.

Document type means the type of payment request or receiving report available for creation in Wide Area WorkFlow

(WAWF).

Local processing office (LPO) is the office responsible for payment certification when payment certification is done external to the entitlement system.

(b) Electronic invoicing. The WAWF system is the method to electronically process vendor payment requests and receiving reports, as authorized by DFARS 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(c) WAWF access. To access WAWF, the Contractor shall--

(1) Have a designated electronic business point of contact in the System for Award Management at https://www.acquisition.gov; and

(2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this Web site.

(d) WAWF training. The Contractor should follow the training instructions of the WAWF Web-Based Training

Course and use the Practice Training Site before submitting payment requests through

WAWF. Both can be accessed by selecting the “Web Based Training” link on the WAWF home page at https://wawf.eb.mil/.

(e) WAWF methods of document submission. Document submissions may be via Web entry, Electronic Data

Interchange, or File Transfer Protocol.

(f) WAWF payment instructions. The Contractor must use the following information when submitting payment requests and receiving reports in WAWF for this contract/order:

(1) Document type. The Contractor shall use the following document type(s).

Combo Only

(2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) in

WAWF, as specified by the contracting officer.

Destination

(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system.

Routing Data Table*

Field Name in WAWF Data to be entered in WAWF

Pay Official DoDAAC F67100

Issue By DoDAAC FA3047

Admin DoDAAC FA3047

Inspect By DoDAAC F9MMNP

Service Approver (DoDAAC) F9MMNP

Service Acceptor (DoDAAC) F9MMNP

(4) Payment request and supporting documentation. The Contractor shall ensure a payment request includes appropriate contract line item and subline item descriptions of the work performed or supplies delivered, unit price/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F, (e.g. timesheets) in support of each payment request.

(5) WAWF email notifications. The Contractor shall enter the email address identified below in the “Send Additional

Email Notifications” field of WAWF once a document is submitted in the system.

(g) WAWF point of contact. (1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity's WAWF point of contact.

armand.hale.2.ctr@us.af.mil

(2) For technical WAWF help, contact the WAWF helpdesk at 866-618-5988.

(End of clause)

Section H - Special Contract Requirements

JBSA CLAUSES (LACKLAND 0009) (NOV 13)

Smoking in AF Facilities

Contractors are advised that the AF has placed restrictions on the smoking of tobacco products in AF facilities. AFI

40-102, Tobacco Use in the Air Force, outlines the procedures used by the commander to control smoking in our facilities. Contractor employees and visitors are subject to the same restrictions as government personnel. Smoking is permitted only in designated smoking areas.

Joint Base San Antonio (JBSA) Traffic Code

All applicable Traffic Codes will be enforced and apply to all personnel operating vehicles on a JBSA installation.

The governing instruction for all Traffic Codes is AFI 31-218(I) and AFMAN 31-116. For a complete listing of all

JBSA Traffic Codes and all other applicable traffic policies and procedures, please contact the Contracting Office.

Cell Phone Usage Contractors are advised that DoD Instruction (DoDI) 6055.04 prohibits cellular telephone usage when approaching, entering or exiting any installation gate. Cell phone usage by drivers on installations is prohibited in moving vehicles unless used with a hands-free device. The installation Security Forces Squadron (SFS) is strictly enforcing this regulation. Those found in violation of this regulation are subject to be ticketed.

Base Fire Prevention Program The contractor will be required to comply with the applicable Fire Prevention Program, for JBSA Lackland the applicable directive is AFI 91-203. Contact the Contracting Office for a copy of AFI 91-203.

SECURITY REQUIREMENTS FOR UNCLASSIFIED SOLICITATIONS AND CONTRACTS (LACKLAND

0010) (FEB 11)

1. Base Entry and Vehicle Control Requirements. Contractor shall comply with AFFARS Clause 5352.242-

9000, “Contractor access to Air Force installations” which is hereby incorporated by reference if not otherwise included. Contractor personnel shall comply with all on-base traffic laws. Background investigations will be conducted by the government at no additional cost to the contractor on all contractor personnel prior to issuance of any base pass.

2. Government Computer Access Requirements. If this contract requires contractor personnel to have access to government computers, contractor personnel requiring access to government computers shall successfully complete, a National Agency Check with Inquiries (NACI) request, before obtaining access to the computer. These investigations shall be submitted by the government at no additional cost to the contractor. All contractor employees affected by this requirement must have completed an acceptable submission that complies with all directions for completion of the investigation request through the government security office within 30 calendar days of Contract

Award or Notice of Award. To begin this process, all affected contractor employees must complete within 15 calendar days after Contract Award or Notice of Award Standard Form 85P worksheet that can be downloaded from http://www.opm.gov/forms/pdf_fill/SF85P.pdf . The contractor shall notify the Contracting Officer Representative

(COR) or Government Inspector when the worksheet is complete. The affected employee will then be scheduled by the government for two or more appointments to complete the security package. If at any point after submission of the security worksheet, disqualifying information is discovered or developed, the government reserves the right to deny computer access. In this instance the Contracting Officer will notify the contractor of the denial. That individual will no longer be allowed to perform duties requiring computer access. After submission of the complete http://www.opm.gov/forms/pdf_fill/SF85P.pdf security package through the security office and completion of an adjudicated NACI, contractor employees may obtain their “Common Access Card” (CAC) for the duration of their contract, unless disqualifying information is subsequently discovered. In this instance access will be revoked. The NACI adjudication process normally takes 2 to 5 months after submission of the package. Contractor shall comply with AFFARS Clause 5352.242-9001

Common Access Cards (CACs) for Contractor Personnel which is hereby incorporated by reference if not otherwise included. The contractor shall comply with DODD 5200.08R Physical Security Program, (Chapter 3, Section C.3) requirements.

3. 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, social security number, 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. 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 period.

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…