RFP FA4407-09-R-0002 PWS 13 Feb 09 Attch 1.pdf

FA4407-09-R-0002

Attachment 1

PERFORMANCE WORK STATEMENT

FOR

AMBULANCE SERVICES AT

SCOTT AIR FORCE BASE

ILLINOIS

13 February 2009

SECTION 1- Description of Services

SECTION 2- Service Delivery Summary

SECTION 3- Government-Furnished Property and Services

SECTION 4- Health Requirement

SECTION 5- Certification Requirements

SECTION 6- Reimbursement

SECTION 7- General Information

SECTION 8- Scott AFB Attachments

1. DESCRIPTION OF SERVICES

The contractor shall provide full emergency patient transport services at Scott Air Force Base (SAFB) to include but not limited to the flight line and the surrounding housing areas of Patriots Landing, Shiloh West, and Shiloh East (all of these locations will be referred to as SAFB hereafter). This emergency patient transport service shall consist of both primary and secondary response to SAFB. In the event the EMS Provider’s primary and secondary response capabilities are exhausted, the EMS Provider will coordinate with SAFB Fire Department, St Clair County Central Communications (CENCOM), the 375 MDG, and Regional Hospital Coordination Center (RHCC) dispatch protocols to coordinate tertiary response. The contractor shall participate in SAFB exercises, special events, specialized training, and in-flight emergencies.

The contractor shall furnish all labor, management, supervision, vehicles, supplies, equipment, and transportation except as provided in Section 3, Government-Furnished Property, and Services. The contractor shall, at a minimum, be responsible for providing the full range of Emergency Medical Technician (EMT), paramedic, and ambulance services provided in the local community to include local protocols or standing orders and staffing minimums in accordance with current and future State of Illinois regulations and protocols (Illinois Administrative Code 515-810 which can be found at www.idph.state.il.us). Performance shall be according to the requirements contained in this Performance Work Statement (PWS) and professional standards of the Joint Commission (JC), Accreditation Association of Ambulatory Health Care (AAAHC) and the Illinois State Department of Public Health and Environment, Health Facilities and Emergency Medical Services Division.

1.1 EMERGENCY MEDICAL RESPONSE AND PATIENT TRANSPORT

The contractor shall provide ambulance and EMT/paramedic resources in order to respond to emergencies and non-emergencies. On a routine basis calls will be routed via CENCOM, however during base events (ie airshow) or base disasters requests may be generated by 375 MDG, the SAFB Medical Control Center (MCC) and or the SAFB Fire Department. Calls will be handled with the same protocol as if they were received from CENCOM. Patients shall be transferred to the nearest appropriate medical facility.

1.1.1. The contractor is authorized to file insurance claims for patient transport and emergency response services by seeking reimbursement in accordance with paragraph 6.

1.1.2. The contractor shall provide ALS services 24 hours per day 365 days per year including all holidays. This contract is the sole avenue for SAFB emergency patient transport. The contractor shall establish and maintain a system to ensure that backup ambulance and related emergency support is provided in the event of simultaneous responses, equipment failures, or other unforeseen circumstances. Services must always be available. Attachment 1 to this document provides the average demographics and population assigned/residing on SAFB.

1.1.3. The contractor shall travel to response sites in an appropriate medical response vehicle.

The contractor shall respond to requests from CENCOM, 375 MDG, the SAFB MCC and/or the SAFB Fire Department and shall provide the full range of Emergency Medical Technician (EMT), paramedic, and ambulance services provided in the local community to include local protocols or standing orders and staffing minimums in accordance with the most current State of Illinois and local regulations and protocols.

1.1.4. Response time is defined as the time of receipt of call from CENCOM, 375 MDG, the SAFB MCC and/or the SAFB Fire Department to the time of arrival at the emergency location identified. Primary Response time for all requests for service on SAFB, to include Basic Life Support (BLS) and Advanced Life Support (ALS) shall be within six (6) minutes in accordance with Section 2, Service Summary. Secondary Response time for all requests for service on SAFB, to include BLS and ALS shall be within a six (6) to fifteen (15) minute average response time. Attachments 2 and 3 to this PWS are maps that outline the average response time from Fire Station 1 on SAFB.

1.1.5. Providing medical care and treatment appropriate to patient’s condition. The contractor shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. The contractor will be notified if an EMT or EMT-P receives complaints validated by Quality Assurance Personnel (QAP) and Chief of the Medical Staff.

1.1.6. The contractor shall provide in-field care and emergency medical flight line care with capability to address decompression sickness and injuries related to in-flight emergencies, to include ALS, in accordance with protocols developed by the contractor’s physician advisor. For in-flight emergencies and other flight line responses, the EMS Provider’s primary assigned ambulance personnel shall require flight line drivers training to be able to respond to/on the flight line. The EMS Provider’s personnel shall not cross onto the flight line until cleared to do so by the SAFB Incident Commander (IC) or the 375th Mission Support Group Commander.

Due to incident management requirements, the IC may not be able to coordinate flight line clearance. Therefore when responding to the flight line, the EMS Provider must coordinate, as soon as possible, with 375th Security Forces Squadron (SFS) to obtain an escort/clearance.

1.1.6.1 SAFB flight surgeon on call shall be notified via the command post at (618) 256-5891 of ambulance transport of any in-flight emergency patient as soon as medically possible after transport.

1.1.7. The contractor will coordinate patient transport with local hospitals when transporting patients from SAFB to local hospitals.

1.1.7.1. The contractor shall notify the 375 MDG Patient Administration via telephone, at (618) 256-7533, Monday through Friday 0730-1630 CST and the 375th Command Post after hours at

(618) 256-5891 when an Active Duty Military Member is transported to a local hospital. During a real or simulated incident, notification will instead be made to the on scene incident response commander or his/her designee before departing the scene. This notification shall be provided as soon as possible in accordance with protocols after receiving hospital properly accepts patient:

name of person, name of hospital, and medical condition. If notification is delayed due to response to another emergent call, then notification must be made ASAP.

1.1.7.2. The contractor shall equip their emergency medical response vehicles operating at SAFB with radio communications equipment which allows for immediate voice communications between its vehicles, to include communications within its operations or dispatch center, and with the SAFB Fire Alarm Control Center (FACC). The SAFB preferred means of radio communications across non-military agencies is the STARCOM-21 800 MHz system used in St Clair County. The contractor shall be solely responsible for the operational readiness, maintenance and servicing of its radio communications equipment used in support of this agreement.

1.1.8 Access to Installation during Force Protection Conditions (FPCONs) - Contractors will be assigned a mission essential designation IAW requirements contained in SAFBI 31-101, Installation Security Instruction. Only the installation commander or the unit commander requesting contract support will assign the mission essential designation.

1.1.9. Performance of Services During Crises Declared by the President/Secretary of Defense/SAFB Base Commander. The service provider shall perform services during a crises or emergency situation per the contractual requirements on a modified schedule provided by the Contracting Officer. The service provider shall supply a list of employees performing duties during the crises to including name, address and phone number, to the Contracting Officer. All services identified in the Performance Work Statement (PWS) shall continue unless otherwise directed by the Contracting Officer.

1.2. 375th AIRLIFT WING, MTF EXERCISES, SPECIAL EVENTS AND SPECIALIZED

TRAINING.

The contractor shall be responsible for participating in SAFB, 375th Airlift Wing, MTF and Fire training (live fire, HAZMAT, etc.) exercises and special events to include but not limited to annual air show, open house, AMC and TRANSCOM change of commands. The contractor shall provide approximately 100 hours in ambulance stand-by coverage per year in addition to normal coverage hours specified in paragraph 1.1.2. The Government will notify the contractor of the number of dedicated ambulances required for each event. This amount is subject to change each year. The QAP will provide the contractor at least 7 days advance notice prior to the exercise/event/training date. Specific contractor responsibilities include:

1.2.1. Participating in advance and post exercise meetings.

1.2.2. Responding with EMTs to exercise sites and performing simulated duties.

1.2.3. Coordinating all activities during exercises with the On-Scene Medical Director and Incident Commander.

1.2.4. Providing one (1) ambulance to stand-by during special events. Periodically, up to two (2) ambulances may be required for these types of events. The ambulance requirements set forth in

1.2.4 are in addition to the ambulance service identified in section 1.1.

1.3. DELIVERABLES

1.3.1. Run report - The contractor shall document each ambulance response within 24 hours following a response. The report shall be timely, legible, accurate, thorough and must contain a signature of an ambulance crew member.

1.3.1.1. The contractor shall provide reasonable access to information related to transports to the MTF within 24 hours. The report shall be accomplished according to relevant HIPAA guidelines and IAW Air Force Instruction 91-204, Safety Investigations and Reports. This information shall include, but is not limited to: Date, Response time, type of run (BLS or ALS), available patient information [full name, military (last 4 of SSN) or civilian, patient condition, address responded to, the name of the hospital transported to] and an explanation of any exceptions to response time contained in Section 2, Service Delivery Summary. All patient refusals shall be documented to the same level of information described within this paragraph.

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

2. SERVICES SUMMARY (SS)

Table 2.1

Performance Objectives SOW Para. Performance Threshold

SERVICE

Providing full emergency patient transport services. 1.1.2.

100% compliance within a calendar month.

AMBULANCE RESPONSE,

PRIMARY

Six (6) Minutes or less response time for all calls. 1.1.4 90% of all calls

AMBULANCE RESPONSE,

SECONDARY

Fifteen (15) Minutes or less average response time for all calls. 1.1.4 90% of all calls

PATIENT CARE

Providing medical care and treatment appropriate to patient’s condition.

1.1.3., 1.1.5., 1.1.6

100% Compliance with Current Medical Standards of Care to include those outlined in 1.1.3

HEALTH REQUIREMENTS

Physical examinations and required immunizations current and on file for ambulance personnel.

4.1, 4.2, 4.3,

4.4 100% compliance

RUN REPORTS 1.3.

90% compliance; documentation of each response completed within 24 hours

2.1. The contractor shall establish and maintain a complete Quality Control Plan (QCP) to ensure the requirements of the contract are provided as specified. The Contractor’s QCP shall address risk management issues to include the contractor’s established processes which are in place to evaluate the standard of care is met in all cases. The contractor shall insure that risk management issues are addressed in its written audit procedures. The contractor’s QCP shall be delivered to the CO for acceptance no later than 15 work days after contract award. The CO will notify the contractor of acceptance or required modifications within 10 work days after receipt. Changes to the QCP must be accepted by the CO no later than 15 work days after implementation.

2.2. Government Quality Assurance Personnel shall periodically evaluate and monitor the Contractor’s performance to ensure services are received. The QAP will evaluate the Contractor’s performance through inspections of call logs/reports and receive and investigate all complaints from base personnel and patients transported. The Government may inspect each task as completed or increase the number of quality control inspections if deemed appropriate because of repeated failures discovered during quality control inspections if performance dictates. The QAP will make final determination of the validity of customer complaint(s). The contractor will not be held responsible for being unable to meet the response time due to factors beyond their control. This will include, but is not limited to, road construction or unplanned road closures, vehicle failures, inclement weather, communications problems, employee incapacitation not related to misconduct or negligence.

2.3. If any of the services do not conform to contract requirements, the Government may require the Contractor to perform the services again in conformity with contract requirements, at no cost to the Government. When the defects in services cannot be corrected by re-performance, the Government may:

(1) Require the Contractor to take necessary action to ensure that future performance conforms to contract requirements; and

(2) Reduce the contract price to reflect the reduced value of the services performed. 1% of the monthly invoice per SS occurrence, as listed above, shall be deduced for each performance objective missed.

2.4. Performance Evaluation Meetings. The CO may require the contractor or representative to meet with the CO, contract administrator, QAP and other Government personnel as often as deemed necessary. The contractor may request a meeting with the CO when necessary.

Meetings will be documented in the contract file with written minutes signed by the contract manager, CO, or contract administrator. Should the contractor not concur with the minutes, such non concurrence shall be provided in writing to the CO within 10 work days of receipt of the minutes.

3. GOVERNMENT-FURNISHED PROPERTY AND SERVICES

3.1 The Government will provide the contractor with a copy of the SAFB’s geobase grid-map prior to start of performance and AFI 91-204 Safety Investigations and Reports.

3.2 The Government will provide a train-the-trainer course for Special Flight Line Driving in accordance with Paragraph 7.2.3. to a contract representative within 30 days of the start of performance. This course will allow the contractor to train their employees.

3.3 The contractor may have access to operate/stand-by at SAFB Fire Stations. The contractor may have access to a kitchen, TV lounge area, fitness/workout room, and sleeping quarters. The crew members will comply with and participate in daily fire station operations, maintenance and cleaning standards as determined by Fire Department leadership if SAFB Fire Stations are utilized by the contractor.

3.3.1. If contractor crew stands-by out of SAFB Fire Stations, the contractor must utilize a special exhaust filter to allow for the ambulance to park inside the respective SAFB Fire Station.

The Government will loan the contractor one filter. The exhaust filter unit will forever remain the property of the United States Air Force unless determined otherwise by the Chief, Fire Emergency Services. Disposition of the filter will be determined by the Chief, Fire Emergency Services.

3.3.2. The 375th Fire Department will provide training for one EMS Provider personnel member in regards to the operations and tracking of the filter unit. Thereafter, the contractor will be responsible for tracking filter hours and replacing filters at their expense immediately when needed. The contractor will ensure the filter unit remains in service. If the operation of the filter unit is ever in doubt, the unit will be removed from the station.

3.3.3 If the current ambulance filter unit is replaced, the EMS Provider will at their expense be responsible to ensure a filter unit is installed on any replacement unit to be assigned permanently at SAFB. Replacement unit(s) and purchased filters must be approved by the Chief, Fire Emergency Services prior to being parked within the station.

3.3.4 The contractor will keep the Chief, Fire Emergency Services advised of any issues involving operation of the ambulance as it applies to the filter unit(s).

3.3.5 If the contractor crew stands-by at any of the SAFB Fire Stations, the contractor will comply with all guidelines, protocols, and regulations for waste disposal safety and other operation guidance to be determined by the Chief, Fire Emergency Services.

3.4 The Government will provide Long-Term Visitor Passes in accordance with section 7.4 of this document.

4. HEALTH REQUIREMENTS

4.1 Contractor personnel providing services under this contract shall meet all State of Illinois and local health requirements prior to commencement of work and annually thereafter. The contractor is responsible for maintaining these records and upon request provide proof of these requirements to the 375th Medical Group/Government.

4.2 Not later than five (5) working days prior to commencement of work, certification shall be available to the QAP that paramedics have completed medical requirements required above.

4.3 Also, as a condition of employment, OSHA requires that all contract personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity to Hepatitis B infection. Personnel who sign declinations may change their minds at any time and receive the Hepatitis B vaccine without penalty. Immunizations are the responsibility of the contractor.

4.4 It is the Contractor’s responsibility to report (to the appropriate MTF staff member) all information necessary to assure patient medical records can be maintained correctly, and thereafter comply with the JC, AAAHC, OSHA, Health Services Inspection (HSI) and CDC heath records requirements.

5. CERTIFICATION REQUIREMENTS

5.1 The contractor shall provide/maintain the following:

5.1.1. Current Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) certification and any certifications required by the State of Illinois.

5.1.2. A copy of the proposed contract paramedic’s professional resume, accompanied by that individual’s sworn affidavit of the truthfulness of same, indicating experience, training, and technical expertise in the type of care to be rendered.

5.1.3. A list of all states in which contract provider currently holds or has held a license to practice related services.

5.1.4. Certification of current physical examination for each employee. The certification shall contain a signed statement by the examining physician stating that the employee is free of any contagious diseases. Physical examination must be current as of 12 months prior to application for privileges.

5.2. The Contractor is required to begin full performance of the contract requirements upon the effective date of the contract award. It is absolutely critical that certification be granted to a sufficient number of contract paramedics to meet the contract requirements by the commencement date of performance.

6. REIMBURSEMENT

6.1. For TRICARE eligible beneficiaries, the contractor will be reimbursed up to the CHAMPUS Maximum Allowable by North Regions Claims (PGBA) P.O. Box 870140, Surfside Beach, SC 29587-9740. If the contractor does not obtain full reimbursement or collects less than the billed amount from PGBA, the contractor will not balance bill any TRICARE eligible member for the balance due. In these circumstances, the contractor will contact PGBA billing for resolution.

6.2 For non-TRICARE eligible beneficiaries, the contractor will seek reimbursement through its normal billing procedures such as billing private insurance, Medicare, or the individual patient.

6.3 The contractor’s failure to obtain reimbursement, or collection of less than the billed amount, will not financially obligate the 375th Medical Group, the United States Air Force, or the United States Government.

6.4. The contractor will seek the appropriate reimbursement for the type of ambulance services provided. If only BLS service is provided, then the contractor will bill for a BLS, not ALS, response.

7. GENERAL INFORMATION.

7.1. Contract Manager: The contractor shall provide a contract manager who shall be responsible for the performance of the work as specified in the SOW. The name of this person and an alternate(s) who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer and 375th Medical Group Contracting Officer’s Technical Representative prior to contract start date.

7.1.1. The contract manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract and be available during normal business hours (0730 -1630 hours). The contract manager must be available or respond to the QAP and Contracting Officer for any contract issues or questions within 10 minutes between 0730 – 1630 hours, Monday through Friday (excluding Federal Holidays), and within one hour (via pager or cell phone access) during all other hours. The senior vehicle crew member will also be available to the QAP or Contracting Officer if questions arise. If questions or direction to the crew are deferred to the Contract Manager, the above response time limits apply. The contractor shall be responsible for providing contractor employees with the appropriate communication equipment to include pagers or cellular telephones. The contractor shall inform the QAP and Contracting Officer in writing of the phone numbers for this equipment and notify the Government immediately upon any subsequent changes.

7.1.1.1. Holidays. The Government observes the following:

New Years Day Labor Day Martin Luther King Jr. Birthday Columbus Day

President’s Day Veterans Day Memorial Day Thanksgiving Independence Day Christmas

7.1.2. The contract manager and alternate(s) must be able to read, write, speak, and understand English.

7.2. The contractor shall ensure that all employees involved in activities that require certification or licensing shall meet all such requirements for:

7.2.1 Operating an emergency ambulance in the State of Illinois and possessing a valid Class “C” Illinois driver’s license. Drivers must not have any reckless or dangerous driving citations within the previous 24-month period and have no Driving While Intoxicated (DWI) or Driving Under the Influence (DUI) convictions in the previous three years.

7.2.2 Possessing a current license to perform EMT and Paramedic services in the State of Illinois.

7.2.3 Providing Special Flight Line Driving Certification to all drivers performing services under this contract within thirty (30) days after the start of contract performance or within thirty (30) days of employment.

7.3 Contractor shall maintain files to assure that all EMTs performing work under this contract shall have current certifications and/or documents listed in 7.2 above. Upon request the contractor shall allow the Government access to review these documents for any EMTs performing under this contract. The contractor will provide copies of certifications upon request.

7.4.Contractor Consent to Background Checks: The contractor and, as applicable, subcontractor shall not employ persons for work on this contract if such employee is identified as a potential threat to the health, safety, security, general well being or operational mission of the installation and its population, nor shall the contractor or subcontractor employ persons under this contract who have an outstanding criminal warrant as identified by Law Enforcement Agency Data System (LEADS) through the National Crime Information Center. LEADS checks will verify if a person is wanted by local, state, and federal agencies. All contractor and subcontractor personnel must consent to LEADS background checks. Contractor and subcontractor personnel who do not consent to an LEADS check will be denied access to the installation. Information required to conduct an LEADS check includes: full name, driver’s license number, and/or social security number, date of birth of the person entering the installation, and completion of a background check questionnaire. The contractor shall provide this information using the Scott AFB Form 21, Contractors Consent for Background Check, and shall submit it in conjunction with the contractor’s request for either base or vehicle passes. Completion of a successful LEADS check does not invalidate the requirement for an escort when contractor or subcontractor personnel are working within controlled or restricted areas.

Contractors shall ensure their employees and those of their subcontracts have the proper credentials allowing them to work in the United States. Persons later found to be undocumented or illegal aliens will be remanded to the proper authorities. The contractor shall not be entitled to any compensation for delays or expenses associated with complying with the provisions of this clause. Furthermore, nothing in this clause shall excuse the contractor from proceeding with the contract as required.

Badges: The contractor is required to provide identification badges for their employees. All contractor personnel shall wear these badges while on duty on the Government site. Badges are required to identify the individual, company name, and be clearly and distinctly marked as contractor. Size, color, style, etc. are to be mutually agreed to by contractor and Government.

The contractor’s identification badge will not be used as an entry requirement for installation entry or into any Government designated controlled or restricted area.

Access to Installation during Force Protection Conditions (FPCONs):

Contractors will be assigned a mission essential designation IAW requirements contained in SAFBI 31-101/Installation Security Instruction. Only the installation commander or the unit commander requesting contract support will assign the mission essential designation.

Property Protection:

Property protection for facility where the contractors’ primary work center is located will be the responsibility of the local facility manager and local Government Security Manager, or their duly authorized representative IAW AFI 31-101, The Air Force Installation Security Program and command/local directives. The contractor shall safeguard all Government-owned equipment and materials in his/her possession or use.

Safeguarding Classified or Unclassified Information: The contractor shall meet Air Force standards for storing, processing, and handling classified information and systems. Additionally, all resources (e.g. maps, publication/instructions, photos) provided by the Government to assist the contractor in the performance of their contract will be surrendered upon termination of employment or the end of the contract performance period.

Non-Disclosure Agreements: To safeguard information, the contractor shall enter into non-disclosure agreements with the responsible local security manager.

Privacy Act: Work on this project requires that personnel have access to Privacy Information.

Personnel shall adhere to the Privacy Act, Title 5 of the U.S. Code, Section 552a and applicable agency rules and regulations.

7.4.1 The contractor will provide to 375 SFS a list of their company’s employees requiring routine access to SAFB as part of their official duties. In addition to the list of names the EMS Provider must provide the following information for checks in the Law Enforcement Agency Data System (LEADS): full name, driver’s license number, and/or social security number, date of birth, and completion of a background check questionnaire (includes consent to background check). A Criminal History Background Check (CHBC) and a check in LEADS must be conducted before a Long Term Visitors Pass (LTVP) is issued. All EMS provider personnel requiring access to SAFB who do not consent to a LEADS check will be denied access to the installation. Provided EMS provider personnel have a record that is clear of serious offenses and no outstanding wants or warrants, they will be issued a LTVP.

7.4.2 The contractor may also provide to the 375 SFS a list of their company’s employees requiring infrequent access to SAFB. The information required for LEADS checks, including consent for LEADS check, must also be provided for these employees. These employees’ names will be entered onto an Entry Authorization Listing (EAL) that will be maintained at SAFB installation Entry Control Points (ECPs). Upon presentation of a valid photo driver’s license and a cross check with the EAL, approved personnel will be granted entry onto the installation, provided they are performing official duties.

7.4.3 All personnel will be required to show identification when entering the installation. All personnel and vehicles are subject to search at any time while on SAFB. In addition, 375 SFS will conduct random monthly CHBC of names of individuals with LTVP and EAL access and delete names of persons deemed unsuitable for installation access. The contractor must notify 375 SFS when an employee with LTVP or EAL access no longer requires access to SAFB, such as termination or suspension of employment with the contractor.

7.5 The contractor shall be solely responsible for compliance with Occupational Safety and Health Act (OSHA) (Public Law 91-596) and the resulting standards, OSHA standard 29 CFR 1910, 1926, and the protection of their employees. The contractor shall be responsible for insuring that all safety requirements are met.

7.6. Employees. The contractor shall not employ persons for work on this contract if such employee is identified to the contractor by the contracting officer as a potential threat to the health, safety, security, well-being or operational mission of the installation and its population.

7.6.1. Contractor personnel shall present a neat appearance and be easily recognized as contractor employees. The contractor shall furnish an identifying badge, which shall include as a minimum the person’s name, the name of the contractor and the function. Each employee shall wear the badge on the outer garments at all times.

7.6.2. The contractor shall not employ any person who is an employee of the US Government if employing that person would create a conflict of interest or interfere with the performance of their Government position. Additionally, the contractor shall not employ any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval according to DODD 5500.7 Standards of Conduct. The contractor shall not employ any person who is an employee of the Department of the Air Force if such employment would be contrary to the policies in AFI 64-106 Air Force Industrial Labor Relations Activities.

7.6.3. The contractor is cautioned that off-duty active military personnel hired under this contract may be subject to permanent change of station, change in duty hours, or deployment.

Military Reservists and National Guard members may be subject to recall to active duty. The abrupt absence of these personnel could adversely affect the contractor's ability to perform;

however, their absence at any time shall not constitute an excuse for nonperformance under this contract.

7.6.4. Personnel Skills and Qualifications. The contractor shall provide its staff with the knowledge, expertise, education and experience necessary to successfully complete all PWS requirements. Contractor personnel must be available on contract start date. The nature of the work may require close contact with Government representatives at all levels of the organizations, and requires working in a team environment. The contractor shall be expected to act in a professional manner and provide courteous customer service at all times.

7.7. Security and Privacy Requirements. All personnel employed by the contractor in the performance of this contract, or any representative of the contractor entering the Government installation, shall abide by all security regulations of the installation. The Government reserves the right to direct the removal of an employee for misconduct or security reasons. This action does not relieve the contractor from total performance of the contract tasks specified herein.

7.8 Access to restricted and controlled areas, including the SAFB flightline: In accordance with AFI 31-101, the contractor personnel and ambulances requiring access to the flightline or other restricted/controlled areas for emergency responses will comply with local emergency entry requirements in each area based on the current Force Protection Condition (FPCON). Contractor personnel will not be issued permanent badges for access to restricted or classified areas. Thus when responding to one of these areas, the EMS Provider must coordinate, as soon as possible, with 375 SFS to obtain an escort.

7.9 During FPCON changes that require SAFB gate closure/restriction, the EMS Provider will coordinate with SFS through the Fire Alarm Control Center (FACC) and/or the 375 MDG on utilization of alternate ECPs. The EMS provider will not be held responsible for being unable to meet response times in the event the gate closures/restriction and/or implementation of alternate ECPs impedes timely access to Scott AFB.

7.9.1 The Government shall ensure contractor is cleared for utilization of alternate ECPs and that the Scott AFB Alternate ECP Plan reflects this clearance. In the event of a change in FPCON status, FACC personnel shall immediately notify the EMS Provider’s assigned crew and Dispatch Center by utilization of the “County Calling” 800 MHz interoperability talk group established by St Clair County. In the event that “County Calling” is overcome with traffic, alternate interoperability talk groups shall be utilized, as designated by St Clair County Central Communications (CENCOM), and/or as indicated in the Scott AFB Emergency Communications Concept of Operations (CONOPS).

7.10 Privacy. The contractor shall comply with the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act of 1996 to protect personal health information the contractor may encounter while completing the tasks associated with this contract.

7.11 The contractor shall comply with existing and future Illinois Administrative Code 515-810 which can be found at www.idph.state.il.us .

7.12 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

OF 1996

http://www.idph.state.il.us/

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

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

Introduction

(a) Definitions. As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DOD 6025.18-R, DOD 8520.02-R or AFI 41-217.

Individual has the same meaning as the term “individual” in 45 CFR 164.50 1 and 164.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g).

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

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

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

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

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

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

Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103, 160.502, 164.103, 164.304 and 164.501.

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

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

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

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

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

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

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

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

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

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

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

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

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

General Use and Disclosure Provisions

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

Specific Use and Disclosure Provisions

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

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

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

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

Obligations of the Government

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

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

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

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

Permissible Requests by the Government

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

Termination

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

(b) Effect of Termination.

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

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

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

Miscellaneous

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

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

(c) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with DOD 6025.18-R, the CFR HIPAA Privacy Rule, DOD 8520.02-R, the CFR HIPAA Security Rule and AFI 41-217.

Attachment 1 – Population Demographics and Call Distribution

Population Size: SAFB has a maximum population of 40K during peak business hours (normal duty hours Monday through Friday).

Call Volume/Distribution Summary:

Total Call Volume 5-1-2008 to 12-30-2008 = 271 Average # calls per month = 34 (271 divided by 5 months) Peak Call Period = 86% of calls occur between 0600 to 1800 (6:00 am to 6:00 pm)

Residential Community Demographics Summary (Zip Code 62225/Scott Air Force Base):

Attachment 2. Estimated Response Times From Fire Station 1 – Geographical Presentation

Attachment 3. Estimated Response Times – Zoomed