Attachment_1_-_PWS.pdf

FA4417-15-Q-0003

ATTACHMENT 1

PERFORMANCE WORK STATEMENT

FOR

EXERCISE PHYSIOLOGIST AND HEALTH FITNESS SPECIALISTS SERVICES

AT HURLBURT FIELD, FL

14 JUL 15

Performance Work Statement (PWS) For

Exercise Physiologist and Health Fitness Specialist Services

1. SCOPE OF WORK. The objective of this contract is to support the Health & Wellness Promotion Program at Hurlburt Field, FL. The purpose of this contract is to develop, manage, maintain, plan and conduct a comprehensive health, wellness and fitness education program aimed at assisting active duty members and their dependents to generally improve their personal health and fitness and overall physical resiliency. Retirees, DoD civilians, and contractors may also be served on a space available basis.

1.1. DESCRIPTION OF SERVICE. Nonpersonal services: The contractor shall provide all personnel, management, supervision, transportation, and all other services necessary to perform on-site Exercise Physiologist and Health Fitness Specialist Services at the Health and Wellness Center (HAWC), 1 SOMDG, Hurlburt Field, FL. The contractor shall perform all services in accordance with this Performance Work Statement (PWS).

1.1.1. Contractor personnel performing Exercise Physiologist and Health Fitness Specialist Services shall work closely together and coordinate with the Health Promotions Program Coordinator (HPPC), Registered Dietitian (RD) and the Information Manager (IM) in performance of the work required in this PWS.

1.2. SPECIFIC TASKS.

1.2.1. Exercise Physiologist Services. The contractor shall assist with developing, managing, maintaining, planning and conducting a comprehensive health, fitness, and wellness program to target active duty members and their dependents to improve their personal health, fitness, and overall physical resilience.

The contractor’s major tasks include:

- Teaching clients healthy lifestyle behaviors that minimize health risks and prevent further disease complications from known disease process

-Providing pre/post rehabilitation, medical assessment, and prescription (non-medicinal) for beneficiaries with injury, illness or controlled, chronic disease

-Accepting and answering referrals for pre/post rehabilitation and medical exercise received from the Military Treatment Facility (MTF).

-Using appropriate treatment/disease management protocol

-Working with Primary Care Optimization teams to provide care

-Reviewing exercise prescriptions ordered by providers

-Conducting musculoskeletal, functional movement screen tests, gait analysis, obtaining client history and gathering other pertinent information

-Analyzing test results, determining functional capabilities, answering questions and/or reporting findings to clients and health care providers or appropriate management officials

-Recommending modifications and alternate exercise techniques to maximize clients’ health and safety

-Counseling individuals or groups regarding screening results either before, during or after the screening process

-Documenting and makes appropriate referrals

-Maintaining client files or requests medical records to provide continuity of care for follow-up visits

-Using realistic and appropriate goal setting with clients to promote behavior change and injury recovery

-Measuring and evaluate client response to exercise services, effectiveness, necessity, efficacy and quality of the services provided and modifies services as needed

-Meeting with ranking base and community officials in matters concerning health, wellness, physical fitness aspects, and the overall physical resilience of the installation Health Promotion Program and the Air Force Fitness Program

-Preparing and submit reports as required

1.2.1.1. The contractor shall assist and encourage improving and ensuring high levels of physical resiliency at the installation and training Airmen in all aspects of fitness level improvement. The contractor shall assist with the planning, development and execution of new wellness programs as well as the planning for the revitalization of existing health, wellness and fitness programs.

1.2.1.2. The contractor shall program, execute and lead pre/post rehabilitation treatment plans and comprehensive corrective exercise programs.

1.2.1.3. The contractor shall conduct functional movement screenings, gait analyses, and develop exercise prescriptions that coincide with the active duty member’s duty limiting condition.

1.2.1.4. The contractor shall develop and lead programs such as Post Pregnancy Physical Training (PT) which focuses on improving post-partum airmen achieve “satisfactory” or “excellent” PT scores.

1.2.1.5. The contractor shall assist with “follow up” appointments for determination of improved fitness and health status. The contractor shall utilize data collection monitoring procedures to conduct effective evaluations on individuals who differ markedly in health status and medical conditions. The contractor shall devise, improvise, and tailor fitness activities to maximize fitness improvement while conforming to limitations in funds, facilities, equipment and staff support.

1.2.1.6. The contractor shall use treatment/disease management protocols to coordinate care. The contractor shall evaluate members’ fitness levels, design medical exercise prescriptions, answer questions, and report findings to health care providers and appropriate management officials.

The contractor shall tailor exercise prescription for injured Active Duty (AD) personnel to maintain worldwide qualification documents in the Armed Forces Health Longitudinal Technology Application (AHLTA) electronic medical record. The contractor shall prescribe exercise rehabilitation for clients with diagnoses to include but not limited to: obesity, diabetes, hypertension, cardiovascular disease, arthritis and orthopedic injury, pregnancy & low back pain.

The contractor shall recommend individual exercise programs to maximize health/safety. The contractor shall create, maintain, and dispose of Government/client records in accordance with AFI 33-322, Records Management Program.

1.2.1.7. The contractor shall prescribe exercises based on strength, flexibility, sub-maximal cardiovascular assessments, and recommend the duration of exercise, frequency and intensity of exercise session, warm-up, cool-down, stretching, aerobics, etc.

1.2.1.8. The contractor shall present orientation and education programs to participants on safety, proper warm-up, stretching, strength, flexibility, correct exercise techniques and different types of resistance exercise. The contractor shall consult with squadron 1st Sergeants, Unit Fitness Program Managers (UFPM’s), Physical Training Leaders (PTL’s) about active duty members’ fitness improvement.

1.2.1.9. The contractor shall interpret Health Care Providers medical profiles and develop client fitness programs accordingly. The contractor shall train members about a variety of safe and effective exercise regimens for active duty personnel at all level of fitness.

1.2.1.10. The Contractor shall consult with physicians, rehabilitative exercise specialists and other health care providers for related fitness related injuries and medical conditions.

1.2.2. Health Fitness Specialist Services. The contractor shall assist with developing, managing, maintaining, planning and conducting a comprehensive health, fitness and wellness program to target active duty members and their dependents to improve their personal health, fitness, and overall physical resilience.

The contractor’s major tasks include:

-Conducting health assessments, body composition screenings, exercise prescriptions, and development/implementation of wellness classes

-Meeting with ranking base and community officials in matters concerning health, wellness and physical fitness aspects of the installation Health Promotion Program (HPP), which may include the Tobacco Cessation Program, Nutrition programs, and the Air Force Fitness Program

-Preparing and submitting reports as required.

1.2.2.1. The contractor shall consult with the HPPC and EP regarding the Air Force Fitness Program to include all aspects of training and fitness level improvement. While major duties will be in classroom instruction, the Health and Fitness Specialist shall assist the EP with program development and exercise prescriptions. The contractor shall also assist with the planning, development and execution of new wellness programs as well as the planning for the revitalization of existing health, wellness and fitness programs.

1.2.2.2. The contractor shall consult and assist the EP with the fitness program and shall assist when EP is involved in other duties or substitute on a limited basis for the EP. The contractor shall also assist with the training of squadron Physical Training Leaders (PTL) and consult on the development of unit conditioning programs.

1.2.2.3. The contractor shall assist with “follow up” appointments for determination of improved fitness status. The contractor shall utilize data collection monitoring procedures to conduct effective evaluations on individuals who differ markedly in health status and medical conditions.

The contractor shall devise, improvise, and tailor fitness activities to maximize fitness improvement while conforming to limitations in funds, facilities, equipment and staff support.

1.2.2.4. The contractor shall present classes, lectures, and workshops to a variety of audiences on wellness subjects, in which the Government will provide instruction and materials, such as (but not limited to) the following:

(a) Classes are conducted in the HAWC or at onsite locations.

(b) Classes include: Commando Ready (CR), Commando Pride Airmen Center (CPAC), MOVE, Health and Performance, Healthy Heart, Lifestyle Change Workshop.

(c) The contractor shall present health and fitness related briefings at commander calls and other base functions on an as needed basis.

1.2.2.5. The contractor shall prescribe exercises on strength, flexibility, sub-maximal cardiovascular assessments, and recommend the duration of exercise, frequency and intensity of exercise session, warm-up, cool-down, stretching, aerobics, etc.

1.2.2.6. The contractor shall present orientation and education programs to participants on safety, proper warm-up, stretching, strength, flexibility, correct exercise techniques and different types of resistance exercise. The contractor shall consult with Squadron Commanders, First Sergeants, Unit Fitness Program Managers (UFPM’s), Physical Training Leaders (PTL’s) about the active duty member’s fitness improvement as necessary.

1.2.2.7. The contractor shall interpret Health Care Providers medical profiles and develop client fitness programs accordingly. The contractor shall train members about a variety of safe and effective exercise regimens for active duty personnel at all level of fitness.

1.2.2.8. The contractor shall consult with physicians, rehabilitative exercise specialists and other health care providers for related fitness related injuries and medical conditions.

1.2.2.9. The contractor shall schedule and assist with the marketing/publicity of the programs offered by the HAWC.

1.2.2.10. The contractor shall perform body composition tests utilizing an InBody570, InBody370, or Bod Pod.

1.3 DELIVERABLES. All deliverables must meet professional standards and meet the requirements set forth in contract documentation. The contractor will be responsible for delivering all end items specified. The following items are deliverables that fall within the scope of the aforementioned tasks.

Deliverable

TITLE

Date of 1st

Submission

As of Date

Date of Subsequent Submission

Distribution POC

Summary of Appointment via AHLTA

As Required

Within 14 calendar days of appointment

As Required 1 SOAMDS

2 Monthly Status Report

1st Month after award

10th day of each month Monthly 1 SOAMDS &

COR

1.3.1. Summary of Appointment via AHLTA. The contractor shall document all medical encounters in Armed Forces Health Longitudinal Technology Application (AHLTA). This summary shall be completed within 14 calendar days from appointment completion.

1.3.2. Monthly Status Report (MSR). The contractor shall submit a MSR by the 10th day of each month. The MSR shall be completed by contractor personnel performing Exercise Physiologist and Health Fitness Specialist services and shall synopsize all activities and significant events that occurred during the previous month. .

2. SERVICES SUMMARY.

The contract service requirements are summarized in performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimally acceptable levels of service required for each requirement. These thresholds are critical to mission success. Procedures as set forth in the FAR 52.212-4 (a), Contract Terms and Conditions -Commercial Items, Inspection/Acceptance, will be used to remedy all deficiencies.

SS # Performance Objectives PWS Paragraph #

Performance Threshold

SS 1 (EP) Present orientation and education programs

1.2.1.8 No more than 1 valid customer

complaint per month. Complaints will be validated by the COR.

SS 2 (EP) Provide patient care through screenings and appointments

1.2.1.2, 1.2.1.3

No more than 1 valid customer complaint per month. Complaints will be validated by the COR.

SS 3 (HFS) Prepare and Present classes 1.2.2.5 No more than 1 valid customer complaints per month. Complaints will be validated by the COR.

SS 4 (HFS) Provide patient care through appointments and educational programs

1.2.2.4, 1.2.2.6, 1.2.2.8, 1.2.2.11

No more than 1 valid customer complaint per month. Complaints will be validated by the COR.

2.1. MEDICAL QUALITY ASSURANCE/RISK MANAGEMENT (QA/RM).

2.1.1. The contractor shall participate in QA/RM activities to the extent required by AFI 44-119, Medical Quality Operations and the individual MTF QA/RM plan or regulation.

3. GOVERNMENT FURNISHED PROPERTY, SUPPLIES AND SERVICES. The Government will provide the facilities, equipment, supplies, and services listed below. The Government will maintain accountability of any Government-furnished property, supplies and services. Government-furnished property shall be used only in the performance of this contract.

3.1 Government Furnished Facilities. The government will provide 100 square feet of office space in the Health and Wellness Center in Building 90232. No alterations to the office space shall be made without the specific written permission from the CO as coordinated and approved via the Civil Engineer work order, AF Form 332. In case of alterations necessary for compliance with OSHA, such permission shall not be reasonably withheld. The Contractor shall return the office space to the government in the same condition as received, fair wear and tear and approved modifications.

3.2. Government Furnished Equipment/Materials.

3.2.1. Contractor personnel will have joint use of all Government equipment available and necessary to perform services required by this contract. This includes copy machines, computers, fax machines, and the medical library. Use is limited to official Government business only.

3.2.2. The HAWC will provide all required Government forms used in the performance of services.

3.2.3. All office/medical supplies currently and normally used in providing the required services.

Contractor personnel may request additional office/medical supplies through the facility supply system contingent on available funds and with the approval of the Flight Commander. Denials and/or delays in acquiring any additional supplies beyond those currently and normally used shall not be cause for nonperformance of required services, or claims against the Government.

3.2.4. The HAWC will not provide uniforms, laboratory coats, or other personal clothing.

3.2.5. Appropriate Personal Protective Equipment (PPE), including scrubs if necessary. The Government will be responsible for any repair, cleaning and inventory required for the PPE.

3.2.10. The Government will provide a personnel identification badge for contractor personnel to be used in accordance with HAWC and base security policy.

3.3. Government Provided Services

3.3.1. Government Furnished Utilities. The Government will furnish electricity, water and sewage service as necessary for accomplishment of work in accordance with this contract. The Contractor shall adhere to all base level utility conservation practices or requirements. The Contractor shall be responsible for operating under conditions that prevent waste of utilities.

3.3.2.Telephone Service. The Government will provide station, local, long distance and Defense Switching Network (DSN) telephone services for official use only. Official use does not include administrative communications by employees on-site and the contractor’s corporate headquarters. Out-of-area calls not directly related to medical care of eligible beneficiaries are not authorized without the approval of the Flight Commander. The contractor shall be responsible for reimbursement to the MTF for the costs of all unauthorized communications.

3.3.3. Mail Service. The Government will provide intra-hospital distribution of mail and will provide outgoing mail service for official government correspondence.

3.3.4. The Government will provide routine custodial services including emptying of trash;

sweeping; mopping; and vacuuming, patient laundry services, and disposal of infectious waste.

Additionally, custodial personnel will provide services upon request for immediate problems.

Housekeeping (custodial services) will not clean nor move equipment such as medical or dental surgical instruments, surgical equipment, patient physiological monitoring equipment, equipment used in the diagnosis, care, or treatment of patients.

3.3.5. Security, Fire, and Medical Services. The Government will provide police and fire protection. In the event of a medical emergency, base ambulance service for transporting an injured employee to a local hospital is available on a cost reimbursement basis.

4. GENERAL INFORMATION.

4.1. Contract Manager. The Contractor shall designate a Contract Manager and alternate in writing to the CO no later than the pre-performance conference and anytime changes are made.

The Contractor shall establish and maintain an office through which the Contract Manager or alternate(s) can be contacted during work hours. The Contractor shall also provide to the CO the names and phone/pager numbers of Contractor POCs for after business hours including nights, weekends, and holidays. This information will be kept updated by the Contractor whenever personnel changes occur. The Contract Manager or alternate shall have full authority to act for the Contractor on all contract matters relating to the daily operation of this contract.

4.2. Contractor Personnel. Contractor personnel shall present a neat appearance. Contractor personnel shall be easily recognizable while on the installation in conjunction with this contract.

This shall be accomplished through the wear of distinctive clothing, overcoats, or hats, bearing the company name or logo. The coloring or design of the items selected should be such that identifies personnel easily and quickly for reasons of safety and personal protection. Athletic footwear (e.g., aerobic, running, and tennis shoes) may be worn provided the footwear is clean and in good taste.

The government may restrict the employment under the contract of any Contractor employee or prospective Contractor employee, who is identified as a potential threat to the health, safety, security, general wellbeing, or operational mission of the installation and its population.

4.2.1. Contractor personnel shall wear appropriate identification badges on the outer clothing on the front of the body between the neck and waist so that the badge is visible at all times.

4.2.2. Prior to commencement of work, contractor personnel shall attend a government orientation to familiarize contractor personnel with the policies and procedures of the HAWC.

The orientation will be scheduled by the COR during normal duty hours.

4.3 KNOWLEDGE AND SKILLS. Contractor personnel performing on-site services must possess the following knowledge and skills:

4.3.1. Read, understand, speak, and write English fluently.

4.3.2. Teaching and public speaking skills.

4.3.3. Knowledge in the use of personal computers and computer programs to include Microsoft Office applications.

4.3.4. Current cardiopulmonary resuscitation (CPR) certification.

4.3.5. Contractor personnel shall complete all staff training required by the HAWC upon start of performance. Such training may include but is not limited to instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training will be conducted during normal duty hours.

4.4. QUALIFICATIONS. In addition to the skills and knowledge listed above in paragraphs 4.3.1-4.3.8 on-site contractor personnel performing shall possess the below qualifications:

4.4.1. Exercise Physiologist.

4.4.1.1. A Bachelor’s Degree from an accredited institution in the field of Exercise Science, Exercise Physiology, Kinesiology, or Biomechanics.

4.4.1.2. A national certification from either the American College of Sports Medicine (ACSM) as a Certified Exercise Physiologist (C-EP), the National Strength and Conditioning Association (NSCA) as a Certified Strength and Conditioning Specialist (CSCS), or from the National Academy of Sports Medicine (NASM) as either a Corrective Exercise Specialist (CES) or Performance Enhancement Specialist (PES).

4.4.2. Health & Fitness Specialist.

4.4.2.1. A Bachelor’s Degree from an accredited institution in a health-related field such as health and wellness, community health promotion, exercise science, human performance, sports medicine, or fitness management.

4.4.2.2. The Health and Fitness Specialist shall hold a personal training certification from an accredited institution. The Health and Fitness Specialist should be a role model in weight, fitness, and other healthy lifestyle behaviors.

4.5. Contractor personnel performing on-site must complete annual training required in accordance with HIPAA, Joint Commission, AF Computer Security Policy, and AF Safety Policy. The COR will identify annual training required after contract award.

4.6. CRIMINAL BACKGROUND CHECK REQUIREMENT.

4.6.1. The Government will conduct criminal background checks on individuals providing services under this contract, using the procedures set forth in Department of Defense Instruction

1402.5 dated 19 January 1993. Background checks will be based on fingerprints of individuals obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureaus of Investigation and state criminal history repositories.

4.6.2. Contractor personnel may provide contract services prior to completion of background checks with the consent of the CO and hospital commander.

4.6.3. Contractor personnel may obtain a copy of any background check pertaining to them and to challenge the accuracy and completeness of the information contained in the report.

4.7. HEALTH CARE REQUIREMENTS. Contractor personnel providing services under this contract shall receive a pre-employment physical examination prior to commencement of work and annually thereafter. All pre-employment requirements are provided at the contractor’s cost.

4.7.1. Not later than five (5) working days prior to commencement of work, the contractor shall provide certification to the COR that contractor personnel have completed the medical evaluation required above. This certification shall state the date on which the examination was completed, the doctor’s name that performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: “(name of contractor personnel) is suffering from no contagious diseases to include but not limited to Tuberculosis, Hepatitis, and Sexual or Venereal Disease.”

4.7.2. All contractor personnel shall receive a 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. Vaccinations are a responsibility of the contractor.

4.7.3. The contractor shall submit (to the appropriate HAWC staff member) all information necessary to assure hospital records can be maintained correctly, and therefore comply with the Joint Commission, OSHA, and Center for Disease Control (CDC) health records requirement.

HEALTH REQUIREMENTS

Contract ACTION Worker

HbsAg* M1

HBV M1**

HBV Refusal Signed Y HIV Consent Y HIV Test M1, A1 Rubella*** M Rubeolla**** M TB Skin Test***** M2, A M2, A M2, A Varicella Status* M

Legend

HBsAg = Employee’s hepatitis B surface antigen status must be known. If the status unknown or positive, then a hepatitis B panel needed.

HBV = Hepatitis B Vaccination HBV Refusal Signed = Employee must sign a written “Refusal of HBV” form in accordance with 29 CFR 1910.1030 when refusing HBV HIV = Human Immunodeficiency Virus HIV Consent = Employee must sign a written “Informed Consent” form in accordance with Florida law when tested for HIV

* = History of illness, titer or vaccination. Vaccinate if susceptible.

** = As condition of employment or when new contract let.

*** = Consider immune if: 1) Documentation of laboratory evidence of immunity or 2) Documentation of adequate vaccination. [NOTE: If pregnant or contemplating pregnancy, do not vaccinate. Otherwise, vaccinate (Pregnancy test should be performed when doubts about pregnancy exists).]

**** = Consider immune if: 1) History of physician diagnosed disease, 2) Documentation of laboratory evidence of immunity or 3) Documentation of adequate vaccination. [NOTE: If pregnant or contemplating pregnancy do not vaccinate. Otherwise, vaccinate (Pregnancy test should be performed when doubts about pregnancy exist).] ***** = Preplacement required if not tested within the last 90 days.

A = Mandatory Annually a = Offered Annually M = Mandatory pre-placement O = Offered pre-placement

1 = High Risk Occupations--(Dentists, Housekeeping Personnel, Immunization Technicians, Laboratory Officers, Nurses, Nurse Anesthetists/Midwife/Practitioners, Occupational Therapists, Optometrists, Physical Therapists, Physicians, Physician Assistants, Podiatrists, Psychologists, and Technicians in associated areas).

2 = If IPPD (+) or history of IPPD(+) at pre-placement, Flight Medicine Reviews Medical Record N = No Y = Yes

4.8. HOURS OF PERFORMANCE. The contractor shall provide Exercise Physiologist and Health Fitness Specialist services, Mondays through Fridays 0700-1600 hours.

The contractor is not required to provide services on Federal Holidays and safety/military down days as follows:

New Year’s Day -1 January Martin Luther King Day -3rd Monday in January President’s Day -3rd Monday in February Memorial Day -last Monday in May Independence Day -4 July Labor Day -1st Monday in September Columbus Day -2nd Monday in October Veteran’s Day -11 November Thanksgiving Day -4th Thursday in November Christmas Day -25 December

If these holidays fall on Saturday, the preceding Friday will be observed. If these holidays fall on Sunday, the following Monday will be observed. If a holiday falls on a scheduled service day, the Contractor will be responsible for rescheduling services for the first day post the holiday observance. Additionally, a list of associated non-duty days will be provided through MAJCOM Guidance by the COR annually.

4.9. Base Closures. In the event of a base closure due to weather, exercises, or actual alerts, the contracting officer will inform the contractor’s program manager and provide further instructions. Contractor personnel shall contact the contractor’s program manager for instructions.

4.10. Contractor/Employee Base Pass and Identification, Special Clearances and Vehicle Passes. The Contractor shall comply with all requirements and procedures IAW AFFAR 5352.242-9000, Contractor Access to Air Force Installations. The contractor shall submit the employee listing at the pre-performance conference and to the CO monthly as changes occur. All documentation shall be submitted for identification badges and base access devices to the Visitor Control Center (VCC) after the employee listing has been submitted to the CO.

4.11. Traffic Laws. The Contractor and its employees shall comply with base traffic regulations.

4.12. Weapons, Firearms, and Ammunition. Contractor employees are prohibited from possessing weapons, firearms, or ammunition, on themselves or within their Contractor-owned or privately owned vehicle while on Hurlburt Field, FL.

4.13. For Official Use Only (FOUO). The Contractor shall comply with DoD 5400-7-R, Chapter 4, DoD Freedom of Information Act (FOIA) Program requirements. This regulation sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding FOUO material.

4.14. Reporting Requirements. Contractor personnel shall report to an appropriate authority any information or circumstances of which they are aware may pose a threat to the security of DoD personnel, Contractor personnel, resources, and classified or unclassified defense information.

4.15. Physical Security. The Contractor shall be responsible for safeguarding all government property and controlled forms provided for Contractor use. At the end of each work period, all government facilities, equipment, and materials shall be secured.

4.16. Reporting Full-Time-Equivalent (FTE) Data. The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract via a secure data collection site. The contractor is required to completely fill in all required data fields at the Contractor Manpower Reporting Application (CMRA) site http://www.ecmra.mil (select the US Air Force logo).

4.16.1. Reporting Period. Reporting inputs will be for the labor executed during the period of performance for each Government fiscal year (FY), which runs 1 October through 30 September.

While inputs may be reported any time during the FY, all data shall be reported no later than 31 October of each calendar year. Contractors may direct questions to the CMRA help desk.

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

4.16.3. User Manuals User manuals are available on the front page of the CMRA link at http://www.ecmra.mil

4.17 Safety Requirements and Reports. The Contractor shall perform work in a safe manner as required by OSHA Safety and Health Requirements. Provide a verbal report to the CO as soon as possible of each occurrence of damage to Government property or an accident resulting in death, injury, occupational disease, or adverse environmental impact. Provide a completed copy of required Accident Investigation Reports to the CO within 5 calendar days of each occurrence.

4.18. Computer Security. A National Agency Check with Inquiries must be completed at the government’s expense to conduct a security background check for appropriate security of privacy act information. IAW AFI 33-202V1_AFMCSUP1, dated 30 November 2005, par

4.1.1.1.2. All contractors must have a National Agency Check with Inquiries (NACI) or single scope background investigation (SSBI) prior to granting access to government e-mail, network or computer systems.

4.18.1. Contractor personnel shall complete and e-mail an electronic copy of the SF85, Electronic Personnel Security Questionnaire (EPSQ) file in the ".zdb" format to the Security Manager two weeks prior to commencement of work in the HAWC.

4.19. RELEASE OF MEDICAL INFORMATION. Contractor personnel shall only release medical information obtained during the course of this contract to other HAWC staff involved in the care and treatment of that individual patient.

4.19.1. PRIVACY OF PROTECTED HEALTH INFORMATION

4.19.1.1. (a) Definitions. As used in this clause:

Individual has the same meaning as the term ``individual'' in 45 CFR 164.501 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.

Required by Law has the same meaning as the term ``required by law'' in 45 CFR 164.501.

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

Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103 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 mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Contract.

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

(f) 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.

(g) 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.

(h) 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.

(i) 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.

(j) 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.

(k) 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 the following purposes, if such use or disclosure of Protected Health Information would not violate the Privacy Rule or the Department of Defense Health Information Privacy Regulation if done by the Government: [List Purposes].

Specific Use and Disclosure Provisions:

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

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

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

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

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

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

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

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

CFR 164.522.

Permissible Requests by the Government: The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the Privacy Rule if done by the Government, except for providing

Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause.

Termination:

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

(b) Effect of Termination.

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

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

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

Miscellaneous:

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

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

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

5.0. APPENDICES. All publications, forms, references and report formats can be accessed on-line at http://www.e-publishing.af.mil/. Supplements or amendments to listed publication from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes in publications, which result in a decrease, or no change in the contract price. Prior to implementing any such revision, supplement, or amendment that will result in an increase in contract price, the Contractor shall submit to the CO a price proposal and obtain prior approval. Price proposals shall be submitted within 15 calendar days from the date the Contractor receives notice of the revision, supplement, or amendment giving rise to the increase in cost of performance. Changes in the contract price due to supplements and amendments shall be considered under the FAR 52.212-4, Contract Terms and Conditions - Commercial Items clause. Failure of the Contractor to submit a price proposal within 15 calendar days from the date of receipt of any change, shall entitle the government to performance in accordance with such change, at no increase in contract price.

APPENDIX A: Workload Estimates

The following are estimated hours required in performance of this contract:

Exercise Physiologist 1,920 Hours Health & Fitness Specialist 1,920 Hours