PWS Dosimetrist 31 Aug 10- CS TL IP DBOreview.doc

Performance Work Statement

For

Dosimetrist Services

David Grant Medical Center

Travis AFB, CA

31 Aug 10

TABLE OF CONTENTS

Section No and Title:

Page No.

I.

Description of Services

II.

Service Summary

III.

Government and Contractor Furnished Property and Services

IV.

General Information: Job Specific Requirements

V.

General Information: Contractor General Requirements

VI.

Appendices

A. Applicable Instructions, Directives and Regulations

B. Staffing Requirement/Work Schedule

C. Specific Profile Requirements

D. Specific Requirements Prior to Performance

Performance Work Statement (PWS)

For

Dosimetrist Services

Medical Treatment Facility, David Grant Medical Center

Travis AFB

I. Description of Services

The objective of this service is to provide a qualified, competent Dosimetrist to deliver dosimetry services as identified in this Performance Work Statement (PWS) at David Grant Medical Center (DGMC), hereafter referred to as the "Medical Treatment Facility" (MTF) at Travis AFB, CA. The contractor shall, except as specified in this PWS as government-furnished property and services provide all items and services necessary to perform dosimetry services.

The contractor will be a member of the radiation oncology team. The contractor must possess knowledge of the overall characteristics and clinical relevance of radiation oncology treatment machines and equipment, in addition to being cognizant of procedures commonly used in brachytherapy. Education and expertise necessary to generate radiation dose distributions and dose calculations in collaboration with the Medical Physicists and Radiation Oncologist is required.

The contractor shall comply with all applicable civilian, DoD, MTF and element directives and instructions, to include Joint Commission Health Services Inspection (HSI), and abide by the “Statement on the Scope and Standards of Medical Dosimetry Practice” as found on the Medical Dosimetrist Certification Board web site www.mbcd.org. The terms, “must, “shall” and “will” denote mandatory actions in this PWS.

The contractor shall provide full time dosimetry services during normal duty hours as scheduled by the Government. Care will be provided in Government supplied facilities at the MTF. The dosimetrist shall primarily perform services in radiation oncology. Additional services may include image fusion of Position Emission Tomography (PET)/Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) files in respect to treatment plan dosimetry.

1. Service will include furnishing all labor, teaching, reports and consultation, except as provided in section III Government and Contractor Furnished Property and Services. Services shall cover the range of dosimetry services provided in a civilian practice/hospital of similar size. Performance shall be according to the requirement contained in this PWS and as directed by the Military Medical Physicists Chief (MMPC) or the Radiation Oncology Chief.Specific Tasks:

a. Design a treatment plan by means of computer and/or manual computation that will deliver a prescribed radiation dose and field placement technique in accordance with the Radiation Oncologist’s prescription to a defined tumor volume.

b. Consider dose-limiting structures in the design of treatment plans and document dose in accordance with the radiation oncologist prescription.

c. Coordinate treatment simulations and tumor localization on dedicated devices, including CT, MRI, and PET when indicated, for radiation oncology treatment planning.

d. Supervise, perform, or assist in the planning and production of the fabrication of compensation filters, custom shields, dynamic and physical wedges, and other beam modifying devices as designated by the MMPC.

e. Supervise, perform, or assist in the planning/production of moulds, casts, and other immobilization devices as designated by the NCOIC.

f. Supervise the therapist staff in the implementation of the treatment plan including: the correct use of immobilization devices, compensators, wedges, field arrangement, and other treatment variables as designated by the NCOIC.

g. Perform calculations for the accurate delivery of the radiation oncologist's prescribed dose, document all pertinent information in the patient verification record system, and verify the mathematical accuracy of all calculations using a system established by the medical physicist.

h. Provide physics and technical support to the medical physicist, in radiation protection, quantitative machine calibrations, and quality control of the treatment planning systems and radiation oncology equipment.

i. Supervise, perform, or assist in the application of specific methods of dosimetry including ion chamber, thermoluminescent dosimeter (TLD), or film measurement as directed by the medical physicist.

j. Assist in intracavitary and interstitial brachytherapy procedures and in the subsequent manual and/or computer calculation of the dose distributions of these treatments.

k. Teach all aspects of medical dosimetry to students, medical physics staff and residents, as assigned by the MMPC. The teaching curriculum will be scheduled and structured to include classroom and clinical instruction.

l. Participate in clinical research for the development and implementation of new techniques and new Radiation Therapy Oncology Group (RTOG) protocols.

m. Participate in continuing education in the area of current treatment planning techniques, and advances in medical dosimetry.

n. Perform treatment simulations and all duties associated with the treatment simulation as directed.

o. Participate in quality improvement initiatives, customer service initiatives, chart rounds, and medical readiness activities designed to enhance health services.

p. Contribute to professional environment using appropriate leadership skills.

q. Evaluation and management of emergency problems immediately as they occur. Inform the medical physicist and NCOIC of any problems/errors in treatment planning and/or treatment delivery.

r. Prepare all documentation to meet or exceed established standards of the MTF to include but not limited to, timeliness, legibility, accuracy, content and signature. Only MTF and Air Force approved abbreviations will be used for documentation of care in the health care record.

s. The Dosimetrist will participate in a continual process of self-evaluation and strive for excellence in dosimetry.

t. Attend and participate in meetings, professional staff conferences, and other appropriate professional activities as requested by the assigned unit Physicist or Radiation Oncology Chief during the contract personnel’s scheduled duty hours.

u. Input all necessary information related to billing and workload into ARIA (Radiation Therapy Electronic Medical Record Database)/CHCS II and other computer programs as directed for the performance/accountability of dosimetry.

v. Skills Required:

1. Must be board certified and able to understand the technical aspects of radiation oncology and medical physics to devise computerized treatment plans, and communicate these aspects to the radiation oncologist for plan approval, and to the radiation therapist for plan implementation.

2. Perform routine duties independent of supervision, but consults with the radiation oncologist and medical physicist as required.

3. Operate and perform quality assurance, under the direction of the medical physicist, on the treatment planning computer.

4. Has working knowledge of radiation safety and current rules and regulation of the Nuclear Regulatory Commission.

5. Has the ability to interpret and execute treatment plans as defined in relevant treatment protocols.

6. Must possess mathematical skills including algebra, trigonometry, and introductory calculus and be able to visualize objects in three-dimensional image space to facilitate the treatment planning process.

7. Must possess knowledge of On Board Imaging (OBI) systems, Intensity Modulated Radiation Therapy (IMRT) plans, Stereotactic Radiation Surgery (SRS) systems, High Dose Rate (HDR) Brachrytherapy systems, and optimization of Volume Modulated Arc Therapies (VMAT) II. Service Delivery Summary

The service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. The thresholds are critical to mission success and the percentages shown indicate acceptable (satisfactory) performance.

Specific Tasks a., b., c., g.

100%

Specific Tasks d., e., f., n.

100%

Specific Tasks h., i.

100%

Specific Tasks j.

100%

Specific Tasks u.

100%

III. Government and Contractor Furnished Property and Services:

1. Property and Services: The Government will furnish facilities and equipment at the MTF for the contractor to effectively perform dosimetry services in accordance with the PWS. Contractor and government representative shall certify their agreement as to the working order of the equipment within 15 days of contract start. The MTF will provide all required preventive maintenance on Government-owned equipment. Telephone and computer equipment use will be for official use only IAW applicable DOD and Air Force Instructions. The contractor shall have the use of the following facilities for performance under this contract only:

a. Property: Office area provided for contract manager will appear in an orderly appearance. Contract personnel shall ensure these areas are tidy and any decorative items present a professional, modest appearance in keeping with accepted community standards. Office space will be shared with other members of the medical team. The government will not be responsible for loss or damage of personal items brought into the MTF.

b. Refuse collection: Office trash cans are emptied per MTF protocol.

c. Recyclable materials: Recyclable materials will be collected on a regularly scheduled basis. Recyclables include white paper, glass and cans.

d. Issued Items: The MTF will provide a nametag for the purposes of identifying the employee and Personal Protective Equipment (PPE) i.e., protective gloves. This does not include any type of uniform or laboratory coat.

e. Security Forces and Fire Protection: Phone Numbers: Non-Emergency Fire Department: 424-3683, Non-Emergency Security Police: 424-3293. Emergencies (all): 911

f. Utilities: The government will provide gas, electricity, sewage disposal, and water.

g. Equipment: On site equipment includes one class A telephone per desk and one desktop computer.

h. Installation equipment and services: This will include, but is not limited to, copy and fax machines, Defense Switching Network (DSN) lines and a medical library. The same restrictions to utilize these items for Government official business apply to the contractor. The Government will provide training on Government equipment and initial facility orientation.

i. Supplies: The MTF will provide commonly used non-medical supplies to include pens, paper, stapler, calendar, and required government forms used in the performance of services.

j. Dining Facilities: The contractor personnel will be allowed to use the hospital dining facilities while on duty.

k. Emergency Health Care. The MTF will provide emergency health care to save loss of life or limb and preserve undue suffering for contract personnel for injuries or illness occurring while on duty in the MTF. These services shall be billed to the contractor at the current full reimbursement rate.

l. The government will provide CHCS II/ALTA training /or other procedures that the medical activity’s staff is required to use. Access to such patient data systems is an “Automated Data Processing Sensitive” position requiring compliance with AFI 41-210 (Chapter 2) and Air Force Systems Security Instruction (AFSSI) 5027. Time will not be billable to the Government.

m. The Government will provide a briefing to familiarize contract personnel with the policies and procedures of the MTF. Orientation will occur at the onset of employment at the MTF; attendance will be mandatory for all contract personnel. Time will not be billable to the Government.

IV. General Information: Job Specific Requirements

1. Education, Training and Professional Requirements

a. Must be a graduate of a formally recognized hospital or a college affiliated Medical Dosimetry program with clinical and classroom curriculum, and other training and /or experience as a Medical Dosimetrist so that the total duration of study, training and experience is at least 18 months, OR

b. Must possess a Bachelor of Arts or Bachelor of Science degree with a major in the physical or biological sciences, or be a Registered Radiation Therapy Technologist. Together with either of these credentials, the applicant must also demonstrate completion of two or more years on-the-job training and work experience in medical dosimetry under the supervision of a Certified Medical Dosimetrist or Medical Physicist, OR

c. Must possess an Associate of Science, a Bachelor of Arts or a Bachelor of Science degree in a field other than those of the physical or biological sciences. Together with this degree, the applicant must also demonstrate completion of on-the-job training in medical dosimetry under the supervision of a Certified Medical Dosimetrist or Medical Physicist and have a subsequent period of supervised work experience in medical dosimetry of a minimum of four years.

d. Must be certified by the American Association of Medical Dosimetrist (AAMD) or the Medical Dosimetrist Certification Board (MDCB).

2. Validation of Qualification, Licensure and certification

a. The contractor must provide documentation on the above licensure and certification.

b. A copy of the proposed contract personnel professional resume, indicating experience, training, and technical expertise in the type of care to be rendered.

c. A signed consent for release of information.

3. English Language Requirement. Contract personnel shall read, understand, speak, and write English.

4. The contractor is required to begin full performance of the contract requirements within 15 days after contract award.

5. If the Dosimetrist has ever been a defendant or the subject of a malpractice liability claim, settlement, judicial or administrative adjudication, or any other resolved or open charges or inappropriate, unethical, unprofessional, or substandard care, then the Dosimetrist shall provide information regarding the actions(s). The Dosimetrist shall indicate if the action(s) were settled prior to final court action; judgment rendered by a court, defendant found liable; or if the matter is still pending for each action. In any of the above cases, if the defendant was not exonerated, the malpractice history will be considered unsatisfactory and is an exclusionary item.

6. Prior to commencement of work, certification will be provided as part of Appendix D, “Requirements Prior to Performance.” 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. Contracted personnel engaged to provide direct patient care should have no physical limitations to provide care to include, but not limited to strenuous bending, lifting, and standing for several hours per shift. The certification shall also contain the following statement: "(name of contract employee) is suffering from no contagious diseases to include, but not limited to, Tuberculosis, Hepatitis, and Venereal Disease” SEE APPENDIX D." Additionally, as a condition of employment, Occupational Safety and Health Administration (OSHA) requires that all contract personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, receive the 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 anytime and receive the Hepatitis B vaccine without penalty. It is the Contractor's responsibility to report (to the appropriate MTF staff member) all information necessary to assure hospital records can be maintained correctly, and therefore comply with the JCAHO, OSHA, and Center for Decease Control (CDC) health records requirements.

7. Indemnification and Medical Liability Insurance: The Contractor will provide and maintain adequate liability insurance coverage consistent with the risks associated with the performance of all services required by this PWS. Refer to Federal Acquisition Regulation (FAR) Clause 52.237-7, "INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE"

8. Medical Quality Assurance/Risk Management (QA/RM): Contract personnel will participate in QA/RM activities to the extent required by AFI 44-119 and the individual MTF QA/RM plan or instruction.

9. Orientation: Contractor will participate in the MTF orientation procedures for newly assigned personnel to include regulations specific to their professional specialty, MTF, and Air Force policy and procedures.

10. The contractor will comply with and attend Government provided annual training that will include topics such as compliance, patient safety, performance improvement, risk management, infection control, fire protection, security, patient sensitivity training, automation processing, and local in-service and safety briefings.

11. Continuing Education (CE) Requirements: the contractor will maintain CE’s commensurate with his/her professional licensure and certifications. CE’s shall be obtained at no additional cost to the Government and shall be reported to the MMPC to be placed in their competency assessment folder as earned. At the discretion of the MMPC or NCOIC, the Government may grant five days for attaining these requirements at national or local meetings. These days must be coordinated with the military medical physicist and requests should be submitted with scheduled absence requests.

12. Off-site visits to other clinics or equipment/software manufacturers as requested by the Chief Physicists. There shall be no costs incurred by the Government except for payment of time to equal time spent during normal duty hours. The off-site visit must be related to radiation oncology and deemed necessary for the continuation or advancement of radiation oncology care at the MTF.

13. Procedure Guidance: The contractor will perform procedures compatible with the MTF’s operating capacity and equipment. New medical procedures/services will not be introduced without prior recommendation to, and approval of, the MTF commander or authorized representative.

V. General Information: Contractor General Requirements

1. In the event of an adverse action, the contracting officer (CO) and the contractor shall be notified by the QAP as soon as possible when the necessity to exercise such authority becomes apparent. The QAP will also provide the contracting officer and the contractor with a written statement advising the contractor of an adverse action involving a health care provider, a brief statement of the basis for the action to provide the contractor sufficient information in order to make employment substitution decision as necessary, and if required, the final outcome of the adverse action process. The written notice will be marked by government as covered by 10 USC 1102. No other information pertaining to the adverse action will be released without MTF/CC permission.

2. CONTINUING MEDICAL EDUCATION (CME) REQUIREMENTS: Health care providers, licensed registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current as prescribed in AFI 44-117, Medical Service Officer Education. CME shall be obtained at no additional cost to the Government and shall be reported to the MTF Credentials Committee annually on the first normal duty day in January or previous calendar year.

2.1. Health care providers shall be in good standing, and under no clinical restrictions, with state licensure board in any state in which a license is held or has been held within the past 10 years.

2.1.1. Health care providers shall maintain current certification in required training as stated in contract.

2.1.2. Health care providers shall be current with and have completed all continuing education requirements specified by their professional licensure or certification.

3. HEALTH REQUIREMENTS

3.1. In accordance with AFI 48-105, all Medical Support Service Personnel shall follow the methods for controlling of diseases as described in the American Public Health Association publication, Control of Communicable Diseases Manual, and the Centers for Disease Control and Prevention (CDC) publication, Morbidity and Mortality Weekly Report (MMWR) and its supplements. Where applicable, the most recent guidelines from these publications are utilized as the standard. Before start of work, contracted staff shall provide proof of immunization for the following diseases according to the CDC guidelines: Hepatitis B, measles, mumps, rubella varicella, and influenza. The contracted employee shall also provide proof of a negative TB skin test within 12 months (if positive, proof of negative chest X-ray within 12 months) prior to start of work. After start of work, the Government will provide post blood borne exposure protocols according to applicable AFIs. In those areas where there is a higher risk of transmission of tuberculosis, contracted staff will be tested as frequently as directed by the MTF policy. This test will be provided by the MTF. Immunization information will be tracked in DoD computer systems for all contracted staff. No medical tests or procedures required by the contract may be performed at the MTF (with the exception of Tuberculosis testing after start of work). Expenses for all required tests and/or procedures shall be borne by the contractor at no additional expense to the Government.

4. MTF REQUIREMENTS. The contractor shall insure compliance with completion of all MTF specified orientation program(s), initial and annual training requirements, and comply with all MTF policies, procedures, productivity standards and instructions as provided by the MTF.

5. ENGLISH LANGUAGE REQUIREMENT. The contracted employees shall read, understand, speak and write “English” properly.

6. CONDUCT. The Contracting Officer may request that any contracted employee or contract personnel whose conduct in the opinion of the Contracting Officer interferes with proper order or professionalism at the installation where services are performed, be removed from such installation and the contractor will comply with such request. Failure to do so may be cause for action under the Termination clauses.

6.1. Contractor shall not employ individuals who are potential threats to health, safety, security general well being or operational mission of the Department of Defense (DoD) and its population. This shall include individuals who are a potential threat because of prior felony convictions..

6.2. The contractor is responsible to ensure all government-issued identification badges, keys, equipment and car passes are returned to the QAE when an individual’s is leaving employment under this contract.

7. DRESS AND APPEARANCE: Contract personnel will maintain good personal hygiene and a well groomed, professional appearance. Business casual dress attire is appropriate for the majority of the positions. If a specific position requires the wearing of a uniform (i.e., scrubs, etc), it will be detailed in the individual position description. Unless otherwise identified, required uniforms will be provided by the contractor.

8. SECURITY REQUIREMENTS. Travis Air Force Base is designated as a closed base. In order to promote security and safety, all contractors desiring access must adhere to installation entry requirements, to include, Criminal Background History (CBH) checks, National Crime Information Center (NCIC) wants/warrants checks and California Law Enforcement Telecommunication System (CLETS) driver license history checks. A CBH check is not required for contractors if they have a current favorable government security clearance which can be verified through the Joint Personnel Adjudication System (JPAS). Contractors are divided into two categories to ensure proper screening and to minimize installation access delays as follows:

· Category 1 (Cat-1) contractors are the primary and some sub-contractors who are identified against a contract prior to the contract performance start date.

· Category 2 (Cat-2) sub-contractors and affiliate workers not previously identified against a contract prior to the contract performance start date.

Contractors will ensure all Cat-1 and Cat-2 contractors possess proper credentials allowing them to work in the United States. Additionally, contractors will ensure illegal aliens are not employed and/or transported onto the installation. The contractor shall not be entitled to any compensation for delays or expenses associated with complying with the provision of this clause. Furthermore, nothing in this clause shall excuse the contractor from proceeding with the contract as required.

Criminal Background Checks. Cat-1 and Cat-2 contractors whose criminal background meets any of the following 12 disqualifiers will not be allowed installation access. All Cat-1 and Cat-2 contractors will be adjudicated based on the following disqualifying base access criteria:

· U.S. citizenship, immigration status, or social security account number cannot be verified.

· Barred from entry/access to any military installation or facility.

· Wanted by federal or civil law enforcement authorities, regardless of offense or violation.

· Name appears on any federal agency’s list for criminal behavior or terrorist activity.

· Convicted of espionage, sabotage, treason or terrorism.

· Incarcerated for 12 months or longer within the past three years, regardless of offense or violation.

· Convicted of a firearms or explosives violation within the past three years.

· Convicted of illegal possession or use of drugs/narcotics on more than one occasion

· within five years from the date access to Travis AFB is requested.

· Convicted of an offense involving drug trafficking, possession with intent to sell or drug

· distribution within 10 years from the date access to Travis AFB is requested.

· Convicted of a felony involving violence against a person, arson, robbery or burglary within five years from the date access to Travis AFB is requested.

· Required to register as a sex offender under federal law or the applicable state law.

· Convicted of any crime involving indecent acts with a minor or a felony that is sexual in nature.

Cat-1 and Cat-2 contractors adjudicated and cleared under the disqualifying criteria are considered cleared for installation access for a two-year period regardless of the number or length of contract; thereafter, a renewal is required. During the two-year period, Pass and Registration or the Visitor Control Center will perform random samplings of CBH, NCIC wants/warrants and CLETS driver license history checks of contractors already cleared. Cat-1 and Cat-2 contractors with disqualifying base access information will be issued a barment letter immediately revoking their base access privileges. Cat-1 and Cat-2 contractors requesting to contest the adjudication, barment, or requesting a waiver/exception to policy must submit a written rebuttal/request within 10 business days of receipt of the barment letter to 60 AMW/CC, through 60 SFS/CC, Attention: 60 SFS/S5R, Bldg 381, 540 Airlift Drive, Suite C-101, Travis AFB 94535-2451.

Primary Contractor Responsibilities. The primary contractor will be responsible for the conduct of all Cat-1 and Cat-2 contractors working under that contract. Additionally, the primary contractor will:

Coordinate Cat-1 and Cat-2 base entry requirements with the 60th Contracting Squadron.

Advise Cat-1 and Cat-2 contractors requesting base access on requirement to complete, sign and submit a Travis Form 251, Consent for Background Check. Forms are available at Pass and Registration, Visitor Control Center or the AF Portal e-publishing website. Any Cat-1 or Cat-2 contractor who does not complete or sign the form will be denied installation access.

Advise Cat-1 and Cat-2 contractors that the badge/pass is only valid for the purpose, person and vehicle for which it was issued. Use of the badge/pass for any other purpose or by any other person will result in the pass being confiscated. Cat-1 and Cat-2 contractors that misuse their pass may face revocation of installation access privileges and/or barment actions. If a pass is lost, notify the Pass and Registration Office immediately.

· To obtain a pass, personnel will need a valid state or government photo identification.

· To obtain a vehicle pass, personnel will need a driver license, registration and insurance.

Provide written notification, within one week, to the 60th Contracting Squadron of any changes in Cat-1 or Cat-2 contractor status. This includes, but is not limited to, the contractor being fired or quitting their position with the company.

Retrieve government issued personal and vehicle passes from Cat-1 and Cat-2 contractors which no longer need installation access upon termination of the contract. Passes will be turned into the Pass and Registration Office, Bldg 599.

Processing Cat-1 Contractors. Provide an EAL (Entry Authority List) of all Cat-1 contractors on company letterhead which require a badge/pass. All requests for a badge/pass will be submitted through the Base Contracting Office NLT 45 days prior to the contract start date. Exceptions will be made for short-notice contracts where the award date and performance start date are less than 45 days. A badge/pass will be issued for a maximum of one year. Prior to renewing a badge/pass, return the old badge/pass to the Pass and Registration for destruction. Ensure the EAL includes:

· Contract number

· Work site or location

· Inclusive dates of the contract

· Work schedule (include days of the week and time periods contractors are on base)

· Contractor’s full name, date of birth, and social security number

When the EAL is submitted, ensure a TAFB Form 251, Consent for Background Check, is attached for each person.

Processing Cat-2 Contractors. Only persons who have undergone a CBH and are clear of disqualifying base access information can serve as a sponsor. Persons appointed as sponsors will meet Cat-2 contractors at the Visitor Control Center, and ensure they complete Travis Form 251, Consent for Background Check.

Restricted Area Badges. Cat-1 contractors may be submitted for unescorted entry into restricted areas if required for their contract. Contact the security manager for the military agency responsible for the project.

Escort Requirements. The following escort requirements apply:

Installation. Cat-2 contractors must be escorted at all times.

Controlled/Restricted Areas. Cat-1 contractors [not in possession of a restricted area badge] and Cat-2 contractors will be escorted at all times when working within controlled, restricted or other sensitive areas. Escorts can be either the military agency responsible for the project or a Cat-1 contractor [if in possession of a restricted area badge]. The military agency or Cat-1 contractor shall follow existing procedures and instructions for obtaining entrance to controlled, restricted and sensitive areas.

Lost Base Passes or Restricted Area Badges.

Base Passes. The supervisor of Cat-1 and Cat-2 contractors will investigate and provide written notification for a lost base pass to the 60th Contracting Squadron. Written notification should include an explanation from the contractor on how, when, where and what steps have been taken to locate the missing base pass. If a replacement is needed, forward the notification with the request for a base pass.

Restricted Area Badges. Cat-1 contractors issued a restricted area badge must report the loss immediately to the security manager of the military agency that submitted the restricted area badge request. The individual who lost the restricted area badge will provide a written explanation on how, when, where and what steps have been taken to locate the missing base pass. The security manager will conduct their own inquiry and forward a report of investigation [with squadron commander endorsement], the member’s written explanation and the original AF Fm 2586 to the Pass and Registration office. A new RAB cannot be reissued until the investigation is complete.

Increased Force Protection Condition (FPOCON). During FPCON Normal, Alpha and Bravo; Cat-1 and Cat-2 contractors without a base issued badge/pass must be sponsored onto the installation. During FPCON Charlie and Delta the base will curtail non-essential operations/functions and non-essential Cat-1 and Cat-2 contractors will be suspended at the direction of the Installation Commander. All Cat-1 and Cat-2 contractors attempting installation access; thereafter, will be physically escorted unless FPCON Mission-Essential designation has been approved in advance and is indicated on the badge/pass.

Identification Common Access Card (CAC). Cat-1 contractors requiring computer access must submit a request through the security manager for the military agency responsible for the project. The security manager will facilitate registration within Contractor Verification System. The QAP is designated as the sponsor and will assist with this process. Once issued, the CAC card must be in the contractors possession at all times while on base and performing official duties.

9. SECURITY REQUIREMENTS – MEDICAL TREATMENT FACILITY

a. ADP Security Requirements. Since the contract employees under this contract have access to and/or process information requiring protection under the Privacy Act of 1974, these positions are considered “ADP Sensitive” positions. Compliance with DoD Directive 5200.28, DoD 5200.2-r and AFI 33-119, is mandatory for ADP Sensitive positions.

b. Common Access Cards (CACs). Cat-1 contractors requiring computer access must submit a request through the security manager for the military agency responsible for the project. The security manager will facilitate registration within Contractor Verification System. The QAP is designated as the sponsor and will assist with this process. Once issued, the CAC card must be in the contractors possession at all times while on base and performing official duties. The contractor shall advise their employees that a favorable background investigation is needed as a condition of employment under this contract.

10. DoDI MISSION ESSENTIAL CONTRACTOR SERVICES DURING CRISIS. These services are designated as mission essential.

11. TRAINING REQUIREMENTS. The Corporate Contractor Management Staff shall ensure that personnel are trained before arriving to the MTF. Maintain complete and accurate training records of Medical Support Service Personnel, ensure that annual training (i.e. HIPAA, CPR, Information Assurance,) is completed before expiration and that new mandatory training is completed within timeframes designated by the Air Force.

12. The contractor shall ensure that all Medical Support Service Personnel receive initial CHCS/AHLTA, (Composite Health Care System, Armed Forces Health Longitudinal Technology Application) Privacy Act, Information Assurance and HIPAA training through MHS Learn.

12.1. Cost associated with all initial training shall be included in the offer or’s fully burdened hourly rates.

12.1.1. Using MHS Learn as the platform and training instrument, the Contractor trainers will facilitate, monitor and validate training of Medical Support Service Personnel as required by each position and duty assignment according to the required curriculum established by MTF (i.e., log on, mailbox, MCP, ADM and specific modules within the computer system applicable to duties, etc.).

12.1.2. For each Contracted Employee trained for placement, the contractor shall submit evidence of training completion and competence assessment to the MTF Security Manager before he or she is granted access to Government computer information systems by the requesting location authority.

13. PHYSICAL REQUIREMENTS. Any specifications regarding physical requirements will be in the position descriptions. In most cases, the positions or services do not require any unusual physical demands. The majority of time is spent stationary at a desk and computer terminal. However, the position descriptions may describe prolonged sitting, walking, bending, and ability to carry up to a specified weight or capability to reach high shelving units with the assistance of step ladders to retrieve and file medical records.

14. RECORDS, FILES, DOCUMENTS, DATA, AND WORK PAPERS. All records, files, documents, data and work papers provided by the government remain Government property. The Quality Assurance Evaluator (QAE) will provide guidance to the contract personnel who shall maintain and dispose of these records, files, and documents in accordance with AFI 33-364, and IAW applicable HIPAA requirements stated in Section H, Para H-7. Contracted personnel will comply with all AFMS requirements for safe keeping, handling, release, and disposal of any of the above information. These AFMS requirements shall include, but are not limited to: limiting access to Government data, tracking information from origin to disposal, removal of personal identifiers and thoroughly destroying information when work is completed according to Federal Law and DoD regulations. If data is used or transmitted outside Government facilities, the contractor shall be responsible for all aspects of physical and operational security. Inside government facilities, the Contractor shall be responsible for following DoD and local directives regarding physical and operational security. Under no circumstances may any information or data used under this Contract be transferred, or work under this contract be performed, outside the United States. The contractor shall comply with AFI 33-322, Records Management Program, paragraphs 7 and 10; DoD Regulation 5400.7_Air Force Supplement, Freedom of information Act, and AFI 33-332, Privacy Act Program. Disposition of records shall be in accordance with Air Force Records Information Management System (AFRIMS) schedule found on the Air Force Portal, or go to the AF Link at https://www.my.af.mil/gcss-af61a/afrims/afrims/ or use the Portal A-Z Applications List to locate the AFRIMS link. The Quality Assurance Evaluator (QAE) will review all records, paper and electronic, to ensure requirements of the Records Management Program, Freedom of Information Act Program, and Privacy Act Program, are met.

14.1. The contractor shall comply with the Privacy Act of 1974 (the Act) and AFI 33-322, the Air Force Privacy Act Program and the agency rules and regulations issued under the Act in the design, development operation of any system of records. Operation of a system means performance of any of the activities associated with maintaining the system of records, including the collection, use and dissemination of personal information. Systems of Records on individuals are defined as a group of any records under the control of an agency from which information is retrieved by the name of the individual or by some identifying number, symbol or other identification unique to the individual.

14.1.1. All records generated during the performance of the contract are considered Government records and shall be turned over to the Government upon termination of the contract.

14.1.2. Records are considered to be all books, papers, maps, photographs, machine-readable materials or other documentary materials, regardless of physical form or characteristics, made or received by any agency of the government under federal laws, or in connection with the transactions of public business, and preserved or appropriate for preservation by any agency, or its legitimate successor, as evidence of the organization, functions, policies, decisions, procedures, operations or other activities of the government or because of the informational value of data in them. This includes all electronic records, which must meet the requirements of DODSTD50152.

14.1.3. The contractor shall create and maintain FOUO material in compliance with the Freedom of Information Act (FOIA) Program requirements. FOUO information may be disseminated between the Air Force and contractors as necessary in the conduct of official business. During working hours, reasonable steps should be taken to minimize risk of access by unauthorized personnel. After working hours, FOUO information shall be stored in unlocked containers, desks or cabinets if government or government-contract building security is provided, or in locked desks, file cabinets, bookcases, locked rooms, or similar items. FOUO documents and material may be transmitted via first-class mail, parcel post or -- for bulk shipments -- fourth-class mail. Electronic transmission of FOUO information (voice, data or facsimile) should be by approved secure communications systems whenever practical. Record copies of FOUO documents shall be disposed of in accordance with 44 U.S.C. Chapter 33 and records management directives. Non-record FOUO documents may be destroyed by shredding in such a manner so the information is unidentifiable. This regulation sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding FOUO material. When documents containing FOUO material are authorized for destruction, shred the records so that the pieces cannot be reconstructed. Degauss or overwrite magnetic tapes or other magnetic media. Proper records maintenance and disposition shall be IAW with the Records Disposition Schedule available on the Web RIMS website at https://www.my.af.mil/gcss-af61a/afrims/afrims/ or use the Portal A-Z Applications List to locate the AFRIMS link. The Quality Assurance Evaluator (QAE) will review all records, paper and electronic, to ensure requirements of the Records Management Program, Freedom of Information Act Program, and Privacy Act Program, are met.

14.1.4.

Patient Lists: Patient lists, no matter how developed, shall be treated as privileged information. Add the following to the bottom of all patient lists: “FOR OFFICIAL USE ONLY.” This document contains information exempt from mandatory disclosure under the Freedom of Information Act (FOIA). Title 5 U.S.C 552 (b) (6) apply. Personally identifiable information (i.e. Names, Date of Birth, Place of Birth, and SSN) of patients shall not be disclosed or revealed in any way for any use outside the MTF without prior written permission by the Chief of Hospital Services.

14.1.5.

Privacy Act Program: The contractor shall create and maintain Privacy Act data IAW AFI 33-333. IAW 33-129, Transmission of Information Via the Internet, paragraphs 7.4, 8.2.3, 16 and 17 and supplements; AFI 33-201, Communications security (COMSEC), Table 1; AFI 33-332, Air Force Privacy Act Program, paragraphs 1.4.7, 1.4.8, 3.3.3, Chapter 7, Chapter 9, Chapter 10 and supplements and Privacy Act systems of records notice(s), which are posted on the internet at (http://www.defenselink.mil/privacy/notices/usaf). The contractor shall not create or maintain a Privacy Act system of records prior to public notice. If the contractor receives a Privacy Act request, the contractor shall be responsible for searching for the records and providing those records to the government official who, as authorized official, will make the decision on releasing government records.

14.1.6.

DoD Freedom of Information Act (FOIA) Program: If the contractor receives a FOIA request the contractor shall immediately hand-carry it to the base FOIA manager for processing. The FOIA manager will task a government official. When tasked, the contractor shall be responsible for searching for the records and providing those records to a government official who, as the authorized official, will make the decision on releasing government records.

14.1.7. Functional Requests: A written request for DoD records that does not cite either the FOIA or Privacy Act may be received from any person (including a member of the public), or organization, or a business. The contractor shall be responsible for searching for the records and providing those records to a government official who, as the authorized official, will make the decision on releasing Government records.

15. CONTRACTOR IDENTIFICATION: All contractor management staff or contracted employee shall clearly be identified as such at ALL times, including conversations, mail, email, faxes, and/or other electronic communication whether with government personnel, other contractor personnel, or with public when supporting this contract. Likewise, the contractor shall abide by all applicable laws and regulations when using government equipment and services in performance of this contract. As a minimum, contractor management staff or contracted personnel shall clearly identify themselves as contractors by: wearing badges which clearly and legibly identify the employee as a contractor; using the label “contractor” in email addresses in accordance with Federal Acquisition Regulation (FAR) 37.114, Special Acquisition Requirements; opening ALL phone conversations with a statement materially the same as, [office name], I am [employee name], a [prime contractor’s company name] employee” including the employing contractor’s name in the letterhead and/or signature block of any written correspondence; and any other means necessary. Contractor-supplied badges shall be worn by contractor management staff and contracted personnel, will be visible at all times, and at a minimum, will state: CONTRACTOR, the employee’s full name, employing company’s name, and position (i.e., CONTRACTOR, Jane A. Doe, XYZ Company, Medical Transcriptionist). Both the MTF-issued identification badge and the contractor badge shall be worn above the waistline during the individual’s duty hours.

16. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996. HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The medical facilities of the military services and the 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. This clause serves as that agreement 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…