FA4484-16-T-0008.doc

Section SF 1449 - CONTINUATION SHEET

Chiropractor

FFP

Provide Chiropractic services in accordance with the attached PWS.

FOB: Destination

SIGNAL CODE: A

NET AMT

Chiropractor Assistant

FFP

Provide Chiropractic Assistant services in accordance with the attached PWS.

NET AMT

FFP

Provide Chiropractic services in accordance with the attached PWS.

NET AMT

FFP

Provide Chiropractic Assistant services in accordance with the attached PWS.

NET AMT

FFP

Provide Chiropractic services in accordance with the attached PWS.

NET AMT

FFP

Provide Chiropractic Assistant services in accordance with the attached PWS.

NET AMT

FFP

Provide Chiropractic services in accordance with the attached PWS.

NET AMT

FFP

Provide Chiropractic Assistant services in accordance with the attached PWS.

NET AMT

FFP

Provide Chiropractic services in accordance with the attached PWS.

NET AMT

FFP

Provide Chiropractic Assistant services in accordance with the attached PWS.

NET AMT

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

DELIVERY INFORMATION

21-JUL-2017

SSGT QUINSHAN DAIS

3458 NEELY ROAD

MCGUIRE AFB NJ 08641

609-754-9309

F3A4S9

21-JUL-2017

F3A4S9

21-JUL-2018

F3A4S9

21-JUL-2018

F3A4S9

21-JUL-2019

F3A4S9

21-JUL-2019

F3A4S9

21-JUL-2020

F3A4S9

21-JUL-2020

F3A4S9

21-JUL-2021

F3A4S9

21-JUL-2021

F3A4S9

EXTERNAL ATTACHMENTS

The following documents are provided external to this solicitation:

1. Joint Commission on Accreditation of Healthcare Organizations (JAHCO) Guidance on Use of Internet to Primary Source Verify (PSV) Credentials

2. List of Clinical Privileges – Chiropractic

3. Air Force (AF) Information Management Tool (IMT) 1540, Application for Clinical Privileges/Medical Staff Appointment

4. AF IMT 1541, Credentials Continuing Health Education Training Record

5. AF IMT 1562, Credentials Evaluation of Health Care Providers

6. Burlington County Wage Determination No. 2005-2449 Revision No. 17

7. Joint Base McGuire-Dix-Lakehurst Security Forces Appendix

8. Antiterrorism Statement

PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT

CHIROPRACTOR AND CHIROPRACTOR ASSISTANT

AT

JOINT BASE MCGUIRE-DIX-LAKEHURST, NJ

1. DESCRIPTION OF SERVICES: The Government requires one full-time equivalent (FTE) Chiropractor and one FTE Chiropractor Assistant for this performance work statement. Contractor personnel shall work at the Joint Base McGuire-Dix-Lakehurst, NJ medical treatment facility, Building 3458. Performance shall be in accordance with the requirements contained in this PWS and professional standards of the Joint Commission (JC).

1.1 CHIROPRACTOR

1.1.1 QUALIFICATIONS: Must hold a current, unrestricted license to practice as a Doctor of Chiropractic in any one of the fifty States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S. Virgin Islands.

Must possess a degree from a chiropractic college accredited by the Council on Chiropractic Education.

Must have at least 24 months within the last 36 months for both diagnostic and treatment services as a Chiropractor.

1.1.2 TYPE OF WORK: The duties include but are not limited to the following:

Must be able to perform standard osseous and soft tissue procedures only, as commonly taught in Chiropractic College accredited by the Council on Chiropractic Education.

The contractor is responsible for delivery of treatment within the personnel and equipment capabilities of the medical treatment facility (MTF), provision of mandated medical surveillance and preventive services and the quality and timeliness of treatment records and reports required to document procedures performed and care provided.

Must employ and record every measure of observation that will more substantially profile the patient during the initial patient interview and consultation.

Shall conduct a patent history and chiropractic physical examination (excluding vaginal examination) as clinically indicated.

Must utilize X-ray and standard laboratory tests appropriate to the chiropractic diagnosis and within the MTF's capabilities as detailed by the standard MTF operating procedures. Radiological examinations shall be limited to musculoskeletal radiographs, skull series, chest (PA and lateral views) and rib series. MRI and CT studies of the spine and Bone Scans may be ordered following protocols established by the Surgeon General of Hospital (SGH) or Medical Group Operating Instruction. Lab tests shall be limited to SMA6, UA/C&S, Occult Blood, Erythrocyte Sedimentation Rate and Complete Blood Count.

Shall utilize the modalities of heat, cold, light, electricity, sound and exercises in patient treatment area.

Shall provide patient instructions and recommendations in all matters pertaining to hygiene, nutrition, exercise and life style changes and ergonomic factors in the activities of daily living.

Refer patients to specialty services available at the MTF.

Orient, instruct, direct, and evaluate work activities of clinical support staff.

Plan and conduct lectures and training programs on chiropractic related subjects for staff, students and patients. The HCW shall teach, conduct or participate in seminars concerning the basic and/or clinical sciences of chiropractic if requested by the Government.

Order orthotics, lifts, collars, and lumbar sacral supports if available at the MTF.

Place active duty patients on limited duty status (profile) according to MTF policy.

Document, on forms provided by the MTF, actions taken such as patient history, patient evaluation, treatments/adjustments, unusual occurrences, and morbidity in accordance with the standard MTF operating procedures.

Participate in weekly meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist.

Attend annual renewal of the following Annual Training Requirements: family advocacy, disaster training, Sexual Harassment, and other courses as directed.

Utilize Government computer systems technology for data input and retrieval (orders, lab results).

1.2 CERTIFIED CHIROPRACTIC ASSISTANT, (CA)

1.2.1 QUALIFICATIONS: Must possess an Associates of Science Degree in Chiropractic Technology or be a Certified Chiropractic Assistant.

Must have a working knowledge in Chiropractic theory, techniques and procedures.

Must have at least 1 year of experience within the last 36 months in a Chiropractic setting. Performing chiropractic activities in the care and treatment of patients, operating and maintaining chiropractic therapeutic equipment, and assisting in chiropractic treatment.

Must have knowledge in medical terminology, anatomy and physiology; emergency medical treatment to include cardiopulmonary resuscitation, aseptic technique, medical ethics, legal aspects and risk management.

1.2.2 TYPE OF WORK: The duties include but are not limited to the following:

Performs a variety of duties to carry out treatments prescribed for patients as a result of injury; surgery; respiratory, cardiac, and/or aging conditions.

Interviews patients and obtains detailed medical and demographic information preliminary to the chiropractic treatment plan. Records age, sex, military status or affiliation and similar demographic data. Develops questions to illicit details of patient condition such as: nature and mechanism of injury; single or multiple conditions, prior treatment, medications, x-ray results, and activities which exacerbate and mitigate symptoms. Recognizes specific details during discussion with patient for implication of pathology problems.

Performs portions of Chiropractic treatment, diagnostic, and therapeutic procedures in accordance with established policies, procedures, and protocols. Records treatment and procedures rendered, and observes effects. Identifies patient problems and accurately notifies Chiropractor.

Performs paraprofessional portions of prevalent health assessments and physical examination when required.

Provides physiotherapy treatments/procedures, to include ultrasound, electrical stimulation, vibration massage, heat, cold, transverse friction massage, trigger point therapy, and PNF stretches.

Immediately report hazardous or malfunctioning equipment to the chiropractor.

Ensures adequate supply of hot packs, ice packs, towels, ultrasound gel, proper levels of water in hydrocollator, table paper, brochures, etc. in treatment rooms are sufficient quantities in reserve in stockroom. Order supplies as necessary to maintain prescribed quantities.

Prepares and positions patients for examinations and treatments.

Maintains outpatient medical records. Prepares and submits administrative reports.

Manage appointment schedules for chiropractor. Assist the chiropractor with appointment templates and manage the clinic appointment system. Must close out the automated clinic support systems at the end of the clinic work day.

Answer telephones and direct patient inquiries appropriately.

Request medical records, x-rays, and test results from appropriate clinics and hospital departments.

Maintain documentation regarding records request, records release, supplies ordered and new patient’s schedules.

2.0 GENERAL INFORMATION

2.1 Replacement of Contractor Personnel. The Contractor shall replace permanent contractor personnel such that vacancies will not exceed 30 consecutive calendar days for non-credentialed positions and/or 60 calendar days for credentialed positions. When replacing a contractor personnel, the consecutive calendar days begin when the contractor personnel terminates employment. For non-credentialed positions, the replacement contractor personnel must begin work within 30 consecutive calendar days after the previous non-credentialed contractor personnel departed the position. For credentialed positions, the replacement contractor personnel must begin work within 60 consecutive calendar days after the previous credentialed contractor personnel departed the position; however, the contractor shall submit complete and accurate credentials packages on all credentialed contractor personnel no later than 30 calendar days after the previous contractor personnel departed.

2.2 Substitute or Temporary Coverage. The Contractor shall substitute permanent contractor personnel whenever a temporary absence is expected to exceed 30 consecutive calendar days. The Contractor shall promptly notify the COR and Government supervisor of any projected absences exceeding 30 consecutive calendar days and ensure no temporary absence exceeds 30 consecutive calendar days through the use of a qualified substitute.

2.3 Resolve Performance Issues. The Contractor shall adequately resolve MTF and patient complaints regarding contractor personnel which satisfy Government concerns.

2.4 Patient Sensitivity. Contractor personnel shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity.

2.5 Communication. Contractor personnel shall maintain open and professional communication with members of the MTF staff. Complaints validated by the Flight Commander/Medical Director shall be reported in writing to the Contract Administrator and the Contractor for action. Failure of the Contractor to correct validated complaints raised by the MTF staff and the Contracting Officer (CO) will be considered a failure to perform.

2.6 Documentation. Contractor personnel shall prepare all documentation (to include patient records) to meet or exceed established standards of the MTF, to include but not limited to, timeliness, accuracy, content, and signature. Only MTF and Air Force-approved abbreviations shall be used for documentation of the patient health record.

2.7 Work Schedule/Duty Hours. Duty hours will be 0730-1630 Monday through Friday excluding federal holidays.

2.8 Holidays. The Contractor shall not be required to provide services on the following Federal holidays (or the actual day set aside for observation): New Year’s Day, Martin Luther King Jr. Day, Presidents’ Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans’ Day, Thanksgiving Day, and/or Christmas Day.

2.9 Family Days. A list of Family Days will be provided by 87 MDOS. Services will not be required on Family Days.

2.10 Vacation/Absences. Contractor personnel are authorized excused absences for vacation, sick leave, CHE, and miscellaneous reasons. Absences are to be coordinated at a minimum two weeks in advance with, and at the discretion of, the Flight Commander/Medical Director.

2.11 Unplanned Closures. In the event of an unplanned closure of the facility due to natural disasters, military emergency, or severe weather, Contractor personnel shall be allowed to account for those hours as billable to the Government if the following two conditions exist: (1) local base policy and base access procedures prevented the Contractor personnel from performing duties at the place of performance; and, (2) the Contractor personnel was scheduled to work, but unable to work because of the unplanned closure. If any of these conditions do not exist (e.g., the Contractor personnel was on leave), the Contractor cannot bill the Government for hours during the unplanned closure.

2.12 Contractor Manpower Reporting. The Contractor shall report ALL Contractor labor hours (including subcontractor labor hours) for performance of services under this contract via a secure data collection site. The Contractor is required to completely fill in all required data fields at http://www.ecmra.mil. Reporting inputs will be for all labor executed during the performance for each Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported at 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 Contractor Manpower Reporting Application (CMRA) help desk.

3.0

PERSONNEL REQUIREMENTS.

3.1 English Language Requirement. Contractor personnel shall read, understand, speak, and write English fluently.

3.2 Appearance and Conduct. Contractor personnel shall present a professional, conservative, and neat appearance. Contractor personnel shall report for duty in appropriate attire befitting a health care setting and having complied with socially acceptable standards of personal hygiene expected of health care workers. The Contractor personnel shall display a professional, positive, and cooperative attitude while in the workplace.

3.3 While on duty, the Contractor personnel shall be neat and clean, free from visible dirt and stains, well groomed, and appropriately dressed. The Contractor personnel’s clothing shall fit correctly to provide a professional, modest appearance, in keeping with normally accepted community standards of dress for the work being performed.

3.4 Facial hair (including beards, mustaches, and sideburns) shall be controlled (restrained) or trimmed. It shall not interfere with safe work practices, look unkempt, or be unclean. Facial hair shall not interfere with the face seal if a tight-fitting respirator (e.g., N95) is required to be worn for normal duties.

3.5 The Contractor personnel shall display legible MTF-provided identification media on his/her outer clothing.

3.6 PROTECTIVE CLOTHING. When required and supplied by the Government, Contractor personnel shall wear special protective clothing and shoe covers. When duties will be performed in specified areas, a disposable protective suit with other appropriate personal protective equipment (PPE) (for example, gloves, boots, etc.) shall be worn to ensure universal precautions are observed. The Government will provide ALL PPE. These items shall remain the property of the Government and shall not be removed from the MTF. After use, protective clothing shall be turned in or destroyed as directed by the Chief of Service.

3.7 MEDICAL TESTS. Contractors are solely responsible for compliance with Occupational Safety and Health Administration (OSHA) standards and the protection of their employees unless otherwise provided by law or regulation to be specified in the contract. Thermoluminescent Dosimetry (TLD) monitoring will be provided to contractor personnel who are a part of a clinic enrolled in the TLD program. No medical tests or procedures required by the contract will be performed by the Government, with the exception of Tuberculosis testing; post blood borne exposure protocols after start of work or exposure. Expenses for all required tests and/or procedures identified in the contract (e.g., N95 particulate respirator duckbill mask fitting) shall be borne by the Contractor or Contractor personnel at no additional expense to the Government.

3.8 MEDICAL QUALITY IMPROVEMENT/RISK MANAGEMENT (QI/RM).

3.8.1 Contractor personnel shall participate in QI/RM activities to the extent required by Section 2C, AFI 44-119, and the individual MTF QI/RM plan or regulation.

3.8.2 The Government will evaluate the Contractor personnel’s professional, as differentiated from administrative, performance under this contract using Quality Improvement standards specified in paragraphs 2.12 and 2.13, AFI 44-119. Nothing in this paragraph precludes the Government from also conducting inspections under the Inspection/Acceptance requirement of FAR clause 52.212-4.

3.9 PERFORMANCE EVALUATION MEETINGS. The CO will require the Contractor to meet with the CO, Contract Administrator, and other Government personnel as often as deemed necessary to discuss performance discrepancies. The contractor may request a meeting with the CO when deemed necessary.

3.10 ORIENTATION. The Contractor shall ensure that all Contractor personnel participate in the MTF orientation procedures for newly assigned personnel to include regulations specific to their professional specialty and hospital and Air Force policy and procedures.

3.11 RECORDS. The Contractor shall create, maintain, and provide Government-owned/Contractor-held records, regardless of media, in performance of this contract IAW the following directives:

AFI 33-322, Records Management Program, 4 Jun 12, Incorporating Change 1, 18 Dec 14

AFMAN 33-363, Management of Records, 1 Mar 08; Change 1, 28 Jan 15, and Keesler Supplement, 23 Apr 14

AFI 33-364, Records Disposition—Procedures and Responsibilities, 22 Dec 06 and AFGM2014-01, Incorporating

Change 1, 9 Apr 15.

Air Force Information Management System database (AFRIMS) (access through the Air Force Portal at https://www.my.af.mil/afrims/afrims/afrims/rims.cfm

Air Force Electronic Records Management Solution

3.11.1 The Contractor shall segregate the Government-owned records from the Contractor-owned records and identify all records required to be created by the PWS on the AFRIMS file plans. The Contractor shall create and maintain paper and electronic records (\\52mahg-fs-106) as appropriate. The Contractor shall maintain the software and background data to retrieve official electronic Government records throughout the lifecycle of the records.

3.11.2 The Contractor maintains and disposes of records IAW the AF records disposition schedules.

3.11.3 Electronically Stored Information (ESI). The Contractor shall maintain Government owned electronic non-official records on the organizational shared network drive according the subjective categories (example: template, common, reference material, and working files). Grant the base records manager access to all files located on the organizational shared network drive. The Contractor shall maintain the official electronic records on the base designated shared network drive (\\52mahg-fs-106) IAW the Air Force Electronic Records Management System and AFMAN 33-363, Chapter 6.

3.11.4 Upon completion of this contract, all Government-owned/Contractor-held records (regardless of media) received, created, maintained, or provided in the performance of the PWS shall be turned over to the Government. Background electronic data and records specified for delivery to the contracting agency must be accompanied by sufficient technical documentation and software to permit the Air Force to use the data. In the event of default or non-performance, the Government will have access to all records in order to ensure mission support is not interrupted.

3.11.5 Contractor-Owned Records. Maintain records that relate exclusively to the Contractor’s internal business or are of a general nature not specifically related the performance of work under the contract separately from the Government-owned records.

3.12 Freedom of Information Act (FOIA) Program. The Contractor shall comply with the requirements of DOD 5400.7-R/AFMAN 33-302, Freedom of Information Act Program, 21 Oct 10, and incorporating through Change 2, 22 January 2015. If the Contractor receives a FOIA request, the Contractor shall ensure it is delivered immediately to the base FOIA manager (81 CS/SCOK) for processing. The FOIA manager will task a Government official who, as the authorized official, will make the decision on releasing Government records.

3.13 Privacy Act Program. The Contractor shall create, maintain, and destroy Privacy Act data IAW AFI 33-332, The Air Force Privacy and Civil Liberties Program, 12 Jan 15; and Privacy Act systems of records notice(s) (http://dpcld.defense.gov/Privacy/SORNs.aspxl). 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 a Government official who, as the authorized official, will make the decision on releasing the Government records.

4.0 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA). HIPAA is comprised of several different sections, each to be implemented by the Department 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 MTF. The specific implementation of HIPAA Privacy for DoD MTFs is set forth in DOD 6025.18-R, DoD Health Information Privacy Regulation, 24 Jan 03, and for HIPAA Security, the requirements for AF MTFs are contained in DOD 8580.02-R, DoD Health Information Security Regulation, 12 Jul 07. DOD 6025.18-R and DOD 8580.02-R are incorporated herein by reference. MTFs are responsible to ensure overall compliance with HIPAA requirements, which includes incorporation of certain requirements in contracts entered or amended after the respective implementation dates. IAW these regulations, the Contractor and its employees meet the definition of Business Associates; therefore, a Business Associate Agreement is required by law to comply with both the HIPAA Privacy and Security regulations. This clause serves as that agreement for each MTF, whereby the Contractor and its employees agree to abide by all HIPAA Privacy and Security requirements regarding health information as defined in this clause, DoD 6025-18-R and DoD 8520.02-R. Additional HIPAA requirements will be addressed when implemented.

a.

Introduction.

(1)

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 or DOD 8520.02-R.

(a)

HITECH Act shall mean the Health Information Technology for Economic and Clinical Health Act included in the American Recovery and Reinvestment Act of 2009.

(b)

Individual has the same meaning as the term “individual” in 45 CFR 164.501 and 164.103 and shall include a person who qualifies as a personal representative IAW 45 CFR 164.502(g).

(c)

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

(d)

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.

(e)

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

(f)

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

(g)

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

(h)

Security Incident shall have the same meaning as the term “security incident” in 45 CFR 164.304, limited to the information created or received by Contractor from or on behalf of the Covered Entity.

(i)

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

(2)

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.

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.

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

The HIPAA Security administrative, physical, and technical safeguards in 45 CFR 164.308, 164.310, and 164.312, and the requirements for policies, procedures, and documentation in 45 CFR 164.316 shall apply to the Contractor. The additional requirements of Title XIII of the HITECH Act that relate to security and that are made applicable with respect to covered entities shall also be applicable to the Contractor. 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.

(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 security incident involving protected health information of which it becomes aware.

(f)

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

(g)

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.

(h)

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

(i)

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.

(j)

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.

(k)

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.

(l)

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 IAW 45 CFR 164.528.

(m)

The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected IAW 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 IAW 45 CFR 164.528.

b.

General Use and Disclosure Provisions. Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, IAW the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the HIPAA Privacy Rule, DoD 6025.18-R, the HIPAA Security Rule, or DoD 8580.02-R if done by the Government. The additional requirements of Title XIII of the HITECH Act that relate to privacy and that are made applicable with respect to covered entities shall also be applicable to the Contractor.

c. Specific Use and Disclosure Provisions.

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.

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.

(3)

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).

(4)

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).

d.

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

Upon request, the Government will provide the Contractor with the notice of privacy practices that the Government produces IAW 45 CFR 164.520, as well as any changes to such notice.

The Government will 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.

The Government will notify the Contractor of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to IAW 45 CFR 164.522.

e.

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

f.

Termination.

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.

Effect of Termination.

If this contract has records management requirements, the records subject to the Clause should be handled IAW the records management requirements. If this contract does not have records management requirements, the records should be handled IAW paragraphs (b) and (c) below.

If this contract does not have records management requirements, except as provided in paragraph c) 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.

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.

g.

Miscellaneous.

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

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

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

5.0 SERVICES SUMMARY (SS).

5.1 The Government will periodically evaluate the Contractor’s performance by appointing Government representatives known as CORs to monitor performance to ensure services are received. The CORs will evaluate the Contractor’s performance through inspections of call logs/reports and receive and investigate all complaints from base personnel. The Government may inspect each task as completed or increase the number of quality assurance inspections if deemed appropriate because of repeated failures or because of repeated customer complaints. Likewise, the Government may decrease the number of quality assurance inspections if performance dictates. The CO shall make final determination of the validity of customer complaint(s).

6.0 In accordance with Air Force Instruction 44-119, subparagraph 4.2.5.1 personal service contract employees are covered by the Federal Tort Claims Act, and therefore are not required to maintain individual malpractice coverage for their performance under said contract.

SITE VISIT

SITE VISIT INFORMATION

A site visit for solicitation FA4484-16-T-0008 is scheduled for 13 April 2016 at 10:15 am EST. Interested vendors are asked to meet at 2402 Vandenberg Avenue, Joint Base Mcguire-Dix-Lakehurst, NJ. Attendees are urged to arrive on time.

In order to gain access to the base the following information must be provided to mark.jenkins.8@us.af.mil NLT 12:00 pm EST 16 April 2016:

a. Names of attendees;

b. Social Security Number;

c. Drivers License Number and state; and

d. Date of birth.

Please note that there will only be one site visit

CLAUSES INCORPORATED BY REFERENCE

ADDENDUM TO 52.212-1

THIS SECTION IS FOR SOLICITATION PURPOSES ONLY. THIS SECTION WILL BE PHYSICALLY REMOVED FROM ANY RESULTANT AWARD, BUT WILL BE DEEMED INCORPORATED BY REFERENCE.

52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS

Addendum to 52.212-1(c), Period for Acceptance of Offers. The paragraph is tailored as follows: “The offeror agrees to hold the prices in its offer firm for 90 calendar days from the date specified for receipt of offers.”

ADDENDUM TO 52.212-1, PROPOSAL PREPARATION INSTRUCTIONS

A. To assure timely and equitable evaluation of the proposal, the offeror must follow the instructions contained herein. The proposal must be complete, self-sufficient, and respond directly to the requirements of this solicitation. The response shall consist of two (2) separate parts; Part I – Price Proposal, and Part II – Technical.

B. The contracting officer has determined there is a high probability of adequate price competition in this acquisition. Upon examination of the initial offers, the contracting officer will review this determination and if, in the contracting officer's opinion, adequate price competition exists no additional data will be requested and certification under FAR 15.406-2 will not be required. However, if at any time during this competition the contracting officer determines that adequate price competition no longer exists; offerors may be required to submit cost data to the extent necessary for the contracting officer to determine the reasonableness and affordability of the price.

C. Specific Instructions:

1. PART I – PRICE PROPOSAL - Submit one

(a) Complete blocks 12, 17a, and 30a, b, and c of the SF1449. In doing so, the offeror accedes to the contract terms and conditions as written in the SOLICITATION, with attachments. The SOLICITATION constitutes the model contract.

(b) Insert proposed unit and extended prices in the Pricing Schedule. The extended amount must equal the whole dollar unit price multiplied by the number of units. The proposal(s) must be submitted for a base year plus four (4) Option Years.

(c) Complete the necessary fill-ins and certifications in provisions. The provisions FAR 52.212-3, Offeror Representations and Certifications – Commercial Items, shall be returned along with the proposal.

2. PART II – TECHNICAL

a. Subfactor 1 – CHIROPRACTOR POSITION submit the following documentation

1. Degree**

2. Post Graduate Training (if applicable)**

3. License in accordance with DoD Licensure Policy (DoD 6025.13-R)**

4. Board Certification (if applicable)**

5. Query Report of National Practitioner Data Bank http://www.npdb.hrsa.gov/pract/selfQueryBasics.jsp

6. Query Report to the Healthcare Integrity and Protection Data Bank http://www.npdb-hipdb.com

7. Query Report to the Department of Health and Human Services https://exclusions.oig.hhs.gov

8. Query Report to the TRICARE Sanction http://www.health.mil/Military-Health-Topics/Access-Cost-Quality-and-Safety/Quality-And-Safety-of-Healthcare/Program-Integrity/Sanctioned-Providers

9. National Provider Identification Number

10. Criminal History Background Check

11. Completed Air Force (AF) Information Management Tool (IMT) 1540, Application for Clinical Privileges/Medical Staff Appointment

12. Completed AF IMT 1562, Credentials Evaluation of Health Care Practitioners**

13. List of Clinical Privileges (form attached) – Complete name of applicant, name of medical facility, ‘Requested’ column, signature of applicant, and date signed (do not fill out ‘Verified’ column)

14. Completed AF IMT 1541, Credentials Continuing Health Education Training Record

15. Training Documents:

a. Basic Life Saving

16. Immunizations

a. PPD (TB Skin Test) – Within 12 Months

b. Hepatitis A – 2 shot series

c. Hepatitis B 3 – 3 shot series

d. Chicken Pox, MMR, and Influenza History

e. HIV Test – member can decline testing

17. Letters of reference: A minimum of two current letters of reference (dated within 12 months from submission) from appropriate sources are required. The individuals providing the letters of reference should be personally familiar with the subject provider’s clinical, professional and ethical performance.

This written input will address the provider’s medical knowledge, clinical judgment and technical skills as well as his/her interpersonal skills, communication skills and professionalism. Appropriate sources are (1) a letter from either the chief of a hospital medical staff, a clinic administrator, professional supervisor or department head where the appointee has current clinical privileges or is professionally associated; (2) a letter from the director or a faculty member of the appointee's training program, if the appointee was in a training program within the last year; or (3) letter from a provider (in the appointee's discipline, if possible) who is in a position to evaluate the appointee's professional standing, character and ability.

** Requires Primary Source Verification (PSV). Offerors must provide documentation of PSV for those documents above (items 1, 2, 3, 4, and 12). In accordance with AF Instruction (AFI) 44-119 a reasonable effort must be made to verify, with the primary issuing authority, all documents noted above with “**”. Documents can be verified by one of the following methods (in descending order of preference): Written verification, verbal via telephone, American Medical Association (AMA) Masterfile, World Wide Web, and touchtone telephone verification. The “chain of transmission” of the document is what distinguishes primary source verification from secondary verification. The document must come from the issuing authority to be considered primary source verification.

a. Written Confirmation from the Issuing Authority: In the case of qualifying degrees, certified copies of the final college transcripts are acceptable if the type of degree and the date it was conferred are included on the transcript AND the document came directly from the issuing authority. Reviewing a certified or raised seal copy of a final college transcript submitted by the provider is not primary source verification.

b. Verbal Telephone Confirmation from the Issuing Authority: The verification annotation will indicate the date, agency contacted for the verification, agency phone number, name of the individual at the agency who verified the information and the signature and signature block of the person who did the verification.

c. AMA Masterfile physician profiles can be used as primary source verification of US medical school graduation and US residency program completion. Contact 1-800-665-2882 or http://www.ama-assn.org for further information and guidance.

d. World Wide Web or internet primary source verification is acceptable, if the criteria, as published in the JCAHO’s Guidance and Use of Internet to Primary Source Verify Credentials (attached)

e. Touchtone Telephone primary source verification (in which the caller does not speak with an actual person; instead, electronically accesses a database) is acceptable only if the other methods listed above are not possible. In addition to including the information required in b above, it must be annotated that this is the only available method of primary source verification.

Forms can be accessed at: http://www.usa-federal-forms.com or http://www.e-publishing.af.mil

b. Subfactor 1 – CHIROPRACTIC ASSISTANT POSITION submit the following documentation:

1. Associates of Science Degree in Chiropractic Technology OR documentation the applicate is a Certified Chiropractic Assistant

2. Documentation of working knowledge in Chiropractic theory, techniques and procedures

3. Documentation of at least one year experience within the last 36 months in a Chiropractic setting

Documents submitted in response to this solicitation must be fully responsive to and consistent with the following:

a. Requirements of the solicitation (contract line items and performance work statement (PWS)) and government standards and regulations pertaining to the PWS.

b. Evaluation Factors for Award (Addendum to 52.212-2) General Information

INFORMATION REGARDING SUBMISSION OF PROPOSAL: Proposals may be submitted electronically to tyler.ingalls@us.af.mil; mailed to 87 Contracting Squadron, ATTN: SSgt Tyler Ingalls, 2402 Vandenberg Avenue, Joint Base McGuire-Dix-Lakehurst, NJ or hand carried. Hand carried proposals must be delivered to Bldg 2402 Vandenberg Avenue, Joint Base McGuire-Dix-Lakehurst, NJ during the hours of 8:00 am through 4:00 pm Monday through Friday (excluding holidays). The sealed envelope or package used to submit your proposal must show the time and date specified for receipt, the Solicitation Number, and the name and address of the offeror.

Offerors are cautioned that Joint Base McGuire-Dix-Lakehurst has visitor control procedures requiring individuals not affiliated with the installation to obtain a visitor pass prior to entrance. SOME DELAY SHOULD BE ANTICIPATED WHEN HANDCARRYING PROPOSALS. Offerors should allow sufficient time to obtain a visitor pass and arrive at Bldg 2402 PRIOR to the time specified for receipt. Late proposals will be processed in accordance with FAR 52.212-1(f) “Late submission, modifications, revisions, and withdrawals of offers.”

FEDERAL HOLIDAYS: The following Federal Legal Holidays are observed by this base:

New Year’s Day 1 January

Martin Luther King’s Birthday Third Monday in January

Presidents Day Third Monday in February

Memorial Day Last Monday in May

Independence Day 4 July

Labor Day First Monday in September

Columbus Day Second Monday in October

Veterans Day 11 November

Thanksgiving Day Fourth Thursday in November

Christmas Day 25 December

CLAUSES INCORPORATED BY REFERENCE

CLAUSES INCORPORATED BY FULL TEXT

52.212-2 EVALUATION--COMMERCIAL ITEMS (OCT 2014)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming…