Attachment 1 -- PWS Paramedic Services.doc

FA4528-09-R-0026

Attachment 1

PERFORMANCE WORK STATEMENT

For

PARAMEDIC SERVICES

At

MINOT AFB, North Dakota 6 May 2009

TABLE OF CONTENTS

1.0 DESCRIPTION OF SERVICE…………………………………………………………3

2.0 SERVICE SUMMARY………………..……………………………………………...…4

3.0 GOVERNMENT FURNISHED PROPERTY AND SERVICES………………….…5

4.0 GENERAL INFORMATION…………………………………………………………...5

5.0 CONTRACTOR PERSONNEL……………………………………………………...…5

6.0 SECURITY REQUIREMENTS………………………………………………………...6

7.0 QUALITY CONTROL………………………………………………………………….8

8.0 QUALITY ASSURANCE……………………………………………………………….8

9.0 KEY CONTROL…………………………………………………………………………9

10.0 TRAINING REQUIREMENTS AND CERTIFICATIONS………………………….9

11.0 PERFORMANCE OF SERVICES DURING CRISIS……………………...…….…...9

Appendix A -- Run Sheet Appendix B -- Customer Complaint Form

1. DESCRIPTION OF SERVICES.

1.1. GENERAL SCOPE. The contractor shall furnish all management, supervision, labor, training, and documentation necessary to provide Paramedic Services for response to requests for emergency medical services, providing patient treatment, and stabilization as required. The Paramedic may be required to perform any level of pre-hospital healthcare, ranging from basic first-aid to Advanced Life Support (ALS). As directed by the shift supervisor, paramedics will provide general support to ambulance services. The Contractor shall provide uninterrupted response coverage, 24-hours a day, seven days per week, including holidays. The Contractor shall provide one paramedic on every shift. The contractor will support all special events as requested by the 5th Medical Group (5 MDG). Performance shall be according to the requirements contained in this Performance Work Statement (PWS), professional standards of the US Department of Transportation (DOT), and EMT Paramedic National Standard Curriculum and Health Services Inspection (HSI). This contract is a non-personal Health Care Services contract under which the Contractor is an independent contractor. “Non-personal Services Contract” means a contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment).

1.2. RESPONSE COVERAGE. The Contractor shall respond to all requests for emergency medical care with ambulance crew, including response to in-flight emergencies (IFE). Coverage includes assessments/treatments in the field and on the ambulance during transport. The Contractor shall assess, treat, and stabilize as necessary. The Contractor shall accompany patients to the gaining Emergency Room and provide the patient’s status to the appropriate medical personnel.

1.3. TRAINING OF AMBULANCE PERSONNEL. The Contractor shall provide up to 48 hours of training monthly to Emergency Medical Technician’s (EMT) as required by NCOIC, Ambulance Services. Training shall cover pre-hospital emergency care procedures. The training schedule shall be established and coordinated by the Education and Training Flight, 5th Medical Group. This training shall be conducted by the Paramedic during normally scheduled shifts.

1.4. PROCEDURE GUIDANCE. The Contractor shall perform procedures within the scope of care for which they are trained. The Contractor shall follow the 5th Medical Group and ND Century Code Chapter (NDCC) State Code 33-11 and NDCC State Code 33-36, as well as NDCC State Statute 23-27 which outline scope of practice for paramedics. The protocols used by the contractor must be approved by the Medical Director, 5th Medical Group. For aeromedical emergencies, flight surgeon consultation and guidance will be provided.

1.5. PATIENT INFORMATION. The Contractor will protect patient information in compliance with Health Insurance Portability and Accountability Act (HIPAA) and the Privacy Act of 1974. The Contractor agrees not to use or further disclose Protected Health Information other than as permitted or required by the Contract or as required by law. The Contractor further agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract.

1.6. REPLACEMENT STAFF. The contractor shall have adequate pre-credentialed/pre-privileged replacement healthcare workers available in such instances so a lapse in coverage does not occur. Substitutes shall be as qualified and privileged as the primary Health Care Worker (HCW). Substitutes are not allowed so the HCW can accept another assignment or to meet the needs of the Contractor.

1.7. SPECIFIC TASKS. The Contractor shall be required to perform the following tasks:

1.7.1. Practice within the paramedic level scope of care and the protocols approved by the 5 MDG Medical Director.

1.7.2. Respond to all medical emergencies and/or inter-facility transport requests in a timely manner.

1.7.3. Perform and/or assist with the supply/equipment inventory and daily appearance maintenance for the assigned ambulances at the beginning of each shift or at any other time as necessary directed by the shift leader.

1.7.4. Complete patient encounter documentation within the timeframe established by the 5 MDG Medical Director.

1.7.5. Provide up to 48 hours of Emergency Medical Services (EMS) related training per month to 5 MDG personnel.

1.7.6. Provide general support to Ambulance Services as directed by the shift leader.

2. SERVICE SUMMARY.

PERFORMANCE OBJECTIVES PARAGRAPH PERFORMANCE THRESHOLD

Maintain paramedic certification; this may require some coordination with civilian agencies

Respond to medical emergencies and provide paramedic support. Support other special events as required.

1.1, 1.2

1.4, 1.7 Paramedics will respond to 100% of ambulance calls; (unless paramedic is already out on an ambulance run)

Zero complaints

Provide up to 48 hours of training monthly.

Zero Complaints

Complete a “Run Sheet” for 100% of the ambulance runs to which a contracted paramedic responds.

As directed, paramedics will provide general support to ambulance services.

Paramedics will follow approved protocols.

Zero Complaints

3. GOVERNMENT FURNISHED PROPERTY AND SERVICES. The government shall provide the facilities, equipment, materials, and services listed below. This equipment will be provided in sufficient time to enable the Contractor to meet his or her performance schedule and this performance work statement. Additional equipment needed, but not listed, shall be requested through 5 MDG as required.

3.1. Emergency Vehicles and EMT-B partner/driver.

3.2. All medical supplies/equipment required on an Advance Life Support Ambulance.

3.3. Work space (Room 1 D16 ) within 5 MDG, 5 MDOS Ambulance Dispatch.

3.4. Meals: paramedics will have authorization to eat meals, at his/her expense, within military dining facilities on-base.

3.5. An inventory of government-furnished equipment shall be done not later than 5 calendar days before start of the contract, within 10 calendar days of the start of any option periods, and not later than 10 calendar days before completion of the contract period (including any option periods). The Contractor and a Government Representative (identified by the Contracting Officer) shall conduct a joint inventory of all government-furnished equipment and the Contractor shall sign a receipt for all equipment provided by the Government. Items of equipment missing or not in working order shall be recorded and the Contracting Officer notified in writing. The Contractor and the Government Representative shall jointly determine the working order and condition of all equipment and document their findings on the inventory. In the event of disagreement between the Contractor and the Government Representative on the working order and condition of equipment, the disagreement shall be reported to the Contracting Officer.

4. GENERAL INFORMATION. The Contractor is solely responsible for compliance with OSHA standards for the protection of their employees. The Contract Manager shall ensure specific safety requirements in Air Force Occupational Safety and Health (AFOSH) standards and Air Force technical orders are complied with by Contractor Personnel when non-compliance would clearly present the potential to harm or damage government resources (see AFI 21-101, paragraph 9.16.). The Air Force is not responsible for ensuring that Contractors comply with “personal” safety requirements that do not present the potential to damage government resources.

4.1. EMERGENCY HEALTHCARE. Minot AFB has limited Medical Emergency Services available. All patients will be assessed and transported to the nearest emergency room if necessary.

4.2 FILES AND DOCUMENTS. All records, files, documents, regardless of media (e.g., paper,electronic, etc.), as described in the PWS, that are the responsibility of the contractor are the property of the Government and shall remain so upon termination or completion of the contract. The contractor shall keep these items current and maintain and dispose of them in accordance with the requirements established in Air Force Instruction (AFI) 33-322, Records Management Program, paragraph 10, Air Force Manual (AFMAN) 33-363, paragraph 6.4, Air Force Manual (AFMAN) 33-364, paragraph 2.13, and the Air Force Records Disposition Schedule which may be accessed from the AF-RIMS Link located on the Air Force Portal. Records shall be turned over to the Government upon completion of the contract unless otherwise stated. All records are subject to the Freedom of Information and Privacy Act. The Minot AFB Records Management Office (5 CS/SCSR), 723-3529/3186, will provide assistance and training to the contractor to ensure compliance with Federal record keeping requirements.

5.

CONTRACTOR PERSONNEL

5.1. CONTRACT MANAGER. The Contractor shall provide a Contract Manager (CM) who shall be responsible for the performance of the work. The name of this person, and an alternate or alternates, who shall act for the contractor when the manager is absent shall be designated in writing to the Contracting Officer before the start of the contract. The CM or alternate shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The CM or alternate shall be available via telephone, cellular telephone, pager, or email to address any emergency situations. For scheduled installation meetings, the CM or alternate shall be available during normal duty hours (7:30 a.m. to 4:30 p.m., Monday through Friday) to meet with government personnel (designated by the Contracting Officer) to discuss problem areas.

5.1.1. CONTRACTOR PERSONNEL. In order to communicate with appropriate medical personnel, each Paramedic shall be able to read, write, and communicate clearly in the English language.

5.1.2. Contract employees are authorized and required to obtain a Government Vehicle Operator’s Licenses, and Flight Line Access Training.

5.1.3. The Contractor shall not employ persons for work on this contract if such employee is identified to the Contractor by the Contracting Officer as a potential threat to the health, safety, security, general well-being or operational mission of the installation and its population.

5.2. CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval in accordance with the Joint Ethics Regulation, DoD 5500.7R.

5.3. LISTING OF EMPLOYEES. The contractor shall maintain a current listing of employees. The list shall include the employee's name, social security number and type of investigation if contract work involves unescorted entry to Air Force restricted areas or other sensitive areas designated by the installation commander. The list shall be provided to the Program Manager and sponsoring agencies Security Manager. An updated listing shall be provided when an employee's status or information changes.

5.4. UNIFORMS. Paramedic uniforms shall be functional, in good taste, and appropriate for extended severe weather exposure. All Personnel shall present a neat appearance and be easily recognized as Contractor employees. This shall be accomplished by wearing distinctive clothing bearing the name of the company and employee name. Medical Director will approve uniform prior to start of contract. Each uniform should include medical insignia. Paramedics will also be required to wear the 5th Medical Group ID badge while on shift. The badge will be provided by the 5th Medical Group.

6.0. SECURITY REQUIREMENTS. The Contractor’s duties may require entry into restricted areas, therefore, a favorable check by National Agency Investigation (NACI) is required. Previous favorable investigations higher than a NACI (ANACI, NACLC or SSBI) conducted by the Government will be an acceptable substitute. This will be verified by the unit security manager in the Joint Personal Adjudication System. Subsequent employees hired to work shall require a favorable NACI check. Contractor employees shall have submit the required NACI paperwork no later than 10 days after hire date. If no NACI are approved, the Government will be required to provide an escort until NACI check outcome. The approximate time for processing a NACI is 90 to 120 days. The Government will conduct and assume the costs for background investigation for the required NACI.

6.1. The Government shall conduct criminal background checks on all Paramedics under this contract. Background checks shall be based on fingerprints of individuals obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureau of Investigation and state criminal history repositories. When possible all background checks conforming to North Dakota state law shall be completed prior to start of contract.

6.1.1. With the consent of the Contracting Officer, contract providers may provide contract services prior to completion of background checks. However, at all times while children are in the care of that individual, the contract provider shall be within sight and continuous supervision of a staff person, whose background check has been completed, a chaperone, or parent/guardian.

6.1.2. Individuals shall have the right to obtain a copy of their background check and to challenge the accuracy and completeness of the information contained in the report.

6.1.3. Individuals who have previously received a background check shall provide to the Quality Assurance Personnel (QAP) proof of the check.

6.2. The Contractor shall obtain the following pass and identification items: a personnel identification card for each of the employees hired under the terms of the contract, or ensure that the individual obtains same. Contract Personnel who violate federal laws or regulation may be barred from the installation at the discretion of the Installation Commander. In such cases, the Contractor is responsible for providing adequate manning at all times, regardless of one or more personnel being barred.

6.3. Security Training. The Contractor ensures all Contractor employees receive initial and recurring security education training from the sponsoring agencies security manager. Training must be conducted IAW DOD 5200.1-R, Information Security Program Regulation, and AFI 31-401, "Information Security Program Management". Contractor personnel who work in Air Force controlled/restricted areas must be trained IAW AFI 31- 101, The Air Force Installation Security Program.

6.4. Pass And Identification Items. The Contractor shall ensure the pass and identification items required for contract performance are obtained for employees.

6.5. Retrieving Identification Media. The Contractor shall retrieve all identification media, from employees who depart for any reason before the contract expires; e.g. terminated for cause, retirement, etc.

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

6.7. Weapons, Firearms, and Ammunition. Contractor employees are prohibited from possessing weapons, firearms, or ammunition, on themselves or within their contractor-owned vehicle or privately-owned vehicle while on Minot AFB, North Dakota.

6.8. For Official Use Only (FOUO). The contractor shall comply with DoD 5200.1-R, Appendix 3

(AP3.2), Information Security Program, requirements. This regulation sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding FOUO material.

6.9. Reporting Requirements. Contractor personnel shall report to an appropriate authority any information or circumstances of which they are aware may pose a threat to the security of DOD personnel, contractor personnel, resources, and classified or unclassified defense information. Contractor employees shall be briefed by their immediate supervisor upon initial on-base assignment.

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

6.11. Controlled/Restricted Areas. The Contractor shall implement local base procedures for entry to Air Force controlled/restricted areas where contractor personnel will work. An AF Form 2586, Unescorted Entry Authorization Certificate, must be completed and signed by the sponsoring agencies Security Manager before a Restricted Area Badge will be issued.

7.0. QUALITY CONTROL. The Contractor shall develop and maintain a quality program to ensure services are performed in accordance with state and local standards and codes. The Contractor shall develop and implement procedures to identify and prevent defective services from recurring. As a minimum, the Contractor shall develop quality control procedures that address the areas identified in section 2, Service Summary. These procedures will be submitted to the Contracting Officer for approval within 10 days of contract award.

7.1. The plan shall include a description of the methods to be used for identifying and preventing defects in the quality of service performed before the level of performance becomes unacceptable as outlined in the Service Summary. The plan shall include methods and procedures for identifying and preventing defects in the quality of service.

7.2. A description of the inspection system to cover all services listed on the Service Summary (SS). The description shall include specifics as to the areas to be inspected on a scheduled and unscheduled basis, frequency of inspections, and the title and organizational placement of the inspectors. Additionally, control procedures for any government provided keys or lock combinations shall be included.

7.3. Develop, implement and maintain a comprehensive Quality Control Program (QCP) that assures compliance with all requirements of this PWS. Safety violation(s) and deviation(s) from established technical data will constitute an unsatisfactory condition(s) and will be documented as such. If the Contractor exceeds the error rate as listed on the Service Summary, they may be subject to a lower performance evaluation rating. The QCP shall also include procedures for training, qualification and any required certification of employees prior to performance of assigned duties under this contract. Procedures shall include assignment of management responsibility for employee task qualification to specific positions/individuals within the Contractor’s organization, as well as the quality control process that will be utilized to ensure compliance.

8.0. QUALITY ASSURANCE.

8.1. The government will periodically evaluate the Contractor’s performance by appointing a representative(s) to monitor performance to ensure services are received. The government representative will evaluate the Contractor’s performance through intermittent on-site inspections of the Contractor’s quality control program and receipt of complaints from customers and base personnel. The government will inspect each task through review of the ambulance “Run Sheets” (Attachment A). The Contractor will complete a “Run Sheet” for every ambulance call to which a paramedic responds. The Run Sheet should be completed as soon as possible and must be completed prior to shift change. The Medical Director of Ambulance Services will review each run sheet. Complaints will be validated by the QAP and Chief of Professional Staff. The complaint shall be reported in writing to the CO and the Contractor for action on AF Form 714, Customer Complaint Record (Appendix B).

8.2. When an inspection/observation indicates defective performance, the QAP will require the Contract Manager or Representative at the site to initial the inspection documentation. The initialing of the inspection/observation does not necessarily constitute concurrence with the observation, only acknowledgment that he or she has been made aware of the defective performance. Government surveillance of tasks not listed in the SS or by methods other than those listed in the SS (such as provided for by the Inspection for Services Clause) may occur during the performance period of this contract. Such surveillance will be done according to standard inspection procedures or other contract provisions.

8.3. The Contracting Officer may require the Contract Manager to meet with the Contracting Officer, Contract Administrator, QAP, and other Government Personnel as deemed necessary. The Contractor may request a meeting with the Contracting Officer when he or she believes such a meeting is necessary.

9.0. KEY CONTROL. The Contractor shall establish and implement methods of making sure all keys issued to the Contractor by the government are not lost or misplaced and are not used by unauthorized persons. The Contractor shall not duplicate any keys issued by the government. The contractor shall immediately report to the Quality Assurance Personnel (QAP) or Functional Director any occurrences of lost or duplicated keys. In the event keys, other than master keys, are lost or duplicated, the Contractor may be required, upon written direction of the Contracting Officer, to re-key or replace the affected lock or locks without cost to the government. The government may, however, at its option, replace the affected lock or locks or perform re-keying and deduct the cost of such from the monthly payment due the contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the government and the total cost deducted from the monthly payment due the Contractor. The Contractor shall prohibit the use of keys, issued by the government, by any persons other than the contractor’s employees and the opening of locked areas by contractor employees to permit entrance of persons other than Contractor employees engaged in performance of contract work requirements in those areas.

10.0. TRAINING REQUIREMENTS AND CERTIFICATIONS.

10.1.The Contractor shall meet the National Registry Emergency Medical Technician – Paramedic and the State of North Dakota Paramedic licensing requirements. The contract personnel staffing the 5 MDG ambulances shall have all applicable paramedic certifications required by law in the state of North Dakota, such as Cardio Pulmonary Resuscitation (CPR), Advanced Cardiac Life support (ACLS), and Pediatric Advanced Life Support (PALS). The Contractor shall ensure all certifications are current. The Contractor must take specific action; including Primary Source Verification to ensure contract personnel have the required prerequisites for privileging and do not have disqualifying impediments for privileges in the state of North Dakota prior to submitting credentials for hire. In addition to these requirements, the Contractor will establish with civilian institutions the capability to maintain current certifications and licensing. Annual EMS awareness training will be required for all government employees and contractors. There is no cost to take this class and it is on-line.

10.2. ACCREDITATION ASSOCIATION FOR AMBULATORY HEALTH CARE, INC. (AAAHC)/HEALTH SERVICE INSPECTION (HSI) CRITERIA. Contractor will fully comply with AAAHC and HSI standards.

11.0. Performance of Services During Crisis Declared by the National Command Authority or Overseas Combatant Commander. According to Department of Defense Instruction (DoDI) 3020.37, Continuation of Essential DoD Contractor Services During a Crisis, and the Air Force implementation thereof, unless otherwise directed by an authorized government representative, it is determined that the Paramedic Services requirements under this PWS are essential to be performed during a crisis.

11.1. INCLEMENT WEATHER. The Contractor should have knowledge of the inclement weather plans IAW Minot AFB Operating Instruction 36-101. Paramedics are defined as Category I, Storm Essential Personnel. Inclement weather does not preclude contractor from performing assigned tasks of this contract.