(Attch_1)_JWN_Performance-based_Work_Statement_(7_Jun_2013).docx

FA5209-13-R-0009

Attachment 1 7 Jun 2013

PERFORMANCE-BASED

WORK STATEMENT

FOR

NURSES & SOCIAL WORKER

IN JAPAN

KADENA AIR BASE, MISAWA AIR BASE

AND

YOKOTA AIR BASE, JAPAN

1. SCOPE

1.1. INTRODUCTION. The Air Force Medical Service (AFMS) has a requirement for five (5) registered nurse case managers, two (2) licensed practical nurse or licensed vocational nurse (LPN/LVN) utilization managers and one (1) social worker case manager at Air Force medical treatment facilities in Japan. The contractor shall provide all labor, materials, tools, equipment, transportation, and supervision necessary to recruit, qualify, place, manage and retain the following case manager, utilization management and social worker professionals:

1.2. NON-PERSONAL SERVICES. The services to be performed shall be non-personal services and are not inherently governmental. The contractor is solely liable for the actions of their employees.

2. CONTRACTOR MANAGEMENT STAFF RESPONSIBILITIES.

2.1. The prime contractor’s staff, including all teaming partners, subcontractors and their staff at corporate level involved in the company’s or team’s administration of this contract will hereafter be termed as contractor management staff. The contractor retains responsibility for any teaming partner or subcontractor and shall be accountable for their performance.

2.2. The three (3) labor categories recruited and hired by the contractor management staff to perform the services as described in this contract will be termed hereafter as contractor personnel.

2.3. At least fourteen (14) business days prior to the required start date at the Military Treatment Facility (MTF), the contractor management staff shall provide to the MTF an employee package for that employee as proof the employee meets all experience and training requirements of the contract. The package shall consist of a resume or curriculum vitae, minimum of two (2) letters of recommendation, a copy of nursing license, a copy of any applicable certification certificate or cards and any other qualifying documentation (i.e., immunization record).

2.4. The Defense Medical Human Resources System Internet (DMHRSi) is the DoD accounting system for financial, personnel, education and training, and workload within MTFs. The Contractor Management Staff is responsible to provide all required information monthly (for example: personal data, work schedule, worked hours, work center, etc.) for all contractor personnel to the Medical Expense and Performance Reporting System (MEPRS) manager or clinic MEPRS monitor for entry into the system by the Air Force.

3.1.1. Work Environment/Physical Requirements. The work is primarily sedentary. However, there may be some physical demands. Requirements include standing, sitting or bending. Individual is required to walk throughout facility to interact with staff and providers including transport of relevant documents.

3.1.2. Information Technology Systems (ITS): The Composite Health Care System (CHCS), the Armed Forces Health Longitudinal Technology Application (AHLTA), CarePoint and the Integrated Clinical Database (ICDB) programs must be used for case management services. The MTF will provide system accounts/access to contractor personnel after required training and security procedures have been completed by the contractor. The contractor shall comply with DoD communication and information technology security standards and policies. Initial and ongoing ITS training is necessary and provided by the Government.

3.1.3. Utilizes MTF performance improvement tools in data collection and identifies barriers to the achievement of improvement in multidisciplinary treatment teams and/or clinical programs. Seeks assistance from the MTF’s Quality/Performance Improvement Manager and other case managers as needed.

3.1.4. Complies with requirements, and assists clinical programs and treatment teams in preparation for The Joint Commission (TJC), Accreditation Association for Ambulatory Health Care (AAAHC) and/or National Committee for Quality Assurance accreditations; the Air Force Inspection Agency Health Service Inspection; Air Force Audit Agency audits and other internal or external reviews, as applicable. Implements and monitors follow-up recommendations for corrective actions.

3.1.5. Must comply with Air Force Equal Opportunity and safety policies and procedures.

3.2. Licensed Practical Nurse/Licensed Vocational Nurse (LPN/LVN), Utilization Manager

3.2.1. Education. Graduation from a State Board of Nursing approved LPN/LVN training program or completion of equivalent United States military training that permits sitting for a state licensure examination.

3.2.2. License/certification. Nurse applicants must be a current U.S. LPN/LVN. Active, current, valid and unrestricted license to practice nursing in accordance with State Board requirements. License cannot be under investigation nor have any adverse action pending from a Nursing State Board or national licensing/certification agency.

3.2.3. Experience. Four (4) years of clinical nursing experience is required. LPN/LVN shall have held full time employment in a nursing field for twelve (12) out of the last twenty-four (24) months (mandatory). Equivalent combinations of education and experience may be qualifying if the experience is directly related to utilization management. Equivalency combinations must be acceptable to the MTF and approved by the Contracting Officer.

3.2.4. Knowledge. The contractor must have a working knowledge of Ambulatory Procedure Grouping (APGs), Diagnostic Related Grouping (DRGs), International Classification of Diseases-Version 9 (ICD-9), Current Procedural Terminology-Version 4 (CPT-4) coding and InterQual or Milliman Ambulatory Care Guidelines. Working knowledge is defined as having at least one (1) year of experience working these items or training certifications.

3.2.5. Specific Tasks

3.2.5.1. Works in collaboration with providers, case managers (CM), disease management (DM) nurses, health care integrator and group practice manager to determine measures to target and manage enrollees and/or processes that relate to high-cost, high-volume or problem-prone diagnoses, procedures, services and beneficiaries who have demonstrated high utilization rates. Uses the TRICARE Management Activity Medical Management Guide in performance of these duties. Makes appropriate recommendations to DMs and CMs for high-utilization or high-risk enrollees to be entered into their processes.

3.2.5.2. Conducts special analyses on patient utilization of health services and health care provider orders and referrals for specialty care, therapies, pharmaceuticals and diagnostic testing to identify both excessive and insufficient use of services (e.g., patients with 100% or more emergency room visits compared to the average of all patients; physicians who order 50% more special tests than their peers). Identifies ways to reduce overutilization and suboptimal underutilization of services.

3.2.5.3. Reviews referrals for administrative, clinical completeness and appropriateness in coordination with the Chief, Medical Staff (SGH) or deputy SGH. Completes medical necessity and benefit reviews on referrals and makes recommendations to the MTF approval authority for approval/disapproval of the specialty care requested. Coordinates with the TRICARE Overseas Program contractor as needed to determine availability of local care.

3.2.5.4. Schedules referral appointments in accordance with Air Force Access to Care (ATC) standards with DoD and civilian health care providers. Ensures appointing is done within the Access to Care standards. Notifies the MTF group practice manager, TRICARE Operations and Patient Administration Flight or SGH if ATC standards are not met for referrals.

3.2.5.5. Coordinates with specialty referral clinics to obtain special patient instructions and/or tests required prior to appointment. Provides pre-appointment instructions to patients as well as the details regarding their referral appointment (i.e., date/time, provider, and location). Ensures patients receive necessary documentation appropriate for the referred medical care visit.

3.2.5.6. Locates referral requests and ensures appropriate documents are available prior to all specialty appointments. Prints diagnostic reports and/or treatment profiles as necessary.

3.2.5.7. Verifies eligibility of beneficiaries using Defense Eligibility Enrollment Reporting System (DEERS).

3.2.5.8. Facilitates utilization management activities by participation in multidisciplinary patient care activities. Initiates/coordinates communication between beneficiaries, team members, internal staff and providers, DoD/civilian providers and ancillary health care workers. Provides feedback regarding utilization review issues within one (1) business day.

3.2.5.8. Reviews and enters first right of refusal referrals into CHCS and database within one (1) business day of the date of the referral.

3.2.5.9. Interfaces with the TRICARE Overseas Program contractor, SGH and multidisciplinary personnel as needed to ensure appropriateness of referrals. Submits referrals from civilian providers to the TRICARE Service Center or TSC for medical necessity and appropriateness review.

3.2.5.10. Performs data collection, trending and analysis to identify patient care requiring intensive management. Refers to case management officials as needed.

3.2.5.11. Receives and makes patient telephone calls and computer/written correspondence regarding specialty clinic appointments and referrals. Routinely monitors referral management CHCS queue to ensure patients are being called that do not utilize the Referral Management Center (RMC) walk-in service.

3.2.5.12. Contacts patients in event referral requests are invalid, disapproved by second level review or TRICARE Overseas Program contractor and reschedules patients as soon as possible or instructs patients of other health care options.

3.2.5.13. Answers, completes and/or appropriately forwards patient or provider telephone calls.

3.2.5.14. Coordinates with patient movement office to advise patients of their referral/health treatment options as related to their eligibility per beneficiary status and covered benefits.

3.3. Registered Nurse Case Manager

3.3.1. Education. Must have graduated from an associate degree (AD) or a baccalaureate degree program in nursing (BSN) accredited by a national nursing accrediting agency recognized by the US Department of Education.

3.3.2. License/certification. Nurse applicants must be a current U.S. licensed Registered Nurse. Active, current, valid and unrestricted license to practice nursing in accordance with State Board requirements. License cannot be under investigation nor have any adverse action pending from a Nursing State Board or national licensing/certification agency.

3.3.3. Experience. RN must have at least five (5) years of licensed nursing practice. Two (2) years’ experience in Discharge Planning or Case Management is required. Certification in case management from the American Case Management Association, the American Academy of Case Management or the American Nurses Credentialing Center issued within the last (2) two years may be substituted for direct case management experience.

3.3.3.1. Equivalent combinations of education and experience may be qualifying if the education or experience is directly related to case management. Equivalency combinations must be acceptable to the MTF and approved by the Contracting Officer.

3.3.3.2. Knowledge and understanding of developmental growth; dynamics of human behavior, family, and other social systems; and the impact of illness and disability on social functioning.

3.3.3.3. One registered nurse case manager position each at Yokota AB and Misawa AB must speak fluent Japanese. Japanese-Language Proficiency Test Certificate of Results and Score of at least N2 or equivalent certificate are required for non-native Japanese speakers.

3.3.4. Specific Tasks

3.3.4.1. Provides patient-centered case management and discharge/disposition planning (e.g., patient advocacy, assessment, planning, implementation, coordination, monitoring, and evaluation) in inpatient and ambulatory care settings, with early identification and interventions focused on outcomes.

3.3.4.2. Completes general and special needs program planning, implementation, and evaluation, and in conducting individual, family, group, and community interviews and assessments as well as individualized identification of special needs.

3.3.4.3. Ensures initial and ongoing assessments identify patient needs, issues, resources and care plans in a timely manner including patient health education needs.

3.3.4.4. Ensures initial and ongoing assessments identify patient needs, issues, resources and care plans in a timely manner including patient health education needs.

3.3.4.5. Ensures care goals are set and agreed upon by the primary provider and patient.

3.3.4.6. Ensures coordination of care delivery processes to enhance patient’s health and wellness, safety, productivity, and quality of life, to include alternate care settings and the home environment.

3.4. Social Worker Case Manager

3.4.1. Education. Master of Social Work (MSW) degree from a Council on Social Work Education (CSWE) accredited school.

3.4.2. License/certification. Must possess a current social worker license/certification by a U.S. jurisdiction at a level that allows practice of clinical social work without supervision. License/certification cannot be under investigation nor have any adverse action pending from any state or national licensing/certification agency. Substitute or related degrees are not acceptable.

3.4.3. Experience. A minimum of two (2) years of full-time post-Master’s Degree experience within the last four (4) years working a professional case management or discharge planning program with adults, children, families, seniors and groups.

3.4.3.1. Equivalent combinations of education and experience may be qualifying if the education or experience is directly related to Social Worker Case Management. Equivalency combinations must be acceptable to the MTF and approved by the Contracting Officer.

3.4.4. Specific Tasks

3.4.4.1. Provides patient-centered case management and discharge/disposition planning (e.g., patient advocacy, assessment, planning, implementation, coordination, monitoring, and evaluation) in inpatient and ambulatory care settings, with early identification and interventions focused on outcomes.

3.4.4.2. Coordinates care with interdisciplinary team to promote continuity for service members and/or veterans and their families who are experiencing a wide range of complicated mental, emotional, behavioral, physical, psychosocial, and environmental problems.

3.4.4.3. Completes general and special needs program planning, implementation, and evaluation, and in conducting individual, family, group, and community interviews and assessments as well as individualized identification of special needs.

3.4.4.4. Proactive in case finding and identify patients who potential candidates for case manager enrollment or are in need of care coordination through discharge/disposition planning to include, but not limited to:

3.4.4.5. Multiple complex healthcare needs, such as but not limited to, patients requiring home IV therapy/chemotherapy; investigational protocol patients; patients deemed injury-prone; post-deployment service members; or Exceptional Family Member Program (EFMP) beneficiaries.

3.4.4.6. Catastrophic, severe illness or traumatic injuries that may result in death or major permanent loss of function (sensory, motor, physiologic, intellectual), such as but not limited to, traumatic injuries, AIDS, neoplasm, neonates admitted to Intensive Care Units; major burns, organ transplants, bone marrow transplants.

3.4.4.7. Chronic, major diseases and conditions that may result in permanent lessening of quality of life, health, safety, productivity, functioning, permanent disability, and, or increased-risk for diminished independence, such as, but not limited to, poorly controlled chronic disease; depression; dual medical and psychiatric diagnoses; dual psychiatric and substance abuse diagnoses that may qualify them for enrollment into EFMP. This includes administrative enrollment of those patients and family members that fit EFMP criteria into the EFMP Program to include participating in overseas clearance screenings. Collaborates with the Special Needs Coordinator for the EFMP program as required.

3.4.4.8. Coordinates follow-up care and services determined by the patient’s provider (e.g., medical equipment needs for in-home rehabilitation or extended care placement). Resolves complicated healthcare, social, interpersonal, and financial patient situations.

3.4.4.9. Accepts case management referrals from multiple sources, such as DoD and civilian healthcare providers.

3.4.4.10. Monitors care delivery to the patient across the care continuum (sub-acute, long-term and home health care) and document assessments of patient progress in reaching healthcare outcome goals.

3.4.4.11. Collaborates with DoD and civilian health care providers to ensure a smooth transition, including ground and air transportation, for patients from one level of care or care setting to another, such as rehabilitation, extended long-term healthcare programs or other care institutions.

3.4.4.12. Ensures coordination of care delivery processes to enhance patient’s health and wellness, safety, productivity, and quality of life, to include alternate care settings and the home environment.

3.4.4.13. Conducts discharge/disposition planning for all patients in inpatient and ambulatory acute care settings, such as same-day surgery, special procedure clinics, outpatient clinical area, to the extent appropriate for each patient.

3.4.4.14. Applies social work principles and concepts to systems or processes at the unit, team and work group level to improve care.

3.4.4.15. Ensures initial and ongoing assessments identify patient needs, issues, resources and care plans in a timely manner including patient health education needs.

3.4.4.16. Uses the social work process (psychosocial assessment, diagnosis, and treatment) in collaboration with interdisciplinary team members to develop a case management plan and psychosocial interventions. Evaluates the need for mental health services and makes appropriate referrals for individual, group, marital and family treatment services.

3.4.4.17. As a member of the health care team, participates fully in developing, planning, implementing and evaluating the interdisciplinary treatment plan and care-related goals. This includes all provisions of case management services such as social service and home care. Ensures referral(s) are coordinated with appropriate disciplines.

3.4.4.18. Analyzes medical record documentation for quality and appropriateness of provider actions and treatment plans specific to patient needs.

3.4.4.19. Develops and uses appropriate military and community resources. Maintains points of contact such as active duty service members, veterans and their families, facility clinical and administrative staff, staff at other MTFs, TRICARE, National Guard and Reserve units, community agencies, and representatives of local, state, and federal institutions.

3.4.4.20. Serves as an advocate for service members and/or veterans and their families, helping them access needed services at military facilities, at Veterans Affairs facilities, and in the community that leads to adherence to treatment plan and improved healthcare outcomes.

3.4.4.21. Assists beneficiaries and their families with advance directives, guardianships, and applications for home care and extended care services.

3.4.4.22. Participates in the orientation and training of MTF staff on case management matters via knowledge sharing. May serve on committees, work groups, and task forces at the facility, or as a representative of the facility for other agency taskings.

3.4.4.23. Conducts and/or participates in data analysis and/or program evaluation as appropriate. This may include, but is not limited to statistical analysis of case management data to identify variances, patterns or trends from established practice guidelines and/or standards.

3.4.4.24. Participates in interdisciplinary team meetings, appropriate facility meetings, and Case Management/Social Work meetings. Shares knowledge and experiences gained from clinical practice and education relevant to the field of Social Work.

3.4.4.25. Communicates effectively both orally and in writing. Must be skillful and tactful in communicating with people who may be physically or mentally ill, uncooperative, fearful, emotionally distraught, and occasionally dangerous.

3.5. MEDICAL LIABILITY INSURANCE. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor’s professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its issued employees. The Contractor shall provide a copy of the medical liability insurance document to the Contracting Officer prior to contract performance and maintain such insurance during the terms of this contract. The liability insurance shall be issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrence $1,000,000.00, $3,000,000.00 aggregate. If at any time the Contractor changes insurance providers, the Contractor shall provide evidence to the Contracting Officer that the Government will be indemnified to the limits specified above per specialty per occurrence. Reference AFI 44-119, Medical Quality Operations, 4.2.5.2. Non-personal services contract personnel are independent contractors and are required to carry professional liability insurance. The Federal Tort Claims Act does NOT cover this individual. The contractor is responsible to ensure that the individual has malpractice liability coverage and often indemnifies its employee. Non-personal services contract employees must maintain a current, unrestricted, active license from the state in which they are practicing and, if required, a certification or registration when caring for patients within the MTF.

3.6. PRE-PERFORMANCE HEALTH REQUIREMENTS

3.6.1. All healthcare workers (HCW) must in-process through Public Health (PH) within 10 duty days of arrival at the 374 Medical Group.

3.6.1.2. The Centers for Disease Control and Prevention (CDC) Healthcare Infection Control Practices Advisory Committee (HICPAC) and Advisory Committee on Immunization Practices (ACIP) definition for HCW is used here and includes:

i. All paid and unpaid persons working in health-care settings who have the potential for exposure to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air.

ii. HCW might include (but are not limited to) physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, volunteers, contractual staff.

iii. HCW might also include persons (e.g., clerical, dietary, housekeeping, maintenance, and volunteers) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted to and from HCW.

3.6.1.3. Department of Defense Joint Instruction AFJI 48-110 “Immunizations and Chemoprophylaxis” directs immunizations and chemoprophylactic practices follow current national standards as per CDC ACIP. Specific guidance for healthcare workers is posted on the internet.

iv. http://www.cdc.gov/vaccines/acip/index.html and http://www.cdc.gov/niosh/topics/healthcare/

v. For further information on current requirements, please contact PH at DSN 315-225-5311

3.6.1.4. HCW will not begin duties until and unless determined to be in compliance with infection/immune status as defined by CDC ACIP and determined by PH.

3.6.1.5 Preventive, Prophylactic and Follow-up Procedures. The contractor shall ensure that his/her employees are in compliance with preventive, prophylactic and follow-up procedures, as well as infection control and employee health program procedures, as established by the MTF. Required preventive, prophylactic and follow-up procedures will be paid by the Contractor. If care is received somewhere other than Yokota AB, the Contractor shall provide written verification of treatment.

3.6.1.6. Pregnant Employees. It is the responsibility of the Contractor to notify the COR of a pregnant employee. MTF Employee Health Office will provide information concerning any work hazards in that area. The contractor is to notify their pregnant employee of any work hazards. It will be the employee and the contractor’s joint decision whether the contracted employee works in the environment.

3.6.1.7. HIPAA Compliance. The Contractor agrees to abide by all the requirements of the Health Insurance Portability and Accountability Act (HIPAA) as codified at 45 CFR Part 160 and Part 164, subparts A and E, and implemented by DoD 6025.18-R regarding the privacy and confidentiality of health records and information being provided and shared under the resulting contract. The Contractor shall also comply with the Business Associate Agreement under Privacy of Protected Health Information.

3.6.1.8. At least fourteen (14) business days prior to start of work, the contractor management staff is required to supply a complete employee qualification record (reference Paragraph 2.3.) as proof of immunization of contractor personnel working within MTFs for the following diseases: hepatitis B, influenza, measles, mumps, rubella, varicella, TDap, and proof of a negative TB skin test completed within the past twelve (12) months (if positive, proof of negative chest X-ray within the past twelve (12) months), hepatitis A and poliovirus.

3.6.1.9. Contractor personnel working at Kadena Air Base (registered nurse case managers and social worker case manager) who must travel to the United States Naval Hospital Okinawa daily must have HIV titer as required by the MTF prior to the start of work.

3.6.1.10. No pre-employment medical tests or procedures required by the contract will be performed by the MTF (with the exception of Tuberculosis testing after start of work and exposure). Expenses for all required tests and/or procedures shall be borne by the contractor management staff or contractor personnel, not the Government.

3.6.1.11. In those areas where there is a higher risk of transmission of tuberculosis, contractor personnel may be tested as frequently as directed by the MTF policy at the Government’s expense.

3.6.1.12. Contractor personnel working in an MTF are required to be immunized annually with the influenza vaccine as recommended by the CDC. This vaccine will be provided by the Government at no cost to contractor personnel. If the vaccine is obtained at other facilities, the cost will be borne by the Contractor Management Staff or contractor personnel, not the Government.

3.6.1.13. Immunization information for contractor personnel shall be provided to the respective MTF for government personnel to record and track in DoD computer systems.

3.6.1.14. The Government will provide post blood borne exposure protocols according to applicable Air Force Instructions.

3.6.2. MEDICAL HEALTH INSURANCE COVERAGE Contractor personnel and their dependents residing with them in Japan, if applicable, must have adequate health insurance coverage for overseas medical services. This includes coverage to pay for the cost of medical evacuation from the host country to receive emergency medical treatment when adequate treatment is not available in the host country.

3.7. OVERSEAS MEDICAL/EDUCATION SERVICES

3.7.1. Contractor personnel should be prepared to use the medical and dental services of the host country. Medical care at overseas military treatment facilities is limited. Care, when available will be provided on a reimbursable basis, through MTF billing of the patients’ medical insurance. Patients are responsible for paying any copays, deductibles or non-covered services, if applicable, to the MTF. Mental health care professionals are generally not available in the military medical units and host nation mental health professionals usually do not meet the needs of Americans. Individuals or family members with behavior disorders or requiring psychiatric or mental health care should not travel to overseas areas. Internal medicine practitioners and cardiologists are generally not available in military health care units. Military and foreign country pharmacies may not stock medicines or prescription drugs that are available in the U.S. Contractor personnel must pay for all prescriptions filled at the MTF. The MTFs pharmacy rates are comparable to rates in the United States. The contractor must determine whether adequate medical care is available in the host country prior to sending personnel or their family members that have medical problems or require medication. Military dental clinics are usually only available to provide emergency services.

3.7.1.2. Emergency healthcare services, if available, resulting from employment related accidents or injuries will be provided by the Government on a reimbursable basis.

3.7.1.3. It is the responsibility of the contractor to ensure the Government and host nation health care providers are paid for medical services rendered to contractor personnel and their dependents.

3.7.1.4. Under extreme emergency conditions where special circumstances require government transportation, the contractor shall be charged at the DoD established movement rate or Full Reimbursement Rate (FRR).

3.7.2. DEPARTMENT OF DEFENSE SCHOOLS (DoDDS). Education, including special education, to the children of contractor personnel who are eligible for services from DoDDS may attend school on a tuition and space available basis. Students must meet DoDDS criteria for special education. Services are provided based on an Individualized Educational Program. Most schools are not staffed for all disabilities although DoDDS staffs schools in specific locations for a full range of disabilities. Prior to sending a contractor employee and their child(ren) with significant disabilities (i.e., blindness, deafness, severe mental retardation, serious emotional impairments) to the job location, the contractor employee shall ensure the child's educational needs can be met.

3.8. PROCEDURE GUIDANCE. Contractor personnel shall perform medical duties in accordance with the MTF’s operating instructions and DoD or Air Force guidance. Changes or deviations from established objectives for services shall not be made without prior recommendation to, and approval of, the MTF Commander or authorized representative (COR).

3.9. WORK SCHEDULES.

3.9.1. Workdays will generally consist of eight (8) hour days. Services are generally required five (5) days each week (Monday through Friday), excluding U.S. Federal holidays. Required services may be scheduled between the hours of 6:00 a.m. to 7:00 p.m., Monday through Friday. Hours are subject to change based on need and as mutually agreed between the COR and the Contractor however; the total number of hours will not exceed eighty (80) hours per two (2) week period. A lunch period is not a payable period, but will be coordinated with the COR. Commuting time to and from required place of performance is not compensable by the Government. In no case will overtime be authorized or paid.

3.9.2. Non-Duty Days. Contractor personnel may not be required to perform on government non-duty days or other times when the MTF may be closed such as Pacific Air Forces (PACAF) family days (approximately 5 - 6 days per year). The COR at each location shall notify the contractor five (5) work days prior the family day if performance will be required. Non-duty days shall be considered non-paid days and shall be deducted from the contractor’s monthly invoice.

3.9.3. Scheduled and Unscheduled Absences. Contractor personnel are allowed to take up to twenty (20) work days of leave annually. Leave is classified as both annual, vacation or sick leave. Leave shall be taken in one (1) day increments and shall not exceed ten (10) consecutive work days. All leave is considered non-paid days and shall be deducted from the contractor’s monthly invoice. Timing and details shall be coordinated with the COR. Scheduled absences shall be scheduled at least thirty (30) calendar days in advance and mutually agreed upon by the COR and individual. Unscheduled absences shall be called into the COR by the contract provider within the first two (2) hours of each duty day that he/she is unable to report to work.

3.9.4. Replacement of contractor personnel. The contractor management staff shall replace permanent contractor personnel at the earliest possible date ensuring vacancies do not exceed sixty (60) calendar days. The consecutive calendar days begin on the departing contract employee’s last duty day at the requesting location. The contractor management staff shall ensure that all temporary or permanent replacement staff are fully qualified, meet all pre-placement requirements and are ready to perform within the required timeframe.

3.9.5. Non-paid days. The government will not be required to pay for non-duty days, scheduled/unscheduled absences or days where the contractor does not perform services (i.e. waiting for replacement contractor personnel to arrive). Non-paid days shall be deducted from the monthly invoice amount and shall be calculated as follows:

CLIN Monthly Amount divided by thirty (30) calendar days = Daily Rate

Thirty (30) calendar days shall be used for calculation purposes regardless of the total number of days within the month.

3.10. CONDUCT.

3.10.1. The contracting officer may request that any contractor management staff or contractor 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.

3.10.1.1. The contractor management staff shall not employ individuals who are potential threats to health, safety, security, general well-being, or operational mission of the DoD and its population.

3.10.1.2. The contractor management staff is responsible to ensure all government-issued identification badges, common access cards, keys, equipment and car passes are returned to the COR or his/her designated representative when an individual is leaving employment under this contract.

3.10.2. CONTRACTOR IDENTIFICATION: All contractor management staff or contractor personnel 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 contractor 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 contractor personnel and will be visible at all times. An acceptable badge would include: Name, Title, Contractor Company Name, For example, Jane Doe, RN Case Manager, Contractor, XYZ Company. Both the MTF-issued identification badge and the contractor badge shall be worn above the waistline during the individual’s duty hours.

3.10.3. DRESS AND APPEARANCE: Contractor personnel will maintain good personal hygiene and a well-groomed, professional appearance. Business casual dress attire is appropriate. If an MTF requires their contractor personnel to wear a uniform (i.e., scrubs, lab coat, etc.), the Government will provide it to the employee from the supply stock that other MTF personnel utilize on a daily basis. Laundering will be accomplished by the Government. Uniforms will remain the property of the Government and must be returned.

3.10.4. LANGUAGE REQUIREMENTS. Contractor personnel shall read, understand, speak, and write English fluently. TOEIC score of at least 730 or equivalent certificate is required for non-native English speakers.

4. AUTOMATED INFORMATION SYSTEMS III SECURITY REQUIREMENTS

4.1. Contractor personnel will have access to and/or process information requiring protection under the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act (HIPAA) of 1996 on unclassified automated information systems (AIS) under this contract. Therefore, contractor personnel working for the Government under this contract are in non-sensitive public trust positions designated as AIS III (formally ADP) positions in accordance with DoD Directive 5200.2-R. In compliance with DoD Directive 5200.2-R a National Agency Check (NAC) is required for all AIS III positions. The contractor management staff shall fully adhere to the provisions in these referenced publications by ensuring all contractor personnel who are performing under this contract are prepared to complete the security requirements in accordance with requesting installation policy and procedures. Contractor personnel shall, for example, submit appropriate security forms that are complete and accurate or schedule and attend scheduled appointments.

4.2. Contractor personnel shall submit security investigation forms per base requirements to the COR at least fourteen (14) business days prior to the employee’s required start date in the MTF. Contractor personnel shall complete the Electronic Questionnaires for Investigations Processing (e-QIP) process in accordance with requesting base or MTF policy and procedure. Failure to submit the e-QIP prior to starting performance may result in a “stop work” on the contract until the e-QIP is completed.

4.3. The MTF Security Manager will assist and process the security investigation forms in conjunction with the base Information Protection Office.

4.4. Contractor personnel shall coordinate submission of fingerprints with the responsible base agency (i.e. MTF Security Office, Information Protection Office (IPO), etc.) and in accordance with applicable base procedure. Fingerprints shall be coordinated immediately following the successful submission of the security investigation forms as verified by the MTF Security Manager.

4.5. Contractor personnel shall produce proof of citizenship (e.g., original Birth Certificate, passport, Naturalization Certificate) upon request.

4.6. The contractor management staff shall advise contractor personnel that a favorable Joint Personnel Adjudication System report is needed as a condition of employment under this contract. The contractor management staff understands the MTF commander may allow contractor personnel temporary or interim access to government systems in non-sensitive positions pending final adjudication of the NACI. Any contractor personnel receiving an “Unfavorable” determination will be immediately removed from the position.

4.7. MISSION ESSENTIAL STATUS. Contractor personnel are not designated as mission essential personnel.

4.8. MTF REQUIREMENTS. Contractor personnel shall complete 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. The Government will provide initial MTF orientation and annual refresher training for contractor personnel. This requirement will be conducted during normal duty hours.

5. TRAINING REQUIREMENTS

5.1. Initial Training.

5.1.1. The Government will ensure adequate, consistent and available training to all contractor personnel through MTF orientation, computer based training (CBT) and section orientations.

5.1.2. This program requires utilization of a government-owned training websites. The Government shall use CBTs as the training platform; facilitate, monitor and validate training of contractor personnel; maintain complete and accurate training records for contractor personnel and ensure annual/refresher training is completed within three (3) days of expiration. Contractor personnel will complete all newly introduced mandatory training is completed within timeframes designated by the Air Force.

5.2. Other Training Requirements

5.2.1. Continued Education. The contractor management staff, at their own expense, shall ensure contractor personnel continue to meet the minimum standards for Continuing Education Unit (CEU) requirements for all contractor personnel licensed, registered or certified by state, national, or medical associations as prescribed in AFI 44-119, Medical Quality Operations. CEUs shall be obtained at no additional cost to the government. Contractor personnel CEU maintenance will be validated at least annually for compliance and currency by the COR or his/her designee. Occasionally, no-cost CEUs may be available at the MTF and available to any contractor personnel desiring to attend if space is available.

5.2.2. Basic Life Support Certification. At a minimum, all contractor personnel working within an MTF must maintain current certification in the American Heart Association Basic Life Support (BLS)-Course C or the American Red Cross CPR/BLS (Heartsaver) Course. Training shall be obtained at no cost to the Government so that contractor personnel arrive in the position fully qualified. The Government may offer refresher training for contract workers on a space available basis. The Government will not pay for initial or recertification training obtained outside the MTF.

5.2.3. Health Insurance Portability and Accountability Act (HIPAA) of 1996. All contracted management staff or contractor personnel performing services for the Air Force are required to complete initial and annual refresher HIPAA Privacy and Security Rule training as provided by the MTF for its personnel and will be held accountable for complying with health information privacy and security policies and procedures. Reference Section H, Special Contract Clauses, for detailed HIPAA language.

6. RECORDS, FILES, DOCUMENTS, DATA, AND WORK PAPERS. All records, files, documents, data and work papers provided by the government remain Government property. Contractor 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, contractor personnel 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 nor may work under this contract be performed outside the MTF.

7. CONTRACTOR PROPRIETARY PROCESSES/TECHNIQUES. The contractor may use proprietary processes and techniques; however, the contractor recognizes that these processes or techniques shall become the property of the Air Force if the contractor uses them in an Air Force facility and they become integrated into the internal processes and workflow. Additionally, processes and techniques may be required to be shared with other contractors.

8. SERVICE SUMMARY

Performance Objective PWS Para

Performance Measure

Licensed Practical/Vocational Nurse, Utilization Manager

Registered Nurse Case Manager

Social Worker Case Manager

6. Specific Tasks: ensures initial and ongoing assessments identify patient needs, issues, resources, health education and care plans.

9. GOVERNMENT FURNISHED PROPERTY. The Government will provide the following equipment, supplies, and services listed below for services performed inside government facilities unless otherwise stated in the contract.

9.1. Equipment/Office Furniture. The contractor personnel will be provided space and equipment for performing services required by this contract.

9.2. Forms. The Government shall provide required forms, either hardcopy or computer-generated used in the performance of services.

9.3. Supplies. The Government will provide non-medical supplies commonly used in the facility for administrative, non-clinical services supporting the care and management of patients.