CLR_PWS_3_Dec_13.pdf

Attachment 1 To Solicitation No. FA5209-14-T-0009

PERFORMANCE-BASED WORK STATEMENT

FOR

REFERRAL MANAGEMENT CENTER CLEAR AND LEGIBLE RESULTS TECHNICIAN

FOR

374TH MEDICAL GROUP,

YOKOTA AIR BASE, JAPAN

374 MDSS/SGSM

3 Dec 13

Table of Contents

Section Number and Title Page Number

1.0 Description of Services/General Information 3

2.0 Service Summary 14

3.0 Government Furnished Property and Services 16

4.0 Contractor Manpower Reporting Requirements 18

REFERRAL MANAGEMENT CENTER CLEAR AND LEGIBLE RESULTS

TECHNICIAN

AT 374TH MEDICAL GROUP YOKOTA AIR BASE, JAPAN

1. DESCRIPTION OF SERVICES/GENERAL INFORMATION: This is a non-personal health care services contract, under which the contractor is an independent contractor. The Contractor shall provide one (1) Referral Management Center (RMC) Clear and Legible Results (CLR) Technician to provide services required for Government beneficiaries. The Contractor shall provide care at the 374th Medical Group, Yokota Air Base, Japan, also referred to as the “medical treatment facility” (MTF) herein. The Contractor care shall cover the range of services provided in a civilian medical treatment facility. Performance shall be according to the requirements contained in this performance-based work statement (PWS), professional standards of the Joint Commission (JC), and Health Services Inspection (HSI).

1.1 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

1.1.2 Mission Essential Status. Contractor personnel are not designated as mission essential personnel.

1.2 PROFESSIONAL QUALIFICATIONS/REQUIREMENTS

1.2.1. Qualifications.

1.2.1.1. Education. The contractor personnel shall possess a high school diploma or General Educational Development (GED) equivalency.

1.2.1.1.1. Experience. Reserved

1.2.1.2. Knowledge. Reserved

1.2.1.2.1 The Contractor shall ensure Contractor personnel is knowledgeable of the policies and procedures of their specific place of duty and of the medical activity.

1.2.1.3 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.

1.2.2. Position Requirements. Reserved

1.2.3. General Information and Type of Work:

1.2.3.1. Responsible for tracking and receiving CLRs of referrals deferred to network within 60 calendar days for review by applicable healthcare provider and will track open referrals on a daily basis to ensure Access-to-Care (ATC) standards are maintained and notify patient and healthcare provider IAW/Medical Group Instruction (MDGI) 41-111.

1.2.3.2. Responsible for scanning CLRs into Armed Forces Health Longitudinal Technology Application (AHLTA) IAW local/Air Force Instruction (AFI) 44-176, Chapter 14 guidance and closure of the referral in Composite Health Care System (CHCS) within 60 calendar days and will prepare a wide variety of recurring and some nonrecurring correspondence, reports, and other documents IAW MDGI 41-111.

1.2.3.3. Proofreads/edits documents. Ensures coordination procedures are followed and prepare patient briefing packets, routing/delivery of correspondences (referrals, CDs, reports, etc.) from RMC staff throughout the MTF.

1.2.3.4. Covers front desk. Answers telephone calls, greets visitors, and receives/relays messages for RMC staff members. Demonstrates telephone etiquette and communication skills and will schedule of patient referral appointments (internal/external appointments) and documenting/tracking of the referral in the Referral Management System (RMS) Tracking Database and within CHCS.

1.2.3.5. Verifies patients are registered in CHCS and Defense Enrollment Eligibility Reporting System (DEERS); updates demographic information as needed. Obtain current, accurate contact information from patient (i.e. cell/home phone number).

1.2.3.6. Schedules specialty referral appointments to MTF or Network providers using correct CHCS booking procedures, ATC standards and established clinic capability/booking protocols.

Performs/assists with appointing network specialty care referrals as allowed by the Managed Care Support Contractor (MCSC), IAW MDGI 41-111.

1.2.3.7. Informs patients of the provider, location, time and day of referral appointments.

Requests the patient to call back for appointment information if not provided appointment prior to leaving MTF for MTF and network provider initial specialty care appointments and will provide pre-appointment instructions to patients as indicated by the MTF IAW MDGI 41-111.

1.2.3.8. Submits referrals to the appropriate reviewer when required for medical necessity and appropriateness review and will document patient appointments in CHCS and/or RMS Tracking Database.

1.2.3.9. Creates of referrals into standard format for submission to request appointments on DD Form 2161, Referral for Civilian Medical Care and will coordinate of referral authorizations from International SOS (ISOS).

1.2.3.10. Copies medical records for Release of Information as required.

1.2.3.11. Coordinates translation services for beneficiaries with translation contract services and will communicate to host nation hospitals/healthcare providers to facilitate beneficiary referral requirements as needed.

1.2.3.12. The government will provide training to the contractor on the following systems to assist as needed:

AHLTA

CHCS

Referral Manage System (RMS) Carepoint Juniper

1.2.4. Communication Skills.

1.2.4.1. 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.

1.2.4.2. Communication. The Contractor shall ensure contract healthcare workers under his/her supervision maintain adequate communication with members within the MTF and all patients.

Complaints validated by the Contracting Officer Representative (COR) shall be reported in writing to the Contracting Office and the Contractor for action. Failure of the Contractor to correct validated complaints brought by the MTF staff and the Contracting Officer will warrant administrative action.

1.3 DOCUMENTATION

1.3.1. All contractor personnel shall prepare all documentation to meet or exceed established standards of the MTF as outlined in the “Operating Instructions of the MTF” to include but not limited to: timeliness, legibility, accuracy, content and signature. Only MTF and Air Force approved abbreviations may be used to document care in the health care record. Contractor personnel shall ensure complete patient identifying information is on all documentation that is to become part of a health care record.

1.3.2. Performance of Services during Crisis Declared by the National Command Authority of Overseas Combatant Commander. The Contractor is required to perform services in accordance with this PWS in emergency or limited force protection conditions such as natural disaster;

however DODI 1100.22 does not apply to this contract for crisis situations where continuation of essential services by the Contractor is unfeasible.

1.3.3. 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).

1.4 HEALTH REQUIREMENTS

1.4.1. The Centers for Disease Control and Prevention (CDC) Healthcare Infection Control Practices Advisory Committee (HICPAC) and Advisory Committee on Immunization Practices (ACIP) definition for Health Care Workers (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.

1.4.2. 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.

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

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

1.4.3. 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.

1.4.4. 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.

1.4.5. 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.

HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The medical facilities of the military services and the DOD health plans are specifically listed as covered by HIPPA. Currently, HIPAA Privacy and Security Rules, as set forth in the Code of Federal Regulations, are in effect for all MTFs. The specific implementation of HIPPA Privacy for DOD medical facility is set forth in DOD 6025.18-R, and for HIPAA Security, the requirements for AF MTF’s are contained in DOD 8580.02-R and AFI 41-217, which also contains additional Information Assurance requirements for all AF MTF’s .

DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. MTRs are responsible to insure 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, DOD 8520.02-R and AFI 41-217. Additional HIPAA requirements will be addressed when implemented.

1.5 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.

1.6 OVERSEAS MEDICAL

1.6.1. 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.

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

1.6.3. 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.

1.6.4. 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).

1.7. GENERAL INFORMATION

1.7.1. English Requirement. The CLR shall read, understand, speak, and write English well enough to effectively communicate with patients and other HCW. For native speakers, the contractor shall provide a copy of contractor personnel passport. If not a native speaker, proof of a minimum score or higher of the following English test shall be submitted:

(a) TOEIC score: 730 or higher

(b) Other English Test if no TOEIC score is available: Equivalent level as the above TOEIC score.

1.7.2. Identification. All contractor personnel shall be clearly identifiable while on duty. All contractor personnel shall wear a Contractor nametag with the company name, individual’s name, and specialty displayed: The nametag shall be worn on the outermost garment. Facility badges, provided by the government, must be worn at all times.

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

1.7.4. Point of Contact. The Contractor shall provide a point of contact that shall be responsible for the performance of the work. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The point of contact may be a healthcare worker providing care in accordance with this PWS. The Contractor shall designate this individual, in writing, to the Contracting Officer upon award.

1.7.5. Availability.

1.7.6. Work days 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 0730-1630., 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.

1.7.6.1. 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.

1.7.6.2. Scheduled and Unscheduled Absences. 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. Unscheduled absences shall be identified though the COR by the contractor personnel within the first two (2) hours of each duty day that he/she is unable to report to work for continuity of office’s service.

1.7.6.3. Federal Holidays. Federal Holidays listed below:

New Year’s Day 01 January Martin Luther King’s Birthday Third Monday in January President’s Day Third Monday in February Memorial Day Last Monday in May Independence Day 04 July Labor Day First Monday in September Columbus Day Second Monday in October Veteran’s Day 11 November Thanksgiving Day Fourth Thursday in November Christmas Day 25 December

1.7.6.4. The contractor employee should follow command announcements for reporting to work as it relates to inclement weather or base closures. In the event of real world disasters, all personnel are required to respond to the MTF within 30 minutes and will work until released by the COR.

1.7.6.5. Arrange for Replacement Staff. 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.

1.7.7. Other Requirements. Reserved.

1.7.8. Security Requirements.

1.7.8.1. The Contractor Manager or alternate shall complete a Request for Identification Credential (AFMC Form 496) for each employee of the contractor requiring access to Yokota Air Base. The request shall be submitted to Pass and Registration. The Government shall provide a completed Identification Credential (AFMC Form 3876), which shall be issued, displayed and surrendered as directed in AFI 31-209, The Air Force Resource Protection Program.

1.7.8.2. Computer Security. A National Agency Check must occur for clearance for appropriate security of privacy act information. Contractor is responsible for completing SF85P Worksheet and providing fingerprint cards for each employee immediately with the hiring process, complying with regulations, DoD 5200.2-R, Chapter 1 and Appendix A, and AFSSSI 5027, Section 1.8.1.2.1. The above information must be completed and submitted to the MTF prior to seeing patients.

1.7.8.3. Government Computer Access. The contractor will ensure that all contract employees comply with the requirement to obtain the minimum personnel security investigations as prescribed by DoD 5200.2-R and AFI 31-501, paragraphs 3.27.3.7 to 3.27.3.7.2. The contractor will work with the MTF to ensure that the pre-employment screening process for each employee classified as ADP I, II, III (as defined in DoD 5200.2-R) includes the appropriate investigations and that each contract employee has the appropriate questionnaires and forms to be completed.

All completed forms will be reviewed by the contractor and forwarded to the MTF for processing prior to the employee beginning work. The contractor understands that, while the MTF Commander may allow contractor personnel to temporarily occupy non-critical sensitive positions pending National Agency Check (NAC), the employee will be immediately removed from the position if at any time the NAC receives unfavorable adjudication, or if other unfavorable information that would affect the NAC becomes known. This must be completed prior to the start of health care delivery. All documents will be submitted to the designated MTF Security Manager.

1.7.9. Criminal Background Check Requirement.

1.7.9.1. The contractor shall ensure that, as a condition of employment, the contractor personnel providing patient care services under this contract meet the requirements of the Crime Control Act of 1990, as amended. This will be accomplished by successfully completing a Criminal Background Check consisting of a Federal Bureau of Investigation (FBI) fingerprint check and State Criminal History Repository check. The procedures for completing the required background checks are outlined within Department of Defense Regulation 5200.1, The DoD Information Security Program and DoD Instruction 1402.5, Criminal History Background Checks on Individuals in Child Care Services, 19 Jan 93. The Contractor is responsible for any costs associated with the Criminal Background Check.

1.7.9.2. Personnel may be employed under the contract pending completion of background checks but will not care for minor children alone until completion of the background checks.

1.7.9.3. All background investigation requests shall be submitted to the designated MTF security manager. The name of the COR shall be included in each request as the recipient of the results.

1.7.9.4. Individuals shall have the right to obtain a copy of any background check pertaining to them and to challenge the accuracy and completeness of the information contained in the report.

1.7.9.5. Individuals who have previously received a background check shall provide proof of the check to the MTF security manager and submitted with the credentialing package, or obtain a new one. A new investigation is required if a break in service to the Department of Defense results in a time lapse of more than 2 years.

1.7.9.6. National Agency Check. The contractor must submit a SF-85P (Application for Public Trust Position) to designated MTF Security Manager to begin the National Agency Check (NAC). When contractor personnel arrives Applicant will be fingerprinted using SF-87/FD258 (Fingerprint Card). The documentation will be submitted to the US Office of Personnel Management. Any person who receives an unfavorable NAC or is determined disloyal, untrustworthy, or unreliable, shall be removed from employment by the Contractor.

1.7.9.7. Emergency Health Care. The MTF will provide emergency health care for contractor personnel for injuries occurring while on duty in the MTF. These services will be billed to the Contractor Personnel.

1.7.9.8. Patient Sensitivity. The contractor personnel shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. Whenever the contractor personnel receives complaints, COR validates those, valid complaints will be forwarded to the Contracting Officer for further action.

1.7.9.9. Communication. The Contractor shall ensure contractor personnel under his/her supervision maintain open and professional communication with members of the MTF.

Complaints validated shall be reported in writing to the Contracting Office and the Contractor for action.

1.7.9.10. Applicable Publication and Forms. The contractor shall comply with Air Force Instruction (AFI) 44-102 and MDGI 44-110. The applicable areas of those instructions will be briefed to the contractor personnel prior to commencement of services. These documents are available in the MTF and maintained by the Government. Supplements or amendments to instructions or publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes.

1.8. AUTOMATED INFORMATION SYSTEMS III SECURITY REQUIREMENTS

1.8.1. 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.

1.8.2. 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.

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

1.8.4. 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.

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

1.8.6. 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.

1.9. TRAINING REQUIREMENTS

1.9.1. Initial Training.

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

1.9.1.2. 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.

1.9.2. Other Training Requirements.

1.9.2.1. 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.

1.9.2.2. Training. Training will be conducted on military specific needs and the DD Form 2792, Exceptional Family Member Medical Summary, completion for overseas clearance. These activities will be a daily part of medical care for active duty military dependents.

1.10. 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.

1.11. 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.

2. SERVICES SUMMARY (SS).

Performance Objective PWS Paragraph Performance Threshold

SS#1: Responsible for tracking and receiving CLRs of referrals deferred to network within 60 calendar days for review by applicable healthcare provider and tracking open referrals on a daily basis to ensure Access-to-Care (ATC) standards are maintained and notify patient and healthcare provider as applicable.

1.2.3.1.

98% complete performance of the requirements under the PWS.

SS#2: Responsible for scanning CLRs into Armed Forces Health Longitudinal Technology Application (AHLTA) IAW local/Air Force Instruction (AFI) 44- 176, Chapter 14 guidance and closure of the referral in Composite Health Care System (CHCS) within 60 calendar days and will prepare a wide variety of recurring and some nonrecurring correspondence, reports, and other documents IAW

MDGI 41-111.

1.2.3.2.

98% complete performance of the requirements under the PWS.

SS#3: Proofreads/edits documents.

Ensures coordination procedures are followed and prepare patient briefing packets, routing/delivery of correspondences (referrals, CDs, 1.2.3.3.

98% complete performance of the requirements under the PWS.

reports, etc.) from RMC staff throughout the Medical Treatment Facility (MTF).

SS#4: Covers front desk. Answers telephone calls, greets visitors and receives/relays messages for RMC staff members. Demonstrates telephone etiquette and communication skills and will schedule of patient referral appointments (internal/external appointments) and documenting/tracking of the referral in the Referral Management System (RMS) Tracking Database and within CHCS.

1.2.3.4.

SS#5: Verifies patients are registered In CHCS and Defense Enrollment Eligibility Reporting System (DEERS); updates demographic information as needed.

Obtain current, accurate contact information (i.e. cell/home phone number).

1.2.3.5.

98% complete performance of the requirements under the PWS.

SS#6: Schedules specialty referral appointments to MTF or Network providers using correct CHCS booking procedures, ATC standards and established clinic capability/booking protocols.

Performs/assists with appointing network specialty care referrals as allowed by the Managed Care Support Contractor (MCSC), IAW

MDGI 41-111.

1.2.3.6.

98% complete performance of the requirements under the PWS.

SS#7: Informs patients of the provider, location, time and day of referral appointments. Requests the patient to call back for appointment information if not provided appointment prior to leaving MTF for MTF and network provider initial specialty care appointments and will provide pre-appointment instructions to patients as indicated by the MTF IAW MDGI 41-111.

1.2.3.7. 98% complete performance of the

SS#8: Submits referrals to the appropriate reviewer when required for medical necessity and appropriateness review and will document patient appointments in CHCS and/or RMS Tracking Database.

1.2.3.8. 98% complete performance of the requirements under the PWS.

SS#9: Creates referrals into standard format for submission to request appointments on DD Form 2161, Referral for Civilian Medical Care and will coordinate of referral authorizations from International

SOS (ISOS).

1.2.3.9. 98% complete performance of the requirements under the PWS.

SS#10: Copies medical records for Release of Information as required.

1.2.3.10. 98% complete performance of the requirements under the PWS.

SS#11: Coordinates translation services for beneficiaries with translation contact services and will communicate to host nation hospital/healthcare providers to facilitate beneficiary referral requirements as needed.

1.2.3.11 requirements under the PWS.

SS#12: Trained on the following systems to assist as needed.

AHLTA

CHCS

Referral Manage System

(RMS)

Carepoint Juniper

1.2.3.12.

3. Government Furnished Property/Services. The Government will provide the following equipment, supplies, and services listed below:

3.1. Office/Work/Locker Area. Those areas (office, exam room, etc.,) provided for the use of the contractor personnel will present an orderly appearance. Contractor personnel shall ensure these areas are tidy and any decorative items present a professional, modest appearance in keeping with accepted community standards. Office space will be shared with other members of the medical team. The Government will not be responsible for loss or damage of personal items brought into the MTF. Ensure safe work environment and employee safe work habits, reference MTF and base safety programs.

3.2. Equipment. The contractor personnel shall have joint use of all available equipment for performing services required by this contract.

3.3. Personal Protective Equipment (PPE). The Government will furnish the contractor personnel with appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

3.4. Forms. The MTF will provide required Government forms used in the performance of services.

3.5. Supplies. The MTF will provide medical and non-medical supplies commonly used in the facility for the care and management of patients.

3.6. Computer Equipment. The MTF will provide computer equipment required to schedule, check-in, document, order ancillary services, and maintain appropriate electronic medical information that supports the hard copy medical record. The MTF will provide required training for these systems. The contractor personnel will be required to use the computer systems that are standard for the support of health care delivery at the MTF.

3.7. Administrative Support. The contractor personnel will be authorized to use all administrative support available to the government employees. This will include, but is not limited to copy machines, fax machines, installation distribution, Class “A” telephone lines and Defense Switching Network (DSN) lines. The same restrictions to limit use of these items for official government business apply.

3.8. Identification Cards. The Government will issue a hospital identification (ID) badge which must be worn at all times within the MTF, when Infection Control issues are not compromised.

The ID badge must be visibly displayed between the shirt collar and the waist. A Common Access Card will also be issued to allow the contractor access to necessary computer systems and to the base and the MTF during heightened security. Both cards must be carried by the individual at all times while working at the MTF.

4. CONTRACTOR MANPOWER REPORTING REQUIREMENTS.

4.1. IAW FY11 NDAA Section 8108, the contractor shall report all contractor labor hours (including subcontractor labor hours) required for performance of services provided under this PWS via a secure data collection site. The contractor is required to completely fill in all required data fields at: http://www.ecmra.mil.

4.1.1. Reporting Period. Reporting inputs will be for the labor executed during the period of performance for each Government Fiscal Year (FY), which runs 1 October through 30 September. While inputs may be reported any time during the FY, all data shall be reported no later than 31 October of each calendar year. Contractors may direct questions to the Contractor Manpower Reporting Application (CMRA) help desk.

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

4.1.3. User Manuals. Data for Air Force service requirements must be input at the Air Force CMRA link. However, user manuals for contractors are available at the Army CMRA link at:

http://www.ecmra.mil.