Atch_1_PWS_-_FY_16_Child_Psychologist-_7_Apr_16.pdf

Attachment 1

Solicitation No. FA5209-16-R-0014

PERFORMANCE-BASED WORK STATEMENT

FOR

CHILD PSYCHOLOGIST

FOR

374TH MEDICAL GROUP,

YOKOTA AIR BASE, JAPAN

374 MDOS/SGOW

7 Apr 2016

Table of Contents

Section Number and Title Page Number

1.0 Description of Services/General Information 3

2.0. Service Summary 16

3.0. Government Furnished Property and Services 17

4.0. Contractor Manpower Reporting Requirements 18

CHILD PSYCHOLOGIST CONTRACT

AT 374TH MEDICAL GROUP YOKOTA AIR BASE, JAPAN

1. DESCRIPTION OF SERVICES/GENERAL INFORMATION. The Contractor shall provide Child Psychologist services which will be referred to singularly, as a Psychologist throughout the remainder of this Performance based Work Statement (PWS). The psychologist will support the Air Force Psychologist Health Program, 374th Medical Group, Yokota AB, Japan, also referred to as the “Medical Treatment Facility” (MTF) herein. The psychologist shall cover the range of services provided in a civilian medical treatment facility. Performance shall be according to the requirements contained in this PWS, professional standards of the Joint

Commission (JC), National Committee for Quality Assurance (NCQA), Air Force Pediatric

Patient Centered Medical Home (PCMH) 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 functions. The contractor is solely liable for the actions of their employees.

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

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

1.1.3. 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. PROFESSIONAL QUALIFICATIONS/REQUIREMENTS

1.2.1. Qualifications.

1.2.1.1. Education. The Psychologist shall have a Doctor of Philosophy (Ph.D.) or (Psy.D.)

degree in clinical or counseling psychology from an American Psychological Association (APA) accredited psychology program

1.2.1.2. Licensure/Certification. Have a current license to practice psychology in any one of the

50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands. Employee is responsible for maintaining/renewing licensure from a state and if required, a certification or registration when caring for patients within the MTF. The psychologist shall not perform any service if license is inactive or revoked. Copies of required licensure shall be furnished to the

Contracting Officer prior to performance on this contract and then turned in to the COR. Copies of renewals must be submitted ten (10) days before date of expiration.

1.2.1.3. Work Experience. Skilled in individual, family and group psychotherapy, and couples therapy, alcohol and drug treatment evaluations.

1.2.1.3.1. Work experience for at least two years with children in a therapeutic capacity is required. Additional experience such as specialty internship or six months to a year fellowship in additional clinical work understanding, diagnosing and treating children's psychological, cognitive, emotional, developmental, behavioral problems is preferable.

1.2.1.3.2. EMR Experience. Psychologist should have experience and skills of the Electronic

Medical Records (EMR) and preferably have experience with Armed Forces Health Longitudinal

Technology Application (AHLTA).

1.2.1.4. Knowledge. Must have knowledge and skills of the basic computer knowledge (ex.

Microsoft office) to effectively apply to psychology functions.

1.2.2. Position Requirements.

1.2.2.1. Psychologist shall perform all duties in accordance with this PWS, 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.

1.2.2.2. Responsible for and applies psychological procedures and techniques, including interviewing, behavioral assessment, cognitive- behavioral therapy, and psychological testing/psycho diagnostic testing, in the evaluation, diagnosis, and treatment of psychological and neuropsychological disorders with children.

1.2.2.3. Conduct applied research and clinical investigations in clinical/behavioral health psychology as needed.

1.2.2.4. Maintain accurate and current notes in both the separate mental health clinic records and patient electronic medical records of all patients seen, as appropriate, and produces reports of evaluation and/or treatment, as required. Notes must be completed within 72 business hours and must be documented in the most current clinic template.

1.2.2.5. Consult with medical personnel, legal authorities, military commanders and school districts, as required for complex cases such as instances of child abuse, cases requiring drug abuse treatment, and cases that exceed the level of care available at the local facility.

1.2.2.6. Attend and participate in meetings during normal duty hours and professional staff conferences and other appropriate professional activities such as the following: Quality

Improvement meeting, professional staff meetings, Commander's staff meetings, Department meetings, and others required by applicable regulations, MTF guidance, or as directed by the

Chief, Department of Psychology or his/her designated representative.

1.2.2.7. Participate in military specific trainings as deemed necessary to execute the duties of this position.

1.2.2.8. Coordinate and collaborate with the Early Developmental Intervention Services (EDIS)

Team, military child psychiatrists, Special Needs Coordinator and MTF pediatric clinic for inbound and outbound referrals and continuity of care.

1.2.2.9. Psychologist shall be proficient in reading, writing, understanding and speaking English at a level necessary to fully perform all required duties and tasks of their job. The MTF may request demonstrations of ability to meet personnel language proficiency requirements by any reasonable method.

1.2.3. Professional Qualities/Judgment and Decisions. Psychologist shall perform as a professional and their judgment and decision making shall be in accordance with the American

Psychological Association’s Ethical Principles of Psychologists and Code of Conduct.

1.2.4. Organizational Skills. The contractor will need to be able to maintain case notes in an organized fashion and complete all patient care documentation within 72 hours of the patient encounter.

1.2.5. Communication Skills.

1.2.5.1. Provide appropriate customer service skills with all patients and foster development of those skills throughout entire medical team.

1.2.5.2. Communicate and collaborate with the PCM and appropriate members of the health care team to ensure that needs of assigned patients are met without duplication of effort.

1.2.5.3. Network with social services, Integrated Delivery System (IDS), utilization management, and HCI. Recognize limitations on interventions imposed by MTF capabilities, community resources, local TRICARE contracts, and remain within scope of authority

1.2.6. Productivity.

1.2.6.1. Psychologist is required to see the standard number of patients per day as is set by the individual MTFs average patient turnover.

1.2.6.2. Psychologist shall perform up to eight patient care hours per day averaging approximately 8 patients per day or 40 patients per week.

1.3. PRIVILEGING & CREDENTIALS. Psychologist will be subject to the credentials and privileging requirements of AFI 44-119, Clinical Performance Improvement as well as adverse actions.

1.3.1. Psychologist shall be able to obtain privileges through the applicable MTF Credentials

Committee. The Contractor shall provide a complete, current and accurate credentialing package for each individual as required in AFI 44-119, Chapter 4.

1.3.2. The Government shall review the credentials of the Psychologist. The MTF must award privileges before the psychologist may start work at the MTF. The MTF needs a minimum of 30 days after receipt of a complete package to grant privileges.

1.3.3. Any clinical or administrative adverse actions will be handled and processed IAW applicable Air Force instruction(s). In the event of an adverse action, the Contracting Officer will provide a written statement advising the Contractor adverse action. The written statement will detail the basis for the action, provide the Contractor sufficient information in order to make employment/substitution decisions as necessary, and if required, the final outcome of the adverse action process. Per 10 USC 1102, the Government will mark the written notice(s) as Confidential and Privileged. No other information pertaining to the adverse action will be released without MTF permission. Examples of adverse action include loss of credentials or loss of base access and could be the result of innumerable situations (misconduct on base, impaired provider, unsafe patient care, etc…)

1.4. GENERAL INFORMATION

1.4.1. Documentation. HCW 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. HCW shall ensure complete patient identifying information is on all documentation that is to become part of a health care record.

1.4.2. SOFA STATUS. SOFA article I (b) will be provided to United States National(s), who is/are not ordinarily resident in Japan and solely for the purpose of executing this contract as employee(s) of the contractor.

1.4.3. Evaluation. 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).

1.4.4. Health Requirements.

1.4.4.1. The Centers for Disease Control and Prevention (CDC) Healthcare Infection Control

Practices Advisory Committee (HICPAC) and Advisory Committee on Immunization Practices

(ACIP) definition for 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.

1.4.4.2. 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

1.4.4.3. At least fourteen (14) business days prior to start of work, the contractor is required to submit to the Contracting Officer, a complete employee qualification record for the HCW 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.

1.4.4.4. HCW must in-process through Public Health (PH) within 10 duty days of arrival at the

374 Medical Group.

1.4.4.5. 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.

1.4.4.6. 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 or contractor personnel, not the Government.

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

1.4.4.8. HCW working in an MTF is 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 the contractor. If the vaccine is obtained at other facilities, the cost will be borne by the

Contractor or contractor personnel, not the Government.

1.4.4.9. Immunization information for contractor personnel shall be provided to the respective

MTF for government personnel to record and track in DoD computer systems.

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

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

1.4.4.11. 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.

1.4.4.12. 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.

1.4.4.13. 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.

1.4.5. 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 maintain during the terms of this contract liability insurance 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 via COR 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.

Non-personal services contract employees must have an active, valid, current and unrestricted license (with no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Employee is responsible for maintaining/renewing licensure from a state and if required, a certification or registration when caring for patients within the MTF. The psychologist shall not perform any service if license is inactive or revoked.

1.4.6. CLAIMS PROCEDURES. Reserved.

1.4.7. 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.

1.4.8. OVERSEAS MEDICAL

1.4.8.1. 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. Emergency 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.

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

1.4.8.3. 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.

1.4.8.4. 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).

1.4.9. English Requirement. The HCW shall read, understand, speak, and write English well enough to effectively communicate with patients and other HCWs. If not a native speaker, proof of a minimum score or higher of the following English test shall be submitted to the Contracting

Officer prior to start of contract performance:

(a) TOEIC score: 730 or higher

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

TOEIC score.

1.4.10. Identification. All contract personnel shall be clearly identifiable while on duty. All contract 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.

1.4.11. Appearance. While on duty, contract personnel shall be neat and clean, well-groomed, and dressed appropriately. Contract 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

1.4.12. 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.

1.4.13. Reserved.

1.4.14. Hours of Operation. Normal hours of operation of the MTF are 0730-1630hrs, Monday-Friday, with variability depending on patient care needs and mission requirements.

1.4.15. Availability.

1.4.15.1. Workdays can consist of eight (8) to 10 hour days based on mission requirements.

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 0700-1800hrs., 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.

1.4.15.2. Scheduled and Unscheduled Absences. Contracted child psychologist is 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 30 days in advance and mutually agreed upon by the COR and contractor. Unscheduled absences shall be called into the COR by the contract personnel within the first two (2) hours of each duty day that he/she is unable to report to work.

1.4.15.3. Contract 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 10 - 12 days per year). The COR at each location shall notify the Contractor five (5) work days prior to 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.

The base closure due to the incremental weather may not be non-duty days. The rare cases will be determined whether duty or non-duty days by the COR.

1.4.15.6. If the contractor employee is ill or sick, the contractor or designee must notify the COR of anticipated length of absence.

1.4.15.7. 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.

1.4.16. Federal Holidays. Federal Hoslidays are paid days. The contractor personnel may be required to perform duties during about 10 -12 PACAF “Family Days” as well as during monthly

SRTD (Samurai Readiness Training Days) as stated para 1.4.15.3.

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

Note: If holiday occurs on a Saturday it will be celebrated on the Friday preceding the holiday. If the holiday occurs on a Sunday will be celebrated on the Monday following the holiday.

1.4.17. Arrange for Replacement Staff. The contractor shall have adequate qualified replacement personnel available to provide services when current contract personnel will be unable to provide services ten (10) or more scheduled shifts. In the event a replacement is needed, the contractor should contact the Contracting Officer. The replacement shall be accomplished based on coordination with the COR. Substitutes shall be as qualified as the contract personnel being replaced. The Contractor must provide a list of replacement personnel at the start of the contract and update whenever personnel change. In the case that an alternate child psychologist is necessary, the Contractor shall notify the COR immideately and shall identify the name of the alternate in two weeks.

1.4.18. Other Requirements. Reserved.

1.4.19. Security Requirements.

1.4.19. 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.

1.4.19.2. 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.

1.4.19.3. 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.

1.4.20. Criminal Background Check Requirement.

1.4.20.1. 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.

1.4.20.2. 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.

1.4.20.3. 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.

1.4.20.4. 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.

1.4.20.5. 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.

1.4.20.6. 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 contract employee 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.

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

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

1.4.23. Communication. The Contractor shall ensure contract 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.

1.4.24. Applicable Publication and Forms. The contract personnel shall comply with Air

Force Instruction (AFI) 44-102 and Medical Group Instruction (MDGI) 44-110. The applicable areas of those instructions will be briefed to the contractor’s 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 contract personnel shall immediately implement those changes.

1.4.25. Automated Information System III Security Requirement.

1.4.25.1. Contract 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.

1.4.25.2. Contract 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.

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

1.4.25.4. Contract 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.

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

1.4.25.6. The contractor management staff shall advise contract 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 contract personnel receiving an

“Unfavorable” determination will be immediately removed from the position.

1.4.26. Training Requirements.

1.4.26.1. Initial Training.

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

1.4.26.2. 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. Contract personnel will complete all newly introduced mandatory training is completed within timeframes designated by the Air Force.

1.4.27. Other Training Requirements.

1.4.27.1. 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.

1.4.27.2. 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.

1.4.27.3. 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.

1.4.27.4. 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.

1.4.28. 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.

1.4.29. Department of Defenses 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

Performace

Threshold

Method of

Assessment

SS1. Responsible for and applies psychological procedures and techniques, including interviewing, behavioral assessment, cognitive-behavioral therapy, and psychological testing/psycho diagnostic testing, in the evaluation, diagnosis, and treatment of psychological and neuropsychological disorders with children.

1.2.2.2. No more than 5

discrepancies noted on the MDG peer review form per 3 charts peer reviewed each month. The same or similar discrepancies will not occur more than three times

No more than one validated customer complaints per month

Periodic

Inspection

Customer

Complaints

SS2. Maintain accurate and current notes in both the separate mental health clinic records and patient electronic medical records of all patients seen, as appropriate, and produces reports of evaluation and/or treatment, as required.

Patient encounters documented using the locally approved template within

72 hrs of the encounter. No more than

3 failures per month.

1.2.2.4 No more than 5

discrepancies noted in monthly peer review and the same or similar discrepancies will not occur more than three times

No more than 3 failures per month.

SS3. Consult with medical personnel, legal authorities, military commanders and school districts, as required.

1.2.2.5 100% compliance Periodic

SS4. Attend and participate in meetings during normal duty hours and professional staff conferences and other appropriate professional activities such as the following:

Quality Improvement meeting, professional staff meetings, Commander's staff meetings, Department meetings, and others required by applicable regulations, MTF guidance, or as directed by the

1.2.2.6 100% compliance Periodic

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

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

MTF and base safety programs.

3.2. EQUIPMENT. The healthcare worker 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 contract 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 supplies commonly used in the facility to perform in accordance with this PWS.

3.6. 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. The contractor must return all government issued IDs and keys to the facility management and MPS as appropriate.

Chief, Department of Psychology or his/her designated representative.

SS5. Coordinate and collaborate with the Early Developmental Intervention

Services (EDIS) Team, military child psychiatrists, Special Needs

Coordinator and MTF pediatric clinic for inbound and outbound referrals and continuity of care.

1.2.2.8 No more than 1

failure to accurately meet this per month

3.7. 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 will be required to use the computer systems that are standard for the support of health care delivery at the MTF.

3.8. ADMINISTRATIVE SUPPORT. The contractor personnel will be authorized to use all administrative equipment/systems 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.

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.

http://www.ecmra.mil/