6_Atch_3_PWS.pdf

Attachment 3 of FA520919U0035

PERFORMANCE WORK STATEMENT

FOR

LICENSED PRACTICAL NURSE

FOR

TRICARE OPERATIONS & PATIENT ADMINISTRATION (TOPA),

374TH MEDICAL GROUP

YOKOTA AIR BASE, JAPAN

374 MDSS/SGST

15 July 2019

Table of Contents

SECTION 1 Description of Services / General Information Page 3

SECTION 2 Services Summary Page 21

SECTION 3 Government Furnished Property and Services Page 23

SECTION 4 Appendix Page 24

Appendix A. Applicable Publications and Forms

REFERRAL MANAGEMENT CENTER NURSE

AT 374TH MEDICAL GROUP AT YOKOTA AIR BASE, JAPAN

SECTION 1.

DESCRIPTION OF SERVICES. The Contractor shall provide one (1) Licensed Practical Nurse (LPN) to support 374th Medical Group, Yokota AB, Japan, also referred to as the “Military Treatment Facility” (MTF) herein. The Contractor shall furnish all management, tools, supplies, equipment, and labor necessary to perform as a Referral Management Center (RMC) Nurse in the office that acts as the “central clearing house” for referral services between providers and patients.

1.1. NON-PERSONAL SERVICES. This is a non-personal services contract. No personal services will be performed under this contract. The Contractor shall not perform any inherently governmental actions under this contract. The services rendered by the Contractor are rendered in the capacity of an independent contractor. The Government retains no direct control over the services provided by the Contractor. No Contractor employees shall hold himself/herself out to be a Government employee, agent or representative.

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

1.1.2. MTF Requirements. Contractor employees 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 employees. This requirement will be conducted during normal duty hours.

1.2. PROFESSIONAL QUALIFICATIONS/REQUIREMENTS.

1.2.1. Qualifications. Contractor’s employee will meet the criteria outlined in the following sections of Education, Licensure/Certification, and Experience.

1.2.1.1. Education. Proof of graduation from an approved National League of Nursing LPN program.

1.2.1.2. Licensure/Certification. The contractor employees shall possess and maintain a valid, current, unrestricted license to Practice Nursing from the state at which services are rendered. Contractor employees will be responsible for renewing all licenses before expiration date and will provide proof of renewal submission to MDG POC. Contractor employee will also be required to annually submit a copy of their current license the first duty day in January.

1.2.1.2.1. The contractor employees are responsible for maintaining/renewing licensure from a state and if required, a certification or registration when caring for patients within the MTF.

The contractor employees shall not perform any service if license is inactive or revoked.

1.2.1.2.2. Copies of required licensure shall be furnished to the Contracting Officer (KO) and Contracting Officer Representative (COR) prior to performance on this contract. Copies of renewals must be submitted ten (10) days before date of expiration.

1.2.1.2.3. When offerors intend to use personnel whose resume was not submitted at the solicitation, they should submit resume to the contracting office to verify that the proposed personnel have the same level of knowledge, skill, experience and training as the one whose resume was submitted and evaluated at the time of solicitation. When the resume does not show the same level of knowledge, skill, experience and training as the one whose resume was submitted and evaluated at the time of solicitation, the contracting officer will request the offerors to submit another personnels’ resume.

1.2.1.3. Experience. Contractor employees shall have minimum of three (3) years for full-time employment in a nursing field.

1.2.1.4. English Language Requirement. The Contractor shall read, understand, speak, and write English fluently and clearly.

1.3. GENERAL SCOPE. The Contractor shall be responsible for providing medical consultation and administrative support for the Medical Treatment Facility (MTF) staff and patients. Duties include but are not limited to greeting the patients, screening patient records, referral coordination, referral reviews, referral tracking, and administration services between patients, team members, network/external providers, as well as ancillary health care workers.

Performance shall meet the professional standards of The Joint Commission (TJC) and Health Services Inspection (HSI).

1.3.1. The Government will provide training to include appointing, referral management business rules, and Government IT systems requirements. The contractor employees shall have functioning knowledge of Government appointing and referral management business rules, Government appointing information systems, The Joint Commission (TJC), HIPAA, DoD Health Information Privacy Regulation (DoD 602118-R) the Privacy Act, and DoD Privacy Program (DoD 5400. 1 l-R) to appoint patients correctly. All contractor employees that access Government IT systems shall be trained in security awareness, protection of Government sensitive and privacy information, and their responsibility and consequences before access is authorized.

1.4. POSITION REQUIREMENTS.

1.4.1. The contractor employees shall maintain health record storage. Contractor employees shall maintain and dispose of records, files, documents, and work papers in accordance with instructions provided by Functional Requirements Evaluator Designees (FRED) and in accordance with MTF policy and procedures.

1.5. REFERRALS.

1.5.1. The contractor employees coordinate referral management functions and ensures team members receive information in a timely and efficient manner to facilitate continuity of patient care.

1.5.2. The contractor employees schedules/coordinates appointments for patients requiring referrals to specialty care within the automated appointment booking and appointment validation system while providing pre-appointment instructions to patients. Reviews all specialty care referral requests for any required testing, appropriate referral agencies and completeness while maintaining and tracking referral records.

1.5.2.1. As a functional expert for health benefits, advises patients of all health benefits available.

1.5.2.2. Reviews new consults to ensure that each consultation contains the necessary information to include the appropriate patient identification and clinical referral information.

1.5.3. Referral Scheduling. The contractor employees are responsible for ensuring the patient is briefed on treatment facility options, as well as acceptance of the referral facility if referral is deferred to the local civilian healthcare sector. Perform Right of First Refusal (RFR) determination, booking and patient notification within twenty-four (24) hours for specialty care. Advice patients of the provider, location, date and time of the MTF or other direct care system referral appointment.

1.5.3.1. Appointments shall be made upon receipt of the referral. Ensure all initial specialty care referrals are either accepted for appointing to the direct care system or deferred to the network within one (1) business day from the order date. One (1) business day includes the order date plus the entire following day, excluding weekend and holidays. Ensure acute appointments are booked within twenty-four (24) hours, routine appointments are booked within seven (7) days, and wellness appointments are booked within twenty-eight (28) days.

Determine where referral will be treated based on rule sets/MOUs/local market conditions, and on MTF capabilities.

1.5.3.2. Verify patients are registered in Composite Health Care System (CHCS)/ Defense Enrollment Eligibility Reporting System (DEERS); update demographic information as necessary.

1.5.3.3. Schedules specialty referral appointments to MTF or Direct Care System in accordance within the time standard in paragraph 1.3.1. of the PWS.

1.5.3.4. Advises patients of the provider, location, date and time of the MTF or other direct care system referral appointment. Locates referral requests and ensures appropriate documents are available prior to all specialty appointments.

1.5.4. Ensures that all diagnostic testing documentation and provider notes are forwarded to the referred network specialist. Ensure patient leaves MTF with all necessary documentation appropriate for the referral provider. Provide instructions to the referral provider for returning referral results.

1.5.5. Coordinates with specialty referral clinics (internal or external) on special patient instructions and tests required prior to appointment.

1.5.6. Import Clearly Legible Reports (CLR), follow-up CLRs, urgent primary care results and all other reports that require an authorization into the Health Artifacts Imagery Management System (HAIMS) within three (3) working days from receipt of results.

1.5.7. The Contractor shall notify both the patient and MTF if a defer to network referral request is invalid or disapproved by second level review. The Contractor shall ensure that the patient is aware of all other health care options.

1.6. Referral Tracking. The contractor employees shall be responsible for tracking and coordinating all initial specialty care referral results generated by the MTF, regardless of beneficiary status or enrollment, from the time the referral is written until the results are available to the referring provider or cancelled/not used by the patient.

1.6.1. Ensure that results are returned to the requesting provider within twenty-four (24) hours on urgent/emergency situations and ten (10) business days for routine appointments.

1.6.2. For referrals accepted for MTF appointing, the communication should be repeated until the appointment is booked, the patient cancels the referral, or the message has been delivered three (3) times on separate days.

1.6.3. The contractor employees shall close all referrals in CHCS no later than one-hundred and eighty (180) days from the date of the acceptance, if the patient did not utilize the referral or keep the appointment.

1.7. Referral Review. The contractor employees are responsible for ensuring all referrals are submitted for review to the network providers for clinical suitability, administrative and clinical completeness, documentation of benefits briefed to the patient, as well as review of all required tests and work-up.

1.7.1. All referrals submitted to the network shall be screened for clinical protocol compliance as established 374 MDG.

1.7.2. Reports. The contractor employees shall prepare and submit trend analysis reports requested by the FRED.

1.7.3. Maintain and provide monthly statistical reports to oversight committees and functions within the timelines designated by the FRED.

1.7.4. The contractor employees are responsible for conducting orientation of all new personnel to the RMC.

2.0. GENERAL INFORMATION.

2.1. CONTRACTOR PERSONNEL.

2.1.1. Contractor Employees. All contractor employees shall be clearly identifiable while on duty. All contract employees 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.

2.1.2. Removal of Contractor’s Employees. The Contractor shall utilize only experienced, responsible and capable employees in the performance of this contract. The KO may require that the Contractor remove any of his/her employees who endanger persons or property, or whose continued employment under this contract is inconsistent with the interests of the U.S.

Government.

2.1.3. Third Country Nationals (TCN). The Security Forces on each base control entry to the base. Under certain circumstances, the TCN might be denied entry. It is the Contractor’s responsibility to coordinate with Security Forces at each base when there is a question about particular entry circumstances.

2.1.4. U.S. Government and/or Master Labor Contract Employees. The Contractor shall not hire employees of the U.S. Government and/or Government of Japan Master Labor Contract employees in violation of the Procurement Integrity Act. See FAR 3.104.

Furthermore, the contractor shall not employ any Department of Defense employee, either military or civilian, unless such person seeks and receives approval in accordance with Department of Defense 5500.7-R, Joint Ethics Regulation.

2.1.5. Military Personnel. The Contractor is cautioned that off-duty active military personnel hired under this contract may be subject to permanent change of station (PCS), change in duty hours, or deployment. Military Reservists and National Guard members may be subject to recall to active duty. Abrupt absence of these personnel could adversely affect Contractor’s ability to perform; however, their absence at any time shall not constitute an excuse for non-performance under this contract.

2.1.6. Point of Contact (POC). 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 Contractor shall designate this individual, in writing, to the KO upon award. The Contractor shall maintain a current listing of employees, providing updates as changes occur. The POC shall be proficient in English and have a good understanding of the requirements pertaining to this contract for interpretation and implementation of directives (written and oral), issued in English by the KO or COR.

2.1.7. Appearance. While on duty, contractor employees shall be neat and clean, well-groomed, and dressed appropriately. Contractor employee’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.

2.2. QUALITY CONTROL. The Contractor shall develop and maintain a quality control program to ensure the services are performed in accordance with commonly accepted commercial practices. The Contractor shall develop and implement procedures to identify, prevent and ensure non-recurrence of defective services. At a minimum, the Contractor shall develop quality control procedures addressing the areas identified in Section 2, Services Summary.

2.3. QUALITY ASSURANCE. The Government will evaluate the Contractor’s performance in accordance with the Quality Assurance Surveillance Plan (QASP) by appointing a COR to monitor performance to ensure services are received.

2.4. GOVERNMENT REMEDIES. The KO shall follow FAR 52.212-4, Contract Terms and Conditions-Commercial Items, for the Contractor’s failure to perform satisfactory services or failure to correct non-conforming services.

2.5. CONTRACTING OFFICER (KO) AUTHORITY. Only the KO has authority to enter into, administer, terminate or modify the terms and conditions herein. Any changes made by persons other than the KO will be considered an unauthorized commitment and subject to ratification actions in accordance with FAR 1.602-3.

2.6. CONTRACTING OFFICER’S REPRESENTATIVE (COR). The Contractor shall coordinate all aspects of this requirement with the COR. Completed work shall be subject to inspection and acceptance by COR. This designation will be made in writing by the KO at the time of contract award, or prior to commencement of COR duty. The COR shall NOT direct or redirect any contractor action(s). This can only be done by the KO.

2.7. AVAILABILITY OF FACILITY.

2.7.1. Hours of Operations. Normal hours of operation of the MTF are 0730-1630 hrs, Monday thru Friday, with variability depending on mission requirements.

2.7.2. Federal Holidays. Federal Holidays are paid days. The contractor employees may be required to perform duties during the PACAF family days as well as during monthly SRTD (Samurai Readiness Training Days).

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

*Holidays falling on a Saturday will be observed on the preceding Friday, and holidays falling on a Sunday will be observed on the following Monday.

2.7.3. Availability.

2.7.3.1. Workdays can consist of eight (8) to ten (10) hours a day, based on mission requirements. Services are generally required five (5) days each week (Monday thru Friday), excluding U.S. Federal holidays. Required services may be scheduled between the hours of 0700-1800 hrs., Monday thru Friday. Hours are subject to change based on need and as mutually agreed between the FRED/COR and contractor employees. 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 FRED/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.

2.7.3.2. Scheduled and Unscheduled Absences. Contractor employees 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 FRED/COR. Scheduled absences shall be scheduled at least thirty (30) days in advance and mutually agreed upon by the FRED/COR and Contractor. Unscheduled absences shall be called into the FRED/COR by the contract employees within the first two (2) hours of each duty day that he/she is unable to report to work.

2.7.3.3. Contractor employees 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 7 - 9 days per year). The FRED/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.

Contract Line Item Number (CLIN) Monthly amount divided by two-hundred and forty (240) hours (30 calendar days) = Hourly Rate

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

2.7.3.4. If the contractor employees are ill or sick, the Contractor or designee must notify the FRED/COR of anticipated length of absence.

2.7.3.5. The contractor employees 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 thirty 30 minutes and will work until released by the FRED/COR.

2.7.3.6. The base closure due to the incremental weather will be payable days.

2.7.4. Arrange for Replacement Staff. The Contractor management staff shall replace permanent contractor employees at the earliest possible. Contractor employees must notify to the Contractor and the Government staff (FRED, COR, CA or KO) of the intention to vacate the job at least thirty (30) calendar days prior to the last duty day at the requesting location. (e.g. send resignation form/document to the Contractor). The Contractor must provide candidate package to the Government staff no later than thirty (30) calendar days prior to the date of resignation. 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.

2.8. SECURITY REQUIREMENTS.

2.8.1. 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.

2.8.2. 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.

2.8.3. Government Computer Access. The Contractor will ensure that all contractor 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 contractor employees 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 employees to temporarily occupy non-critical sensitive positions pending National Agency Check (NAC), the employees 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.

2.9. CRIMINAL BACKGROUND CHECK REQUIREMENT.

2.9.1. The Contractor shall ensure that, as a condition of employment, the contractor employees 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.

2.9.2. 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.

2.9.3. 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.

2.9.4. 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.

2.9.5. 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 two (2) years.

2.10. EMERGENCY HEALTH CARE. The MTF will provide emergency health care for contractor employees for injuries occurring while on duty in the MTF. These services will be billed to the contractor employees.

2.11. PATIENT SENSITIVITY. The contractor employees shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.

Whenever the contractor employees receives complaints, COR validates those, valid complaints will be forwarded to the KO for further action.

2.12. COMMUNICATION. The Contractor shall ensure contractor employees 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.

2.13. APPLICABLE PUBLICATION AND FORMS. The contractor employees 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 employees 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 employees shall immediately implement those changes.

2.14. AUTOMATED INFORMATION SYSTEMS III SECURITY REQUIREMENTS.

2.14.1. Contractor employees 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 employees 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 employees who are performing under this contract are prepared to complete the security requirements in accordance with requesting installation policy and procedures. Contractor employees shall, for example, submit appropriate security forms that are complete and accurate or schedule and attend scheduled appointments.

2.14.2. Contractor employees 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 employees 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.

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

2.14.4. Contractor employees 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.

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

2.14.6. The contractor management staff shall advise contractor employees 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 employees temporary or interim access to government systems in non-sensitive positions pending final adjudication of the NACI. Any contractor employees receiving an “Unfavorable” determination will be immediately removed from the position.

2.15. TRAINING REQUIREMENTS.

2.15.1. Initial Training.

2.15.1.1. The Government will ensure adequate, consistent and available training to all contractor employee through MTF orientation, Computer Based Training (CBT) and section orientations.

2.15.1.2. 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 employees; maintain complete and accurate training records for contractor employees and ensure annual/refresher training is completed within three (3) days of expiration. Contractor employees will complete all newly introduced mandatory training is completed within timeframes designated by the Air Force.

2.15.2. Other Training Requirements.

2.15.2.1. Continued Education. The contractor management staff, at their own expense, shall ensure contractor employees continue to meet the minimum standards for Continuing Education Unit (CEU) requirements for all contractor employees 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 employees 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 employees desiring to attend if space is available.

2.15.2.2. Basic Life Support (BLS) Certification. At a minimum, all contractor employees 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 employees 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.

2.15.2.3. Health Insurance Portability and Accountability Act (HIPAA) of 1996. All contracted management staff or contractor employees 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.

2.15.2.4. 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.

2.16. RECORDS, FILES, DOCUMENTS, DATA, AND WORK PAPERS. All records, files, documents, data and work papers provided by the government remain Government property. Contractor employees 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 employees 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.

2.17. DEPARTMENT OF DEFENSE SCHOOLS (DoDDS). Education, including special education, to the children of contractor employees 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 employees and their child(ren) with significant disabilities (i.e., blindness, deafness, severe mental retardation, serious emotional impairments) to the job location, the contractor employees shall ensure the child's educational needs can be met.

2.18. REQUIRED INSURANCE. (In addition to that required by Japanese Law).

2.18.1. The Contractor shall procure and maintain during the entire period of his performance under this contract the following minimum insurance on each vehicle used by the Contractor at the work site.

2.18.2. Type: Automobile Property Damage Insurance, Amount: Y3,000,000 or Dollar equivalent Bodily Injury Insurance Amount: Y30,000,000 or Dollar equivalent. All vehicles must be properly inspected/insured in accordance with Japanese Compulsory Insurance (JCI) requirements.

2.18.3. Prior to the commencement of work, the Contractor shall certify in writing that your company has obtained and will maintain the required insurance for the life of the contract.

2.19. SECURITY AND SAFETY REQUIREMENTS.

2.19.1. Installation Base Passes. The U.S. Government will issue all required Installation/Base Passes and Controlled Area Badges to contractor personnel at no cost to the Contractor. Vehicle insurance certificates are required to obtain Base Passes and must cover the automobile liability insurance in the types and minimum amounts of (a) Bodily Injury - ¥30,000,000 per person per occurrence, in addition to the Japanese Compulsory Insurance (JCI), and (b) Property Damage - ¥3,000,000 per occurrence. The Prime Contractor shall be responsible for all passes issued to his/her own or subcontractor’s employees under this contract. The Contractor shall return all applicable passes upon termination of employment or completion of this contract to the Japanese Pass Section, and a certificate of receipt shall be obtained.

NOTE: Contractor personnel are required to comply with U.S. Army Regulation 190-5 for personnel pass requirements. Contractors are also required to comply with U.S. Army Garrison Japan Regulation 190-13 for vehicle pass requirements. These regulations are available for the selected Contractor’s review upon personnel and/or vehicle pass issuance.

2.19.2 Security Requirements. The Contractor shall ensure each employee obtains all the required passes and identification items for access to U.S. Government’s installations. These items are issued by the Security Forces Pass and Registration Section. The Contractor and employees shall return identification cards to Security Forces within twenty-four (24) hours of termination or completion of this contract. All other Government identification for terminated employees shall be returned to the KO within twenty-four (24) hours of termination.

2.19.4. Photography Permission. The Contractor shall obtain COR approval prior to commencing any photography.

2.19.5. Reports of Damages, Destruction, Injury, or Death

2.19.5.1. The Contractor shall report all incidents of damage or destruction to property, or personal injury or death to any person, arising out of and during the performance of this contract. The term “property” includes equipment, freight, or property of any type, whether Government owned or not. The term “Contractor” includes the Contractor, its agents, servants or employees.

2.19.5.2. The Contractor shall submit these reports to the KO through the COR as follows:

(a) A preliminary report shall be made as soon as practicable after the time the incident occurs. The report may be either verbal or facsimile.

(b) A complete written report shall be submitted within four (4) days (96 hours) after occurrence of the incident. A copy of this report shall be furnished to the COR.

2.19.6. Security Danger Warning, Accident Prevention, Fire Prevention and Fire Protection Requirements. The Contractor shall comply with all pertinent requirements of the U.S. Air Force and Fire Protection and Safety Regulations or Laws of Japan, whichever is more stringent, to insure compliance by all subcontractors.

2.19.10. Environmental Regulations. The Contractor shall comply with all U.S.

Government and Japanese environmental laws (whichever are most stringent) to protect the health and safety of employees/residents, and preserve the local and global environment.

The Contractor shall comply with the Japan Environmental Governing Standards (JEGS) and shall minimize or eliminate environmental pollution and energy/utility waste.

2.19.11. Delivery and Storage of Materials. All materials delivered and placed in storage shall be protected from the weather, humidity and temperature variations, dirt and dust, or other contaminants by the Contractor.

2.19.12. Disposal of Materials. All debris and unserviceable materials generated under this contract such as industrial waste, non-recyclable materials and equipment/material not listed on hand-receipts shall be disposed of off-base by the Contractor in accordance with the laws of Japan. Hand receipt items require turn-in action by the contractor when the listed items have to be replaced.

2.19.13. Responsibility for Damages. Any damages caused to U.S. Government property during the course of performing this contract shall be restored, replaced and/or repaired to its original condition at no additional cost to the U.S. Government.

2.20. 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 a Referral Management Center Nurse.

2.21. KEY CONTROL. The Contractor shall establish and implement methods of ensuring that all keys issued to the Contractor by the government are not lost or misplaced and are not used by unauthorized persons. The Contractor shall report lost keys to the FRED/COR. The Contractor shall not duplicate any keys.

2.21.1. The Government may, at its option, require the Contractor to replace keys, reimburse the government for replacement of locks, or re-key as a result of Contractor losing keys. In the event a master key is lost or duplicated, the Contractor shall replace all locks and keys for that system and the total cost shall be deducted from the monthly payment.

2.22. HEALTH REQUIREMENTS.

2.22.1. 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 Worker (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.

2.22.2. 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 Public Health (PH) at DSN 315-225-5311

2.22.3. At least fourteen (14) business days prior to start of work, the Contractor is required to submit to the KO and COR, a complete employee qualification record for the HCW as proof of immunization of contractor employees 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.

2.22.3.1. HCW must in-process through Public Health (PH) within ten (10) duty days of arrival at the 374 Medical Group.

2.22.3.2. 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.

2.22.3.3. 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 employees, not the Government.

2.22.3.4. 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 employees, not the Government.

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

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

2.22.3.7. 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.

2.22.3.8. Pregnant Employees. It is the responsibility of the Contractor to notify the COR of a pregnant employee. MTF Employees 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 employees work in the environment.

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

2.22.4. 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 DoDI 8580.02 and AFI 41-217, which also contains additional Information Assurance requirements for all AF MTF’s. DOD 6025.18-R, DOD 8580.02-R 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.

2.22.5. 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 KO 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 employees 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 psychology as a psychologist in any US state/jurisdiction. Employees are 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.

2.22.6. Medical Health Insurance Coverage. The Contractor employees 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.

2.22.7. Overseas Medical.

2.22.7.1. The contractor employees 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. The contractor employees must pay for all prescriptions filled at the MTF. The MTFs pharmacy rates are comparable to rates in the U.S. 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.

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

2.22.7.3. 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 employees and their dependents.

2.22.7.4. 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).

2.23. CONTRACTOR MANPOWER REPORTING. 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.

2.23.1. 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.

http://www.ecmra.mil/

2.23.2. Uses and Safeguarding of…