MLTPWS.DOC

PWS dated 15 Jan 16

Medical Laboratory Technician, Okinawa, Japan

PERFORMANCE-BASED WORK STATEMENT (PWS)

FOR

AIR FORCE MEDICAL SERVICE

MEDICAL LABORATORY TECHNICIAN

18TH MEDICAL GROUP

PERSONAL SERVICES

TABLE OF CONTENTS

Section

Title

Page(s)

Description of Services

Special Requirements

General Information

Attachments-Special Clauses etc.

1. DESCRIPTION OF SERVICES

1.1. OBJECTIVE. To provide one (1) Medical Laboratory Technician. The technician shall be responsible for assisting in collecting and testing patient samples that are related to scheduled, walk-ins, referrals and emergencies when required by the Flight Commander, to ensure access standards are met during personnel deployments, unscheduled absences, or when limited technician staffing dictates. The Medical Laboratory Technician shall be assigned to the Medical Laboratory within the 18th Medical Group, Kadena AB.

1.2. SPECIFIC TASKS. The duties include but are not limited to the following:

1.2.1. Perform/review clinical laboratory testing in accordance with established operating instructions (OI), ensuring reporting of accurate results within established turnaround time.

1.2.2. Manage administrative aspects of analytical testing by ensuring compliance with routine quality control and preventive maintenance requirements.

1.2.3. Provide prompt resolutions to errors and quality concerns by filing variance or incident reports as applicable within 3 duty days of discovery; troubleshoot analyzer problems, recognize discrepancies, erroneous results, and takes appropriate follow up actions.

1.2.4. Coordinate with supervisor in planning work flow and duty schedules for assigned section(s) and set work deadlines as necessary.

1.2.5. Track the status and progress of work, making day-to-day adjustments in work assignments in accordance with established priorities, and obtaining assistance from the supervisor on irresolvable issues as necessary.

1.2.6. Maintain records of work accomplished, time expended, and prepare/review reports as required.

1.2.7. Consult with other medical staff members to determine their requirements for effective patient care.

1.2.8. Review/Revise Operating Instructions (OI) annually/ within 30 days of new procedures being implemented (except in cases of complete instrument replacement).

1.2.9. Conduct/Document clinical laboratory training through on-the job bench training.

1.2.10. Detect problems with tests and discuss possible solutions with other technicians.

1.2.11. Provide guidance for new, difficult, or unusual assignments with other technicians.

1.3. Service Summary.

1.3.1. The Contractor service delivery requirements are summarized into performance objectives that relate directly to standards of performance required to meet mission essential needs. For the Performance Objective to be met, service delivery must be in substantial compliance with applicable performance standards. The Performance Threshold describes the minimum overall levels of service delivery required for acceptable quality control. Failure to meet these Performance Thresholds means that contractor Quality Control is unacceptable. The following is a list of the key performance objectives that will be verified as contractually compliant by government personnel; however, inspection of any contract requirement is authorized.

Perform a variety of procedures including complex analysis and infrequently requested tests in various sections of the laboratory

A. Maintains working knowledge of all lab operating instructions for tests performed.

B. Performs timely and appropriate analysis for the tests ordered by the health care provider.

C. Performs testing competently without assistance.

D. Reviews, transcribes, and verifies testing results for acceptability before result certification.

A. Receives less than 2 documented variance reports per quarter associated with procedure deviations; based on FY calendar.

B. Does not receive more than 10 validated complaints a year from the medical staff on the accuracy and timeliness of test results reported.

C. Should not exceed more than two safety violations per year.

D. Receives less than 2 Amended reports per quarter associated with failure to follow documented reporting procedures; based on FY calendar

Performs and evaluates quality control (QC) and performance improvement (PI) programs

A. Records, documents, QC data.

B. Completes and submits College of American Pathologists (CAP) and other proficiency surveys within allotted suspense dates and scores at or above national standard levels.

C. Identifies trends that could lead to problems or unacceptable results, and reports them to the OIC or NCOIC of the laboratory while initiating appropriate actions.

A. Does not exceed 5 errors per month in recording or transferring lab QC data.

B. Meets all suspenses or obtains prior approval from leadership for new suspenses; passes all proficiency surveys with a minimum score of 80% or higher.

C. Identifies and maintains at minimum a 95% capture rate for trends that could lead to problems or unacceptable results. Produces a <5% error rate when conducting quality control testing and Quality Assurance processes.

Prepares reagents, assembles equipment, performs instrument maintenance, and verifies correct instrument operations

A. Prepares and stores reagents according to manufacturer’s instructions.

B. Performs tests analysis, equipment, safety hazard checks and instrument maintenance in accordance with manufacturer’s recommendations or regulatory agencies requirements

C. Takes appropriate action and documents appropriately when troubleshooting each equipment or instrument.

A. Accumulates < 2 errors per month regarding storage and preparation of reagents.

B. Accumulates < 2 errors per month regarding test analysis, equipment, and instrument maintenance. Follows safety hazards guidance 100% of the time.

C. Accumulates < 2 instances per quarter where appropriate action and communication are not initiated.

Ensures the pre-analytical suitability of patient specimens used for testing

A. Provides appropriate containers and detailed instructions to patients for specimen collection, properly schedules patients for timed tests, and rejects inappropriate samples that do not match provider’s orders.

B. Enters or records appropriate demographics, test requests, and other necessary information in CHCS when entering provider’s request.

C. Follows established recall procedures A. Accumulates < 2 instances per quarter, involving inappropriate instructions, mis-scheduled tests, inappropriate collection containers issued to patients, or inappropriate sample acceptance.

B. Accumulates < 2 instances per quarter, involving the correct entry of provider data when ordering tests or accessing the patient record.

C. Conducts patient recalls when needed with < 2 errors per quarter.

Accepts referrals of unusual or abnormal results and observations from lower-grade laboratory personnel

A. Takes action when QC is unacceptable B. Follows correct action when patient results are abnormal, critical, or delta checked.

C. Documents the course of action taken when results have been verified and appropriate authorities notified.

A. Receives < 2 occurrences per year regarding unacceptable QC follow-up.

B. Accumulates < 2 instances per year regarding failure to act on abnormal, critical, or delta checked patient results.

C. Accumulates <2 instances per year regarding failure to document follow-up actions and notifications to providers.

Personally instructs military and civilian personnel on laboratory techniques employed within the laboratory

A. Provides training to staff. Provides constructive feedback, evaluates efforts, implements necessary corrective actions, and documents training in staff member’s competency assessment record.

B. Attends all in-service requirements required by regulatory agencies and the Medical Treatment Facility.

A. With < 2 occurrences per year provides for and completes training of required personnel as directed.

B. Required training and in-services are kept 100% current or are coordinated /rescheduled to be completed w/in 60 days of notification of due. For rare instances where availability is compromised these requirements may be waived or substituted with prior approval of the appropriate authority.

Advises OIC, NCOIC, and section NCOICs in the procurement of new laboratory instrumentation/test methodologies

A. Provides input and assists in the development of new protocols.

B. Assists in the performance of the validation and/or correlation studies of old versus new equipment or methods.

A. When requested, provides input and assists OIC, NCOIC, or Section NCOICs with < 2 failures to do so per year.

B. With < 2 failures per year, assists when directed in performing validation and/or correlation studies related to new or old instruments and test methods.

Accurately reports hours worked on invoices

Provides satisfactory patient care

2. SPECIAL REQUIREMENTS

2.1. Skills and Knowledge

2.1.1. The Medical Laboratory Technician shall possess basic knowledge to perform analyses of biologic and related materials in hospital, environmental, occupational, epidemiological, toxicological, or research and development laboratories; and teach medical laboratory sciences.

2.1.2. The Medical Laboratory Technician shall possess ability to acquire and use basic computer skills to enter patient data and extract patient’s information, from a variety of sources to include Composite Health Care System (CHCS) and Aeromedical Services Information Management System (ASIMS).

2.1.3. The Medical Laboratory Technician shall possess basic knowledge of various training methods and interpersonal skills in order to develop a rapport with the patients and co-workers during which instructional and education information is presented and a supportive, trusting relationship is established.

2.1.4. The Medical Laboratory Technician shall possess basic knowledge of and ability to demonstrate leadership skills in order to provide guidance, counseling, training and professional evaluation.

2.1.5. The Medical Laboratory Technician shall possess basic knowledge of operating medical equipment/non-medical equipment associated within the areas of Phlebotomy, Chemistry, Hematology, Urinalysis, Serology, and Microbiology to ensure patient and staff safety, proper equipment maintenance and accessibility.

2.1.6. The Medical Laboratory Technician shall possess basic knowledge of established clinic standards of care and The Joint Commission requirements for clinical and documentation protocols, safety, infection control, performance improvement, etc., to insure compliance with policies and provide consistent training and guidance for clinic staff.

2.1.7. The Medical Laboratory Technician should possess basic knowledge in management and daily operation of a clinic servicing a large number of patients with a variety of healthcare needs and illnesses.

2.2. Qualifications

2.2.1. Education. Possess an Associate’s degree in Medical Laboratory Technology or must have graduated from a medical laboratory technician training program accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) or the Accrediting Bureau of Health Education Schools (ABHES). Upon acceptance and start of position, the Medical Laboratory Technicians will be required to complete Medical Treatment Facility specific annual training required in accordance with HIPAA, The Joint Commission, AF Computer Security Policy, and AF Safety Policy.

2.2.2. Privileging and Credentialing. The credentials of all Medical Laboratory Technicians shall be reviewed. The Contractor is responsible to ensure that proposed staff possesses the qualifications sufficient to allow for performance of all tasks identified in Sections 1 & 2 of this PWS.

2.2.3. Certification. Medical Laboratory Technician must be certified by the American Society of Clinical Pathologists (ASCP) or American Medical Technologists (AMT), or State Licensure.

2.2.4. Maintains current certification in Basic Life Support (BLS) at no expense to the government.

2.2.5. Language Requirement. Personnel shall read, understand, speak, and write English to at least a STEP (Eiken) 2nd grade, TOEIC score 519 or TOEFL score 456 level or higher. If technician’s primary language is English, no certification is required.

2.3. Criminal Background Check Requirement

2.3.1. The Government shall conduct criminal background checks on individuals providing child care services under this contract, using the procedures set forth in Department of Defense Instruction 1402.5 dated 19 January 1993. Background checks will be based on fingerprints of individuals obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureaus of Investigation and state criminal history repositories.

2.3.2. The technician 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.

2.4. Security Requirements

2.4.1. The Medical Laboratory Technician shall complete a Kadena Contractor Access Badge (CAB) affidavit to acquire access to Kadena AB and forward to Security Forces for a background investigation at least two weeks prior to employment on base. Once the background investigation has been accomplished the Medical Laboratory Technician will report to Medical Logistics to input their data into computer system, after input into computer system, Medical Laboratory Technician can report to Bldg 31 to get Common Access Card (CAC). Upon termination of employment, the contractor shall return identification cards and base passes to Security Forces within 24 hours.

2.5. Computer Security

2.5.1. A National Agency Check with Inquiries must be completed to conduct a security background check for appropriate security of privacy act information, IAW AFI 33-202V1_AFMCSUP1, dated 30 November 2005, par 4.1.1.1.2. All contractors must have a National Agency Check with Inquiries (NACI) or single scope background investigation (SSBI) prior to granting access to government e-mail, network or computer systems.

2.5.2. The Medical Laboratory Technician shall complete and e-mail an electronic copy of the SF85, Electronic Personnel Security Questionnaire (EPSQ) file in the ".zdb" format to the Security Manager two weeks prior to employment in the MTF.

2.6. Employee Health Requirements.

2.6.1. Certification of current physical examination for each employee. The certification shall contain a signed statement by the examining physician stating that the employee is free of any contagious diseases. Physical examination must be current as of 12 months prior to application for privileges.

2.6.2. A condition of employment, Occupational Safety and Health Administration (OSHA) requires that all contract personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity to Hepatitis B infection. Personnel who sign declinations may change their minds at any time and receive the Hepatitis B vaccine without penalty.

2.6.3. The Medical Laboratory Technician shall report (to the appropriate MTF staff member) all information necessary to assure hospital records can be maintained correctly, and therefore comply with The Joint Commission, OSHA, and Center for Disease Control (CDC) health records requirement. See below:

EMPLOYEE HEALTH REQUIREMENTS

B. Proved by history of illness, titer or vaccination; Vaccinate if susceptible.

C. Mandatory prior to placement in high risk occupations (Laboratory).

B. Mandatory prior to placement in high risk occupations (Laboratory).

B. Mandatory annually in high risk occupations (Laboratory)

1. Documentation of laboratory evidence of immunity or

2. Documentation of adequate vaccination.

B. Vaccinate if susceptible; however, if pregnant or contemplating pregnancy, do not vaccinate. Pregnancy test should be performed when doubts about pregnancy exists C. Mandatory prior to placement in Medical Treatment Facility

1. History of physician diagnosed disease.

2. Documentation of laboratory evidence of immunity or

3. Documentation of adequate vaccination.

B. Vaccinate if susceptible; however, if pregnant or contemplating pregnancy, do not vaccinate. Pregnancy test should be performed when doubts about pregnancy exists C. Mandatory prior to placement in Medical Treatment Facility

B. Mandatory prior to placement in Medical Treatment Facility

C. Mandatory annually in Medical Treatment Facility

B. Mandatory prior to placement in Medical Treatment Facility

2.7. Preventative, Prophylactic, and Follow-Up Procedures

2.7.1. The Medical Laboratory Technician shall ensure that he/she is 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 provided by the Government to contract employees in the military MTF. The Medical Laboratory Technician shall reimburse payment for these services. If care is received elsewhere, the Medical Laboratory Technician shall provide written verification of treatment.

2.7.2. 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 employee at the current full reimbursement rate.

3. GENERAL INFORMATION

3.1. Hours of Operation.

3.1.1. Normal Hours of Operation. The contractor shall perform the services required under this contract during the following hours: Monday - Friday 0730-1630 (with a one hour non paid lunch), except U.S. Federal Holidays .The contractor may work, with prior approval of the Contracting Officer, extended hours to ensure timely completion of work at no additional cost to the government.

3.1.2. Recognized Holidays. The contractor is not required to provide service on the following holidays and will not be compensated if he/she chooses to work on these days. If the holiday falls on Saturday, it is observed on Friday. If the holiday falls on a Sunday, it is observed on Monday.

New Year’s Day 1 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 4 July

Labor Day First Monday in September

Columbus Day Second Monday in October

Veterans’ Day 11 November

Thanksgiving Day Fourth Thursday in November

Christmas Day 25 December

3.1.3. Absences and Leave.

All scheduled leave shall be coordinated/approved two weeks in advance. Appointments should be approved two days prior to scheduling. In case of unplanned absences or illness, exceeding one (1) day the Contractor shall replace the absent employee with another person, of equal or exceeding qualifications, within 24 hours of COR’s notification. The identified substitute must have already completed, or be in the process of completing, NAC requirements in order to access government computers. The Contractor shall advise the COR regarding absences due to illness or incapacitation. If the technician is absent for more than two consecutive days due to illness, the Contractor shall provide the government with a statement that the employee is free from communicable illness and the cause of the illness before or as the employee returns to work.

3.1.4. Failure or Inability to Perform. Any worker demonstrating impaired judgment shall not be permitted to work in the MTF. The Government reserves the right to remove from the facility any worker who in the judgment of a licensed provider is impaired by drugs or alcohol. Workers removed for alcohol/drug abuse or behavioral misconduct may be allowed to return to work under the terms of this agreement only with prior Government approval. Evidence of continued problems will be cause for the Government to require that the contractor furnish another worker to perform the required duties.

3.1.5. Probation Period. All contractor personnel shall undergo an initial 30-day probation performance period. During this period of time, government personnel will more closely monitor contractor performance. At the end of the 30 days, the MTF will notify the contractor of any employee who demonstrates unsatisfactory performance in relation to the performance objectives outlined in this document.

3.2. Conflict of Interest. The contract shall not be any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval in accordance with DOD Directive 5500.7-R, Joint Ethics Regulation. The contractor personnel shall not employ persons for the work of this contract if such employment would create a conflict of interest per AFI 64-106, Air Force Industrial Labor Relations Activities.

3.3. Contractor Furnished Items and Supplies. The contractor shall furnish everything required to perform this contract in accordance with all of its terms.

3.4. RELEASE OF MEDICAL INFORMATION

3.4.1. The Medical Laboratory Technician shall only release medical information obtained during the course of this contract to other MTF staff involved in the care and treatment of that individual patient.

Attachment 1 – Section H Special Contract Clauses

H.1 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996

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 HIPAA. 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 HIPAA Privacy for DOD medical facilities is set forth in DOD 6025.18-R, and for HIPAA Security, the requirements for AF MTFs are contained in draft/final AFI 41-217, which also contains additional Information Assurance requirements for all AF MTFs. Both DOD 6025.18-R and the final AFI 41-217, when published, are incorporated herein by reference. The draft AFI 41-217 will be an attachment to this contract in the interim. MTFs 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 DoD 6025-18R, the Contractor and Health Care Workers 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 Health Care Workers agree to abide by all HIPAA Privacy and Security requirements regarding health information as defined in this clause, DoD 6025-18-R, as amended and draft/final AFI 41-217, incorporated by reference. Additional HIPAA requirements will be addressed when implemented.

1. Privacy of Protected Health Information-

(a) Definitions. As used in this clause generally refer to the CFR definition, unless a more specific provision exists in DOD 6025.18-R:

Individual has the same meaning as the term “individual” in 45 CFR 164.501 and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g).

Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160 and part 164, subparts A and E.

Protected Health Information has the same meaning as the term “protected health information” in 45 CFR 164.501, limited to the information created or received by The Contractor from or on behalf of The Government.

Required by Law has the same meaning as the term “required by law” in 45 CFR 164.501.

Secretary means the Secretary of the Department of Health and Human Services or his/her designee.

Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103 and 164.501.

(b) The Contractor agrees to not use or further disclose Protected Health Information other than as permitted or required by the Contract or as Required by Law.

(c) The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract.

(d) The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Contract.

(e) The Contractor agrees to report to the Government any use or disclosure of the Protected Health Information not provided for by this Contract.

(f) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the Contractor on behalf of the Government, agrees to the same restrictions and conditions that apply through this Contract to the Contractor with respect to such information.

(g) The Contractor agrees to provide access, at the request of the Government, and in the time and manner designated by the Government to Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524.

(h) The Contractor agrees to make any amendment(s) to Protected Health Information in a Designated Record Set that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or an Individual, and in the time and manner designated by the Government.

(i) The Contractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Contractor on behalf of, the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner designated by the Government or the Secretary, for purposes of the Secretary determining the Government’s compliance with the Privacy Rule.

(j) The Contractor agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

(k) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

General Use and Disclosure Provisions Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for the other purposes, if such use or disclosure of Protected Health Information would not violate the Privacy Rule or the Department of Defense Health Information Privacy Regulation if done by the Government: Treatment, Payment or Healthcare Operations.

Specific Use and Disclosure Provisions

(a) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

(b) Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of the information has been breached.

(c) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information to provide Data Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B).

(d) Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j) (1).

Obligations of the Government Provisions for the Government to Inform the Contractor of Privacy Practices and Restrictions

(a) Upon request the Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice.

(b) The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the Contractor’s permitted or required uses and disclosures.

(c) The Government shall notify the Contractor of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to in accordance with 45 CFR 164.522.

Permissible Requests by the Government The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the Privacy Rule if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause.

Termination

(a) Termination. A breach by the Contractor of this clause, may subject the Contractor to termination under any applicable default or termination provision of this Contract.

(b) Effect of Termination.

(1) If this contract has records management requirements, the records subject to the Clause should be handled in accordance with the records management requirements. If this contract does not have records management requirements, the records should be handled in accordance with paragraphs (2) and (3) below

(2) If this contract does not have records management requirements, except as provided in paragraph (3) of this section, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of the Contractor. The Contractor shall retain no copies of the Protected Health Information.

(3) If this contract does not have records management provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected Health Information.

Miscellaneous

(a) Regulatory References. A reference in this Clause to a section in the Privacy Rule or DOD 6025.18-R means the section in effect or as amended, and for which compliance is required.

(b) Survival. The respective rights and obligations of Business Associate under the “Effect of Termination” provision of this Clause shall survive the termination of this Contract.

(c) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with DOD 6025.18-R first and then the Privacy Rule as contained in the CFR.

2. Security of Protected Health Information

(a) Definitions. As used in this clause:

Electronic Protected Health Information has the same meaning as the term “electronic protected health information” in 45 CFR 160.103.

Secretary means the Secretary of the Department of Health and Human Services or his/her designee.

Security Rule means the Security Standards for the Protection of Electronic Protected health Information at 45 CFR part 160 and part 164, subpart C.

Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103, 164.103, and 164.304.

(b) The Contractor agrees to implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of the Electronic Protected Health Information that it creates, receives, maintains, or transmits on behalf of the Government.

(c) The Contractor agrees to report to the Government any security incident of which it becomes aware.

(d) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Electronic Protected Health Information that it creates, receives, maintains, or transmits on behalf of the Government, agrees to the same restrictions and conditions that apply through this Contract to the Contractor with respect to such information.

Termination

A breach by the Contractor of this clause, may subject the Contractor to termination under any applicable default or termination provision of this Contract.

Miscellaneous

(a) Regulatory References. A reference in this Clause to a section in the Security Rule means the section as in effect or as amended, and for which compliance is required.

(b) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with the Security Rule per the CFR, then AFI 41-217 and any subsequent MTF Health Information Assurance Policies.

H.5 CONTRACTOR EMPLOYEE STATUS

The Air Force does not dictate whether the individual health care workers provided under this contract would be classified by the contractor as an “independent contractor” or an “employee” for federal tax purposes. This determination is made solely by the contractor. If the contractor’s determination is challenged, this shall be a matter to be resolved between the contractor, the Internal Revenue Service (IRS), and the health care worker(s). The Air Force will not consider favorably any request for equitable adjustment to the contract based upon the contractor’s receipt of an adverse action by the IRS.

H.6 LIABILITY INSURANCE

(a) Before commencing work under a contract, the contractor shall certify to the CO in writing that the required insurance has been obtained by the contractor. The following insurance as referenced in FAR 28.306 (b) (1) and 28.307, is the minimum insurance required:

(1) General liability - Bodily injury liability insurance coverage written on the comprehensive form of policy of at least $500,000 per occurrence.

(2) Automobile liability - Automobile liability insurance written on the comprehensive form of policy. The policy shall provide for bodily injury and property damage liability covering the operation of all automobiles used in connection with performing the contract. Policies covering automobiles operated in the United States shall provide coverage of at least $200,000 per person and $500,000 per occurrence for bodily injury and $20,000 per occurrence for property damage. The amount of liability coverage on other policies shall be commensurate with any legal requirements of the locality and sufficient to meet normal and customary claims.

(3) Workers' compensation and employer's liability - Contractors are required to comply with applicable Federal and State workers' compensation and occupational disease statutes. If occupational diseases are not compensable under those statutes, they shall be covered under the employer's liability section of the insurance policy, except when contract operations are so commingled with a contractor's commercial operations that it would not be practical to require this coverage. Employer's liability coverage of at least $100,000 shall be required, except in States with exclusive or monopolistic funds that do not permit workers' compensation to be written by private carriers.

H.7 CONFIDENTIALITY OF INFORMATION

Unless otherwise specified, all financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the contractor or health care worker during the performance of this contract are considered Government confidential business information and shall not be used for purposes other than performance of work under this contract. The contractor and/or the health care worker shall not release any of the above information without prior written consent of the CO. All medical records and reports remain the property of the Government.

Patient lists, no matter how developed, shall be treated as confidential information in accordance with the Privacy Act and the Health Insurance Portability and Accountability Act (HIPAA). Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF, except through MTF-specified processes.

All inquiries and complaints shall be brought to the attention of the health care provider’s employer.

January 2016