Attachment_1_-_PWS_DRHA_Provider_1_Feb_2017.pdf

PERFORMANCE WORK STATEMENT

FOR

DEPLOYMENT-RELATED HEALTH

ASSESSMENT (DRHA)/ANNUAL MENTAL

HEALTH ASSESSMENT (MHA) PROVIDER

SERVICES

REVISED

1 February 2017

Kadena Air Base, Japan

18 MDG/SGPM

15 July 2016

PERFORMANCE WORK STATEMENT TABLE OF

CONTENTS

SECTION PAGE

1 DESCRIPTION OF SERVICES 3

2 SUMMARY OF SERVICES 12

3 GOVERNMENT FURNISHED PROPERTY AND SERVICES 13

4 GENERAL INFORMATION 13

5 APPENDICES 24

1. DESCRIPTION OF SERVICES.

The contractor under this contract will provide personal services as described in 10 U.S.C. 1091 and DFARS 237.104. The position provides direct patient care activities and will primarily include Deployment Medicine and annual MHA Services at the 18th Medical Group, Kadena AB, Okinawa, Japan, also referred to as the “Medical Treatment Facility” (MTF) herein.

The contractor shall provide all management, tools, supplies, equipment, and labor necessary to operate and maintain their ability to include Deployment Medicine and annual MHA Services.

Given that this Performance Work Statement (PWS) requires performance of work in a foreign country, the contractor will be responsible for providing all necessary information to the Government for appropriate notification to foreign government agencies. The contractor shall consider any lead-time necessary to meet those requirements. All individuals placed under this contract must be granted host country approval or accreditation to perform in that country. The contractor is responsible for obtaining all passports, visas, or other documents necessary to enter and/or exit the foreign countries where performance is required.

1.1. PROFESSIONAL QUALIFICATIONS/REQUIRMENTS

1.1.1 DEPLOYMENT MEDICINE: In accordance with (IAW) DoDI 6490.12, Mental Health Assessments for Service Members Deployed in Connection with a Contingency Operation, requires person-to-person deployment mental health assessments be conducted for each Service member deployed resulting from a Joint Chiefs of Staff (JCS) combatant command deployment order for 31 continuous days or greater to a land-based location outside the United States or according to reporting instructions. The mental health assessments will be conducted IAW the DRHA Program Guide. All DRHAs will be completed using Aeromedical Services Information Management System (ASIMS) and documented in Armed Forces Health Longitudinal Technology Application (AHLTA)/Electronic Health Record.

1.1.1.1. DRHA 1: within 120 days before the estimated date of deployment or IAW with current policy and is accomplished as part of the pre-deployment medical out-processing.

1.1.1.2. DRHA 2: within 30 days prior to departure from theater or within 30 days upon return to home station or IAW with current policy.

1.1.1.3. DRHA 3: between 90-180 days after return from deployment or IAW with current policy.

1.1.1.4. DRHA 4: between 181-545 days after return from deployment or IAW with current policy. Whenever possible, DRHA 4 and 5 will be completed with the annual Preventative Health Assessment (PHA).

1.1.1.5. DRHA 5: between 546-910 days after return from deployment or IAW with current policy. Whenever possible, DRHA 4 and 5 will be completed with the annual PHA.

1.1.2. Ensure deployer’s Individual Medical Readiness (IMR) is current.

1.1.3. DRHAs rely heavily on the delivery of multiple levels of education to multiple audiences in the process, including deployers, leaders, and clinicians and the provider may be needed to brief in these particular forums. Educating patients about their individual deployment-related health concerns is critical. The provider must maintain logs on meetings attended and be able to brief statistics monthly to public health flight leadership.

1.1.4. The provider must have a working knowledge of Microsoft Office applications and become proficient in the use of the following computer systems: Composite Health Care Systems (CHCS) – Armed Forces Health Longitudinal Technology Application (AHLTA), ASIMS.

1.1.5. ANNUAL MENTAL HEALTH ASSESSMENT: All active duty members and selected reserve service members receive an annual telephone consult or person-to-person MHA appointment, if warranted with a provider. The MHA will be aligned with non-flyer service members’ PHA. The annual mental health assessments will be conducted IAW with the tri-service PHA guide and DoDI. All annual mental health assessments will be completed using ASIMS and documented in AHLTA/Electronic Health Record.

1.1.6. All patients selected for a person-to-person MHA appointment must be seen within 15 minutes of scheduled arrival time.

1.1.7. PERSONAL SERVICES. The provider under this contract will be personal services as described in 10 U.S.C. 1091 and DFARS 237.104. The position shall provide direct patient care activities in primary care clinics and/or mental health clinics in support of Air Force mental health services. The person placed under this contract shall be a U.S. citizen. The personal services designation does not apply to the prime contractor’s staff, including all teaming partners, subcontractors and their staff at corporate level involved in the company’s administration of this contract.

1.1.8. MEDICAL MALPRACTICE. This contract establishes a personal services relationship between the DRHA/MHA and the Government while performing services under this contract.

This personal services relationship is entered into under the authority of section 1091 of Title 10, United States Code. Accordingly, section 1089 of Title 10, United States Code shall apply to personal injury lawsuits filed against the health care worker(s) based on negligent or wrongful acts or omissions incident to performance within the scope of this contract. This personal services relationship is solely between the DRHA/MHA and the Government. This contract will create an employer-employee relationship between the Government and the provider.

1.1.9. The DRHA/MHA provider is not required to maintain medical malpractice liability insurance. The provider providing services under this contract shall be rendering personal services to the Government and shall be subject to day-to-day supervision and control by Government personnel. Supervision and control is the process by which the individual MHA receives technical guidance, direction, and approval with regard to a task(s) within the requirements of this contract. All other employer/employee duties and responsibilities (payroll, etc.) remain the responsibility of the DRHA/MHA.

1.1.10. ADDITIONAL SERVICES: Although the DRHA/MHA mission will remain priority, upon approval by the FRED, the provider may support clinical or administrative support to Family Health or Flight Operational Medicine Clinic, which may include, but is not limited to providing direct or in-direct patient care whether in-person, over-the-telephone, or via other DoD/DHA approved patient/provider forms of communication. The population seen within the clinics includes deployers, service members, family members, and other DoD beneficiaries. In addition the provider may augment the clinics above in other clinical/administrative tasks as needed that include annual Public Health Assessments. These assessments may involve patient record reviews, a person-to-person appointment, or a patient/provider led telephone consultation.

1.2. BASIC SERVICES.

1.2.1. The contractor shall supply a licensed or certified medical provider (see paragraph 4.11 “Special Qualifications” for acceptable providers) to manage and monitor the DRHA/MHA program and coordinate appropriate aspects of the program with the base Installation Deployment Officer (IDO), Unit Deployment Managers (UDMs), Unit Health Monitors (UHMs), Public Health, Flight Operational Medicine Clinic/BOMC, commanders, Chief of Medical Staff (SGH), Chief of Aerospace Medicine (SGP) and medical clinic personnel.

1.2.2. Monitor and facilitate processing of DRHA/MHA and ensure members are assessed within the prescribed timeframe.

1.2.3. Contact patients for clinic appointments. Relay general appointment instructions to patients.

1.2.4. The MDG will familiarize the contractor with the following information: Maintain knowledge of content and intent of DoD and USAF policies listed in https://kx2.afms.mil/kj/kx3/DeploymentHealth/Pages/home.aspx and http://www.pdhealth.mil regarding deployment health.

1.2.4.1. Ensure the Kadena Air Base DRHA/MHA program is administered in accordance with current DoD and USAF policy regarding deployment health and PHA.

1.2.4.2. Ensure accurate knowledge of referral system and limitations on island.

1.2.4.3. Remain knowledgeable in DoD/Veterans Affairs (VA) Post-Deployment Health Clinical Practice Guideline (PDH-CPG) found at http://www.pdhealth.mil/guidelines/default.asp.

1.2.4.4. Remain updated on DRHA/MHA guidance provided by DoD and USAF listed on https://kx2.afms.mil/kj/kx3/DeploymentHealth/Pages/home.aspx.

1.2.4.5. Ensure healthcare providers conducting DRHA/MHA receive, DoD/VA PDH-CPG training IAW with AFI 48-122, Deployment Medicine and any other appropriate mental health education, and are sufficiently trained and certified to perform mental health assessments.

Additionally, the provider shall perform peer reviews IAW MDGI 44-119, Peer Review.

https://kx2.afms.mil/kj/kx3/DeploymentHealth/Pages/ProviderEducationTraining.aspx.

https://kx2.afms.mil/kj/kx3/DeploymentHealth/Pages/home.aspx http://www.pdhealth.mil/ http://www.pdhealth.mil/guidelines/default.asp https://kx2.afms.mil/kj/kx3/DeploymentHealth/Pages/home.aspx

1.2.4.6. Ensure all personnel deploying to a location that requires a DRHA, complete the DRHA questionnaire and receive a person-to-person interview or is arranged with a privileged provider in the required timelines. All personnel redeploying from these locations must receive a person-to-person interview in accordance with the timeframes listed in paragraphs 1.1.1

– 1.1.5 and the following:

1.2.2.5.1. For CRITICAL findings, contact the patient to determine if urgent care or immediate intervention is required, within 1 duty day. Ensure a person-to-person provider interview occurs within 3 duty days.

1.2.2.5.2. For PRIORITY findings, ensure a person-to-person provider interview occurs within 7 calendar days.

1.2.2.5.3. For ROUTINE findings, ensure a person-to-person provider interview occurs within 30 calendar days.

1.2.2.6. Ensure accurate knowledge of referral system and limitations on Okinawa.

1.2.2.7. Ensure all personnel deploying receive appropriate Force Health Protection Prescriptive Products (FHPPP) per AFI 44-102, Medical Care Management, to include:

1.2.2.7.1. Prescribing anti-malarial prophylaxis IAW Centers for Disease Control and Prevention (CDC), National Center for Medical (NCMI) and location specific reporting instructions.

1.2.2.7.2. Prescribing chemical warfare antidotes including but not limited to ATNAA (atropine and pralidoxime chloride) and Diazepam auto injectors, pyridostigmine bromide.

1.2.2.7.3. Prescribing biological warfare antibiotics IAW CDC and NCMI and location specific Reporting Instructions (RIs).

1.2.2.7.4. Providing clinical guidance for members with potential counter-indications to Force Health Protection Prescription Products vaccinations including but not limited to smallpox and anthrax.

1.2.2.7.5. Consult with the Public Health Flight Commander, SGH and SGP regarding members requiring medical waivers.

1.2.2.7.7. The provider will identify the need for a Medical Alert Identification Tag for deployers identified with specific medical conditions.

1.2.2.7.6. The provider may assist in any deployment-related task to include, but not limited to managing waivers or IMR requirements for the deployer.

1.2.2.7.8. Coordinates with the designated Mental Health Provider Consultant/SGH on mental health or adverse health trends identified by DRHA/annual MHA data analysis to the Population Health Working Group and the Community Action Information Board/Integrated Delivery System.

1.2.2.7.9. Provide Advanced Cardiac Life Support certification, Basic Life Support certification, Pediatric Advanced Life Support certification and any other training that is inherent to the 18 MDG at the 18 MDG’s expense.

1.2.2.8. Interview and assess patients regarding pre/post deployment health concerns, and appropriately document all interviews and assessments.

1.2.3. The MDG will familiarize the contractor with the AFMS guidelines https://kx2.afms.mil/kj/kx3/DeploymentHealth/Pages/home.aspx and remain knowledgeable in the stressors and health threats common to deploying personnel. Maintain proficiency in implementation of interventions or programs or knowledge of such programs to make appointment referrals that may mitigate such threats or adequately treat deployment-related health conditions.

1.2.4. Consult with Kadena Air Base UDMs to ensure deploying and redeployed Service members are notified of eligibility for DRHA/MHA completion in a timely manner and to assist with maintaining satisfactory completion rates.

1.2.5. Conduct DRHAs IAW the Deployment Health Assessments Program Guide, 10 November 2014 or most current guidance.

1.2.6. Document clinical encounters in patients’ electronic medical records using appropriate codes for DRHA/MHAs, and other deployment-related-condition encounters. The contract provider shall prepare all documentation to meet or exceed established standards of the MDG to include but not limited to: timeliness, legibility, accuracy, content, and signature.

1.2.6.1. Provide patient referrals for specialty care and ensure follow-up. Document referrals on DRHA/MHA questionnaire and in patients’ electronic medical records. The contract provider shall follow Federal, DoD, Air Force, MTF, and clinic regulations and policies when arranging for a referral or consult. The contract provider shall inform patient of the required referral or consult by indicating the specialty involved. The contract provider shall not recommend to the patient that he/she consult a specific practitioner or use a specific practice.

1.2.7. As appropriate, report DRHA/MHA and applicable IMR compliance metrics and program initiatives to installation leadership, such as Population Health Working Group, Aerospace Medicine Council, Kadena Team Staff Meeting, Community Action Leadership Board, Public Health Flight Meeting, etc.

1.2.7.1. The MDG will familiarize the contractor with all applicable IMR elements.

1.2.8. QUALITY IMPROVEMENT: The contract provider shall assess mental health care to assure its quality. The contract provider shall participate in a continual process of self-evaluation and strive for excellence in their clinical practice. A sampling of the contract provider’s work will be peer reviewed monthly IAW MDGI 44-119, Provider Peer Review, to ensure quality.

The provider will also attend the monthly Pro Staff meeting unless prevented by leave or patient care.

1.2.9. TRAINING: The contract provider shall serve in an advisory and teaching capacity to other staff members during their work hours, will conduct peer review of other staff members as assigned monthly, as well as one hour of in-service training as needed.

1.2.10. PATIENT SENSITIVITY: The contract provider shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. Providers receiving complaints validated by the Quality Office or Chief of Medical Staff, will be submitted to the 18th Contracting Squadron (18 CONS) and shall be subject to counseling and, depending on the nature and severity of the complaint, separation from performing services under this contract.

1.2.11. RELEASE OF MEDICAL INFORMATION: The provider shall only release medical information obtained during the course of this contract as is appropriate to other MTF staff involved in the care and treatment of that individual patient in accordance with HIPAA regulations, Privacy Act, FOIA requests, AFI 41-210, AFI 44-109 and 18 MDGI 37-1.

1.2.12. COMMUNICATIONS: The contract provider shall maintain open and professional communication with members of the 18 MDG and with Unit Commanders IAW DOD, AF, MDG, and clinic instructions. See Appendix A for a listing of relevant publications/instructions.

Complaints validated by the Quality Office and Chief of Medical Staff shall be reported in writing to the contract administrator and the Contractor for action by the 18 CONS office.

Failure of the Contractor to correct validated complaints raised by the MTF staff will be considered a failure to perform.

1.2.13. PROFESSIONAL MANNER AND POSITIVE/ COOPERATIVE ATTITUDE:

Contract provider shall refrain from the use of profanity, sexual or racial jokes, or other behavior that would normally be considered unprofessional in a medical setting. Complaints validated by the Healthcare Integrator (HCI) shall be reported in writing to the contract administrator and the contractor for action by the 18 CONS office. Failure of the contract provider to correct validated complaints by the MDG staff or patients will be considered a failure to perform.

1.3. SPECIAL REQUIREMENTS.

1.3.1. English Language Requirement. The contractor shall read, understand, speak, and write English clearly and fluently.

1.3.2. Licensure/Registration. In accordance with paragraph 4.1, AFI 44-119, Medical Quality Operation, 16 August 2011, contract personnel should maintain a valid, unrestricted state license to practice.

1.3.3. Copies of required certification for each Provider shall be furnished to the CO or designated representative prior to performance on this contract.

1.3.4. Appearance. Contract personnel shall present a neat appearance and be easily recognized.

This may be accomplished by wearing clothing bearing the name of the company or by wearing the MTF Badge or other appropriate badges, which contain the company name and employee’s name. Such badges shall be worn on the outermost garment. The Contractor is responsible for acquiring an appropriate number of badges to meet their needs at their own expense.

1.3.5. No pending ethical complaints.

1.3.6. Health Requirements.

1.3.6.1. Contract provider shall receive a pre-employment physical examination prior to commencement of work and annually thereafter. Contractor shall report the pre-employment examination and immunizations/shots as prescribed by the MDG and AFI standards MDGI 48- 10, Employee Health Program and AFI 44-108, Infection Prevention and Control Program.

1.3.6.2. Prior to commencement of work, medical certification shall be provided to the contracting officer that health care providers have completed the medical evaluation no later than five (5) working days. This certification shall state the date on which the examination was completed, the doctor’s name that performed the examination, and a statement concerning the physical and mental health of the individual. The certification shall also contain the following statement: “(name of contract employee) is not suffering from any contagious diseases to include but not limited to Tuberculosis and Hepatitis or from any medical or mental condition which would compromise safe patient care.”

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

1.3.6.4. It is the contractor’s responsibility to report (to the appropriate MDG staff member) all information necessary to assure hospital records can be maintained correctly, and therefore comply with AAAHC, OSHA, and CDC health records requirements.

1.3.6.5. 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 Contractor at the current full reimbursement rate.

1.3.6.6. All contract employees performing health care services under this contract shall complete annual medical evaluations, laboratory testing, and immunizations, as required, IAW MDGI 48-10, Medical Employee Health Program. The contractor shall provide a medical certificate to the CO, documenting the results of the evaluation.

1.3.7. Orientation. The contractor shall ensure that all contract providers participate in the MTF orientation procedures for newly assigned providers to include regulations specific to their professional specialty and hospital and Air Force policies and procedures.

1.3.8. HIPAA Compliance. The contractor agrees to abide by all the requirements of the Health Insurance Portability and Accountability Act (HIPAA) regarding the privacy and confidentiality of health records and information being provided and shared under the resulting contract. The contractor shall also enter a Business Associate Agreement with the Medical

Group.

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

1.3.8.2. The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the PHI other than provided by this Contract.

1.3.8.3. The Contractor agrees to assist in mitigation, when disclosure of PHI is known to the Contractor, as it is in violation of the requirements of this Contract.

1.3.8.4. The Contractor agrees to report to the Government any use or disclosure of the PHI not provided for by this Contract.

1.3.8.5. The Contractor agrees to ensure that any agent, including whom it provides or receives PHI, agrees to the same restrictions and conditions that apply through this Contract.

1.3.8.6. The Contractor agrees, at the request of the Government, to provide access to PHI in a Designated Record Set, to an Individual in order to meet the requirements under 45 CFR 164.524, Right to access of Protected Health Information.

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

1.3.8.8. The Contractor agrees to make internal practices, books, and records relating to the use and disclosure of PHI 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.

1.3.8.9. The Contractor agrees to document such disclosures of PHI 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 PHI in accordance with 45 CFR 164.528, Right to an Accounting of Disclosures of Protected Health Information.

1.3.8.10. 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 PHI in accordance with 45 CFR 164.528, Right to an Accounting of Disclosures of Protected Health Information.

1.3.8.11. The contractor shall complete required initial HIPAA training within 30 days of the start of contract performance, and annually thereafter. The contractor may submit proof of prior comprehensive training to the Privacy Office. It will be evaluated and accepted if it meets the training standards of the Department of Defense and the 18 MDG.

1.4. PRIVILEGING REQUIREMENTS:

1.4.1. Privileging. The credentials of all providers shall be reviewed and privileges granted as outlined in AFI 44-119, Medical Quality Operations. The credentials required and privileges awarded by the MDG must be sufficient to allow for performance of all tasks identified in this

PWS.

1.4.2. Initial application for clinical privileges, to include credentials action history, malpractice history, and completed copies of the below listed documents, shall be submitted to the MDG Credentials Office within 30 calendar days from receipt of notice of contract award, to the Contracting Office. If credentialing is not awarded for the provider, the contract may be terminated.

1.4.2.1. Copy of valid, current, unrestricted state license to practice and, if applicable, Board Certification

1.4.2.2. Provider’s Education and Training Information

1.4.2.3. Current Basic Life Support (BLS) card

1.4.2.4. Signed consent for Release of information

1.4.2.5. Copy of proposed contract provider’s professional resume, accompanied by that individual’s sworn affidavit of the truthfulness of same.

1.4.2.6. List of states in which contract provider currently holds or has held a license to practice related services.

1.4.2.7. Certification of current physical examination. The certification shall contain a signed statement by the examining physician stating that employee is free of any contagious diseases or any medical condition that would prevent safe patient care. Physical examination certification shall be within the 12 month period prior to application for privileges.

1.4.2.8. Reference letters- need evaluation forms (AF Form 1562) completed by most current supervisor, peer, and department head

1.4.2.9. Verified Privilege list (Provider’s Specialty) by Supervisor- AF Form 2824 (Clinical Privileges, Mental Health Provider), AF Form 4305 ( Clinical Privileges-Preventive Medicine Specialists), AF Form 2816 (Clinical Privileges – Family Practice and Primary Care Physicians)

1.4.2.10. National Provider Identifier (NPI)

1.4.2.11. Criminal History Background Check – required for providers who will see patients less than 18 years old

1.4.3. Review of Credentials Packages. The Government reserves the right to limit the number of credentialing packages it will evaluate.

1.4.4. Adverse Privileges Actions. Action to suspend, limit or revoke a contract provider’s privileges will be in accordance with AFI 44-119.

1.4.5. The Medical Group and the contractor shall be notified via MDG Service Contract Manager (630-4543) and Credentials Manager (630-4780) by Contracting Office as soon as possible when the necessity to exercise such authority becomes apparent. The MDG will also provide the CO and contractor with copies of documentation initiating the revocation process if such actions become apparent.

1.4.6. If individual clinical privileges have been summarily suspended pending an investigation into questions of professional ethics or conduct, the contractor’s performance under this contract may be suspended until clinical privileges are reinstated. No reimbursement shall be made and no other compensation shall accrue to the contractor so long as performance is suspended. The denial, suspension, limitation, or revocation of clinical privileges based upon practitioner impairment or misconduct shall be reported to the appropriate authorities.

1.4.7. Change in Personnel/Locum Tenens. When a change in contract provider/locum tenens is anticipated, the contractor shall provide to CO the same credentials as required for the initial contract provider four (4) weeks prior to when the proposed change in personnel is to take place. The same review process applies to all replacement contract personnel as for the original contract provider.

2. SUMMARY OF SERVICES.

This PWS identifies contract requirements for one full-time equivalent healthcare provider (physician assistant or nurse practitioner) to manage operations of the Active Duty Annual Mental Health Assessment and DRHA program at Kadena Air Base, Japan.

Performance Objective PWS Para Performance Threshold Provide quality patient care to our deployers , service members, family members, and other DoD beneficiaries as needed

1.1.1.0., 1.1.1., 1.1.8.1.

No more than 3 discrepancies on assessment and treatment peer review items per month.

Complete person-to-person evaluations for all members with a completed DRHA/annual MHA questionnaire within the required timeframes

1.2.2.5. Completion metric will remain at

or above 90%.

Patient care and documentation will be clear and concise, and comply with MDG, Health Services Inspection, The Joint Commission (TJC), and clinic standards.

1.2.6., 1.2.6.1. No more than 2 discrepancies on documentation peer review items per month.

Maintains patient privacy/confidentiality.

1.2.6., 1.3.8. Standard is zero breeches of privacy (may exceed by actively protecting patient information)

Personnel in the work area and available for work at the appointed times.

4.5.1.1. No more than 3 instances of

unapproved tardiness or leaving early per quarter.

Absences scheduled at least 30 days

4.5.3. No more than 2 unplanned

3. GOVERNMENT FURNISHED SUPPLIES.

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

3.2. OFFICE/WORK/LOCKER AREA. Those areas 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. 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.

3.3. 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

3.4. 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.

3.5. 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. Government telephones shall be used only for official government business.

3.6. The Contractor is responsible to ensure all government-issued identification badges, keys, equipment and car passes are returned to the Contracting Officer Representative (COR) or Government designee when an individual is leaving employment under this contract.

4. GENERAL INFORMATION.

4.1. QUALITY CONTROL.

4.1.1. The contractor is required to control the quality of service delivery and offer to the Government for acceptance only services, which conform to contract requirements. The overall control of quality must meet the specified performance thresholds for each requirement in the Services Summary.

4.1.2. Quality Control Plan. The contractor shall provide a complete Quality Control Plan (QCP) to the CO for approval prior to contract start date. The CO will notify the contractor of acceptance or modifications to the plan before the contract start date. The contractor shall make appropriate modifications (at no additional costs to the government) and obtain acceptance of the plan by the CO before the start of the first operational performance period.

4.2. QUALITY ASSURANCE.

The government will periodically evaluate the contractor’s performance by appointing a representative(s) to monitor performance to ensure services are received. The government representative will evaluate the contractor’s performance through intermittent on-site inspections of the contractor's quality control program and receipt of complaints from base personnel. The government may inspect each task as completed or increase the number of quality control inspections if deemed appropriate because of repeated failures discovered during quality control inspections or because of repeated customer complaints. Likewise, the government may decrease the number of quality control inspections if merited by performance. The government will also investigate complaints received from various customers located on the installation. The contractor shall be responsible for initially validating customer complaints. However, the government representative shall make final determination of the validity of customer complaint(s) in cases of disagreement with customer(s).

4.2.1. The Contracting Officer Representative (COR) is the authorized government representative(s) who will perform assessments of the contractor’s performance. Subsequent to contract award, the identity of the COR(s), with a letter defining their duties and authority will be promptly furnished to the successful bidder/offeror.

4.2.2. The COR(s) or alternate(s) will inform the contract manager in person when discrepancies occur and will request corrective action. The COR(s) or alternate(s) will make a notation of the discrepancy on their surveillance checklist with the date and time the discrepancy was noted and will request the contract manager (or authorized representative) to initial the entry on the checklist.

4.2.3. Any matter concerning a change to the scope, prices, terms or conditions of this contract shall be referred to the CO and not to the COR(s).

4.2.4. The services to be performed by the contractor during the period of this contract shall at all times and places be subject to review by the CO or authorized representative(s).

4.3. SECURITY REQUIREMENTS.

4.3.1. Security and base access requirements are contained in clause 5352.242-9000 “Contractor Access to Air Force Installations.” Contractor employees will be required to obtain and display identification badges. Anticipate delays in getting commercial vehicles on base and allow time for commercial vehicles to reach their destination by driving designated routes at posted speed limits throughout the base. Procedures for commercial vehicle access to the base are subject to change without prior notice.

4.3.2. ID Passes, Badges and Vehicle Stickers: The contractor is responsible to obtain such clearances and/or passes as required for his/her employees to enter military installations on Okinawa prior to start to work. The contractor shall be responsible for all passes issued to his/her employees under this contract. Applications shall be coordinated through the Contracting Officer or designated representative. At the time of application, Security Forces may conduct a background check on employees. Upon termination of employment, the contractor shall be responsible for returning identification cards and base passes to Security Forces within 24 hours.

4.3.3. OPERATIONS SECURITY (OPSEC) Contractor personnel will participate in the OPSEC program locally administered by the AF activity if applicable.

4.4. PHYSICAL SECURITY.

The Contractor shall be responsible for safeguarding all government property provided for contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured, and utilities turned off or set for conservation.

4.4.1. Identification and Base Passes: The contractor shall obtain identification card and base pass for the contract provider and vehicle. Application shall be coordinated through the CO. At time of application, Security Forces may conduct a background check on employee. Upon termination of employment, the contractor shall return identification card and base pass to Contracting Office within 24 hours.

4.4.2. Key control: The contractor shall establish and implement methods of ensuring that all keys/key cards 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 QA personnel. In the event keys, other than master keys, are lost or duplicated, the contractor shall, upon written direction of the contracting officer, rekey or replace the affected lock or locks; however, the government, at its option, may replace the affected lock or locks or perform rekeying. When the replacement of locks or rekeying is performed by the government, the total cost of rekeying or the replacement of the lock or locks shall be deducted from the monthly payment due the contractor.

4.4.3. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the government and the total cost deducted from the monthly payment due the contractor. The contractor shall not duplicate any keys issued by the government.

4.4.3.1. Unauthorized Use. The contractor shall prohibit the use of keys issued by the government by any persons other than the contractor’s employees. The contractor shall prohibit the opening of locked areas by contractor employees to permit entrance of persons other than contractor’s employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the Contracting Officer.

4.4.3. Contract personnel will adhere to all local traffic laws while on Kadena AB.

4.4.4. Reporting Requirements. Contractor personnel shall report to an appropriate authority any information or circumstances of which they are aware may pose a threat to the security of DOD personnel, contractor personnel, resources, and classified or unclassified defense information. Contractor employees shall be briefed by their immediate supervisor upon initial on-base assignment.

4.4.5. Weapons, Firearms, and Ammunition. Contractor employees are prohibited from possessing weapons, firearms, or ammunition, on themselves or within their contractor-owned vehicle or privately-owned vehicle while on Kadena Air Base.

4.4.6. The contractor shall achieve the same level of trustworthiness for contractor or subcontractor personnel as required for Government personnel with similar access to automated information systems (AISs) and networks containing DoD Sensitive Information (SI). The contractor shall meet the personnel security requirements for Automated Data Processing (ADP) access in DoD 5200.2-R, Personnel Security, for employees and subcontractor employees that require access to Government (IT) systems or DoD SI, or are involved in developing, delivering, or supporting IT systems and services, or safeguarding DoD sensitive information within Government or contractor systems. The contractor shall classify ADP/IT or related positions, submit appropriate paperwork for background investigations or proof of a favorable adjudication, ensure individuals receive requisite training and document compliance. Personnel background investigations and training must be initiated before access to DoD AIS/networks or DoD SI is allowed. Following contract award, details for completing and forwarding forms for requesting an investigation will be coordinate with the Government IT Security Officer designated for the networks and systems being accessed.

4.4.7. National Agency Checks (NAC). The contractor shall comply with DoD 5200.2-R, Department of Defense Personnel Security Program and AFI 33-119, electronic Mail Management and Use requirements for contractor personnel operating Government workstations that have unclassified automated information systems (e-mail, MIS, Internet, CAMS, etc.)

Request for NAC on contractor personnel hired at the beginning of the contract, shall be submitted to the Government not later than 14 working days from the contract start date. Request for NACs on contractor personnel hired subsequent to the contract start date shall be submitted to the Government not later that five (5) workdays from the employee’s first duty day.

Contractor personnel receiving unfavorable NACs shall not be hired. The contractor at no additional cost to the Government shall submit these investigations.

4.5. HOURS OF OPERATION.

4.5.1. Normal Hours of Operation. The contractor shall perform the services required under this contract during the following hours: 7:30 a.m. to 4:30 p.m., Monday through Friday with a maximum of 40 hrs per week. When necessary for contractor personnel to work hours other than 7:30 a.m. to 4:30 p.m., Monday through Friday, contractor must coordinate with the Contracting Officer Representative (COR). There will be no overtime paid on this contract. 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.

4.5.1.1. The contractor shall be available within 1 hour during normal duty hours, Monday through Friday, to meet with government personnel designated by the CO to discuss problem areas.

4.5.2. Recognized Holidays. The contractor is not required to provide service on the following days: New Year’s Day, Martin Luther King Day, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Days, Thanksgiving Day, and Christmas. If the holiday falls on Saturday, it is observed on Friday. If the holiday falls on a Sunday, it is observed on Monday. Exception: Emergency calls approved by COR and coordinated with the Contracting Officer.

4.5.2.1. Down/Family Days. On work days that have been declared “family days,” the Base may be minimally manned with many offices and facilities closed. On these days, the COR shall ensure that the contractor can gain entrance to the work site. The contractor shall perform the services required under this contract or coordinate unpaid leave with COR prior to the down or family day.

4.5.3. Absences and leave. All absences should be scheduled at least 30 days prior to the days off, and approved by the Public Health Flight Commander. The contractor shall not be compensated during periods of absences and leave to include both annual and sick leave. If the contractor is absent for three or more consecutive days due to illness, the contractor shall be required to provide written documentation from a qualified health care provider that he or she is free from communicable disease and the cause of the worker’s current illness, The Government reserves the right to examine and or re-examine any worker who meets this criterion.

4.5.3.1. The contractor shall maintain a timesheet to document hours worked daily, weekly, monthly. This shall be provided with contractor’s monthly invoice.

4.5.3.2. The contractor shall notify the COR in advance of scheduled leave and accommodate the Medical Treatment Facility (MTF) schedule for leave periods of a week or more. In cases of scheduled leave and temporary absences (scheduled or unscheduled) greater than 80 consecutive hours, the Contractor shall provide temporary replacement staff or salary will be deducted for approximate hours missed.

4.5.3.2.1 The Contractor agrees to provide temporary replacement staff of equal or greater qualifications per the PWS requirements (Section 1 and 4). If the Contractor does not provide a temporary replacement staff within 2 weeks or submit a replacement plan to the CO/COR for approval. Salary will be deducted for approximate hours missed. If the Contractor does not provide a temporary replacement, the Government reserves the right to procure such services from another source, until the Contractor restores routine services.

4.5.3.2.2. When the Government exercises its right to procure these services from another source, the Government will reduce the Contractor’s invoice at an equivalent amount to that incurred for the other source’s services. A copy of the other source’s service ticket will be used as the basis for this reduction. The Government will furnish the Contractor a copy of this ticket upon the Contractor’s request.

4.6. CONSERVATION OF UTILITIES. The contractor shall instruct employees in utilities conservation practices. The contractor shall be responsible for operating under conditions which prevent the waste of utilities which include the following:

4.6.1. Lights shall be used only in areas where and when work is actually being performed.

4.6.2. Mechanical equipment controls for heating, ventilation, and air conditioning systems shall not be adjusted by the contractor or by contractor employees unless authorized.

4.6.3. Water faucets or valves shall be turned off after the required use has been accomplished.

4.6.4. Government telephones shall be used only for official government business.

4.7. ENVIRONMENTAL CONTROLS

4.7.1. Notification of Environmental Spills. If the contractor spills or releases any substance contained in 40 CFR 302 into the environment, the contractor or its agent shall immediately report the incident to Kadena AB Fire Dept at 911. The liability for the spill or release of such substances rests solely with the contractor and its agent.

4.7.2. Material Storage and Use. The contractor shall follow manufacturer’s guidelines and professional recommendations for control of humidity, temperature, cleanliness, and materials handling. This includes hazardous materials.

4.8. GOVERNMENT OBSERVATIONS.

4.8.1. Government personnel, other than contracting officers (COs) and Contracting Officer Representative (COR), may from time to time, with CO coordination, observe contractor operations. However, these personnel may not interfere with contractor performance or make any changes to the contract.

4.8.2. Conduct. The CO may request that the contractor whose documented conduct, in the opinion of the CO and MTF commander, interferes with proper order or professionalism at the MTF where services are performed or places patients at risk be removed from such installation, and the contractor will comply with such request.

4.8.3. Dress and Appearance. The contractor will maintain good personal hygiene and a well-groomed, professional appearance. Personnel should wear appropriate health care uniforms or professional business attire. If an MTF requires their providers wear a uniform (i.e., scrubs, lab coat, etc.), the Air Force will provide it to them.

4.9. SAFETY REQUIREMENTS. In performing work under this contract, the contractor shall:

4.9.1. Conform to the safety requirements contained in the contract for all activities related to the accomplishment of the work.

4.9.2. Perform work in a safe manner as required by OSHA 2206, General Industry, Occupational Safety and Health Standards (29 CFR 1910) and Japan Environmental Governing Standards (JEGS) by US Force Japan.

4.9.3. Provide protection to government property to prevent damage during the period of time the property is under the control or in possession of the contractor.

4.9.4. Record and report promptly (within one hour) to the contracting officer or designated government representative (GR), all available facts relating to each instance of damage to government property or injury to either contractor or government personnel.

4.9.5. If the government elects to conduct an investigation of the accident/mishap, the contractor shall cooperate fully and assist government personnel in the conduct of investigation until the investigation is completed.

4.9.6. Ensure personnel have the following on-base emergency services phone numbers programmed into their cell phones:

While working on Kadena, Okuma, Camp Shields, or Torii Station, call Kadena Dispatch at 098-934-5911 or 098-962-9445.

While working on Camp Foster, Camp Courtney, Camp Hansen, Camp Schwab, or Camp Kinser, call Foster Dispatch at 098-911-1911.

4.10. TRAINING.

4.10.1. Training Participation. The contractor shall complete all training requirements for MDG credentialed providers IAW DoD, Air Force, MDG and clinic instructions.

4.10.2. Continuing Education (CE) Requirements. Health care providers shall meet the minimum standards for CE to remain current as prescribed in AFI 44-119. CE shall be obtained at no additional cost to the Government and shall be reported to the CO annually on the first normal duty day in July for the previous 12 months and forwarding to Contracting. Periodic CE may be conducted at the MDG and will be available, at no cost, to any health care provider desiring to attend. If the contractor attends CE conducted at the MDG, these hours will not be charged to the government.

4.10.3. Medical Quality Assurance/Risk Management (QA/RM).

4.10.3.1. Health care providers shall participate in QA/RM activities to the extent required by AFI 44-119 Chapter 8 and the 18 MDG QA/RM plan or regulation.

4.10.3.2. The Government will evaluate the provider’s professional, as differentiated from administrative, performance under this contract using quality assurance standards specified in AFI 44-119. Nothing in this paragraph precludes the Government from also conducting inspections under the Inspection/Acceptance clause of FAR 52.212-4.

4.11. SPECIAL QUALIFICATIONS.

4.11.1. Advanced degree in accepted field of study from an accredited institution, along with current, valid license and/or certification (as applicable) to practice in field of expertise. The contract provider must be trained and licensed/certified provider in one of the following fields:

4.11.1.2. Physician Assistant (PA). PA must have a Master of Physician Assistant Studies degree from a PA educational program accredited by Accreditation Review Commission for the Physician Assistant. Candidate also must hold current certification from the National Commission on Certification of Physician Assistants (NCCPA). Maintenance of required Certification is mandatory. It is highly recommended that candidates have experience with evaluation and treatment of mental health disorders to include Post Traumatic Stress Disorder.

Have at least 24 months of experience as a Physician Assistant within the last 36 months.