Attachment_1_-_PWS_BHCF_Clinical_Nurse_7_May_18.pdf

FA5270-18-Q-B059

Attachment 1 - PWS

PERFORMANCE BASED WORK STATEMENT

FOR

Behavioral Health Care Facilitator Clinical Nurse

SERVICES

Kadena Air Base, Japan

7 May 2018

TABLE OF CONTENTS

SECTION PAGE

1 DESCRIPTION OF SERVICES 3-6

2 SERVICES SUMMARY 6-7

3 GOVERNMENT PROVIDED SUPPLIES AND SERVICES 7

4 GENERAL INFORMATION 8-17

5 APPENDICES 17-27

1. DESCRIPTION OF SERVICES.

As a member of the Behavioral Health team, the Clinical Nurse – Behavioral Health Care Facilitator (BHCF) Clinical Nurse (CN) will provide mental health clinical case management, care coordination and disease management. This includes, but is not limited to the conditions of depression, anxiety disorders, tobacco cessation, weight management, Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD). The BHCF CN will also monitor and facilitate adherence to treatments, provide education, coordinate care, and maintain data registries. Lastly, the BHCF CN will perform the full scope of clinical nursing in the execution of outpatient mental health care.

1.1. BASIC SERVICES.

1.1.1. Proactively identifies and evaluates patients and targeted populations for mental health case management, care coordination and facilitation, and conditions monitoring from a variety of sources such as Behavioral Health or primary care provider referrals, discharge planning, Medical Evaluation Board (MEB) process, facility staff and patient self-referral. Conducts systematic, on-going, thorough assessment of patient’s emotional, psychological, social and medical status, prescribed medications, behavioral health referrals/treatments, and other pertinent information via direct patient or telephonic contact, or other relevant sources such as professional and non-professional caregivers and the medical records.

1.1.2. Develops, executes and provides ongoing monitoring of appropriate patient-specific plan of care including short and long term goals, objectives and actions. Coordinates and collaborates on the care plan along with the patient, family/caregiver, and healthcare team.

1.1.3. Identifies, develops and executes appropriate targeted population-based mental health disease management activities such as, but not limited to individual and/or group patient contacts and training programs.

1.1.4. Serves as an advocate for and ensures appropriate education is provided to the patient or targeted populations for the purpose of promoting adherence to treatment plans, self-care actions, and education programs. Ensures activities match the level of the patient’s clinical risk, readiness to change and health literacy.

1.1.5. Identifies, collects, monitors, interprets and evaluates measureable outcome data within established time frames according to local/AF/DoD requirements. Submits reports as required per local/AF/DoD policy and guidance.

1.1.6. Educates/trains the healthcare team and facility staff on policies and procedures for utilization and implementation of guidelines, protocols and other behavioral health and mental health disease management activities.

1.1.7. Coordinates and participates in interdisciplinary team meetings, designated facility meetings, and Care Coordination meetings. Shares knowledge and experiences gained from own clinical nursing practice and education relevant to mental health nursing and case management.

Participates in local, AF, DoD and national teleconferences as required and relative to the program operations and reporting requirements.

1.1.8. Participates in the orientation, education and training of other staff. May serve on committees, work groups, and task forces at the facility.

1.1.9. Must maintain a level of productivity and quality consistent with: complexity of the assignment; facility policies and guidelines; established principles, ethics, standards, and scope of practice for professional mental health nursing as outlined by the American Nurses Association and the American Psychiatric Nurses Association; the American Hospital Association’s Bill of Rights for Patients, the Case Management Society of America (CMSA), American Accreditation Healthcare Commission/Utilization Review Accreditation Commission (URAC); Accreditation Association of Ambulatory Health Care (AAAHC); Health Services Inspection (HSI); and other applicable DoD and Service specific guidance and policies. Must also comply with the Equal Employment Opportunity (EEO) Program, infection control and safety policies and procedures.

1.1.10. Follows applicable local MTF/AF/DoD instructions, policies and guidelines.

1.1.11. Completes electronic medical record documentation, coding and designated tracking logs and data reporting as required by local MTF/AF/DoD instructions, policies and guidance.

1.1.12. Completes all required electronic medical record training, MTF-specific orientation and training programs, and AF/DoD mandated training applicable to the job.

1.1.13. Has a thorough understanding of psychopharmacology and psychotropic medications, administers medications and monitors patient response to medications.

1.1.14. Conducts regular psychoeducational groups on relevant mental health topics.

1.1.15. Maintains professional manner and displays positive/cooperative attitude.

1.1.16. Contacts patients prescribed anti-depressant medications in accordance with Health Plan

Employer Data and Information Set (HEDIS) Anti-depressant Medication Management (ADM) measures.

1.2. POSITION REQUIREMENTS.

1.2.1. Mandatory Knowledge and skills

1.2.2. Ability to effectively apply core case management functions: a) assessment and identification of patients for case management and need for an established plan of care; b) collaboration with the patient, family/caregiver, and members of the health care team for developing an effective plan of care; c) facilitation of care coordination and communication among all involved parties; d) advocate for the patient and family/caregivers to ensure identified education and appropriate, timely care is received.

1.2.3. Ability to effectively apply core disease management principles to mental health conditions: a) assessment and identification of target populations; b) implementation and execution of Clinical Practice Guidelines or standards; c) collaboration and coordination of activities with other healthcare members; d) promotion and education of patient self-management actions; e) collection, analysis and reporting on identified process and outcome metrics.

1.2.4. Knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability Act [HIPAA]), and accreditation standards of Accreditation Association for Ambulatory Health Care (AAAHC) and The Joint Commission (TJC).

1.2.5. Working knowledge of computer applications/software to include Microsoft Office programs, MS Outlook (e-mail) and Excel.

1.2.6. Must be skillful and tactful in communicating with people who may be physically or mentally ill, uncooperative, fearful, emotionally distraught, and occasionally dangerous.

1.2.7. Must demonstrate ability to apply critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations.

1.2.8. Must possess organization, problem-solving and communication skills to articulate medical requirements to patients, families/care givers, medical and non-medical staff in a professional and courteous way.

1.2.9. Education Shall be a graduate from an associate (ADN) or baccalaureate (BSN) degree program in nursing accredited by a national nursing accrediting agency recognized by the US Department of Education.

1.2.10. Experience Shall have a minimum of 3 years experience for ADN or 2 years experience for BSN in mental health nursing.

1.2.10.1. Must have practiced in a mental health setting within the last 24 months.

1.2.10.2. Prior Military Health Care Setting Case Management and Mental Health Experience Preferred.

1.2.10. License/certification Certified/certification eligible by the American Nurses Credentialing Center (ANCC) as a Psychiatric and Mental Health Nurse with 2 years full time experience in mental health.

1.2.11.1. Maintains an active, valid, current, and unrestricted license (with no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction.

1.2.11.2. Certified/certification eligible by the American Nurses Credentialing Center (ANCC) as a Psychiatric and Mental Health Nurse with 2 years full time experience in mental health.

1.2.12. Physical Requirements. Requirements include some walking, standing, extended periods of sitting. Position may have exposure to communicable illnesses.

1.2.13. MEDICAL MALPRACTICE. This contract establishes a personal services relationship between the BHCF CN 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 BHCF CN and the Government. This contract will create an employer-employee relationship between the Government and the provider.

1.2.14. The BHCF CN is not required to maintain medical malpractice liability insurance.

BHCF CN 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 BHCF CN 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 prime BHCF CN.

2. SERVICES SUMMARY.

Performance Objective PWS Para Performance Threshold SS #1 Maintains patient privacy/confidentiality.

Appendix F Para F.2.

Standard is zero breeches of privacy (may exceed by actively protecting patient information)

SS #2 Personnel in the work area and available for work at the appointed times.

4.5.1.

4.5.3.

No more than 3 instances of unapproved tardiness or leaving early in a quarter.

SS#3 Maintains professional manner and displays positive/cooperative attitude.

1.1.15. No more than 2 valid complaints from

patients, MDG staff, or base leadership annually.

SS #4 Contacts patients prescribed anti-depressant medications in accordance with Health Plan Employer Data and Information Set (HEDIS) Anti-depressant Medication Management (ADM) measures.

1.1.16.

Attempts/documents contact with 100% of applicable patients in accordance with HEDIS ADM measures.

SS #5 Provides care coordination management services for mental health patients being referred to higher levels of care.

1.1.1.

1.1.7.

1.2.2.

Locates appropriate higher level of care facility within 5 business days. Coordinates process of transferring patients to external facility. Ensures 100% weekly contact with external facility once patient has been received by that facility.

SS #6 Conducts regular psychoeducational groups on relevant mental health topics.

1.1.14. Markets and provides psychoeducational

groups on mental health topics including, but not limited to, depression management, anxiety management, sleep management, and tobacco cessation.

SS #7 Attends relevant Medical Group provider meetings to advertise/educate on pertinent mental health services.

1.1.6.

1.1.7.

At least monthly attends Medical Group provider meetings on a rotating basis (i.e.

Family Practice, then Flight Medicine, then Women’s Health, etc.) to educate providers on available services.

SS #8 Attends relevant Medical Group case management / disease management meetings to present relevant mental health cases.

1.1.1.

1.1.7.

No unexcused absences from case management / disease management meetings.

SS #9 Documents all patient care activities in patients’ medical records according the 18 MDG policies.

1.1.11. No more than 2 clinical notes per month

completed outside of the required 72-hour post-care delivery documentation window.

3. GOVERNMENT PROVIDED SUPPLIES AND SERVICES.

Unless otherwise stated in the individual task order, the Government will provide the following equipment, supplies, and services listed below for services performed inside government facilities:

3.1. EQUIPMENT/OFFICE FURNITURE. The medical administrative workers will be provided space and equipment for performing services required by this contract.

3.2. FORMS. The MTF shall provide required Government forms, either hardcopy or computer generated used in the performance of services.

3.3. SUPPLIES. The MTF will provide non-medical supplies commonly used in the facility for administrative, non-clinical services supporting the care and management of patients. Commonly used supplies are those routinely stocked by the MTF.

3.4. COMPUTER EQUIPMENT. The MTF will provide computer equipment, software and peripherals as required for accomplishment of duties. The BHCF CN will be required to use Government computer systems in support of the Air Force Medical Service mission.

3.5. UTILITIES. The government will furnish all required utilities (such as water, telephone, electricity, etc.) at no cost to the medical administrative worker. Long distance and Defense Switched Network (DSN) telephone services will be provided for official use only. The medical administrative workers shall participate in government energy conservation programs.

3.6. CONTRACTOR FURNISHED EQUIPMENT. The Contractor Management staff may not be required to provide equipment and supplies

3.7. HOUSEKEEPING. Housekeeping services will be provided by the MTF.

4. GENERAL INFORMATION.

4.1 QUALITY CONTROL.

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.

4.1.1. The government shall rely on the contractor's existing quality assurance systems as a substitute for government inspection and testing, when contracting for commercial services, unless market research indicates otherwise.

4.1.2. Quality Control Plan. The contractor’s QCP shall contain, as a minimum, the following items:

a. A description of the inspection system to cover all services. Description shall include specifies as to the areas to be inspected on a scheduled and unscheduled basis, frequently of inspections, and the title and organizational placement of the inspector(s).

b. A description of the methods to be used for identifying and preventing defects in the quality of service performed.

c. A description of how the records will be kept. Records must document all inspections and corrective or preventive actions taken.

4.1.3. Records of inspections shall be kept and made available to the Government throughout the contract performance period and for the period after contract completion until final settlement of any claims under this contract.

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’s 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, with a letter defining their duties and authority will be promptly furnished to the successful bidder/offeror.

4.2.2. The COR(s) will inform the contract manager in person when discrepancies occur and will request corrective action. The COR(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 Contracting Officer 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 are subject to review by the Contracting Officer or authorized representative(s).

4.3. SECURITY REQUIREMENTS.

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.

4.3.1 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 CO 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.

4.3.2 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, property, and materials shall be secured.

4.4.1. 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.

4.4.1.1. The contractor shall immediately report the occurrences of a loss of duplicate key to the

COR.

4.4.1.2. In the event keys, other than master keys, are lost or duplicated, the contractor shall, upon written direction of the COR, re-key or replace the affected lock or locks; however, the government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the contractor. 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.

4.4.1.3. 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 COR.

4.4.2. Lock Combinations. The contractor shall establish and implement methods of ensuring that all lock combinations are not revealed to unauthorized persons. The contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations.

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 COR. There will be no overtime paid on this contract. The contractor may work, with prior approval of the CO, extended hours to ensure timely completion of work at no additional cost to the government).

4.5.1.1. Federal Holidays. Federal Holidays are paid days. Any Federal Holidays falling on Saturday will be observed on the preceding Friday, holidays falling on a Sunday will be observed the following Monday.

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

4.5.2. 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 2 weeks prior to the days off, and approved by the COR. 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 to the COR electronically prior to submittal of invoice approval by the Government with contractor’s monthly invoice.

4.5.3.2. Replacement of contractor personnel. The contractor management staff shall replace permanent contractor personnel at the earliest possible. Contractor personnel 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.

4.5.3.2.1. 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. RECORDS.

The contractor shall be responsible for creating, maintaining, and disposing of only those government required records that are specifically cited in this PWS. If requested by the Government, the contractor shall provide the original record or a reproducible copy of any such record within five working days of receipt of the request.

4.8. GOVERNMENT OBSERVATIONS.

Government personnel, other than contracting officers (COs) and CORS, 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.

4.9. 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 CO 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. CONTINUED EDUCATION. The Contractor Management Staff, at their own expense, shall ensure BHCF CNs continue to meet the minimum standards for Continuing Education Unit (CEU) requirements for all psychiatric nurses registered or certified by national/medical associations as prescribed in AFI 44-119, Clinical Performance Improvement. CEUs shall be obtained at no additional cost to the Government. A psychiatric nurse education and training folder should be maintained by the Contractor Management Staff for government inspection as described in AF 36-2201V1, Training Development, Delivery and Evaluation. This will be validated annually for compliance and currency by the COR for their designee. Periodic CEUs may be conducted at the military facilities and will be available, at no cost, to any psychiatric nurse desiring to attend if space is available. If training is received within the MTF or requesting location, the time spent out of the duty section not performing contracted services (in order to obtain the CEUs), will not be billable to the Government.

4.10.2. BASIC LIFE SUPPORT CERTIFICATION. At a minimum, all BHCF CNs working within an MTF must maintain current certification in either the American Heart Association Basic Life Support (BLS) (Course C) or the American Red Cross CPR/BLS (Heart Saver) Course. Initial training shall be obtained at no cost to the Government so that the BHCF CN arrives in the position fully qualified; however, the government may offer initial or refresher training for contract workers on a space available basis. If training is received within the facility, the time will NOT be billable to the Government. The Government will not pay for initial or recertification training obtained outside the MTF.

4.10.3. MTF ORIENTATION. The Government will provide initial MTF orientation and annual refresher training for the BHCF CN. This requirement will be conducted during normal duties hours; thereby, the time is billable to Government.

4.10.4. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

OF 1996. All Contracted Management Staff or BHCF CNs 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 Appendix F, Special Contract Clauses, for detailed HIPAA language.

4.10.5. SPECIFIC REQUIRED TRAINING. The BHCF CN will be required to attend government oriented training in a CONUS location during the base year of the contract. A specific and separate Contract Line Item Number (CLIN) has been established with enough funds to cover the contractor’s costs of travel (airline tickets), lodging, and taxi from airport to final destination on arrival and departure day. No additional funds will be available.

4.11. SUBMISSISION OF INVOICES.

Electronic Invoicing Procedures In accordance with DFARS Clause 252.232-7003 titled "Electronic Submission of Payment Requests" this contract/order requires use of the DoD Wide

Area Workflow (WAWF) system for the submission of invoices. This web-based system, located at https://wawf.eb.mil, provides the technology for Government contractors and authorized Department of Defense (DoD) personnel to generate, capture and process receipt and payment-related documentation in a paperless environment. Invoices rendered under this contract shall be submitted electronically through WAWF. Submission of hard copy invoices will no longer be accepted for payment.

4.11.1. The COR will verify that all services have been performed in a satisfactory manner and accept services performed by processing the contractor's invoice on the WAWF system.

4.11.2. Payment will be made to the contractor upon submission of the invoice through WAWF system.

The payment office will be:

DIP-DARTS-AF-AP@dfas.mil Defense Finance Accounting Service - Japan

DFAS-JRLE/JA - JAPAN AIR FORCE

Bldg 4 Unit 5220

APO AP 96328-5220

4.12. CONTINUATION OF ESSENTIAL DOD CONTRACTOR SERVICES DURING

CRISIS IAW DoDI 3020.41.

IAW DoDI 3020.41, Operational Contract Support, paragraph 2.c, it is determined that BHCF, has been identified by the Functional Commander/Director as non-essential service.

4.13. PHASE OUT.

4.13.1 If there is a change in contractor or if the operation reverts to in-house, the incumbent contractor will provide familiarization, to the government or the follow-on contractor, whichever the case may be. During the phase-out familiarization period, the incumbent will be fully responsible for job orientation for their replacement.

4.13.2 The government reserves the right to conduct site visits in all contractor operated facilities in conjunction with the solicitation of offers for the follow-on contract. In the event the follow-on contract is awarded to other than the incumbent, the incumbent contractor will cooperate to the extent required to permit an orderly change over to the successful contractor.

With regard to the successor contractor’s access to incumbent employees, a recruitment notice may be placed in each facility.

4.14 PUBLICATIONS.

4.14.1 Compliance with all publications, regulations and operating instructions provided by the Government is required when:

4.14.2 They pertain to the procedures for materials expediting herein and where the contractor is authorized by the performance work statement to accomplish the work specified in the publication, regulation or operating instructions.

https://wawf.eb.mil/ mailto:DIP-DARTS-AF-AP@dfas.mil

4.14.3 The publications prescribe USAF policies, use of materials, procedures and processes applicable to the work requirements.

4.14.4 The contractor is required to acquire and work on the latest version of the publication.

4.15. CONTRACTOR PERSONNEL

4.15.1. Contract Manager: the contractor shall provide a contract manager and alternate contract manager (responsible in the absence of the contract manager) who shall be responsible for the performance of the services. The names of the contract manager and alternate(s) shall be provided to the CO in writing prior to the beginning of the first performance period. The contract manager and alternate(s) must be able to read, write, speak, and understand English.

4.15.1.1. The contract manager and alternate shall have full authority to act for the contractor on all contract matters relating to daily operations of this contract.

4.15.1.2 The contract manager or alternate shall be available to discuss any problems within 2 business days via telephone, email, or in person.

4.15.2. Contractor Employees: the contractor shall not employ persons for work on this contract if such employee is identified to the contractor by the CO as a potential threat to the health, safety, security, general wellbeing or operational mission of the installation and its population.

4.15.2.1. Contractor personnel shall present a neat appearance and be easily recognized as contractor employees. This may be accomplished by wearing distinctive clothing bearing the name of the company or by wearing appropriate badges, which contain the company name and employee name in English.

4.15.2.2. The contractor shall not employ any person who is an employee of the U.S.

Government if employing that person would create a conflict of interest. Additionally, the contractor shall not employ any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval according to DOD 5500-7-R Joint Ethics Regulation. The contractor shall not employ any person who is an employee of the Department of the Air Force if such employment would be contrary to the policies in AFI 64-106, Air Force Industrial Labor Relations Activities.

4.15.2.3. The contractor is cautioned that off-duty active military personnel hired under this contract may be subject to permanent change of station, change in duty hours or deployment.

Military Reservists and National Guard members may be subject to recall to active duty. The abrupt absence of these personnel could adversely affect the contractor’s ability to perform;

however, their absence at any time shall not constitute an excuse for nonperformance under this contract.

4.16. JAPANESE ROAD LAWS

4.16.1. The contractor shall comply with Japanese Road Laws while on US Military installations to specifically include: Article 43 The Road Law (Japan) (prohibited acts relative to roads). No person shall commit the following described acts:

4.16.1.1. Damaging the road, causing roads to be littered with debris, polluting the roads with debris or fallout from motor vehicles or otherwise defacing roads unreasonably or without due cause.

4.16.1.2. Article 43-2 (Measures to be taken to prevent cargo or things loaded on motor vehicles from falling out)

4.16.2. The agency managing a road may when there is reasonable cause for him to feel that items or cargo being carried in or on a motor vehicle may fall out and damage, pollute, or otherwise deface the road in such manner as to hinder or obstruct the traffic, order the operator of the vehicle in question to take steps or measures necessary to prevent occurrence of such hindrance by stopping operation of the vehicle, or correcting the method of loading or traveling or operation of the vehicle.

4.17. REQUIRED INSURANCE by JAPANESE LAW

4.17.1. 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.

4.17.1.1. Type: Automobile Property Damage Insurance Amount: ¥3,000,000 or Dollar equivalent Bodily Injury Insurance Amount: ¥30,000,000 or Dollar equivalent

4.17.1.2. All vehicles must be properly inspected/insured in accordance with Japanese Compulsory Insurance (JCI) requirements.

4.17.2. The policies evidencing required insurance shall contain an endorsement to the effect that cancellation or any material change in the policies adversely affecting the interests of the U.S. Government in such insurance shall not be effective for such period as may be prescribed by the laws of the state in which this contract is to be performed and in no event less than thirty

(30) days after written notice thereof to the Contracting Officer.

4.18. CONTRACTOR MANPOWER REPORTING

4.18.1. The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Air Force (or applicable service) via a secure data collection site. The contractor is required to completely fill in all required data fields at http://www.ecmra.mil.

4.18.2 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 http://www.ecmra.mil/ 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 CMRA help desk.

4.19. INDIVIDUAL LOGISTICAL SUPPORT

4.19.1 INDIVIDUAL LOGISTICAL SUPPORT: Individual logistical support may be provided under this contract in accordance with FAR 25.802, DFARS 225.802, and the policies and procedures of DoD 4525.6-M and AFI 36-3026. Policies and procedures are subject to change. Examples of support are: DOD Common Access Card (CAC); Commissary (including rationed items); Base Exchange (including rationed items); MWR Facilities (e.g. chapels clubs, cinema, fitness center); Military Banking Facilities; Military Postal Service (APO/FPO);

Mortuary Services (on reimbursable basis); POV (Privately-Owned Vehicle license); Purchase of POL (Petroleum and Oil products); Transient Billets or Visiting Officers Quarters (VOQ) on space-available and reimbursable basis when travel is performed on Official Government Orders; Department of Defense Public Schools (DODDS) on a space guaranteed and tuition paying basis; Medical Services on a reimbursable basis; Dental care only for emergency conditions on a reimbursable basis; Pet Registration and Control and Housing Referral.

Logistical support is not authorized for Local National hires as it is forbidden by the Status of Forces Agreement (SOFA). Local National hires may be authorized a CAC if their duties require access to Government computer programs. ( See Appendix F, Special contract Clauses)

5. APPENDICES

A. Acronyms & Abbreviations List B. Estimated Workload Data

C. Government Provided Supplies/Services/Equipment D. Publications/Forms E. Special Contract Clauses

APPENDIX A

ACRONYMS AND ABBREVIATIONS LIST

Acronym/Abbreviation Definition

AF Air Force

AFB Air Force Base

BHCF Behavioral Health Care Facilitator

CFR Code Federal Regulation

CN Clinical Nurse

CO Contracting Officer

COR Contracting Officer Representative

DEPT Department

DOD Department of Defense

FAR Federal Acquisition Regulation

GR Government Representative

OSHA Occupational Safety and Health Act

PBSA Performance Based Service Acquisition

PTSD Post Traumatic Stress Disorder

PWS Performance-Based Work Statement

QA Quality Assurance

QCP Quality Control Program

SS Services Summary

TBA Traumatic Brain Injury

USAF United States Air Force

APPENDIX B

ESTIMATED WORKLOAD DATA

ITEM

NAME

ESTIMATED QUANTITY

1 Operate and Maintain Behavioral Health Care Facilitator program.

Total 130 – Case management

APPENDIX C

The Government will provide workspace, desk, computer, associated office equipment and office supplies.

APPENDIX D

PUBLICATIONS/INSTRUCTIONS

Applicable Publication/Instruction /Name Date Paragraph/Chapter

AFI 64-106, AF Industrial Labor Relations, 25 Mar 1994, Entire Document Applicable

DoDI 3020.41, Contractor Personnel Authorized to Accompany the U.S. Armed Forces, 3 Oct 2005, Entire Document Applicable

USFJI 64-100, 9 February 2018, Attachment 2, PWS Appendix E - SOFA Agreement

APPENDIX E

SPECIAL CONTRACT CLAUSES

F.1. RESTRICTION ON THE USE OF GOVERNMENT-AFFILIATED PERSONNEL

The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of the Department of Defense, either military or civilian, unless such person seeks and receives approval in accordance with Title 5, USC, Section 5536, DoD 5500.7-R (1993), as amended, and service directives.

F.2. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

OF 1996: All individuals performing services at an Air Force MTF are required to complete initial and annual refresher HIPAA 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.

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 ensure 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 CN 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 CN 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.

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

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

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

(g) The CN 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 CN 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 CN 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 CN 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 CN 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 CN 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 CN 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 CN may use Protected Health Information for the proper management and administration of the CN or to carry out the legal responsibilities of the CN.

(b) Except as otherwise limited in this Agreement, the CN may disclose Protected Health Information for the proper management and administration, provided that disclosures are required by law, or the CN 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 CN 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 CN 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) CN 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 CN of Privacy Practices and Restrictions

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

(c) The Government shall notify the CN 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 CN 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 CN as otherwise permitted by this clause.

Termination

(a) Termination. A breach by the CN of this clause, may subject the CN 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.