Attachment_1_-_Performance_Based_Work_Statement_(PWS).pdf

RFQ # FA527019QB025

PERFORMANCE WORK STATEMENT

FOR

DISEASE MANAGER NURSE

Kadena Air Base, Japan

18 MDG/SGH

6 June 2019

PERFORMANCE WORK STATEMENT (PWS)

TABLE OF CONTENTS

SECTION PAGE

1 DESCRIPTION OF SERVICES 3-11

2 SERVICES SUMMARY 12

3 GENERAL INFORMATION 13-23

4 APPENDICES 23-25

1 DESCRIPTION OF SERVICES.

Utilizing major components of population health and disease management, ensures health care interventions for individuals and populations of patients with prevalent and/or chronic diseases in order to achieve disease management compliance, improved overall quality of life, and reduced healthcare costs. Also performs clinical nursing care in the execution of disease management services.

1.1 CONTINUATION OF ESSENTIAL DEPARTMENT OF DEFENSE (DoD)

CONTRACTOR SERVICES DURING CRISIS (MANDATORY). This service is determined to be non-essential for performance during crisis according to Department of Defense Instruction (DoDI) 3020.41, Operational Contract Support. In the event of crisis, the contractor will be notified by the CO/COR of the need to discontinue services due to contingency, base closure or other causes. If notification to discontinue services is not received, the contractor will be expected to continue performance in accordance with this PWS.

1.2 BASIC SERVICES: The Disease Manager Nurse (DMN) duties include but are not limited to following:

1.2.1 Develops and evaluates the annual disease management plan for the inclusion in the population health plan in collaboration with stakeholders (e.g., Chief of Medical Staff, Chief Nurse, Health Care Integrator, Group Practice Manager, medical management team).

1.2.2 Uses available data sources to identify, assess, and prioritize the needs of target subset of beneficiaries for specific disease management programs.

1.2.3 Ensures preventive care is included in the disease management plan of care.

1.2.4 Proactively implements disease management services for populations with chronic conditions, collaborates with patients in formulating patient-centered goals, and educates individuals and groups based on clinical practice guidelines approved by the Executive Committee of the Medical Staff.

1.2.5 Documents disease management related care provided using the ELAD medical Expense and Performance Reporting System (MEPRS) code for all face-to-face, telephonic, or TRICARE Online Patient Portal Secure Messaging interactions. Coding will include current international Classification of Disease (ICD), Evaluation and Management (E&M), and disease management-specific Healthcare Common Procedure Coding System (HCPCS) codes and the encounters must be completed and signed within 3 business days.

1.2.6 Completes medical record documentation (in AHLTA and/or other AF/DHA approved electronic health care record).

1.2.7 Will daily track (via Carepoint) disease management-related data, process and outcome measures, identified opportunities for improvement, and status of process improvement programs, and report this information to the Population Health Working Group quarterly.

1.2.8 Communicates and collaborates with other member so the healthcare team and managed care support contractor’s medical management staff as needed to ensure continuity of care for patients with chronic illness.

1.2.9 Tracks and reports healthcare outcomes of individual patients with chronic conditions to applicable primary care teams.

1.2.10 Provides a direct person-to-person summary (i.e., verbal communication providing continuity of care and a seamless transfer of information) of patients transitioning to other levels or places of care by providing pertinent information to the receiving healthcare provider (e.g., patient self-management status at graduation from the disease management program to primary care team, or transfer to case management for more sensitive services); document direct person-to-person summary in the electronic health record.

1.2.11 Will conduct standardized peer review at least quarterly to evaluate appropriate use of resources, timely assessments and interventions, and adherence with clinical and administrative standards to include appropriate coding practices for workload.

1.2.12 Develops and executes appropriate multidisciplinary disease management activities in collaboration with the Chief of Medical Staff, Chief Nurse, Health Care Integrator, Medical Management Director, Behavioral health Care Facilitator, Case Manager, Utilization Manager, and primary care teams in support of population health and population health management initiatives.

1.2.13 Ensures collaborative communication processes exists between the primary care and medical management teams. Collaborates with the Health Care integrator, other medical management staff, and primary/specialty care teams to plan and implement population health strategies.

1.3 NON-PERSONAL SERVICES. The services to be performed shall be non-personal services and are not inherently governmental. The contractor is solely liable for the action of their employees.

1.4 SPECIAL REQUIREMENTS/QUALIFICATIONS.

1.4.1 Must be knowledgeable of clinical and administrative theories, principles, practices, and procedures underlying nursing practice; a wide range of medical disorders/conditions and disease processes across the lifespan to include pediatrics, adolescence, adults, obstetrics, and geriatrics;

assessing patients, including the ability to assess/evaluate telephonically; preventive health schedules, procedures, processes and education methods; disease management and population health principles to include primary, secondary and tertiary prevention protocols; a variety of pharmacological agents used in patient treatment, the desired effects, side effects, and complications of their use as well as the accurate administration of the pharmacologic agent, including dosage calculations; computer applications/software to include Microsoft Office programs, MS Outlook (e-mail), and internet; and problem-solving techniques to articulate medical requirements to patients, families/care givers, medical and non-medical staff in a professional and courteous way.

1.4.2 Must be skilled in analyzing and defining healthcare needs of a defined population using standardized assessment tools; administrative requirements for proper documentation of patient’s condition including disease progress, acknowledgement of teaching, and follow up care;

communicating with people who may be physically or mentally ill, uncooperative, fearful, emotionally distraught, and occasionally dangerous; applying critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations.

1.4.2.1 ENGLISH LANGUAGE REQUIREMENT. The DMN shall read, understand, speak, and write English fluently.

1.4.3 EDUCATION. Shall be a licensed registered nurse graduated from a baccalaureate of science in nursing program accredited by a national nursing agency and recognized by the United States Department of Education.

1.4.4 LICENSE. Shall hold and maintain an active, current, valid, and unrestricted license as a Registered Nurse in any US state or jurisdiction.

1.4.5 EXPERIENCE. A minimum of 2 years full-time experience as a BSN in management of patient populations with prevalent and chronic diseases.

1.4.6 LIFE SUPPORT CERTIFICATION. The DMN must maintain current certification in either the American Heart Association Basic Life Support (BLS) Healthcare Provider or the American Red Cross BLS Healthcare Provider course.

1.5 HEALTH REQUIREMENTS

1.5.1 In accordance with AFI 48-105, all health care workers shall follow the methods for controlling and preventing disease as described in the American Public Health Association publication, Control of Communicable Diseases Manual, and the Centers for Disease Control and Prevention (CDC) publication, Morbidity and Mortality Weekly Report (MMWR), and its supplements. Where applicable, the most recent guidelines from these publications are utilized as the standard.

1.5.2 During in-processing, health care workers shall provide proof of immunization from the following diseases according to CDC guidelines: Hepatitis B, measles, mumps, rubella, varicella, and influenza. The DMN shall also provide proof of a negative TB skin test within 12 months (if positive, proof of negative chest X-ray within 12 months) prior to start of work. After start of work, the Government will provide post blood borne exposure protocols according to applicable AFIs.

1.5.3 In those areas where there is a higher risk of transmission of tuberculosis, health workers will be tested as frequently as directed by the MTF policy. This test will be provided by the MTF.

1.5.4 Immunization information will be tracked in DoD computer systems for all health care workers.

1.5.5 MEDICAL TEST. No medical tests or procedures required by the contract may be performed at the MTF (with the exception of Tuberculosis testing after start of work). The other exception to this policy will be if the provider is otherwise a military healthcare beneficiary or if the provider resides on Okinawa. There may be undue hardship incurred to perform testing at another facility. Expenses for all required tests and/or procedures (e.g., respirator fit testing where required) shall be borne by the health care workers at no additional expense to the Government.

1.5.6 Health care workers must be immunized annually with the influenza vaccine. This vaccine will be provided by the Government, if available as determined by the MTF. Although this vaccine may be provided by the Government, it may be obtained at other facilities with the cost being borne by the DMN. Unless vaccinated by the Government, the DMN shall be required to show proof of the vaccination.

1.6 PREGNANT EMPLOYEES. Health care workers should report their pregnancy to the Contractor who will relay the information to the Government supervisor. The MTF Employee Health Office will provide information concerning any work hazards in her work area inherent to gestational females. The Government is to notify the pregnant health care worker of any work hazards. It will be the Government and health care worker joint decision whether she continues work in the environment. The contractor will find a replacement during leave of absence within 15 days.

1.7 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.

1.8.1 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.

1.8.2 IAW DoD 6025-18R, the DMN 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 DMN 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 DMN 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 DMN 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 DMN 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 DMN agrees to mitigate, to the extent practicable, any harmful effect that is known to the DMN of a use or disclosure of Protected Health Information by the DMN in violation of the requirements of this Contract.

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

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

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

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

(a) Upon request the Government shall provide the DMN 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 DMN 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 DMN 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 DMN 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 DMN as otherwise permitted by this clause.

Miscellaneous

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

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

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

Security of Protected Health Information

(a) Definitions. As used in this clause:

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

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

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

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

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

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

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

Miscellaneous

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

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

1.9 RECORDS, FILES, DOCUMENTS, DATA, AND WORK PAPERS. All records, files, documents, data and work papers provided by the government remain Government property. Contractor personnel will comply with all AFMS requirements for safe keeping, handling, release, and disposal of any of the above information. These AFMS requirements shall include, but are not limited to, limiting access to Government data, tracking information from origin to disposal, removal of personal identifiers and thoroughly destroying information when work is completed according to Federal Law and DoD regulations. If data is used or transmitted outside government facilities, the Contractor shall be responsible for all aspects of physical and operational security. Inside Government facilities, contractor personnel shall be responsible for following DoD and local directives regarding physical and operational security. Under no circumstances may any information or data used under this contract be transferred nor may work under this contract be performed outside the MTF.

1.10 MEDICAL LIABILITY INSURANCE

The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor’s professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its issued employees. The Contractor shall provide a copy of the medical liability insurance document to the COR prior to contract performance and maintain such insurance during the terms of this contract. The liability insurance shall be issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrence $1,000,000.00, $3,000,000.00 aggregate. If at any time the Contractor changes insurance providers, the Contractor shall provide evidence to the Contracting Officer that the Government will be indemnified to the limits specified above per specialty per occurrence. Reference AFI 44-119, Medical Quality Operations, 4.2.5.2. Non-personal services contract personnel are independent contractors and are required to carry professional liability insurance. The Federal Tort Claims Act does NOT cover this individual.

The contractor is responsible to ensure that the individual has malpractice liability coverage and often indemnifies its employee. Non-personal services contract employees must maintain a current, unrestricted, active license from the state in which they are practicing and, if required, a certification or registration when caring for patients within the MTF.

2 SERVICES SUMMARY.

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

Performance Objective PWS Para Performance Threshold Will conduct standardized peer review to evaluate appropriate use of resources, timely assessments and interventions, and adherence with clinical and administrative standards to include appropriate coding practices for workload

1.2.1 Peer reviews will be

conducted quarterly and each review will have no more than 5 errors

Maintains professional manner and displays positive/cooperative attitude. Will respond to referrals within 48 hours. Will answer phone calls immediately or return call within the duty day the call is received.

1.2.4

No more than 2 validated complaints from patients, MDG Staff, or base leadership annually.

Document disease management-related care provided using the ELAD Medical Expense and Performance Reporting System (MEPRS) code for all face-to-face; telephonic, or TRICARE Online Patient Portal Secure Messaging interactions.

1.2.5 100% with no deviation

Encounters must be completed and signed within 3 business days.

1.2.5 100% with no deviation

Coding will include current International Classification of Diseases (ICD), Evaluation and Management (E&M), and disease management-specific Healthcare Common Procedure Coding System (HCPCS) codes.

1.2.5 100% with no deviation

Tracks Carepoint disease management-related data, process and outcome measures, identified opportunities for improvement, and status of process improvement programs, and report this information to the Population health Working Group quarterly.

1.2.7 100% with no deviation

Tracks and reports healthcare outcomes of individual patients with chronic conditions to applicable primary care Completes medical record documentation (in AHLTA and/or other AF/DHA approved electronic health care record).

1.2.9 100% patient care documentation requirement with no deviation

Maintains patient confidentiality in accordance with the Privacy Act and all HIPAA regulations/guidance.

1.7 1.8.1 1.8.21.2.7

Standard is zero breaches of privacy/confidentiality.

3.1 GENERAL INFORMATION.

3.2 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.

3.2.1 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.

3.2.2 Quality Control Plan. The contractor shall provide a complete Quality Control Plan (QCP) to ensure the requirements of the contract are provided as specified. The contractor shall provide a QCP describing the inspection system for the requested services listed in the PWS. The contractor shall develop and implement procedures to identify, prevent and ensure non-recurrence of unacceptable services. The contractor shall submit to the Contracting Officer for review no later than five business days. The contractor shall update the plan as changes occur and changes shall be submitted for review by the Contracting Officer.

3.2.3 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 specifics as to the areas to be inspected on a scheduled and unscheduled basis, frequency of inspections, and the title and organizational placement of the inspector.

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.

3.2.4 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.

3.3 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).

3.3.1 The Contracting Officer Representative (COR) is the authorized government representative who will perform assessments of the contractor’s performance compliance with the terms and conditions of the contract. 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/offer.

3.3.2 The FRED (Functional Requirement Evaluator Designee) is responsible for monitoring, assessing, recording and reporting on contractor’s performance. The FRED will have primary responsibility for completing quality assurance monitoring forms that will be used to document the inspection and evaluation of the contractor’s performance and submit to COR. COR will sign off quality assurance monitoring form which is completed by FRED and maintain surveillance documentation, notify the Contracting Officer (CO) of any significant performance deficiencies and recommend improvements to the QASP and Performance Work Statement (PWS) throughout the life of the acquisition.

3.3.3 The COR will inform the contract manager in person when discrepancies occur and will request corrective action. The COR 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. Any matter concerning a change to the scope, prices, terms or conditions of this contract shall be referred to the Contracting Officer.

3.3.4 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).

3.4 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.

3.4.1 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 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.

3.4.2 Operations Security (OPSEC). Contractor personnel will participate in the OPSEC program locally administered by the AF activity if applicable.

3.5 SOFA STATUS/LOGISTICAL SUPPORT

3.5.1 Applicant for status under the SOFA shall be in accordance with USFJ Instruction 64-100 and, in specific and limited circumstances, USFJ Instruction 64-102.

a. The Contracting Officer, through consultation with their legal counsel and the USFJ/J06 office, makes the determination of status under SOFA Article I(b) for contractor personnel.

b. If the Contracting Officer makes a request for status as a United States Official Contractor under Article XIV, USFJ Headquarters (HQ USFJ) shall make the final determination on the Contractor’s SOFA status upon consultation with the government of Japan.

c. The Contractor shall request a determination of status under the SOFA for its eligible personnel through the Synchronized Predeployment and Operational Tracker (SPOT) system. The Contracting Officer will approve a LOA generated in SPOT indicating the SOFA status of the contactor personnel only after verifying that eligibility criteria describe in USFJ Instruction 64-100 are met.

d. Contractor personnel dependent information is also required to be entered into SPOT as part of the employee record.

e. Offenses committed by the Contractor or contractor personnel may be subject to United States or host nation prosecution and/or civil liability. Japan authorities have the right to exercise jurisdiction over SOFA-covered contractor personnel, including dependents, in relation to offenses committed in Japan and punishable by the law of Japan. In those cases in which the Japanese authorities have the primary right to exercise jurisdiction but decide not to do so, the United States shall have the right to exercise such jurisdiction as is conferred on it by the law of the United States.

3.5.2 Logistical support may be authorized, when the Contracting Officer determines it necessary and appropriate, for contractor personnel in Japan. Generally, the full range of logistical support listed below is not necessary for contactor personnel performing services in Japan on a short-term, less than 91 days. Contractor personnel granted SOFA Article I(b) status and their dependents may be provided logistical support, subject to availability as determined by the installation commander or designee. Logistical support includes the following:

a. Base Exchange, including exchange services stations, theaters, and commissary.

b. Military banking facilities.

c. Transient billeting facilities.

d. Open mess (club) membership, as determined by each respective club.

e. Casualty assistance (mortuary services), on a reimbursable basis.

f. Emergency medical care, on a reimbursable basis.

g. Dental care, limited to relief of emergencies, on a reimbursable basis.

h. Department of Defense Dependent Schools, on a space-created and tuition-paying basis.

i. Postal support, as authorized by military postal regulations.

j. Local recreation services, on a space-available basis.

k. Issuance of USFJ Operator’s Permit, if the Contracting Officer determines it necessary based on length of contract performance.

l. Issuance of personal vehicle license plates.

3.5.3 No Other logistical support is authorized for contractor personnel in Japan unless the Contracting officer obtains a specific authorization from the installation commander where the support will be provided, after coordination with USFJ/J06.

3.6 ADP III SECURITY REQUIREMENTS

3.6.1 Since the DMN under this contract has access to and/or processes information requiring protection under the Privacy Act of 1974, these positions are considered “ADP III” positions.

Compliance with DoD Directive 8500.1, DoD Directive 5200.2, AFI 31-501 and AFI 33-202 is mandatory for ADP III positions. Therefore, a National Agency Check with Inquiries (NACI) is required for health care workers under this contract. The DMN/Contractor shall fully adhere with the provisions of referenced publications by having each of their employees who are performing under this contract make an appointment (through the FRED) with the appropriate security organization at the installation where service is provided. Each individual will be fingerprinted and required to complete the appropriate forms, usually a Standard Form 86, Standardized Investigative Request Form. The DMN/Contractor shall advise their employees that a positive report is needed as a condition of employment under this contract. The DMN shall apply for the NACI or provide a copy of Joint Personnel Adjudication System (JPAS) from previous military installation prior to the start of performance.

3.6.2 The DMN understands that, while the MTF commander may allow health care workers to temporarily occupy non-critical sensitive positions pending NACI, the DMN will be immediately removed from the position if at any time the NACI receives unfavorable adjudication, or if other unfavorable information that would affect the NACI becomes known.

3.6.3 Privacy System Notices The medical information systems identified in Appendix B are identified for the purposes of privacy system notices. These systems may be accessed by health care workers during performance of task orders.

3.7 HOURS OF OPERATION.

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

3.7.2 The contractor shall be available within 24 hour during normal duty hours, Monday through Friday, to meet or via tele-conference with government personnel designated by the CO to discuss problem areas.

3.7.3 Recognized Federal Holidays. The contractor is not required to provide service on the days approved by the 5th Air Force as observed for Federal Holidays. This is in accordance with the current Fiscal Year Holiday Schedule release by the 5th Air Force.

3.7.4 Down/Family Days. On work-days that have been declared “family days,” the clinic may be minimally manned. The contractor shall perform the services required under this contract or coordinate unpaid leave with FRED prior to the down or family day.

3.7.5 Absences and leave. All absences should be scheduled at least 30 days prior to the days off, and approved by the Health Care Integrator (HCI). The contractor shall not be compensated during periods of absences and leave. Planned absences and/or leave shall not exceed 10 working days. If the contractor is absent for two or more consecutive days due to illness, the contractor shall be required to provide written documentation from a qualified health care provider.

3.7.6 In cases of unscheduled leave and temporary absences greater than 80 consecutive hours, the Contractor agrees to provide temporary trained replacement staff of equal or greater qualifications per the PWS requirements within 14 days.

3.7.7 The contractor shall maintain an accurate timesheet to document hours worked daily, weekly, monthly and submitted to the FRED monthly.

3.8 UTILITIES. The Government will furnish all required utilities (such as water, telephone, electricity, etc.) at no cost to the contractor. Long distance and Defense Switched Network (DSN) telephone services will be provided for official use only. Services for this phone will be for official use only and will be paid for by the government. The contractor personnel shall participate in Government energy conservation programs.

3.9 RECORDS.

The contractor shall be responsible for creating, maintaining, and disposing of only those government required records that are specifically cited in this PWS or required by the provisions of a mandatory directive listed in [APPENDIX C] Applicable Publications and Forms. 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.

3.10 ENVIRONMENTAL CONTROLS.

3.10.1 Compliance with Laws and Regulations. The contractor shall be knowledgeable of and comply with all applicable Japan Environmental Governing Standards (JEGS), and requirements regarding environmental protection. In the event environmental laws/regulations change during the term of this contract, the contractor is required to comply as such laws come into effect. If there is an increase or decrease in cost as a result of the change, the contractor shall inform the Contracting Officer pursuant to notice requirements and negotiate a modification to the contract.

3.10.2 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

3.10.3 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.

3.11 GOVERNMENT OBSERVATIONS.

Government personnel, other than contracting officers (COs), COR, and FRED/s, 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.

3.11 SAFETY REQUIREMENTS

In performing work under this contract, the contractor shall:

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

3.11.2 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.

3.11.3 Develop and provide at the start of the orientation period or the start of the first operational performance period (if there is no orientation period) a safety plan for the protection of government facilities and property and to provide a safe work environment for contractor personnel

3.11.4 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.

3.11.5 Include a clause in all subcontracts to require subcontractors to comply with the safety provisions of this contract as applicable.

3.11.6 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.

3.11.7 In the event of an accident/mishap, take reasonable and prudent action to establish control of the accident/mishap scene, prevent further damage to persons or property, and preserve evidence until released by the accident/mishap investigative authority through the contracting officer.

3.11.8 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.

3.11.9 Include a clause in each applicable subcontract requiring the subcontractor's cooperation and assistance in accident reporting and investigation.

3.11.10 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.

3.12 TRAINING.

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

3.12.3 Disease Management Specific Training. Will complete all required training within 3 months of assuming Disease Manager role as directed and outlined by the Air Force Medical Operations Agency. Will also complete refresher training as updates become available.

3.12.4 At no additional expense to the Government, may attend the disease management formal training course, if eligible, no earlier than 30 days after, and no later than 4 months after, assuming the role. Disease Managers hired prior to inception of the disease management course will attend the course at the earliest opportunity. Acquires access to needed data sources and gains familiarity with the military medical treatment facility’s enrolled population and medical management programs prior to attending the course.

3.13 SPECIAL CONSIDERATIONS.

3.13.1 Licensure/Registration. In accordance with paragraph 4.2, AFI 44-119, Medical Quality Operations, 16 August 2011 non-personal services contract personnel providing care in the MTF must maintain a current, active, unrestricted license from any U.S. jurisdiction.

3.13.2 Copies of required certification for each Provider shall be furnished to the Contracting Officer or MDG designated representative prior to performance on this contract.

3.13.3 Appearance: DMN personnel shall present a professional, conservative, and neat appearance. DMN personnel shall report for duty in a professional manner, in appropriate attire befitting a health care setting, and having complied with socially acceptable standards of personal hygiene expected of health care workers.

3.13.4 While on duty, DMN shall be neat and clean (free from visible dirt and stains), well groomed and appropriately dressed. The provider’s clothing shall fit correctly to provide a professional, modest appearance, in keeping with normally accepted community standards of dress for the work being performed.

3.13.5 DMN provider shall display legible MTF-provided identification media on their outer clothing.

3.13.6 Facial hair (including beards, mustaches, and sideburns) shall be controlled (restrained) or trimmed. It shall not interfere with safe work practices, look unkempt, or be unclean.

3.13.7 No pending ethical complaints.

3.14 PHASE OUT.

3.14.1 If there is a change in contractor or if the operation reverts to in-house, the incumbent contractor will provide three week 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 the operation of disease management services

3.14.2 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.

Contractor agrees that incumbent contractor will be released without prejudice to apply for employment with the awarded company if so desired.

3.15 PUBLICATIONS.

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

3.15.2 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.

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

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

3.16 CONTRACTOR PERSONNEL

3.16.1 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 COR 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.

3.16.2 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.

3.16.3 The contract manager or alternate shall be available via teleconference during normal duty hours within 24 hours to meet on the installation with government personnel (designated by the CO) to discuss problems. After normal duty hours the manager or alternate shall be available within four (72) hours.

3.16.4 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 well being or operational mission of the installation and its population.

3.16.5 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.

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