Attachment_1_-_Performance_Work_Statement__21_Jun_19.pdf

Attachment 1: RFQ # FA527019QB036

PERFORMANCE-BASED WORK STATEMENT (PWS)

PATIENT APPOINTMENT

AND ADMINSTRATIVE SUPPORT CLERKS

FOR

THE 18TH MEDICAL GROUP

KADENA AIR BASE

OKINAWA, JAPAN

21 June 2019

Contents

DESCRIPTION OF SERVICES

1.1. SCOPE:

1.2. PLACE OF PERFORMANCE:

1.3. MISSION ESSENTIAL STATUS…………………………………………………………………………………………………….3

1.4. SPECIFIC APPOINTING SERVICES TASKS:

1.5. PERSONNEL:

1.6. TRAINING:

1.7. HOURS OF OPERATION:

FACILITY AND EQUIPMENT

2.1. GOVERNMENT PROVIDED:

GENERAL INFORMATION

3.1. QUALITY ASSURANCE/CONTROL:

3.2. SECURITY REQUIREMENTS:

3.3. PRIVACY AND CONFIDENTIALITY:

3.4. PERFORMANCE EVALUATION MEETINGS:

SERVICE SUMMARY

APPENDICES

APPENDIX 1 – APPOINTMENT LINE HISTORICAL DATA

APPENDIX 2 –DEFINITIONS/ACRONYMS

APPENDIX 3 - APPLICABLE PUBLICATIONS

ATTACHMENTS

ATTACHMENT 1: 18 MDG APPOINTING PROTOCOL SAMPLE

ATTACHMENT 2: AFI 44-176 EXCERPT

ATTACHMENT 3: QUALITY MONITORING SCORECARD

DESCRIPTION OF SERVICES

1.1. SCOPE:

1.1.1. The Contractor shall perform all duties and tasks required to provide medical appointment services to the 18th Medical Group (18 MDG) beneficiaries. Performance shall be according to the requirements contained in this performance-based work statement (PWS). Appointments shall be made following the 18 MDG appointing protocols, and comply with Military Health System (MHS) Access to Care standards (as required by 32 CFR 199.17), as well as standards set forth by the Defense Health Agency and AFI 44-176, Access to Care Continuum. Release of information services shall comply with the contract statement of work, Military Health System (MHS) and all rules and regulations that apply to the 18 MDG. All services shall be made using a government provided electronic systems; Automated Call Directory (ACD) Module, Composite Health Care System (CHCS), Armed Forces Health Longitudinal Technology Application (AHLTA), AHLTA Webprint, TRICARE Online Patient Portal (Secure Messaging), and Genesis (when available).

1.2. PLACE OF PERFORMANCE:

1.2.1. The Contractor shall provide services at the 18 MDG, Kadena AB, Japan.

1.3 MISSION ESSENTIAL STATUS:

1.3.1 This service is determined to be non-essential for performance during crisis according to DODI 3020.41, Operational Contract Support, paragraph 2.c. in the event of crisis, the contractor will be notified by the Contracting Officer 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 PWS.

1.3.2. SOFA status is not a provided benefit for Contract personnel assigned to this position.

1.4 SPECIFIC APPOINTING SERVICES TASKS:

1.4.1. Contractor shall verify patient identity/information, review booking protocols, book appointments/follow-up appointments appropriately, input telephone consults (T-CON), monitor cancellation line, input cancellations, perform call-back reminders to patients, and reschedule appointments according to government provided appointing protocols and guidelines for the following clinics:

Family Health (FHC)/Behavioral Health (BHOP) Pediatrics (Peds) Flight Medicine (FM)/ Base Operational Medicine Clinic (BOMC) Women’s Health (WH) Optometry (Opt) Internal Medicine (IM)

The Military Treatment Facility (MTF) will provide the Contractor an electronic copy of the appointing protocols and guidelines. This document is a working document, and the 18 MDG will revise the appointment protocols and guidelines on an as needed basis and will provide updates to the Contractor as necessary. Contractor errors after adequate training in booking appointments will be validated, tracked, and used as a performance measure. The Contractor is expected to maintain a 95% accuracy rate when performing appointment procedures. Errors may include sending a T-Con to the incorrect contact, not obtaining and providing appropriate information to/from the patient, booking appointments contrary to 18 MDG appointing protocols, etc. Performing accurate patient verification is vital to patient safety and therefore there may be no more than two deficiencies per month per Contractor. Patient verification is accomplished by confirming two patient identifiers including name, date of birth, DODI, and/or social security number.

1.4.2. The Contractor shall accept appointments telephonically from authorized beneficiaries, from MTF staff members, or by the automated appointment system. The Contractor shall transfer all patients to the appropriate clinic if the patient chooses an incorrect option or if a clinic phone system is unavailable by referencing the Government provided phone list. At no time will callers be asked to call back, even if appointments for a particular day are unavailable. All callers should be told of the next available appointment. Space Available (Space A) patients are an exception and can be told to call back the next day if there is no availability.

1.4.3. The Contractor shall abide by telephony metrics established within the most current AFI 44-176 (paragraph 7.2) Access to Care Continuum. The Government will review the appointment line metrics on a monthly basis and provide feedback to the Contractor and Contractor personnel on standards met/not met.

1.4.4. The Contractor shall maintain over 80% “available time” logged in to the Automated Call Directory (ACD). [40 hours – 5 lunch hours – 2.5 (2 * 15 minute breaks a day) = 32.5. 32.5/40=81.25%]. The Government will pull ACD logs monthly to review data.

1.4.5. The Contractor shall administratively support the secure messaging system, TRICARE Online Patient Portal Secure Messaging. Administrative support includes enrollment of 18 MDG staff and beneficiaries, transferring provider empanelments, and deactivating relationships for patients who are no longer enrolled.

1.4.6. The Contractor shall work closely with the Group Practice Manager (GPM) and other sections within the 18 MDG to ensure and enhance access for all 18 MDG enrollees.

1.4.7. The automated appointment system to be used is the Government provided CHCS and AHLTA systems and Genesis when available. The Contractor shall verify and update, as required, patient registration information (i.e., patient demographics, patient contact, and any additional health insurance data). Perform an eligibility check in the Government provided Dependent Eligibility Enrollment Requirement System (DEERS). Issues with enrollment shall be referred to the TRICARE Operations and Patient Administration Flight.

1.5 PERSONNEL:

1.5.1. The Contractor’s personnel shall possess, at minimum, a high school diploma or equivalent as well as the ability to read, write, and speak English in order to communicate effectively with all patients and staff. The Contractor shall provide personnel that have an adequate skill level to interpret the patient’s request for a medical appointment and apply the appropriate MTF appointing protocols to the request.

The Contractor’s personnel shall possess good customer service skills, with minimum six months prior customer service experience. The Contractor shall provide personnel competent in the operation of computer systems to include the Windows suite of processing programs.

1.5.2. The Contractor shall supply two full-time employees during operating hours to facilitate coverage for breaks, lunch, and necessary training.

1.5.3. When in-processing the MTF, contractors are required to provide proof of immunizations including, but not limited to: Hepatitis B; Measles, Mumps, and Rubella (MMR); Tetanus, Diphtheria, Pertussis (Tdap); Tuberculosis; Varicella; and Influenza (annual requirement). Any missing immunizations will be required in order to finalize in-processing and will be obtained at the Contractor’s expense.

1.5.4. In case of absences or illness exceeding two weeks, the Contractor shall replace the absent employee with another of equal or exceeding qualifications. The Contractor/Contractor’s personnel shall advise the Functional Representative Evaluator Designee (FRED), supervisor or designee of absences due to illness or incapacitation.

1.5.5. If the Contractor is absent for more than two consecutive days due to illness, the Contractor shall provide the Government with a statement that the employee is free from communicable illness before/as the employee returns to work. The Government’s intent is to ensure that illnesses will not be passed to others in the workplace. The Government reserves the right to examine and or re-examine any worker who meets this criterion.

1.5.6. For normally scheduled leave, the Contractor shall notify the MTF in writing 14 days in advance of scheduled leave for all employees. Emergency leave will be dealt on a case by case basis.

1.5.7. For planning purposes, the Contractor shall notify the COR in writing of any personnel changes NLT 30 days. Upon notification of personnel changes, the Contractor shall provide replacement personnel within two weeks.

1.5.8. All Contractor staff will park in the18 MDG’s staff parking areas. Contractor personnel will be notified upon in-processing where staff parking is located.

1.6 TRAINING:

1.6.1. The Government will provide training on the following electronic systems:

(1) CHCS

(2) AHLTA

(3) DEERS

(4) ACD Module Note: The Contractor shall be required to sign and submit a Request for Functional Automated Information Systems Access memorandum for system access.

1.6.2. The Government will provide the following 18 MDG initial and ongoing trainings:

(1) Newcomers Orientation (Initial)

(2) Medical Facility/Air Force Unique Training (Ongoing)

(3) Security Training (Ongoing)

(4) Military Health System (MHS) Access to Care standards (Ongoing)

(5) Section specific safety briefings (Ongoing)

(6) Clinic Specific Training (Ongoing)

1.6.3. The Government will provide initial and ongoing training on 18 MDG appointing protocols/protocol changes to the Contract personnel. These trainings will be given on an as needed basis. An additional four hours of training time is allotted for in-depth training, typically occurring on the 4th Thursday of every month.

1.7 HOURS OF OPERATION:

1.7.1. The Contractor shall provide services normally Monday-Friday, 0645-1630, with calls beginning promptly at 0700 and ending at 1630. Peak times for calls are expected on Mondays, daily from 0700- 0900, following holidays, extended weekends, and/or inclement weather. See historical data provided in Appendix 1. The Contractor shall ensure adequate staffing during hours of operation, in order to meet performance metrics. Each contract personnel will be required to work a 40 hour work-week with no overtime allowed.

1.7.2. The Contractor is required to work during days that have been designated by the Installation Commander or 18 MDG leadership as days of reduced operations (i.e., PACAF/5th Air Force Training Days, Family Days, Exercises, minimally manned or reduced hours of operation). The Contractor is encouraged to conduct in-house training when clinic services are limited and/or call volumes are below normal. The FRED will notify the Contractor personnel of any changes to the provider staffing schedules due to inclement weather, clinic closures, etc.

1.7.3. Contract personnel are not required to provide services on the observance day for the following Federal Holidays:

New Year’s Day Martin Luther King Day President’s Day Memorial Day Independence Day Labor Day Columbus Day Veteran’s Day Thanksgiving Day Christmas Day

1.7.4. The Defense Medical Human Resources System Internet (DMHRSi) is the DoD accounting system for financial, personnel, education and training, and workload within the MDG. The Contractor Staff is responsible to provide all required information monthly (for example: personal data, work schedule, worked hours, work center, etc.) for all contractor personnel to the Medical Expense and Performance Reporting System (MEPRS) manager or clinic MEPRS monitor for entry into the system by the Air Force.

1.7.5. Contractor will only be allowed to invoice for hours rendered.

FACILITY AND EQUIPMENT

2.1. GOVERNMENT PROVIDED:

2.1.1. The Government will provide a private room within building 626 for the appointing clerks. No alterations to the facilities shall be made without specific written permission and approval. In case of alterations necessary for compliance with OSHA, such permission shall not be unreasonably withheld.

The Contractor shall return the facilities to the Government in the same condition as received, except for fair wear and tear and approved modifications. These facilities shall only be used in performance of this contract.

2.1.2. The Government will furnish utilities to include heating, electricity, water, and sewer.

2.1.3. The Government will provide all equipment necessary to accomplish the appointing procedures including telephony equipment, computers, and general office supplies.

2.1.4. The Government will provide telephony (including telephones and headsets) equipment to appointing clerks. The Contractor shall notify COR, in writing, of any equipment that is broken, damaged, or in any way inoperable. The MDG will be responsible for the maintenance and replacement of any damaged or broken equipment.

GENERAL INFORMATION

3.1. QUALITY ASSURANCE/CONTROL:

3.1.1. The Government will periodically evaluate the contractor’s performance by appointing a FRED to monitor performance to ensure services are received. The COR will complete a monthly surveillance report and submit to the Contracting Officer. The COR may evaluate the Contractor’s performance through intermittent on-site inspections of the Contractor’s performance and receipt of validated complaints. The Government may increase or decrease the number of inspections based on performance. The COR shall make determination of the validity of customer complaint(s). In the event there is a dispute, the Contracting Officer will make the final determination. Government personnel will record all surveillance observations. The preferred method, when possible, of correcting contract defects is re-performance at no additional contract cost. At a minimum, contractor shall provide documentation of their efforts to preclude repeat deficiencies.

3.1.2. The Contractor shall develop, submit for CO acceptance, and maintain a quality control plan to ensure appointing services are performed in accordance with this statement of work and specifically address the Service Summary (SS) items. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services.

3.1.3. The Contractor’s quality plan shall include, as a minimum:

3.1.3.1. Inspection System. A description of the inspection methodology used to cover all tasks and services. The description shall include specifics as to the areas to be inspected on a scheduled and unscheduled basis, frequency of inspections, submission of quality control inspection schedule, and the title and organizational placement of the inspectors.

3.1.3.2. Identification/Prevention Methods. A description of the methods to be used for identifying and preventing defects in the quality of service performed.

3.1.3.3. Documentation. The Contractor shall document inspections and corrective or preventive actions taken. The record 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.

3.1.4. The Contractor shall establish and implement methods of making sure all keys/combinations issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons. The Contractor shall not duplicate any keys issued by the Government. The Contractor shall immediately report to the COR any occurrences of lost or duplicated keys. In the event keys, other than master keys, are lost or duplicated, the Contractor may be required, upon written direction of the COR, to re-key or replace the affected lock or locks without cost to the Government. The Government may, however, at its option, replace the affected lock or locks or perform re-keying and deduct the cost of such from the monthly payment due the Contractor. In the event a master key is lost or duplicated, the Government shall replace all locks and keys for that system, and deduct total cost from the monthly payment due the Contractor.

3.2. SECURITY REQUIREMENTS:

3.2.1. All personnel employed by the Contractor in the performance of this contract, or any representative of the Contractor entering the Government installation, shall abide by all security regulations of the installation. All employees shall possess base provided identification cards and Vehicle Registration Certificates for personal vehicles requiring access to Kadena AB. When any employee no longer works for the Contractor at the installation, the Contract Manager shall return any Government-furnished identification to the Government. These passes are at no cost to the contractor. The 18th Contracting Squadron shall coordinate assistance in attaining the proper installation identification.

3.2.2. Contractor employees shall wear visible identification badges on the front of outer clothing, between the neck and waist.

3.2.3. The Contractor’s employees shall have, a background check completed in order to have access to Government systems. Contractor is responsible for completing SF85P Worksheet and providing fingerprint cards for each employee prior to access to the installation. The Contractor shall comply with regulations, DoD 5200.2-R Personnel Security Program. Note: the Contractor may request an interim clearance for access to government systems when the clearance has not been finalized at the time of employment. However, the 18 MDG Commander must approve this interim access, and evidence must be presented that shows the clearance has been initiated, pending favorable final approval. The POC for this will be the 18 MDG Security Officer.

3.2.4. The Contractor shall be responsible for safeguarding all government property provided for contractor use. At the end of each work shift, all government facilities, equipment, and materials shall be secured. The Contractor shall designate a custodian and alternate(s) to receipt for and account for government-provided facilities and equipment.

3.3. PRIVACY AND CONFIDENTIALITY:

3.3.1. Patient Health Information (PHI). The Contractor shall comply with all Health Insurance Portability and Accountability Act (HIPAA) guidelines. Patient information, lists and/or names of patients shall not be disclosed or revealed in any way for any use outside the MTF without prior written permission by the 18 MDG Commander. Any unauthorized disclosures shall be immediately documented and forwarded to the COR. The Contractor shall maintain, transmit, retain in strictest confidence, and prevent the unauthorized duplication, use, and disclosure of PHI in accordance with Standards for Privacy of Individually Identifiable Health Information, final rule, December 18, 2000 DoD Health Information Privacy Regulation (DoD 6025.18-R), the Privacy Act, and DoD Privacy Program (DoD 5400.11-R). The Contractor shall provide patient information only to employees, contractors, subcontractors, and government personnel having a need to know requirement for such information in the performance of their duties for this tasking. The 18 MDG shall approve the release of any patient information prior to the release.

3.4. PERFORMANCE EVALUATION MEETINGS:

3.4.1. The CO shall require the Contractor or his representative to meet with the CO, contract administrator, FRED and other government personnel at least quarterly, and as often as deemed necessary. The Contractor may request a meeting with the CO when he deems such necessary. Meetings will be documented in the contract file with written minutes signed by the CO or designated official.

Should the Contractor not concur with the minutes, such non-concurrence shall be provided in writing to the CO within ten (10) calendar days of receipt of the minutes.

SERVICE SUMMARY

SS# PERFORMANCE OBECTIVE PWS PARAGRAPH PERFORMANCE THRESHOLD

01 Perform accurate patient verification 1.3.1. No more than two deficiencies per month, per contractor

02 Perform appointing procedures IAW 18 MDG appointing protocols

1.3.1. No more than 5 appointing

errors a month *

03 Meet telephony metrics including:

Percent of Abandoned Calls (less than or equal to 8%), Service Level (90% of calls answered within 90 seconds), Average Speed of Answer (less than or equal to 45 seconds), and Average Talk Time (less than or equal to 180 seconds)

1.3.3. Monthly review of Key

performance indicators met IAW AFI 44-176, para 7.2, dated 8 September 2017

04 Maintain adequate “Available Time” logged into ACD module

1.3.4 Over 80% “Available Time”

to be verified monthly by ACD log review

05 Competency to interpret patient’s needs, display good customer service, and clear communication.

1.4.1. Four calls per month per

contractor to be monitored by the Government utilizing quality monitoring scorecard. No more than 3 “No” scores per call. (See attachment 3)

* 18 MDG Appointing protocols are a living document and are subject to change. See 1.5.3. for training information

** AFI subject to change. Notification will be given to the Contractor if/when this occurs.

APPENDICES

APPENDIX 1 – APPOINTMENT LINE HISTORICAL DATA

NOTE: The following data is provided for information only.

1. EXEPECTED VOLUME OF WORK. The approximate annual level of effort is 80,000 appointing transactions per year. The population consists of approximately 15,000 TRICARE Prime enrollees.

Majority (96%) of requests for appointments will be received telephonically. Approximately (4%) will be face-to-face or written requests from the MTF personnel.

2. SURGE REQUIREMENTS. Peak appointment hours are 0700 – 0900 Monday through Friday, with Monday morning being the heaviest, and any day after long weekends.

3. TRICARE ONLINE PATIENT PORTAL SECURE MESSAGING. The secure messaging system volume of work is approximately 2,700 invitations and 2,000 deactivations per year. The activation/deactivation information will be given to the clerks via written forms or electronically.

4. HISTORICAL DATA TABLES:

TOTAL: MARCH 2018-FEBRUARY 2019

INTERNAL

MEDICINE

WOMEN’S

HEALTH

PEDIATRICS FAMILY

HEALTH

BASE

OPERATIONAL

MEDICINE

CLINIC

OPTOMETRY FLIGHT

MEDICINE

GRAND

TOTAL

480 5,531 9,652 30,882 1,561 3,085 4,175 55,365

APPENDIX 2 –DEFINITIONS/ACRONYMS

1. GENERAL DEFINITIONS.

APPOINTING ERRORS. The act of booking an appointment in a manner that contradicts the appointing protocols.

ABANDONED CALL. Calls are considered abandoned after a customer reaches the appointment queue then hangs up before talking with an appointing clerk.

CONTRACTING OFFICER. A person duly appointed with the authority to enter into, administer, and terminate contracts on behalf of the Government.

CONTRACTING OFFICER REPRESENTATIVE. Government personnel who survey contractor compliance.

They are the contractor’s first point of contact for contract issues.

GOVERNMENT. The Federal government of the United States of America.

GOVERNMENT QUALITY ASSURANCE. Those actions taken by the Government to assure contractor services meet the requirements of the contract.

MEDICAL GROUP/MEDICAL TREATMENT FACILITY. Air Force hospitals or clinics, including all activities providing outpatient and/or in-patient healthcare services for authorized personnel.

PERFORMANCE WORK STATEMENT. A document that accurately describes a service in terms of the output requirements.

QUALITY CONTROL. Those actions taken by a Contractor to control the quality of output and to ensure that they conform to contract requirements and reasonable standards of medical care.

TELEPHONE CONSULT. An option in lieu of a face-to-face appointment.

2. ACRONYMS

ACD - Automated Call Directory AHLTA - Armed Forces Health Longitudinal Technology Application ASIMS - Aeromedical Services Information Management System CHCS - Composite Health Care System CO: - Contracting Officer COR - Contracting Officer’s Representative DEERS - Dependent Eligibility Enrollment Requirement System FRED - Functional Representative Evaluator Designee MHS - Military Health System MTF - Medical Treatment Facility PHI - Protected Health Information PWS - Performance Work Statement

APPENDIX 3 - APPLICABLE PUBLICATIONS

Publications and forms applicable to the PWS are listed below. The Contractor is obligated to follow these publications. These publications are available in the MDG and maintained by the Government.

Supplements or amendments to listed publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes that result in a decrease or no change in the contract price and notify the contracting officer in writing of such change.

Should a decrease in contract price result, the Contractor shall provide a proposal for a reduction in the contract price to the contracting officer. Before implementing any change that will result is an increase in contract price, the Contractor shall submit to the Contracting Officer a price proposal within 30 calendar days following receipt of the change by the contractor. The contracting officer and the contractor shall negotiate the change into the contract under the provisions of the contract clause entitled “Changes.” Failure of the contractor to submit a price proposal within 30 calendar days following receipt of the change entitles the government to performance according to such change at no increases in contract price (unless the time requirement in waived by the contracting officer according to paragraph (c) of the Changes clause).

32 CFR 199.17

Military Health System’s Guide to Access Success Accreditation Association for Ambulatory Health Care Current Edition DoD 5400.11-R, DoD Privacy Program DoD Directive 5500.7, Standards of Conduct DoD 6025.18-R, DoD Health Information Privacy Regulation DoD 5200.2-R, Personnel Security Program AFSSSI 5027, Section 5.3.3 AFI 33-119, Electronic Mail (E-Mail) Management and Use AFI 41-210 Patient Administration Function AFI 33-332 Air Force Privacy Act Program AFI 44-176 Access to Care Continuum Defense Health Agency Procedure Memorandums The Contractor shall abide by all Medical Group (unit level) Instructions published.

ATTACHMENTS

ATTACHMENT 1: 18 MDG APPOINTING PROTOCOL SAMPLE

PATIENT

COMPLAINT SIGNS/SYMPTOMS APPT TYPE NOTES:

ADD/ADHD (NO

TCON!!!)

Initial Evaluation BOOKED BY

PEDIATRICS

Must come into clinic with completed Parent/Teacher BLE forms (issued at Pediatrics front desk) to get appointment booked

Follow-Up FTR Every six months, or as directed

Medication Refill FTR 90 day prescription. Alternate between FTR and HC every three months

Medication Adjustment/Medication F/U after initial

SPEC/HC Pt must have been seen for ADHD within the last 3 months

Allergy Action Plan For children with issued EPI pens & Benadryl T-CON Only if well visits are up-to-date

Allergy Clinic Initial evaluation/testing FTR Must have referral from PCM and approval of allergy extender Annual f/u per allergy extender FTR

Animal Bites Bites- dog, cat, snake, rodent, other 24HR If no 24HR appt - contact nurse for further instructions

Bedwetting Concerns about bedwetting FTR

Behavioral Health Evaluation / Referral

(BHOP CLINIC)

Child HAS NOT had a WELL appt w/in the last year OR referred by PCM

FTR

Child HAS HAD a WELL appt w/in the last year T-CON

Follow-Up BOOKED BY

FAMILY HEALTH

May self-refer to BHOP

Breastfeeding

Spitting up (not vomiting), formula issues/concerns T-CON

General concerns T-CON

Breathing Test/PFT Schedule only if provider requests FTR

Bug Bites and Stings

Sudden hives, swelling in the face, difficulty breathing, dizziness, fainting OR had a serious allergic reaction to an insect bite or sting before

WARM HAND

OFF TO

NURSE/ER

Painful, bleeding, discharge, change in color, stung near mouth, area getting larger, allergic reaction or signs of infection

24HR If no 24HR appt - contact nurse for further instructions

Bites- bug, spider, other T-CON

ATTACHMENT 2: AFI 44-176 EXCERPT

ATTACHMENT 3: QUALITY MONITORING SCORECARD