PWS - 18th MDG Nursing IDIQ (DRAFT).pdf

Performance of Work Statement

For

18th Medical Group (MDG) Nursing Services - Indefinite Quantity Indefinite Delivery (IDIQ)

Contract

Kadena AB, Okinawa, Japan

Current as of: 15 January 2020

PART 1

PERFORMANCE WORK STATEMENT

1.1. Introduction: The Contractor shall provide qualified Health Care Workers (HCW) for the 18 Medical Group (MDG) in accordance with (IAW) the terms and conditions of this contract, to include any terms and conditions defined in Exhibit 1 issued under this contract. This contract requires the Contractor to provide non-personal medical services to the MDG with qualified HCWs within Kadena AB, Okinawa, Japan.

1.2. Description of Services: The Contractor shall provide qualified, credentialed and non-credentialed HCWs in Exhibit 1.

1.2.1. Nursing Services: Services provided by HCWs including, but not limited to, registered and/or licensed nursing personnel including all types of registered and advanced practice nurses as well as practical and vocational nurses.

1.3. Background:

1.3.1. The 18 MDG has a requirement nurses positions. The contractor shall provide all labor, materials, tools, equipment, transportation, and supervision necessary to recruit qualify, place, manage, and retain the following nurse specialties: Special Needs Coordinator (SNC), Clinical Nurse Case Manager, Women’s Health Nurse, Family Health Clinical Nurse (BHCF), Deployment-related Health Assessment (DHRA) License Practical Nurse (LPN),Utilization Nurse, Referral Management Coordinator Nurse, Behavioral Health Care Facilitator (BHCF) Nurse, Disease Manager Nurse (DMN) and FOMC nurse positions.

1.4. Scope: This contract shall serve as a vehicle to provide all Full-Time Equivalent (FTE)-based HCWs, with Product Service Codes (PSCs) within Q200 through Q500 series, at DoD MTF’s identified in paragraph 1.1. PSC Manual can be found at https://www.acquisition.gov/PSC_Manual The HCWs shall supplement the MTF’s clinical staff (e.g., military personnel, DoD civilian employees or other contracted staff) in accomplishing its mission of providing direct health care services to eligible beneficiaries. Direct health care services may take the form of but not limited to treatment, movement of patients, advice, clinical evaluations, recommendations, area and equipment preparation, and other medical services.

1.4.1. Reserved.

1.4.2. Period of Performance: The period of performance shall consist of a 1-year base ordering period, from the date of award, with 4 optional ordering periods. Positions issued under the contract will be in accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 252.216-7006

– Ordering, and Federal Acquisition Regulation (FAR) 52.216-22 -- Indefinite Quantity, of this solicitation/contract. The base period of performance for all awarded positions under this contract shall start prior to the expiration of the base plus four-year ordering period.

1.5. General Information:

https://www.acquisition.gov/PSC_Manual

1.5.1. Type of Contract: This contract is an Indefinite Delivery, Indefinite Quantity (IDIQ) Multiple Award Contract (MAC).

1.5.2. Non-Personal Services: This contract is a non-personal services arrangement for which the Government shall neither supervise contractor employees nor control the method by which the Contractor performs the required tasks. Under no circumstances shall the Government assign tasks to, or prepare work schedules for, individual contractor employees under a non-personal services arrangement. It shall be the responsibility of the Contractor to manage its non-personal service employees and to guard against any actions that are of the nature of personal services, or give the perception of personal services. If the Contractor believes that any actions constitute, or are perceived to constitute personal services, it shall be the Contractor's responsibility to notify the Contracting Officer (CO) immediately.

1.5.3. Quality Assurance: The Government will evaluate the Contractor’s performance under this contract IAW a separate Quality Assurance Surveillance Plan (QASP). This Government-only plan is primarily focused on what the Government will do to ensure that the Contractor has performed IAW contract performance standards. The QASP provides a systematic method of evaluating performance to include how the performance standards in Exhibit, Program Performance Summary will be applied, the frequency of surveillance, and surveillance method. The QASP is created with the premise that the Contractor is responsible for management and quality control actions to meet the terms of the contract while the Government is responsible for quality assurance actions.

1.5.4. Contracting Officer’s Representative (COR): The Government will identify a COR for the contract. The COR shall monitor all technical aspects of the contract and assist in contract administration. Unless otherwise identified in a delegation letter, the COR is authorized to perform the following functions: assure that the Contractor performs the technical and administrative requirements of the contract; perform necessary inspections in connection with contract performance;

maintain written and oral communications with the Contractor concerning technical aspects of the contract; issue written interpretations of technical requirements; monitor the Contractor's performance and notify both the CO and contractor of any deficiencies; coordinate availability of government furnished property; and, provide facility access of contractor personnel. The CO will send a letter of designation to the COR and the Contractor, which states the specific responsibilities and limitations of the COR. The COR is not authorized to change any of the terms and conditions of the contract.

1.5.5. Recognized Holidays: The following is a list of legal federal holidays. Any federal holiday falling on a Saturday will be observed on the preceding Friday, holidays falling on a Sunday will be observed on the following Monday.

U. S. Holidays:

January 1 New Year’s Day 3rd Monday in January Martin Luther King, Jr. Day 3rd Monday in February Washington’s Birthday Last Monday in May Memorial Day July 4 Independence Day 1st Monday in September Labor Day 2nd Monday in May Columbus Day November 11 Veterans Day

4th Thursday in November Thanksgiving Day December 25 Christmas Day

1.5.6. Hours of Operation: The Contractor is responsible for conducting business on the days and hours according to 5.4.4 except when the Government facility is closed as listed in 1.5.6.5.

1.5.6.1. Down Days/Clinic Closures: The HCW is not required to provide service on PACAF Family Days or clinic down days. Any holidays that are declared by Presidential Executive Order shall be observed in the same manner as the holidays listed above. These dates are identified at the beginning of each fiscal year, which runs from 1 October – 30 September. If the area in which contract personnel is scheduled to work is closed due to the holiday declared by an Executive Order and the HCW is not required to report in, payment will not be made for those hours. Closures of the installation due to inclement weather or other such acts of God shall be handled in the same manner.

1.5.6.2. Recording HCW Time: The Contractor shall be responsible for recording arrival or departure times, reporting absences, signing payroll timesheets, or completing corporate appraisal reports for HCWs.. The Government will use its own time sheets and compare it with the HCWs for invoice verification purposes. The Government will not sign any contractor documents.

1.5.6.3. Invoicing: The Contractor shall only invoice for services as outlined in 5.5.4.

1.5.6.4.1 Planned Absences: HCW are allowed to take up to twenty (20) work days of leave annually. Leave is classified as both annual, vacation or sick leave. Leave shall be taken in one (1) day increments and shall not exceed ten (10) consecutive work days. All leave is considered non-paid days and shall be deducted from the contractor’s monthly invoice. Timing and details shall be coordinated with the COR or section manager. Planned absences shall be scheduled at least thirty

(30) calendar days in advance and mutually agreed upon by the COR and/or section manager and

HCW.

1.5.6.4.2. Unplanned Absences: Unplanned or unscheduled absences of the HCW shall be coordinated with the COR or section manager IAW notification policies of the place of performance.

1.5.6.4.3. Substitute HCWs: If the Contractor substitutes permanent HCWs for a temporary period of time, the substitute shall meet the same qualification standards, health requirements, and terms as stated in the contract. All substitution requests to the CO must provide an explanation of the circumstances necessitating the proposed substitute of personnel.

1.5.6.4.4. Replacement HCWs: If the Contractor replaces a HCW as a permanent placement, the replacement shall meet the same qualification standards and health requirements as stated in the contract.

1.5.6.4.4.1. The Contractor shall replace permanent HCWs such that vacancies will not exceed 30 consecutive calendar days. The consecutive calendar days starts once the incumbent HCW leaves the position.

1.5.6.5. Closures: During a planned closure of the facility due to training, holiday or unplanned closure due to unusual and compelling circumstances (e.g., natural disasters, military emergencies, severe weather), the Contractor will only be paid for the actual hours the HCW provided services.

1.5.7. Place of Performance: The work to be performed under this contract will be at the 18 MDG, Kadena AB, Okinawa, Japan. While each HCW will be assigned to a primary location, the Government retains the right to assign a HCW, permanently or temporarily, to another location within a 20-mile commuting radius of their assigned location. The reassignment will be to a department or clinic comparable to that of their primary location and within the scope of the HCW’s duties, expertise and qualifications. Contractors and the HCWs shall receive notification two weeks prior to the reassignment. Under a mutual agreement between the Contractor and the Government, this two week notice may be waived.

1.5.8. Mission Essential: This service is determined to be non-essential for performance during crisis according to DoDI 3020.41, Operational Contract support. In the event of crisis, the contractor will be notified by the CO of the need to discontinue service 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 the contract.

1.5.9. Use of Government Property: The Contractor or HCWs shall not use government facilities, supplies, or equipment in private practice or for any purpose other than providing the health care services required under this contract.

1.5.10. Non-Compete Clauses: The use of non-compete agreements (including non-compete clauses within employment agreements) that are aimed at preventing the loss of contract HCWs are acceptable only if the non-compete clause is limited to the performance period specified in the contract/task orders. However, the use of non-compete conditions in employment agreements and/or in subcontracts that prevent employees and/or subcontractors of the incumbent from being interviewed by, employed, or accepting offers of employment and/or subcontracts by another contractor is prohibited.

1.5.11. Media and Other Inquiries: The Contractor or the HCWs shall not respond to any inquiries or complaints. All inquiries and complaints from the media, third parties, private or public agencies shall be immediately relayed to the COR.

1.5.12. Billing of Beneficiaries: The Contractor or HCW shall not request or accept compensation of any kind for beneficiaries treated, procedures performed, or any other actions provided outside the terms and conditions of this contract. While on duty, HCWs shall not advise, recommend, or suggest to individuals authorized to receive services at government expense that such individuals should receive services from the HCW when (s)he is not on duty, or from a partner or group associated in practice with the Contractor or HCW.

1.5.13. Confidentiality of Information: All financial, statistical, personnel, and technical data furnished, produced, or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. The Contractor shall not release any of the above information without prior written consent of the CO. The Contractor or HCW shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication. Contractors are not privy to patient information based on HCW patient care interactions. HCWs shall adhere to standards pertaining to the access of all patient information laws and regulations. The Contractor shall not persuade, induce or influence HCWs to expose patient information for any reason. The HCWs shall prepare medical records, forms and documents as required IAW established the 18 MDG regulations and guidelines.

1.5.14. Communications: HCWs shall abide by federal and the Medical Treatment Facility (MTF) regulations and requirements concerning the nature of limited privileged communication between patients and the HCW as may be necessary for security and personnel reliability programs. HCWs shall also abide by federal and the MTF regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act (HIPAA) of 1996. All medical records and reports will remain the property of the Government.

1.5.15. Off-Duty Employment: HCWs are not prohibited from conducting a private practice of their profession or from engaging in other employment. However, the HCWs shall not, simultaneously with performance under this contract, engage in other employment that creates a conflict of interest, violates federal law or potentially compromises the quality of their work under this contract. Further, such private practice or other employment shall not be conducted during those hours in which the HCW is required to render services under this contract. HCWs shall make no use of the Government facilities or property provided under this contract in connection with other employment.

1.5.16. Government Personnel: The Contractor shall not employ active duty military or government civilian employees to perform services under this contract unless approved by the CO on a case-by-case basis.

1.5.17. Emergency Health Care: The MTF will provide emergency health care for injuries or life threatening medical emergencies to contracted HCWs occurring while on duty. The Contractor shall reimburse the Government for medical services provided unless the required health care is both not covered by workers compensation insurance and the HCW is otherwise entitled to receive Government medical services.

1.5.18. Government Systems: The HCW shall operate and manipulate automated systems to include, but not limited to, Composite Healthcare Computer System (CHCS), Armed Forces Health Longitudinal Technology Application (AHLTA), Ambulatory Data System (ADS), Essentris, and Clinical Information System (CIS).

1.6. General Requirements:

1.6.1. Quality Control Plan (QCP) (Deliverable): The Contractor shall have a planned and systematic QCP that outlines the quality control process covering every aspect of the Contractor’s operation under this contract. The Contractor shall submit a complete QCP to the Procuring Contracting Officer (PKO) 14 calendar days before contract award. The PKO will approve the QCP in writing. The Contractor shall submit changes to an approved QCP to the PKO for approval throughout the life of the contract. At a minimum, the Contractor’s QCP shall include the following:

1.6.1.1. Written code of business ethics, which includes the process to identify and handle ethical issues related to the business practice.

1.6.1.2. Written emergency management plan, which includes an analysis of potential emergencies that could affect service performance, notification processes, backup communication systems, and a periodic test of the plan.

1.6.1.3. Written policy to address privacy, confidentiality and security of information.

1.6.1.4. Procedures to ensure that services are performed IAW this contract throughout the life of the contract.

1.6.2. Security Requirements:

1.6.2.1. Security Identification Badges: The Contractor and HCWs shall comply with the 18 MDG’s personnel identification and access requirements.

1.6.2.2. Contracted HCWs shall wear government-furnished identification badges (IDs) as required by the 18 MDG. The Contractor shall not alter or obscure the badge.

1.6.2.3. The Contractor is responsible for ensuring HCW badges are renewed before expiration to prevent installation access problems. Absences caused by expired IDs shall not relieve the Contractor of its obligation to perform the services.

1.6.2.4. HCWs shall immediately report any lost or stolen badges to the COR.

1.6.2.5. HCWs shall turn in all IDs to the COR, or a designated government representative, upon termination of their services or upon demand by the COR or designated government official.

1.6.2.6. Safeguarding Information: The Contractor shall safeguard information of a confidential or sensitive nature. Neither the Contractor nor any of its HCWs shall disclose or cause to be disseminated any information concerning the operation of the 18 MDG that could increase the possibility of a breach in security, or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974.

1.6.3. Post Award Conference/Periodic Progress Meetings: The Contractor shall attend a contract post award conference established by the PKO within 30 days of contract award. The Contractor also agrees to attend any post award conference or progress meeting convened by the contracting activity or contract administration office IAW Federal Acquisition Regulation (FAR) Subpart 42.500 -- Post-award Orientation.

1.6.4. Contractor Representative:

1.6.4.1. The Contractor shall designate a representative who will be the Contractor’s Point of Contact (POC) at the contract level. The POC shall be an individual who is knowledgeable of the terms and conditions of the contract and authorized to make decisions regarding the contract. The Contractor shall submit the representative’s contact information, to include email address and phone number, and any other key personnel, in writing, to the PKO not later than 10 business days after receiving notice of contract award.

1.6.4.2. Representative Status Change: The Contractor shall notify the PKO and CO in writing of changes in the status (i.e., termination or replacement) of designated contract-level contractor representative within one (1) business day of the change.

1.6.4.3. The Contractor representative shall be available to discuss all aspects of performance during the life of the contract and have the authority to resolve issues and problems as they arise. Problems or issues regarding performance of the contract that cannot be resolved between the COR and the Contractor, will be referred to the CO.

1.6.5. Identification of Contractor Employees: Contracted HCWs must use the label “contractor” in e-mail addresses and identify themselves as contract personnel in all meetings, telephone conversations, and written correspondence with government personnel.

1.6.6. Contractor Travel: HCWs may be required to perform travel for training or to provide services as requested by the COR and approved in advance as identified in the exhibit. The Contractor shall be responsible for obtaining all passenger transportation, lodging, and subsistence. Reimbursement of travel costs will be IAW FAR 31.205-46, Travel Costs. Such reimbursement will not be provided for travel within a 20-mile radius of the place of performance.

1.6.6.1. When using a personal vehicle for official duties, the Contractor will be compensated for mileage at the Federal Travel Regulation (FTR)/Joint Travel Regulation (JTR) prevailing rate.

The HCW shall not transport the patient or the patient’s family in his/her personal or government issued vehicle without prior approval from the COR

1.6.6.2. The Government will not issue government travel orders to the HCW.

1.6.6.3. Government contract air carriers and the Government's contract airfares are not available for Contractor use.

1.6.6.4. The FTR/JTR shall serve as the basis for the cost limits for lodging, per diem, miscellaneous expenses and mileage reimbursement if use of privately owned vehicle is authorized. The Contractor shall use discount hotel/motel and car rental practices. Per diem rates can be found on the World Wide Web at:

http://www.defensetravel.dod.mil/site/perdiemCalc.cfm.

1.6.6.5. Costs for transportation, lodging, meals and incidental expenses incurred by the HCW are allowable subject to FAR 31.205-46 and FTR/JTR.

1.6.6.6. The Government retains the right to direct the mode of travel including the availability and size of rental cars.

1.6.6.7. The Contractor shall submit an invoice IAW Wide Area Workflow (WAWF) instructions itemizing expenses in amounts allowable by the FTR/JTR. The COR will specify the 18 MDG procedure to document that the travel was completed and an accounting of expenses incurred. All http://www.defensetravel.dod.mil/site/perdiemCalc.cfm reimbursements will be retrospective, payable only upon presentation of a properly prepared invoice to the COR.

1.6.7. Relationship of the Parties and Liability:

1.6.7.1. Non-Personal Services - Professional Liability Responsibility and Procedures: Any personal injury claims alleging negligence by the individual contract HCW either within or not within the scope of the HCW’s performance of the non-personal services will not be processed by DoD or protected by the Federal Tort Claims Act.

1.6.7.2. The Contractor shall immediately notify the COR of any suit, action filed or claim made against the non-personal services HCW, which occurred as a result of work performed by the HCW under this contract. The Contractor is responsible for ensuring that the HCW promptly furnishes copies of all pertinent documents to the above referenced individuals.

1.6.8. Orientation: HCWs shall complete all the 18 MDG-specified orientation programs(s), initial and annual training requirements, and comply with all the 18 MDG policies and instructions as required by the 18 MDG.

1.6.8.1. In/Out-Processing: HCWs shall complete all the 18 MDG in-processing requirements. When a HCW’s performance under this contract ceases, the HCW shall return the Common Access Card (CAC), and all other government issued badges, as outlined in 1.6.2.5.

1.6.8.2. Annual Training Requirements: The Contractor shall ensure that HCWs complete all DoD and the 18 MDG’s specific annual training requirements. HCWs attending such training shall be in a paid status as part of the normal services required and billed under the contract.

1.6.8.3. Continuing Education (CE): HCWs, licensed, registered or certified by state bodies, professional organizations or national/medical associations shall continue to meet the minimum standards for CE to remain current as prescribed by their professional agency. CE shall be obtained at no additional cost to the Government. The COR may approve contractor HCWs to attend the 18 MDG CE courses on a space available basis. This time will not be billable to the Government.

1.6.9. Emergency Preparedness Training: HCWs shall participate in executing the 18 MDG's Emergency Preparedness Plan which may be in the form of drills/exercise or actual emergencies.

1.6.10. 18 MDG Standards: The HCWs shall comply with all applicable federal, state, and local laws, and 18 MDG policies, procedures and instructions.

1.6.11. Record HCW Time: HCWs may be required to personally record hours worked in the Defense Medical Human Resources System – internet (DMHRSi) system, or other system, as required by the 18

MDG.

1.6.12. Dress and Appearance: HCWs shall maintain good personal hygiene and present a well-groomed and professional appearance.

1.6.13. Productivity and Quality Standards: HCWs shall comply with all 18 MDG productivity and quality standards and maintain a level of productivity and quality comparable with that of other individuals performing similar services.

1.6.14. Medical Protocols: The HCW shall follow established government and professional clinical standards and accepted clinical protocols in the performance of duties as outlined in the 18 MDG policies and procedures.

1.6.15. Referrals and Consults: HCWs shall follow the 18 MDG regulations and policies when arranging for a referral or consult. Neither the HCW nor the Contractor shall bill individuals entitled to those services rendered pursuant to 1.5.13.

1.6.16. Peer Review: Credentialed HCWs will participate in peer review and other staff requirements in the 18 MDG.

1.6.17. Removal of HCWs: The Government may direct the immediate removal of any HCW who demonstrates a health, safety, Health Insurance Portability and Accountability Act (HIPAA) violation or mission risk. In the event the Government directs the removal of a HCW, the CO may direct the submission of a corrective action plan and issue a stop work order while the Contractor's response, contractor's implementation of the plan, and/or any government investigation is pending.

1.6.17.1. If the need for a removal occurs, the COR will contact the Contractor’s POC and direct the Contractor to remove that individual from the military facility. The Contractor shall not schedule individuals removed under such circumstances to perform any services required under the TO until authorized by the CO. The Contractor shall formally meet with the COR to discuss further action IAW 18 MDG instructions and regulations. A review of the basis for removal will be made by the CO within 7 business days after the COR directed the removal.

1.6.17.2. If, after any investigation deemed necessary by the CO, the CO concludes that the HCW’s performance requires permanent removal from performance under the contract, the CO will notify the Contractor that permanent removal is required. In the event of disagreements between the Government and the Contractor’s representative concerning matters of impaired HCWs, the decision of the CO will be final. During the period between the removal and the final decision of the CO, the Contractor shall agree to provide a substitute/replacement HCW IAW the terms and conditions of the

PWS.

1.6.17.3. The 18 MDG Commander has the prerogative to hold in abeyance, to deny, or to summarily suspend clinical privileges/practice when there is a reasonable cause to doubt the HCW’s competence to practice or for any cause affecting the safety of patients or others. Performance may be suspended until clinical privileges are reinstated. The Contractor shall provide a substitute HCW until the investigation is concluded. If clinical privileges of a HCW have been summarily suspended or are being held in abeyance pending an investigation into questions of professional ethics or conduct (per DoD or agency specific regulations, policies, or instructions), performance under the TO may be suspended until clinical privileges are reinstated. No reimbursement shall be made and no other compensation shall accrue to the Contractor for the affected HCW so long as performance is suspended or clinical privileges are held in abeyance. The denial, suspension, limitation, or revocation of clinical privileges based upon practitioner impairment or misconduct will be reported to the appropriate licensing authorities of the State(s), the District of Columbia, or a Commonwealth, territory, or possession of the United States in which the license(s) is(are) held.

1.6.18. Scope of Practice: HCWs shall not introduce new procedures or services without prior approval through established 18 MDG practice guidelines and individual privileges granted.

1.6.19. HCW Health Requirements: The Contractor shall comply with all health requirements in the contract. Prior to physical performance of services by the HCW, but no earlier than 30 days prior to physical performance of services by the HCW, the Contractor shall provide documentation certifying health requirements such as immunizations, annual vaccinations, medical testing (i.e., tuberculosis, N95 particulate respirator duckbill mask fitting) and physical examination when required at the time of initial placement and annually thereafter, as required. The expense for all health requirements, to include monitoring and tracking annual requirements, shall be borne by the Contractor at no additional cost to the Government.

1.6.20. Annual Immunizations: The Contractor shall ensure HCWs are immunized annually with the seasonal influenza vaccine and any other vaccine recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control (CDC) for HCWs or service/18 MDG specific guidance as outlined in DoDD 6205.02e, Policy and Program for Immunizations to Protect the Health of Service Members and Military Beneficiaries. The annual influenza vaccine may be provided by the Government, if available, as determined by the 18 MDG. If the HCW chooses to be immunized by the Government, the HCW shall sign a waiver releasing the Government from the legal liability IAW local procedures and policies. Alternately, the HCW may obtain the vaccine at another facility, at no cost to the Government, and provide proof of vaccination to the Government. If the HCW declines vaccination, a signed declination form will be provided to the COR IAW CDC recommendations and 18 MDG policy.

1.6.20.1. Immunization Tracking: The Contractor shall maintain their own process and system of tracking the currency of health immunizations and shall not rely on the Government for ensuring the HCWs are in compliance.

1.6.20.2. Blood Borne Pathogen Exposure: HCWs shall participate in the 18 MDG’s Blood Borne Pathogen Program, which outlines the post blood borne exposure protocols for testing, treatment, and monitoring.

1.6.20.3. Occupational Health: If required, the HCW shall obtain, at contractor expense, documentation of required physical testing, and a statement from the HCW's licensed medical practitioner or a report of a physical examination. The physical examination shall indicate that the HCW is free from mental or physical impairments that would restrict the HCW from providing the services described in the contract.

1.6.20.4. Universal Precautions: HCWs shall comply with the CDC’s “Universal Precautions” for the prevention of the transmission of the human immunodeficiency virus (HIV). HIV positive HCWs will be managed IAW the current CDC guidelines and Section 503 of the Rehabilitation Act (29 U.S.C. Section

793) and any implementing regulations (41 CFR § 60-741).

1.6.20.5. Tuberculosis Screening: Prior to reporting for service at the 18 MDG, each contract HCW shall be screened at contractor expense for risk of exposure to tuberculosis (TB) as part of the health examination and immunization/screening requirement. If the HCW is determined to have a low risk of exposure, no further screening or testing is required under this contract. The initial screening may be waived, at the discretion of the 18 MDG, if the Contractor provides evidence of a prior low risk assessment by a licensed physician. If the initial screening results in a determination that the HCW has an increased risk of exposure to TB, the contractor is responsible for ensuring that the HCW receives targeted screening and testing IAW CDC Guidelines for Health- Care Settings at Contractor expense and submitting timely records of subsequent screening or testing to the COR.

1.6.21. Health Notifications: The 18 MDG will notify the Contractor of any work hazards. If work hazards exist, it will be the 18 MDG’s decision whether the HCW continues work in the environment.

1.6.22. Medical Tests: No medical tests or procedures required by the contract will be performed by the Government with the exception post blood borne exposure protocols after exposure; and occupational exposure programs such as the Thermoluminescent Dosimetry (TLD) monitoring program.

1.6.23. Installation Access Procedures: Contracted HCWs shall comply with Kadena AB’s requirements for access to military installations.

1.6.23.1. Entry Security and Vehicle Search: HCWs may encounter long delays for entry security, vehicle inspection and identification checks upon entering and exiting Kadena AB. The Government will not reimburse the HCW for time spent at installation checkpoints.

1.6.24. Trusted Associated Sponsorship System (TASS): The Contractor, and all subcontractors, shall comply with agency personal identity verification procedures that implement Homeland Security Presidential Directive-12 (HSPD-12), Office of Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

1.6.25. Status of Forces Agreement (SOFA): The SOFA between the United and Japan governs the rights and obligations of the United States armed forces in Japan. Unless a contract is present in Japan solely to perform under a contract with the United States for the sole benefits of the United States armed forces in Japan and accorded privileges under SOFA Article XIV, it and its employees shall be subject to all the laws and regulations of Japan. Certain contractor employees and their dependents not accorded privileges under SOFA Article XIV may be accorded privileges under SOFA Article 1 (b)

1.6.25.1. The HCW shall comply with the instruction of the Contracting Officer concerning the entry of its employees, equipment, and supplies into Japan, and shall comply with all applicable Japanese Laws and regulations as well as United States Forces Japan (USFJ) and USFJ component policies and regulations during the performance of this contract.

1.6.26. SOFA Article 1(b) Status

1.6.26.1. (A) SOFA Article l(b) status. Contractor employees performing under contracts with the United States for the provision of services in support of U.S. armed forces in Japan, and whose presence is required in Japan to provide such services, may be determined eligible to acquire 1(b) does not create a lawful status in Japan for any entity other than individuals (e.g.,the company employing the individual does not acquire SOFA status under Article 1(b)). To qualify for SOFA status under SOFA Article 1(b), such individuals must be:

(i) United States nationals

(ii) Not ordinarily resident in Japan

(iii) Present in Japan at the invitation of, and solely for the purpose of executing contracts, with, the United States for the benefit of the United States armed forces, and

(iv) Not contractors or employees of a contract whose presence in Japan is solely for the purpose of executing contracts within the definition of SOFA Article XIV.

1.6.26.2. (B) The contracting officer may determine a proposed contract employee’s eligibility for recognition as a Member of the Civilian Component under Article 1(b) of SOFA by documenting on a Letter of Authorization (LOA) that the contractor employee is essential to the mission of the United States armed forces and has a high degree of skill knowledge for the accomplishment of mission requirements by fulfilling one of the following:

(i) Acquiring the skill and knowledge through a process of higher education or specialized training and experience; or

(ii) Possessing a security clearance recognized by the United States to perform his or her duties; or

(iii) Possessing a license or certification issued by a U.S. Federal Department of Agency, U.S. State, U.S.

Territory, or the District of Columbia to perform his or her duties; or

(iv) Identified by the United States armed forces a necessary in an emergent situation and will remain in Japan for less than 91 days to fulfill specialized duties; or

(v) Specifically authorized by the Joint Committee

1.6.26.3. (C) HCW shall present a valid LOA, signed by the Contracting Officer, to Japanese immigration officials upon entry into Japan to received GOJ recognition as a Member of the Civilian Component under Article 1(b) of SOFA

1.6.26.4. (D) SOFA Article l(b) privilege and benefits. Persons granted authority to enter Japan under SOFA Article 1(b) and their dependents (defined as spouse, children under 21, and, if dependent for over half their support upon an individual having SOFA Article 1(b) status, parents and children over

21) may be accorded the following benefits of the SOFA. These privileges are personal to the employee/dependent and do not inure to the employer:

(i) Access to and movement between facilities and areas in use by the United States armed forces and between such facilities and areas and the port or airports of Japan as provided for in SOFA Article V, paragraph 2;

(ii) Entry into Japan and exemption for Japanese laws and regulations on the registration and control of aliens as provided for in SOFA Article IX;

(iii) Acceptance as valid by Japan, without a driving test or fee, a U.S. Forces, Japan Operator’s Permit for Civilian Vehicle as provided for in SOFA Article X, Issuance of such permit shall be subject to applicable military regulation;

(iv) Exemption form customs duties and other such charges on materials, supplies, and equipment which are to be incorporated into articles or facilities used by the United States armed forces furniture, household goods for private use imported by person when they first arrive to work in Japan, vehicles and parts imported for private use, and reasonable quantities of clothing and household good for everyday private use which are mailed into Japan through United States military post offices as provided for in SOFA Article Xi, paragraphs 2 and 3;

(v) Exemption from the laws and regulations of Japan with respect to terms and conditions of employment as provided for in SOFA Article XII, paragraph 7, except that such exemption shall not apply to the employment of local national in Japan;

(vi) Exemption from Japanese taxes to the Government of Japan or to any other taxing agency in Japan on income received as a result of their service with the United States armed forces as provided for in SOFA Article XIII. The provisions of Article XIII do not exempt such persons from payment of Japanese taxes on income derived from Japanese sources;

(vii) If authorized by the installation commander or designee, the right to use exchanges, commissaries, messes, social clubs, theaters, newspapers and other non-appropriated fund organizations regulated by United States military authorities as provided for in SOFA Article XV;

(viii) The transmission into or outside of Japan of United States dollar or dollar instruments realized as a result of contract performance as provided for in SOFA article XIX, paragraph 2;

(ix) The use of postal facilities as provided for in SOFA Article XXI;

(x) Exemption from taxation in Japan on the holding, use transfer by death, or transfer to person or agencies entitled to tax exemption under the SOFA, of movable property, tangible or intangible, the presence of which in Japan is due solely to the temporary presence of these persons in Japan, provided such exemption shall not apply to property held for the purpose of investment or the conduct of other business in Japan or to any intangible property registered in (xii) Logistics Support.

Contractor, contractor personnel, and in case of personnel granted SOFA article 1(b) status dependents, shall, subject to availability as determined by the installation commander or designee, by provided logistics support including, but not limited to, the items below:

1. Base Exchange, including exchange service stations, theaters, and commissary (Article 1.b personnel/dependents and Article XIV personnel only);

2. Laundry and dry cleaning

3. Military banking facilities (Article 1(b) personnel/dependents and Article XIV personnel only;

4. Transient billeting facilities;

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

6. Casualty assistance (mortuary Services) on reimbursable basis;

7. Routine medical care on a reimbursable basis for U.S. citizen and emergency medical care on a reimbursable basis for non-U.S citizens;

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

9. Department of Defense Dependent Schools on a space-available and tuition-paying basis;

10. Postal support; as authorized by military postal regulations

11. Local recreation services on a space-available basis;

12. Issuance of U.S. Forces, Japan Operator’s Permit;

13. Issuance Of vehicle license plates

14. Conduct. Civilian personnel supporting the U.S. armed forces in Japan are guests in a foreign country and must at all times conduct themselves in an honorable and credible manner. Criminal conduct and dishonorable personal behavior committed either on or off duty adversely impacts U.S.

and Japanese relations, tarnishes the image of the DoD and USFJ, and hampers the Force’s military readiness.

1.6.27. Compliance with laws and regulations. The Contractor shall comply with, and shall ensure that its personnel are familiar with, and comply with, all applicable-

(i) United States, host country, and third country national laws;

(ii) Treaties and international agreements;

(iii) United States regulations, United States Armed Forces directives, instructions, policies, and procedures; and

(iv) Removal and replacement of Contractor personnel. The Contracting Officer may direct the contractor, at its own expense, to remove and replace any Contractor personnel who fail to comply with or violate applicable requirements of this contract, including those stipulated in this section. Such action may be taken at the Government’s discretion without prejudice to its rights under any other provision of this contract, including the termination for default or cause.

1.6.28. Contractors shall comply with the policies and procedures described in DFARS 225.370, DFARS PGI 225.370 (c)(i), USFJI 64-100, “Contract Performance in Japan,” and USFJI 36-2811, “Indoctrination Training Programs.”

PART 2

DEFINITIONS AND ACRONYMS

2. Definitions and Acronyms:

2.1. Definitions:

2.1.1. ACCEPTABLE QUALITY LEVEL (AQL): The minimum level of performance a contractor shall meet to be satisfactory on this contract.

2.1.2. BENEFICIARY: An individual eligible for medical care in an MTF as outlined in 10 U.S.C. Part 55.

2.1.3. CERTIFICATION: Official recognition of an individual by a national agency or association that is intended to assure the public that the health care professional has successfully completed an approved education program and evaluation. This includes a formal process designed to assess the knowledge, experience, and skills required to provide quality patient care in that specialty.

2.1.4. CALL-BACK HOUR: An hour when the HCW is required to report in-person to the 18 MDG from an on-call status.

2.1.5. COMPETENCY: The ability to integrate knowledge, skills, and attitudes in their job performance.

In addition, the performance is equivalent to stated requirements and to professional standards of care and practice.

2.1.6. CONTRACTOR: A supplier or vendor awarded a contract to provide specific supplies or service to the Government. The term used in this contract refers to the Prime Contractor.

2.1.7. CONTRACTING OFFICER (CO): A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the Government.

2.1.8. CONTRACTING OFFICER'S REPRESENTATIVE (COR): An employee of the U.S. Government appointed by the Contracting Officer to monitor the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.9. CONTRACTOR PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS): The web-enabled application that collects government assessments on contractor performance, both positive and negative, based on objective facts captured during a specific period of time.

2.1.10. CREDENTIALS: The documents that constitute evidence of qualifying education, training, licensure, certification or registration, experience, current competence, health status, and other qualifications of health care workers.

2.1.11. CREDENTIALING PACKAGE: The documents that provide the necessary information for the Government to validate credentials on a HCW prior to performance at the 18 MDG. The type of information in a credentialing package includes, but is not limited to, qualifying degrees, education, professional experience, licensure/registration, and certification requirements. Additional requirements for credentialed HCWs will be outlined in Exhibit 1.

2.1.12. CREDENTIALED HCW: Any individual identified in the Military Department (MILDEP) and DHA credentialing instructions/regulations as credentialed. This may include an individual who maintains professional qualifications such as education, internship/fellowship, licensure, registration, and/or certification to practice in a clinical discipline.

2.1.13. CREDENTIALS REVIEW: The process by which the health care professional’s credentials are determined to be appropriate for the position requested or held prior to being granted clinical privileges or assigned patient care responsibility. It is based on the following four core criteria: current licensure;

relevant education, training or experience; current competence; and ability to perform the requested privileges or scope of practice. Credentials review is conducted on health care workers prior to selection and receipt of services from HCW.

2.1.14. DELIVERABLE: Anything that can be physically delivered, which may include non-manufactured items such as meeting minutes or reports.

2.1.15. FULL-TIME EQUIVALENT (FTE): The ratio of the required number of HCW hours by 1920 hours.

2.1.16. FTE-WEIGHTED DAY: An FTE-weighted day is the number of days in the reporting period multiplied by the full-time equivalent (FTE) of a HCW.

2.1.17. HCW MINIMUM REQUIREMENTS: The minimum qualifications for specific HCW.

2.1.18. HEALTH CARE WORKERS (HCWs): Refers to contract personnel who provide clinical care. This does not include personnel whose duties are primarily administrative or clerical in nature, or provide maintenance or security services.

2.1.19. KEY PERSONNEL: Personnel designated by the Contractor who is knowledgeable of the terms and conditions of the contract and authorized to make decision on behalf of the Contractor.

2.1.20. LICENSE: A grant of permission by an official agency of a State, the District of Columbia, or a Commonwealth, territory, or possession of the United States to provide health care within the scope of practice of a specified discipline. Licenses shall be current, active, valid and unrestricted.

2.1.21. MALPRACTICE: A dereliction of professional duty, incorrect or negligent treatment, failure of professional skill or learning, as well as illegal or immoral conduct by any provider/professional responsible for health care, that results in death, injury, loss, illness or damage to the health care beneficiary.

2.1.22. MEDICAL/PATIENT RECORDS: Those documents generated in conjunction with, or as a result of, an episode of preventive, diagnostic, or therapeutic and rehabilitative care.

2.1.23. MILITARY DEPARTMENT (MILDEP): Air Force, Army or Navy

2.1.24. MILITARY HEALTH CARE SYSTEM (MHS): The combination of military and civilian medical systems used to provide health care to DoD medical beneficiaries. The MHS incorporates all aspects of health care services for DoD.

2.1.25. NATIONAL AGENCY CHECK WITH WRITTEN INQUIRIES (NACI): A personnel security investigation that is conducted by the Government for the HCWs performing under this contract.

HCWs in public trust positions require a favorable suitability determination on the NACI in order to perform on this contract.

2.1.26. NON-CREDENTIALED HCW: Any individual not identified in the MILDEP and DHA credentialing instructions/regulations as credentialed. This may include an individual whose performance does not require internship/fellowship, licensure, registration, and/or certification to provide services in a clinical discipline.

2.1.27. NON-PERSONAL SERVICES CONTRACT: The performance of health care services by HCWs under a non-personal services contract are not subject to day-to-day supervision and control by health care facility personnel comparable to that exercised over military and civil service health care personnel engaged in comparable health care services. The Government shall neither supervise non-personal services contractor employees nor control the method by which the Contractor performs these required tasks.

2.1.28. ON-CALL HOUR: An hour scheduled for the HCW to carry a communication device (e.g. cell phone, pager) to respond to calls when away from the 18 MDG.

2.1.29. OVERAGE HOUR: An hour scheduled for the HCW to perform services beyond regularly scheduled duty hours for continuity of care or surge purposes.

2.1.30. PERFORMANCE MEASURE: A method or instrument to estimate or monitor the extent to which the actions of a health care practitioner or personnel conform to clinical practice guidelines.

2.1.31. PHYSICAL SECURITY: Actions taken to prevent the loss or damage of government property and to prevent harm to personnel at or within government facilities.

2.1.32. PROGRAM MANAGEMENT OFFICE (PMO): The organization that manages the requirements on the contract.

2.1.33. PRIMARY SOURCE VERIFICATION: The process utilized to authenticate the…