Performance_Work_Statement_-Translator_Service_Geilenkirchen.pdf

Attachment 1 FA5606-15-R-0016

PERFORMANCE WORK STATEMENT

FOR

Referral Management Center (RMC) Translation Support Services

470th ABS, Geilenkirchen

6 August 2015

Table of Contents

SECTION Page Number

1.0. DESCRIPTION OF SERVICES 3

2.0. SPECIFIC REQUIREMENTS 3

3.0. SERVICES SUMMARY 5

4.0. GENERAL INFORMATION 6

5.0. APPENDICES 11

5.1. APPLICABLE PUBLICATIONS AND FORMS 11

5.2. CONTRACTOR MANPOWER REPORTING 13

5.3. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT

(HIPAA) OF 1996 13

6.0. HISTORICAL WORKLOAD DATA 17

PERFORMANCE WORK STATEMENT

1.0. DESCRIPTION OF SERVICES/GENERAL INFORMATION:

1.1. DESCRIPTION OF SERVICES. The contractor shall provide non-personal services in support of the 470th ABS US Clinic’s (470 ABS/SG) Tricare Operations and Patient Administration (TOPA) Flight.

The contractor shall provide all management, supervision, and personnel to obtain medical consultation and administrative support for the Medical Treatment Facility (MTF) staff and beneficiaries. Contractor personnel shall support the Referral Management Center section of the 470ABS/SG, service daily operations functions of host nation medical report translations. Contracted services shall include proper review, process and maintenance of medical records, medical admin assistance and customer service.

Performance shall be according to the requirements contained in this Performance Work Statement (PWS), and professional standards of the Joint Commission on Accreditation of Healthcare Organization (JCAHO), Accreditation Association for Ambulatory Health Care (AAAHC), Unit Effectiveness Inspection (UEI), and Health Insurance Portability & Accountability Act (HIPAA).

1.2. Requested services are considered to be non-mission essential.

1.3. BACKGROUND INFORMATION. The Referral Management Center section is an essential Health Service Management function of the 470ABS/SG. Duties and responsibilities assigned to the section affect guidance and instruction, general management and control of health information, implementation of computer applications, and other dimensions of outpatient medical records and referrals.

1.4. Period of Performance: Base- 15 September 2015 – 14 September 2016 Option Year 1- 15 September 2016 – 14 September 2017

Option Year 2- 15 September 2017 – 14 September 2018 Option Year 3- 15 September 2018– 14 September 2019 Option Year 4- 15 September 2019 – 14 September 2020

2.0. SPECIFIC REQUIREMENTS:

2.1. SPECIFIC TASKS.

The contractor personnel shall provide ( 1) Full Time Equivalent (FTE) (160 hours a month for 12 months) to clerical/administrative support in clinics, or other departments of the MTF. Contractor personnel shall serve as patient liaisons and translators to review, translate, process, maintain, and release medical records and referrals. Contractor personnel are required to compile or extract medical records data to ensure compliance with regulatory requirements.

2.1.1. Translation Support Service. Contractor personnel shall:

2.1.1.1. Provide official medical translation from German to English, Dutch to English, on host nation medical reports received in the Referral Management Center;

2.1.1.2. Answer main office phone line, direct telephone calls to appropriate sections for assistance and take messages as required;

2.1.1.3. Initiate and locate patient medical records as needed; scan medical report results and translations into the Healthcare Artifact and Image Management Solution (HAIMS) system as required;

review medical report translation with patients, MTF providers and staff as needed

2.1.1.4. Perform other administrative and clerical duties in support of the medical care and operational support

2.1.1.5. arrange and schedule medical appointments with host nation providers, relay general instructions to patients, or make referrals to other sections;

2.1.2. Medical Translation Support Services.

2.1.2.1. Translate Host Nation Provider medical reports from German to English

2.1.2.2. Maintain industry standard of translating 1.5 medical report pages per hour; performance threshold of 95% of industry standard per month

2.2. PERFORMANCE QUALIFICATION. Contractor personnel shall meet the following minimum qualification:

2.2.1. LANGUAGE REQUIREMENT. Contractor personnel shall be able to type with a minimum of 40 words per minute and have the ability to speak and write English ,German, and Dutch. The contractor shall provide a significant service as a translator between the German, and Dutch, health care providers, and American medical health care beneficiaries. All languages should be spoken with sufficient structural accuracy and vocabulary pronunciation effective in most formal and informal conversations on practical and professional topics. An understanding in medical vocabulary is required. All translating in writing will be done verbatim based on writer documentation received and transcribing. Correct grammar, spelling, punctuation, capitalization, and format to prepare written correspondence, forms or reports is required. The work is primarily sedentary. However, there may be some physical demands.

Requirements include prolonged walking, standing, sitting or bending.

2.2.1.1 Contractor shall provide personnel who meet the language proficiency level at the beginning of their employment. Demonstrations of ability to meet personnel language requirements may be requested and may be by any method determined reasonable by the contracting officer. Contractor employees who fail to demonstrate the required proficiency may request one repeat demonstration of language capability within 30 calendar days. Failure to satisfy language proficiency requirements shall have the effect of the position being considered vacant and the contractor will be required to have a replacement within three duty days of the repeat demonstration failure. The 470ABS/SG requires contractors to meet minimum English, German, and Dutch language proficiency levels of 4, as proficiency levels outline in Bureau for International language Coordination (BILC) STANGAG 6001 Edition 4 dated 12 October 2010.

English Dutch German Speak Read Write Speak Read Write Speak Read Write

4 4 4 4 4 4 4 4 4

Reading Ability

Ability level 1: Able to read some personal and place names, street signs, office and shop designations, number and isolated words and phrases. Can recognize all the letters in the printed version of an alphabetic system and high frequency elements of a syllabus or a character system.

Ability level 2: Able to read simple prose, in a form equivalent to typescript or printing, on subjects within a familiar context. With extensive use of a dictionary, can get the general sense of routine business letters or articles in technical fields within his/her competence.

Ability level 3: Able to read routine correspondence, reports and technical material in his/her special field. Can grasp the essentials of articles of the above types without using a dictionary. For accurate understanding, frequent use of a dictionary required. Has occasional difficulty with unusually complex sentence structures.

Ability level 4: Able to read all styles and forms of the language pertinent to professional needs.

With occasional use of a dictionary, can read all material in his/her special field, including official and professional documents and correspondence. Can read reasonably legible handwriting without difficulty.

Speaking Ability

Ability level 1: Can ask and answer questions on topics very familiar to him/her. Within the scope of his/her very limited language experience, can understand simple questions and statements, allowing for slowed speech, repetition, and paraphrases. Speaking vocabulary is inadequate to express anything but the most elementary needs. Errors in pronunciation and grammar are frequent, but can be understood by a native who is accustomed to dealing with foreigners attempting to speak his language. Any person at this level should be able to ask and give simple directions and tell time.

Ability level 2: Able to handle limited work requirements, needing help only in handling complications or difficulties. Can get the gist of most conversations on Non-technical subject that requires no specialized knowledge and has a speaking vocabulary sufficient to express him/her Simply.

Accent, though often quite faulty, is intelligible. Can usually handle elementary constructions quite accurately but does not have thorough or confident control of the grammar.

Ability level 3: Able to speak the language with sufficient structural accuracy and vocabulary to participate effectively in most formal and informal conversations on practical and professional topics.

Can discuss particular interests and special fields of competence with reasonable ease and comprehension.

Vocabulary is broad enough that he/she rarely has to grope for a word. The accent may be obviously foreign but control of grammar is good. Errors never interfere with understanding and rarely disturb the native speaker.

Ability level 4: Able to use the language fluently and accurately on all levels normally pertinent to professional needs. Can understand and participate in any conversation within the range of his/her experience with a high degree of fluency and precision of vocabulary. Would rarely be taken for a native speaker but can respond appropriately even in unfamiliar situations. Errors of pronunciation and grammar are quite rare. Can handle formal interpreting from and into the language.

Writing Ability

Ability level 1: Has sufficient control of the writing system to meet limited practical needs. Can produce all symbols in an alphabetic or syllabic writing system. Can write numbers and dates, his/her own name and nationality, address, etc. Otherwise, ability to write is limited to simple lists of common items or a few short sentences. Spelling may erratic.

Ability level 2: Can draft routine correspondence and meet limited professional need. Is familiar with the mechanics of the writing system, except in character systems where ability is limited to a small stock of high frequency items. Makes frequent errors in spelling, style and writing conventions. Must be able to write simple notes, draft routines, and limited office messages. Material normally requires editing by a more proficient writer.

Ability level 3: Can draft official correspondence and reports in a special field. Control of structure, spelling and vocabulary is adequate to convey the message accurately, but style may be quite foreign. All formal writing needs to be edited by an educated native.

Ability level 4: Can draft all levels of prose pertinent to professional needs. Control of structure, vocabulary and spelling is broad and precise. Sense of style is nearly native. Errors are rare and do not interfere with understanding. Nevertheless, drafts of official correspondence and documents need to be edited.

2.2.1.2. A certification as German-English/English-German, Dutch-English/English-Dutch translator/interpreter is required. One of the following certifications will meet this requirement :Bachelor of Arts in Translation/Interpretation, Diplom Uebersetzer/Dolmetscher, Staatlich gepruefter Uebersetzer, Staatlich anerkannter Uebersetzer, US State Department certified translator, or other international or national organizations like American Translators Association, International Interpreters Association, etc.

2.2.2. EDUCATION REQUIREMENT. High school diploma or General Educational Development (GED) equivalency. Medical terminology required . Must hold and maintain proper credentials as certified German, and Dutch translator. Contractor personnel performing this duty shall be knowledgeable in general medical ethics, health records administration, telephone etiquette, office management methods, excellent communications and customer service skills, strong organizational background, and computer operations to include Microsoft Windows and spread sheet type applications.

Knowledge of coding is desirable, but not required.

2.2.3. OTHER SIGNIFICANT FACTS. Excellent knowledge of medical terminology is highly desired.

Basic knowledge of available office automation software as they relate to a medical facility is required (Microsoft Office programs). Must possess knowledge of customer service focused operations and be familiar with Air Force Quality Management principles. Patient confidentially and ability to deal with patient sensitive information are indispensable. Displays courtesy toward coworkers and customers and maintains professional composure all the times. Requires understanding/knowledge of both HIPAA and German and/or Dutch privacy laws/regulations. Maintains a thorough understanding of the healthcare of DoD beneficiaries.

2.3. UNIQUE MILITARY HEALTH CARE SYSTEMS/PROCEDURES:

2.3.1. Armed Forces Health Longitudinal Technology Application (AHLTA).

2.3.2. Composite Health Care Systems (CHCS).

2.3.3. Defense Enrollment Eligibility Reporting System (DEERS).

2.3.4. IAW AFI 41-210, Paragraph 5.10 and 5.11. Military filing system – to file by sponsor social security, terminal digit order, color-coded and blocked filing system. Divide files into 100 equal sections.

Establish a minimum of file guides bearing the 100 primary numbers, “00” through “99.” Contents of a military medical record, layout, sections, family members prefix designation, forms used in a MTF, and the medical record tracking procedures.

2.3.5. Healthcare Artifact and Image Management Solution (HAIMS).

3.0. SERVICES SUMMARY.

Performance Objective PWS Para

Performance Threshold Method of Assessment

Provides timely and accurate information/performance to all admin support tasks

2.1.1.1. – 2.1.1.5.

1 deficiency per month

Random Sampling and Customer Feedback

Provides accurate and adequate written responses to medical report translation requests

2.1.2.1- 2.1.2.2

5% industry standard deficiency per month

Industry standard of 1.5 medical report pages per hour

3.1. Quality Control:

3.1.1. The contractor shall have a planned and systematic quality control process for monitoring, analyzing and improving their contract performance.

3.1.2. The contractor shall ensure that all contractor employees comply with the MTF quality management/process improvement activities.

3.1.3. The contractor shall provide a copy of their proposed Quality Control Plan (QCP) at the pre-performance conference for acceptance by the Contracting Officer (CO). The accepted QCP will automatically become part of the contract. The QCP shall assure the requirements of the contract are provided consistent with reasonable standards of administrative support. The CO will notify the contractor of the acceptance or rejection of the plan within 10 calendar days of receipt. The contractor shall effect modifications and obtain acceptance of the plan by the CO within 10 calendar days of receipt. The Contractor QC program shall include:

3.1.3.1. Continuing review of the contract performance including compliance with regulations referenced in the contract. Review shall be accomplished and recorded on a schedule as dictated by the contractor's written QCP. Records shall be made available to the Government Contracting Officer Representative (COR) upon Government request throughout the contract performance period and for the period after contract completion until final settlement of any claims under this contract.

3.1.3.2. A method of identifying deficiencies in the quality of service before the level of performance deteriorates to an unacceptable level. This method must also measure correctness of words translated.

Audit results shall be made available to the COR upon Government request.

3.1.3.3. Subsequent changes to the QCP shall be provided to the CO for review and acceptance before implementation.

3.1.4. Inspection: The inspection and acceptance point for all services rendered under this contract will be the COR. The performance by the contractor employee, the quality of services rendered, and any documentation or written material in support of same, will be subject to continuous inspection, surveillance and review for acceptance by the CO or COR. Quality assurance procedures established by the MTF will be used for continuous monitoring.

4.0. GENERAL INFORMATION:

4.1. PERSONNEL:

4.1.1. The Contractor shall designate to the Contracting Officer (CO), in writing, a primary point-of-contact for contract implementation, coordination and administration not later than ten work days after receiving notice of contract award. The Contractor shall notify the CO of changes in the primary point-of-contact at least five work days prior to any change. All notifications shall be in writing and shall state the name and contact information for the point-of-contact. The Contractor Representative may reside/be located outside of Germany (i.e. in the United States), but shall be available by telephone or email from 0700 to 1600 Central European Time.

4.1.2. Contract personnel shall present a neat appearance commensurate with that required of a professional.

4.1.3. Neither uniformed personnel nor U.S. Government civilian employees shall be employed to perform services under this contract.

4.1.4. Services are non-credentialed/privileged. Services are not approvable under NATO SOFA status accreditation under Article 72 or 73. Therefore, services are subject to German income tax.

4.2. REGULATIONS. The Contractor shall abide by all Medical Treatment Facility (MTF) standards, rules, and procedures including requirements for any licensure, credentialing, and quality assurance requirements. Such regulations include, but are not limited to, general safety, fire prevention, waste disposal, infection control, AAAHC, JCAHO, UEI, HIPAA, and patient safety initiatives.

4.3. REMOVAL OF CONTRACTOR PERSONNEL. At any time during the performance of this contract, the CO or COR may direct the Contractor to immediately remove any Contractor personnel whose actions or impaired state raises reasonable suspicion that clear and present danger of physical harm exists to a patient, other Contractor personnel, and government personnel or to the impaired individual. This provision will be used in emergency situations only and not for the purpose of bringing performance issues or other non-urgent concerns to the attention of the Contractor. If the need for a removal occurs, the COR will contact the Contractor's point-of-contact and direct the Contractor to remove that individual from the MTF and to not use that individual to perform any services required under this contract until the issue has been resolved by the CO. A review of the basis for removal will be made by the CO within three (3) working days after the COR directed the removal. If, after any investigation deemed necessary by the CO and discussions with the Contractor's representative, the CO concludes that the Contractor personnel’s impairment 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 the impaired Contractor personnel, the decision of the CO will be final. During the period of time between the removal and the final decision of the CO, the Contractor shall provide back-up/replacement Contractor personnel IAW the terms and conditions of this contract.

4.4. CONFIDENTIALITY OF INFORMATION. Unless otherwise specified under this contract, all financial, statistical, personnel, and/or technical data which is 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.

4.5. MEDIA AND OTHER INQUIRIES. The Contractor or Contractor personnel shall not respond to any media inquiries. Any inquiries from the media, third parties, or public agencies shall be immediately relayed to the COR, who will relay them to the MTF Public Affairs Officer or, after duty hours, to the Administrative Officer of the Day. There shall be no interviews, comments, or any other response without the prior knowledge and approval of the MTF Commander. Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the COR.

4.6. EMERGENCY HEALTHCARE FOR CONTRACTOR PERSONNEL. The MTF will provide emergency health care for injuries or life threatening medical emergencies occurring while on duty. The Contractor shall reimburse the U.S. Government for such services as billed by the MTF.

4.6.1 OVERSEAS EMERGENCY MEDICAL SERVICES. In emergencies, transportation in U.S.

Government ambulances may be furnished by the U.S. Government on a reimbursable basis. Contractor personnel may not be authorized occupational health services in all locations. Locations where occupational health services are available will be identified in the contract. Contractor employees may receive emergency first aid and medical treatment subsequent to on the job injuries under the provisions of AFH 41-114. (See 5.0–Appendix) These services will be chargeable to the contractor.

4.7. Contract personnel shall not introduce new procedures or services without prior approval of the Department Chief or representative. If disagreements or deviations from protocols or procedures occur, the Department Chief or representative shall be the deciding authority.

4.8. All contractor employees shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s “Bill of Rights for Contractor patients”. Performance shall be in accordance with the standards contained in this PWS and the terms and conditions of the contract. The contractor employees shall abide by MTF rules, regulations, and bylaws, including Medical Staff Bylaws and applicable Air Force regulations and Health Insurance Portability & Accountability Act (HIPAA) governing such things as medical records, etc. (See Appendix 5).

4.9. OVERSEAS REQUIREMENTS (if applicable). The Contractor is responsible for ensuring all country clearances, passports, visas, and accreditations required by the Host Nation are obtained prior to employment of individuals under this contract. The Contractor will be responsible for obtaining the appropriate country specific requirements, and will coordinate this with the CO or COR. All Contractor personnel shall have been, cleared, granted visas, etc. The Contractor shall provide written notification to the CO and the COR within 24 hours of becoming aware of Contract personnel no longer performing duties requiring clearances/permissions. The Contractor shall recognize that Host Nation authorities may conduct on-site inspections at any time in the Contractor personnel’s work area for the purpose of verifying the status of positions and Contractor personnel and appropriate visas or permissions. The Contractor shall assume all costs related to submission of required documentation.

The contractor shall comply with all business registration requirements in Germany.

4.10. CONTRACTOR PERSONNEL HEALTH REQUIREMENTS. Contractor personnel shall be up to date on immunizations required or recommended by the U.S. Department of Health and Human Services for travel to the Host Nation. The U.S. Government will not reimburse the Contractor for this expense.

Contractor personnel providing services under this contract shall receive a pre-employment physical examination prior to commencement of work and annually thereafter. No later than seven (7) working days prior to commencement of work, certification shall be provided to the COR that Contractor personnel have completed medical evaluation required above. This certification shall state the date on which the examination was completed, the doctor’s name that performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: “(name of contractor employee) is suffering from no contagious diseases to include but not limited to Tuberculosis and Hepatitis.” Per OSHA requirements, all Contractor personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity to Hepatitis B infection. Personnel who sign declinations may change their minds at any time and receive the Hepatitis B vaccine without penalty. It is the Contractor’s responsibility to report all information necessary to assure hospital records can be maintained correctly, and therefore comply with the OSHA and CDC health records requirement

4.11. ADMINISTRATIVE CHECKS AND REQUIREMENTS:

4.11.1. SECURITY REQUIREMENTS. Since contract personnel under this contract will have access to critical government information and/or process information requiring protection under the Privacy Act of 1974, these positions are considered Public Trust Positions. Compliance with DoD Directive 5200.2- R, AFI 31-501, AFMAN 33-202 and Homeland Security Presidential Directive 12 (HSPD-12) is mandatory for these positions. A back-ground investigation consisting of a National Agency Check with Inquiries (NACI) is required for all contract personnel under this contract. The Contractor shall fully adhere with the provisions of referenced publications by having each of their employees who are performing under this contract initiate and complete a NACI. Background investigation requests for employee will be submitted through the Personnel Security Office, Spangdahlem Air Base, Germany.

Member will be fingerprinted and required to complete the appropriate forms (Standard Form 85, Questionnaire for Non-Sensitive Positions and OF 306, Declaration for Federal Employment). The contractor shall advise employee that a favorable suitability determination is required as a condition of employment under this specific contract. The employee shall apply for the NACI prior to start of performance. The government is solely responsible for the cost associated with the initiation, application and completion of the background investigation with exceptions for expenses incurred for Police Checks for “local hire” personnel.

4.11.2. PENDING COMPLETION OF NACI. The Contractor personnel may provide contract services prior to completion of background investigation. The Contractor understands that the MTF Commander may allow the Contractor personnel to temporarily occupy sensitive positions pending NACI. The

Contractor personnel 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.

4.12. PLACE AND HOURS OF OPERATION. The translation support services are to be performed at the 470 ABS, Geilenkirchen, Germany, Clinics have designated operating hours established by the local MTF and clinic policies, and may vary by location (typically 0730-1630) however hours may be modified during surge activities. Required services may be scheduled between the hours of 6:00 a.m. to 7:00 p.m., Monday through Friday. Workdays will generally consist of eight hour days. Services are generally required five days each week (Monday through Friday), excluding U.S. Federal holidays. Hours are subject to change as mutually agreed between the COR and the Contractor, however, the total number of hours will not exceed 40 hours per week. Duty on weekends and outside normal clinic hours may be required based on mission requirements. Lunch periods are not payable periods, but will be coordinated by the assigned MTF supervisor and scheduled with the contract service provider. Commuting time to and from required place of performance is not compensable by the U.S. Government. In no case will overtime be authorized or paid

The employee must be able to respond to incoming work requests within two minutes and complete approximately 16 pages of translations per workday.

4.13. HOLIDAYS.

4.13.1. There are eleven (11) U.S. federal holidays each year. They are New Year’s Day (observed 1 January), Martin Luther King, Jr’s Birthday (observed the third Monday in January), President’s Day (observed the third Monday in May), Memorial Day (observed the last Monday in May), Independence Day (observed 4 July), Labor Day (observed the first Monday in September), Columbus Day (observed the second Monday in October), Veterans Day (observed 11 November), Thanksgiving Day (observed the fourth Thursday in November), and Christmas Day (observed 25 December). If New Year’s Day, Independence Day, Veterans Day or Christmas Day falls on a Saturday, it is observed on Friday; if it falls on Sunday it is observed on Monday.

4.13.2. There are eleven (11) German holidays each year. They are New Year’s Day (observed 1 Jan), Good Friday (observed the Friday before Easter), Easter Monday (observed the Monday after Easter), Labour Day (observed the first day of May), Ascension Day (observed 39 days after Easter), Whit Monday (observed 51 days after Easter), Corpus Christi Day (observed 60 days after Easter), Day of German Unity (observed on 3 Oct), All Saints Day (observed on 1 Nov), Christmas Day (observed on 25 Dec), and St. Stephen’s Day (observed on 26 Dec)

4.14. FAMILY/DOWN DAYS: Typically, a “Family Day/Down Day” is associated with, but not limited to the following holidays: New Year’s Day, July 4th, the day after Thanksgiving, and Christmas Eve.

Contract personnel may be required to work these days as directed by the commander. Notification to work Family/Down Days will be provided to the contract employee many days in advance as possible no less than one week’s notice.

4.14.1 All Holidays, German, U.S. Federal, and Family Days that the contractor is not present in the facility are non-chargeable to the U.S. Government and will not be reimbursed to the Contractor.

4.15. UNPLANNED CLOSURES. In the event of unplanned closure of the MTF due to natural disaster, military emergency, severe weather, security threat, or a facility-related problem that prevents contractor personnel from performing services under this contract, these contractor personnel shall follow the same departure and reporting directions given to Government personnel and the contractor shall treat its personnel as they determine appropriate.

4.16. CONTRACTOR ORIENTATION AND NEW PERSONNEL REQUIREMENTS:

4.16.1 GENERAL TRAINING. Contractor personnel shall abide by all MTF standards, rules, and procedures including quality assurance requirements. Such regulations include, but are not limited to, general safety, fire prevention, waste disposal, infection control, AAAHC, JCAHO, UEI, and patient safety initiatives. All Contractor personnel performing services at the MTF are required to complete initial and annual refresher Health Insurance Portability and Accountability Act of 1996 (HIPAA), Anti-terrorism/Force Protection (AT/FP), monthly safety training, and annual training requirements as provided by the MTF for its personnel. The Contractor will be held accountable for ensuring personnel comply with health information privacy and security policies and procedures. The Government will also provide training on Government provided forms and equipment, universal precautions, initial orientation, and continuing orientation. The Government will also train and provide access to Air Force directives, MTF policies and procedures prior to start of contract performance.

4.16.2 ORIENTATION TRAINING. The Contractor shall ensure that all Contractor personnel participate in the government provided MTF orientation program for newly assigned personnel within the first two weeks of performance start. Orientation training will be conducted during normal hours of operation, and will be scheduled by the COR. Orientation shall include training on regulations specific to clinic and Air Force policy and procedures, instructions on automation processing, quality assurance policies, Composite Healthcare Computer System (CHCS) (obtain password), AHLTA, and other information systems, local in-service, and safety briefings as they apply to the position.

4.16.3 If a personnel change occurs during the contract performance period, a 6-week overlap for orientation and training and pass over of duties is required without additional charge to the government.

4.16.4. COMPUTER TRAINING. Contractor personnel who have any interaction with the MTF computer systems must receive training for the applicable system(s). The COR will coordinate the necessary computer training. The training will be on-site and during normal hours of operation. This training will be at no cost to the Contractor. Access to patient data systems is an “Automated Data Processing Sensitive” position requiring compliance with AFI 31-501. The Contractor 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. The Government will train and give access to contractor personnel on the following systems: AHLTA, which is the DoD’s (Department of Defense) world-wide automated medical information system that interfaces with 40+ external clinical and administrative systems; CHCS, which contains the MTF’s appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the MTF. In addition, it contains the electronic medical records for MHS beneficiaries and the Electronic Documentation System, which is a local MTF standardized method of filing electronic medical records.

4.17. CONFORMANCE WITH ENVIRONMENTAL MANAGEMENT SYSTEMS. The

Contractor shall perform work under this contract consistent with the relevant environmental policy and objectives identified in the installation environmental management system (EMS) applicable for your contract. The Contractor shall perform work in a manner that conserves water, energy and other resources to the maximum extent feasible and ensure minimum production of waste as possible, giving preference to recycling and reutilization opportunities. Furthermore, the Contractor shall give preference to less toxic materials whenever available and still reliable for their work. In the event an environmental nonconformance or noncompliance of host nation and USAF environmental laws and regulations associated with the contracted services is identified, the contractor shall take corrective and/or preventative actions. In the case of a noncompliance, the Contractor shall respond and take corrective action immediately. In the case of a nonconformance, the Contractor shall respond and take corrective action based on the time schedule established by the EMS Coordinator. In addition, the Contractor shall ensure that their employees are aware of the environmental management system on base and how these requirements affect their work performed under this contract. All on-site contractor personnel shall receive the installation EMS awareness level information.

4.18. CONFORMANCE WITH ENVIRONMENTAL REQUIREMENTS. The contractor shall perform all work in accordance with applicable German and US Air Force environmental laws, regulations and operating standards, including but not limited to the Final Governing Standards (FGS) for Germany. The contractor shall be immediately capable of understanding and addressing environmental laws and regulations as they pertain to work performed under this contract.

The FGS for Germany and other important environmental laws & requirements applicable for all contractors working on base can be found at the EMS SharePoint Website. Link for the website can be provided upon request.

4.19. U.S. GOVERNMENT-FURNISHED PROPERTY, INFORMATION AND SERVICES:

4. 19.1. Government furnished property under this contract will be furnished to Contractor employees at no cost and shall be used only in performance of services under this contract.

4. 19.2. The Government will provide the Contractor access to Air Force directives, MTF policies and procedures prior to start of contract performance date.

4. 19.3 Facilities: During the hours of performance under this contract, the Contractor employees shall have the use of office space available.

4. 19.4. Equipment and Supplies: Available equipment and office supplies for the performance of services under this contract, such as desk, chair, lighting, computer, printer, FAX machine, phone, copier, paper, folders, file cabinets, etc.

4. 19.5. Electronic Documentation: As available at the local MTF, a standardized electronic documentation system or electronic medical record will be provided, such as, but not limited to CHCS and AHLTA.

5.0. APPENDICES.

5.1. APPLICABLE PUBLICATIONS AND FORMS. Supplements or amendments to listed publications and/or forms from any organizational level may be issued during the life of this contract.

Should any publication or form revision cause a change in the contractor’s processes, procedures and/or standards of operation, the contractor shall advise the CO of such changes in writing within 30 days of receipt of the publication or form revisions.

5.1.1 Publications and forms are available electronically through the internet and are maintained by the Government.

5.1.2. DoD Directives can be found at http://www.dtic.mil/whs/directives/corres/dir.html . Regulations are followed by a “-R” (e.g., DoD 6025.18-R) and can be located on the website by clicking on “Publications” instead of “Directives.”

DEPARTMENT OF DEFENSE (DoD) REGULATIONS/MANUALS

INSTRUCTIONS/DIRECTIVES

PUB NO. TITLE

DoD 5400.11-R Department of Defense Privacy Program DoDD 5200.2 Personnel Security Program DoDD 5400.11 DoD Privacy Program DoDD 5500.07 Standards of Conduct DoDD 8190.1 DoD Logistics Use of Electronic Data Interchange (EDI) Standards DoDD 8500.01E Information Assurance DoDI 1402.5 Criminal History Background Checks on Individuals in Child Care Services DoDI 3020.41 Contractor Personnel Authorized to Accompany the U.S. Armed Forces DoDI 6015.23 Delivery of Healthcare at Military Treatment Facilities: Foreign Service Care;

Third Party Collection; Beneficiary Counseling and Assistance Coordinators (BCACs)

DoDI 6025.20 Medical Management (MM) Programs in Direct Care Systems (DCS) & Remote Areas

DoDI 6040.42 Medical Encounter and Coding at Military Treatment Facilities DoDI 6040.43 Custody and Control of Outpatient Medical Records

5.1.3. The Air Force’s E-Publishing site (http://www.e-publishing.af.mil) will be used to obtain Air Force Instructions.

AIR FORCE INSTRUCTIONS/MANUALS

PUB NO. TITLE

AFI 41-210 TRICARE Operations and Patient Administration Functions AFI 33-332 Privacy Act Program AFI 33-322 Records Management Program AFI 33-364 Records Disposition – Procedures and Responsibilities AFI 31-501 Personal Security Program Management AFI 33-200 Information Assurance (IA) Management AFI 33-129 Web Management and Internet Use AFI 40-102 Tobacco Use in the USAF AFI 44-119 Medical Quality Operations http://www.dtic.mil/whs/directives/corres/dir.html

5.1.4. Other References

TITLE

AAAHC Accreditation Association for Ambulatory Healthcare www.aaahc.org Referral Management Center User’s Guide https://kx.afms.mil/healthbenefits.

Public Law 91-596, Occupational Safety and Health Act (OSHA) Public Law 99-661, Title 10 USC Section 1102, Privacy Act of 1974 Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996

5.2. CONTRACTOR MANPOWER REPORTING:

The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract. The contractor is required to completely fill in all required data fields at http://www.ecmra.mil .

Reporting inputs will be for the labor executed during the period of performance for each Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported any time during the FY, all data shall be reported no later than 31 October of each calendar year. Contractors may direct questions to the CMRA help desk.

Uses and Safeguarding of Information: Information from the secure web site is considered to be proprietary in nature when the contract number and contractor identity are associated with the direct labor hours and direct labor dollars. At no time will any data be released to the public with the contractor name and contract number associated with the data.

User Manuals: Data for Air Force service requirements must be input at the Air Force CMRA link. However, user manuals for government personnel and contractors are available at the Army CMRA link at http://www.ecmra.mil.

5.3. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) of 1996

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 DOD 8580.02-R and AFI 41-217, which also contains additional Information Assurance requirements for all AF MTFs. DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. MTFs are responsible to insure overall compliance with HIPAA requirements, which includes incorporation of certain requirements in contracts entered or amended after the respective implementation dates.

IAW these regulations, the Contractor and its employees 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 Contractor and its employees agree to abide by all HIPAA Privacy and Security requirements regarding health information as defined in this clause, DoD 6025-18-R, DOD 8520.02-R and AFI 41-217. Additional HIPAA requirements will be addressed when implemented.

https://kx.afms.mil/healthbenefits http://www.ecmra.mil/

Introduction

(a) Definitions. As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DOD 6025.18-R, DOD 8520.02-R or AFI 41-217.

HITECH Act shall mean the Health Information Technology for Economic and Clinical Health Act included in the American Recovery and Reinvestment Act of 2009.

Individual has the same meaning as the term “individual” in 45 CFR 164.50 1 and 164.103 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 Contractor from or on behalf of the Government.

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

Required by Law has the same meaning as the term “required by law” in 45 CFR 164.501 and 164.103.

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

Security Incident shall have the same meaning as the term “security incident” in 45 CFR 164.304, limited to the information created or received by Contractor from or on behalf of the Covered Entity.

Security Rule means the Health Insurance Reform: Security Standards at 45 CFR part 160,162 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, 160.502, 164.103, 164.304 and 164.501.

(b) The Contractor 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 Contractor agrees to use appropriate safeguards to maintain the privacy of the Protested Health Information and to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract.

(d) The HIPAA Security administrative, physical, and technical safeguards in 45 CFR 164.308, 164. 310, and 164.312, and the requirements for policies, procedures and documentation in 45 CFR 164.316 shall apply to the Contractor. The additional requirements of Title XIII of the HITECH Act that relate to security and that are made applicable with respect to covered entities shall also be applicable to the contractor. The Contractor agrees to use 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 in the execution of this Contract.

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

(f) The Contractor agrees to report to the Government any security incident involving protected health information of which it becomes aware.

(g) The Contractor agrees to report to the Government any use or disclosure of the Protected Health Information not provided for by this Contract of which the Contractor becomes aware of.

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

(i) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides electronic Protected Health Information, agrees to implement reasonable and appropriate safeguards to protect it.

(j) The Contractor 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.

(k) The Contractor 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.

(1) The Contractor 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 Contractor on behalf of, the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner designated by the 'Government or the Secretary, for purposes of the Secretary determining the Government's compliance with the Privacy Rule.

(m) The Contractor 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.

(n) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

General Use and Disclosure Provisions

Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R if done by the Government. The additional requirements of Title XIII of the HITECH Act that relate to privacy and that are made applicable with respect to covered entities shall also be applicable to the Contractor.

Specific Use and Disclosure Provisions

(a) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

(b) Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor 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 Contractor 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 Contractor 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) Contractor may use Protected Health Information to report violations of law…