PWS Physician Liaison Review 10 Aug 11.docx

21 October 2010

Performance Work Statement Patient Liaison Services Non-Personal Services

1. Description of Services: The Government requires 1 Full Time Equivalents (FTE) for this Performance Work Statement (PWS). The individual shall provide patient liaison services required for Government beneficiaries. The individual shall provide liaison services for the 31st Medical Group, Aviano AB, Italy, also referred to as the “Medical Treatment Facility” (MFT) herein. Performance shall be according to the requirement contained in this Performance Work Statement (PWS), professional standards of the Joint Commission on Accreditation of Healthcare Organization (JCAHO), and the USAF Medical Service standards.

1.1. Specific Duties/Responsibilities which the individual shall perform:

1.1.1. The patient liaison shall provide clinical liaison services for patients as scheduled by the Government.

1.1.2. Services shall include but not be limited to routine, acute and chronic patient conditions.

1.1.3. Duties include:

1.1.3.1. To aid in disease case management, and discharge planning of patients, admitted to Italian hospitals.

1.1.3.2. Performing regular in-hospital visits to address patient needs and concerns. At a minimum daily visits for patients in Pordenone/ Udine hospital, with more frequent visits if the patient’s condition or circumstances require. For patients in outlying hospitals, visits will be based upon clinical necessity. However, daily phone contact must be accomplished directly with the patient, supervisor, and/or family member.

1.1.3.3. Communicating clinical progress to 31 MDG commander, unit commanders, first sergeants, SGH, and international personnel who have a need to know as determined by the 31 MDG commander or designee.

1.1.3.4. Coordinating and resolving differences in medical care practice styles/patterns with Italian hospitals, local and regional emergency response directors.

1.1.3.5. Coordinating patient transfers from 31 MDG facilities to Host Nation hospitals. This will involve finding accepting Host Nation Physicians and communicating with those physicians the current clinical situation that has resulted in the transfer. Coordinate aeromedical evacuation/transfers from Host Nation Hospitals to U.S. Facilities.

1.1.3.6. Coordinate the availability of beds in local hospitals for exercise and real-world needs

1.1.3.7. Comprehend/translate (the physician liaison cannot sign the RX) and convert host nation provider prescriptions into the 31 MDG formulary equivalent.

1.1.3.8. Serve as point of contact or medical group laboratory when transition needs arise for all stat lab requests. This may be anytime day or night. Serves as point of contact for the procurement of local blood products for the MDG.

1.1.3.9. Contractor will provide the SGH with daily updates on the status of all 31FW patients and dependents, who are hospitalized in the Host Nation Hospitals.

1.1.4. Be productive and perform with minimal supervisory direction.

1.1.5. Adhere to Service Delivery Summary, for Performance Objective and Performance Measures. Section 2 of this Performance Work Statement.

1.1.6. Adhere to safety policies and procedures when working within any 31 MDG facility either alone or with other 31 MDG personnel in assistance, ensure a safe work environment and employee safe work habits.

1.1.7. Perform other duties as assigned by the 31 MDG/CC that fall in under the general intent of patient liaison responsibilities.

1.1.8. REFERRALS AND CONSULTS. The provider shall follow DoD, Air Force and 31 MDG policies when assisting with a referral or consult. The provider shall inform patients of the required referral or consult by indicating the specialty involved. All consults and referrals will adhere to the 31 MDG approved referral and consult management process.

1.1.9. Contract Physician may be required to participate in 31 MDG committees as deemed necessary by the Chief, Medical Services.

1.1.10. Coordinate with host nation medical services when 31 FW and local community perform mass casualty training sessions.

1.1.11. Coordinate with medical group personnel to assist in the interviewing and hiring process of local nationals. This may include: Translating, Quality checking previously translated documents.

1.1.12. Provide translation assistance and quality checks for TRICARE liaisons on medical terminology.

1.1.13. Review all MOUs between 31 MDG and Italian healthcare facilities.

1.1.14. Review translations that have been conducted by outside sources.

1.1.15. Be available on stand-by as point of contact for the Chief of Medical Staff and 31 MDG Commander or designee on all motor vehicle accidents or severe illnesses reported to any emergency room (ER) in the area: this includes immediately reporting to E.R. upon notification.

1.1.16. Support healthcare at Pordenone/Udine Hospital on all presidential or VIP visits to the base. This may include working directly with the secret service for phone installation at the local hospital.

1.1.17. Serve as advisor to the medical group commander and medical group staff on customs, courtesies and cultural differences.

1.1.18. Consult with Chief of Medical Staff on overseas clearances for potential inbound members and communicate local medical capabilities.

1.1.19. Serve as POC for the Carabinieri PROCURA DELLA REPUBBLICA, Aviano Italian School Services, Office of Special Investigation, Family Advocacy, Chaplains, and Squadrons of families involved in any matters regarding child abuse, spouse maltreatment, SIDS ( Sudden Infant Death Syndrome), wrongful death of an adult on base, and suicide attempts.

1.1.20. Serves as alternate point of contact for dog bite issues and contagious illness in the local area in the Friuli-Venezia-Giulia region.

1.1.21. Accompany legal officer to Pordenone prison to perform obligatory military medical visitation to any U.S. member in Italian prison system.

1.1.22. Coordinate and attend all autopsies performed on all (requested) US Air Force member or their dependents by Italian pathologists. This may include requesting toxicology screenings and blood alcohol Testing at the autopsy, and any other coordination as deemed necessary by the U.S. military authorities through the MDG Commander or designee.

1.1.23. Perform as a consultant on all U.S. military member deaths.

1.1.24. Serve as a consultant to Mortuary Affairs in order to aid with local funeral homes regarding the movement of deceased patients.

1.1.25. Perform recognition of death duties on all newborn or still born infants delivered in Italian hospitals.

1.1.26. Serve as point of contact Army Unit at Vicenza in coordinating embalming and release of remains back to Vicenza Army.

1.2 PATIENT SENSITIVITY. The contracted health care provider shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity.

1.3. COMMUNICATION/CONDUCT. Contracted personnel shall maintain open and professional communication and conduct with members of the MFT staff. Complaints validated by the Chief of Medical Service shall be reported in writing to the contract administrator and the immediate supervisor for action. Failure of the contracted physician to correct validated complaints raised by the MFT staff and the contract administrator will be considered a failure to perform.

1.4. DOCUMENTATION. Contracted personnel shall prepare all documentation to meet or exceed established standards of the MFT, to include, but not limited to, timeliness, accuracy, content and signature. Only MFT and Air Force-approved abbreviations shall be used for documentation of the patient health record.

2. SERVICE DELIVERY SUMMARY, PATIENT LIAISON

10. Maintains appropriate DoD, AF and/or State Licensure/certifications requirements

17. Adheres to all HIPPA requirements.

2.1 The Government will periodically evaluate the contractor physician performance by appointing a representative (s) to monitor performance to ensure services are received. The Government representative will evaluate the contracted physician performance through inspections of medical care documentation coding and requested reports and receive and investigate all complaints from base personnel. The Government may respect each task as completed or increase the number of quality assurance inspections if deemed appropriate because of repeated failures or because of repeated customer complaints. Likewise, the Government may decrease the number of quality assurance inspections of performance dictates. The Government Contracting Officer shall make final determination of the validity of customer complaint(s).

2.2 If any of the services do not conform to contract requirements, the Government may require the contracted physician to perform the services again in conformity with contract requirements, at no increase in contract amount. When the defects in services cannot be corrected by re-performance, the Government may –

(a) Require the contracted physician to take necessary actions to ensure that future performance conforms to contract requirements; and

(b) Reduce the contract price to reflect the reduced value of the services performed.

3. GOVERNMENT-FURNISHED PROPERTY AND SERVICES

3.1. EQUIPMENT. Contracted physician shall have joint use of all available equipment for performing services by this contract, and ensure all equipment is properly cleaned and stored at the end of each work shift. In addition, they will ensure preventive maintenance on equipment is scheduled.

3.2. PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish the contract provider with appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

3.3. IDENTIFICATION CREDENTIALS. The MFT will provide each contractor provider all required identification media.

3.4. FORMS. The MFT will provide required Government forms used in the performance of services.

3.5. SUPPLIES. The MFT will provide medical and non-medical supplies commonly used in the facility for the care and management of patients and the performance of the requirements of this contract.

3.6. UTILITIES. For the purpose of this contract, the Government will furnish all required utilities (such as water, telephone, electricity etc.) at no cost to the contracted physician. Long distance and Defense Switched Network (DSN) telephone services will be provided for use only in the lines of duties. The contractor shall participate in government energy conservation program.

3.7. SERVICES.

3.7.1. Administrative support. The MFT will provide normal office administrative support services, to include telephone and utilities.

3.7.2. Patient scheduling. Clinic personnel will assist in patient scheduling. Complete administrative control of the patient shall remain with the Government.

3.7.3. The MFT will provide Life Saving Training through the Military training Network.

3.8 CONTRACTOR FURNISHED ITEMS AND SERVICES. Except for these items or services specifically stated above to be Government-furnished, the contracted physician shall furnish everything required to perform this contract in accordance with all its terms.

4. GENERAL INFORMATION

4.1. PERSONNEL.

4.1.1. POINT OF CONTACT: The 31st MDG commander shall provide a point of contact who shall be responsible for the oversight of the performance of the work. The point of contact shall have full authority to act for the commander on all matters relating to the daily operation of this contract. The 31 MDG Commander shall designate this individual, in writing, to the Contracting Officer (CO) before the contract start date. An alternate may be designated, but the 31 MDG Commander shall identify those times when the alternate shall be the primary point of contact.

4.1.2. AVAILABILITY: The patient liaison must be available to respond to patient needs at anytime. The contracted physician shall notify the Chief of Medical Service, as early as possible of programmed absences to allow for planning of service coverage and workload distribution.

4.1.2.1. HOURS OF OPERATION. The nature of this position requires availability 24 hours per day, 7 days per week. Routine work hours will be scheduled by the Chief of Medical Services to correspond to the needs of the MFT.

4.1.2.2. HOLIDAYS. The contracted physician may be required to provide services on the following Federal Holidays (or the actual day set aside for observation): New Year’s Day, Martin Luther King Jr’s Birthday, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day or Christmas Day.

4.1.2.3. VACATIONS/ABSENCES. Contracted personnel shall be allowed 28 days of absences per year for vacation, sick leave, and miscellaneous reasons. The absences are to be coordinated with, and at the discretion of the Chief of Medical Services. Absences will not excuse the performance of any duty under this contract.

4.1.2.4. ON CALL DUTY. The contracted physician shall provide on call telephone coverage through the 31 FW Command Post. When required, to ensure completion of services that extend beyond the normal close of business, the patient liaison shall remain on duty in excess of the scheduled shift.

4.1.2.5. CONTINUITY OF SERVICES/REPLACEMENT STAFF. The 31 MDG point of contact shall ensure qualified personnel are available to provide coverage during scheduled absences of the contracted patient liaison or when they will be unable to provide services for greater than one day.

4.1.2.6. PERFORMANCE OF SERVICES DURING CRISIS DECLARED BY THE NATIONAL COMMAND AUTHORITY OR OVERSEAS COMBATANT COMMANDER. On occasion, services may be required to support an activation or exercise of contingency plans outside the normal duty hours.

Emergency situations (i.e. accident and rescue operations, civil disturbances, natural disasters, military contingency operations, and exercises) may necessitate the contracted physician provide increased or reduced support as determined by the contracting officer. The Government will negotiate an equitable adjustment with the contracted physician for the cost of these emergency requirements.

4.1.3. PERSONNEL REQUIREMENTS:

4.1.3.1. LANGUAGE REQUIREMENT. The contracted physician shall read, understand, speak, and write English and Italian fluently.

4.1.3.2. FORMAL EDUCATION. The physician must have a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited college or university in the specialty area required to complete the FTE. European License, if equivalent, to the US License will be accepted.

4.1.3.3. LICENSURE/REGISTRATION. In accordance with paragraph 3.1, AFI 44-119, Clinical Performance Improvement, 4 Jun 2001, personnel services contract personnel providing care in the MFT must maintain an active license or other authorizing document such as board certification or registration form any US jurisdiction/ European License, if equivalent, to the Us License. In addition, the contract physician must have completed an approved residency training program. Assignment to a position not involving direct patient care within or outside an MFT does not eliminate the requirement for license or authorizing document.

4.1.3.3.1. Copies or required certification shall be furnished to the Contracting Officer prior to performance on this contract.

4.1.3.3.2. CERTIFICATION. The physician must have national and/or state (required) approved and current board certification or board eligible certification in a specialty area.

4.1.3.3.. EXPERIENCE. The physician must have 3-5 years of experience within a specialty area to include fellow and residency time.

4.1.3.4. CRIMINAL BACKGROUND CHECK REQUIREMENT. The Government will conduct criminal background checks on individuals providing direct, unsupervised child care services under this contract, using the procedures set forth in Department of Defense Regulation 5200.1.The DoD information Security Program and DoD Instruction 1402.5, Criminal History Background Checks on Individuals in Child Care Services, 19 Jan 93.

4.1.3.4.1. The contractor patient liaison shall provide the required certificates for background checks issued by the host nation. It will be the 31st Medical Group’s responsibility to conduct the necessary criminal background checks through the Federal Bureau of Investigation (FBI) in accordance with the Law (agreements between the Host Nation and United States).

4.1.3.4.2. Additional favorable security check will be performed by the 31st Medical Group Security Manager, as required prior to the individual beginning to provide the required service.

4.1.3.4.3. Background checks will be based on fingerprints of individuals obtained by a Government law enforcement officer and inquiries conducted through the Federal Bureau of Investigation (FBI) and state criminal history repositories.

4.1.3.4.4. With the consent of the Contracting Officer, contract personnel may provide contract services prior to completion of background checks. However, at all times while children are in the care of that individual, the contract provider shall be within sight and continuous supervision of a staff person whose background check has been completed.

4.1.3.4.5. Individuals shall have the right to obtain a copy of any background check pertaining to them and to challenge the accuracy and completeness of the information contained in the report.

4.1.3.4.6. Individuals who have previously received a background check shall provide proof of the check to the Chief, (Medical Services) Services or obtain a new one.

4.1.3.5. CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval in accordance with DoD Directive 5500.7 and Air Force policy.

4.1.4. APPEARANCE. The contracted physician shall present a professional, conservative, and neat appearance. The contracted physician shall report for duty in a professional manner, in appropriate attire befitting a health care setting, and having complied with socially acceptable standards of personal hygiene expected of health care workers.

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

4.1.4.2. Contracted physician shall display legible MFT-provided identification media on their outer clothing.

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

4.1.4.4. PROTECTIVE CLOTHING. When required and supplied by the Government, the physician shall wear special protective clothing and shoe covers. When duties will be performed in specified areas, a disposable protective hood shall be worn to ensure infection control standards are met. The Government will provide this hood. These items shall remain the property of the Government and shall not be removed from the MFT. After use, protective clothing shall be turned in or destroyed as directed by the Chief of Service.

4.2. HEALTH REQUIREMENTS.

4.2.1. The contracted physician providing services under this contract shall receive a pre-employment physical examination prior to commencement of work, and annually thereafter. The physical shall report to a Government physician to receive a pre-employment examination and immunization prescribed by the MFT.

4.2.2. Not later than five (5) working days prior to commencement of work, certification shall be provided to the FAC ensuring the physician has completed the medical examination required above. This certification shall state the date on which the examination was completed, the name of the doctor who performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement:” (Name of the contracted physician) is suffering from no contagious diseases to include, but not limited to, Tuberculosis, Hepatitis, and Venereal Disease”.

4.2.3. OSHA requires that all contract 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 anytime and receive the Hepatitis B vaccine without penalty.

4.2.4. The contracted physician is responsible for reporting to the Chief of Medical Services, all information necessary to assure hospital records can be maintained correctly, and therefore comply with the JCAHO, OSHA, and CDC health record requirements.

4.4. EMERGENCY HEALTH CARE. The MTF will provide emergency health care for the contracted physician for injuries incurred while on duty in the MTF. These services will be billed to the contracted physician’s medical insurance carrier at the current full reimbursement rate.

4.5. MEDICAL QUALITY IMPROVEMENT/RISK MANAGEMENT (QI/RM).

4.5.1. The contracted physician shall participate in QI/RM activities to the extent required by Section 2C, AFI 44-119 and the individual MTF QI/RM plan or regulation.

4.5.2. The Government will evaluate the providers’ professional, as differentiated from administrative, performance under this contract using Quality Improvement standards specified in paragraph 2-12 and 2-13, AFI 44-119. Nothing in this paragraph precludes the Government from also conducting inspections under the Inspection/Acceptance requirement of FAR clause 52.212-4.

4.6. PERFORMANCE EVALUATION MEETINGS. The contracting office (CO) will require the contract physician to meet with the CO, contract administrator, Functional Commander, and other government personnel as often as deemed necessary. Meetings will be documented in the contract file with written minutes signed by the contract physician and the CO, or contract administrator. Should the contract physician not concur with the minutes, such non-concurrence shall be provided in writing to the CO within ten (10) calendar days of receipt of the minutes.

4.7. ORIENTATION. The 31 MDG/CC shall ensure that all contract providers participate in the MTF orientation procedures for newly assigned providers to include regulation specific to their professional specialty, hospital and Air Force policy and procedures and completion of all mandated training.

4.8. RECORDS. The 31st MDG/CC shall create and maintain Government-owned /contractor –held records, regardless of media, in accordance with 33-119, Electronic Mail (E-mail) Management and Use, paragraph 8; AFI 33-202, Computer Security , paragraphs 3.5.1 and 3.6.1; AFI 33-322, Records Management Program, paragraphs 7,8,9, and 10 and supplements; AFMAN 37-123, Management of Records, Chapters 2-6, paragraph 7.10 – 7.29, and AFI 37-138, Records Disposition – Procedures and Responsibilities, Chapters 2,, 3 and 6 and supplements. Identify all records required to be created by the performance work statement on the RIMS file plans. Upon completion of this contract, all government-owned/contract physician-held records (regardless of media) received, created, maintained, or provided in the performance of the performance work statement shall be turned over to the Government. Background electronic data and records specified for delivery to the contracting agency must be accompanied by sufficient technical document to permit the Air Force to use the data. In the event of default or non-performance, the Government will have access to all records in order to ensure mission support is not interrupted.

4.9 DOD FREEDOM OF INFORMATION ACT (FOIA) PROGRAM. The contract physician shall comply with the requirements of DoD Regulation 5400.7/Air Force Supplement, DoD Freedom of Information Act Program. The regulation sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding For Official Use Only (FOUO) material. If the Contract physician receives a FOIA request, the Contract physician shall ensure it is delivered immediately to the base FOIA manager (81 CS/SCBR) for processing. The FOIA manager will task a Government official who, as the authorized official, will make the decision on releasing Government records.

4.9.1. FOR OFFICIAL USE ONLY (FOUO). The contract physician shall create and maintain FOUO material IAW DoD 5400.7R, DoD Freedom Of Information Act Program, Chapter 4; AFI 33-129, Transmission of Information via the Internet, paragraphs 7.4, 8.2.3, 16 and 17; and AFI 33-201, Communications Security (COMSEC), Table 1. Mark all documents meeting the requirements identified in DoD Regulation 5400-7/Air Supplement, paragraphs C3.2.1.2 thru 3.2.19. as “For Official Use Only” IAW instructions identified in paragraph C4.2.1. Safeguard all sensitive data IAW DoD Regulation 5400.7/ Air Force Supplement, paragraph C4.4. When documents containing FOUO material are authorized for destruction, shred the records so that the pieces cannot be reconstructed. Degauss or overwrite magnetic tapes or other magnetic media.

4.9.2. PATIENTS LISTS. Patients lists, no matter how developed, shall be treated as privileged information. Add the following to the bottom of all patient lists: FOR OFFICIAL USE ONLY. This document contains information exempt from mandatory disclosure under the Freedom Of Information Act (FOIA), Title 5 U.S.C. 552 (b)(2) High and (b)(6) apply.” Lists and /or names of patients shall not be disclosed or revealed in any way for any use outside the MTF without prior written permission by the Chief of Hospital Services.

4.9.3. RELEASE OF MEDICAL INFORMATION. The Contract physician shall release medical information obtained during the course of this contract to MTF staff involved in the care and treatment of that individual patient only.

4.10. PRIVACY ACT PROGRAM. The Contract physician shall create and maintain Privacy Act data IAW AFI 33-129, Transmission of Information Via the Internet, paragraphs 7.4, 8.2.3, 16 and 17, and supplements; AFI 33.201, Communications Security(COMSEC), table 1; AFI 33-322, Air Force Privacy Act Program, paragraphs 1.4.7, 1.4.8, 3.3.3, Chapters 7, 9 and 10 and supplements: and, Privacy Act systems of records notice (s) (http://www.defenselink.mil/privacy/notices/usaf). The contract physician shall not create or maintain a Privacy Act system of records prior to public notice. If the Contract physician receives a Privacy Act request, the contract physician shall be responsible for searching for the records and providing those records to a Government official who, as the authorized official, will make the decision on releasing the Government records.

4.11. FUNCTIONAL REQUESTS: A functional request is a written for DoD records that does not cite either the FOIA or Privacy Act received from any person (including a member of the public), an organization, or a business. The contract physician shall be responsible for searching for the records and providing those records to a Government official who, as the authorized official, will make the decision on releasing the Government records.

4.12 SECURITY. The contract physician shall notify the 31st Security Forces Squadron at Aviano AB, Italy, 30 days before on-base performance of the contract begins. The notification shall include:

a. Name, Address and Telephone Number of Contract physician

b. The contract number and contracting agency

c. The reason for the contract (i.e. the work to be performed)

d. The location (s) of contract performance and future performance, if known

e. The date contract performance begins

f. Any change to information previously provided under the paragraph

4.12.1. The contract physician shall ensure the following pass and identification items required for contract performance are obtained for contract physician and non-government owned vehicles.

a. DD Form 1172, Application for Uniformed Services Identification Card, if applicable

b. AETC Form 58, Civilian Identification Card, if applicable

c. AF Form 2219 (series), Registered Vehicle Expiration Tab

d. DD Form 2220, DoD Registered Vehicle and Installation Tab

e. AF Form 75, Visitor/Vehicle Pass

f. AF Form 1199, USAF Restricted Area Badge, or locally developed badge

4.12.2. The contract physician shall return all identification media, including vehicle decals, to the Pass & ID Office upon completion /termination of the contract, as appropriate.

4.12.3. NATIONAL AGENCY CHECK (NAC). As a minimum, Contract physician shall successfully complete a NAC operating government-furnished workstations that have access to Air Force automated information systems. Requests for personnel hired at the beginning of the contract, shall be submitted to the Government not later than 45 working days from the contract start date. Requests for personnel hired subsequent to the contract start date shall be submitted to the Government not later than five (5) workdays employee’s first duty day. Contract physician personnel receiving unfavorable NACs shall not be employed. The government will submit requests for investigations on AF Form 2583, “Request for Personnel Security Action”, at no additional cost to the contract physician. The contract physician shall comply with the requirements of DoD 5200.2-R, Personnel Security Program, and AFI 33-119, Electronic Mail (E-mail) Management and Use.

4.12.4 The contract physician shall comply with the requirements of Volume 1, AFI 71-101, Criminal Investigations, and paragraph 1.1. Volume 2, Protective Service Matters. Contract physician shall report any information or circumstances of which they are aware that may pose a threat to the security of DoD personnel, resources, and classified or unclassified defense information to the Chief, (Medical) Services.

The Contract physician employee’s immediate supervisor shall brief him/her upon initial on-base assignment and as required thereafter.

4.12.5. Physical Security. The contract physician shall safeguard all government property, including controlled forms provided for contract physician use. At the close of each work period, government equipment, facilities, and other valuable materials shall be secured.

4.12.5.1. Entry Procedures to Controlled/Restricted Areas. The contract physician shall implement local base procedures for entry to Air Force controlled/restricted areas where contract physician personnel will work.

4.12.5.1. Entry Procedures to Controlled/Restricted Areas. The contract physician shall implement local base procedures for entry to Air Force controlled/restricted areas where contract physician personnel will work.

4.12.5.2. Key Control. The contract physician shall establish and implement key control procedures in the Quality Control Plan to ensure keys issued to the contract physician by the government are properly safeguarded and not used by unauthorized personnel. The contract physician shall not duplicate keys issued by the government.

4.12.5.3. Lost Keys. Lost keys shall be reported immediately to the 31st MDG Facilities Manager. The government replaces lost keys or performs re-keying. The total cost of lost keys, re-keying or lock replacement shall be deducted from the monthly payment due the contract physician.

4.12.5.4. The contract physician will not allow government issued keys to be used by personnel other than self. Contract Physician employees shall not use keys to open work areas for personnel other than 31st MDG employees engaged in performance of their duties, unless authorized by the government functional area chief.

4.12.6. Traffic Laws. The contract physician shall comply with the installation traffic code as specified in AFI 91-207, USAF Traffic Safety Program, USAFE Supplement to AFI 91-207, and local traffic instructions.

4.13. SMOKING IN USAFE FACILITIES. Contract physicians are advised that the Commander has placed restrictions on the smoking of tobacco products in USAFE facilities. AFI 40-102, Tobacco Use in the Air Force, and its AETC supplement 1, outline the procedures used by the commander to control smoking in our facilities. Contract physician employees and visitors are subject to the same restrictions as government personnel. Smoking is permitted only in designated smoking areas.

4.14. PRIVACY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (HIPAA), Contract physicians will complete all mandated training in order to comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and DoD Health Information Privacy Regulation, 6025.18-R.

4.14.1.(a) Definitions. As used in this contract:

Individual has the same meaning as the term “individual” in 45 CFR 164.501 and shall include a person who qualifies as 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 Contract physician from or on behalf of the Government.

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

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

Terms used, used, but not otherwise defined, in this Performance work statement shall have the same meaning as those terms in 45 CFR 160.103 and 164.501.

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

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

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

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

(g) The Contract physician 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 b y the Government, to an individual in order to meet the requirements under 45 CFR 164.524.

(h) The Contract physician agrees to make agreement(s) to Protected Health Information in Designated Record Set that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or an Individual, and in the time and manner designated by the Government.

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

(j) The Contract physician agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

(k) The Contract physician 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.

4.14.2. General Use and Disclosure Provisions. Except as otherwise limited in this Contract, the Contract physician may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for the following purposes, if such use or disclosure of Protected Health Information would not violate the Privacy Rule or the Department of Defense Health Information Privacy Regulation if done by the Government:

(i) To carry out treatment, payment and health care operations as provided in Sec. 164.502;

(ii) To individually of protected health information about them as provided in Sec. 164.502;

(iii) For the facility’s directory or to persons involved in the individual’s care or other notification purposes as provided in Sec. 164.510;

(iv) For national security or intelligence purposes as provided in Sec. 164.512(k)(2);

(v) To correctional institutions or law enforcement officials as provided in Sec. 164.512(k)(5).

4.14.3. Specific Use and Disclosure Provisions

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

(b) Except as otherwise limited in this contract, the Contract Physician may disclosure Protected Health Information for the proper management and administration of the Contract provided that disclosures are required by law, or the Contract physician 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 Contract physician 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 contract, the Contract physician 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) Contract physician may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j)(1).

4.14.4. Obligations of the Government. Provisions for the Government to Inform the Contract physician of Privacy Practices and Restrictions.

(a) Upon request, the Government shall provide the Contract physician with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice.

(b) The Government shall provide the Contract physician with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the Contract physician’s permitted or required uses and disclosures.

(c ) The Government shall notify the Contract physician of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to in accordance with 45 CFR 164.522.

4.14.5. Permissible Requests by the Government. The Government shall not request the Contract physician to use or disclose Protected Health Information in any manner that would not be permissible under the Privacy Rule if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contract physician as otherwise permitted by this clause.

4.14.6. Termination

(a) Termination. A breach of contract by the Contract physician of this clause, may subject the Contract physician to termination under any applicable default or termination provision of this Contract.

(b) Effect of Termination

(1) if this contract has records management requirements, the records subject to the Clause should be handled in accordance with the records management requirements. If this contract does not have records management requirements, the records should be handled in accordance with paragraph (2) and (3) below

(2) If this contract does not have records management requirements, except as provided in paragraph (3) of this section, upon termination of this Contract, for any reason, the Contract physician shall return or destroy all Protected Health Information received from the Government, or created or received by the Contract physician on behalf of the Government. This provision shall apply to Protected Health Information that is in the possession of subcontract physicians or agents of the Contract physician. The Contract physician shall retain no copies of the Protected Health Information.

(3) If this contract does not have records management provisions and the Contract physician determines that returning or destroying the Protected Health Information I infeasible, the Contract physician shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contract Physician that return or destruction of Protected Health Information is infeasible, the Contract physician shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contract physician maintain such Protected Health Information.

4.14.7. Miscellaneous

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

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

(c ) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with the Privacy Rule.

APPENDIX A

GENERAL DEFINITIONS

As used throughout this Performance work statement, the following terms shall have the meaning set forth below:

Composite Health Care System (CHCS) Computer system, which stores clinical and administration data.

This system provides on-line communication for users in any supported location.

1. Contracting Officer (CO). A duly appointed person with the authority to enter into, administer, and/or terminate contracts and make related determination and findings on behalf of the Government.

2. Credentials. Certified documents providing evidence of education, training, licensure, board certification, experience and expertise of a health care provider.

3. Defective Service. A service output that does not meet the standard of performance specified in the contract for that service. The method of surveillance for each performance objective is listed in the Service Delivery Summary. Defective services will be determined by either customer complaint or periodic inspection. A defect may be either an unsatisfactory inspection report or a customer complaint, which addresses unacceptable turn-about times or errors in reports.

4. Exposure-prone procedure. A certain invasive surgical or dental procedure that has been implicated in the transmission of the hepatitis-B virus from an infected health care worker to a patient. Characteristics of exposure-prone procedures include digital palpation of a needle tip in a body cavity or the simultaneous presence of the health care worker’s fingers and a needle or other sharp instrument or object in a poorly visualized or highly confined anatomic site.

5. Freedom of Information Act (FOIA) Request. A written request for DoD records made by any person, including a member of the public, an organization, or a business that either explicitly or implicitly involves The FOIA, DoD Directive 5400.7.

6. FAC or Functional Area Chief. A generic term used interchangeable to refer to the Functional Commander, the Chief of Service, designated Quality Assurance personnel or technical representative of the Contracting Officer.

7. Full reimbursement rate. A rate, which is set annually by Congress, for reimbursement by non-eligible personnel who receive medical services at the MTF. This is a flat rate set for outpatient and inpatient care.

8. Functional Commander. The Chief/Director of the MTF medical service for whom contracted providers are acquired, or his designated representative. Also referred to as the FAC.

9. Functional Request. A written request for DoD records made by any person, including a member of the public, an organization, or a business that either does not cite the FOIA or Privacy Act. This does not include requests from Government employees with a need to know to perform official Government business.

10. Health care provider. Any contract health care professional who, under regulations of a Military Department, is granted clinical practice privileges in a military MTF Dental Treatment Facility, or who is licensed or certified to perform health care services by a Governmental board or Agency, or professional health care society or organization.

11. Invasive medical procedure. Any procedure that involves a puncture of the skin, the insertion of an instrument or foreign material into the body, or breaking of the mucosal lining of the body.

12. Privacy Act Request. A written request from the subject of the records or a request with the subject’s written consent.

13. Quality Assurance. A planned and systematic pattern of all actions necessary to provide confidence that adequate technical requirements are established, products and services conform to established technical requirements, and satisfactory performance is achieved. For purposes of this contract, quality assurance refers to actions by the government.

14. Valid License. A grant of permission by an official agency of the District of Columbia, a state, or territory of the United States, to provide care independently as a health care professional. Licenses must be current to be valid. Some jurisdictions issue no-fee licenses to federal employees or military personnel.

These are acceptable if the issuing authority will exercise professional regulating control over individuals with these licenses.

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