ATTACHMENT_1--PWS.pdf

PERFORMANCE WORK STATEMENT

NON PERSONAL SERVICES

FOR

INFORMATION MANAGEMENT TECHNICIAN ASSISTANT

1.1. SCOPE OF SERVICES. The Government requires one Full Time Equivalent for this Statement of Work (SOW). The individual shall provide Information Management Technician services at the 31st Medical Group, Aviano, Italy, also referred to as the Medical Treatment Facility (MTF) herein. The contractor will provide assistance for various information systems applications, equipment custodian, Telephone Control Officer, and training to the Medical Group users.

1.2. PERSONAL QUALIFICATIONS

1.2.1. EDUCATION & TRAINING REQUIRMENTS.

1.2.1.1. Language Requirement. The Contractor shall be proficient in reading, writing, understanding and speaking English at a level necessary to fully perform all required duties and tasks of their job.

The CO may request demonstrations of ability to meet personnel language proficiency requirements by any reasonable method.

1.2.1.2. Formal Education. Bachelor Degree in Information Technology or Computer Science from an accredited college or university plus 3 years of specialized experience, or an Associate Degree in Information Technology Computer Science plus 7 years of recent specialized experience, or 8 years of recent specialized experience. The contractor must be a US citizen.

1.2.1.3. License/Certification. The contractor must be a US citizen and possess valid Comptia Security+ Certification as a minimum.

1.2.1.4. Provides services support to the Medical Information Systems operation to include administrative support to a team of Computer Specialists/Analysts engaged in the development, implementation, and operation of Medical Information Systems Maintains documentation and program databases Uses the baseline education and experience to troubleshoot IT issues. Keeps up-to-date records of hardware and software within the organization, regularly consults on equipment changes, and ensures follow-up on all reported difficulties. Establishes and maintains official documentation to track inventory of all computer equipment. Prepares and coordinates purchase order requests, provides necessary documentation and justification for computer equipment and software purchases, and coordinates requests with appropriate officials within and outside the organization.

Additionally, contractor will provide assistance to the Chief Information Officer (CIO) in verifying requests, coordinating moves, scheduling/conducting training of MTF staff. Also, contractor will provide support services to include initiating and following up on requests for base telecommunication services.

1.2.1.5. Provides customer support and assistance for the medical information systems flight. Performs customer service help desk duties. Greets customers, takes calls, and answers questions which sometimes the guidelines may provide for judgmental deviations. Perform duties as the Telephone Control Officer Assistant. As such, responsible for surveying hospital staff/users regarding telephone systems requirements. Researches available literature regarding commercial-off-the-shelf (COTS) systems; provides CIO with data on projected costs and recommendations as to which system(s) are the most appropriate and cost effective within established cost and feature parameters. Coordinates transition of existing system(s) with communication squadron personnel, users and hospital staff to ensure technical requirements are resolved and transition activities are consummated in a smooth, professional manner. May perform administrative duties for the Medical Information Systems Flight to include meeting minutes, appointment letters, and reports.

1.2.1.6. Project Management: manages a limited number of projects. Projects and available resources are identified by the MDSS/CC and the CIO.

1.2.1.7. Knowledge of automated data processing standards, policies, and techniques.

1.2.1.8. Knowledge of information processing sequences, controls, and procedures; and computer hardware and/or software systems and their interfaces.

1.2.1.9. Knowledge of automated data processing standards, policies, and techniques.

1.2.1.10. Knowledge of information processing sequences, controls, and procedures; and computer hardware and/or software systems and their interfaces.

1.2.1.11. Knowledge of health information software applications, or other higher level programming language; and the terminology, codes, abbreviations, and graphics for preparing system documentation or programs.

1.2.1.12. Knowledge of local rules and procedures controlling job priorities and controls on access to data and program files.

1.2.1.13. Ability to use and maintain a computer system, equipment, and software; and analyze computer software and/or hardware problems and develop economical solutions.

1.2.1.14. Ability to provide training and guidance to users in the proper application of software and security requirements.

1.2.1.15. Ability to communicate effectively in English, both orally and in writing, to provide customer service/training to users of software applications.

2. SERVICE SUMMARY

Performance Objective (General) Ref. Paragraph Performance Measure

1. Duties performed with minimal direct supervision 1.2 2 Violations per month

2. Maintains patient privacy/confidentiality 1.2 No violations.

3. Personnel in the work area and available for work at the appointed times. Adheres to work duties and shift schedules. Adheres to vacation and sick leave policies

4.7.1-4.7.5

1 Violation (tardiness, no show, or leaving early) per month

2 Violations (work duties and shift times) per month

3. DODI 6025.5 NOTIFICATIONS. Pursuant to DoDI 6025.5, the anticipated contract is a Personal Services

Contract (PSC) and any resultant contract is intended to create an employer-employee relationship between the Government and the individual Contractor. The performance of the individual Contractor under the PSC is subject to day-to-day supervision and control by healthcare facility personnel comparable to that exercised over military and civil service engaged in comparable work; and any personal injury claims alleging negligence by the individual Contractors within the scope of the Contractor’s performance of the PSC shall be processed by DoD as claims alleging negligence by DoD military or civil service healthcare professionals. The personal service contract does not create an employer-employee relationship between the Government and any corporation, partnership, business association or other party or legal entity with which the individual Contractor may be associated.

3.1. GENERAL DEFINITIONS.

3.1.1. COMMANDER: MTF Commander or designee

3.1.2. CONTRACTING OFFICER REPRESENTATIVE (COR): Individuals designated to perform quality assessment functions. They serve as on-site technical managers assessing contractor performance against contract performance standards. Personnel in this area may have many titles, such as Functional Requirements Evaluator Designee (FRED), Quality Assurance Evaluator (QAE), Quality Assurance Specialist Personnel (QASP), Contracting Officer Technical Representative (COTR); however, their duties are essentially the same.

3.1.3. CONTRACTOR: The individual recruited and hired by the Government to perform services.

4. GOVERNEMENT FURNISHED PROPERTY AND SERVICES. Government will provide the following equipment, supplies, and services:

4.1. EQUIPMENT/OFFICE FURNITURE. The Contractor will be provided Government-controlled working space to perform services required by this contract. Those areas provided for the use of the contract personnel will present an orderly appearance. Contract personnel shall ensure these areas are tidy and any decorative items present a professional, modest appearance in keeping with community standards. Office space may be shared with other staff members. The government will not be responsible for loss or damage of personal items brought into the MTF.

4.2. COMPUTER EQUIPMENT. The MTF will provide computer equipment, software and peripherals as required for accomplishment of duties. The Contractor will be required to use Government computer systems in support of the Air Force Medical Service mission.

4.3. UTILITIES: The government will furnish all required utilities (such as water, telephone, electricity, etc.) at no cost to the Contractor. Long distance and Defense Switched Network (DSN) telephone services will be provided for official use only. The Contractor shall participate in government energy conservation programs.

4.4. HOUSEKEEPING. Housekeeping services will be provided by the MTF.

4.5. PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish the Contractor with any appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE. This does not include any type of required uniform or laboratory coat, which shall be contractor provided.

4.6. FORMS. The MTF shall provide required Government forms, either hardcopy or computer-generated used in the performance of services.

4.7. SUPPLIES. The MTF will provide non-medical supplies commonly used in the facility for administrative, non-clinical services supporting the care and management of patients. Commonly used supplies are those routinely stocked by the MTF.

4.8. ADMINISTRATIVE SUPPORT. The contractor personnel will be authorized to use all administrative support available to government employees. This will include, but is not limited to copy machines, fax machines, medical library, installation distribution, telephone lines and Defense Switching Network (DSN) lines. The same restrictions to limit use of these items for official government business apply.

4.9. EMERGENCY HEALTH CARE. Emergency healthcare services, including all required transportation expenses, if available, may be provided by the Government on a cost reimbursable basis. It is the responsibility of the contractor to ensure the Government is reimbursed for services rendered, or the local agencies are paid. The Contractor must have adequate health insurance coverage to pay for medical evacuation from the host country to receive emergency medical treatment when adequate treatment is not available in the host country.

4.10. INDIVIDUAL LOGISTIC SUPPORT (ILS). Lack of availability of any ILS service shall not serve as a basis for a claim against the U.S. Government. No equitable adjustment will be made for unavailability of ILS not explicitly authorized below or to any non-TR positions or personnel. The following ILS will be made available if Technical Representative status is granted:

4.10.1. Tax-free and duty-free shopping at the base exchange and commissary

4.10.2. Military post office and banking services

4.10.3. Privately-owned vehicle registration

4.10.4. Tax-free gasoline coupons

4.10.5. Tobacco and spirit ration cards

4.10.6. Dependent Schools (DoDDs) on a space available, tuition-reimbursable basis

4.10.7. Morale, Welfare and Recreation (MWR) services

4.11. DoD CONTRACTOR PERSONNEL OFFICE NOTIFICATION. There are two categories of employees of DoD contractor employees in Italy: (1) those who are accredited as Technical Representatives and, (2) those who are employed under locally prevailing conditions of employment and are not considered Technical Representatives:

4.11.1. TECHNICAL REPRESENTATIVES (TRs). TRs require a missioner visa and sojourn permit (permesso di soggiorno, or soggiorno). They are exempt from Italian income taxation, labor legislation and social contributions. TRs may be eligible for ILS. The following persons will not acquire TR status:

a person who is an Italian national, a person ordinarily resident in the Republic of Italy, a national of any state (country) not party to the North Atlantic Treaty, or a stateless person.

4.11.2. NON-TECHNICAL REPRESENTATIVES. Persons determined not to meet the eligibility criteria of TRs require Italian working visas. In addition, they are employed under local prevailing conditions of employment and are subject to Italian income taxation, labor legislation, and social contributions; and they are not eligible for individual and family ILS.

4.11.3. ***Family members of “members of the force” (i.e., active duty military) and family members of civilian component members are authorized to be employed on USF installations without modification of their passports, visas, and sojourn permits that otherwise reflect a family member status. Upon the sponsor’s departure from Italy, such employment terminates.***

4.11.4. This requirement presumes the Contractor will be a technical representative. United States authorities and Italian authorities are involved in the accreditation of contractor employees who are intended to fill such contract positions. To be eligible for technical representative status under DOCPER, the contractor must have a bachelor’s degree in related field or 8 years of related work experience. To expedite accreditation, the contractor agrees to promptly complete in accurate detail and return to the Contracting Officer or Contracting Officer’s Representative information on the contract and contract positions for which technical representative accreditation is requested, and the individual information on each employee designated to fill a technical representative position. Positions accredited as technical representatives will be documented by an individual letter of accreditation.

5. GENERAL INFORMATION.

5.1. OFFICE/WORK/LOCKER AREA: Those areas (office, staff locker, break room, etc.,) provided for the use of the contract personnel will present an orderly appearance. Contract personnel shall ensure these areas are tidy and any decorative items present a professional, modest appearance in keeping with Air Force standards.

The government will not be responsible for loss or damage of personal items brought into the MTF.

5.2. APPEARANCE. Contractor shall present a professional, conservative, and neat appearance. Contractor shall report for duty in a professional manner, in appropriate attire befitting members of MTF executive leadership team and having complied with socially acceptable standards of personal hygiene. 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.

5.3. IDENTIFICATION. Contractor shall display legible MTF-provided identification badge on their outer clothing, above the waistline, and visible at all times.

5.4. HEALTH REQUIREMENTS.

5.4.1. In accordance with AFI 48-105, Surveillance, Prevention and Control of Diseases and Conditions of

Public Health or Military Significance, the Contractor shall follow the methods for controlling and preventing disease as described in the American Public Health Association publication, Control of Communicable Diseases Manual, and the Centers for Disease Control and Prevention (CDC) publication, Morbidity and Mortality Weekly Report (MMWR), and its supplements. Where applicable, the most recent guidelines from these publications are utilized as the standard. The contractor shall be in compliance with AFI 48-105, Surveillance, Prevention and Control of Diseases and Conditions of Public Health or Military Significance, or CDC recommendations.

5.4.2. Prior to start of work, no medical tests or procedures required by the contract shall be performed by the Government unless the Contractor is an eligible beneficiary (unless otherwise noted below). Expenses for all required tests and/or procedures shall be borne by the Contractor, not the Government. After start of work, in the event of blood borne exposure, the Government will provide follow up and care protocols according to applicable AFIs.

5.4.3. At least seven (7) calendar days before start of work, the contractor will provide documentation that he/she has been immunized from contagious diseases according to CDC guidelines or AFI 48-105, Surveillance, Prevention and Control of Diseases and Conditions of Public Health or Military Significance. They may include, but are not limited to: Hepatitis B, measles, mumps, rubella, varicella, and influenza, and Tetanus, Diphtheria, Pertussis.

5.4.4. Additionally, proof of a negative TB skin test (completed within the past 12 months [if positive, proof of negative chest X-ray within the past 12 months] prior to start of work) is required In those areas where there is a higher risk of transmission of tuberculosis, the Contractor may be tested as frequently as directed by the MTF policy. The Government may provide this test and a positive result will be handled according to current MTF or AFMS clinical guidelines.

5.4.5. A Contractor working in an MTF is strongly encouraged to be immunized annually with the influenza vaccine. The Government may provide this vaccine to the Contractor if available based on supply, demand, and risk of exposure. If the vaccine is obtained at other facilities, the cost will be borne by the Contractor, not the Government.

5.4.6. Immunization information will be tracked in DoD computer systems for the Contractor.

5.4.7. The Contractor should inform the COR or FRED of pregnancy. The Government is to notify the

Contractor of any work hazards. If work hazards exist, it will be the Government’s decision whether the worker continues work in the environment. INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE. The Contractor shall provide and maintain adequate liability insurance coverage consistent with the risks associated with the performance of all services required by this SOW. Refer to Federal Acquisition Regulation (FAR) Clause 52.237-7, "Indemnification And Medical Liability Insurance".

5.5. TRAINING REQUIREMENTS.

5.5.1.The Government will provide initial MTF orientation and annual refresher training for the Contractor.

This requirement will be conducted during normal duties hours; thereby, the time is billable to Government. The Government will provide all training required to have access to Government computer systems. For example, initial CHCS/AHLTA, Data Safeguarding, Privacy Act, Anti- Terrorism, and Information Assurance training will be provided upon in-processing at the requesting location.

5.5.2.The Government will provide the required Health Insurance Portability and Accountability (HIPAA) Privacy and Security Rule training. The Contractor performing services for the Air Force is required to complete initial and annual refresher provided by the MTF and will be held accountable for complying with health information privacy and security policies and procedures.

5.5.3. Mandatory training and documentation for DoD-sponsored contractor personnel must complete Anti- Terrorism/Force Protection Training. Level 1 training compliant (IAW DoDI 2000.16) may be completed on line at https://atlevel1.dtic.mil/at/. Users must register for a new account on the AT Level I training application.

5.5.4. The Government will provide training specific to the job requirements/skills in person or virtually.

5.6. PROCEDURE GUIDANCE. The Contractor shall perform duties in accordance with the medical facility’s operating instructions, Air Force instruction and policies and higher-level DoD regulations. Changes or deviations from established objectives for services shall not be made without prior recommendation to, and approval of, the MTF Commander or authorized representative.

5.6.1. The Contractor is responsible to ensure all government-issued identification badges, keys, equipment and car passes are returned to the COR, FRED, or Government designee when an individual is leaving employment under this contract.

5.7. GENERAL INFORMATION

5.7.1. AVAILABILITY: The Contractor will work 40 hours every week. The Contractor has 45 days from the award date to have the employee in place. The Contractor shall be available from Monday through Friday, 0730 until 1630 or 0830 until 1730, Central European Time (CET) or Central European Summer Time (CEST), excluding U.S. federal holidays and any other military sponsored wing holidays. The Contractor’s lunch period of 60 minutes/day is coordinated within the specific working area; during appropriate time IAW appointments and co-worker schedule. The Contractor may be required to work other than normal duty hours, which may include evenings, weekends, and/or holidays not listed in 4.1.

5.7.2. VACATIONS/ABSENCES. The Contractor shall be allowed 160 hours of absences per year for vacation, sick leave and miscellaneous reasons. The absences are to be coordinated with, and at the discretion of, the assigned Flight Commander or his/her designee. The Contractor will provide 15 days advance notice of any absences/vacations of more than 3 days to the assigned Flight Commander.

5.7.3. ON-CALL DUTY. N/A

5.7.4. 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 contractor provide increased or reduced support as determined by the contracting officer. The Government will negotiate an equitable adjustment with the contractor for the cost of these emergency requirements.

5.7.5. DENIAL/TERMINATION OF PRIVILEGES. Actions to limit, suspend, or revoke clinical privileges shall be in accordance with the procedures outlined in AFI 44-119

5.8. AUTOMATED INFORMATIO SYSTEM (AIS) III SECURITY REQUIREMENTS.

https://atlevel1.dtic.mil/at/

5.8.1. A Contractor who is a potential threat to health, safety, security, general well-being, or operational mission of the Department of Defense (DoD) and its population will not be considered for this position.

This shall include individuals who are a potential threat because of prior felony convictions

5.8.2. The Contractor will have access to and/or process information requiring protection under the Privacy Act of 1974 on unclassified automated information systems (AIS) under this contract. Because of this access, the Contractor working for the Government under this contract is in a non-sensitive public trust position designated as an Automated Information Systems III (formally ADP) position IAW DoD Directive 5200.2-R. In compliance with DoD Directive 5200.2-R and AFI 31-501, Personnel Security Program Management, Homeland Security Presidential Directive 12 and OPM memorandum, Interim Credentialing Standards for Issuing Personal Identity Verification Cards Under HSPD 12, 18 Dec 07, a National Agency Check with Inquiries (NACI) will be done for all contractor personnel. Additionally, security package processing must be initiated in the Office of Personnel Management (OPM) system and the Federal Bureau of Investigates (FBI) advanced fingerprint and name check completed prior to allowing interim access for the Contractor.

5.8.3. The Contractor shall fully adhere to the provisions in these referenced publications by submitting the appropriate forms and have a positive outcome to the NACI investigation.

5.8.4. A favorable report is needed as a condition of employment under this contract. While the installation or MTF commander may allow the Contractor temporary or interim access to military installations and Government systems after an investigation is opened in the Joint personnel Adjudication System (JPAS) and following completion of the FBI national checks (hereafter termed as Interim Credentialing), the Contractor will be immediately removed from the position if at any time the NACI receives an unfavorable adjudication.

5.8.5. The below disqualifying suitability factors include, but are not limited to:

5.8.5.1. U.S. citizenship that cannot be verified.

5.8.5.2. Individual has been barred from entry/access to any federal installation or facility or denied issuance of a DoD identification credential in the past.

5.8.5.3. The individual is wanted by federal or civil law enforcement authorities, regardless of offense/violation.

5.8.5.4. Incarcerated for 12 months or longer with the past 10 years regardless of offense/violation unless released on proof of innocence.

5.8.5.5. Any conviction of espionage, sabotage, treason, terrorism or murder.

5.8.5.6. Name appears on any federal agency’s watch list or hit list for criminal behavior, terrorist activity or expert control violations.

5.8.5.7. Knowingly and willingly providing false information or documents associated with the SF85P process or orally during any subsequent personal interviews.

5.8.6. The Government process for the NACI (a.k.a., NAC with criminal history background check) from the

USAF Submitting Office to OPM, through the FBI and ending with the favorable personnel security determination from the Air Force Central Adjudication Facility is a Government expense and is hereafter termed as an adjudicated investigation.

5.8.7. The time the Contractor spends completing the required documentation either at home or at the USAF submitting office is not billable to the Government. Any anticipated cost incurred by the Contractor shall be included in their fully burdened prices submitted in the Price Section of the offeror’s proposal (i.e., wages, travel to Government facilities, etc.).

5.8.8. The Contractor will have a complete Criminal History Background Check (CHBC) because he/she may have contact with children less than 18 years of age on a frequent and regular basis. This CHCB is done by the Government as part of the NACI and the Adjudicated Investigation process. No additional background check is necessary. No person shall begin performance in an MTF until all requirements for the Interim Credentialing Standards for Issuing Personal Identity Verification Cards under HSPD-12 have been met.

5.8.9. A NACI package includes:

5.8.9.1. SF-85P, Questionnaire for Public Trust Positions from the Internet at http://www.opm.gov/forms/pdf_fill/SF85P.pdf.

5.8.9.2. Authorization for Release of Information (Page 8 of SF 85P).

5.8.9.3. Two (2) sets of FD-258, FBI Fingerprint Cards for each OPHSS employee.

5.8.9.4. The Contractor may also be required to submit a Birth or Naturalization Certificate to the MTF

Unit Security Manager.

5.8.10. The Adjudicated Investigation may take 4-6 months from the Interim Credentialing. However, the

USAF Submitting Office will notify the Contractor when complete and the Government will make record in JPAS. The Government emphasizes that a favorable report is needed as a condition of continued employment under this contract.

5.8.11. If there is documentation in the Government security systems of a previous NACI and/or criminal history background check, proof of the check may be used in lieu of new request for the same investigation provided the previous favorable investigation was completed with no more than a 2-year break in service (from contract award date). The USAF Submitting Office will check JPAS for this proof prior to coordinating appointments with the Contractor.

5.8.12. The Contractor shall insure re-verification of the SNC if required during the contract period of performance.

5.9. CONDUCT. The CO may request that the Contractor whose documented conduct, in the opinion of the CO and MTF commander interferes with proper order or professionalism at the MTF where services are performed or places patients at risk, be removed from such installation and the contractor will comply with such request.

5.10. MTF REQUIREMENTS: The Contractor shall complete all MTF-specified orientation program(s), initial and annual training requirements, and comply with all MTF policies, procedures, productivity standards and instructions as provided by the MTF.

5.11. RECORDS, FILES, DOCUMENTS, DATA, AND WORK PAPERS. All records, files, documents, data and work papers provided by the government remain Government property. The Functional requirements Evaluator Designee or FRED will provide guidance to the contract personnel who shall maintain and dispose of these records, files, and documents in accordance with Air Force Manual 37-138, and IAW applicable HIPAA requirements. The Contractor will comply with all AFMS requirements for safe keeping, handling, release, and disposal of any of the above information.

6. SPECIAL CONTRACT CLAUSES.

6.1. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996

6.1.1. HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The medical facilities of the military services and the DoD health plans are specifically listed as covered by HIPAA. Currently, HIPAA Privacy and Security Rules, as set forth in the Code of Federal Regulations, are in effect for all MTFs. The specific implementation of HIPAA Privacy for DoD medical facilities is set forth in DoD 6025.18-R, and for HIPAA Security, the requirements for AF MTFs are contained in 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, Health Information Assurance for Military Treatment Facilities, 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.

6.1.2. 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, Health Information Assurance for Military Treatment Facilities. Additional HIPAA requirements will be addressed when implemented.

6.1.3. 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, Health Information Assurance for Military Treatment Facilities.

6.1.3.1. 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).

6.1.3.2. Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160 and part 164, subparts A and E.

6.1.3.3. 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.

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

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

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

6.1.3.7. Security Rule means the Health Insurance Reform: Security Standards at 45 CFR part 160,162 and part 164, subpart C.

6.1.3.8. 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.

6.1.4. 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.

6.1.5. The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract.

6.1.6. 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.

6.1.7. 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.

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

6.1.9. 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.

6.1.10. 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.

6.1.11. 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.

6.1.12. 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.

6.1.13. 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.

6.1.14. 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.

6.1.15. 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.

6.1.16. 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

6.2. GENERAL USE AND DISCLOSURE PROVISIONS.

6.2.1. 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.

6.3. SPECIFIC USE AND DISCLOSURE PROVISIONS.

6.3.1. 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.

6.3.2. 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.

6.3.3. 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).

6.3.4. Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j)(1).

6.4. OBLIGATIONS OF THE GOVERNMENT. Provisions for the Government to Inform the Contractor of Privacy Practices and Restrictions

6.4.1. Upon request the Government shall provide the Contractor 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.

6.4.2. The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the Contractor's permitted or required uses and disclosures.

6.4.3. The Government shall notify the Contractor 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.

6.5. PERMISSIBLE REQUESTS BY THE GOVERNMENT.

6.5.1. The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the HIPAA Privacy Rule, DoD 6025.18R, the HIPAA Security Rule, or DoD 8580.02-R, if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause.

6.6. TERMINATION.

6.6.1. A breach by the Contractor of this clause, may subject the Contractor to termination under any applicable default or termination provision of this Contract.

6.6.2. Effect of Termination.

6.6.2.1. 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 paragraphs below.

6.6.2.2. If this contract does not have records management requirements, except as provided in the directly successive paragraph, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of the Contractor. The Contractor shall retain no copies of the Protected Health Information.

6.6.2.3. If this contract does not have records management provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor 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 Contractor maintains such Protected Health Information.

6.6.3. Miscellaneous

6.6.3.1. Regulatory References. A reference in this Clause to a section in DoD 6025.18-R, HIPAA Privacy

Regulation or DoD 8580.02-R, HIPAA Security Regulation, or any CFR or AFI provision means the section as currently in effect or as amended, and for which compliance is required.

6.6.3.2. 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.

6.6.3.3. Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with DoD 6025.18-R, the CFR HIPAA Privacy Rule, DoD 8520.02-R, the CFR HIPAA Security Rule and AFI 41-217, Health Information Assurance for Military Treatment Facilities.

7. APPLICABLE PUBLICATIONS. Publications applicable to this requirement include, but are not limited to, those listed below. The Contractor is obligated to follow all applicable publications and references thereto.

Supplements or amendments to listed publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes in publications, which result in a decrease or no change in the price and notify the CO in writing of such change. Should a decrease in contract price result; the Contractor shall provide a proposal for reduction in the price to the CO. Prior to implementing any change that will result in an increase, the Contractor shall submit to the CO a price proposal within 30 days of receipt of the change by the Contractor. The CO and the Contractor shall negotiate the change into the contract under the provisions of the contract clause entitled "Changes". Failure of the Contractor to submit a price proposal within 30 days from receipt of the change shall entitle the Government to performance in accordance with such change at no increase in price.

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

7.2. DoD Directives can be found at http://west.dtic.mil/whs/directives. 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 DATE

DoD 5400.11-R Department of Defense Privacy Program May 07 DoD 6025.18R DoD Health Information Privacy Regulation Jan 03 DoD 8580.02-R DoD Health Information Security Regulation Jul 07 DoDD 1300.22 Mortuary Affairs Policy Feb 00 DoDD 2310.2 Personnel Recovery Dec 00 DoDD 5200.2 Personnel Security Program Apr 99 DoDD 5400.11 DoD Privacy Program Nov 04 DoDD 5500.7 Standards of Conduct Aug 93

DoD 6010.13-M Medical Expense and Performance Reporting System for Fixed Military Medical and Dental Treatment Facilities Nov 00

DoDD 6040.41 Medical Records Retention and Coding at Military Treatment Facilities Apr 04

DoDD 8190.3 Smart Card Technology Aug 02 DoDD 8500.1 Information Assurance Oct 02 DoDI 1010.15 Smoke Free DoD Facilities Jan 01 DoDI 2000.16 DoD Antiterrorism (AT) Standards Oct 06

DoDI 1402.5 Criminal History Background Checks on Individuals in Child Care Services Jan 93

DoDI 3020.37 Continuation of Essential DoD Contractor Services During a Crisis Nov 90

DoDI 3020.41 Contractor Personnel Authorized to Accompany the U.S. Armed Forces Oct 05

DoDI 6000.11 Patient Movement Sep 98

DoDI 6015.23 Delivery of Healthcare at Military Treatment Facilities: Foreign Service Care; Third Party Collection; Beneficiary Counseling and Assistance Coordinators (BCACs)

Oct 02

DoDI 6025.8 Ambulatory Procedure Visit (APV) Sep 96 DoDI 6040.42 Medical Encounter and Coding at Military Treatment Facilities Jun 04 DoDI 6040.43 Custody and Control of Outpatient Medical Records Jun 04

7.3. 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

AFH 41-114 Military Health Services System (MHSS) Matrix Mar 97 AFI 31-204 Air Force Motor Vehicle Traffic Supervision, Chapter 3 Jul 00 AFI 31-501 Personal Security Program Management Jan 05 AFI 33-119 Air Force Messaging Jan 05 AFI 33-129 Web Management and Internet Use Feb 05 AFI 33-200 Information Assurance (IA) Management Dec 08 AFI 33-322 Records Management Program Oct 03 AFI 33-332 Privacy Act Program May 11 AFI 34-242 Mortuary Affairs Program Apr 08 AFMAN 10-3902 Nuclear Weapons Personnel Reliability Program Nov 06 AFI 36-2101 Classifying Military Personnel (Officer and Enlisted) Jun 10 AFI 36-2910 Line of Duty (Misconduct) Determinations Oct 02 AFI 36-3002 Casualty Services Mar 12 AFI 36-3003 Military Leave Program Oct 09 AFI 36-3026(1) Identification Cards for Members of the Uniformed Services, Their Eligible Family Members or Other Eligible Personnel

Dec 09

AFI 33-364 Records Disposition – Procedures and Responsibilities Dec 06 AFI 40-102 Tobacco Use in the USAF Mar 12 AFI 41-102 Air Force Medical Expense and Performance Reporting

System (MEPRS) For Fixed Military Medical and Dental Treatment Facilities

Jan 11

AFI 40-701 Medical Support to Family Member Relocation and Exceptional Family Member Program (EFMP)

Feb 12

AFI 41-115 Authorized Health Care and Health Care Benefits in the Military Health Services System (MHSS)

Dec 01

AFI 41-120 Medical Resource Operations Oct 01 AFI 41-209 Medical Logistics Support Jun 06 AFI 41-210 Patient Administration Functions Mar 06 AFI 41-217 Health Information Assurance for Military Treatment Facilities Dec 05 AFI 41-301 Worldwide Aeromedical Evacuation System Aug 96 AFI 44-102 Medical Care Management Jan 12 AFI 44-119 Medical Quality Operations Aug 11 AFI 44-172 Mental Health Mar 11 AFI 48-105 Surveillance, Prevention, and Control of Disease and

Conditions of Public Health or Military Significance Mar 05

AFI 48-123 Medical Examinations and Standards Sep 09 AFMAN 33-363 Management of Records Mar 08

7.4. Host Nation References

AE Reg 715-9 Contractor Personnel in Germany—Technical Expert, Troop Care and

Analytical Support Personnel http://www.per.hqusareur.army.mil/CPC/DocPer/GermanyDefault.asp x

Apr 03

HQ USFJ INST 64-102 U.S. Official Contractors and Their Employees Feb 03 USFK Reg 700-10 The Invited Contractor and Technical Representative Program http://www.usfk.mil Jun 07

USFK Reg 350-2 Theater Specific Required Training for all Arriving Personnel and Units Assigned to, Rotating To, or in Temporary Duty Status to USFK

7.5. Other References

TITLE

JCAHO Ambulatory Health Care Standards Manual current edition Population Health PCO Guide https://phsd.afms.mil/PHSO/indexPHSO.htm Referral Management Center User’s Guide https://kx.afms.mil/healthbenefits.

UK Immigration http://www.ukimmigration.com/ http://travel.state.gov/travel/travel_1744.html http://www.per.hqusareur.army.mil/CPC/DocPer/GermanyDefault.aspx http://www.per.hqusareur.army.mil/CPC/DocPer/GermanyDefault.aspx https://phsd.afms.mil/PHSO/indexPHSO.htm https://kx.afms.mil/healthbenefits