Final Ortho PWSMay2011.pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR

NON-PERSONAL SERVICES FOR ORTHOPEDIC

SURGERY SERVICES

AT THE

MILITARY MEDICAL TREATMENT FACILITY

39th MEDICAL GROUP (39 MDG)

25 May 2011

PERFORMANCE WORK STATEMENT

FOR

NON-PERSONAL ORTHOPEDIC SURGERY SERVICES

AT

MEDICAL TREATMENT FACILITY

39th MEDICAL SQUADRON

TABLE OF CONTENTS

SECTION TITLE PAGE

C-1 DESCRIPTION OF SERVICES 3

C-2 SERVICE DELIVERY SUMMARY 16

C-3 GOVERNMENT FURNISHED PROPERTY AND SERVICES 17

C-4 GENERAL INFORMATION 18

C-5 APPENDICES 24

TECHNICAL EXHIBITS:

1. HISTORICAL DATA 24

2. ESTIMATED PROCEDURES DATA 25

SECTION C-1

DESCRIPTION OF SERVICES

1.1. SCOPE OF WORK. The Contractor shall provide Orthopedic services to perform inpatient and outpatient Orthopedic Surgery services required for Government beneficiaries. The Contractor shall provide care to eligible beneficiaries at the 39th Medical Group (also referred to as the “Medical Treatment Facility” [MTF] herein) or in local civilian hospitals as required to support the orthopedic surgery needs of the MTF. Contractor shall serve as a liaison between the MTF and local host nation hospitals as designated by the Chief of Medical Staff (SGH).

Contractor shall furnish all labor, management, supervision, consultations and reports.

Contractor care shall be as comprehensive as government-supplied facilities, equipment and support services permit. Performance shall be according to the requirements contained in this Performance Work Statement (PWS).

1.2. CONTRACT PERSONNEL.

1.2.1 POINT OF CONTACT. The Contractor shall provide a point of contact that shall be responsible for the performance of the work. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The Contractor shall designate this individual, in writing, to the Quality Assurance Personnel (QAP) before the contract start date.

1.2.2. ROUTINE AVAILABILITY. Contractor shall perform outpatient/APU, emergency, and clinical services in the MTF and designated local civilian hospitals which have active Preferred Provider Agreements with the 39 MDG, with which the MTF, or TRICARE/International SOS (ISOS), has a Memorandum of Understanding (MOU). The contractor may not see patients at a private office unless care is coordinated with the 39 MDG staff. The contractor shall be available by telephone unless replacement staff is covering calls per section 1.2.2.6. Regular Clinical Services and consultation shall be provided for a minimum of 25 hours per week, which includes a combination of clinical, surgical and administrative liaison time as the representative to host nation facilities. Regular clinical services, consultation and physician liaison times shall be coordinated with the 39 MDG staff for maximum support of orthopedic requirements for the population’s need for care. Major and minor outpatient procedures shall be performed during regular clinical services and consultations inclusive of a maximum of 120 hours per month during open MTF clinic days according to a schedule that is mutually agreed upon between the 39 MDG and the contractor. Contractor must be available for call 24 hours a day seven days a week. Emergency consultations shall be performed as needed.

Authorized callers will be all 39 MDG medical providers assigned to the MTF.

1.2.2.1. ON-CALL/AFTER DUTY RESPONSE TIME REQUIREMENTS. On-call telephone standby shall be provided on a 24-hour basis 7 days a week. As required and directed by the MTF, the Contractor shall be required to provide Orthopedic Surgery services after normal duty hours and also to respond to requests for on-call support at any hour of the day, since services are frequently required during night hours and on weekends. The contractor must provide a Turkish Air Force approved mobile phone for on-call use and also be permitted to have their privately owned vehicle on base. The contractor may be called in to perform procedures on or off base. The contractor shall provide Orthopedic services on-site or at the local civilian hospital as directed by MTF within 60 minutes of notification by the 39th Medical Group’s medical provider(s) of a routine on-call consultation requirement and within 30 minutes of an emergency. When it is agreed upon that the service/procedure can be provided at a local host-nation facility in which the provider has privileges to practice and in facilities which provide Orthopedic services to the 39 MDG, with which the MTF, or TRICARE/International SOS (ISOS), has a Memorandum of Understanding. In this situation, the contractor reimbursement will be solely the responsibility of the host nation facility. The contractor must be privileged and maintain privileges to provide services in all local host nation hospital facilities which provide Orthopedic services to the 39 MDG, with which the MTF, or TRICARE/ISOS, has a Memorandum of Understanding. The MTF may negotiate with the contract provider, on a case-by-case basis, for procedures that are not listed in Technical Exhibit 1 if the following conditions are met prior to the provision of care: The provider provided proof of competency/currency in performing the procedure and the procedure was approved by the Chief of Medical Services (SGH). Contractor will use call back hours if the MTF calls the contractor back to the MTF for advice and/or consultation, and/or if the contractor provides consultation in a local host nation hospital facility where no service/procedure can be billed to TRICARE/ISOS. Contractor will provide an up-to-date log of services rendered and time spent in the facilities to the QAP.

1.2.2.2. HOURS OF OPERATION. The Contractor shall not schedule regular clinic services or surgery during Goal days, Family days, Federal Holidays or other days when the entire MTF is closed, or due to maintenance and/or facility limitations such as power or water outages. The change in schedule shall be coordinated with the Quality Assurance Personnel (QAP) or Section Chief. This number does not include instances when the contractor is called after normal hours or for emergencies. The contractor will be expected to render care in the clinic and operating room for up to 120 hours per month, depending on population demand, to eligible beneficiaries inclusive in this contract. Contractor and section chief may agree to provide services on American and/or Turkish holidays with the 25 hours per week limit, when services are needed.

Contractor schedule should be arranged 30 days in advance with the Section Chief or supervisor.

Dual compensation in accordance with United States Code (USC) 55-36 will not be reimbursed to the contractor by US Government or TRICARE/ISOS as contractor is already considered a contract employee of the US government.

1.2.2.3. FEDERAL HOLIDAYS There are ten (10) Federal holidays each year. They are New Year’s Day (1 January), Martin Luther King Jr’s Birthday (observed the third Monday in January), President’s Day (observed the third Monday in February), Memorial Day (observed the last Monday in May), Independence Day (observed 4 July), Labor Day (observed the first Monday in September), Columbus Day (observed the second Monday in October), Veterans Day (observed 11 November), Thanksgiving Day (observed the fourth Thursday in November), and Christmas Day (observed 25 December). If New Years Day, Independence Day, Veterans’ Day or Christmas falls on a Saturday, it is observed on Friday; if it falls on Sunday, it is observed on Monday.

1.2.2.4. TIME OFF. The Contractor is required to give written notification to the 39th Medical Group 30 days prior to any scheduled or routine absences that would affect performance of this contract. Time off will not exceed two consecutive weeks except for extenuating circumstances which will be authorized by the QAP in writing. If Contractor is off for a week and not seeing patients in house, to include replacement staff, contractor will not bill for that week not seeing patients in house.

1.2.2.5. WORK SCHEDULE. Personnel will be scheduled in accordance with the MTF dictated work schedule for maximum heath care utilization. A flexible schedule may be requested based on the needs of the MTF. Normal MTF clinic hours are 7:30AM-4:30PM.

Policy regarding daily lunch or other breaks will follow the Government’s standard procedures for contract personnel. The contract personnel should follow command announcement for reporting to work as it relates to inclement weather or base closures.

1.2.2.6. ARRANGE FOR REPLACEMENT STAFF. When absences exceed 2 scheduled working days the Contractor shall arrange for a replacement surgeon with equal qualification and skill to care for eligible beneficiaries in case of emergencies or post-operative complications at no additional cost to the 39 MDG. This arrangement should be made 30 days prior to requesting an extended absence. The replacement will be one of the orthopedic staff at one of the facilities with an active Preferred Provider Agreement. The name of qualified and credentialed surgeons shall be submitted to the MTF at the start of the contract and will be maintained on file for adequate general surgery coverage. Replacement personnel are required to meet the same credentialing criteria as that of contract personnel. The Government reserves the right to accept the recommended replacement provider. If not accepted, a qualified substitute will have to be resubmitted by the Contractor for acceptance by the government. The replacement staff shall possess a valid unrestricted license to practice orthopedics in the Republic of Turkey. The replacement staff shall be English and Turkish speaking. The replacement staff member will conduct services at an approved local host-nation facility with which the MTF, or TRICARE/ISOS has a Memorandum of Understanding and will receive payment for services solely from that facility. The Government reserves the right to request the replacement staff to see patients in the MTF, and the contractor shall arrange for replacement staff that shall meet the same requirements outlined in the PWS. If the Government does not request that the replacement staff to see patients in the MTF, the Contractor will not bill for time patient’s were not seen in the MTF. The Contractor will only bill for base pay for the time they see patient’s in the MTF.

Upon return of the Contractor, the replacement staff shall provide a report on any care delivered to our beneficiaries. The Contractor will be expected to give a report to the replacement staff regarding patients under their care including inpatients and outpatients.

1.2.2.7. TRAVEL. Contract personnel may be required to travel to various locations to participate in clinical case experience at government expense. When travel is required and not optional, authorized expenses will be reimbursed supported by expense log and hand receipts not to exceed the maximum per diem rates in accordance with Federal Acquisition Regulation (FAR) 31.205-46 and Joint Travel Regulations Vol. II, Appendix E, Part III. Travel documentation requirements will be obtained at the Contractor’s expense to include passport, visa, etc. Travel will be approved by the Medical Operations Squadron Commander. Authorized expenses include, but are not limited to airfare, ground transportation (taxi, shuttle), lodging, meals and applicable taxes (hotel). All travel requirements will be coordinated with the Contracting Officer at least thirty days prior to departure. After completion of travel, the Contractor shall submit an invoice via Wide Area Work Flow (WAWF) and attach a detailed breakdown of reimbursable travel costs incurred and receipts for all expenses using the expense log. Current per diem rates can be accessed via the following website:

http://perdiem.hqda.pentagon.mil/perdiem/pdrates.html

1.3. PERSONNEL REQUIREMENTS.

1.3.1. ENGLISH LANGUAGE REQUIREMENT. The contractor must be able to read, write, speak and understand English and Turkish. Languages should be spoken with sufficient structural accuracy and vocabulary to participate effectively in most formal and informal conversations on practical and professional topics.

1.3.2. CRIMINAL HISTORY BACKGROUND CHECK (CHBC) REQUIREMENT.

Criminal background check will be conducted not less than every five years by means of written professional reference and screening of all prior and existing lawsuits and their outcomes.

Screening of lawsuits will be requested in writing to the Turkish Health Department at the address listed below:

Saglik Mudurlugu Stadyom Giris Kapisi Karsisi Hifzisihha Mlid Bitisigi Adana

1.3.2.1. Concurrent with the consent of the Contracting Officer, contract providers 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 a chaperone or parent/guardian.

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

1.3.2.3. Contractors who have previously received a background check shall provide to the Contracting Office or QAP proof of the check or obtain a new one. If there has been a break in U.S. government service, a complete CHBC must be re-accomplished, even if the individual has had a security clearance and/or recent CHBC.

1.3.2.4. All contract employees shall provide all reasonable and necessary assistance to the Government.

1.3.3. UNIFORMS/PERSONAL APPEARANCE. Contract personnel shall present a neat appearance and be easily recognized as Contractor employees.

1.3.3.1. Clothing should present a professional, modest appearance in keeping with the normally accepted community standards of dress for the work being performed. In all cases, clothing shall be neat and clean. This includes being free from visible dirt, stains, strong cologne and offensive odors. When required and supplied by the MTF, personnel shall wear special protective clothing and shoe covers. These items shall remain the property of the Government and shall not be removed from the MTF. Special protective clothing shall be turned in or destroyed after use as directed by the QAP.

1.3.3.2. All contract personnel shall wear a nametag designating them as a “Contractor.”

1.3.3.3. Facial hair including beards, mustaches, and sideburns shall be controlled (retained) or trimmed to have a professional appearance and to maintain safe work practices. When duties will be performed in specified areas, a disposable protective hood shall be worn to ensure infection control standards are met. This hood will be provided by the Government.

1.3.4. OFFICE/WORK AREA APPEARANCE. Those areas (office examination rooms etc.)

provided for contractor use shall present an orderly appearance. The contractor shall ensure these areas are tidy and any decorations present a professional modest appearance in keeping with acceptable community standards.

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.

1.4. PRIVILEGING REQUIREMENTS. (ALL SUBMISSIONS MUST BE TRANSLATED

INTO ENGLISH).

1.4.1. PRIVILEGING. The credentials of all providers shall be reviewed and privileges granted as outlined in Air Force Instruction (AFI) 44-119, Medical Quality Operations. The Contractor is responsible to ensure that proposed staff possesses the requisite credentials enabling the granting of privileges by the applicable MTF sufficient to allow for performance of all tasks identified in section C-5 of this PWS. The contractor must be privileged to provide services in the MTF and all local host nation hospital facilities which provide Orthopedic services to the 39 MDG, with which the MTF or TRICARE/ISOS has a MoU. The Contractor is required to begin full performance of the contract requirements within 5 days after contract award.

1.4.1.1. Initial applications for clinical privileges, to include credentials action history, malpractice history, and completed copies of the below listed document, shall be submitted to the MTF Credentials Committee 30 calendar days from receipt of notice of contract award, or when requested by the QAP. Additionally, the Contractor shall make all proposed healthcare providers available for interview by the MTF during the credentialing process.

*Copy of any applicable medical licenses and board certifications.

*Provider education and training.

*Current Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) certification.

*Current certification in Neonatal Resuscitation Program (NRP), if applicable.

*A signed consent for release of information.

*A copy of the proposed contract provider’s professional resume, accompanied by that individual’s sworn affidavit of the truthfulness of same, indicating experience, training, and technical expertise in the type of car to be rendered.

*A list of all places in which contract provider current holds or has held a license to practice related services *A certification of current physical examination for each employee. The certification shall contain a signed statement by the examining physician stating that the employee is free of any contagious diseases. Physical examination must be current and within the 12 months prior to the application for privileges.

1.4.1.2. Professional staff appointments and clinical privilege actions will be based on review of documents in accordance with AFI 44-119. Reappointment shall occur not less than every two years, in accordance with AFI 44-119.

1.4.1.3. Applications for clinical privileges for replacement contract providers shell be submitted IAW AFI 44-119, chap 5 “The Credentialing Process”. The replacement contract provider shall complete the process no later than 30 calendar days prior to the provider assuming duty.

1.4.1.4. The Contractor is required to begin full performance of the contract requirements within 5 days after the contract is awarded. It is absolutely critical that privileges be granted to a sufficient number of contract providers to meet the contract requirements by the commencement date.

1.4.1.5. The Contractor must submit only complete credentials applications for processing.

Incomplete applications (those that do not fully comply with the requirements) will not be accepted by the Government and will be returned without action.

1.4.1.6. The Contractor must take specific action, including Primary Source Verification, to ensure that contract provider applications have the required prerequisites for privileging and do not have disqualifying impediments for privileges at the MTF. This is a non-delegable responsibility of the Contractor.

1.4.1.7. The Contractor will submit applications for only those contract providers who can reasonably be anticipated to render the actual, substantial performance on the contact. The submission of primary contact providers for credentialing who lack the requisite qualifications, or who will not work at all, is unacceptable and will be considered a failure to perform.

1.4.1.8. The Contractor will maintain active, valid, unrestricted privileges at all local referral hospitals with which the 39 MDG or the managed care support contractor has an active PPN agreement.

1.4.2. DENIAL/TERMINATION OF PRIVILEGES.

1.4.2.1. Actions to limit, suspend or revoke clinical privileges shall be in accordance with the procedures outlined in AFI 44-119, Medical Quality Operations (September 2007), Chapter 9.

1.4.2.2. The QAP should notify the Contractor Officer (CO) as soon as possible when the necessity to exercise such authority becomes apparent. The QAP will also provide the CO with copies of documentation initiating the revocation process if such actions become apparent. The Contracting Officer has the responsibility to notify the Contractor.

1.5. EDUCATION AND TRAINING REQUIREMENTS.

1.5.2. LICENSE/REGISTRATION. The contract provider shall possess and maintain a valid, unrestricted license to practice orthopedic surgery in the Republic of Turkey. The Contractor is required to turn in copies of all supporting documents prior to contract performance to the QAP.

1.5.3. BOARD CERTIFICATION. The contract provider shall be board certified by the Turkish Doctor’s Chambers, Division of Orthopedic Surgery. The Contractor is required to turn in copies of all supporting documents prior to contract performance to the QAP.

1.5.4. OTHER CERTIFICATIONS. The contract providers must maintain current training in Basic Life Support (BLS), Advance Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS). The contractor is required to turn in copies all supporting documents prior to contract performance to the QAP. Membership in United States Professional Organization commensurate with medical specialty is highly encouraged.

1.6. GOVERNMENT ORIENTATION/TRAINING.

1.6.1. INITIAL ORIENTATION. The contractor shall attend Government provided initial training for the procedures and use of Government provided equipment, supplies and forms, safety, infection control and quality assurance (QA) procedures and policies, personnel reliability program and facility orientation.

1.6.1.1. The Contractor shall ensure that contract provider and support staff participate in the MTF orientation and service/clinic specific orientation prior to furnishing services under this contract. Clinic orientation must occur within five duty days of employment start date. Medical Center orientation must occur within 30 days of employment start date.

1.6.2. CONTINUING ORIENTATION. The contractor shall participate in orientations for new equipment, procedures, etc. as determined by the Chief of Medical Staff.

1.6.3. CONTINUING MEDICAL EDUCATION (CME) REQUIREMENTS. Health care providers, registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current as prescribed in AFI 41-117, Medical Service Officer Education. CME shall be obtained at no additional cost to the Government and shall be reported to the QAP and MTF Credentials Committee annually. The report shall be submitted no later than the first normal duty day in January for the previous calendar year. Periodic CME may be conducted at the MTF and will be available, at no cost, to any healthcare provider desiring to attend. CME hours are not billable hours for purposes of this contract. CME hours must be formally approved/sponsored by an accredited organization as acceptable to the 39 MDG. The CME must be approved Category I CME or a satisfactory equivalent as approved by the Chief Medical Staff. BLS, ACLS, and PALS are at no charge but do not constitute compensation time.

1.6.4. ANNUAL TRAINING REQUIREMENTS. All contract employees must complete annual training requirements IAW local MDG policies.

1.6.5. PATIENT SENSITIVITY TRAINING. Contractor receiving more than two (2) valid complaints (as determined by the QAP or CO) within 100 hours of service shall not be permitted to provide services through the MTF with this PWS until the contractor successfully completes a Government approved patient sensitivity training class within a month of a second complaint.

Training may include attendance at a customer college and/or computer based customer sensitivity training. Contractor participation in the training class shall be at no cost to the Government

1.6.6. ADDITIONAL TRAINING REQUIREMENTS. Contractor will be required to attend additional training not listed in this PWS on an as required basis, at the Government’s expense.

1.7. HEALTH REQUIREMENTS:

1.7.1. PREASSIGNMENT MEDICAL EVALUATION. The purpose of this medical evaluation is to determine if the individual, from a medical standpoint, possesses the minimum physical abilities needed to perform the proposed job without significant risk to personal health or the health and safety of others. As a minimum, the individual shall be free of physical defects or medical conditions that might reasonably be expected to place others at risk. Not later than five days prior to the commencement of performance of health care services under this contract by any employee, the Contractor shall provide to the Public Health (Employee Health) Flight certification that such employees have completed the medical evaluation requirements identified below. This certification shall state the date on which the examination was completed, the doctor’s name that performed the examination and a statement concerning the physical health of the individual. Initial documentation is required for: MMR (immunization or titer levels for Rubella and Rubeola), history of chicken pox disease or positive titer (varicella vaccination must be accomplished if lack of immunity), TB Mantoux skin test (IPPD) if positive, minimum requirement will be follow-up with Contractor’s physician and a chest x-ray. A physician must provide documentation of “no active respiratory disease”, Hepatitis B vaccination/series are required for all personnel with occupational risk of exposure (declination are not acceptable, this is a condition of employment) and if the employee will be involved in exposure-prone procedures they will have their HbsAg status determined. This is to be done by providing documentation of the HbsAb (if positive they will be referred to the MTF Credentials committee to determine scope of practice). If, in the opinion of the evaluating medical practitioner, the individual is found to be qualified for duty, the medical statement shall include the following wording: “(NAME OF EMPLOYEE) possesses the minimum physical abilities to perform the proposed duties of a (insert job title). He/she has documented proof of immunization against/immunity to rubeola, rubella, and hepatitis B and does not have an active infectious condition which might place others at risk.” If, in the opinion of the evaluating medical practitioner, the individual does not possess the minimum capabilities needed to perform the proposed job or does not meet the conditions of employment or will pose a risk to others, the medical statement shall contain the following wording: “For medical reasons, (NAME OF EMPLOYEE) is not qualified for employment as a (insert job title).” Certification shall be provided to the CO, who will forward to the MTF Employee Health Office.

1.7.1.1. It is the Contractor’s responsibility to report (to the appropriate MTF staff member) all information necessary to assure hospital records can be maintained correctly and therefore comply with the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC), Occupational Health and Safety Administration (OSHA) and Centers for Disease Control (CDC) health records requirements.

1.7.1.2. Contract employees should report their pregnancy to the contractor. It is the responsibility of the contractor to notify the QAP of the pregnancy. MTF Employee Health Office will provide information concerning any work hazards in that area. The contractor is to notify their pregnant employee of any work hazards. It will be the employee and the contractor’s joint decision whether the contracted employee works in the environment.

1.7.2. ANNUAL MEDICAL EVALUATION. All contract employees performing health care services under this contract shall complete annual medical evaluations as required by the MTF hospital employee health program. The Contractor shall provide to the QAP a certificate, as described above, documenting the results of this evaluation.

1.7.3. PREVENTATIVE, PROPHYLACTIC AND FOLLOW-UP PROCEDURES. The Contractor shall ensure that his/her employees are in compliance with preventive, prophylactic and follow-up procedures, as well as infection control and employee health program procedures, as established by the MTF. Required preventive, prophylactic and follow-up procedures will be provided by the Government to contract employees in the military MTF. If care is received elsewhere, the Contractor shall provide written verification of treatment.

1.7.4. EMERGENCY HEALTH CARE. The MTF will provide emergency health care for contract personnel for injuries occurring while on duty in the MTF. These services will be billed to the Contractor at the current full reimbursement rate as directed by the Uniform Business Office Billing Procedures as directed by the Department of Defense.

1.8. MEDICAL QUALITY ASSURANCE/RISK MANAGEMENT (QA/RM).

1.8.1. Contractor shall participate in QA/RM activities to the extent required by AFI 44-119 and the individual MTF QA/RM plan or regulation.

1.8.2. The Government will evaluate the contractor’s professional, as differentiated from administrative, performance under this contract using quality assurance standards specified in AFI 44-119, Medical Quality Operations (September 2007) Chapter 8, and the individual MTF QA/RM plan or regulation. Nothing in this paragraph precludes the Government from also conducting inspections under the Inspection of Services clause.

1.9. GENERAL and SPECIFIC TASKS

1.9.1. GENERAL. The Contractor shall perform the professional orthopedic surgery services required for patients’ healthcare needs as stated in Technical Exhibit 2. The quality of medical practice shall meet or exceed reasonable standards of professional practice for orthopedic surgery healthcare as determined by the same authority that governs military medical professionals in orthopedic surgery and will be audited by the QA/RM Committee, the individual MTF QA/RM plan or regulation. A percentage of all records will be reviewed through a peer review process per AFI 44-119 and 39 MDG policies.

1.10. SPECIFIC PROCEDURES FOR WHICH THE CONTRACTOR SHALL BE

RESPONSIBLE.

1.10.1. PROCEDURE GUIDANCE. Contract personnel shall perform procedures compatible with the MTF’s operating capacity and equipment. Medical procedures/services other than those included in Technical Exhibit 2 shall not be introduced by the contract provider without prior recommendation to, and approval of, the MTF Commander or authorized representative.

1.10.2. DUTY ASSIGNMENT. Contract personnel shall be primarily required to perform orthopedic surgery services. The contractor may be required to perform peripheral orthopedic procedures as assigned by the Chief of Medical Services to provide support in other sections/departments of the MTF commensurate with their experience. Contractor shall serve as a liaison between the MTF and local host nation hospitals as designated by the Chief of Medical Staff (SGH). The contractor will also act as a medical liaison between the local Turkish Host Nation providers and the 39 MDG.

1.10.3. COMMUNICATION. The Contractor shall ensure contract providers maintain open and professional communication with members of the MTF. Complaints validated by the QAP and Chief of the Medical Staff, shall be reported in writing, in turn to the Contracting Officer/Administrator and the Contractor for action. Failure by the Contractor to correct validated complaints that are raised by the MTF staff and the CO will be considered as failure to perform.

1.10.4. MEDICAL MALPRACTICE LIABILITY INSURANCE. This contract is a non-personal services contract and the Contractor shall provide and maintain adequate medical malpractice liability insurance in accordance with the (FAR) 52.237-7. The Contractor is required to turn in copies of all supporting documents prior to contract performance.

1.10.5. CLINIC SUPPORT AND OUTPATIENT SURGERY. The contract provider shall provide outpatient services for patients as scheduled by the Government. This shall include but not be limited to examinations, diagnosis and treatment by surgical and other means, injuries and disorders consistent with injuries and disorders in the field of orthopedic surgery. This shall include initial visits as well as follow up visits.

1.10.5.1. The Contractor shall provide outpatient clinic visits at a minimum average of (2) patients each duty hour. This shall include initial visits as well as follow up visits.

1.10.5.2. The Contractor may work up to one hour past the end of the Contractor’s scheduled duty day at no additional cost to the government to ensure provision of minimum services.

1.10.5.3. Patient scheduling will be at the determination of the MTF.

1.10.5.4. The contract provider shall maintain proficiency in all types of major and minor surgeries to include multiple traumas. The contract provider will maintain a log of surgeries done outside the MTF as proof of surgical proficiency. The log will be provided to the QAP on a quarterly basis within the first week of the following quarter.

1.10.6. TYPES OF MAJOR AND MINOR SURGERY. Major and minor outpatient procedures shall be performed during regular clinical services and consultation when possible.

1.10.6.1. Examples of Minor Surgery include:

Carpel tunnel repair Bunionectomy

Knee Arthroscopy

1.10.6.2. Examples of Major Surgery include:

Anterior crucriate ligament repair Bankhart procedure

1.10.7. DOCUMENTATION. Contract personnel shall prepare all documentation to meet established standards of the MTF and AFI 41-210 to include but not limited to: timeliness, legibility, accuracy, content and signature. Note: only Air Force approved abbreviations can be used to document patient care in the health care record. MTF staff practitioners will note defects, omission, agenda, etc in medical documentation. If errors or discrepancies exist, a request will be made to have contract personnel make required corrections.

1.10.7.1. Indicate responsibility for the content and correctness of all prepared and transcribed reports by affixing the contractor’s own signature to the documents and validating their contents.

1.10.7.2. Prepare appropriate narrative summaries; document recommendations for medical boards, profile changes and job retraining recommendations.

1.10.7.3. Write patient progress notes at appropriate intervals as determined by the clinic executive committee. Ensure postoperative notes and discharge summaries are prepared and signed within the MTF’s required time frame.

1.10.7.4. Provide and document appropriate history, physical examination, required laboratory and x-ray examination, provisional diagnosis and pre-operative diagnosis as required.

Contractor shall complete these procedures prior to the performance of any treatment.

1.10.7.5. The contractor shall ensure complete patient identifying information is on all documentation that is Chronological Record of Medical Care; SF 513, Medical Record – Consultation Sheet and AF Form 781, Multiple Item Prescription shall be stamped with a rubber stamp provided by the contractor which includes the following information: Contractor name, Turkish Citizenship (T.C.) number, professional degree (M.D., D.O.) and facility.

1.10.7.6. Documentation of patient visits shall be done in the Composite Health Care System (CHCS) and/or Armed Forces Health Longitudinal Technology Application (AHLTA) or as required by the Executive Committee of the Medical Staff.

1.10.7.7. All contract providers will be trained on and required to use CHCS and/or AHLTA.

1.10.8. MEDICAL CODING OF PROCEDURES/OFFICE VISITS. All contractors will be required to accurately and timely code all medical encounters in the Ambulatory Data Module (ADM) of CHCS or AHLTA. Coding encounters must meet the documentation in the medical records for procedures and services performed. Coding of all encounters must be completed within 24 hours of medical encounter.

1.10.9. REFERRALS AND CONSULTS. The contractor shall follow DOD, Air Force and MTF regulations and policies when arranging for a referral or consult. The contractor shall inform patients of the required referral or consult by indicating the specialty involved. The contractor shall not recommend to the patient that he/she should consult a specific practitioner or use a specific practice in the local civilian community. The contractor may not refer patients for consult to him/herself outside of this MTF without prior approval from the Chief, Medical Staff. Contractor will not be reimbursed for any eligible beneficiaries seen for medical care outside of the MTF, other than stated under the provision of this PWS. TRICARE/ISOS reimbursement will not be pursued or granted under this contract. All Orthopedic services for eligible beneficiaries are all inclusive of this contract for payment. There will be no other forms of compensation for services rendered except what is identified herein.

1.10.10. PRESCRIPTIONS. The contractor shall use and be guided by the MTF formulary and enter all prescriptions into CHCS and/or ALHTA. The Pharmacy and Therapeutics Committee must approve drugs not listed on the formulary.

1.10.11. ATTENDANCE AT MEETINGS. The contractor shall attend and participate in meetings, professional staff conferences and other appropriate professional activities within the MTF as directed by the Chief of Medical Staff.

1.10.12. GOVERNMENT COMPUTER ACCESS. The Contractor will ensure that all contract employees comply with the requirement to obtain the minimum personnel security investigations as prescribed by DoD 5200.2-R and AFI 31-501. The Contractor will work with the MTF to ensure that the pre-employment screening process for each employee classified as ADP I, II, III (as defined in DoD 5200.2-R) includes the appropriate investigations and that all contract employees have the appropriate questionnaires and forms to be completed. All completed forms will be reviewed by the Contractor and forwarded to the MTF for processing.

The Contractor understands that, while the MTF Commander may allow Contractor personnel to temporarily occupy non-critical sensitive positions pending National Agency Check (NAC), employees will be immediately removed from the position if at any time the NAC received unfavorable adjudication or if other unfavorable information that would affect the NAC becomes known.

1.10.13. RECORDS. The Contractor shall be responsible for creating, maintaining and disposing of only those government required records which are specifically cited in the PWS or as may be required by the provisions of a mandatory directive listed in Section C-4 of this PWS.

If requested by the Government, the Contractor shall provide the original record or a reproducible copy of any such records within five working days of receipt of the request.

1.10.14. PATIENT LISTS. Patient lists, no matter how developed shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF without prior written permission by the Chief of Hospital Services.

1.10.15. PATIENT SENSITIVITY. Contractor shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships and human relationships and IAW MDG patient rights and responsibilities and MDG policies. The QAP will validate any complaints against the contractor and will forward the complaint to the contracting officer for corrective action.

1.10.16. HEALTH INSURANCE PORTABILITY ACCOUNTABILITY ACT (HIPAA).

Contractor shall be briefed and trained on HIPAA and the requirements for protecting patient information and confidentiality, along with release of information. The Contractor will assist the MTF in ensuring all network providers or local providers comply with HIPAA to the maximum extent practicable. The Contractor will assist with ensuring all local providers have on file a signed acknowledgement of all HIPAA requirements. The Contractor will assist in resolving disputes in the healthcare arena for the MTF.

1.10.17. RELEASE OF MEDICAL INFORMATION. The contractor shall only release medical information obtained during the course of this contract to other MTF staff and host nation providers involved in the care and treatment of that individual patient and in accordance with HIPAA.

1.10.18. EMERGENCY RESPONSE. The contract provider will be required to respond to patient codes occurring in the MTF while the provider is physically present.

1.10.19. PERSONAL RELIABILITY PROGRAM (PRP). The contract provider shall be responsible for knowing and adhering to the regulations and guidelines under the PRP as outlined in AFI 36-2104. The Contractor shall adhere to the policy and procedures attached to the PRP notification.

1.10.20. ACCREDITATION ASSOCIATION FOR AMBULATORY HEALTH CARE

(AAAHC) and HEALTH SERVICES INSPECTION (HSI), AIR FORCE INSPECTION AGENCY (AFIA) and corresponding AIR FORCE INSTRUCTIONS (AFI) and MEDICAL GROUP INSTRUCTIONS (MDGI). Contractor shall meet all applicable AAAHC and HSI standards during the performance of this contract.

SECTION C-2

SERVICE DELIVERY SUMMARY

2. GENERAL INFORMATION.

2.1. QUALITY CONTROL. Contractor shall develop and maintain a quality program to ensure services are performed in accordance with commonly accepted commercial practices.

Develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. As a minimum, the contractor shall develop quality control procedures that address the areas identified in Section 2.2.1., Service Delivery Summary. The government evaluator must have a specific quality control inspector to notify in case of customer complaints.

2.2 QUALITY ASSURANCE. The government will periodically evaluate the contractor’s performance by appointing a representative(s) to monitor performance and patient satisfaction surveys to ensure services are received. The government will also receive and investigate complaints from various customers located on the installation. The government will give the contractor a written copy of the complaint and the contractor shall sign for the copy. The contractor shall reply in writing to the government on the complaint within 10 calendar days from the date of receipt of the complaint from the government. The government representative will evaluate the contractor’s performance through intermittent on-site surveys with customers and receipt of complaints from customers. The government may inspect each task as completed or increase the number of quality assurance inspections if deemed appropriate because of repeated failures discovered during quality assurance inspections or because of repeated customer complaints. Likewise, the government may decrease the number of quality assurance inspections if performance dictates. The contractor shall be responsible for initially validating customer complaints. However, the government representative shall make a final determination of the validity of customer complaint(s) in cases of disagreement with customer(s).

2.2.1. SERVICE DELIVERY SUMMARY.

Performance Objective PWS Reference Performance Measure Performance

Threshold Attendance at Meetings 1.10.11. Contract personnel attend and participate in meetings, professional staff conferences, and other appropriate professional activities as directed (monthly)

95%

PRP 1.10.19 Makes notifications of PRP status changes as required.

100%

On-all/After Duty Response Time

1.2.2.1. Within 60 minutes of notification

for routine on-call consultation and 30 minutes for emergency requirement

100%

Referrals and Consults 1.10.9. Contract personnel shall follow DoD, Air Force and MTF regulations and policies when arranging for a referral or consult

100%

Documentation Accuracy/Timeliness

1.10.7. Contract personnel shall follow

DoD, Air Force and MTF regulations and policies

100%

Medical Coding of Procedures/Office Visits

1.10.8. Contract personnel must accurately

and timely code medical encounters

100%

Patient Sensitivity 1.10.15. Contract personnel shall respect the basic rights of patients, demonstrating concern for personal dignity

100%

SECTION C-3

GOVERNMENT FURNISHED PROPERTY AND SERVICES.

3. GENERAL. The Government will provide the following equipment, supplies, and services listed below:

3.1. EQUIPMENT. Contract personnel shall have joint use of all available equipment for performing services required by this contract only, including a computer for use while in the

MTF.

3.2. FORMS. The MTF will provide required Government forms used in the performance of services.

3.3. PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish contract personnel 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.

3.4. SUPPLIES. The MTF will provide medical and non-medical supplies commonly used in the facility for the care and management of patients. This does not include any type of uniform or laboratory coat except “scrubs” for use in those parts of the MTF where they are commonly worn by Government personnel.

3.5. SERVICES.

3.5.1. ADMINISTRATIVE SUPPORT. Contractor will be authorized to use selected administrative support available to Government employees. This will include but not be limited to copy machines, telephone-fax machines, installation distribution, Government E-Mail account, Class A telephone lines and Defense Switching Network (DSN) lines.

3.5.2. CENTRAL STERILE SUPPLY. The MTF will provide Central Sterile Supply services to personnel. Sterile equipment trays, instrument packs, and supplies will be provided by this service. After use, personnel shall follow local policies and procedures to have the Government clean and re-sterilize the supplies. This service will be available to contractor personnel on an equal basis with those of other hospital personnel/services.

3.5.3. GOVERNMENT ORIENTATION/TRAINING. The government will provide training on Government provided forms and equipment, initial orientation and continuing orientation.

3.5.4. HOUSEKEEPING. Routine housekeeping will be provided by the Government as a part of the MTF housekeeping contract.

3.5.5. PATIENT SCHEDULING. MTF personnel shall arrange patient scheduling. Complete administrative control of the patient shall remain with the Government.

3.5.6. RECORDS, FILES, DOCUMENTS, AND WORK PAPERS. All records, files, document, and work papers provided by the Government remain Government property (per current HIPAA guidelines). The QAP will provide guidance for contractors who shall maintain and dispose of these records, files, documents and work papers.

3.5.7. TRANSCRIPTION SERVICES. The MTF may provide transcription services. Legible handwritten documentation of medical records is acceptable in place of recorded dictation. In the event that MTF transcription services cannot adequately perform, the Contractor may hire outside transcription service as part of the contract upon approval from the Chief of Medical Services. If approved, reimbursement for transcription services will be at cost.

SECTION C-4

GENERAL INFORMATION

4. GENERAL DEFINITIONS. As used throughout this PWS, the following terms shall have the meaning set forth below:

4.1. CLINICAL PRIVILEGES. Those inpatient and ambulatory clinical activities permitted the provider in the granting MTF after evaluation by the credentials function and approved by the MTF Commander.

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

4.3. CREDENTIALS. Documents providing, evidence of education, training, licensure, experience, board certification and expertise of a health care provider.

4.4. CREDENTIALS COMMITTEE. The professional body set up to review credentials, make recommendation on clinical privileges for providers, and to promote quality control practice.

4.5. CRISIS SITUATION. Any emergency so declared by the National Command Authority (NCA), or the overseas Combatant Commander, whether or not U.S. Armed Forces are involved, minimally encompassing civil unrest or insurrection, civil war, civil disorders, terrorism, hostilities buildup, wartime conditions, disasters or international conflict presenting a serious threat to DoD interests.

4.6. EXPOSURE-PRONE PROCEDURE. Examples of certain invasive surgical and dental procedures that have been implicated in the transmission of the hepatitis B virus from an infected health care worker to a patient include certain oral, cardiothoracic colorectal and obstetric/gynecological procedures. Characteristics of exposure-prone procedures include the following: Surgical procedures or object in a poorly visualized or highly confined anatomic site.

4.7. GOVERNMENT. The federal government of the Unites States of America.

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

4.9. HEALTH CARE PROVIDER. Any care professional whom, under regulations of a Military Department is granted clinical practice privileges in a military MTF or Dental Treatment Facility or who is licensed or certified to perform health care services by a Government board or Agency or professional health care society or organization.

4.10. INVASIVE MEDICAL PROCEDURE. Is any procedure that involves a puncture or incision of the skin, the insertion of an instrument or foreign material into the body, or breaking the mucosa lining of the body.

4.11. MEDICAL TREATMENT FACILITY (MTF). Air Force hospitals or clinics, including all activities providing outpatient and inpatient health care services for authorized personnel.

4.12. ON CALL. Contractor shall be available for emergency consultations via telephone or cellular telephone.

4.13. PERFORMANCE WORK STATEMENT (PWS), A document that accurately describes a service in the terms of the output requirements and the required quality level or a standard of acceptable performance of those outputs.

4.14. PRACTITIONER, An individual providing direct patient care other than contract personnel.

4.15.…