PWS_Gen_Surg_Ver__5.pdf

PERFORMANCE WORK STATEMENT

FOR

General Surgeon Services

(NON-PERSONAL SERVICE)

21 March 2014

39th Medical Support Squadron

SECTION 1

DESCRIPTION OF SERVICES

1. DESCRIPTION OF SERVICES. The Government requires Full Time Equivalent (FTE) for this Performance Work Statement (PWS). The contract shall be performed at the 39th Medical Group (39 MDG), also referred to as the "medical treatment facility" (MTF). The contracted General Surgeon provided under this contract is a non personal service as described in Federal Acquisition Regulation 37.

The contracted General Surgeon shall provide all services and labor required in accomplishing the performance of General Surgeon duties as specified, in strict accordance with all terms, conditions, general and special provisions, specifications, attachments, etc., contained herein or incorporated by reference. Performance shall be according to the requirements contained in this Performance Work Statement (PWS) and professional standards of the The Joint Commission (TJC), Health Services Inspection (HSI) and the Accreditation Association for Ambulatory Health Care (AAAHC). The contracted General Surgeon shall perform services in accordance with the ethical, professional, and technical standards of the Air Force Medical Service as outlined in DoD Instruction 1332.38

1.2. GENERAL DEFINITIONS.

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

1.2.1. ACCREDITATION ASSOCIATION for AMBULATORY HEALTH CARE (AAAHC).

Civilian accreditation program for ambulatory healthcare organizations.

1.2.2. 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.

1.2.3. COMPOSITE HEALTH CARE SYSTEM (CHCS), ARMED FORCES HEALTH

LONGITUDINAL TECHNOLOGY APPLICATION (AHLTA). Computer system, which stores clinical and administrative data. This system provides on-line communication for users in any supported location.

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

1.2.5. CONTRACTING OFFICER REPRESENTATIVE (COR). An individual, including a contracting officer’s technical representative (COTR), designated and authorized in writing by the contracting officer to perform specific technical or administrative functions.

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

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

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

1.2.9. 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.

1.2.10. FAC or FUNCTIONAL AREA CHIEF. A generic term used interchangeably to refer to the Functional Commander, the Chief of Medical Staff, designated Quality Assurance personnel or technical representatives on the Contracting Officer

1.2.11. FREEDOM of INFORMATION ACT (FOIA) REQUEST. A written request for DoD records made by any person, including a member of the public, an organization, or a business that either explicitly or implicitly involves the FOIA, DoD Directive 5400.7.

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

1.2.13. FUNCTIONAL COMMANDER. The MTF Commander will appoint the Medical Logistics Flight Commander who will be the liaison between the COR and the CO.

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

1.2.15. 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.

1.2.16. HEALTH SERVICES INSPECTION (HSI). Air Force-specific health care inspection.

1.2.17. 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.

1.2.18. THE JOINT COMMISSION. An independent, not-for-profit group in the United States that administers accreditation programs for hospitals and other healthcare organizations.

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

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

1.2.21. 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.

1.2.22. PERSONNEL RELIABILITY PROGRAM. (PRP). Program that maintains reliable individuals to perform duties associated with nuclear weapons.

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

1.2.24. PREPRIVILEGING. The application of screening process whereby prospective DoD health care providers, required to be privileged to provide patient care within MTFs, have their education, retraining, and past performance evaluated preliminary to their being considered for a contractual relationship.

1.2.25. PRIVACY ACT REQUEST. A written request from the subject of the records or a request with the subject’s written consent.

1.2.26. PRIVILEGING, frequently referred to as credentialing. The process whereby the MTC Commander or the Major Command Surgeon General, upon recommendations from the MTF credentials function, grants to individual health care providers the privileges and responsibility of providing specific medical and dental care within the MTF.

1.2.27. TECHNICAL DEFINITIONS. Include definitions peculiar to the particular PWS.

1.2.28. VALID LICENSE. A grant of permission by an official agency of the Republic of Turkey to provide care independently as a health care professional. Licenses must be current.

1.3. GENERAL and SPECIFIC TASKS

1.3.1. GENERAL. The Contractor shall perform the professional general 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 general surgery healthcare as determined by the same authority that governs military medical professionals in general surgery and will be audited by the QA/RM Committer, 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.

1.3.2 SPECIFIC PROCEDURES FOR WHICH THE CONTRACTOR SHALL BE

RESPONSIBLE.

1.3.3. TYPE of WORK. The duties will be performed in accordance with established procedures and protocols, within the scope of practice. Duties include but are not limited to the following:

1.3.4. 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.

1.3.5. DUTY ASSIGNMENT. Contract personnel shall be primarily required to perform general surgery services. The contractor may be required to perform general surgeon 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.

1.3.6. COMMUNICATION. The Contractor shall ensure contract providers maintain open and professional communication with members of the MTF. Complaints validated by the COR 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.

1.3.7. 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. The minimum amount of this insurance shall be not less than $500,000.00 U.S dollars.

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

1.3.8.1. The contract provider shall provide outpatient clinic visits at a minimum average of four patients each duty hour. This shall include initial visits as well as follow up visits.

1.3.8.2. The contract provider may work up to one hour past the end of the scheduled duty day, at no additional cost to the Government, to ensure provision of minimum services.

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

1.3.8.4. 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 COR on a quarterly basis within the first week of the following quarter.

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

1.3.9.1. Examples of Minor Surgery include:

Breast Biopsy

Colonoscopy

Hernia

Upper Gastrointestinal Endoscopy

Lipoma Removal

Scar Revision

Hemorrhoidectomy

Would Exploration

1.3.9.2. Examples of Major Surgery include:

Gallbladder Appendectomy

Wound Exploration

* May be required to render assistance for Obstetrics/Gynecology Surgery, Orthopedic Surgery and ENT surgery during emergent situations to include Cesarean Sections.

1.3.10. 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 MTF and 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.

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

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

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

1.3.10.4. Provide and document appropriate history, physical examination, required laboratory and x-ray examination, provisional diagnosis and preoperative diagnosis, as required. Contract personnel shall complete these procedures prior to the performance of any treatment.

1.3.10.5. 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.

1.3.10.6. 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.

1.3.10.7. All contract providers will be trained on and required to use Composite Health Care System (CHCS) and/or AHLTA.

1.3.11. MEDICAL CODING OF PROCEDURES/OFFICE VISITS. All contract personnel 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.

1.3.12. 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 General Surgeon 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.

1.3.13. PRESCRIPTONS. The contract provider 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

1.3.14. TOTAL QUALITY IMPROVEMENT. The contract provider shall assess general surgery care to assure its quality. The contract provider shall also respect and maintain the basic rights of patients to include, but not limited to, personal dignity.

1.3.15. ATTENDANCE AT MEETINGS. The contract provider 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.

1.3.16. 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.

1.3.17. 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.

1.3.18. 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. Personnel receiving complaints validated by COR and Contracting Officer for corrective actions.

1.3.19. 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.

1.3.20. 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.

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

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

1.3.23. 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.

1.3.24. OPSEC TRAINING. According to AFI 10-701: 5.2.4. : OPSEC PMs/SMO/SMNCOs/Coordinators will provide OPSEC training or training materials to contract employees within 90 days of employees’ initial assignment to the contract. Any contractor attached to the 39 MDG must complete OPSEC training (ADLS).

1.4. PERSONNEL REQUIREMENTS.

1.4.1. LANGUAGE REQUIREMENT. The contracted General Surgeon must be able to read, write, speak and understand English and Turkish. Languages shall be spoken with sufficient proficiency and accuracy and vocabulary to participate effectively in most formal and informal conversations on practical and professional topics to include medical specific terminology without the assistance of an interpreter.

1.4.2. CRIMINAL BACKGROUND CHECK REQUIREMENT. Provider checks will be conducted by the Government 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 Bitsigi Adana

1.4.2.1 Concurrent with the consent of the Contracting Officer and the Chief of Medical Services, contract personnel may provide contract services prior to completion of background checks. However, at all times while children are in the care of that individual, the contract provider shall be witting sight and continuous supervision of a staff person whose background check has been completed, a chaperone, or parent/guardian.

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

1.4.2.3. Contractors who have previously received a background check shall provide to the Contracting Office or COR 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.

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

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

1.4.3.1. 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 COR.

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

1.4.3.3. Facial hair including beards, mustaches, and sideburns shall be controlled (restrained) 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.

The Government will provide this hood.

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

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

1.4.5. CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government as 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.

1.5 PRIVILEGING REQUIREMENTS. (ALL SUBMISSIONS MUST BE TRANSLATED INTO

ENGLISH)

1.5.1. 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 General Surgeon 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.

1.5.1.1 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 COR.

Additionally, the Contractor shall make all proposed healthcare providers available for interview by the MTF during the credentialing process.

a. Copy of any applicable medical licenses and board certifications.

b. Provider education and training.

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

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

e. A signed consent for release of information.

f. 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.

g. A list of all places in which contract provider current holds or has held a license to practice related services

h. 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.

i. Peer reviews will be conducted by the employee by contacting another military surgeon (i.e. ENT surgeon at Lakenheath AB, England) on a monthly basis, assistance will be provided by the COR.

1.5.1.2 Professional staff appointments and clinical privilege actions will be based on review of documents listed in paragraph 1.3.2., in accordance with AFI 44-119. Reappointment shall occur not less than every two years, in accordance with AFI 44-119.

1.5.1.3. Applications for clinical privileges for replacement contract providers shall be submitted to the MTF Credentials Committee through the COR where services are to be provided not later than 30 calendar days prior to the provider assuming duty. The credentials requirements delineated in AFI 44- 119.

1.5.1.4. 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.

1.5.1.5. 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.

1.5.1.6. 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.

1.5.1.7. 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.

1.5.1.8. 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.

1.5.2. DENIAL/TERMINATION OF PRIVILEGES.

1.5.2.1 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.

1.5.2.2. The COR should notify the Contractor Officer (CO) as soon as possible when the necessity to exercise such authority becomes apparent. The COR 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.

1.6 EDUCATION AND TRAINING REQUIREMENTS.

1.6.1. FORMAL EDUCATION. The contract providers must have graduated from an approved school of medicine or completed a residency or fellowship acceptable to the U.S. Air Force Surgeon General and Turkish Doctor’s Chambers, Division of General Surgery. The Contractor is required to turn in copies of all supporting documents prior to contract performance to the COR.

1.6.2. LICENSE/REGISTRATION. The contract provider shall possess a valid, unrestricted license to practice General Surgery in the Republic of Turkey. The Contractor is required to turn in copies of all supporting documents prior to contract performance to the COR.

1.6.3. BOARD CERTIFICATION. The contract provider shall be board certified by the Turkish Doctor’s Chambers, Division of General Surgery. Membership in United States, International, or National Professional Organization commensurate with medical specialty, is required. The Contractor is required to turn in copies of all supporting documents prior to contract performance to the COR.

1.6.4. EXPERIENCE. The contract providers shall be actively practicing General Surgery and will have a minimum of five years’ experience in their respective field. The Contractor is required to turn in copies of all supporting documents prior to contract performance to the COR.

1.6.5. 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). In the event contractor does not currently hold required certifications, they shall complete required coursework successfully. Courses will be offered by the 39 MDG. Although BLS, ACLS, and PALS training will be at no charge to the contractor, they will not constitute compensation time. The contractor is required to turn in copies all supporting documents prior to contract performance to the

COR. Membership in United States Professional Organization commensurate with medical specialty is highly encouraged.

1.7. GOVERNMENT ORIENTATION/TRAINING.

1.7.1. 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.

1.7.1.1. 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 stat date. Medical Center orientation must occur within 30 days of employment start date.

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

1.7.3. 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 COR 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

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

1.7.5. PATIENT SENSITIVITY TRAINING. Contractor receiving more than two (2) valid complaints (as determined by the COR 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

1.7.6. ADDITIONAL TRAINING REQUIREMENTS. Contractor will be required to attend additional training no listed in this PWS on an as required basis, at the Government’s expense.

1.7.6.1 The contracted General Surgeon shall be current with and have completed all continuing education requirements, certifications in required training specified by their professional licensure or certification. These requirements must be maintained throughout course of contract,

1.7.7. CREDENTIALING. The contracted General Surgeon shall be subject to the credential verification requirements of AFI 44-119, Clinical Performance Improvement, to include adverse actions.

1.7.7.1. CREDENTIALING REQUIREMENTS.

a. Copy of valid, current unrestricted license.

b. Documentation of continuing education and training.

c. Current Basic Life Support (BLS), certification.

d. A signed consent of release of information.

e. A copy of the proposed contract General Surgeon professional resume, accompanied by that individual’s sworn affidavit of the truthfulness of same, indication experience, training, and technical expertise in the type of care to be rendered.

1.8 DENIAL/TERMINATION OF ACCESS.

1.8.1. In the event of an adverse action, the Contracting Officer (CO) and the Contractor, shall be notified by the Functional Commander (FC) in coordination with the COR as soon as possible when the necessity to exercise such authority becomes apparent. The FC will also provide the CO and the Contractor with a written statement, provided by the COR, advising the Contractor of an adverse action involving the contracted General Surgeon, a brief statement of the basis for the action to provide the Contractor sufficient information in order to make employment/substitution decisions as necessary, and if required, the final outcome of the adverse action process. The written notice(s) will be marked by the government as covered by 10 USC.

1.8.2. The right/opportunity to dispense medications and/or clinical privileges may be limited, suspended, or revoked in the event of substandard performance. Actions to limit, suspend, or revoke clinical privileges/dispensing rights shall be in accordance with the procedures outlined in AFI 44-119, Medical Quality Operations and MDGI 44-126, Medical Staff Bylaws.

SECTION 2

SERVICE SUMMARY, GENERAL SURGEON

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.

SDS Performance Objective

PWS

Para.

Performance Measure Surveillance Method

Frequency

1 Routine Availability Appendix B.2.

Contract personnel available for duty , Ensure maximum compliance with contract hours for clinic and surgery cases performed monthly

98% Inspection Monthly

2 Replacement Staff Contingency Plan

Appendix B.8.

Locum tenums are pre-credentialed with MTF (annual)

Annual inspection

Annual

3 Board Certification 1.2.6 and 1.5.1.1.

Contract provider shall be board eligible or board certified (annual)

Annual inspection

Annual

4 Provider Licensure 1.6.2 and 1.2.28.

Contract provider shall possess valid, unrestricted license

Annual inspection

Annual

5 Completes CHCS, AAAHC, or job specific data training as required by the 39 MDG, as necessary.

4.1.2.1. Mandatory to initial or

maintaining job performance

Periodic inspection

Monthly

6 Annual Medical Evaluation

4.1.7. Contractor provides

certificates of annual medical evaluation for contract staff to the COR

Annual inspection

Annual

7 Continuing Medical Education

1.7.3. CME shall be obtained at no

additional cost to the Government and shall be reported to the COR and MTF Credentials Committee every six months and upon re-privileging

Bi-annual inspection

Bi-annual

8 Attendance at Meetings

1.3.15. Contract personnel attend

and participate in meetings, professional staff conferences, and other appropriate professional

95% Monthly inspection

Monthly activities as directed 9 HIPAA Training 4.5.5. Contractor employees complete all required HIPAA training

Annual inspection

Annual

10 On-Call/After Duty Response Time

Appendix B.3

Within 60 minutes of notification for routine on-call consultation and 30 minutes for emergency requirement

100% inspection

Monthly

11 Documentation Accuracy/Timeliness

1.3.10. Contract personnel shall

follow DoD, Air Force and MTF regulations and policies when documenting pharmacy interventions when required

98% inspection Monthly

12 Patient Sensitivity 4.5.3. Contract personnel shall respect the basic rights of patients, demonstrating concern for personal dignity

95% inspection Monthly

13 Complies with AFI 44-102, Chapter 10 and safety policies

4.1.2.1. Contract personnel will

comply with written AFI and safety policies

100% inspection

Monthly

14 Referrals and Consults

1.3.12. Contract personnel shall

follow DoD, Air Force and MTF regulations and policies when arranging for a referral or consult

100% Inspection

Monthly

15 Medical Coding of Procedures/Office Visits

1.3.11. Contract personnel must

accurately and timely code medical encounters

100% inspection

Monthly

16 Adheres to vacation and sick leave policies IAW PWS

Appendix B.6.

Contract personnel will have no more than 2 unplanned absences per quarter.

Planned leave and work coverage will be coordinated with the COR in advance.

100% Inspection

Quarterly

17 Maintains professional manner and displays positive/cooperative attitude

1.4.3.1. Contract personnel will have

no more than 2 valid complaints per quarter

100% Inspection

Monthly

18 Personal Appearance 1.4.3. Contract personnel will not have any more than 3 valid complaints per quarter

100% Inspection

Quarterly

19 Maintains patient privacy/ HIPAA compliance

4.5.5 Contract personnel will have

zero breaches of privacy

100% Inspection

Monthly

2.2. CONTRACT COMPLIANCE. If the contractor fails to maintain compliance within the Performance Measure, a Contract Performance Assessment Report will be sent to him/her annotating the discrepancy. If Performance Measures are not met each month, this may lead to a disciplinary proceeding.

SECTION 3

ACCESS TO GOVERNMENT PROPERTY AND SERVICES

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

3.1. IDENTIFICATION CREDENTIALS. The MTF will provide all required identification media.

3.2. 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.

3.3. 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 PE. This does not include any type of uniform or laboratory coat.

3.4. FORMS. The MTF will provide required government forms used in the performance of services.

3.5. 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, with the exception of “scrubs” for use in those parts of the MTF where they are commonly worn by government personnel.

3.6. COMPUTER EQUIPMENT. The MTF will provide access to computer equipment required to schedule, document, and maintain appropriate electronic medical information that support the hard copy medical record. The MTF will provide required training for these systems. The health care workers will be required to use the computer systems that are standard for the support of health care delivery at the

MTF.

3.5. UTILITIES. For the purpose of this contract, the government will furnish all required utilities (such as water, local telephone, electricity, etc.) at no cost to the contracted General Surgeon. The contracted General Surgeon shall participate in government energy conservation programs.

3.6. EMERGENCY HEALTH CARE. The MTF will provide emergency health care for the contracted General Surgeon for injuries incurred while on duty in the MTF. These services will be billed to the contracted General Surgeon at the current full reimbursement rate.

3.7. 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, with the exception of “scrubs” for use in those parts of the MTF where they are commonly worn by government personnel.

3.8. SERVICES.

3.8.1. 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. The same restrictions apply to use these items for Government official business only applies.

3.8.2. 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.

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

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

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

3.8.6. 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 COR will provide guidance for contractors who shall maintain and dispose of these records, files, documents and work papers.

3.8.7. 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.

3.9. CONTRACTOR FURNISHED ITEMS AND SERVICES

3.9.1 GENERAL. Except for those items or services specifically stated in Section 3 par 3.1 thru 3.8.7.

the Contractor shall furnish everything required to perform this contract in accordance with all of its terms.

3.9.2. SPECIFIC. Contractor shall furnish a cell phone number, which must be available 24 hours a day, 7 days a week. Cell Phone service must be for the entire Republic of Turkey. This is to ensure 24-hour support.

3.9.3. 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 Contracting Officer (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 10 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”.

SECTION 4

GENERAL INFORMATION

4.1. HEALTH REQUIREMENTS

4.1.1. PROPOSAL REQUIREMENT. With their proposal, the contracted General Surgeon shall provide proof of immunization from the following diseases according to CDC guidelines:

Hepatitis B, measles, mumps, rubella, vermicelli, and influenza. The contracted General Surgeon shall also provide proof of a negative TB skin test within 12 months (if positive, proof of negative chest X-ray within 12 months) to be considered for award.

4.1.2. 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 which might reasonably be expected to place other workers, patients, or the public 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.

4.1.2.1. 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.

4.1.3. IMMUNIZATION. In accordance with AFI 48-105, the contracted General Surgeon 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.

4.1.3.1. The contracted General Surgeon providing services under this contract shall receive a pre-employment…