Otorhinolarynologist_Services_PWS_(7_Oct_2016).pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR

NON-PERSONAL SERVICES FOR OTORHINOLARYNGOLOGIST SERVICES

(EAR, NOSE AND THROAT – ENT)

AT THE

MILITARY TREATMENT FACILITY

39th MEDICAL GROUP (39 MDG)

DATE: 07 October 2016

TABLE OF CONTENTS

SECTION TITLE

C-1 GENERAL INFORMATION

C-2 DEFINITIONS AND ACRONYMS

C-3 GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

C-4 CONTRACTOR FURNISHED ITEMS AND SERVICES

C-5 SPECIFIC TASKS

C-6 APPLICABLE PUBLICATIONS

TECHNICAL EXHIBITS:

1. PERFORMANCE REQUIREMENTS SUMMARY

2. ESTIMATED WORKLOAD DATA

SECTION C-1

GENERAL INFORMATION

1.1. SCOPE OF WORK. The Contractor shall provide inpatient and outpatient otorhinolaryngologist services 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 otorhinolaryngologist needs of the MTF. The Contractor shall furnish all labor, management, supervision, consultations and reports to perform the requirements of this performance work statement (PWS). Contractor care shall be as comprehensive as available at government-supplied facilities, equipment, and support services permit.

1.2. CONTRACT EMPLOYEES.

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 Contracting Officer’s Representative (COR) before the contract start date.

1.2.2. ROUTINE AVAILABILITY. The Contractor shall perform inpatient, outpatient, emergency and clinical otorhinolaryngology services in the MTF and designated local civilian hospitals, which have active Preferred Provider Agreements with the 39 MDG, and with which the MTF or TRICARE/ International SOS (ISOS), has a Memorandum of Understanding (MOU). Contract employees may not see patients at a private office, unless that care is coordinated with the 39 MDG staff. Major and minor inpatient and outpatient procedures shall be performed during regular clinical services and consultations. Regular clinical services and consultation shall be coordinated with the 39 MDG staff for maximum support of needed otorhinolaryngology services. The Contractor shall be available by telephone. The Contractor must be available on call 24-hour basis, 7 days a week. Emergency consultations shall be performed as needed. Authorized callers are all 39 MDG medical providers assigned to the MTF.

1.2.2.1. ON-CALL RESPONSE TIME REQUIREMENTS. The Contractor shall provide on-call telephone standby on a 24-hour basis, 7 days a week. As required and directed by the MTF, the Contractor shall be required to provide otorhinolaryngologist 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 maintain an Incirlik Air Base pass for their privately owned vehicle. The Contractor may be called in to perform procedures on or off base. The Contractor shall provide otorhinolaryngologist services on-site or at the local civilian hospital as directed by MTF within 60 minutes of notification by a 39th Medical Group’s medical provider of a routine on-call consultation requirement and within 30 minutes of an emergency. When it is agreed upon, 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 otorhinolaryngologist services to the 39 MDG, with which the MTF, or TRICARE / International SOS (ISOS), has a Memorandum of Understanding. In this situation, the contractor’s 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 otorhinolaryngologist services to the 39 MDG, with which the MTF, or TRICARE/ISOS, has a

Memorandum of Understanding. The Contractor will use call back hours if the MTF calls the contract employees back to the MTF for advice and/or consultation, and/or if the contract employees provides consultation in a local host nation hospital facility where no service/procedure can be billed to ISOS.

The Contractor will provide an up-to-date log of services rendered and time spent in the facilities to the COR. This will be submitted no later than (NLT) the 5th business day of the month.

1.2.2.2. HOURS OF OPERATION. The Contractor shall not schedule regular clinic services or otorhinolaryngology 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. During these days when the MTF is considered closed and the otorhinolaryngologist is not required to work.

If the regular clinic hours land on a holiday or scheduled day off, clinic hours for otorhinolaryngologist services shall be scheduled for another day. The change in schedule shall be coordinated with the COR. The Contractor shall account for these and any other non-working days to ensure that he is available for the time periods as delineated in PWS, paragraph 1.2.2. The Contractor will be expected to render care in the clinic and operating room for up to 40 hours per month, depending on population demand, to eligible beneficiaries inclusive in this contract. The Contractor and MTF section chief may agree to provide services on American and/or Turkish holidays within the 9 hours per week limit, when services are needed. Dual compensation in accordance with United States Code (USC) 55-36 shall not be reimbursed by US Government or TRICARE/ISOS to the Contractor as the otorhinolaryngologist surgeon is already considered a contract employee of the US government.

1.2.2.3. TIME OFF. The Contractor is required to give a minimum of 30 days written notification to the COR and 39th Medical Group 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 COR in writing. During a 365 fiscal year, the regular contract employee is authorized to take 14 days of nonpaid vacation.

1.2.2.4. 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 7:30 AM - 4:30 PM. Policy regarding daily lunch or other breaks will follow the Government’s standard procedures for Contract employees. The Contract employees should follow command announcement for reporting to work as it relates to inclement weather or base closures.

1.2.2.5. TRAVEL. Contract employees may be required to travel to various locations to participate in clinical case experience at government expense. All travel requirements should be coordinated at least 30 days prior to departure with the COR. 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). 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. Current per diem rates can be accessed via the following website:

http://perdiem.hqda.pentagon.mil/perdiem/pdrates.html . 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. Travel documentation requirements to include passport, visa, etc. will be obtained at the Contractor’s expense.

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

1.2.2.6. CRISIS SITUATION. Contract employees may be required to continue services during times deemed as Mission Essential Operating Conditions. “Mission-essential functions” means those organizational activities that must be performed under all circumstances to achieve DoD component missions or responsibilities, as determined by the appropriate functional commander or civilian equivalent. Failure to perform or sustain these functions would significantly affect DoD’s ability to provide vital services or exercise authority, direction, and control. As directed by the Contracting Officer, the Contractor shall participate in training events, exercises, and drills associated with Government efforts to test the effectiveness of continuity of operations procedures and practices. In the event the Contractor anticipates not being able to perform any of the essential contractor services, the Contractor shall notify the Contracting Officer or other designated representative as expeditiously as possible and use its best efforts to cooperate with the Government in the Government’s efforts to maintain the continuity of operations.

1.3. PERSONNEL REQUIREMENTS.

1.3.1. ENGLISH LANGUAGE REQUIREMENT. The contract employees shall be able to read, write, speak and understand English and Turkish. Language 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 checks will be conducted not less than every five years 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 Bitisigi Adana

1.3.2.1. AWAITING BACKGROUND CHECKS. Concurrent with the consent of the COR, contract employees 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 employees shall be within sight and in continuous supervision of a staff person, whose background check has been completed, a chaperone or parent/guardian.

1.3.2.2. RESPONSES TO BACKGROUND CHECKS. The Contractor 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.

1.3.2.3. BACKGROUND CHECK SUBMITTALS. The Contractor, who has previously received a background check, shall provide proof of the check or obtain a new one to the COR. 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.

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

1.3.3.1. CLOTHING. Contract employees’ 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, contract employees 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.

1.3.3.2. NAME TAG. All contract employees shall wear a nametag, designating them as a “Contractor” and not a MTF staff member.

1.3.3.3. FACIAL HAIR. 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 the contractor’s use shall be maintained in an orderly appearance. Contract employees shall ensure that these areas are tidy and any decorations present a professional and 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 that creates 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. (Note: All submissions must be translated into English.)

1.4.1. PRIVILEGING. The credentials of all contract employees 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 contract employees possesses the requisite credentials enabling the granting of privileges by the applicable MTF, sufficient to allow for performance of all tasks identified in PWS section C-5. The contract employees must be privileged to provide services in the MTF and all local host nation hospital facilities which provide otorhinolaryngologist services to the 39 MDG, with which the MTF, or TRICARE/ISOS, has a Memorandum of Understanding.

1.4.1.1. APPLICATIONS FOR PRIVILEGING. Initial applications for clinical privileges, to include credentials action history, malpractice history, and completed copies of the below listed documents 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 contract employees available for interviews conducted by the MTF during the credentialing process. The following must be provided at a minimum:

− 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.

− A signed consent for release of information.

− A copy of the proposed contract employee’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 care to be rendered.

− A list of all places in which contract employee currently holds or has held a license to practice medical services.

− A certification of a current physical examination for each contract employee. The certification shall contain a signed statement by the examining physician stating that the contract employee is free of any contagious diseases. The physical examination must be current and within the 12 months prior to the application for privileges.

1.4.1.2. PRIVILEGING TIME FRAMES. 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. The Contractor is required to begin full performance of the contract requirements to comply with the performance periods, specified in the contract award. It is absolutely critical that privileges be granted to a sufficient number of contract employees to meet the contract requirements by the commencement date.

1.4.1.3. PRIVILEGING SUBMITTALS FOR REPLACEMENTS. Applications for clinical privileges for replacement contract employees 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 contract employee assuming duty. The credentials requirements are delineated in AFI 44-119.

1.4.1.4. LOCAL HOSPITAL PRIVILEGES. The contract employees 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. 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. As soon as possible when the necessity to exercise such authority becomes apparent, the COR will provide documentation initiating the revocation process to the Contracting Officer. The Contracting Officer shall notify the Contractor accordingly.

1.5. EDUCATION AND TRAINING REQUIREMENTS.

1.5.1. LICENSE/REGISTRATION. The contract employees shall possess and maintain a valid unrestricted license to practice otorhinolaryngology 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.

1.5.2. BOARD CERTIFICATION. The contract employees shall be certified by the Turkish Ministry of Health as an Otorhinolaryngologist Surgeon who can solely run an otorhinolaryngologist clinic.

Membership in United States, International, or National Professional Organization commensurate with medical specialty, is also required. The Contractor is required to turn in copies of all supporting documents prior to contract performance to the COR.

1.5.3. OTHER CERTIFICATIONS. The contract employees must maintain current training in Basic Life

Support (BLS) and Advance Cardiac Life Support (ACLS). In the event that the contract employees do not currently hold required certifications, they shall complete the required coursework successfully in 30 days or less. Courses will be offered by the 39 MDG. Although BLS and ACLS 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.

1.6. GOVERNMENT ORIENTATION/TRAINING.

1.6.1. INITIAL ORIENTATION. The contract employees shall attend Government provided initial training for 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. MTF ORIENTATION. The contract employees shall 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 the contract start date.

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

1.6.3. CONTINUING MEDICAL EDUCATION (CME) REQUIREMENTS. The contract employees, 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 and ACLS are at no charge but do not constitute compensation time.

1.6.4. ANNUAL TRAINING REQUIREMENTS. The contract employees must complete annual training requirements in accordance with local MDG policies.

1.6.5. PATIENT SENSITIVITY TRAINING. Once the Contractor receives more than two (2) valid complaints (as determined by the COR and/or CO) within 1 month of service, the Contractor shall not be permitted to provide services until the contract employees successfully complete a Government approved patient sensitivity training class within a month of the 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. HEALTH REQUIREMENTS:

1.7.1. PREASSIGNMENT MEDICAL EVALUATION. No contract employee shall perform health care services under this contract unless a pre-assignment medical evaluation has been performed prior to submission of credentials. 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. At 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. No later than five days prior to the commencement of performance of health care services under this contract by any contract employee, the Contractor shall provide to the Public Health (Employee Health) Flight certification that such contract 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. MEDICAL REPORTING. 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 AAAHC, Occupational Health and Safety Administration (OSHA) and Centers for Disease Control (CDC) health records requirements.

1.7.1.2. PREGNANT CONTRACT EMPLOYEES. Contract employees should report their pregnancy to the Contractor. It is the responsibility of the Contractor to notify the COR of the pregnancy within 24 hours of receiving the information. 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 contract 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 a certificate, as described above, documenting the results of this evaluation to the COR.

1.7.3. PREVENTATIVE, PROPHYLACTIC AND FOLLOW-UP PROCEDURES. The Contractor shall ensure that contract 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 employees 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. PARTICIPATION IN QA/RM. The 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. EVALUATION OF CONTRACT EMPLOYEES. The Government will evaluate the contract employees, 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 professional otorhinolaryngologist services required for patients’ health care needs as stated in Technical Exhibit 3. The quality of medical practice shall meet or exceed reasonable standards of professional practice for otorhinolaryngologist health care as determined by the same authority that governs military medical professionals in otorhinolaryngologist and will be audited for Quality Assurance/Risk Management (QA/RM) Reference AFI 44-119. A percentage of all records will be reviewed through a peer review process per AFI 44-119.

1.10. SPECIFIC PROCEDURES FOR WHICH THE CONTRACTOR SHALL BE RESPONSIBLE.

1.10.1. PROCEDURE GUIDANCE. Contract employees shall perform procedures compatible with the MTF’s operating capacity and equipment. Medical Procedures/services other than those included in Technical Exhibit 1 shall not be introduced by the contractor without prior recommendation to, and approval of, the MTF Commander or authorized representative. New medical procedures/services shall not be introduced without prior recommendation to and approval of the MTF Commander or authorized representative.

1.10.2. DUTY ASSIGNMENT. Contract employees shall be primarily required to perform otorhinolaryngologist services. Contract employees may be required to perform peripheral otorhinolaryngologist services, as assigned by the Chief of Medical Services to provide support in other sections/departments of the MTF commensurate with their experience.

1.10.3. COMMUNICATION. The Contractor shall ensure that contract employees 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 for action. Failure by the Contractor to correct validated complaints that are raised by the MTF staff and the Contracting Officer will be considered as failure to perform.

1.10.4. MEDICAL MALPRACTICE LIABILITY INSURANCE. This Contractor shall provide and maintain adequate medical malpractice liability insurance in the amount of 1,000,000.00 Turkish Lira or more, in accordance with the FAR 52.237-7. The Contractor is required to turn in copies of all supporting documents prior to beginning contract performance.

1.10.5. CLINIC SUPPORT AND OUTPATIENT OTORHINOLARYNGOLOGIST. The Contractor shall provide outpatient services for patients as scheduled by the government. This shall include but not be limited to examinations, diagnosis and treatment using otorhinolaryngologist services. This shall include initial visits as well as follow up visits.

1.10.5.1. CLINIC VISITS. The Contractor shall provide clinic visits for perioperative care. This shall include initial visits as well as follow up visits.

1.10.5.2. OTORHINOLARYNGOLOGIST PROFICIENCIES. Contract employees shall maintain proficiency in all types of otorhinolaryngologist to include otorhinolaryngologist for multiple trauma victims. The Contractor shall maintain a log of otorhinolaryngologist surgeries done outside of MTF as proof of otorhinolaryngologist delivery proficiency. This log shall be presented to COR upon request and on a quarterly basis.

1.10.5.3. SCHEDULING. The Government will not schedule the contract employees to provide outpatient visits at the same time the Government schedule training, meeting, conference, etc.

1.10.5.4. RECORD KEEPING. The contract employees shall maintain proficiency in all types of major and minor surgeries to include multiple traumas. The Contractor will maintain a log of surgeries done outside of MTF as proof of surgical proficiency. This log will be presented to COR upon request or on a quarterly basis.

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

1.10.6.1 EXAMPLES OF MINOR SURGERY.

− Pressure Equalizer (PE) tubes

1.10.6.1 EXAMPLES OF MAJOR SURGERY.

− Septoplasty with Functional Endoscopic Sinus Surgery (FESS)

1.10.7. DOCUMENTATION. Contract employees 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, omissions, agenda etc. in medical documentation. If errors or discrepancies exist, a request will be made to have Contract employees make required corrections.

1.10.7.1. SIGNING. Contract employees shall indicate responsibility for the content and correctness of all prepared and transcribed reports by affixing their own signature to the documents and validating their contents.

1.10.7.2. DOCUMENTATION. Contract employees shall prepare appropriate narrative summaries, document recommendations for medical boards, profile changes, and job retraining recommendations.

1.10.7.3. TIMELINESS. Contract employees shall write patient progress notes at appropriate intervals as determined by the MTF’s executive committee. They shall ensure postoperative note and discharge summaries are prepared and signed within the MTF’s required time frame.

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

1.10.7.5. CERTIFICATIONS. Contract employees 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: Physician name, Turkish Citizenship (T.C.) number, professional degree (M.D., D.O.), and facility.

1.10.7.6. RECORD SYSTEMS. 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. All contract employees shall be trained and required to use CHCS and/or AHLTA.

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

1.10.9. REFERRALS AND CONSULTS. The contract employees shall follow DOD, Air Force, and MTF regulations and policies when arranging for a referral or consult. The contract employees shall inform patients of the required referral or consult by indicating the specialty involved. The contract employees shall not recommend to the patient that he 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 outside of the MTF without prior approval from the Chief, Medical Staff. The 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 otorhinolaryngologist 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. Contract employees shall use and be guided by the MTF formulary and enter all prescriptions into CHCS and/or AHLTA. The pharmacy and Therapeutics Committee must approve drugs not listed on the formulary.

1.10.11. ATTENDANCE AT MEETINGS. Contract employees 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 each 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 contract employees to temporarily occupy non-critical sensitive positions pending National Agency Check (NAC), contract employees will be immediately removed from the position if at any time the NAC receives 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 the 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. Contract employees shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships and in accordance with MDG patient rights and responsibilities and MDG policies. Once the Contractor receives more than two

(2) valid complaints (as determined by the COR, Chief of Medical Staff and/or CO) within 1 month of service, the Contractor shall not be permitted to provide services until the contract employee successfully completes a Government approved patient sensitivity training class within a month of the second complaint. Training may include attendance at a 39 MDG hosted course and/or computer based customer sensitivity training. Depending on the nature and severity of the complaint, performing services under this contract may be terminated.

1.10.16. HEALTH INSURANCE PORTABILITY ACCOUNTABILITY ACT (HIPAA). The 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 health care 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. Contract employees 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). Contract employees shall be responsible for knowing and adhering to the regulations and guidelines under the PRP program as outlined in AFI 36- 2104. Contract employees 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).

The Contractor shall meet all applicable AAAHC/HSI/AFIA/AFI/MDGI standards during the performance of this contract.

SECTION C-2

DEFINITIONS

2. GENERAL DEFINITIONS. As used throughout this performance work statement, the following terms shall have the meaning set forth below:

2.1. CLINICAL PRIVILEGES. Those inpatient and ambulatory clinical activities permitted the provider in the granting medical treatment facility (MTF) after evaluation by the credentials function and approved by the MTF Commander.

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

2.3. CONTRACTING OFFICER’S REPRESENTATIVE (COR). A person duly appointed by the Government to assure services meet the requirements of the contract.

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

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

2.6. 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.

2.7. EXPOSURE-PRONE PROCEDURE. 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. Examples 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.

2.8. GOVERNMENT. The federal government of the United States of America.

2.9. HEALTH CARE PROVIDER. Any care professional who, 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.

2.10. INVASIVE MEDICAL PROCEDURE. 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 mucous lining of the body.

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

2.12. ON CALL. Contracted otorhinolaryngologist surgeon shall be available for emergency consultations via beeper or telephone.

2.13. 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.

2.14. PRACTITIONER. An individual providing direct patient care other than Contract employees.

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

2.16. PRIVILEGING. Frequently referred to as credentialing. The process whereby the MTF 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.

2.17. QUALITY ASSURANCE/RISK MANAGEMENT (QA/RM). MTF QA/RM plan to include the duties outlined in AFI 44-119. The MTF ensures an ongoing assessment of the quality and appropriateness of all medical care and will put in priority sequence suspected problems for evaluation, resolution, and follow-up.

2.18. QUALITY ASSURANCE/RISK MANAGEMENT (QA/RM) PLAN. An organized document which describes the methods of doing quality assurance (QA) reviews within the program and the mechanisms for monitoring and evaluating patient care. It is consistent with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and Accreditation Association for Ambulatory Health Care (AAAHC) monitoring, and evaluation (M&E) approach and the Air Force Risk Management (RM) efforts.

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

2.20. 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.

SECTION C-3

GOVERNMENT FURNISHED PROPERTY AND SERVICES

3. GENERAL. The Government will provide the following equipment, supplies, and services listed below. Note: With the exception of personal protective equipment for Chemical Gear and Training which must be signed for through Base Supply, the items listed in this section C-3 will not be for the exclusive use of the Contractor. As defined by FAR 45.000(a)(5), the Government property is incidental to the place of performance, when the contract requires contract personnel to be located on a Government site or installation, and when the property used by the contractor within the location remains accountable to the Government. Therefore, Government Furnished Property clauses shall not be included in the contract.

3.1. EQUIPMENT. The Contractor shall have joint use of all available equipment for performing services required by this contract only. Such equipment shall include a computer for use while in MTF and a beeper for on call coverage. Protective equipment for Chemical Gear and Training will be required and provided to the Contractor to work during times of war.

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

3.3. PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish appropriate PPE to contract employees. 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. Contract employees 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, medical library, installation distribution, Government E-Mail account, Class-A telephone lines and Defense Switching Network (DSN) lines. These items shall only be used for official government business in support of this PWS and not for personal use.

3.5.2. CENTRAL STERILE SUPPLY. The MTF will provide Central Sterile Supply services to the Contractor. Sterile equipment trays, instrument packs, and supplies will be provided by this service.

After use, the Contractor shall follow local policies and procedures to have the Government clean and re-sterilize the supplies. This service will be available to contract employees on an equal basis with those of other MTF 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 part of the MTF housekeeping staff.

3.5.5. PATIENT SCHEDULING. MTF personnel shall arrange patient scheduling. Complete administrative (managing forms) 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 COR will provide guidance for contract employees who shall maintain and dispose of these records, files, documents, and work papers.

3.5.7. TRANSCRIPTION SERVICES. The MTF will 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 services part of the contract upon approval from the Chief of Medical Services. If approved, reimbursement for transcription services will be at cost. Note: Before starting a contracted transcription services, a Government Purchase Card official must pay for the service or a formal contract modification must be accomplished.

SECTION C-4

CONTRACTOR FURNISHED PROPERTY AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 GENERAL. The Contractor shall furnish all supplies, equipment, facilities, and services required to perform work under this contract that are not listed under Section C-3 of this PWS.

SECTION C-5

SPECIFIC TASKS

5. SPECIFIC TASKS.

5.1. BASIC SERVICES. The Contractor shall perform or know how to perform the tasks listed below.

The contractor shall at no point receive additional payment for performing tasks outside of this list or outside of the scope of this contract. If additional tasks are required, the contractor and customer shall contact the contracting officer prior to performance in order to increase the scope of the contract and complete negotiations for equitable adjustment.

5.1.1 Shall evaluate, diagnose, treat and consult for patients of all ages presenting with diseases, deformities, or disorders of the head and neck, including the ears, nose or throat, the respiratory and upper alimentary systems, and related structures of the head and neck.

5.1.1.2 Includes comprehensive medical and surgical care, head and neck oncology, facial plastic reconstructive surgery, and the treatment of disorders of hearing and voice.

5.1.1.3 Shall provide care to patients in the intensive care setting.

5.1.1.4 Shall assess, stabilize and determine disposition of patients with emergent conditions.

5.1.2 ADMINISTRATIVE

5.1.2.1 Shall document his or her medical care in accordance with local MTF regulations and Air Force Instructions (AFI). Must maintain accurate and proper records management with no more than two (2) discrepancies per quarter.

5.1.2.2 Shall attend Surgical Services Department and monthly MTF Medical Professional Staff meetings.

5.1.3 GENERAL PROCEDURES

5.1.3.1 Shall independently perform excision of benign and malignant lesions of the following:

• Skin

• Oral cavities

• Nasal cavities

• Pharynx

• Larynx

• Lymphatic system

• Cervical esophagus and neck

• Cervical trachea including major ablative cancer surgery

5.1.3.2…