Attachment_1_Performance_Work_Statement_28_May_2014.pdf

Attachment 1

PERFORMANCE WORK STATEMENT (PWS)

28 May 2014

PERSONAL SERVICES CLINICAL SUPPORT SERVICES FOR

THE COLORADO SPRINGS MILITARY HEALTH SYSTEM

10th Medical Group, United States Air Force Academy

21st Medical Group, Peterson Air Force Base

Evans Army Community Hospital

1.0. DESCRIPTION OF SERVICES/GENERAL INFORMATION. This is a personal services clinical healthcare support PWS and resulting contract. The Contractor shall provide Healthcare

Workers who will perform a full range of personal clinical support services in accordance with

(IAW) the Position Descriptions described in Appendix A of this PWS, the terms and conditions of this contract, subsequent task orders and in accordance with the precepts within the professional standards of the Joint Commission on Accreditation of Healthcare (JCAHO) and

Accreditation Association for Ambulatory Health Care (AAAHC). The Contractor shall perform services in accordance with the ethical, professional, and technical standards of the healthcare industry and the Air Force medical department. The Healthcare Worker may provide services in support of TRICARE beneficiaries at any of the three Medical Treatment Facilities (MTF) in the in the Colorado Springs Military Health System to include 10 MDG, United States Air Force

Academy; 21 MDG, Peterson AFB; and/or Evans Army Community Hospital, Fort Carson Army

Post.

1.1. SPECIFIC REQUIREMENTS:

See Appendix A for Position Descriptions and Specific Work Requirements. See Appendix B for additional specific information applicable to Healthcare Workers performing services at

Evans Army Community Hospital.

1.2. SCREENING OF POTENTIAL CANDIDATES. The contractor shall screen all potential candidates to ensure they possess all required qualifications, including those in the PWS and position descriptions, prior to submitting the candidate to the Government.

1.3. SUBMISSION OF CANDIDATE LISTS. The contractor shall submit the potential candidate/candidates for open positions to the Contracting Officer Representative (COR) within

30 days of vacancy notification. Notification begins upon written notice from the Government of a new requirement (issuance of a Task Order) or upon notification of a vacancy by a current employee.

1.4. COMMUNICATION. Healthcare Workers shall maintain open and professional communication with members of the MTF staff, patients, and customers.

1.5. DOCUMENTATION. Healthcare Workers shall prepare all documentation, using AHLTA or other designated system, to meet established standards of the MTF, to include, but not limited to, timeliness, accuracy, content and signature. Only MTF approved abbreviations shall be used for documentation of the patient health record. The MTF’s documentation standards will be outlined during orientation.

1.6. CONTINUING MEDICAL EDUCATION (CME) REQUIREMENTS. Healthcare Workers licensed, registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME shall be obtained at no additional cost to the Government and shall be reported to the MTF Credentials Committee annually on the first normal duty day in January for the previous calendar year. Periodically, CME may be conducted at the MTF and will be available, at no cost, to any health care provider desiring to attend.

Admittance to any course shall be on a space available basis as determined by the Chief, Education and Training Department of the MTF.

1.7. MTF ORIENTATION AND TRAINING. The Healthcare Worker shall complete all MTF-specified orientation program(s), initial and annual training requirements, and comply with all

MTF policies, procedures, productivity standards and instructions as provided by the MTF.

1.8. CONTRACTOR IDENTIFICATION: All contractor management staff and contractor personnel shall be clearly identified as such at ALL times, including conversations, mail, e-mail, fax, and/or other electronic communication whether communicating with government personnel, other contractor personnel, or with the public when supporting this contract. Likewise, the contractor shall abide by all applicable laws and regulations when using government equipment and services in performing this contract. At a minimum, contractor management staff and contractor personnel shall clearly identify themselves as contractors by (1) wearing badges that clearly and legibly identify themselves as contractors, (2) using the label “Contractor” in e-mail addresses IAW Federal Acquisition Regulation (FAR) 37.114, Special Acquisition

Requirements, (3) opening all phone conversations with a statement materially similar to, “[office name], I am [employee name], a [prime contractor’s company name] employee,” including the employing contractor’s name in the letterhead and/or signature block of any written correspondence, and (4) any other means necessary. Contractor personnel shall wear contractor-supplied badges in addition to government provided badges when required at requesting locations. Contractor personnel shall wear the contractor supplied identification badge above the waistline during duty hours.

1.6. GENERAL INFORMATION

1.6.1. PERSONNEL. The Contractor shall provide sufficient personnel who meet all requirements herein and who can be relied upon to perform in strict accordance with the contract.

The Contractor shall provide personnel who are competent, qualified, and adequately trained to perform assigned duties.

1.6.1.1. POINT OF CONTACT. The Contractor shall provide a point of contact who 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’s point of contact shall notify the Government supervisor as early as possible of programmed absences of Contractor personnel to allow for planning of service coverage and workload distribution.

1.6.2. BILLABLE HOURS. Billable hours are hours established in the contract work schedule as duty hours, on-call hours, overtime hours or Holiday/Weekend hours. In order for an hour to be billed to the Government, the Healthcare Worker must have performed as required in the work schedule. The Contractor shall only submit payment requests for hours actually worked/provided.

1.6.3. HOLIDAYS. The Healthcare Worker may be required to provide routine services on the following Federal holidays (or the actual day set aside for observation): New Year’s Day, Martin

Luther King Jr.’s Birthday, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, Christmas Day, and executive ordered days off.

1.6.3.1. MTF Scheduled Family Days. Certain days are designated as Family Days during the year. This is typically a single day off for military personnel to create a 4-day weekend in conjunction with a Federal Holiday, to include Thanksgiving, Christmas, Memorial Day, Friday after USAFA’s Graduation, Independence Day and Labor Day The specific days will be announced in advance to allow adequate planning. Contractors may be allowed to work on

Family Days under the following conditions: if (1) there is work that can be done during the entire day (shift), (2) there is a government supervisor, and (3) the supervisor approved the contractor working on the Family Day. The option for contractor Healthcare Workers to work during down days, however, is ultimately a Squadron Commander’s decision. The contractor will not be reimbursed for Family Days unless prior direction/approval was given and services were provided.

1.6.4. CONTINUITY OF SERVICES/REPLACEMENT STAFF. The Contractor point of contact shall ensure qualified personnel are available to provide coverage during scheduled absences of contractor personnel of more than three consecutive weeks.

1.6.4.1. PROGRAMMED ABSENCES. The contractor shall notify the appropriate section supervisor or COR as early as possible of contractor employee’s programmed absences. At a minimum, the contractor shall coordinate programmed absences with the supervisor or COR at least 30 days in advance to allow for planning of service coverage and workload distribution.

Repetitive absences may require medical documentation before returning to work, at the discretion of the MTF Commander. No-notice absences not related to medical reasons or emergencies may be grounds for dismissal/termination.

1.6.4.2. MEDICAL AND EMERGENCY ABSENCES. In the event a contractor employee cannot perform services due to medical reasons or an emergency, the contractor shall notify the appropriate supervisor or COR as soon as possible. Medical absences exceeding three consecutive duty days will require medical documentation before returning to work.

1.6.4.3. CONTRACTOR EMPLOYEE START DATE (Credentialed). Credentialed Healthcare

Workers will physically begin performance within 90 days after task order award or upon notification of a vacant position. Credentialed Healthcare Workers may begin performance earlier than 90 days if an earlier start date is mutally agreed upon between the Contracting

Officer and the Contractor.

1.6.4.4. CONTRACTOR EMPLOYEE START DATE (Non-credentialed). Non-Credentialed

Healthcare Workers will physically begin performance within 60 days after task order award or upon notification of a vacant position. The non-credentialed Healthcare Worker may begin performance earlier than 60 days if an earlier start date is mutually agreed upon between the

Contracting Officer and the Contractor.

1.6.5. CRIMINAL BACKGROUND CHECK REQUIREMENT. The MTF will conduct criminal background checks on all Healthcare Workers involved in the delivery of care to children, under the age of 18 on a frequent and regular basis, as stated in Enclosure 5 of the

DODI 1402.5. The Contractor is responsible for ensuring the completed Standard Form 85

(Questionnaire for National Security Positions) and an Optional Form 306 (Declaration for

Federal Employment) are contained in credentialing packages for privileged healthcare providers and submitted for non-privileged Healthcare Workers prior to providing services at the MTF.

The contractor shall ensure that the Healthcare Worker follows local MTF policy to provide fingerprints. The procedures for completing the required background check are outlined in

Enclosure 6 of the Department of Defense Instruction (DODI) 1402.5.

1.6.5.1. With the consent from the MTF, the Healthcare Workers 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 Healthcare Worker shall be within sight and continuous supervision of a MTF staff person whose background check has been completed with a favorable result.

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

1.6.5.3. Healthcare Workers who have previously received a background check shall provide proof of the check to the MTF.

1.6.6. CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest.

1.6.7. APPEARANCE. All Healthcare Workers shall present a professional, conservative, and neat appearance. Contractor personnel shall report for duty in a professional manner, in appropriate attire befitting a healthcare setting, and have complied with socially acceptable standards of personal hygiene expected of healthcare workers.

1.6.8. HEALTH REQUIREMENTS. All Healthcare Workers shall follow the methods for controlling and preventing disease as described in the American Public Health Association publication, Control of Communicable Diseases Manual (entire manual), and the Centers for

Disease Control and Prevention (CDC) publication, Morbidity and Mortality Weekly Report

(MMWR), and its supplements (entire reports). The most recent guidelines from these publications are utilized as the standard.

1.6.8.1. Before start of work, Healthcare Workers shall provide proof of immunization from the following diseases according to CDC guidelines (where applicable): Hepatitis B, measles, mumps, rubella, varicella, and influenza. The Healthcare Worker shall also provide proof of a negative TB skin test within 12 months (if positive, proof of negative chest X-ray within 12 months) prior to start of work. After start of work, the Government will provide post bloodborne exposure protocols.

1.6.8.2. Immunization information will be tracked in DoD computer systems for all Healthcare

Workers.

1.6.8.3. Medical Tests. No medical tests or procedures required by the contract may be performed at the MTF (with the exception of Tuberculosis testing after start of work). Expenses for all required tests and/or procedures shall be borne by the Healthcare Worker at no additional expense to the Government.

1.6.8.4. Healthcare Workers must be immunized annually with the influenza vaccine. This vaccine will be provided by the Government, if available as determined by the MTF. Although this vaccine may be provided by the Government, it may be obtained at other facilities with the cost being borne by the Contractor. Unless vaccinated by the Government, the Healthcare

Worker shall be required to show proof of the vaccination.

1.6.8.5. All contractor personnel performing direct healthcare services under this contract, who experience a parenteral (e.g., needle-stick or cut) or mucous membrane exposure (e.g., splash to the eye or mouth) to blood or bloody body fluids, shall receive prompt treatment. The MTF will evaluate the source of exposure for risk of Hepatitis-B, Hepatitis-C, and Human

Immunodeficiency Virus (HIV) and will provide a report of the contractor’s responsibility to provide appropriate treatment as needed to possibly include Tetanus-Diptheria booster, Immune

Globulin, Hepatitis-B vaccine booster, or Hepatitis-B Immune Globulin. The contractor shall be responsible for providing the contract employee with initial testing and if the source of exposure was unknown, positive, or considered at high risk for HIV infection, follow-up testing 3, 6, and

12 months after exposure. In the event of a confirmed or highly suspected parenteral exposure to

HIV, the contractor shall insure that the contractor provider receives appropriate counseling and is referred immediately to a private infectious disease specialist for consideration of any experimental therapy (e.g., AZT). The Government may require the contractor to provide evidence of the status of treatment and testing of the individual provider under the contract.

1.6.8.6. Emergency health care/on-the-job injury: If the contract personnel should experience a personal bona fide medical emergency or an on-the-job injury while on duty at the MTF, medical care will be provided by the MTF until the condition is stabilized. The Contractor will reimburse the Government for all medical services provided.

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

1.6.9.1. The Healthcare Worker shall participate in QI/RM activities to the extent required by the individual MTF QI/RM plan or regulation.

1.6.9.2. The Government will evaluate the providers’ professional, as differentiated from administrative, performance under this contract using Quality Improvement standards of the

MTF. The standards will be addressed during orientation.

1.6.10. SECURITY. Since the Healthcare Workers under this contract have access to and/or process information requiring protection under the Privacy Act of 1974, these positions require a

National Agency Check with Inquiries (NACI) for each Healthcare Worker under this contract.

The Contractor shall fully adhere with the provisions of referenced publications by having each of their employees who are performing under this contract make an appointment (through the

COR) with the MTF security organization. Each individual will be fingerprinted and required to complete the appropriate forms, usually a Standard Form 85 (Questionnaire for National Security

Positions) and an Optional Form 306 (Declaration for Federal Employment). The contractor shall advise their employees that a positive report is needed as a condition of employment under this contract. The Contractor shall apply for the NACI prior to the start of performance for each health care worker.

1.6.10.1. The contractor understands that the MTF commander may allow Healthcare Workers to temporarily occupy non-sensitive positions pending results of the NACI. NACI’s showing

Unfavorable Adjudication or No Determination Made will result in a suitability determination completed from the MTF Commander or designee for continued employment.

1.6.10.2. The Government reserves the right to require removal from the job site any contract employee who endangers persons or property, whose actions are inconsistent with professional conduct, whose continued employment is inconsistent with the interest of military security or who is found to be incapacitated or under the influence of alcohol, drugs, or other substances.

Removal of employees for any reason does not relieve the Contractor of the requirement to perform services specified herein.

1.6.11. CONFIDENTIALITY OF INFORMATION. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the contractor or healthcare worker during the performance of this contract are considered

Government confidential business information and shall not be used for purposes other than performance of work under this contract. The contractor and/or the healthcare worker shall not release any of the above information without prior written consent of the Contracting Officer.

All medical records and reports remain the property of the Government.

1.6.11.1. Patient lists, no matter how developed, shall be treated as confidential information in accordance with the Privacy Act and the Health Insurance Portability and Accountability Act

(HIPAA). Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF, except through MTF-specified processes.

1.6.12. NON-COMPETE PROVISION IN CONTRACTOR’S EMPLOYMENT

AGREEMENTS. A non-compete condition in the contractor's employment agreement with its employees that prevents employees of the incumbent from being employed, or accepting offers of employment, by the new contractor on the follow-on contract hinders the government's ability to accomplish the mission of providing continuity of quality medical care to beneficiaries. The contractor agrees to not enforce any non-compete provisions, if any, against any employee that accepts an offer of employment with the follow-on contractor to provide the same services covered by the provisions of this contract and will not seek reimbursement from the government.

1.6.13. PERFORMANCE DURING FACILITY CLOSURE. During anticipated closure of the facility due to administrative leave granted to the entire staff or during unplanned closure of the facility due to natural diasters, military emergencies, severe weather, or otherwise, the Contractor shall not invoice the Government for services not performed and the Government will not be liable to the Contractor for any such closure. For delayed reporting or early release due to severe weather, or otherwise, the Contract employee will be treated (for leave and pay purposes) in the same manner as DoD civilian employees.

1.6.14. PERFORMANCE OF SERVICES DURING CRISIS DECLARED BY THE

SECRETARY OF DEFENSE OR OVERSEAS COMBATANT COMMANDER. The contractor employee(s) shall not perform work during a crisis declared by the Secretary of

Defense or the Overseas Combatant Commander.

1.6.15. RELATIONSHIP OF THE PARTIES. This is a personal services contract and is characterized by the employer-employee relationship it creates between the Government and the individual Healthcare Worker. The contract Healthcare Worker who furnishes services under this contract is subject to the day-to-day supervision and control of employees of the United

States Government, comparable to that exercised over military and civil service Healthcare

Worker engaged in comparable work. This personal services contract does not create an employer-employee relationship between the government and any corporation, partnership, business association or other party or legal entity with which the individual(s) providing service, may be associated. The authority for this contract is 10 United States Code 1089 and 10 United

States Code 1091.

1.6.16. INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE. The contract

Healthcare Worker status as a personal servant of the United States entitles it to applicable coverage of the Federal Tort Claims Act as provided in the Medical Malpractice Immunity Act, 10 U.S.C. 1089. Therefore, the Healthcare Worker shall not be liable for claims of personal injury or death, allegedly caused by the negligence of the healthcare worker, which occur within the scope of work performed by the healthcare worker under this contract, and are not otherwise compensated for, or covered by, private insurance. Such claims will be processed in accordance with the procedures established by those statutes, implementing regulations, and as set out below.

1.6.17.1. CLAIMS PROCEDURES. If any suit or action is filed or any claim is made against the contracted Healthcare Worker, which occurred as a result of work performed by the Healthcare

Worker under this contract, the Healthcare Worker shall:

1.6.17.2. Immediately notify the Risk Manager and the CO, and promptly furnish copies of all pertinent papers received;

1.6.17.3. Cooperate with the Government, without further compensation, in the processing, review, settlement or defense of the suit, action or claim; and,

1.6.17.4. Authorize Government representatives to settle or defend the claim and to represent the

Healthcare Worker in, or take charge of, any litigation involved in such an action. The

Healthcare Worker may, at his/her own expense, participate in defense of such claim or litigation.

1.6.18. APPLICABLE PUBLICATIONS: Publications applicable to the PWS are listed below.

The Contractor is obligated to follow these publications. These publications are available online and are maintained by the Government. Supplements or amendments to listed publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes in publications which result in a decrease or no change in the price and notify the CO in writing of such change. Should a decrease in contract price result, the Contractor shall provide a proposal for reduction in the price to the CO. Prior to implementing any change that will result in an increase; the Contractor shall submit to the CO a price proposal within 30 days of receipt of the change by the Contractor. The CO and the

Contractor shall negotiate the change into the contract under the provisions of the contract clause entitled "Changes". Failure of the Contractor to submit a price proposal within 30 days from receipt of the change shall entitle the Government to performance in accordance with such change at no increase in price.

1.6.18.1. Publications and forms are also available electronically through the internet. For example, http://www.e-publishing.af.mil/ is the Air Force’s e-Publishing site and one way to obtain Air Force Instructions. DoD Directives can be found at http://west.dtic.mil/whs/directives/. Regulations are followed by a “-R” (e.g., DoD 6025.18-R) and can be located on the website by clicking on “Publications” instead of “Directives.”

DEPARTMENT OF DEFENSE (DoD) REGULATIONS/MANUALS

INSTRUCTIONS/DIRECTIVES

PUB NO. TITLE DATE

Department of Defense Criminal History Background Checks on Jan 93

Instruction (DODI) 1402.5 Individuals in Child Care Services--Enclosures 5 & 6

AIR FORCE INSTRUCTIONS/MANUALS

PUB NO. TITLE DATE

AFI 44-119 Medical Quality Operations--Chapter 4 24 Sep 07

2.0. SERVICES SUMMARY

Performance Objective

(General)

PWS

Paragraph

Performance Measure

1. The contractor shall provide personnel who are competent, qualified, and adequately trained to perform assigned duties

1.6.1 Maintain a 80% or above mission support status.

Mission support status is measured as Number of

Positions Filled/Number of Positions Available for Fill.

2. The contractor shall perform services in accordance with the ethical, professional, and technical standards of the health care industry.

1.0 The contractor’s healthcare worker employee

staff receive no more than 2 validated patient or

MTF complaints per month.

3. Possess and maintain current certifications and licenses and complete all

MTF-specified orientation programs and annual training requirements.

1.4 and 1.5

100% compliance

4. Credentialed Healthcare

Workers physically begin performance within 90 days after task order award and

Non-credentialed Healthcare

Workers begin within 60 days.

1.6.4.3

1.6.4.4

No more than 1 credentialed healthcare worker starts performance later than 90 days within a 12-month period. No more than 1 non-credentialed healthcare worker starts performance later than 60 days within a 12-month period.

5. Contractor Manpower

Report (CMR)

Appendix

D

100% compliance

2.1. Government Quality Assurance

2.1.1. The Government will periodically evaluate the Contractor’s performance by appointing a representative(s) to monitor performance to ensure services are received. The Government may inspect each task as completed or increase the number of quality assurance inspections if deemed appropriate because of repeated failures or because of repeated customer complaints.

Likewise, the Government may decrease the number of quality assurance inspections if performance dictates. The Government Contracting Officer shall make final determination of the validity of customer complaint(s). If any of the services do not conform with contract requirements, it will be handled through the Inspection of Services Clause.

3. GOVERNMENT-FURNISHED PROPERTY AND SERVICES.

3.1. EQUIPMENT. The Healthcare Worker shall have joint use of all available medical and office equipment for performing services required by this contract:

3.2. PERSONAL PROTECTIVE EQUIPMENT (PPE). The MTF will furnish the Healthcare

Worker with appropriate PPE. The MTF will be responsible for any repair, cleaning and inventory required for the PPE.

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

3.4. SUPPLIES. The MTF will provide medical and non-medical supplies commonly used in the facility for the care and management of patients. Commonly used supplies are those routinely stocked by the MTF and used in a medical healthcare setting.

3.5. COMPUTER EQUIPMENT. The MTF will provide computer equipment required to schedule, check-in, document, order ancillary services, and maintain appropriate electronic medical information that support the hard copy medical record. The MTF will provide required training for these systems. The Healthcare Worker will be required to use the computer systems that are standard for the support of health care delivery at the MTF.

3.6. UTILITIES. For the purpose of this contract, the MTF will furnish all required utilities

(such as water, telephone, electricity, etc.) at no cost to the Healthcare Worker. Long distance and Defense Switched Network (DSN) telephone services will be provided for official use only.

The Healthcare Worker shall participate in government energy conservation programs.

3.7. PATIENT SCHEDULING. Complete administrative control of the patient shall remain with the Government.

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

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

4.0. APPENDICES:

A—Position Descriptions and Position Requirements

B—Evans Army Community Hospital Additional Requirements

C—Definitions

D—Contractor Manpower Reporting

APPENDIX A

C-Credentialed; N-Non-Credentialed

Type POSITION DESCRIPTION

N Assistant Lead Polysomnographic Technician

C Chiropractor

C Clinical Nurse – Family Practice

C Clinical Social Worker - Integrated Primary Care

N Echocardiogram Technician

C Emergency Services Physician

C Family Health Physician - Board Certified

C Family Practice Physician - Board Certified

C Gastroenterologist

C Internal Medicine Physician - Board Certified

C Internal Medicine Physician - Cardiology

C Internal Medicine Physician - Endocrinology

C Internal Medicine Physician - Hospitalist

C Internal Medicine Physician - Pulmonology

N Licensed Vocational Nurse/Licensed Practical Nurse

N LPN/LVN – Flight Medicine/Occupational Medicine/MSME

N Medical Laboratory Technologist

C Operating Room Registered Nurse

N Ophthalmology Lead Laser Technician

N Ophthalmology Technician - Laser Eye

N Ophthalmology Technician - Ophthalmology Clinic

N Optometry Technician

C Orthopedic Hand Surgeon

C Orthopedic Surgeon

C Pediatrician

N Pharmacy Technicians

N Phlebotomist

C Physical Therapist

C Physician Assistant – AMDS - Occupational Health/Flight Medicine

C Physician Assistant - General

C Physician Assistant - Orthopedics

C Podiatrist

N Polysomnographic Technician

C Psychiatrist - Board Certified - Adult

C Psychiatrist – Board Certified - Child/Adolescent

C Radiologist - Interventionist

C Registered Dietitian

C Urgent Care Center Physician

C Urologist – General or Surgical

Assistant Lead Polysomnographic Technician

1.0 Specific Tasks:

1.1 Shall assist Lead Technician in the day to day operations of the clinic and the work of the

Polysomnographic technicians. Responsible for assisting Lead Technician in the management of support staff, and ordering and maintaining supplies.

1.2 Assists in requisitioning forms required for daily operation of the Sleep Lab. As required, type’s routine correspondence, progress reports medical statements, and memoranda.

1.3 Is able to manage several tasks simultaneously and has strong leadership and organizational skills.

1.4 Has effective interpersonal skills. Maintains a professional manner and displays a positive cooperative attitude toward patients and 10 Medical Group personnel.

1.5 Has knowledge of clinic/department regulations, policies and procedures.

1.6 Meets short-notice suspense’s as established by the organization.

1.7 Demonstrate the knowledge and skills necessary to recognize and provide age specific care in the treatment, assessment and education of adolescent, adult and geriatric patients.

1.8 Program montages on sleep acquisition systems; troubleshoot acquisition and scoring program issues.

1.9 Address environmental, equipment and engineering issues that affect patient care delivery; determine appropriate course of action including test cancellations and initiating system changes.

1.10 Conduct and score all types of sleep studies including overnight polysomnography

(multiple montages), Multiple Sleep Latency Test (MSLT), Maintenance of Wakefulness

Test (MWT), Continuous Positive Air Pressure (CPAP) and Bi-level Positive Air Pressure

(PAP) titration, and supplemental O2 titration.

1.11 Perform end-tidal Carbon Dioxide CO2.

1.12 Performs test and accurately transcribes and prepares data for physician interpretations.

1.13 Prepare and calibrate equipment required for testing to determine proper functioning and make adjustments if necessary.

1.14 Apply electrodes and sensors according to accepted standards. Perform appropriate physiologic calibrations to ensure proper signals and make adjustments if necessary.

1.15 Perform positive airway pressure (PAP) mask fitting.

1.16 Ensure a safe work environment and employee safe work habits.

2.0 Qualifications:

2.1 The Assistant Lead Technician must be registered by the Board of Polysomnographic

Technologists (RPSGT) and meet the American Academy of Sleep Medicine (AASM) sleep lab certification standards.

2.2 Assistant Lead Technician must have and maintain current certification in Basic Life Support

(BLS). This certificate must be current at all times. Certification is at no expense to the government.

2.3 The Assistant Lead Technician shall have a minimum of 2 years of experience managing technicians and running a Sleep Study Clinic.

2.4 The Assistant Lead Technician shall have a minimum of three (3) years of experience within the last five (5) years, conducting sleep studies in a patient care setting including one year scoring sleep studies.

Chiropractor

1.1 Perform standard osseous and soft tissue procedures only, as commonly taught in

Chiropractic College accredited by the Council on Chiropractic Education.

1.2 Be responsible for delivery of treatment within the personnel and equipment capabilities of the MTF, provision of mandated medical surveillance and preventive services and the quality and timeliness of treatment records and reports required to document procedures performed and care provided.

1.3 Employ and record every measure of observation that will more substantially profile the patient during the initial patient interview and consultation.

1.4 Conduct a patent history and chiropractic physical examination (excluding vaginal examination) as clinically indicated.

1.5 Utilize X-ray and standard laboratory tests appropriate to the chiropractic diagnosis and within the MTF's capabilities as detailed by the standard MTF operating procedures.

Radiological examinations shall be limited to muscular-skeletal radiographs, skull series, chest

(PA and lateral views) and rib series. MRI and CT studies of the spine and Bone Scans may be ordered following protocols established by the department of orthopedics.

1.6 Utilize the physical therapy modalities of heat, cold, light, electricity, sound and rehabilitation exercises in patient treatment area.

1.7 Provide patient instructions and recommendations in all matters pertaining to hygiene, nutrition, exercise and life style changes and ergonomic factors in the activities of daily living.

1.8 Refer patients to specialty services available at the MTF.

1.9 Orient, instruct, direct, and evaluate work activities of clinical support staff.

1.10 Plan and conduct lectures and training programs on chiropractic related subjects for staff, students and patients. The HCW shall teach, conduct or participate in seminars concerning the basic and/or clinical sciences of chiropractic if requested by the Government.

1.11 Order orthotics, lifts, collars, and lumbar sacral supports if available at the MTF.

1.12 Place active duty patients on limited duty status (profile) according to MTF bylaws.

1.13 Place active duty patients on quarters for a maximum of 72 hours.

1.14 Document, on forms provided by the MTF, actions taken such as patient history, patient evaluation, treatments/adjustments, unusual occurrences, and morbidity in accordance with the standard MTF operating procedures.

1.15 Participate in weekly meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist.

1.16 Attend annual renewal of the following Annual Training Requirements: family advocacy, disaster training, Sexual Harassment, and other courses as directed.

1.17 Utilize Government computer systems technology for data input and retrieval (orders, lab results).

1.18 Other related duties as assigned.

2.1 Holds a current, unrestricted license to practice as a Doctor of Chiropractic in any one of the fifty States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S.

Virgin Islands.

2.2 Possess a degree from a chiropractic college accredited by the Council on Chiropractic

Education.

2.3 Experienced as a chiropractor, licensed independent practitioner for at least 24 consecutive months within the last 36 months for both diagnostic and treatment services.

2.4 ENGLISH LANGUAGE REQUIREMENT. Shall be able to read, understand, speak, and write English well enough to communicate effectively and be a United States citizen.

CLINICAL NURSE - FAMILY PRACTICE

1.0 Specific Tasks. The duties include but are not limited to the following:

1.1 Strongly preferred working knowledge of the military health care system including

TRICARE health benefits.

1.2 Ability to synthesize data from a variety of sources and make appropriate clinical decisions.

1.3 Coordinates patient care through a continuum and facilitates the achievement of optimal outcomes in relation to clinical care, quality and cost effectiveness.

1.4 Ensures compliance with standards of care and practice in accordance with all established policies, procedures, and guidelines used in the medical treatment facility. Provides care within ethical and legal boundaries.

1.5 Accountable for making patient care assignments based on the scope of practice and skill level of assigned personnel.

1.6 Assesses patient needs telephonically.

1.7 Ability to recognize adverse signs and symptoms and quickly react in emergency situations.

1.8 Ability to effectively communicate and collaborate with a diverse group of people for the purpose of informing the healthcare team of plans/actions, for teaching/education to benefit the patient/family and organization. Effectively uses appropriate communication format in addressing professional issues.

1.9 Excellent oral communication skills for patient/family education and telephone triage of patients. Telephone and in-person assessment/evaluation includes the determination of optimal time and location for patient management (ER, clinic, homecare) and follow-up care as required.

Prescribes and communicates treatment plans and patient teaching in accordance with established protocols. Collects and assesses significant patient history information and performs all necessary patient teaching.

1.10 Excellent written communication skills to perform accurate documentation, both written and electronic, of all activity, including telephone contacts, in accordance with requirements.

1.11 Makes referral appointments and arranges specialty care as appropriate.

1.12 Skill in setting up, operating and monitoring specialized medical equipment such as cardiac monitoring devices, EKG units, oxygen analyzers, nebulizers, and other clinic specific equipment.

1.13 Performs/assists with procedures such as bladder catheterizations, administration of oxygen, visual acuity tests, EKGs, irrigation of eyes and ears, tympanograms, splinting, phlebotomy and other clinic specific procedures, in accordance with established protocols.

1.14 Ensures for proper documentation of procedures and treatments.

1.15 Ensures all equipment is properly cleaned and stored at the end of each work shift.

1.16 Ensures preventive maintenance and routine cleaning are performed as directed. Ensures medication/supplies are replenished.

1.17 Participates in the orientation and training of newly assigned personnel, as appropriate.

1.18 May be required to work various shifts or augment clinical nursing support during the absence of other team nurses due to illness, leave or deployment,

1.19 Ensures a safe work environment, employee safe work habits and patient safety IAW regulatory agencies, infection control policies, and process improvement initiatives.

2.0 Work Schedule:

2.1 The Clinic is an outpatient clinic open from 0700 to 1600 Mondays through Fridays. The

Contract Nurse shall work no more than 40 hours per week (Mondays through Fridays).

3.0 Qualifications:

3.1 Knowledge of professional care theories, principles, practices, and procedures to perform nursing assignments of moderate difficulty and experience in assessing pediatric, adolescent, adults, obstetrics, and geriatric patients, as appropriate. Utilizes the nursing process as a basis for professional practice.

3.2 Knowledge of a wide range of medical disorders/conditions and disease processes across the lifespan, as appropriate.

3.3 Knowledge of preventive health schedules, procedures, processes and education methods.

3.4 Knowledge of disease management and population health principles.

3.5 Knowledge of a variety of pharmacological agents used in patient treatment, the desired effects, side effects, and complications of their use as well as the accurate administration of the pharmacologic agent, including dosage calculations as required. Knowledge of the administrative requirements for proper documentation of patient conditions including disease progress, acknowledgement of teaching, and follow up care.

3.6 Knowledge of computer operations and proficiency in use of basic word processing, data entry and automated medical records.

3.7 ENGLISH LANGUAGE REQUIREMENT. Shall be able to read, understand, speak, and write English well enough to effectively communicate with all patients and other health care providers and be a United States citizen.

3.8 FORMAL EDUCATION. Registered nurse shall have successfully completed a degree in

Nursing from a National League of Nursing or from an American Academy College of Nursing accredited college or university. BSN preferred

3.9 LICENSURE/REGISTRATION. Registered Nurse shall possess a current, active, full and unrestricted Registered Nurses (RN) licensed in Colorado compact state from any United States jurisdiction.

3.10 Registered nurses shall hold a national or state nursing license that is valid and current with no limitations, stipulations or pending adverse actions. License must be unencumbered and remain in effect during contract employment

3.11 Registered Nurses shall have a current Basic Cardiac Life Support (BCLS) certificate by the

American Heart Association, Advanced Cardiac Life Support (ACLS) and Pediatric Advanced

Life Support (PALS). These certifications shall be maintained in a current status at all times while performing services under this contract at no expense to the Government.

3.12 EXPERIENCE. The nurse shall have at least 24 months of experience within the last 48 months in a primary care clinic setting.

Clinical Social Worker – Integrated Primary Care

1.1 Clinical social worker may be required to function in a specialty mental health clinic or in a patient centered medical home (PCMH) location as a behavioral health consultant (BHC) and/or

Behavioral Health Care Facilitator (BHCF).

1.2 Provider in the Specialty Mental Health Clinic. The type of work may include, but is not limited to, the following:

1.3 Attend and participate in meetings during normal duty hours, professional staff conferences and other appropriate professional activities such as, but not limited to the following: quality improvement meetings, professional staff meetings, commander's staff meetings, mental health flight meetings, and other meetings required by applicable regulations, MTF guidance, or as directed by the mental health flight Commander or his/her designated representative.

1.4 Clinical/Counseling services. Responsible for and applies psychological procedures and techniques, including interviewing, behavioral assessment, and evidenced-based therapies, in the evaluation, diagnosis, and treatment of psychological and neuropsychological disorders using the following skills:

1.5 Individual, family and group psychotherapy, and couples therapy, alcohol and drug treatment evaluations.

1.6 Consults with medical personnel, legal authorities, military commanders and school districts, as required.

1.7 Maintains accurate and current notes in the Mental Health records, inpatient medical records and electronic medical records of all patients seen, as appropriate, and produces reports of evaluation and/or treatment, as required.

1.8 Participates in military specific training (e.g., training to perform security clearances, use of the Air

Force Guide to Managing Suicidal Behavior, pre-post deployment screening, PTSD, and combat stress) and others as directed by the mental health flight Commander or AF policy.

1.9 May include supervision of unlicensed providers or trainees.

1.10 Behavioral Health Consultant in the Patient Centered Medical Home (PCMH). The type of work may include, but not limited to, the following:

1.10.1 Participates in and successfully completes Air Force BHC training. Demonstrates core competency skills to an expert trainer within 90 days of starting to see patients in primary care.

The 90-day threshold for demonstration of core competency skills will be extended if the Air

Force is unable to provide training opportunities within 90 days.

1.10.2 Provides brief (typically no more than four appointments) cognitive/behavioral interventions in primary care under the Air Force consultation model (i.e., per the Air Force Behavioral Health

Optimization Program Practice Manual). Services will mimic the pace of primary care (i.e., patients seen for 15- to 30-minute appointments).

1.10.3 May provide classes and/or groups in format appropriate for primary care (e.g., drop-in stress management class, group medical visit for a chronic condition).

1.10.4 Successfully consults with PCMs on-demand about general issues or specific patients.

1.10.5 Ensures PCMs receive same-day verbal and/or written feedback on patients referred.

1.10.6 Delivers brief presentations/trainings to primary care team members regarding behavioral health issues and BHC services.

1.10.7 Participates in team efforts to develop, implement, evaluate, and revise clinical pathway programs needed in the clinic.

1.10.8 Duties may include supervision of providers who are in training or not fully licensed.

1.10.10 Maintain accurate and current notes in the electronic medical records of all patients seen.

1.10.11 Consults with medical personnel, legal authorities, and military commanders as required.

1.10.12 Participates in military specific training (e.g., use of the Air Force Guide to Managing

Suicidal

Behavior, pre-post deployment screening, PTSD, and combat stress, etc.).

1.10.13 Attends and participates in meetings during normal duty hours and professional staff conferences and other appropriate professional activities such as, but not limited to the following: quality improvement meetings, professional staff meetings, commander's staff meetings, primary care staff meetings, appropriate meetings of the mental health flight, High Interest Log case staffing, and others required by applicable regulations, MTF guidance, or as directed by supervisor.

1.11 Behavioral Health Care Facilitator (BHCF) in a Patient Centered Medical Home (PCMH).

The type of work may include, but is not limited to, the following:

1.11.1 Participates in and successfully completes Air Force BHCF training.

1.11.2 Contact referred patients to assess treatment adherence.

1.11.3 Use validated symptom inventories to assess current symptom severity.

1.11.4 Assess barriers to treatment adherence and help patient problem-solve solutions to barriers.

1.11.5 Provide patients with education regarding their mental health condition and treatment regimen.

1.11.6 Maintain patient information in a patient registry.

1.11.7 Maintain accurate and current notes in the electronic medical records of all patients contacted for review by the managing physician.

1.11.8 Routinely staffs difficult cases with the referring provider, behavioral health consultant and/or psychiatry consultant.

1.11.9 Performs case management functions.

1.11.10 Participates in military specific training (e.g., pre-post deployment screening, PTSD, and combat stress, etc.).

1.11.11 Attends and participates in meetings during normal duty hours and professional staff conferences and other appropriate professional activities such as, but not limited to the following: quality improvement meeting, professional staff meetings, commander's staff meetings, primary care staff meetings, appropriate meetings of the mental health flight, High Interest Log case staffing, and others required by applicable regulations, MTF guidance, or as directed by supervisor.

NOTE: Supervision, as used in this PD, means clinically-related supervision only and does not include inherently governmental supervisory duties, including, but not limited to, personnel and employment related activities, i.e., timecards or leave approval.

2.1. AVAILABILITY. Contractor employees shall be required to provide Social Worker services not more than 40 hours per week. Overtime is not anticipated.

2.2 HOURS OF OPERATION. Duty hours would be Mondays through Fridays. The exact hours would be dependent on where the person is working, but would definitely be 8 hours per day. The

Social Worker could be required to provide services in the Market Area (10 th

MDG, 21

st

MDG,

and/or Evans Army Community Hospital). Actual work hours for the contracted social worker will be agreed to between the government and contractor, considering the performance requirements of the contract

3.1 Must hold a Master of Social Work (M.S.W.) degree from a graduate school of social work fully accredited by the Council on Social Work Education (CSWE).

3.2 Maintain a current, unrestricted clinical license to independently practice social work in any one of the 50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands.

3.3 Have a minimum of two (2) years within the past five (5) years in the independent practice of clinical social work in a mental health setting working with an adult population, or with children and teens if specifically working with that population. Experience working in a Government setting such a DOD or Department of Veterans Affairs (VA) MTF is preferable.

3.4 Demonstrate a working knowledge of professional standards and ethics regarding the delivery of clinical social work services.

3.5 Must have experience in brief behavioral interventions.

Echocardiogram Technician

1.1 The technician shall screen and check in patients and escorts patients to treatment areas.

1.2 Accurately prepares room & patient for examinations, therapeutic measures and procedure assuring all needed equipment and supplies are available prior to the start of the exam.

1.3 Takes, monitors and records physiological measurements.

1.4 Performs medical treatment, diagnostic and…