DRAFT PWS 17 Jan 12.docx

AIR FORCE MEDICAL SUPPORT AGENCY (AFMSA)

PERFORMANCE WORK STATEMENT

FOR

AIR FORCE HOSPITAL ASEPTIC MANAGEMENT (HAMS)

SERVICES

10 January 2012

TABLE OF CONTENTS

1.1 Background 3

1.2 Scope 3

1.3 Definitions 3

1.4 Acronyms 7

2.0 SUMMARY OF REQUIREMENTS 9

2.1 Tasks/Requirements/Position Descriptions 9

2.2 Services Summary 29

2.3 Government Furnished Services/Information/Property/ Materials 30

2.4 Deliverables 32

3.0 QUALITY CONTROL/ASSURANCE 33

4.0 NON PERSONAL SERVICES 33

5.0 CONTRACTOR IDENTIFICATION 33

6.0 HOURS OF OPERATION 34

7.0 APPENDICES/EXHIBITS 34

7.1 Appendix A Health Insurance Portability and Accountability Act (HIPAA) of 1996 35

7.2 Appendix B Publications and Regulations 40

7.3 Appendix C Customer Complaint Form 41

7.4 Exhibit A Individual Medical Facility Exhibit (IMFE) 45

1.0 DESCRIPTION OF SERVICES

1.1 BACKGROUND. The purpose of this effort is to acquire non personal healthcare services to provide medical aseptic housekeepers to implement the United States Air Force (USAF), Hospital Aseptic Management Service (HAMS) at United States Air Force Medical Treatment Facilities (MTF) based throughout the Continental United States (CONUS). Services performed under this Performance Work Statement (PWS) shall comply with established standards and Air Force directives. Compliance with all standards and directives will be evaluated during the quality assurance and inspection process.

1.2 SCOPE. HAMS services is a centrally procured service for all management, labor, supervision, management support, transportation, equipment and materials to provide complete aseptic management services for medical and dental facilities in the Air Force. The contractor shall provide all labor, personnel, tools, equipment, transportation, and materials that are not specified as Government furnished in this PWS to perform all task as identified in this PWS. The contractor shall perform all services in accordance with (IAW) this PWS and the Individual Medical Facility Exhibit (IMFE) (exhibit A). This program provides for the aseptic cleaning, protection, and beautification of all rooms and areas identified for coverage at a particular installation to maintain a level of asepsis commensurate with the use of the facility, rooms, and areas. The primary focus of HAMS is for facilities with a potential for exposure to human blood and body fluids. As medical operations include a wide range of services from inpatient to outpatient care, the HAMS program is designed to accommodate differing work hours (7-days or 5-days a week) and differing drivers for cleaning (case driven, non-case driven, patient check-out, etc.). Further, HAMS requires horizontal surfaces be wiped down with a phenolic disinfectant solution to destroy surface borne pathogens and keep them from spreading throughout the MTF thru Heating Ventilation and Air Conditioning (HVAC) systems to limit Nosocomial infections. This HAMS program also has provisions for management of linen service and regulated medical waste as identified in the IMFE.

1.3 DEFINITIONS

1.3.1 Aseptic Cleaning. This is the removal of soil, and or grime from a surface that includes total disinfection standards, policies, and procedures.

1.3.2 Beautification. Is the thorough cleaning, protection and continuous policing to provide a pleasant environment for patients, visitors and staff.

1.3.3 Between-Case Cleaning. The surgical, labor, and delivery room clean up tasks performed at the end of each scheduled or unscheduled case (between-case cleaning shall be started within a response time specified in the IMFE).

1.3.4 Case-Driven. Case-driven rooms/areas include all areas where housekeeping services are required to be performed as a result of the occurrence of an individual procedure or event.

1.3.5 Constant Policing. Cleaning as the need arises; including the cleanup of papers and any other debris and the removal of spills, body fluids, spots, and marks from walls, loading docks, walkways, floors, carpets, and furniture, etc.

1.3.6 Consumable Supplies. Items that are consumed, or otherwise utilized in the normal course of operations.

1.3.7 Controlled Access Areas/Rooms. Areas or rooms that require inspection and cleaning as necessary during the normal duty hours of the assigned function and as indicated on the IMFE room listings and that require an escort for entry to clean.

1.3.8 Critical Care Areas. Areas that include (but are not limited to) surgery, recovery, labor/delivery areas, infant nursery, and central sterile supply areas. These areas are sometimes described as cap and gown areas, or behind the red line, or behind the double doors.

1.3.9 Cycle Task Line Items. These are cleaning services that do occur on a daily or routine basis are therefore separate contract line items. They are to be performed at the frequencies specified in the Services Summary or in the IMFE, unless exempted.

1.3.10 Dedicated Personnel. Employee(s) assigned to a specific area that are dedicated to completing all work in that area before proceeding elsewhere to perform other duties in the MTF.

1.3.11 End of Day Cleaning. The last surgery or labor/delivery room clean up is required at the end of the normal hospital duty hours for the area. End of day cleaning response time shall be specified in the IMFE.

1.3.12 Exterior Entrance. Areas that are located outside the outer entry door that point where a vehicle can approach (if canopy covered, it is the area there under).

1.3.13 Interior Entrance. Areas that are located inside the outer entry door, up to the area where the corridor or main entrance room begins. This area is often set-off by a set of interior doors. This includes atrium entrance areas.

1.3.14 Facility Defects. Are defects in the facility found by the housekeeping staff that require fixing, e.g., leaking faucets, broken or torn furniture, torn or loose floor covering, improperly operating toilets, or broken curtain rods which, if not corrected, could impact the contractor's ability to maintain a totally clean facility, and to keep the facility in a safe condition.

1.3.15 Full Service Hospital. Is an inpatient MTF where all services including surgery and labor/delivery cleaning services.

1.3.16 Healthcare Associated Infections (HAIs). HAIs are infections that patients acquire during the course of receiving treatment for other conditions or that Healthcare Workers (HCWs) acquire while performing their duties within a healthcare setting.

1.3.17 Hospital Infection Control Committee (ICC)/Infection Control Review Function (ICRF). A designated interdisciplinary group of MTF staff members responsible for monitoring and managing the total MTF infection control program.

1.3.18 Hospital Quiet. A noise level of less than 72 db (Decibels) at five feet from the noise source in patient occupied areas.

1.3.19 Individual Medical Facility Exhibit (IMFE). The IMFE tailors the HAMS PWS to the MTF requirement. The IMFE consist of two parts: Narrative and Room Inventory Listings. The narrative identifies specifics (including cycle task line item requirements) applicable to a particular MTF. The room inventory listing identifies the intended usage of the rooms, establishes the daily lot size of the RS and identifies the categories of time a room/area shall be cleaned.

1.3.20 Invasive Procedure Rooms. Are those areas or rooms such as cardiac catheterization rooms, endoscopy rooms, minor surgery rooms, oral surgery, and special procedure rooms.

1.3.21 Items Other Than Cycle Task Line Items. Interior windows, walls, floors, and any other item or surface that can be touched from the room interior is not cycle task.

1.3.22 Medical Facility Adapted Manual (MFAM). Developed by the contractor and comprised of all procedures/work instructions, contractor’s quality control instructions, training, and other literature and directives contractually required to implement the HAMS services program.

1.3.23 Nosocomial Infection. An infection acquired by patients as a result of hospitalization confirmed by clinical or laboratory evidence. (See HAI’s)

1.3.24 Onsite. Services provided within a Government provided MTF.

1.3.25 Patient Use/Visit Areas. Are those areas that the patient occupies, uses, or visits (while in the MTF), or areas where ancillary patient care is delivered or patient treatment is administered (or areas adjacent to these areas) such as patient rooms, examination rooms, nurses stations, clinics, and toilet facilities, etc. This also includes administrative areas in buildings where patients are treated.

1.3.26 Performance Work Statement (PWS). A statement of work for performance based acquisitions that describe the required results in clear, specific, and objective terms with measurable outcomes.

1.3.27 Pre-Cleaning. The daily complete and thorough cleaning performed prior to start of day or use of the area.

1.3.28 Pre-Move in Cleaning. This is an in-depth cleaning to bring an area up to the level of aseptic cleanliness, protection, and beautification to ensure the room/area is acceptable for occupancy.

1.3.29 Protection. This is preventing damage to surfaces and equipment caused by normal use or improper cleaning procedures.

1.3.30 Quality Assurance Audit. Examine periodically for the purpose of ensuring compliance with written work instructions/procedures, schedules, and contract requirements.

1.3.31 Regulated Medical Waste. Any solid waste, generated in the diagnosis, treatment, (i.e., provision of medical services), or immunization of human beings, or in the production or testing of biological products.

1.3.32 Restricted/Secured/Sensitive Areas. These are secured areas that require cleaning less often than daily, on a schedule indicated by the IMFE.

1.3.33 RS Category 1. Is aseptic housekeeping in 7 days per week, non case-driven, critical care areas indicated as RS #1 in IMFE room listings.

1.3.34 RS Category 2. Is aseptic housekeeping in 7 days per week, case-driven, critical care areas indicated as RS #2 in IMFE room listings.

1.3.35 RS Category 3. Is aseptic housekeeping in 7 days per week, patient use/visit areas, indicated as RS #3 in IMFE room listings.

1.3.36 RS Category 4. Is patient unit checkout aseptic housekeeping in 7 days per week, patient units, an Administrative Officer of the Day (AOD), or Medical Officer of the Day (MOD) rooms listed in the IMFE as RS # 4 rooms.

1.3.37 RS Category 5. Is aseptic housekeeping in 5 days per week (Mon-Fri), non case- driven, critical care areas indicated as RS #5 in the IMFE room listings.

1.3.38 RS Category 6. Is aseptic housekeeping in 5 days per week (Mon-Fri), case driven, critical care areas indicated as RS #6 in the IMFE room listings.

1.3.39 RS Category 7. Is aseptic housekeeping in 5 days per week (Mon-Fri) areas indicated as RS #7 in the IMFE room listings.

1.3.40 RS Category 8. Reserved.

1.3.41 RS Category 9. Reserved.

1.3.42 RS Category 10. Is 7 days per week collection and delivery of all medical waste. Clean medical waste holding rooms indicated as RS #10 in the IMFE room listings.

1.3.43 RS Category 11. Reserved.

1.3.44 RS Category 12. Is 7 days per week linen services indicated as RS #12 in the IMFE room listings.

1.3.45 Services Summary. The minimum level of acceptable performance that the contractor must meet.

1.3.46 Soil. Dust, dirt, stains, grease, smudges, streaks, spots, lint, odors, organisms, fomites, or any agent that is injurious to health. Soil can be visible such as dust, or can be invisible such as organisms, and odors.

1.3.47 Total Clean. Upon completion of any and all work by the contractor in a specific area in compliance with the schedule defined in the PWS, the area shall be aseptically cleaned, maintained, protected and beautified as required per the PWS.

1.3.48 Walk-Off Mats and Runners. Nonpermanent floor or carpet covering normally placed at entrances and in high traffic areas.

1.4 ACRONYMS

2.0 SUMMARY OF REQUIREMENTS

2.1 TASKS/REQUIREMENTS AND POSITION DESCRIPTIONS. The contractor shall furnish all management, labor, supervision, management support, transportation, equipment and materials (except as specified as Government furnished, or exempted by the site specific IMFE) to provide complete HAMS services as described herein, and supplemented or modified by the IMFE (exhibit A).

2.1.1 Task Requirements

2.1.1.1 Administrative. The contractor shall accomplish all administrative tasks necessary to ensure performance of the aseptic services, including but not limited to preparation and distribution of work schedules, emergency recall rosters, facility defects reports, and all other data submissions listed below. The contractor shall maintain his publication library with the most current changes/revisions/updates of all publications identified in appendix B.

2.1.1.2 Voluntary Consensus Standards. This Performance Work Statement (PWS) is consistent with OMB Circular No. A-119, Federal Participation in the Development and Use of Voluntary Standards dated 10 Feb 1998. This Circular directs agencies to use voluntary consensus standards (VCS) in lieu of government-unique standards except where inconsistent with law or otherwise impractical. For purposes of this PWS, "voluntary consensus standards" are applicable to hospital/healthcare facility cleaning, green cleaning, Leadership in Energy and Environment Design (LEED), Occupational Safety and Health Administration (OSHA), and International Organization for Standardization (ISO) standards developed or adopted by voluntary consensus standards bodies. The following are VCSs applicable to this effort:

2.1.1.2.1 Association for Healthcare Environment (AHE) Practice Guidance for Healthcare Environmental Cleaning Standards. The Contractor shall meet the AHE standards for “green” environmental cleaning in MTFs. The AHE Practice Guidance cleaning techniques and procedures are based on guidelines by the CDC, OSHA, and other government agencies.

2.1.2 International Sanitary Supply Association (ISSA) Cleaning Industry Management Standard – Green Building (CIMS-GB) or Equivalent.

2.1.2.1 The Contractor shall either possess a current ISSA CIMS-GB certification or equivalent, or shall have the capability to obtain an ISSA CIMS-GB certification or equivalent within 180 days of the contract’s start date. The supporting documentation shall be of substantive, objective evidence (e.g., certification, letter from ISSA) that the offeror is currently ISSA CIMS-GB certified or will be ISSA CIMS-GB certified within contractual timeframe. The Contractor shall maintain ISSA CIMS-GB certification or equivalent throughout the contract period.

2.1.2.2 If a Contractor proposes an equivalent certification, the Contractor shall provide a certified copy of the equivalent certification and provide supporting documentation that the equivalent certification, at a minimum, meets the voluntary consensus standards (VCS) of the ISSA CIMS-GB certification. The supporting documentation shall be substantive, objective evidence (e.g., letter from ISSA) demonstrating equivalency to the ISSA CIMS-GB certification.

2.1.2.3 If a Contractor is awaiting a proposed equivalent certification, the Contractor shall provide supporting documentation demonstrating equivalency to the ISSA CIMS-GB certification and supporting documentation that the Contractor will be equivalent certified within 180 days of the contract’s start date. The supporting documentation shall be substantive, objective evidence (e.g., letter from ISSA) demonstrating equivalency to the ISSA CIMS-GB certification and substantive, objective evidence (e.g., letter from the proposed equivalent certifier) that the Contractor will be equivalent certified within contractual timeframe.

2.1.3 LEED Associate Certification. The LEED Green Building Rating System™ is a voluntary, consensus-based standard to support and certify successful green building design, construction and operations. The Contractor shall provide, at a minimum, one (1) LEED Associate-certified member (corporate or staff) for the execution of “green” healthcare environmental services in MTFs.

2.1.4 Quality Management Standard - ISSA CIMS-GB Certification or International Organization for Standardization (ISO) 9001:2008 Certification.

2.1.4.1 ISSA CIMS-GB certification is acceptable as a quality management standard; however, if not CIMS-GB certified, the Contractor shall be ISO 9001:2008 certified. The Contractor shall maintain ISSA CIMS-GB certification or ISO 9001:2008 certification throughout the contract period.

2.1.5 Environmental Protection Management. The Contractor shall control environmental pollution and damage in consideration of visual esthetics, noise, solid waste, and pollutants. The Contractor shall protect environmental resources for the duration of the contract. The Contractor shall comply with all applicable federal, state and local environmental resources and laws.

2.1.5.1 Identification and Certification of Mandatory Product Attributes. The Contractor shall comply with procurement requirements established by the Federal Acquisition Regulation (FAR) Subpart 23.7 and Executive Order 13101.

2.1.5.2 Environmental Protection Agency (EPA) Comprehensive Procurement Guidelines (CPG). The Contractor shall comply with the EPA CPG program. The CPG program is authorized by Congress under Section 6002 of the Resource Conservation and Recovery Act (RCRA) and Executive Order 13423. The Contractor shall purchase designated products with the highest recovered material content practicable. (http://www.epa.gov/cpg).

2.1.5.3 Biobased Products. The Contractor shall comply with the Department of Agriculture BioPreferred program. Federal acquisition of biobased products is required by Executive Order 13514 and the Farm Security and Rural Investment Act of 2002, Section 9002. The Contractor shall purchase biobased products with the minimum biobased content practicable (http://www.biopreferred.gov).

2.1.5.4 Green Seal (GS) Product Standards. The Contractor shall provide bio- based products that meet Green Seal Product Standards (http://www.greenseal.org) in the performance of this PWS.

2.1.5.5 Sustainable Earth Green Cleaning (SEGC) Product Standards. The Contractor shall provide cleaning products that meet the Sustainable Earth Green Cleaning (SEGC) products standard 104-E.

2.1.5.6 Environmentally-Preferable Products. The Contractor shall purchase and implement environmentally preferable cleaning products or equivalent listed below:

Green Seal GS-37 for general purpose, bathroom, glass, and carpet cleaners used for industrial and institutional purposes

Green Seal GS-37 for general purpose, bathroom, glass, and carpet cleaners used for industrial and institutional purposes

Green Seal GS-37 for general purpose, bathroom, glass, and carpet cleaners. Used for industrial and institutional purposes

Green seal GS-34 for cleaning and degreasing agents

Green seal GS-40 for industrial and institutional floor-care products

Environmental choice CCD-115 for odor control additives

Also review Design for the Environments (DfE) Key Characteristics of Laundry Detergent Ingredients Green Seal GC-11 Environmental Criteria for Powdered Laundry Bleach

2.1.5.7 Disposable Products. The Contractor shall purchase and implement disposable products or equivalent listed below. In addition, all disposable products or equivalent shall be certified Processed Chlorine-Free® (PCF), if applicable.

2.1.5.8 Energy Star or Energy Efficiency Product Standards. The Contractor shall purchase and use Energy Star or other energy-efficient items listed on the Department of Energy’s Federal Energy Management Program (FEMP) Product Energy Efficiency Recommendations product list. Supplements or amendments to listed publications from any organizational level may be issued during the life of the contract.

2.1.6 Work Scheduling

2.1.6.1 The contractor shall determine and schedule daily, the number of times per day areas shall be inspected and necessary services performed to ensure that all rooms/areas are maintained to meet the total clean requirement.

2.1.6.2 The contractor shall determine and provide to the Contracting Officer Representative (COR) copies of schedules for the exact day-by-day performance of all cycle task line item cleaning.

2.1.6.3 Schedules for RS #3 and RS #7 inspection and cleaning and cycle task daily effort shall be provided to the COR one-month prior to accomplishment. RS #3 and RS #7 schedules shall show the phasing of completion of work by room/area throughout the day. Cycle task schedules shall indicate the rooms/areas to be completed on a given date. Critical Care rooms/areas listed in RS items 1, 2, 5, and 6 are the only rooms/areas that do not require a written schedule.

2.1.6.4 The contractor shall submit schedule changes in writing to the COR at least 24 hours in advance of the initially scheduled time for beginning the output. If a cycle task scheduled is not completed on a given date, the contractor shall notify the COR at the start of business the next workday. Cycle task line items shall not be paid for until completed to the satisfaction of the COR and/or CO.

2.1.7 Dedicated Personnel. Sufficient dedicated housekeeping personnel shall be permanently assigned to meet the case-driven response times required in the IMFE and to provide all HAMS services required in the areas specified as dedicated. Supplemental personnel shall be trained and assigned to fill in during breaks, lunch, or any other absence of the permanently assigned personnel and to provide additional support personnel when the need arises as a result of heavy case loads, (e.g., three surgical cases occurring at the same time). Upon completing all required work in the dedicated area, the employee(s) may work elsewhere within the facility. When requested, the employee(s) shall return to the dedicated area within the response time indicated in the IMFE. NOTE: Personnel shall be dedicated 24 hours per day in labor and delivery areas.

2.1.7.1 Certified Executive Housekeeper (CEH). Provide an onsite CEH for each hospital listed in the IMFE.

2.1.7.2 Associate Executive Housekeeper (AEH). Provide an onsite AEH at in- patient MTF as identified in the IMFE.

2.1.7.3 Shift Leader. Appoint shift leaders for each shift. The shift leader shall represent the contractor in the absence of the CEH and AEH and shall be capable of interpreting and implementing all requirements of the contract. The names of these individuals shall be provided in writing to the COR within 20 calendars days after award and when the individual employees change.

2.1.8 Personnel Roster

2.1.8.1 The contractor shall have a written personnel roster that shall be maintained current and that includes at a minimum the name of the employee and job assignment. The COR shall be furnished the original roster and all changes thereafter. Employees not listed shall not be allowed to work in the MTF.

2.1.9 Facility Defects

2.1.9.1 The contractor personnel shall report facilities defects immediately, in writing, to the COR or Facility Manager. If the COR or Facility Manager is not on duty at that time, report is to be made to the appropriate personnel as designated by the COR.

2.1.10 Aseptic Maintenance through Housekeeping

2.1.10.1 All rooms/areas shall receive necessary cleaning, protection, and beautification in accordance with (IAW) the individual contractor’s written procedures MFAM which shall specify the proper solutions, and mixtures appropriate to the intended use for the room/area location within the MTF. When the housekeeper leaves the room/area, it shall be total clean. The contractor's procedures shall include the wear of appropriate Personal Protective Equipment (PPE) and practices for each cleaning procedure.

2.1.10.2 Use of dry dusting tools is not permitted.

2.1.10.3 Use of alcohol, ammonia or other ingredients that would produce any harsh, harmful or noxious odors or fumes shall not be used.

2.1.10.4 Use of Steel wool, abrasive metal cleaners, or any other cleaning material or supply that could cause damage to Government property is prohibited.

2.1.10.5 Soil can be removed chemically, mechanically, or by a combination of both. Mechanical soil removal is removing soil with a machine such as a vacuum cleaner. Chemical soil removal is removing soil with a liquid that contains cleaning agents, such as detergents, disinfectants, and sanitizers. The combination of chemical and mechanical methods, such as an automatic floor-scrubbing machine, uses the chemical method to break down and loosen the soil while the mechanical method picks up and carries the soil away. Which soil removal method is used is dependent on the cleaning objectives and on the size, location, and type of surface to be cleaned and is the prerogative of the contractor.

2.1.10.6 Mixing of chemicals shall be accomplished in areas having permanent eye wash stations only.

2.1.11 Categories of Cleaning Times

2.1.11.1 There are three categories when pre-inspection and daily cleaning is required. Cleaning shall be accomplished as needed to maintain the facility as Total Clean in the following categories:

2.1.11.1.2 Seven days per week in RS1, RS2, RS3, RS4, RS10 and RS12.

2.1.11.1.3 Five days per week (Monday through Friday) in RS5, RS6, and RS7.

2.1.11.1.4 Cycle task line item cleaning (as required in the PWS and supplemented by the IMFE (Exhibit A).

2.1.11.1.5 The Case-Driven Operating (RS 6) and Labor/Delivery rooms (RS2) identified on the room charts shall be made totally aseptically clean within the time frames identified in the IMFE. A between-case cleaning required after end-of-day cleaning shall be considered emergency response cleaning. The contractor shall have sole use wet vacuums, sprinkle apparatus (for application of solutions to floors), mops, buckets, and other equipment needed for cleaning operating and delivery rooms, and written procedures for use of this equipment for sprinkle disinfecting/wet vacuuming, and two-bucket wet mopping (both techniques).

2.1.11.1.6 Unit Checkout Service is a seven days per week service, required as necessary when the room occupant permanently leaves. Rooms include patient rooms, birthing rooms, recovery rooms, infant nursery, Medical Officer of the Day (MOD), student resident, or On-Call bedrooms and any additional bedrooms listed in the IMFE as RS #3 rooms. During the day shift and until 9:30 p.m. on the evening shift, the contractor shall begin cleaning within 15 minutes after notification by a Government representative (or as specified in the IMFE). After 9:30 p.m. if the room is vacated, cleaning shall start within 30 minutes of the following day shift. Exceptions to this requirement shall be considered as an emergency response. All unit check out cleaning includes obtaining clean linens for the rooms and bathrooms, removal of all soiled hospital linens (including MTF furnished staff clothing in the MOD, student Resident or On-Call rooms) and making the beds. It also includes the housekeepers changing of cubical curtains when visibly soiled or as required by MTF personnel. Unit checkout service shall continue without interruption until completed.

2.1.12 Cycle Task Cleaning. In addition to routine daily aseptic maintenance, the items identified below, shall be cleaned at the frequencies specified in the IMFE. The exact month the cycle task is to be started and completed is specified in the IMFE. Room listings are not provided for cycle task cleaning.

2.1.12.2 Light Fixtures. Light covers shall be removed and the light fixtures are to be cleaned inside and out. This includes cleaning inside ceiling lights, emergency exit lights, patio lights, outside entrance and loading dock lights, interior lighted signs, canopy lights, delivery and operating room lights, and all other lights (except desk, table, bed, floor). This cleaning is in addition to the cleaning of the outside of the light fixtures performed as part of daily scheduled inspection and cleaning.

2.1.12.3 Exterior Windows. This includes cleaning of the frame and the areas immediately adjacent to the frame and ledges and removing, cleaning and replacing of screens, and/or storm windows are included unless exempted in the IMFE. This includes cleaning all glass surfaces on the exterior of the MTF (includes storm windows).

2.1.12.4 Limited Interior Duct Cleaning. Removable portions of registers, diffusers, and grills shall be removed and cleaned on an annual cycle or as scheduled in the IMFE. The entire removable portion shall be cleaned. The inside of the ducts behind the registers, diffusers, and grills shall be vacuumed (as far as the vacuum hose shall reach), and then washed and sprayed with a germicidal detergent, and the removable portions replaced.

2.1.12.5 On a six-month cycle or as scheduled in the IMFE, window/wall drapes and curtains shall be removed within two days after COR notification and provided to the designated source for cleaning. They shall be re-hung, with the same style as those removed, within two days after they are returned to the HAMS contractor. Cubicle curtains are not included in cycle cleaning; they are to be maintained as part of routine unit checkout services.

2.1.12.6 Should other cycle task cleaning or unique requirements be identified, the IMFE (Exhibit A) shall specify the requirements and the months that they are to be started and completed within.

2.1.12.7 Restricted/Secure/Controlled/Sensitive Access Areas. Cleaning of these areas shall be performed at the frequency specified in the IMFE and shall consist of trash removal, damp dusting, high damp dusting, and vacuuming or wet mopping. All cycle tasks services shall be performed in these areas at the same time and frequency as all other areas of the facility.

2.1.13 MISCELLANEOUS SERVICES

2.1.13.1 The contractor shall provide continuous inspection and necessary cleaning services to exterior entrances and platforms (areas outside the buildings). Entrances and entrance platforms shall be cleaned once daily as a minimum (per contractor schedule) prior to the start of heavy traffic hours. These items shall be included as part of this service: Clean foot scrapers, exterior entrance mats, and individual trash, and smoking receptacles. Remove lint, cobwebs, mud, dirt, bugs, and litter from canopies and entrance lights and from the outside walls of (and in the immediate vicinity of) the entrances. Wash down the area (except during freezing weather) and remove any standing water from the entrance and adjacent sidewalks. Police and clean up within 15 feet of each direction from the bulk refuse containers and entrance walkways. Clean entrance windows, storm windows and doors, as required, maintaining a clean appearance. This includes all glassed-in areas of solariums and administrative and clinic entrances. Patios shall be cleaned except during inclement weather.

2.1.13.2 Light and lamp bulb/tube replacement shall be done on a daily basis when burnout occurs, either when the contractor's inspection identifies the need or when notified.

2.1.13.3 Ceilings. Vacuum or damp dust ceilings (as necessary to pass daily inspection) to assure all dust, streaks, and cobwebs are removed. The immediate vicinity of air ducts in acoustical tile ceilings shall be kept clean using an approved ceiling tile cleaner.

2.1.13.4 Elevators. No less than once daily (during the evening or night shift), clean all interior surfaces (including all light fixtures, ventilator slots, and guide tracks), and floor door guide tracks of passenger and service elevators, as often as necessary, to maintain them in a polished and presentable appearance. Only one car is to be out of service for cleaning at a time, and it shall be included in the room listing and cleaned at the lowest floor level only.

2.1.13.5 Housekeeping equipment shall not be allowed in the same elevator with full food service carts and/or clean linen carts. Food service carts have precedence over housekeeping equipment being transported.

2.1.13.6 Constant policing shall be performed as defined herein and as expanded in the contractor's procedures manual. Constant policing shall provide the inspection necessary to assure a continuously aseptically total clean area. Constant policing and cleaning as the need arises; including the cleanup of papers and any other debris and the removal of spills, body fluids, spots, and marks from walls, loading docks, walkways, floors, carpets, and furniture, etc. Cleaning shall be the result of constant inspection by contractor's personnel.

2.1.13.7 Occupied patient beds shall be moved by the Government medical personnel.

2.1.14 RESPONSE TO STAFF REQUESTS FOR IMMEDIATE ASSISTANCE OR FAILURE TO CLEAN

2.1.14.1 The contractor shall respond to a request by a Government representative for immediate assistance or take corrective action if the contractor fails to provide adequate scheduled cleaning or constant policing.

2.1.14.2 Response shall begin within 10 minutes from notification. If a response is needed at a time when the contractor is not required to have an employee working in the facility, the contractor shall respond at the start of the next shift.

2.1.14.3 Response for Unit Checkout Services between 9:30 p.m. and the start of the next day shift shall follow the conditions below. At all other times, the contractor shall respond as directed in the IMFE.

2.1.14.3.1 The checkout services are for the only available bed in a nursing unit, or the last single patient room, when a new patient has been admitted needing the bed.

2.1.14.3.2 The patient is transferred from a non-isolation room to an isolation room. The entire room vacated shall be cleaned with isolation room terminal room cleaning procedures in the MFAM.

2.1.14.3.3 If it is an isolation room that is vacated, it shall be cleaned with isolation terminal room cleaning procedures in the MFAM.

2.1.15 MTF NATUARL DISASTER/EMERGENCIES

2.1.15.1 During extreme or protracted emergency incidents it may be necessary to direct contractor employees on cleaning procedures appropriate to address an MTF natural disaster/emergency.

2.1.16 EQUPMENT AND SUPPLIES

2.1.16.1 Housekeeping equipment shall not be allowed in the same elevator with full food service carts and/or clean linen carts. Food service carts have precedence over housekeeping equipment being transported.

2.1.16.2 Mop heads and bonnets shall meet the requirements in the IMFE. The contractor is responsible for proper cleaning of all mop heads and it shall not be done in the facility. Non disposable mop heads shall be changed when soiled and laundered daily as a minimum.

2.1.16.3 Sole-use supplies and equipment shall be stored and used in the designated area and shall not be transferred between sole-use areas. All items assigned to a sole-use area shall be plainly marked with that area's designation. These markings shall be permanent, such as paint or a metal tag. Sole-use areas are identified in the IMFE.

2.1.16.4 All equipment shall be routinely cleaned and sanitized with an Environmental Protective Agency (EPA) registered germicidal detergent product prior to introduction or re-entry into the MTF. In addition, project-cycle-cleaning equipment being moved within the facility shall be cleaned, as defined above, prior to entry into or removal from each asepsis level and between sole-use areas.

2.1.16.5 All containers of cleaning chemicals and similar products shall be conspicuously marked with a factory label to identify contents and all other labels shall be removed or defaced. Materials bearing Department of Transportation (DOT) red labels (meaning FLAMMABLE) shall not be used.

2.1.16.6 Supplies and equipment shall not be transported in trash barrels, mop buckets, etc. All materials and equipment not immediately in use shall be properly stored. All wheeled and mobile equipment shall be equipped with protective non-marking wheels and rubber bumpers or guards around the entire perimeter.

2.1.17 Pre-move in cleaning may be required as a result of the following:

2.1.17.1 An area had been closed and removed from the contract and is being returned to the contract.

2.1.17.2 A construction contract has been completed, the construction contractor has completed the cleaning required by the construction contract and the area is ready to move into.

2.1.17.3 A contingency area is being activated.

2.1.17.4 Bonnet/pad cleaning of carpet may be used between extractions using low foaming carpet cleaner for surface cleaning only to prevent rapid resoiling in high traffic areas.

2.1.18 MEDICAL FACILITY ADAPTED MANUAL (MFAM). The contractor shall develop a MFAM and provide it to the COR, no earlier than 20 calendar days after award but not later than start of performance at a particular site. The MFAM shall include as a minimum the following:

2.1.18.1 Work instructions/procedures, processes, and product descriptions to implement contractual obligations. The preparation and maintenance of, and compliance with, these instructions shall be audited as a function of the contractor’s Quality Control Program to assure compliance with or timely changes to the instructions.

2.1.18.2 A documented inspection system covering the service requirements in the PWS and IMFE. This inspection system shall include as a minimum, daily sampling inspection of the rooms in RS #3 and RS #7 and cycle tasks. Description shall include specifics as to the areas to be inspected, frequency of inspections, and the title and organizational placement of the inspectors.

2.1.18.3 A documented method of early detection and correction of assignable conditions adverse to the quality of service, to include analysis of corrective action records (including customer complaints) in order to determine causes of defects. This method shall include providing timely written explanation/documentation of the correction of the defectiveness and correction of cause in response to Government corrective action request on the Customer Complaint Record, Corrective Action Report (CAR) Form, or the Contract Discrepancy Report (CDR) to the COR and shall also include bacteriological monitoring when necessary.

2.1.18.4 A documented method for using the results of contractor performed inspections and other quality-related data, such as customer complaints, to implement quality trend analyses as means to identify and implement appropriate management actions.

2.1.19 REGULATED MEDICAL WASTE

2.1.19.1 MTF personnel shall place all regulated medical waste into appropriate containers. Regulated medical waste shall be collected and removed by HAMS contractor personnel in a transport cart separate from general refuse and shall be delivered to a locked storage area designated in the IMFE. Waste shall be stored in this area until destroyed, treated, or picked up by a licensed contractor. Contractor personnel must wear appropriate PPE during any handling of waste. Chemotherapy waste designated as regulated medical waste by the Facility Waste Management Program shall be picked up by contractor personnel and treated in the same manner as regulated medical waste. Contractor personnel shall also pick up regulated medical waste from outlying MTF buildings.

2.1.19.2 All waste receptacles/containers and holding areas shall be cleaned daily, and as needed, seven days per week, unless otherwise specified in the IMFE. Cleaning of the regulated medical waste storage area shall be accomplished using an ICC/ICRF-approved germicidal detergent to ensure floors, walls and ceilings are aseptically clean. Cleaning of the area/room containing the regulated medical waste treatment or destruction equipment shall also be accomplished on the same schedule. Waste holding areas shall be kept secure.

2.1.19.3 Regulated medical waste shall be handled, treated, destroyed, weighted or disposed of as specified in the IMFE.

2.1.19.4 If regulated medical waste is disposed off-site by another contractor, the HAMS contractor personnel shall package regulated medical in accordance with federal, state and local regulations. The waste, to include sharps containers, shall be placed in containers that are rigid, leak-resistant, and impervious to moisture (containers to be supplied by the waste contractor). Containers shall be sealed to prevent leakage and handled in a manner that shall prevent bursting or tearing during transport. Liquid containers shall be placed in break-resistant and tightly sealed packages. All exterior containers used shall display the biohazard symbol. Bags used as container liners need not be labeled. All exterior containers shall be marked in accordance with local and State guidelines. Documentation shall be retained by the Facility Management Office.

2.1.20 LINEN SERVICES

2.1.20.1 The HAMS contractor shall manage, schedule, and perform the requirements listed below unless otherwise specified or exempted in the IMFE.

2.1.20.2 Semi-annual Inventory

2.1.20.2.1 A physical inventory of linen shall be performed at the beginning of the contract and every six months thereafter unless linen distribution is exempted in the IMFE.

2.1.20.2.2 A six month inventory report shall be provided to the COR within 15 calendar days after the linen inventory.

2.1.20.2.3 The report shall identify all linen on hand, new linen received, and old linen salvaged since the prior inventory.

2.1.20.3 Monthly Report

2.1.20.3.1 Prepare and submit a monthly report of linen on hand, unless linen distribution is exempted in the IMFE.

2.1.20.3.2 A Medical Linen Supply Record shall be maintained for each line item in the inventory.

2.1.20.3.3 Five workdays after the end of the month, a written report showing the number of each item on hand shall be provided to the COR.

2.1.20.4 All linen items shall be sorted, weighed, and/or accounted for by HAMS contractor personnel (according to the method identified in the IMFE) at the time of pickup by the laundry contractor. Curtains and drapes shall be accounted for on a count basis. The daily record count shall be provided to the MTF laundry contract COR. Personnel must wear complete PPE.

2.1.20.5 HAMS contractor personnel shall verify the quantities of items received from the laundry contractor to be consistent with the delivery tickets. Delivery tickets shall be forwarded to the MTF laundry contract COR, and shall include a separate list of all discrepancies noted. The laundry contractor may modify the delivery tickets in pen to obtain the concurrence/verification by HAMS contractor personnel.

2.1.20.6 Clean linen shall be stored in the central clean linen area in accordance with facility infection control guidelines.

2.1.20.7 Clean linen shall be distributed and soiled linen shall be removed from all MTF outlying buildings in accordance with the IMFE schedule.

2.1.20.8 Clean linen shall not be transported or stored in the same rooms, carts, bins, elevators, or shelves used for the storage or transportation of soiled linen without use of proper precautions (described in MFAM procedures and quality manuals) being taken to prevent cross contamination.

2.1.20.9 Clean and soiled linen shall not be handled at the same time by one person. Linen personnel who handle soiled linen shall change all PPE (outer garments and shoes/shoe covers) and wash their hands before handling clean linen.

2.1.20.10 All soiled linen shall be placed in impervious or plastic bags or as specified in he IMFE. Bags used shall not be of the same type or color as those being used for regulated medical waste in the MTF. Once closed, bags shall not be opened. Bags shall only be opened by the laundry contractor at his/her facility.

2.1.20.11 Sufficient linen (including a small reserve) shall be maintained in the using areas to support normal usage until the next scheduled distribution. The HAMS contractor shall replenish depleted linen levels on an on call basis, due to a medical emergency.

2.1.20.12 All new linen shall be marked with the name of the medical facility immediately upon removal from the original shipping packages or no later than five days after receipt.

2.1.20.13 Linen items with non legible identifying marks shall be remarked before placing in use or linen room.

2.1.20.14 Linen that cannot be repaired shall be stored in a separate area for inspection and disposition by the Government.

2.1.20.15 Soiled linen removed from each section shall be weighed (or as specified in the IMFE) and recorded by user section. A weight summary by user sections shall be submitted to the COR by the 5th working day of the following month.

2.1.20.16 Soiled-for-Clean Uniform Exchange Service shall be operated during the hours specified in the IMFE, unless exempted in the IMFE.

2.1.20.17 Linen ring stands and hamper covers shall be cleaned with a germicidal detergent daily, as a minimum.

2.1.21 TRAINING

2.1.21.1 The contractor shall provide initial training of all employees two weeks prior to start of work for all employees who have never received HAMS initial intensive training. Employees who have had previous HAMS training (including specialized area training) shall complete this training within two weeks after starting work. The contractor shall ensure that their employees participate in any required MTF sponsored personnel orientation courses. The following topics shall be included:

2.1.21.1.2 A general orientation of basic bacteriological concepts, infection control, and Standard or Universal Precautions and related duty functions.

2.1.21.1.3 Complete instructions on obtaining, use, storage, care, and disposal of supplies and equipment. Instructions on the selection and measurement of proper cleaning chemicals.

2.1.21.1.4 Duties of each employee and techniques for measuring quality of work performance (including evaluation of cleaning effectiveness).

2.1.21.1.5 Familiarization with applicable Federal, State, local, hospital, and base regulations and policies. Orientation/overview on fire prevention, ground safety, smoking, security, employee health, standard or universal precautions, exposure control plan, facility emergency management plan, utilities plan, and PPE. Orientation/overview of the Government respiratory protection plan and Government furnishing and fitting of HEPA masks as required.

2.1.21.1.6 Familiarization with all technical and procedural manuals provided as part of the MFAM.

2.1.21.1.7 The role of housekeeping in the healthcare facility and its effects on the health and well-being of patients, staff, and visitors.

2.1.21.1.8 Linen exchange services (including proper handling and care of all linen). (If linen service is identified in the IMFE.)

2.1.21.1.9 Techniques for cleaning the maximum asepsis areas such as surgical suite, obstetrical suite, newborn nursery, and central sterile supply, etc., (For persons being assigned to these specialized areas.)

2.1.21.1.10 Employee’s personal hygiene.

2.1.21.1.11 Adherence to all work schedules.

2.1.21.1.12 Documentation of completion of scheduled work assignments.

2.1.21.1.13 Patient/Personnel/Staff/Visitor Relations.

2.1.21.1.14 HIPAA and Patient Privacy regulations and…