Attach__2-QASP_FY14_Paramedic_Training_21_APR_14.pdf

AIR FORCE MEDICAL OPERATIONS AGENCY

QUALITY ASSURANCE SURVEILLANCE PLAN

FOR

Paramedic Training

21 APRIL 2014

1387325650C Typewritten Text

FA8052-14-R-0014

Attachment #2

SECTION 1.0

1.1 Purpose: This Quality Assurance Surveillance Plan (QASP) has been developed and will be implemented in accordance with Performance-Based Services Acquisition (PBSA) guidelines. This

QASP prescribes how the multi-functional team (MFT) for the contracted Paramedic Training program will assess the contractor’s performance and manage the acquisition throughout its life cycle. The team’s goal is successful contract performance. This plan addresses both Performance

Management and Performance Assessment.

1.2 Objective: This QASP is based on the premise that the Contractor is responsible for contract management and quality control. The Government’s objective is to obtain the necessary training required to certify up to 60 Air Force Medical Services (AFMS) Emergency Medical Technicians

(EMTs) annually to the Paramedic level in accordance with the established standards set by the

National Registered Paramedic (NRP) certification guidelines and the National EMS Education Standards and Paramedic Instructional Guidelines. Training shall be conducted in two courses no less than 20 students, no more than 35 students per course.

1.3 Results: The results in managing this acquisition through this QASP are to provide the AFMS

Emergency Medical Services with additional Paramedic Certified technicians to help overcome the current shortage in these first responder Paramedics and improve medical care to patients at the accident scene and en-route to the Medical Treatment Facility (MTF).

1.4 Incentive Plan: Positive incentives as a result of performance that continually exceeds the performance objectives as outlined in the PWS may result in reduced surveillance and favorable

Contractor Performance Assessment Reports (CPAR). Negative performance incentives include re-performance of the defective service in accordance with the Inspection of Services clause, reduction of fee/price, negative CPAR reporting and/or increased surveillance.

1.5 Multi-Functional Team Roles & Responsibilities: The purpose of the multi-functional team is to create an environment that shapes and effectively executes acquisitions within their purview. The emphasis is on teamwork, trust, common sense and agility. These stakeholders are responsible for the acquisition throughout the life of the requirement, instituted under the authority of the senior leadership; every representative within the multi-functional team brings to the team their unique level of expertise. The following members will participate in the performance management of this specific contract. Their roles and responsibilities are described as follows:

1.5.1 The COR Supervisor: Has overall responsibility for identifying mission essential services and developing the necessary documents in accordance with DoDI 3020.37, Continuation of

Essential DoD Contractor Services During Crisis, assigning primary and alternate Contracting

Officer’s Representatives (CORs) who will be available full time or as warranted by the procurement cycle, and reviewing contractor performance documentation on a regular basis to ensure performance is compatible with contract and mission objectives while supporting a higher level of contractor performance, and fostering synergistic partnerships.

1.5.2 The Program Manager (PM): Has the overall responsibility for initiating, managing and tracking the various programs/projects that support the contract. The PM is the primary liaison of the contractor employees’ performance and the Contracting Officer (CO) and the Contracting Officer’s

Representative (COR). The PM is responsible for assisting in the preparation of requirements documents providing customers with a single contact point, monitoring the contractor’s overall performance of all assigned contracts, task orders and initiating contract changes and other supporting documentation. The CO and PM share joint responsibility in facilitating the multi-functional team meetings.

1.5.3 The Contracting Officer (CO): Has overall responsibility for overseeing the contractor’s performance. The CO, through assigned COR’s, monitors contractor performance in the areas of contract compliance, contract administration and cost control. The CO resolves all differences between the COR version and the contractor’s version of events by reviewing the COR’s assessment of the contractor’s performance. The CO is the only person with the authority to direct the contractor in the performance of duties under the contract and to make interpretations of and changes to the contract. The CO and PM share joint responsibility in facilitating the multi-functional team meetings.

1.5.4 The Contracting Officer’s Representative (COR): Has the responsibility for the contractual/ technical monitoring of the contractor’s performance and assessing, recording, and reporting on the contractor’s compliance with the terms and conditions of the contract. The COR is the primary liaison between the CO and the PM. The COR will ensure availability to receive training prior to performing contract surveillance. The COR will ensure that contract surveillance documentation is accomplished, and notify the COR Supervisor through the PM and CO, of any significant performance deficiencies, and recommend improvements to the QASP and PWS throughout the life of the contract.

1.5.5 Quality Assurance Program Coordinator (QAPC): Has the responsibility for overseeing COR surveillance activity. The QAPC is responsible for providing Initial QA Training.

The QAPC is also responsible for COR Management on contracting requirements associated with the

Quality Assurance Program. The QAPC also supports the acquisition team in the development of contract QA requirements specifically ensuring that requirements are clearly stated and enforceable.

1.5.6 The Contractor: Is responsible for complying fully with the terms and conditions of the contract, participating as a member of the multi-functional team in the post-award management phase, maintaining and implements a Quality Control Plan (QCP) that compliments the QASP, insuring that non-conforming contract services are identified and corrected. When necessary, revising the QCP to prevent recurrence. Responsible for tendering to the Government for acceptance only those services that conform to contract requirements and recommending any changes to the contract that will provide more effective operations or eliminate unnecessary costs.

SECTION 2.0

2.1 Methods of Inspection Applicable To This Contract: This is a Firm Fixed-Price contract.

2.1.1 Quality Control Plan: The contractor shall maintain and implement a quality control plan to ensure the contract services conform to the requirements of the performance work statement. COR shall monitor contractor’s performance against the contractor’s quality control plan.

2.1.2 Initial Contract Performance Review: The initial evaluation of contractor performance is a joint determination by the multi-functional team that the contractor has successfully started performance, completed transition, is fully operational, and is within the estimated cost, schedule, and performance parameters of the contract. The initial evaluation will be conducted by the government within thirty (30) days after the contractor assumes full performance responsibilities.

2.1.3 Periodic Inspection: These items are inspected using periodic surveillance (daily, weekly, monthly, quarterly, etc.) as determined by the COR. The results of the periodic surveillance inspections may be used as the basis for actions towards the contractor. In such cases, the Inspection of Services clause becomes the basis for the Contracting Officer’s actions. Periodic inspections may be conducted via site visits to verify progress on site or telephone calls with onsite representatives, review of contractor reports and other deliverable documents.

2.1.4 Customer Feedback: The COR is the primary point of contact for collection & validation of all customer feedbacks. The Customer Complaint Record (Appendix C to the PWS) or a contractor furnished form approved by the Government may be used for this purpose. All feedbacks and any resulting resolution of such complaints must be documented. Customer feedback forms (Appendix D to the PWS) can be used by the customer for positive and/or negative feedback on contractor performance. All customer complalint records and Customer feedback forms and supporting documentation become a permanent part of the COR surveillance records. The COR will contact each customer involved with this contract periodically to assure there is an understanding of the contract requirement by all appropriate personnel and that they have a sufficient number of customer feedback forms. Positive feedback will also be maintained for inclusion in the final CPARs for this contract.

2.1.5 Contract Services Summary with Inspection Methods

Performance Objectives PWS

Paragraph

Performance

Threshold

Inspection Method

Be fully certified and accredited by the Committee on

Accreditation of Educational

Programs for the Emergency

Medical Services Professions

(CoAEMSP) as an approved source for paramedic training and certification. Provide curricula of training that results in certification of Air Force EMTs to the Paramedic Level in accordance with the established standards set forth by NRP, National EMS Education

Standards and Paramedic

Instructional Guidelines

2.1.1 Must obtain

90% first time pass rate 90% of the time.

Periodic Monthly

Inspections

Required training includes real world “ride along” (field internship)/Clinical program for all students

2.1.2 100% of students shall participate in the “ride along” program

Periodic Monthly

Inspections

Customer Feedback

Provide, at no cost, remedial training for students following their first time failure of the

NREMT Paramedic Exam.

Remedial training days will be in addition to the 120 calendar days allowed for initial training

3 Provide, at no cost, remedial training for students following their first time failure of the NREMT Paramedic Exam. Remedial training days will be in addition to the 120 calendar days allowed for initial training.

2.1.6 No more than 3

substantiated deficiencies during a 6 month period

2.1.8 No more than 3

substantiated deficiencies during a 6 month period

Periodic Monthly

Inspections

Customer Feedback

2.2 Performance Status Notification: The COR will ensure that the CO is continually informed of contract performance status. The CO should also be informed of any contract discrepancies noted during COR surveillance.

2.3 Discrepancy Reporting: The COR will notify the CO of any discrepancies noted during inspections. This notification is for discrepancy correction only and does not indicate concurrence to the discrepancy. The COR will also notify the PM and the CO of all discrepancies noted during the surveillance. The frequency and method of notification to the CO will be provided to the COR during contract specific training.

2.4 Remedies for Unacceptable Performance: In accordance with the contract Inspection of

Services clause, if any of the services do not conform to contract requirements; the Government may require the Contractor to perform the services again in conformity with contract requirements, at no increase in contract amount. This includes but is not limited to termination of Contractor personnel and recruitment of substitute personnel that are equally qualified within established timeframes.

When the defects in services cannot be corrected by re-performance, the Government may:

2.4.1 Require the Contractor to take necessary action to ensure that future performance conforms to contract requirements; and

2.4.2 Reduce the contract price to reflect the reduced value of the services performed.

2.4.3 If the Contractor fails to promptly perform the services again or to take the necessary action to ensure future performance in conformity with contract requirements, the Government may

2.4.4 By contract or otherwise, perform the services and charge to the Contractor any cost incurred by the Government that is directly related to the performance of such service; or

2.4.5 Decrement invoice as stated in the PWS related to performance; or terminate the contract.

2.5 Non-SS (Non-Service Summary) Items: Quality performance is expected on all contract requirements (Non SS) items by the contractor. All Non-SS items may be inspected by the COR to include on site locations.

2.6 Certification of Services: Certification of services is performed by the COR and or the PM via

Wide Area Work Flow (WAWF) system. At the end of each billing period the contractor inputs invoice information in the WAWF system. The WAWF automatically notifies the appropriate COR via email of pending invoice. The COR accesses WAWF and verifies accuracy of the contractor’s data. If data is correct the COR certifies invoice and payment is affected by the Defense Finance

Accounting System. If the COR encounters errors in the contractor’s invoice, the COR will resolve with the CO. If the contractor disagrees with the COR the issue is forwarded to the CO for resolution.

SECTION 3.0

CONTRACT MANAGEMENT

3.1 The multi-functional team shall utilize the following approaches, methods, and tools to manage the contract upon award:

3.1.1 Initial Contract Performance Review: The initial performance review criteria are included in this

QASP and the review shall take place within 30 days after the contractor assumes full performance responsibilities. (i.e. after completion of transition/mobilization).

a. Technical. Assess the contractor’s conformance to contract requirements. Specifications and standards of services (e.g., commonly accepted technical, professional, safety or health standards)

b. COR shall conduct, document, track, and analyze contractor performance via regularly scheduled assessments. The assessment results shall be maintained as Past Performance Information and utilized to prepare and support annual Contractor Performance Assessment Report System (CPARS) reporting. Assessment results will be used to develop metrics to track Contractor’s overall compliance with contract terms and conditions.

3.1.2 COR File: A contract file must be established and maintained by the COR assigned to the contract. The file is typically maintained in a computer data base system using the Contractor Officer

Representative Tracking (CORT) Tool. The COR will self-nominate and this nomination will be approved by the COR supervisor and the Contracting Officer. Upon Approval, the COR will create a profile, complete the required training, and upload their certificates into the CORT Tool. The CORT tool will be used to track CORS, contract documents, and reports.

Any computer maintained documents must be readily available for inspection by the contracting office and possible audits. All contract documents must be maintained for the life of the contract and turned in to the contracting office upon contract expiration, including all computer maintained documents. The contract file must contain as a minimum, the following documents and be set up utilizing an index:

a. Appointments. COR Nomination letters signed by the COR’s supervisor, the CO’s Letter of

Delegation to the COR, CO notification to the contactor of COR assignment, QAPC Led training certificate and contract specific training by the CO.

b. Contract Documents. The Contract with all modifications (modifications to be posted to the contract), directive document references, maps, pertinent terms defined by the contract, equipment listings, and QASP.

c. Surveillance Documentation. All surveillance inspections performed must be documented by the

COR and maintained in this section. Any customer complaint training and all customer complaints and resolution thereof will be maintained in this section. Other information that may be included are details of inspections or data gathering, conversations or meetings with the contractor, notes and comments that support the inspection paperwork.

d. Meeting Minutes: Copies of all MFT minutes (minimum annual) and Periodic Progress Meeting minutes (frequency to be determined at contract start and may be adjusted accordingly).

e. Unacceptable Performance Documentation: A section used for filing all documentation associated with contract quality assurance correspondence, the COs inputs/determinations, Cure notices, Show Cause with all supporting documentation.

f. Acceptance and Funding Issues. A copy of the Service Contractor Monthly Satisfaction Survey will be maintained in this section. This is also the location to maintain AF Form 9s, delivery orders, funding issues etc.

g. Reports/Submittals. Contractor reports/submittals as directed by the PWS.

h. Correspondence. Any other documentation that does not fall into sections listed above.

i. Lessons Learned. Document here any areas that you determine need to be changed/amended in future contracts. (i.e. accountability issues, better description of work hours, cost and performance constraints).

3.2 Periodic Progress Meetings (PPM): The multi-functional team shall conduct periodic progress meetings Semi Annually or at any time the contracting officer feels a need to review the contractor’s performance. At these meetings the Contracting Officer will apprise the contractor of how the

Government views the contractor’s performance and the contractor will apprise the Government of problems, if any, being experienced. The contractor will also at any time notify the Contracting

Officer in writing, of any work being performed, if any, that the contractor considers over and above the requirements of the contract. Appropriate action shall be taken to resolve any outstanding issues.

SECTION 4.0

ASSESSMENT PROCEDURES

4.1 Assessment Schedule:

4.1.1 The COR will develop an assessment schedule, based on this QASP’s requirements. A locally devised form may be used. An annual surveillance schedule may be used. The schedule will be completed no later than 7 calendar days before the beginning of the period it covers. Copies of the assessment schedule shall be provided to COR supervisor and the Contracting Office before the start of the assessment period. Assessment schedules, when completed, shall be marked “For Official Use

Only” and shall not be shown to the contractor.

4.1.2 Changes to the assessment schedule shall be posted promptly. Copies of the changed schedule shall be sent to the COR Supervisor and Contracting Officer. The COR shall document the reason(s) for changes of the assessment schedule, and maintain the documentation in the COR files with the corresponding changed assessment schedule.

4.2 Assessment of SS Items:

4.2.1 It is essential that the COR conduct assessments in accordance with projected assessment schedule for an effective quality assurance program. Mission requirements may require deviations from the assessment schedule. Assessment should be performed as close to the schedule as is practicable. The COR shall document assessment as it is conducted.

4.2.2 The COR shall conduct assessment of the contractor’s performance by determining whether or not the performance meets the standards contained in the contract, the PWS and the SS items.

4.2.3 Assessment Documentation shall include as a minimum, the date, time, and location the assessment was conducted, results of the assessment (acceptable or unacceptable), PWS paragraph number referencing the requirement, a short description of the requirement being surveyed, applicable remarks, signature of COR conducting the assessment. When the COR determines that contractor performance is unacceptable, the specific reason for the unacceptable performance shall be recorded on the COR’s assessment documentation.

4.3 Assessment of non-SS Items: The Government has the right to inspect all services called for by the contract, to the extent practicable at all times and places during the term of the contract.

Therefore, the COR has the right to conduct assessment for SS items and non-SS items to include on site locations. When the COR identifies unacceptable performance on non-SS items, the COR shall follow the procedures in section 2.4 of this QASP, entitled Remedies for Unacceptable Performance.

4.4 COR Report: The COR shall submit a summary assessment report as needed to the CO and

COR Supervisor. The report shall identify the number of assessments scheduled and conducted, the number of unacceptable performances observed, the number of Corrective Action Reports issued, number of valid complaints, any significant contractor performance discrepancies, and a rating of the

Contractor’s overall performance. The report shall be signed and dated by the COR and COR Supervisor and a copy provided to the CO.

4.5 Service Contract Monthly Satisfaction Survey: (SCMSS) (Appendix1). Monthly, the COR is required to complete a SCMSS rating contractor performance for the past month. The COR should look back at the monthly inspection results to rate the contractor. Elements included in the SCMSS are:

(1) Promptness of Service. Assess the timeliness of the contractor’s performance against contract requirements.

(2) Quality of Service. Assess the contractor’s conformance to contract requirements and standards of good workmanship (i.e. commonly accepted technical, professional, environmental or safety standards).

(3) Courtesy/Cooperation by Contractor Personnel. Are open lines of communication maintained?

Are contractor personnel courteous in dealing with customers and government representatives? Are problems resolved at the lowest level when possible?

(4) Response to Defective Notices and Customer Complaints. Does contractor respond timely to customer complaints and provide satisfactory resolution? Are COR directed re-performances accomplished within the allowed time frames?

(5) Overall Satisfaction with the Service Received. Provide your rating as to the contractor’s ability to meet overall contract performance for the month.

(6) Candid Comments. Provide comments to support lower ratings, comments to support exceptional ratings, etc.

(7) Review of the five (5) areas that will require Contractor Performance Assessment Reporting

(CPAR).

Performance Ratings: The ratings used for the SCMSS are described by one of the following five adjectives: 5 = Exceptional, 4= Very Good, 3= Satisfactory, 2= Marginal and 1=Unsatisfactory.

These terms are subjective and are not derived through use of any mathematical computations or formulas. The COR will rate each one of the above assessment elements explained in paragraph b above, using one of the following ratings in their narrative summary. The criteria for each rating are reflected below:

RATING #

(5) Exceptional. Performance meets contractual requirements and *exceeds many to the governments benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

(4) Very Good. Performance meets contractual requirements and *exceeds some to the governments benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were highly effective.

(3) Satisfactory. Performance *meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

(2) Marginal. Performance *does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

(1) Unsatisfactory. Performance *does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

*Key Guidance to Ratings

4.6 Review & Acceptance: The multi-functional team member signatures below indicate their review and acceptance of the QASP for the Paramedic Training program. These signatures indicate coordination on the plan at the time of development and will remain in effect until the plan is changed.

Concur:

HEATHER J. YATES, MSgt DATE

Primary Contracting Officer Representative

USAF EMS Program Manager

AFMOA/SGN

SOWERS, DAVID B CMSgt, USAF DATE

Alternate Contracting Officer Representative

Superintendent, AF Nursing Operations

AFMOA/SGN

PERRY STANSBURY, Lt Col, USAF, MSC, CFAAMA DATE

Chief, Medical Logistics - San Antonio

Air Force Medical Operations Agency/AFMOA/SGA

Joint Base San Antonio – Lackland

DATE

ALICE SANDERS

Contracting Officer

773 ESS/PK

DATE

KARLA DODD

Quality Assurance Program Coordinator

773 ESS/PK

Appendix 1, dated ______ SERVICE CONTRACT MONTHLY SATISFACTION SURVEY

SUBJECT: SERVICE CONTRACT MONTHLY SATISFACTION SURVEY

CONTRACT #: XXXXXX_XX_XXXXXX SERVICE:_______________________

MONTH/YEAR:____________________

Objective Threshold Performance Level

Valid Customer Complaints /

Reperformance

General Contractor Satisfaction Promptness of the Service 5 4 3 2 1

Quality of the Service 5 4 3 2 1

Courtesy/Cooperation by Contractor Personnel 5 4 3 2 1

R Response to Defective Notices and Customer Complaints 5 4 3 2 1

Overall Satisfaction with the Service Received 5 4 3 2 1

NOTE: 5=Exceptional, 4=Very Good, 3=Satisfactory, 2=Marginal, 1=Unsatisfactory

YOUR CANDID COMMENTS:

COR

COR Supervisor

Contracting Officer