TMS_-_Performance_Work_Statement_(PWS).pdf

AFMS COMMODITY

COUNCIL

Temporary Medical Staffing

Performance Work Statement

April 04, 2013

Section C – Descriptions and Specifications

PERFORMANCE STATEMENT OF WORK

Table of Contents

1.0 DESCRIPTION OF SERVICES

1.1 Background

1.2 Scope

1.2.1 Recruit:

1.2.2 Place:

1.2.3 Manage:

1.2.4 Resolve Performance Issues:

1.3 Required Specialties:

1.4 Services:

1.5 Acceptable Quality Levels

2.0 PERFORMANCE REQUIREMENTS

2.1 Credentialing/Privileging

2.1.1 Credentialed HCWs

2.1.2 Adverse Actions

2.1.3 Licensure

2.1.4 Prescriptions

2.1.5 Referrals and Consults

2.1.6 Drug Enforcement Agency (DEA) Number

2.1.7 Certifications

2.1.8 Health Requirements

2.1.9 Tuberculosis

2.1.10 Tracking of Information

2.1.11 Medical Tests

2.1.12 Health Notifications:

3.1 Duties

3.2 Work Schedule

3.3 Billable Hours

3.4 Duty Hours

3.5 On-Call Hours

3.6 Overage Hours

3.7 Non-Duty Days

3.8 Unplanned Closures

3.9 Recording Hours Worked

3.10 Physical Capability

3.11 Participation in Emergency Preparedness Plans

3.12 Government Endorsement

3.13 Conduct

3.14 Contractor Identification

3.15 Dress and Appearance

3.16 English Language Requirement

3.17 Mission Essential Status

3.18 MTF Requirements

3.19 Travel

4.0 SECURITY REQUIREMENTS

4.1 Criminal History Background Checks

4.2 Potential Threat

5.0 CONTINUED MEDICAL EDUCATION (CME)/UNITS

6.0 MANAGEMENT AND ADMINISTRATION

6.1 Contractor Management Staff Responsibilities

6.1.1 Qualifying Documentation for Preliminary Government Minimum Requirements

6.1.2 Qualifying Documentation for Subsequent Government Minimum Requirements

6.1.3 Expedited Credentialing Process:

7.0 SERVICES SUMMARY

7.1 AQLs

7.1.1 Task order proposal participation rate

7.1.2 On-time fill rate (Initial and replacement)

7.1.3 Subsequent Government Minimum Requirements Documentation Submission Rate

8.0 Contractor Furnished Data

8.1 Monthly Activity Report (MAR)

8.2 Contractor Performance Status Report (CPSR)

8.2.1 Task order proposal participation rate

8.2.2 On-time fill rate (Initial and replacement)

8.3 Annual Summary Report

9.0 GOVERNMENT FURNISHED PROPERTY

9.1 Equipment/office furniture

9.2 Personal protective equipment (PPE)

9.3 Forms

9.4 Workspace

9.5 Supplies

9.6 Computer equipment

9.7 Utilities

9.8 Patient scheduling

9.9 Housekeeping

9.10 Contractor furnished equipment

10.0 CONTRACTOR MANPOWER REPORTING

10.1 Reporting Period

10.2 Use and Safeguarding of Information

10.3 User Manuals

11.0 DEFINITIONS

11.1 Acceptable quality level (AQL)

11.2 Addendum

11.3 Air Force Medical Service Commodity Council (AFMSCC)

11.4 Beneficiary

11.5 Billable hour

11.6 Certification

11.7 Clinical privileges

11.8 Commander

11.9 Contract tracking and reporting (CTAR) system

11.10 Contracting officer (CO)

11.11 Contract Year

11.12 Contractor

11.13 Contractor management staff

11.14 Credentialing

11.15 Credentialed health care worker

11.16 Defense medical human resource system-internet (DMHRSi)

11.17 Direct patient care

11.18 Down days

11.19 Duty day

11.20 Duty hours

11.21 Fully Burdened Hourly Rate

11.22 Government Supervisor

11.23 Health care worker (HCW)

11.24 Initial Background Check:

11.25 Initial fill

11.26 Military treatment facility (MTF)

11.27 Medical expense and performance reporting system (MEPRS)

11.28 National agency check with inquires

11.29 Non-credentialed health care worker

11.30 On-call hour

11.31 Ordering contracting officer

11.32 Overage hours

11.33 Performance work statement (PWS)

11.34 Preliminary government minimum requirements

11.35 Primary source verification

11.36 Program management office

11.37 Qualified

11.38 Qualifying documentation

11.39 Quality control (QC)

11.40 Recruit

11.41 Replacement

11.42 Security investigation package

11.43 Services summary (SS)

11.44 Subsequent government minimum requirements

11.45 Task order

11.46 Task order award

11.47 Teaming

11.48 Task order proposal request (TOPR)

11.49 Unplanned closure

11.50 Work schedule

12.0 ACRONYMS

13.0 MINIMUM REQUIREMENTS

13.1 Physicians shall have:

13.2 Nurse Practitioners shall have:

13.3 Physician Assistants shall have:

13.4 Allied/Ancillary Health Professions shall have:

13.5 Non-Credentialed Health Care Workers:

13.6 Clinical Nurses shall have:

13.7 Medical Technicians/Assistants shall have:

14.0 APPLICABLE PUBLICATIONS

14.1 Publications

14.2 Publication Locations

14.3 Air Force E-Publishing Site

14.4 Other References and Sources

15.0 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996 23

16.0 CONFIDENTIALITY OF INFORMATION

17.0 MAXIMUM COMPENSATION

18.0 MEDICAL MALPRACTICE

1.0 DESCRIPTION OF SERVICES

1.1 Background.

The TMS contract is designed to supplement the medical staff at MTFs with a wide range of qualified clinical HCWs on a nationwide scale for periods less than 365 days. A list of possible locations/places of performance is listed at Section J, Attachment 1. The intent of this PWS is to meet MTF short term staffing requirements created by deployments, normal re-assignments, and/or any other situation creating a staffing gap less than twelve months.

Qualified HCWs will provide services based on the number of billable hours established in the task order for each labor category requested. The requesting location will determine the number of billable hours based on need. The standard fill requirement will be lengths of 13 weeks with options up to 364 days. Additionally, the intent of TMS is to provide a vehicle for shorter term fills, less than 13 weeks, should they be required. The contracted HCWs provided under this contract shall be rendering personal services as described in Defense Federal Acquisition Regulation Supplement (DFARS) 237.104 and shall be subject to day-to-day supervision and control by Government Supervisors. Supervision and control is the process by which the contracted HCW receives technical guidance, direction, and approval with regard to tasks within the requirements of the contract. The Contractor shall provide all tools, labor, equipment and materials required to place the HCWs within the MTFs, in accordance with the terms and conditions of this contract and all related task orders.

The TMS contract uses task order competition that includes a candidate approval component and a task order award component. The candidate approval component ends with the Government’s approval of the candidate. The task order award component starts with task order award and ends when contractor performance ends on the task order.

The TMS contract requires the Contractor to accomplish the following activities from issuance of a task order through contractor performance: recruit, place, manage, and resolve performance issues as follows:

1.2 Scope.

This Performance Work Statement (PWS) provides Temporary Medical Staffing (TMS) services for the Air Force Medical Service (AFMS). The AFMS has a requirement for qualified Health Care Workers (HCWs) to provide direct patient care in the treatment of military health system (MHS) beneficiaries inside Military Treatment Facilities (MTFs), as well as logical extensions of the MTFs (e.g., Health and Wellness Centers and satellite clinics) within the 50 United States (U.S.) and Guam. The Contractor shall provide qualified HCWs in accordance with the terms and conditions of the contract and each task order issued under the contract. Based on experience gained from analyzing the information provided above and as a result of market research, we anticipate a five-year ordering period for the TMS acquisition. Task orders issued under the IDIQ contracts for each year of the ordering period may contain the option to extend services; however, the period of performance for each task order (including option to extend services) shall not exceed one year. Performance on all task orders issued during the last 12 months of the ordering period will end no later than 12 months after the end of the ordering period. The TMS contract requires the Contractor to accomplish the following activities from issuance of a task order through contractor performance:

recruit, place, manage, and resolve performance issues as follows:

1.2.1 Recruit:

In response to a task order, the Contractor shall recruit qualified HCWs from outside of the Government to fulfill the duties, qualifications, and requirements in the performance work statement. All HCWs must meet the qualifications of the appropriate position description and addendum (when provided). The Contractor shall find, conduct competency-based screening against preliminary Government minimum requirements, obtain initial background checks, and submit qualifying documentation on HCWs as part of the recruiting requirement. The contractor shall submit a proposal on 85% of all Task Order requirements as defined in Section C 7.1.1, additionally, the contractor will ensure 80% of HCW positions are filled in a reporting period as defined in Section C 7.1.2.

1.2.1.1 Recent Air Force Experience:

Due to the need to place HCWs in an accelerated fashion, while not required, contractors are highly encouraged to recruit both credentialed and non-credentialed HCWs who have filled positions in MTFs in the prior two years prior to task order award. These HCWs are more likely to be established in critical Air Force databases (security and credentialing), and in most cases, the time needed to place them in required positions will be significantly reduced. Additionally, they will be more familiar with Air Force processes and procedures, including the Air Force clinical information systems.

1.2.2 Place:

In response to a task order award, the Contractor shall place qualified HCWs in MTFs to provide clinical services.

The Contractor shall: verify HCW qualifications against subsequent Government minimum requirements; submit complete and accurate credentials packages on all credentialed HCWs requiring privileges in the MTF; establish appointments with the MTF Unit Security Managers on each HCW’s first duty day; ensure HCWs complete the necessary security investigation package on their first duty day.

1.2.2.1 Replacement HCWs. If any HCW cannot perform for the entire period of performance stated on the TO, and at least 30 days remain on the initial period of performance stated on the TO, the contractor responsible for that TO will be required to find a replacement that meets the same requirements listed on the original TO within 14 days from the departure of the incumbent HCW.

1.2.3 Manage:

During contract performance, the Contractor shall manage task order performance by maintaining fill rates without Government involvement within the timeframes specified in paragraph 7.0 – Services Summary of this PWS.

1.2.4 Resolve Performance Issues:

During contract performance, the Contractor shall resolve all performance and behavioral issues identified by the Government within the timeframes documented on a discrepancy notice that has been signed by a CO (e.g., Letter of Concern, Cure Notice, Show Cause Notice). Should any individual HCW receive a third discrepancy notice during the life of the task order or contract, the Contractor shall ensure the removal of that HCW within seven (7) calendar days of receiving the third discrepancy notice.

1.3 Required Specialties:

The Contractor shall provide qualified credentialed and non-credentialed HCWs in the following labor categories as specified in individual task orders. The following table lists the most anticipated potential requirements, additional labor categories may be added during the life of the contract if additional requirements are identified:

Table 1.3, Position Descriptions Labor Categories

Allergist HAWC Exercise Physiologist Anesthesia Technician or Technologist HAWC Clinical Nurse Anesthesiologist Internist – Board Certified Audiologist Internist – Board Eligible Bone Densitometrist Internist - Cardiology Breast Health Educator Internist - Gastroenterology Cardiac Catheterization Technician Internist - Oncology Cardiac Monitoring (Telemetry) Technician Internist – Pulmonology Cardiac Surgery Technician Internist - Rheumatology Certified Medical Dosimetrist Lactation Consultant Cardiopulmonary Lab Technician Licensed Practical Nurse (LPN) Cardiac Sonographer (Ultrasound) Technologist Licensed Clinical Social Worker Case Manager Certified Medical Technician – Hemodialysis/Nephrology Licensed Vocational Nurse (LVN)

Certified Medical Technician (Inpatient) Medical Lab Technician Certified Medical Technician (Outpatient) Medical Laboratory Technologist Certified Medical Technician - Pediatrics Medical Physicist

Certified Nurse Midwife Mental Health Services Technician Certified Registered Nurse Anesthetist (CRNA) Molecular Genetics / Diagnostic Technologist Chiropractor Neurologist Clinical Nurse Case Manager Neurosurgeon Clinical Dietitian Neurology Technician Clinical Geneticist Obstetrician and Gynecologist Clinical Nurse – Adult Critical and Intensive Care Obstetrician and Gynecologist - Endocrinology Clinical Nurse - Discharge Planner Obstetrician and Gynecologist - Maternal-Fetal Medicine Clinical Nurse – Disease Manager Obstetrician and Gynecologist - Oncology

Clinical Nurse - Emergency Room Obstetrician and Gynecologist – Urogynecology/Pelvic Reconstructive Surgery

Clinical Nurse - Endoscopy Occupational Environmental Medicine Physician Clinical Nurse - Family Practice Occupational Therapist Clinical Nurse - General Surgery Ward Ophthalmologist Clinical Nurse - General Ward Nurse Ophthalmology Technician Clinical Nurse – Hemodialysis/Nephrology Optometrist Clinical Nurse - Inpatient Pediatrics Optometry Technician Clinical Nurse - Internal Medicine Orthodontist Clinical Nurse - Labor & Delivery Post Partum Orthopedic Surgeon Clinical Nurse - Medical Surgery Unit Orthopedic Surgeon - Oncology Clinical Nurse - Neonatal Intensive Care Orthopedic Technician Clinical Nurse – Obstetrics Otorhinolaryngologist Clinical Nurse - Operating Room Paramedic/EMT Clinical Nurse - PACU (Post Anesthesia Care Unit) Pathologist

Clinical Nurse - Pediatric Intensive Care Unit Pediatric Intensive Care Unit Physician Clinical Nurse - Pediatric Clinic Pediatric Polysomnographic Technician Clinical Nurse – Radiology Pediatric Polysomnographic Technologist Clinical Nurse - Special Care Unit Pediatrician – Board Certified Clinical Nurse - Utilization Management Pediatrician – Board Eligible Clinical Nurse - Women's Health Pediatrician - Neonatology Clinical Perfusionist Pediatric Nurse Practitioner Clinical Pharmacist Perianatology Ultrasound Technician Clinical Psychologist Periodontist Clinical Social Worker Pharmacist Dental Assistant Pharmacy Technician Dental Hygienist Phlebotomist Dental Lab Technician Physical Therapist Dentist Physical Therapist Assistant Dentist - General Clinical Physician Assistant Dentist - Oral & Maxillofacial Surgeon Physician Assistant - Cardiac Perfusion (Residency Required) Dermatologist Physician Assistant - Emergency Medicine

Diagnostic Imaging Technician Physician Assistant - General Surgery Diagnostic Imaging Technician - Computed Tomography Physician Assistant - Orthopedics

Diagnostic Imaging Technician - Magnetic Resonance Podiatrist

Diagnostic Imaging Technician - Mammography Polysomnographic Technician Diagnostic Imaging Technician - Nuclear Medicine Prosthodontist

Diagnostic Imaging Technician - Ultrasound Psychiatrist Diagnostic Radiologist Psychiatric Nurse Practitioner Diagnostic Radiologist - Interventionalist Radiation Therapist Diet Therapy Technician Radiation Oncologist Echocardiogram Technician Registered Vascular Technologist Electroencephalographic Technologist Respiratory Therapist Emergency Services Physician - Emergency Medicine Specialist Respiratory Therapist Technician

Emergency Medical Technician - Basic (EMT-B) Speech Pathologist Family Practice Physician – Board Certified Surgeon Family Practice Physician – Board Eligible Surgeon - Oncology Family Nurse Practitioner Surgical Service Technician Flight Medicine Physician Surgical Service Technician - Orthopedic Gastroenterology Technician Surgical Service Technician - Otorhinolaryngology HAWC Clinical Nurse Surgical Service Technician – Urology HAWC Health and Fitness Specialist Urgent Care Center Physician Health Promotion Educator Urologist Health Promotion Dietitian Women's Health Nurse Practitioner

1.4 Services:

The Contractor shall provide qualified credentialed and non-credentialed HCWs in the following eight service categories:

1) Allied Health Services: Identifies a number of professional health care services provided by licensed professionals who assist with the treatment of patients including, but not limited to, physical therapy, occupational therapy, speech pathology, audiology, dietetics, optometry, respiratory therapy, and podiatry.

In the TMS contract, Behavioral Health and Dental Services are not considered in the Allied Health Services categories.

2) Ancillary Services: Relates to supplemental professional services provided in an MTF including, but not limited to, radiology, pharmacy, and clinical laboratory.

3) Behavioral Health Services: A branch of medicine that deals with the achievement and maintenance of psychological well-being including, but not limited to, clinical psychology, psychiatry, social work, and psychiatric practitioners.

4) Dental Services: Involves the evaluation, diagnosis, prevention, and surgical or non-surgical treatment of disease, disorders and conditions of the mouth, maxillofacial area and the adjacent and associated structures including, but not limited to, dentistry and dental support.

5) Nursing Services: Services provided by registered and/or licensed nursing personnel including all types of registered and advanced practice nurses as well as practical and vocational nurses. In the TMS contract, technicians and assistants working in nursing service are considered in the Technician Services categories.

6) Primary Care Providers: Relates to the level of care that encompasses routine care of individuals with common health problems or chronic illnesses including, but not limited to, primary care practitioners and physician extenders.

7) Specialty Providers: Relates to a wide range of health care services in virtually every medical specialty and subspecialty.

8) Technician Services: Relates to the certified or registered HCWs who perform administrative and clinical tasks in carrying out the treatment plan including, but not limited to, technologists, technicians, and a wide range of administrative support personnel.

9) The contractor shall submit a proposal on 85% of all Task Order requirements as defined in Section C 7.1.1, additionally, the contractor will ensure 80% of HCW positions are filled in a reporting period as defined in Section C 7.1.2.

1.5 Acceptable Quality Levels

The contractor shall submit a proposal on 85% of all Task Order requirements as defined in Section C.7.1.1, and the contractor will ensure 80% of HCW positions are filled in a reporting period as defined in Section C 7.1.2.

Additionally, the contractor shall submit documents for Subsequent Government Minimum Requirements as defined in C 6.1.2 for 85% of HCW positions (credentialed and non-credentialed), and additional requirements (if any) established in the task order, within 20 calendar days, or 10 calendar days if expedited as defined in C 6.1.3, from task order award.

2.0 PERFORMANCE REQUIREMENTS.

2.1 Credentialing/Privileging.

2.1.1 Credentialed HCWs.

Credentialed HCWs must obtain clinical privileges at the requesting MTF. The Contractor shall meet the following core requirements for credentialed HCWs, as well as any additional requirements that are established in the position description and addendum (if required) in the task orders.

Credentialed HCWs will be subject to the credentialing and privileging requirements of AFI 44-119, Clinical Performance Improvement, to include adverse actions. With the exception of Air Force bases under a joint basing agreement with the Army or Navy (for example: such as the 43d Medical Squadron, Pope Army Airfield and the 62d Medical Squadron, Joint Base-Lewis McChord Field) the credentials of all health care providers shall be reviewed and privileges granted as outlined in AFI 44-119, Clinical Performance Improvement. The credentials of health care providers at performance locations under a joint basing agreement with the Army or Navy shall be reviewed and privileges granted as outlined as part of the joint basing agreements.

The chief of the medical staff, or his/her representative, will define the clinical privileges for all credentialed HCWs during the credentialing process. All credentialed HCWs shall be able to obtain independent privileges for practice within the scope of care through the applicable MTF Credentials Committee. Independent privileges allow the health care worker to practice independently within the scope of care without supervision such as required under supervised privileges.

The Contractor shall provide a complete, current, and accurate credentialing package for each credentialed HCW as required in Chapter 4 of AFI 44-119 (or AR 40-68 where applicable) within 7 calendar days from the time of Task Order award.

The Contractor shall obtain all paperwork, reference letters, work history and application forms IAW AFI 44-119 (or AR 40-68 where applicable) as required by the MTF credentialing process. The MTF staff will not assist the Contractor in obtaining any information necessary to credential the HCW.

The Contractor shall make all proposed credentialed HCWs available for interview (via telephone) by the MTF during the credentialing process.

2.1.2 Adverse Actions.

In the event of an adverse action as identified by AFI 44-119 or AR 40-68 where applicable, the Government Supervisor will notify the ordering Contracting Officer (CO) as soon as possible when the necessity to exercise such authority becomes apparent. The Government Supervisor will also provide the ordering CO with a written statement advising the Contractor of an adverse action involving a HCW, a brief statement of the basis for the action to provide the Contractor sufficient information in order to make employment/substitution decisions as necessary, and if required, the final outcome of the adverse action process. The Government will mark the written notice(s) as covered by 10 USC 1102. No other information pertaining to the adverse action will be released without MTF/CC permission.

2.1.3 Licensure.

All credentialed HCWs shall have and maintain an active, valid, unrestricted, current medical license (with no limitations, stipulations or pending adverse actions) in a U.S. jurisdiction. All licenses must be unencumbered and remain in effect during contract employment.

2.1.4 Prescriptions.

Credentialed HCWs authorized to prescribe pharmaceuticals shall become familiar with the hospital formulary and prescribe pharmaceuticals according to the drugs listed. The MTF Pharmacy Service will provide instruction to all prescribing HCWs on substitutions of generic drugs. Credentialed HCWs shall follow the MTF procedures when prescribing drugs.

2.1.5 Referrals and Consults.

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

2.1.6 Drug Enforcement Agency (DEA) Number.

Credentialed HCWs shall possess a controlled substances registration certificate from the Drug Enforcement Agency (DEA) IAW the laws of the state in which licensed.

2.1.7 Certifications.

All HCWs shall maintain current certification in a basic provider cardio-pulmonary resuscitation (CPR) course such as American Heart Association (AHA) Basic Life Support (BLS) health care provider course or an equivalent course based on published national guidelines for BLS IAW AFI 44-102. Web-based classes do not meet the standards in AFI 44-102. In addition, all HCWs shall maintain current certification in Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS) and Neonatal Resuscitation Course (NRC) as required by AFI 44-102, Community Health Management, Tables 3.1 through 3.3.

2.1.8 Health Requirements.

In accordance with AFI 48-105, all contracted HCWs shall follow the methods for controlling and preventing disease as described in the American Public Health Association publication, Control of Communicable Diseases (CDC) Manual, and the Centers for Disease Control and Prevention publication, Morbidity and Mortality Weekly Report (MMWR), and its supplements. The Contractor shall maintain workforce health qualifications as published in the most recent guidelines from these publications throughout the term of the TMS contract/task order. For the purposes of this contract CDC recommendations are considered requirements.

Before start of work, HCWs shall provide proof of immunization from the following diseases according to Centers for Disease Control (CDC) guidelines: Hepatitis B, influenza, measles, mumps, rubella, and varicella. HCWs shall also provide proof of a negative TB skin test completed within the past 12 months (if positive, proof of negative chest X-ray within the past 12 months) prior to the required start date. In addition, HCWs shall provide proof of TDAP immunization prior to start of work, even if the tetanus booster is not yet due according to CDC guidelines.

After start of work, the Government will provide post blood borne exposure protocols according to applicable AFIs.

HCWs shall be immunized annually with the seasonal influenza vaccine and any other vaccine recommended by the Advisory Committee on Immunization Practices (ACIP) of the CDC for HCWs. This vaccine may 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 or the HCWs. Unless vaccinated by the Government, the health care worker shall be required to show proof of the vaccination.

2.1.9 Tuberculosis.

In those areas where there is a higher risk of transmission of tuberculosis, contracted HCWs may be tested frequently as directed by the MTF policy. This test will be provided by the MTF.

2.1.10 Tracking of Information.

Immunization information will be tracked in DoD computer systems for all contracted HCWs.

2.1.11 Medical Tests.

No medical tests or procedures required by the contract will be performed by the Government (with the exception of Tuberculosis testing after start of work and/or exposure). Expenses for all required tests and/or procedures (e.g., N95 particulate respirator duckbill mask fitting) shall be borne by the Contractor or HCW at no expense to the Government.

2.1.12 Health Notifications:

The Contractor shall inform the Government Supervisor whenever a HCW will be away from work for any period of time for medical reasons. A replacement may be required (see C 1.2.2.1). The Government will notify the Contractor of any work hazards. If work hazards exist, it will be the Government’s decision whether the HCW continues work in the environment.

3.0 PROCEDURE GUIDANCE

3.1 Duties.

HCWs shall perform duties in accordance with AFMS and MTF operating instructions as well as higher-level DoD or Air Force directives. Changes or deviations from instructions and directives shall not be made without prior recommendation to, and approval of, either the ordering or program CO or authorized representative.

3.2 Work Schedule.

Task orders will establish the work schedule and the total number of billable hours for each HCW. The work schedule will identify the weekly work schedule for which the HCW is required to work.

3.3 Billable Hours.

Billable hours are hours established in the task order work schedule as duty hours, on-call hours, or overage hours.

In order for hours to be billed on this requirement, deliverable services must have been performed in direct support of a requirement in the TO and accompanying PD and addendum ( if needed) at the work location as required in the work schedule.

3.4 Duty Hours.

Duty hours are billable to the Government whenever the HCW performs as outlined in the work schedule. Duty hours, to include shift work and Federal Holidays (when required), on the work schedule are established by the requesting location and will be clearly stated on each task order. Any variation of the work schedule must be approved by the Government Supervisor in advance as long as the total number of duty hours does not exceed the number identified in the task order. The HCW shall record and report time worked IAW MTF policy. The Contractor shall establish a process for HCWs to accurately record and report hours worked without relying on the Government.

3.5 On-Call Hours.

On-call hours are billable to the Government whenever the HCW performs as outlined in the work schedule. On-call hours on the work schedule are established by the requesting location and will be clearly stated on each task order.

Any variation of on-call hours on the work schedule must be approved by the Government Supervisor in advance as long as the total number of on-call hours does not exceed the number identified in the task order. The HCW shall record and report time worked IAW MTF policy. The Contractor shall establish a process for HCWs to accurately record and report on-call hours worked without relying on the Government. The contracted HCW shall not work on call hours unless specifically authorized by the TO.

3.6 Overage Hours.

Overage hours are billable to the Government whenever the HCW performs as outlined in the work schedule or for continuity of care purposes. Overage hours on the work schedule are established by the requesting location and will be clearly stated on each task order. Any variation of overage hours on the work schedule must be approved by the Government Supervisor in advance as long as the total number of overage hours does not exceed the number identified in the task order. The HCW shall record and report time worked IAW MTF policy. The Contractor shall establish a process for HCWs to accurately record and report overage hours worked without relying on the Government. The contracted HCW shall not work on overage hours unless specifically authorized by the TO.

3.7 Non-Duty Days.

Government non-duty days, or other times when Government offices may be closed, are not billable to the Government. The Government will only pay for hours worked. Non-Duty days will be designated in the task order.

3.8 Unplanned Closures.

In the event of an unplanned closure of the facility due to natural disasters, military emergency, severe weather, or other issues, the contracted HCW will be allowed to bill the Government if the following two conditions exist:

1) Local base policy and base access procedures prevented the HCW from performing duties at the place of performance; AND

2) The contracted HCW was scheduled to work, but unable to work because of the unplanned closure (e.g., HCW was on leave).

3.9 Recording Hours Worked.

HCWs will be required to record hours worked in the Defense Medical Human Resources System – internet (DMHRSi) as required by the MTF.

3.10 Physical Capability.

All HCWs shall be physically capable of standing for extended periods of time, capable of normal ambulation, and any other physical requirements established in the task order. The nature of this work will, at times, demand the contracted HCW be capable of responding to urgent/emergent medical issues. Physical capability will be determined by the MTF.

3.11 Participation in Emergency Preparedness Plans.

All HCWs shall participate in emergency preparedness plans (drills and actual emergencies) as scheduled by the MTF. HCWs will be required to provide contact information to the Government Supervisor upon commencement of services as part of a recall list in advance of an actual emergency. If an emergency occurs, the Government Supervisor will contact the health care worker with shift and reporting instructions.

3.12 Government Endorsement.

The Government may not offer the Contractor or HCW signs of recognition or appreciation for exceptional performance. Should HCWs be mentioned in team awards with Government employees, these actions shall not constitute Government acceptance of the Contractor’s performance unless made in writing by the CO. Contractors shall not represent themselves as endorsed by the Government in any manner, including any marketing or promotional materials.

3.13 Conduct.

The CO may request that any HCW whose conduct, in the opinion of the CO, interferes with proper order or professionalism at the installation where services are performed be removed from such installation and the Contractor will comply with such requests. Failure to do so may be cause for action under the Termination clause in Section I, Contract Clauses (52.249-2 and 52.249-12).

3.14 Contractor Identification.

All contracted HCWs shall clearly be identified as such at ALL times, including conversations, mail, email, faxes, and/or other electronic communication whether with Government personnel, other contractor personnel, or with the public when supporting this contract. Likewise, HCWs shall abide by all applicable laws and regulations when using government equipment and services in the performance of this contract.

3.15 Dress and Appearance.

HCWs will maintain good personal hygiene and a well-groomed, professional appearance as outlined in MTF policies. Dress attire will be set by MTF policy.

3.16 English Language Requirement.

All HCWs on this contract shall read, understand, speak, and write English fluently as determined by the Government Supervisor during the competency-based interview process for Government approval.

3.17 Mission Essential Status.

The Government will designate those HCWs as mission essential in the task order proposal request. Mission essential functions include those organizational activities that must be performed under all circumstances to achieve Air Force mission or responsibilities as outlined in DFARS 237.7601(2).

3.18 MTF Requirements.

HCWs 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.

3.19 Travel.

HCWs may be required to perform periodic travel within the Continental United States (CONUS) to meet mission requirements, as directed by the Government and approved in advance by the CO. Reference Section B, CLIN 0003. For HCW meeting requirements for this contract, travel should be limited to local travel. If anything other than local travel is required, the contractor shall be responsible for obtaining all passenger transportation lodging, and subsistence. Reimbursement of CONUS travel costs will be in accordance with the Federal Travel Regulations per FAR 31.205-46. The Contractor shall travel using the lowest cost mode transportation commensurate with the mission requirements. When necessary to use air travel, the Contractor shall use the tourist class, economy class, or similar accommodations to the extent they are available and commensurate with the mission requirements. Travel may or may not be reimbursed on a cost reimbursable basis; no profit or fee will be paid. Each task order will identify travel requirements and whether such expenses shall be reimbursed.

4.0 SECURITY REQUIREMENTS

HCWs under this contract have access to and/or process information requiring protection under the Privacy Act of 1974 on unclassified automated information systems. Because of this access, HCWs performing for the Government under this contract are in non-sensitive (public trust), Automated Information Systems III (formally ADP III) positions IAW DoD Directive 5200.2-R. In compliance with DoD Directive 5200.2 and AFI 31-501, a National Agency Check with Inquiries (NACI) is required for all AIS III positions. Security documentation for all HCWs must be submitted within 7 calendar days of the start of performance as required by the TO.

The Contractor shall fully adhere with the provisions of these referenced publications by having each of their employees who are performing under this contract submit the appropriate forms and maintain a positive suitability determination to continue performing under this contract. The Contractor shall ensure the following is accomplished by the contracted HCW before the first duty day.

Schedule an appointment with the appropriate Government Unit Security Manager at the installation where services are provided. The appointment shall be arranged for the HCW’s first day of work at the MTF. The HCW cannot start work earlier than the scheduled appointment date with the Unit Security Manager. This appointment is necessary for the following reasons:

The MTF Unit Security Manager is expecting the HCW’s arrival and is available to receive and process the security package (i.e., SF-85P, Questionnaire for Public Trust Positions) either through a secure website called Electronic Questionnaires for Investigations Processing (e-QIP) Direct or from a downloadable form on the Office of Personnel Management (OPM) Website.

The MTF Unit Security Manager arranges for the government-obtained fingerprints (FD-258, FBI Fingerprint Card) to avoid delays in submission of the security investigation package to the base-level security/information assurance officials and interim approval to grant Government computer system access.

The HCW completes all security requirements on the SF-85P, Questionnaire for Public Trust Positions form. The SF-85P will normally be completed on the first day of performance at the MTF. The Contractor shall ensure each contracted HCW brings the necessary documentation requested on the SF-85P (e.g., current and previous addresses in the past seven years, zip codes, telephone phone numbers, passport numbers, family member names, SSNs) to prevent delays in completing the SF-85P form. If the contracted HCW does not have the appropriate information to complete the SF-85P within two (2) business days of scheduling an appointment, the CO may stop work on the task order until the contracted HCW completes the SF-85P.

In some cases, HCWs may also be required to submit a Birth Certificate or Naturalization Certificate to the MTF Unit Security Manager.

The Contractor shall advise their contracted HCWs that a favorable report, verified through the Joint Personnel Adjudication System (JPAS), is needed as a condition of employment under this contract. The Contractor understands that, while the MTF commander may allow contracted HCWs temporary or interim access to government systems in non-sensitive positions pending the outcome of the NACI (usually through a 90-day waiver), contracted HCWs will be immediately removed from the position if the NACI returns an “unfavorable” or “no determination made” adjudication.

4.1 Criminal History Background Checks

The MTF will conduct criminal history background checks (CHBC) on all HCWs involved in the delivery of healthcare to children, under the age of 18 on a frequent and regular basis, as stated in DODI 1402.5, Enclosure 5.

The Contractor is responsible for ensuring the HCW completes the Standard Form 85-P, Questionnaire for Public Trust Positions before the appointment with the Unit Security Manager. The Contractor shall ensure that the HCWs follow local base policy to provide fingerprints on a properly completed FD Form 258 (FBI US Department of Justice Fingerprint Card). The procedures for completing the required background check are outlined in the Department of Defense Instruction (DODI) 1402.5.

HCWs may be employed under the contract pending completion of the background checks, but will require “close clinical supervision” as outlined in paragraph 5.4.7.5 of AFI 44-119. The MTF Commander will determine if a HCW will be able to work pending a CHBC and make that decision on quality assurance, risk management, licensure, employee orientation, and credentials verification. Close clinical supervision for HCWs whose CHBCs are pending may include supervised privileges or line-of-sight supervision (i.e., chaperoned by an individual whose background check has been successfully completed) to ensure the protection of patients under the age of 18.

If the HCW has previously received a CHBC, proof of the check shall be provided or a new one obtained. A new investigation is required if a break in service to the Department of Defense results in a time lapse of more than 2 years. Re-verification shall be accomplished every 7 years.

Payment of fees incurred in the conduct of any criminal history background check is the responsibility of the Government.

4.2 Potential Threat.

The Contractor shall not employ individuals who are potential threats to the health, safety, security, general well being, or operational mission of the Department of Defense (DoD) and its population. This shall include individuals who are a potential threat because of felony convictions. The Government has wide latitude to disapprove or revoke security credentials due to disclosed or undisclosed derogatory information found during the Government screening processes.

5.0 CONTINUED MEDICAL EDUCATION (CME)/UNITS.

HCWs, licensed, registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current as prescribed by their professional licensing agency regardless of the length of the task order. CME shall be obtained at no additional cost to the Government and shall be reported to the

Government Supervisor and MTF Credentials Committee. Periodic CME classes may be conducted at the MTF and will be available, at no cost, to any HCW desiring, and authorized by the Government Supervisor, to attend.

HCWs shall be in good standing, and under no clinical restrictions, with the state licensure board in any state in which a license is held, or has been held, within the last 10 years.

HCWs shall be current with, and have completed, all continuing education requirements specified by their professional licensure or certification.

HCWs with valid National Agency Checks verified through the Joint Personnel Adjudication System (JPAS), will be provided access to the host base’s unclassified computer network and its inherent capabilities including, but not limited to: Internet access, electronic mail, file and print services and dial-in network access. The HCW shall be aware of and abide with all Government regulations concerning the authorized use of the Government's computer network including the restriction against using the network to recruit Government personnel or advertise job openings.

6.0 MANAGEMENT AND ADMINISTRATION.

The contractor will be responsible for the following management and administrative actions:

6.1 Contractor Management Staff Responsibilities

6.1.1 Qualifying Documentation for Preliminary Government Minimum Requirements.

The Contractor shall provide to the MTF Service Contract Manager the qualifying documentation on preliminary Government minimum at the time they submit their proposal in response to a task order.. The qualifying documentation may be electronic or hardcopy, but must be easily viewed and understood. Qualifying documentation for the preliminary Government minimum requirements shall consist of the following:

1. Candidate telephone number,

2. Documentation demonstrating the candidate meets or exceeds the education and experience requirements,

3. Documentation demonstrating the candidate meets the licensure requirements,

4. Documentation demonstrating the candidate meets the certification requirements set in the performance work statement, position description, and any addendum on the task order proposal request, and

5. Initial background check on candidate.

6.1.2 Qualifying Documentation for Subsequent Government Minimum Requirements.

The Contractor shall provide to the MTF Service Contract Manager the qualifying documentation on subsequent Government minimum requirements 20 days before the start of work, or 10 days. The qualifying documentation may be electronic or hardcopy, but must be easily viewed and understood. Qualifying documentation for the subsequent Government minimum requirements shall consist of the following:

1. Documentation demonstrating the candidate meets health and immunization requirements,

2. Documentation the candidate successfully completed a drug screen,

3. Complete and accurate credentials package for credentialed HCWs,

4. Complete background checks, and

5. Additional documentation required in the task order, including any items listed in an addendum.

6.1.3 Expedited Credentialing Process:

In some instances, MTFs may require fills in less than 30 days. To help facilitate an accelerated submission of credentialing documentation, vendors may receive a fixed price lump sum for expedited submission of credentialing documentation if credentials are received by the MTF within 10 days of task order award (IAW Section H.4).

6.1.4 Recording of Hours Worked:

The Contractor Management Staff shall not use Government staff members to record arrival or departure times, report absenteeism, sign payroll timesheets or complete corporate appraisal reports for HCWs. The Contractor shall have an internal management process in place to confirm HCW hours worked and conduct HCW performance assessments.

7.0 SERVICES SUMMARY

Table 7.0, Services Summary

Performance Objective Reference Performance Outcome Acceptable Quality Monitoring

Submits proposals to perform Air Force requirements (TOPR Participation Rate)

C1.5

Submits a complete and responsive bid on Task Order Proposal Requests

85% of all Task Orders Quarterly as defined in Section C 7.1.1

Government management oversight;

Contractor data

Recruit and place credentialed and non-credentialed HCWs to perform the requirements outlined on Task Orders in a timely manner (On Time Fill - Initial & Replacement)

C1.5

Fills all requirements with qualified credentialed and non-credentialed HCWs meeting Government minimum requirements in the timeframe detailed on the Task Order.

80% of HCW positions are filled in a reporting period as defined in Section C 7.1.2

Government management oversight, discrepancy reports, CTAR entries

Submits Subsequent Government Minimum Requirements documents as defined in C 6.1.2 for HCW positions (credentialed and non-credentialed), and additional document requirements (if any) established in the task order (Subsequent Government Minimum Requirements Documentation Submission Rate)

C1.5

Submits all Subsequent Government Minimum Requirements Documentation required for the Government to fill task order requirements.

85% of documents submitted within 20 calendar days, or 10 calendar days if expedited as defined in C 6.1.3, from task order award in a reporting period as defined in C 7.1.3

Government management oversight;

Contractor data

7.1 AQLs.

Contractor performance will be measured against the Acceptable Quality Levels in the Services Summary (Table 7.0). The AFMSCC will report performance monthly as a primary factor for future task order awards and annually in the Contractor Performance Assessment Reporting System (CPARS).

7.1.1 Task order proposal participation rate.

The task order proposal participation rate is a snapshot metric, which means it captures performance at one point in time, which is on the last day of the reporting period. This measure is calculated by dividing the number of task order proposals from the Contractor in a reporting period by the total number of TOPRs issued by the Government in that same reporting period. The reporting period is defined as each calendar month and this metric will be reported with the submission of the Contractor Performance Status Report (CPSR) as defined in C 8.2.

7.1.2 On-time fill rate (Initial and replacement).

This measure is calculated by dividing the number of HCWs with a required start date in a reporting period filled on time by the total number of HCWs with a required start date in the same reporting period. This measure includes all fills initial and replacement. The reporting period is defined as each calendar month and this metric will be reported with the submission of the Contractor Performance Status Report (CPSR) as defined in C 8.2.

7.1.3 Subsequent Government Minimum Requirements Documentation Submission Rate This measure is calculated by dividing the number of HCWs with a Subsequent Government Minimum Requirements Documentation meeting the time frames required at C 1.5 time by the total number of HCWs with a required start date in the same reporting period. The reporting period is defined as each calendar month and this metric will be reported with the submission of the Contractor Performance Status Report (CPSR) as defined in C 8.2.

8.0 Contractor Furnished Data

8.1 Monthly Activity Report (MAR).

The Contractor shall prepare and submit a MAR electronically. The prime Contractor shall use the Government-provided electronic MAR format included in Section J, Attachment 5 and shall report information for all teaming partners and subcontractors. The MAR includes monthly data related to HCW start dates; HCW end dates; and performance discrepancies as referenced in the Services Summary. The PMO Contracting Officer may update the MAR format during the life of the contract (see Section J, Exhibit A, CDRL A001).

1) The Contractor shall send the MAR, via email, to the AFMSCC using the electronic format no later than (NLT) 10 calendar days after each month. If the 10th calendar day falls on a weekend or holiday, the Contractor shall submit the MAR on the next business day.

2) The MAR provides task order specific information such as task order number, award date, health care worker start date, health care worker end date, place of performance, and the task order value. Other specific information regarding each position includes labor category, quantity (i.e., projected hours) and name of health care workers.

8.2 Contractor Performance Status Report (CPSR).

The Contractor shall prepare and submit a monthly contractor performance status report (CPSR) electronically. The prime Contractor shall use the Government-provided electronic CPSR format included in Section J, Attachment 6 and shall report information for all teaming partners and subcontractors.