PWS_Pathologist-1Feb15-FINAL.pdf

PERFORMANCE WORK STATEMENT

FOR

PATHOLOGIST CONSULTANT

1 Feb 15

SECTION TITLE PAGE

1 DESCRIPTION OF SERVICES 3

2 SERVICE DELIVERY SUMMARY 10

3 GOVERNMENT FURNISHED PROPERTY AND SERVICES 11

4 GENERAL INFORMATION 12

5 APPENDICES 15

SECTION 1

DESCRIPTION OF SERVICES

1.1. SCOPE OF WORK. The Contractor shall provide Pathology consultation services required for Government beneficiaries. The Contractor shall provide care at 75th Medical

Group, also referred to as the “Medical Treatment Facility” (MTF) herein. Contractor care shall cover the range of services provided in a civilian medical treatment facility. Performance shall be according to the requirements contained in this Performance Work Statement (PWS), and professional standards of the Joint Commission on Accreditation of Healthcare Organization and

College of American Pathologists.

1.2. PERSONNEL.

1.2.1. POINT OF CONTACT. The Contractor shall provide a point of contact that shall be responsible for the performance of the work. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The point of contact may be a provider providing care in accordance with this PWS. The Contractor shall designate this individual, in writing, to the Contracting Officer (CO) before the contract start date. An alternate may be designated, but the Contractor shall identify those times when the alternate shall be the primary point of contact.

1.2.2. AVAILABILITY. The Contractor shall provide a point of contact that shall perform compliance reviews on a monthly basis. The Contractor will provide two hours of service monthly as agreed upon by Laboratory Flight Commander or his/her designee. Performance will not be required for federal holidays.

1.2.3. ARRANGE FOR REPLACEMENT STAFF. The point of contact shall arrange for certified anatomic/clinical pathologist coverage when pathologist will be unable to provide services during the month. If services are disrupted for a month, the Government reserves the right to procure such services from another source, until services are restored by the Contractor.

When the Government exercises its right to procure these services from another source, the

Government will reduce the Contractor’s invoice at an equivalent amount to that incurred. A copy of the other source’s service ticket will be used as the basis for this reduction. The

Government will furnish the Contractor a copy of this ticket upon the Contractor’s request.

1.2.4. PERSONNEL REQUIREMENTS.

1.2.4.1. ENGLISH LANGUAGE REQUIREMENT. Personnel shall read, understand, speak, and write English.

1.3. APPREARANCE. Contractor personnel shall present a neat appearance and be easily recognized as contractor employees.

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

Department of the Air Force, either military or civilian, unless such person seeks and receives approval in accordance with DoD Directive 5500.7 and Air Force policy.

1.4. EDUCATION AND TRAINING REQUIREMENTS.

1.4.1. EDUCATION. The contractor shall be a board certified medical pathologist certified in anatomic and clinical pathology. The pathologist must maintain board certification through the

College of American Pathologists.

1.4.2. EXPERIENCE. The provider shall have provided Pathology Consultation services a minimum of five years.

1.5. HEALTH REQUIREMENTS:

1.5.1. Contract personnel providing services under this contract shall receive a pre-employment physical examination, to include HIV testing prior to commencement of work. Documentation of this test shall be provided to the Public Health section upon in-processing.

1.5.2. Not later than five (5) working days prior to commencement of work, certification shall be provided to the contracting officer’s representative that health care providers have completed medical evaluation required above. This certification shall state the date on which the examination was completed, the doctor’s name that performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: “(name of contract employee) is suffering from no contagious diseases to include but not limited to Tuberculosis, Hepatitis, and Venereal Disease.”

1.5.3. Also, as a condition of employment, OSHA requires that all contract personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity to Hepatitis B infection. Personnel who sign declinations may change their minds at anytime and receive the Hepatitis B vaccine without penalty.

1.5.4. It is the contractor’s responsibility to report (to the appropriate MTF staff member) all information necessary to assure hospital records can be maintained correctly, and therefore comply with the JCAHO, OSHA, and CDC health records requirement.

1.6. EMERGENCY HEALTH CARE. The MTF will provide emergency health care for contract personnel for injuries occurring while on duty in the MTF. These services will be billed to the Contractor at the current full reimbursement rate.

1.7. RELATIONSHIP OF THE PARTIES, PROFESSIONAL LIABILITY

RESPONSIBILITY, AND PROCEDURES. This is a non personal services contract as defined in Federal Acquisition Regulation (FAR) 37.101.

1.8. ORIENTATION. The Contractor shall ensure that all contract providers participate in the section specific safety orientation for newly assigned personnel within the laboratory to include regulations specific to their area of operation and hospital and Air Force policy and procedures.

2.0. PERFORMANCE OF SERVICES DRUING CRISIS DECLARED BY THE

NATIONAL COMMAND AUTHORITY OR OVERSEAS COMBATANT

COMMANDER. (IAW AFI 63-124, para 1.2.7.2, DODI 3020.37 this requirement is not considered mission essential).

3.0. FACILITIES. During the hours of performance under this contract, the Contractor employees shall have the use of office space available.

4.0. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

OF 1996

HIPAA is comprised of several different sections, each to be implemented by the Dept. of

Health and Human Services. The medical facilities of the military services and the DOD health plans are specifically listed as covered by HIPAA. Currently, HIPAA Privacy and

Security Rules, as set forth in the Code of Federal Regulations, are in effect for all MTFs. The specific implementation of HIPAA Privacy for DOD medical facilities is set forth in DOD

6025.18-R, and for HIPAA Security, the requirements for AF MTFs are contained in DOD

8580.02-R and AFI 41-217, which also contains additional Information Assurance requirements for all AF MTFs. DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. MTFs are responsible to insure overall compliance with

HIPAA requirements, which includes incorporation of certain requirements in contracts entered or amended after the respective implementation dates.

IAW these regulations, the Contractor and its employees meet the definition of Business

Associates. Therefore, a Business Associate Agreement is required by law to comply with both the HIPAA Privacy and Security regulations. This clause serves as that agreement for each

MTF, whereby the Contractor and its employees agree to abide by all HIPAA Privacy and

Security requirements regarding health information as defined in this clause, DoD 6025-18-R, DOD 8520.02-R and AFI 41-217. Additional HIPAA requirements will be addressed when implemented.

Introduction

(a) Definitions. As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DOD 6025.18-R, DOD 8520.02-R or AFI

41-217.

Individual has the same meaning as the term “individual” in 45 CFR 164.50 1 and 164.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR

164.502(g).

Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at

45 CFR part 160 and part 164, subparts A and E.

Protected Health Information has the same meaning as the term “protected health information” in

45 CFR 164.501, limited to the information created or received by The Contractor from or on behalf of the Government.

Electronic Protected Health Information has the same meaning as the term “electronic protected health information” in 45 CFR 160.103.

Required by Law has the same meaning as the term “required by law” in 45 CFR 164.501 and

164.103.

Secretary means the Secretary of the Department of Health and Human Services or his/her designee.

Security Rule means the Health Insurance Reform: Security Standards at 45 CFR part 160,162 and part 164 subpart C.

Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103, 160.502, 164.103, 164.304 and 164.501.

(b) The Contractor agrees to not use or further disclose Protected Health Information other than as permitted or required by the Contract or as Required by Law.

c) The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the

Protected Health Information other than as provided for by this Contract.

(d) The Contractor agrees to use administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the electronic protected health information that it creates, receives, maintains, or transmits in the execution of this Contract.

(e) The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Contract.

(f) The Contractor agrees to report to the Government any security incident involving protected health information of which it becomes aware.

(g) The Contractor agrees to report to the Government any use or disclosure of the Protected

Health Information not provided for by this Contract of which the Contractor becomes aware of.

(h) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the Contractor on behalf of the Government, agrees to the same restrictions and conditions that apply through this

Contract to the Contractor with respect to such information.

(i) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides electronic Protected Health Information, agrees to implement reasonable and appropriate safeguards to protect it.

(j) The Contractor agrees to provide access, at the request of the Government, and in the time and manner designated by the Government to Protected Health Information in a Designated Record

Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524.

(k) The Contractor agrees to make any amendment(s) to Protected Health Information in a

Designated Record Set that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or an Individual, and in the time and manner designated by the

Government.

(1) The Contractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the

Contractor on behalf of, the Government, available to the Government, or at the request of the

Government to the Secretary, in a time and manner designated by the 'Government or the

Secretary, for purposes of the Secretary determining the Government's compliance with the

Privacy Rule.

(m) The Contractor agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

(n) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the

Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

General Use and Disclosure Provisions

Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected

Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the

HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R if done by the Government.

Specific Use and Disclosure Provisions

(a) Except as otherwise limited in this Agreement, the Contractor may use Protected Health

Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

(b) Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health

Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of the information has been breached.

(c) Except as otherwise limited in this Agreement, the Contractor may use Protected Health

Information to provide Data Aggregation services to the Government as permitted by 45 CFR

164.504(e)(2)(i)(B).

(d) Contractor may use Protected Health Information to report violations of law to appropriate

Federal and State authorities, consistent with 45 CFR 164.502(j)(1).

Obligations of the Government

Provisions for the Government to Inform the Contractor of Privacy Practices and

Restrictions

(a) Upon request the Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice.

(b) The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the Contractor's permitted or required uses and disclosures.

(c) The Government shall notify the Contractor of any restriction to the use or disclosure of

Protected Health Information that the Government has agreed to in accordance with 45 CFR

164.522.

Permissible Requests by the Government

The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the HIPAA Privacy Rule, DOD 6025.18R, the

HIPAA Security Rule, or DOD 8580.02-R, if done by the Government, except for providing Data

Aggregation services to the Government and for management and administrative activities of the

Contractor as otherwise permitted by this clause.

Termination

(a) Termination. A breach by the Contractor of this clause, may subject the Contractor to termination under any applicable default or termination provision of this Contract.

(b) Effect of Termination.

(1) If this contract has records management requirements, the records subject to the Clause should be handled in accordance with the records management requirements. If this contract does not have records management requirements, the records should be handled in accordance with paragraphs (2) and (3) below.

(2) If this contract does not have records management requirements, except as provided in paragraph (3) of this section, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to

Protected Health Information that is in the possession of subcontractors or agents of the

Contractor. The Contractor shall retain no copies of the Protected Health Information.

(3) If this contract does not have records management provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected Health Information.

Miscellaneous

(a) Regulatory References. A reference in this Clause to a section in DOD 6025.18-R, HIPAA

Privacy Regulation or DOD 8580.02-R, HIPAA Security Regulation, or any CFR or AFI provision means the section as currently in effect or as amended, and for which compliance is required.

(b) Survival. The respective rights and obligations of Business Associate under the "Effect of

Termination" provision of this Clause shall survive the termination of this Contract.

(c) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with DOD 6025.18-R, the CFR HIPAA Privacy Rule, DOD

8520.02-R, the CFR HIPAA Security Rule and AFI 41-217.

SECTION 2

SERVICE DELIVERY SUMMARY (SDS).

N/A

SECTION 3

GOVERNMENT FURNISHED PROPERTY AND SERVICES

3.1. GENERAL. The Government will provide the following equipment, supplies, and services listed below:

3.2. EQUIPMENT. The provider shall have use of available equipment for performing services required by this contract.

3.2.1. PERSONAL PROTECTIVE EQUIPMENT (PPE). The Government will furnish provider with appropriate PPE. The Government will be responsible for any repair, cleaning and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

3.3. FORMS. The MTF will provide required Government forms used in the performance of services. Unless noted otherwise, all required Air Force and Department of Defense directives, forms and other work files applicable to the MTF will be furnished by the Government and will be retained by the Government.

3.4. SUPPLIES. The MTF will provide medical and non-medical supplies commonly used in the facility for the care and management of patients.

SECTION 4

GENERAL INFORMATION

4.1. GENERAL. The pathologist shall provide medical consultation services at the 75 th

Medical

Group, herein referred to as the 75 th

MDG and specifically with the Clinical Laboratory Flight.

The consultant pathologist shall provide a range of services provided in a civilian medical treatment facility and as outlined below. Performance shall be in accordance with the requirements contained in the Performance Work Statement (PWS), and professional standards of the College of American Pathologists and the Joint Commission on Accreditation of

Healthcare Organizations (JCAHO).

4.2. SPECIFIC PROCEDURES FOR WHICH THE CONTRACTOR SHALL BE

RESPONSIBLE. The pathology consultant agrees to provide the 75 th

MDG the following services:

4.2.1. Pathology consultation on a monthly basis. The consultant pathologist will provide two hours of service monthly.

4.2.2. Visits are to be coordinated with the Laboratory Officer and mutually agreed upon.

4.2.3. A written report detailing status findings and any recommendations after each visit prior to leaving.

4.2.4. Review of all CAP Proficiency Surveys and Exception Reports

4.2.5. Review of referred hematology peripheral blood smears for interpretation.

4.2.6. Evaluate negative trends identified by staff regarding provider test ordering patterns and abuses and respond appropriately to the respective provider(s) and medical staff.

4.2.7. Provide a minimum of one continuing medical education lecture to the laboratory staff annually, and more as needed.

4.2.8. Provide Establish and maintain a cooperative and effective working relationship with the laboratory staff, medical staff and other departments.

4.2.9. In connection therewith the Laboratory Officer shall work closely in order to support the management of the laboratory and comply with applicable provisions of law, rules and regulations.

4.2.10. Provide test interpretation and consultation to the medical staff as required.

4.2.11. Is available for consultation (by telephone) during normal business hours with laboratory staff personnel and professional staff.

4.2.12. Provide annually one continuing medical education lecture to the professional staff.

4.2.13. Review and sign all laboratory operating instructions annually; this includes chemistry, hematology, serology/immunology, microbiology, urinalysis, specimen collection/processing and administration. Insures all operating instructions meet CAP criteria.

4.2.14. Advises laboratory management on all aspects of quality control/quality assurance programs.

4.2.15. Advises laboratory management on implementation of new laboratory procedures that may increase the quality of patient care. Recommends new procedures that may cut cost or time without decreasing the quality of patient care. Recommends the discontinuation of procedures for same reasons stated.

4.2.16. Be physically present during on-site inspections by the College of American Pathologists

(CAP).

4.2.17. Shall not be required to comply with the 75

th

MDG employee health program and education and training requirements.

4.2.18. In conjunction with the Laboratory Officer ensure that the physical plant and environmental conditions of the laboratory are appropriate for the testing performed and provide a safe environment in which all employees are protected from physical, chemical and biological hazards.

4.2.19. The position requires that the medical pathologist is insured with appropriate medical malpractice insurance in the amount of no less than $ 1/3 million.

4.3. PATIENT LISTS. Patient lists, no matter how developed shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to or revealed in anyway for any use outside the MTF without prior written permission by the Chief of Hospital Services.

4.4. PATIENT SENSITIVITY. Contract providers shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. Providers receiving complaints validated by a Laboratory representative and Contract specialist, shall be subject to counseling and, depending on the nature and severity of the complaint, separation from performing services under this contract.

4.5. RELEASE OF MEDICAL INFORMATION. The provider shall only release medical information obtained during the course of this contract to other MTF staff involved in the care and treatment of that individual patient.

4.6. PERFORMANCE EVALUATION MEETINGS. The CO shall require the Contractor or his representative to meet with the CO, contract administrator, and other government personnel as deemed necessary. The Contractor may request a meeting with the CO when he deems such necessary. Meetings will be documented in the contract file with written minutes signed by the contract manager and the CO, or contract administrator. Should the Contractor not concur with the minutes, such non-concurrence shall be provided in writing to the CO within ten (10) calendar days of receipt of the minutes.

SECTION 5

APPENDICES

APPENDIX A

APPLICABLE PUBLICATIONS AND FORMS

Publications and forms applicable to the PWS are listed below. The Contractor is obligated to follow those publications. These publications are available in the MTF and maintained by the

Government. Supplements or amendments to listed publications from any organizational level may be issued during the life of the contract. The Contractor shall immediately implement those changes in publications which result in a decrease or no change in the price and notify the

Contracting Officer (CO) in writing of such change. Should a decrease in contract price result, the Contractor shall provide a proposal for reduction in the price to the CO. Prior to implementing any change that will result in an increase; the Contractor shall submit to the CO a price proposal within 30 days of receipt of the change by the Contractor. The CO and the

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

PUBLICATION #. MANDATORY

SECTION/PARA/LINE TITLE DATE ADVISORY (M/A)

5.1. DEPARTMENT OF DEFENSE (DoD) REGULATIONS/MANUALS

INSTRUCTIONS/DIRECTIVES

DoD Directive 5500.7 Standards of Conduct Mar 87 M

5.2. AIR FORCE REGULATIONS/MANUALS/INSTRUCTIONS

5.3. OTHER REFERENCES

5.4. FORMS