Performance_Work_Statement_(PWS).pdf

PERFORMANCE WORK STATEMENT

FOR

LICENSED SOCIAL WORKER

Personal Service

Wright Patterson Medical Treatment Facility

Wright Patterson A.F.B., Ohio

23 June 2015

Table of Contents

1. Description of Service 4

1.1. Scope 4

1.2. Licensed Social Worker 5

1.3. Availability of Personnel 9

1.3.1. Hours of Operation 9

1.3.2. Federally Observed Holidays 9

1.3.3. Planned Closure Days 9

1.3.4. Performance Evaluation Meetings 9

1.4. Education, Training, and Professional Requirements 9

1.5. Continuing Education (CE) Requirements 10

1.6. Employee Credentials 10

1.7. General Information 10

1.7.1. Quality Control Program 10

1.7.2. Point of Contact 11

1.7.3. English Language Requirement 11

1.7.4. Appearance 11

1.7.5. Professional Qualities 11

1.7.6. Changes in Personnel 11

1.7.7. Rights to Information and Reports 11

1.7.8. Existing Staff 12

1.7.9. MH Workload Estimates 12

1.8. Security Requirements 12

1.8.1. Contractor Notification Responsibilities 12

1.8.2. Suitability Investigations 12

1.8.3. Freedom of Information Act Program 12

1.8.4. Reporting Requirements 12

1.8.5. Physical Security 13

1.8.6. Key Control 13

1.8.7. Continuation of Essential Department of Defense (DOD) Contractor 13

Services During Crisis

1.8.8. Conflict of Interest 13

1.8.9. Indemnification and Medical Liability Insurance 13

1.8.10. Medical Quality Assurance/Risk Management 13

1.8.11. Orientation 13

1.8.12. Annual Training 14

1.8.13. Infection Control and Safety 14

1.8.14. The Joint Commission 14

1.8.15. Patient Lists 14

1.8.16. Patient Sensitivity 14

1.8.17. Release of Medical Information 14

1.9. Health Requirements 14

1.9.1. Pre-assignment Medical Evaluations 14

1.9.2. Preventive, Prophylactic and Follow-up Procedures 15

1.9.3. Medical Records 15

1.9.4. Immunization Waivers/Exemptions 15

1.9.5. Pregnant Employees 15

1.9.6. Communicable Diseases 16

1.10. Environmental Requirements 16

1.10.1. General 16

1.10.2. Hazardous Materials 16

1.10.3. Hazardous Materials Inventory 16

1.10.4. Storage of Hazardous Materials 16

2. Services Summary 17

3. Base Support 17

4. General Information 18

4.1 Voluntary Protection Program 18

4.1.1 Definitions 18

4.1.1.2 Applicable Contractor 18

4.1.1.3 Days Away, Restricted, and or Transfer Case Incident Rate (DART) 18

4.1.1.4 Total Case Incidence Rate (TCIR) 18

4.1.2 Requirements 18

4.1.2.1 Voluntary Protection Program (VPP) 18

4.1.2.2 Safety and Health Plan 18

4.1.2.3 Safety and VPP Roles and Responsibilities 18

4.1.2.4 Total Case Incidence Rate (TCIR) 19

4.1.2.5 Quality Control Plan 19

4.1.2.6 Establish VPP 19

5. Contract Manpower Reporting 19

5.1. Labor Hour Reporting 19

5.2. Labor Execution 20

5.3. Safeguarding of Information 20

5.4. User Manuals 20

5.5. Proprietary Markings 20

6. Combating Trafficking in Persons 20

6.1. Trafficking in Persons (TIP) 20

PERFORMANCE WORK STATEMENT

FOR

LICENSED SOCIAL WORKER

I. DESCRIPTION OF SERVICE

1.1. SCOPE

1.1.1. The Contractor shall furnish all labor and management of contractor staff, and the reports required to provide the services of the Licensed Social Worker listed in PWS on a personal services basis at the 88th Medical Group (MG), Wright-Patterson Medical Center, Wright Patterson Air Force Base (WPAFB), Ohio, also referred to as the "Medical

Treatment Facility" (MTF) herein.

1.1.2. The Contractor shall perform services in accordance with (IAW) the ethical, professional, and technical standards of the health care industry and the Air Force medical department. Performance shall be according to the requirements contained in this

Performance Work Statement (PWS), the guidelines of the National Association of Social

Workers (NASW), professional standards of practice of The Joint Commission (TJC), the

Air Force Inspection Agency Office of the Health Service Inspector, and applicable Air

Force regulations found in this PWS. Contractor shall cover clinic social worker services provided in the MTF.

1.1.3. Required coverage is for a full time employee (FTE), or 1,920 hours. Contractor shall comply with Air Force and departmental policy along with procedure, federal, and local regulations, TJC requirements, and national and international standards of practice and care.

Specific tasks performed by the contractor include but are not limited to:

1.1.3.1 Conduct psychosocial assessments and provide psychosocial treatment to a wide variety of individuals from socio-economic, cultural, ethnic, educational, and other diversified backgrounds.

1.1.3.2 Complete appropriate treatment plans in collaboration with individuals, groups, couples, and families.

1.1.3.3 Provide counseling and/or psychotherapy services/procedures correctly and appropriately to individuals, groups, couples, and families.

1.1.3.4 Appropriately document counseling and/or psychotherapy services/procedures and all other patient contacts appropriately.

1.1.3.5 Provide consultation services to other staff about the psychosocial needs of patients and the impact of psychosocial problems on health care and compliance with treatment.

1.1.3.6 Evaluate own practice through participation in professional peer review case conferences or other organized means.

1.1.3.7 Effectively assess, plan, facilitate, and advocate care and coordination of care for patients and family/caregivers both with MTF staff and staff from regional Mental

Health-related treatment facilities.

1.1.3.8 Use computer software applications for drafting documents, data management, and tracking, especially those programs in use by DoD.

1.1.3.9 Use appropriate medical and mental health diagnoses, disabilities and treatment procedures. This includes acute, chronic and traumatic illness/injuries, common medications and their effects/side effects, and medical terminology.

1.1.3.10 Implement appropriate treatment modalities in working with individuals, families and groups who are experiencing a variety of psychiatric, medical and social problems to achieve treatment goals.

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

1.1.3.12 Attend all required meetings as designated by the Chief of Mental Health.

1.1.3.13 Comply with annual Continuing Education (CE) and training requirements.

1.2. LICENSED SOCIAL WORKER. The Licensed Social Worker provides clinical social work assessment, treatment, consultation, evaluation, and training for an outpatient mental health care setting within MTF, care coordination and discharge/disposition planning with regional

Mental Health (MH) inpatient care settings outside MTF, and consultation with MTF inpatient care and emergent care settings. Assist service members and/or veterans, family members, and caregivers with receiving the most appropriate options and services to meet their complex mental health care needs, including but not limited to acute, routine, chronic, and/or co-morbid psychiatric conditions. Coordinate care with multiple providers and treatment site staff across all levels and sites of care. Address psychosocial needs of patients. Evaluate care and outcomes to ensure the most appropriate and effective care and services are rendered. The Contractor provider shall:

1.2.1 Be responsible for and apply social work procedures and techniques in the evaluation and treatment of psychological/psychiatric disorders. Activities include, but are not limited to, the following:

1.2.1.1 Responsible for and provide individual, family and group psychotherapy, and couples therapy.

1.2.1.2 Consult to medical personnel, legal authorities, military commanders and school districts, as required.

1.2.1.3 Maintain accurate and current notes in both the Mental Health records and patient medical records of all patients seen and patient contacts made, as appropriate, and produce reports of evaluation and/or treatment, as required.

1.2.1.4 Child, Adolescent and Family Social Work Services, to include:

1.2.1.4.1 Evaluation. Evaluate children from infancy through adolescence, to include conducting child and family interviews. Perform psychosocial evaluations to assess and/or treat emotional/behavior problems, educational/academic problems, attention problems, organic disorders, eating disorders, psychotic disorders, social and interpersonal dysfunction, physical/sexual/emotional abuse and neglect, personality dysfunction and drug/alcohol abuse.

1.2.1.4.2 Treatment. Provide treatment across a range of modalities to include

Psychotherapy, play, group and family therapy with all aged children and adolescents. Treat children and adolescents with adjustment disorders, oppositional and non-compliant behavior, attention deficit disorders, anxiety disorders and phobias, eating disorders, elimination disorders, school-related problems, developmental delay, pervasive developmental disorders, childhood psychosis and affective disorders, abuse and other trauma (either psychological or physical), and support the psychological management of medical problems.

Provide varied levels of intervention, including individual, parent and family therapy.

1.2.1.4.3 Consultation. Consult with other individuals and organizations to include other hospital services (e.g., Pediatrics, Neurology, Social Work), public schools, courts, the Exceptional Family Member Program and social services agencies regarding specific case management and programmatic issues affecting children and families. Provide consultation and feedback to parents in order to relay results of treatment. Collaborate with other professionals in order to provide social work services to children, and in making interventions within the child's psychosocial environment. Provide consultation which includes not only traditional clinical interventions that emphasize delimiting and remediating psychopathology in children and adolescents, but prevention, and the encouragement of psychological health.

1.2.1.4.4 Documentation. Document all contacts with patients in accordance with Mental Health Clinic policy.

1.2.1.4.5 Training. Attend and provide didactic seminars in the areas of normal growth and development, consultation-liaison and psychotherapeutic approaches to child psychopathology.

1.2.1.5 Adult Social Work Services, to include:

1.2.1.5.1 Evaluation. Evaluate adults. Perform psychosocial evaluations to assess and/or treat psychiatric disorders, emotional/behavior problems, educational/academic problems, attention problems, organic disorders, eating disorders, psychotic disorders, social and interpersonal dysfunction, physical/sexual/emotional abuse and neglect, personality dysfunction, and drug/alcohol abuse.

1.2.1.5.2 Treatment. Provide treatment across a range of modalities to include psychotherapy, group, marital, conjoint, and family therapy with all aged adults. Treat adults with the full range of psychiatric disorders. Provide varied levels of intervention, including individual, marital, conjoint, group, and family therapy.

1.2.1.5.3 Consultation. Consult with others individuals and organizations to include other hospital services (e.g., Family Health, Internal Medicine, Neurology, Social Work) and social services agencies regarding specific case management and programmatic issues affecting adults. Provide consultation and feedback to family members and/or command authorities as indicated by treatment and military regulations. Collaborate with other professionals in order to provide social work services to adults, and in making interventions within the adult’s psychosocial environment. Provide consultation which includes not only traditional clinical interventions that emphasize delimiting and remediating psychopathology in adults, but also prevention, and the encouragement of psychological health.

1.2.1.5.4 Documentation. Document all contacts with patients in accordance with Mental Health Clinic policy.

1.2.1.5.5 Training. Attend and provide didactic seminars in the areas of normal growth and development, consultation-liaison and psychotherapeutic approaches to adult psychopathology.

1.2.1.6 Provide consultation and workshops with parents, schools, hospital staff, and other personnel who work with children and adolescents on the theory and practice of working with this population. Provide training to clinical psychology residents, as requested.

1.2.1.7 Participate in and/or direct research and conduct clinical investigations in social work and/or child and adolescent psychology.

1.2.1.8 Care Coordination Services, to include:

1.2.1.8.1 Assessment. Proactively identify and evaluate patients and families for care coordination from a variety of sources such as through discharge/disposition planning, referrals, the Medical Evaluation Board (MEB) process, the healthcare system, employers and facility staff. Conduct systematic, on-going, thorough collection of patient’s physical, emotional, psychological, social and medical status and information to include direct patient contact and other relevant sources such as professional and non-professional caregivers, medical records, family/caregiver interviews.

1.2.1.8.2 Planning. Develop appropriate patient-specific plan of care to include short and long term goals, objectives and actions. Coordinate, collaborate, and obtain approval of the plan among the patient, family/caregiver, primary provider and other members of the healthcare team.

1.2.1.8.3 Implementation. Guide the patient and family/care giver through the healthcare system, maximizing use of resources. Coordinate and execute the plan of care, optimizing access to appropriate services. Ensures necessary referrals are ordered by the appropriate discipline and coordinated. Serve as an advocate for, and ensure education is provided to, the patient and family/caregiver as required. Promote adherence to treatment plans for improved healthcare outcomes.

1.2.1.8.4 Coordination. Ensure coordination of care delivery processes, to include alternate healthcare settings and the home environment, for the purposes of enhancing the patient's health and wellness, safety, productivity, and quality of life, and for providing the most beneficial, cost-effective health care. Develop, utilize and maintain a variety of military and community resources to optimize access to services and medical care. Ensure timely and appropriate provision of services.

1.2.1.8.5 Monitoring. Document and update the treatment plan as needed in accordance with existing DoD, AF, local facility and other agency guidelines.

Maintain documentation and data collection in accordance with DoD, AF, local facility and other specified agency guidelines. Conduct and/or participate in program evaluation as directed.

1.2.1.8.6 Evaluation. Monitor and evaluate to include but not limited to:

patient’s adherence and response to the treatment plan; timeliness of patient and family/caregiver contact and follow-up; identification of variances, patterns or trends from established practice guidelines and/or standards;

established outcome measurements; results of interventions, treatment delivery and timeliness of care; and utilization of resources.

1.2.1.8.7 Coordinate and participate in interdisciplinary team meetings, designated facility meetings, and care coordination meetings. Share knowledge and experiences gained from own clinical practice and education relevant to the field of social work and case management.

1.2.2 Attend and participate in, as necessary, all required Mental Health Clinic and MTF meetings.

1.3. AVAILABILITY OF PERSONNEL.

1.3.1. HOURS OF OPERATION. The normal duty hours for the MTF are between 0730 to 1630, Monday through Friday. Contractor, licensed social work employee, shall be present during normal duty hours in the Mental Health clinic for 40 hours per week or 160 hours per month and shall divide work time evenly throughout the month. Hours per month vary depending on mission and special procedures. Alternative schedules shall be approved by the Mental Health Flight Commander. The Contractor shall reside with 50 miles of

Wright Patterson Air Force Base.

1.3.2. FEDERALLY OBSERVED HOLIDAYS. The Contractor is not required to provide services on the following Federal holidays: New Year’s Day; Martin Luther King Day;

President’s Day; Memorial Day: Independence Day; Labor Day; Columbus Day; Veterans’

Day; Thanksgiving Day; and Christmas Day.

1.3.3. PLANNED CLOSURE DAYS. The Contractor is not required to provide services on

AFMC Family Days.

1.3.4. PERFORMANCE EVALUATION MEETINGS. The Contractor or his representative shall meet with the Contracting Officer’s Representative (COR), and other government personnel at least quarterly, and as requested.

1.4. EDUCATION, TRAINING, AND PROFESSIONAL REQUIREMENTS.

All services shall be rendered IAW established principles and ethics of the social work profession, the national standards established by the TJC, Health Insurance Portability and

Accountability Act (HIPAA), Occupational Safety and Health Administration (OSHA), the professional standards at MTF, and the National Association of Social Workers (NASW). The

Contractor shall provide services to all patients eligible for care at the MTF for treatment or as requested by the Mental Health Flight Commander. The Government will evaluate the quality of professional and administrative services provided based on nationally accepted guidelines

(NASW) and will retain control over the medical and professional aspects of services rendered

(e.g., professional judgments, diagnosis for specific treatment). The Contractor shall certify that the following Contractor personnel have the minimum qualifications/training indicated.

1.4.1 The Licensed Social Worker must maintain either a current, restricted clinical license to practice social work (e.g., LSW) or a current, unrestricted clinical license to practice social work (e.g., LISW, LCSW) in any one of the 50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands.

1.4.1.1 A current, unrestricted clinical social work license is defined as a license that allows the Licensed Social Worker to practice independently without clinical supervision.

1.4.1.2 A current, restricted clinical social work license is defined as a license that allows the Licensed Social Worker to practice under supervision. If the Licensed

Social Worker maintains a current, restricted clinical license to practice social work

(e.g., LSW), the Licensed Social Worker must be working toward and achieve unrestricted clinical license as defined in paragraph 1.4.1.1 within 2 years of hire and arrange for clinical supervision and be supervised by an appropriately credentialed social worker with both current, unrestricted clinical license to practice social work and license to supervise clinical social work practice (e.g., LISW-S).

1.4.2 Have a minimum of two (2) years’ experience within the past five (5) years in either the supervised or independent practice of clinical social work in a mental health setting working with an adult population, or with children and teens if specifically working with that population.

1.4.3 Have at least one (1) year of clinical experience, whether independent or in supervised capacity, working with individuals in either Federal (active duty military or veterans) or

State (prison settings, etc.).

1.4.4 Have at least one (1) year of clinical experience, whether independent or in supervised capacity, working with individuals with co-morbid and/or substance abuse histories.

1.5. CONTINUING EDUCATION (CE) REQUIREMENTS. Contractor employees shall meet the individual State Licensing Board standards for Continuing Education. CEs shall be obtained at no additional cost to the Government. Information on CE completion by Contractor employees shall be provided to the COR annually on the first work day in January for the previous calendar year. Documentation shall also be provided to the Government upon request.

1.6. EMPLOYEE CREDENTIALS. Contractor employee credentials shall be submitted to

COR no later than 15 calendar days after receipt of the notice of contract award, and as requested by the COR. The following minimum documentation is required: a copy of the proposed employee’s professional resume indicating experience, training, technical expertise in the type of services to be rendered, and references, as well as copies of relevant licensure.

1.7. GENERAL INFORMATION

1.7.1. QUALITY CONTROL PLAN. Contractor shall develop and maintain a quality control program to ensure licensed social worker services are performed in accordance with commonly accepted civilian hospital and commercial practices. The Contractor shall develop and implement procedures to identify and prevent defective services from reoccurring. Changes to this program shall be made at no additional cost to the

Government. The Quality Control Plan (QCP) is to be delivered not later than 15 days after contract award to CO for acceptance. Three copies of a comprehensive written QCP shall be submitted to the CO and COR not later than 5 working days when changes are made thereafter.

1.7.2. POINT OF CONTACT. The Contractor shall provide a point of contact who shall be available for the performance of the work Monday thru Friday between the hours of 0730 to 1630. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The Contractor shall designate this individual or individuals, in writing, to the Contracting Officer (CO), after contract award and before the period of performance starts on the contract. The Contractor shall identify the specific individual and times when different individuals will be the primary and alternate point of contact. If any changes occur in personnel the government shall be notified in writing not later than 15 calendar days of the primary point of contact’s last day.

1.7.3. ENGLISH LANGUAGE REQUIREMENT. Contractor personnel engaged in performance of this contract shall read, understand, speak, and write English.

1.7.4. APPEARANCE. All Contractor personnel shall be easily recognized as contractor employees. Contractor personnel shall display on the front of their uniform or civilian clothes legible Contractor-furnished identification media (badge) which lists the company’s name and individual’s name. Any required MTF identification will be provided by the

MTF.

1.7.5. PROFESSIONAL QUALITIES. The Contractor shall ensure contract employees interact professionally with members of the MTF and patients.

1.7.6. CHANGES IN PERSONNEL. When a permanent change in a contract employee is anticipated, the Contractor shall provide the COR the same credentials required for the initial contract employee no later than two (2) weeks prior to outgoing employee’s departure date. The permanent replacement candidate should begin work within 3 business days of outgoing contract employee’s departure. When a temporary change in a contract employee is required (at discretion of Mental Health Flight Commander, length of social worker absence, and clinical needs of the department) the Contractor shall provide a replacement candidate within 3 business days of notification of need; this temporary replacement shall be provided to Government at no additional expense and the same credentials and requirements

(and verification process) apply for the temporary contract employees. All replacements provided shall be at no additional expense to the Government.

1.7.7. RIGHTS TO INFORMATION AND REPORTS. The Contractor shall provide reports to the Government as part of the service in accordance with the guidelines listed in

Paragraph 1.0. The Contractor shall provide the Government with all processes and calculation methods by which the reported data was obtained. These documents and materials are the property of the Government. The Government determines the final disposition of reports and information.

1.7.8. EXISTING STAFF. The Contractor shall support the existing staff within the Mental

Health department. The existing staff is subject to change throughout the period of the requirement. The Mental Health staff includes numerous Active Duty, Civilian, and Contract staff and resident providers in the disciplines of Psychiatry, Psychology, Social Work, and

Psychiatric Nurse Practitioners.

1.7.9. MENTAL HEALTH (MH) WORKLOAD ESTIMATES. Current MH workload estimates are based on historical data and are subject to fluctuations. Each FTE MH provider provides service to an estimated five (5) patients per day.

1.8. SECURITY REQUIREMENTS.

1.8.1. CONTRACTOR NOTIFICATION RESPONSIBILITIES. The Contractor shall submit a “Notification of Contract” letter to the Contracting Office for endorsement before the letter is forwarded to the 88SFS/S5SP for approval. The “Notification of Contract” must be submitted to the 88SFS/S5SP at least 24 hours prior to the issuance of base identification.

The notification shall include: name, address, and telephone number of company representatives; the contract number and contracting agency; the reason for the contract (i.e., work to be performed); the location(s) of contract performance and future performance, if known; the date contract performance begins; any change to information previously provided under this paragraph.

1.8.2. SUITABILITY INVESTIGATIONS. Contractor personnel shall successfully complete, at a minimum, a National Agency Check (NAC), before operating Government-furnished workstations that have access to Air Force e-mail systems. The Government, at no additional cost to the Contractor, will perform these investigations. The Contractor shall comply with the Department of Defense (DOD) requirements of DODI 5200.2R, Personnel

Security Program, and AFI 33-119, Electronic Mail (E-Mail) Management and Use. These references will be provided to the Contractor by the Government.

1.8.3. FREEDOM OF INFORMATION ACT PROGRAM (FOIA). The Contractor shall comply with AFI 37-131, Freedom of Information Act Program (FOIA), requirements. The regulation sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding For Official Use Only (FOUO) material.

1.8.4. REPORTING REQUIREMENTS. The Contractor shall comply with AFI 71-101, Volume-1, Criminal investigations, and Volume-2, Protective Service Matters, requirements.

Contractor personnel shall report to an appropriate Government authority any information or circumstances of which they are aware that may pose a threat to the security of DOD personnel, contractor personnel, resources, and classified or unclassified defense information. Contractor employees shall be briefed by their immediate supervisor upon initial on-base assignment and as required thereafter.

1.8.5. PHYSICAL SECURITY. Areas controlled by contractor employees shall comply with current 88 Air Base Wing Operations Plans/instructions for FORCE PROTECTION

(FPCON) procedures and Random Antiterrorism Measures (RAMS). Valuable materials including equipment and facility area shall be secured in accordance with Air Force and

MTF instructions. These instructions will be provided to the Contractor by the Government.

1.8.6. KEY CONTROL. The Contractor shall establish and implement methods of tracking all keys/combinations issued to the Contractor. The Contractor shall establish that all keys issued by the Government shall be used only by contractor authorized personnel. The

Contractor shall not duplicate any keys issued by the Government. The Contractor shall report to the COR any occurrences of lost or duplicated keys within 24 hours of discovery to the COR. In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon written direction of the Contracting Officer shall rekey or replace the affected lock or locks without cost to the Government. The Government has the option to replace/reprogram the affected lock or locks or perform re-key and deduct the cost from the monthly payment due to the Contractor.

1.8.7. CONTINUATION OF CONTRACTOR SERVICES DURING BASE

EXERCISES, LOCAL EMERGENCIES, CONTINGENCIES, OR

IMPLEMENTATION OF LOCAL CONTINGENCY PLANS. Not applicable to this contract.

1.8.8. 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, nor shall the Contractor 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.

1.8.9. INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE. The

Contractor shall provide the Contracting Officer documentation of liability insurance prior to the start of the contract and annually thereafter and maintain adequate liability insurance coverage consistent with the risks associated with the performance of all services required in accordance with FAR clause 52.228-5 “Insurance – Work on a Government Installation”.

1.8.10. MEDICAL QUALITY ASSURANCE/RISK MANAGEMENT (QA/RM).

Contract employees shall participate and be evaluated in QA/RM activities per requirements in AFI 44-119 and the individual Military Treatment Facility (MTF) QA/RM plan. The

Government will provide the AFI44-119 and MTF QA/RM plan.

1.8.11. ORIENTATION. All contract employees shall participate in the MTF orientation procedures for newly assigned employees to include regulations specific to their professional specialty and hospital and Air Force policy and procedures. MTF orientation classes are offered on a monthly basis and information regarding these scheduled classes will be provided to the Contractor by the Government.

1.8.12. ANNUAL TRAINING. All contractor employees shall attend annual training classes at the MTF. Annual training shall include but not be limited to safety, QA, risk management, infection control, fire protection, security, and patient sensitivity training.

Classes can be scheduled by the Government individually throughout the year as training requirements become due. The class length of time is approximately four to five hours total per individual. Training certification shall be provided to the COR within five (5) business days of training completion .

1.8.13. INFECTION CONTROL AND SAFETY. All contract personnel shall comply with all MTF infection control and safety procedures, practices and standards. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government.

1.8.14. THE JOINT COMMISSION (TJC). Contract personnel shall comply with all applicable TJC standards during the performance of this contract. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the

Government.

1.8.15. PATIENT LISTS. All patient lists, no matter how they are developed, shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF without prior written permission by the

COR.

1.8.16. PATIENT SENSITIVITY. Contract providers shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.

1.8.17. 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 in compliance with current Health

Insurance Portability and Accountability Act (HIPAA) regulations.

1.9. HEALTH REQUIREMENTS.

1.9.1. PREASSIGNMENT MEDICAL EVALUATION. No contract employee shall perform health care services under this contract unless a Physician has performed a pre-assignment evaluation, provided by the Contractor, not more than 30 calendar days prior to submission of credentials. The purpose of this medical evaluation is to determine if the individual, from a medical standpoint, possesses the minimum physical abilities needed to perform the proposed job without significant risk to personal health or the health and safety of others. As a minimum, the individual shall be free of physical defects or medical conditions which might reasonably be expected to place other workers, patients, or the public at risk. Not later than five (5) days prior to the commencement or performance of health care services under this contract by any employee, the Contractor shall provide the

Public Health certification to the medical appointed COR that employees have completed the medical evaluation requirements identified below. This certification shall be provided annually, in October, thereafter. This certification shall state the date of which the examination was completed, the doctor’s name that performed the examination and a statement concerning the physical health of the individual. Initial documentation is required for: MMR (immunization or titer levels for Rubella and rubeola), history of chicken pox disease or positive titer (varicella vaccination must be accomplished if lack of immunity).

TB Mantoux skin test (IPPD) if positive, minimum requirement will be follow-up with contractor’s physician and a chest x-ray. Physician must provide documentation of “no active respiratory disease”, Hepatitis B vaccination/series are required for all personnel with occupational risk of exposure (declinations are not acceptable; this is a condition of employment), and if employee will be involved in exposure-prone procedures (ex: dentist, dental hygienist) they will have their surface antigen of the Hepatitis-B-Virus (HbsAg) status determined. This is to be done by providing documentation of the HbsAb, (if positive they will be referred to the MFT Credentials committee to determine scope of practice). If, in the opinion of the evaluating medical practitioner, the individual is found to be qualified for duty, the medical statement shall include the following wording: “(NAME OF

EMPLOYEE) possesses the minimum physical abilities to perform the proposed duties of a

(insert job title). He/she has documented proof of immunization against/immunity to rebeola, rubella, and hepatitis B and does not have an active infectious condition which might place others at risk.” If, in the opinion of the evaluating medical practitioner, the individual does not possess the minimum capabilities needed to perform the proposed job or does not meet the conditions of employment or will pose a risk to others, the medical statement shall contain the following wording: “For medical reasons, (NAME OF

EMPLOYEE is not qualified for employment as a (insert job title).” All documentation shall be provided to the COR.

1.9.2. PREVENTIVE, PROPHYLACTIC, AND FOLLOW-UP PROCEDURES. All

Contractor employees shall comply with preventive, prophylactic, and follow-up procedures, infection control and employee health program procedures, as established by the

MTF. The Contractor shall provide written verification of treatment to the COR. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government.

1.9.3. MEDICAL RECORDS. The Contractor shall provide to the COR for this contract, all medical information for hospital records, and therefore comply with TJC, OSHA, Centers for Disease Control (CDC), DOD, and USAF health records requirements. This information shall be provided to the COR to ensure the hospital's Employee Health database is current and up-to-date. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government.

1.9.4. IMMUNIZATION WAIVERS/EXEMPTIONS. Waivers and exemptions may be granted in accordance with the governing Air Force Instructions. All waivers and exemptions must be coordinated through Public Health and the COR.

1.9.5. PREGNANT EMPLOYEES. All Contractor pregnant employees shall report the pregnancy to the Contractor. The Contractor shall notify Public Health of the pregnancy within one (1) business day of notification. Public Health will provide information concerning any work hazards in that area. The Contractor shall notify their pregnant employee of any work hazards. It will be the joint decision of the Contractor and their employee whether the employee works in the environment.

1.9.6. COMMUNICABLE DISEASES. Contract employees with communicable diseases shall be reported to the MTF contract project supervisor and the COR. Notification to

Public Health shall be made by the Contractor. The Contractor shall comply with all MTF work restrictions and return-to-work requirements when performing tasks at the facility.

MTF policies and guidelines pertaining to these requirements will be provided to the

Contractor by the Government.

1.10. ENVIRONMENTAL REQUIREMENTS.

1.10.1. GENERAL.

1.10.1.1. Material Safety Data Sheets (MSDSs) are mandated as specified by 10

CFR, 29 CFR (both DOL and OSHA), 40 CFR, AFI 40-201, AFI 48-148, and AFI

91-302, and are provided in all work centers using these materials in the MTF.

Hazardous materials shall be identified to the Contractor by the Government. The

Contractor shall identify all hazardous materials discovered in the course of performance.

1.10.2. HAZARDOUS MATERIALS. Not applicable to this contract.

1.10.3. HAZARDOUS MATERIAL INVENTORY. Not applicable to this contract.

1.10.4. STORAGE OF HAZARDOUS MATERIALS. Not applicable to this contract.

2. SERVICES SUMMARY

Performance Objective PWS para.

Performance Threshold

SS-1 Assessment and treatment of psychiatric disorders

1.1.3.1 Zero (0) defects within the

month

SS-2 Collaborative treatment plans

1.1.3.2 Zero (0) defects within the

SS-3 Correct/appropriate procedures 1.1.3.3 Zero (0) defects within the month

SS-4 Appropriate documentation of patient care/contacts

1.1.3.4 Zero (0) defects within the

month

SS-5 Consultation services 1.1.3.5 Zero (0) defects within the quarter

SS-6. Evaluation of own practice 1.1.3.6 Zero (0) defects within the year

SS-7 Care coordination 1.1.3.7 Zero (0) defects within the quarter

SS-8 Use of computer software applications

1.1.3.8 Zero (0) defects within the

SS-9 Appropriate diagnoses, disabilities, and procedures

1.1.3.9 Zero (0) defects within the

SS-10 Implements treatment modalities 1.1.3.10 Zero (0) defects within the month

SS-11 Demonstrates social work knowledge

1.1.3.11 Zero (0) defects within the

month

SS-12 Attends all required meetings 1.1.3.12 Zero (0) defects within the month

SS-13 Available during required hours of operation

1.3 Zero (0) defects within the

month

SS-14 Documentation of CE 1.5 Zero (0) defects within the year

SS-15 Proper credentials 1.6 Zero (0) defects

3. GOVERNMENT FURNISHED EQUIPMENT, PROPERTY, AND SERVICES

The MTF will provide office space to include one standard telephone and service, facsimile, Internet connectivity (dependent upon existing Contractor security clearance), electronic mail, and utilities. These items shall only be used for performance of tasks related to this PWS. The

MTF will provide required Government forms required in the performance of this contract.

WPAFB OPSEC Requirements: OPSEC requirements are required in an effort to reduce program vulnerability from successful adversary collection and exploitation of critical information. The contractor shall apply OPSEC in the performance of their position description/PWS IAW AFI

10-701 Operations Security, and the 88 MDG OPSEC Plan.

4.0 GENERAL INFORMATION

4.1 Voluntary Protection Program. The Contractor shall participate in the Voluntary Protection

Program (VPP).

4.1.1 Definitions

4.1.1.2 Applicable Contractor. A contractor whose employees worked at least 1,000 hours at the site in any calendar quarter within the last 12 months and is NOT directly supervised by the applicant (installation).

4.1.1.3 Days Away, Restricted, and or Transfer Case Incident Rate (DART). The number of recordable injuries and illness cases per 100 full-time employees resulting in days away from work, restricted work activity, and/or job transfer that a site has experienced in a given time frame.

4.1.1.4 Total Case Incidence Rate (TCIR). Total number of recordable injuries and illness cases per 100 full-time employees that a site has experienced in a given time frame.

4.1.2 Requirements

4.1.2.1 Wright-Patterson AFB is in the process of pursuing VPP recognition or has already been recognized under the OSHA Voluntary Protection Program (VPP). VPP impacts all “applicable contractors” operating on Air Force Installations. The contractor shall be responsible for ensuring their employees and managers have a comprehensive understanding of VPP as well as full compliance with OSHA requirements. The contractor shall follow the safety and health rules of the installation or VPP site. Detailed information on VPP is available on the OSHA website at http://www/osha.gov/dcsp/vpp/index.html.

4.1.2.2 The contractor shall submit a Safety and Health Plan and corresponding site safety checklist to the CO not later than 10 calendar days after contract award. The contractor’s plan shall include appropriate measures to ensure the contractor reacts promptly to investigate, correct, and track alleged safety and health violations and/or uncontrolled hazards in contractor work areas. The plan shall:

4.1.2.3 Identify the roles and responsibilities of the following individuals with respect to safety and VPP: Management, Supervisors, Employees, and Safety Coordinator;

a. Identify applicable safety rules and regulations;

b. Include a worksite hazard analysis to include base-line hazard identification and required control measures;

c. Include a job site analysis to include hazards of tasks required to control measures;

d. Identify employee safety and health training requirements and the documentation process;

e. Include a workplace inspection frequency, to include identifying the individual conducting the inspections;

f. Include employee hazard reporting procedures;

g. Identify individual(s) responsible for corrective action of hazards;

h. Identify first aid/injury procedures;

i. Identify procedures for accident investigation and reporting;

j. Identify emergency response procedures; and

k. Identify the process for tracking controlled hazards in contractor work areas.

4.1.2.4 The contractor shall submit their Total Case Incidence Rate (TCIR) and Days

Away, Restricted, and or Transfer Case Incident Rate (DART) rates and OSHA Form

300A, Summary of Work-related Injuries and Illnesses, annually to the contracting office for consolidation and submission as part of the installation’s annual VPP Safety and

Health Management report. TCIR and DART rates are due by the 15th of January of each year.

4.1.2.5 The contractor’s Quality Control Plan shall identify the processes and procedures the contractor will use to track compliance with the Safety and Health Plan, and the process and procedures that will be used to correct violations.

4.1.2.6 The contractor shall establish these VPP requirements for all subcontractors who qualify as applicable contractors under the resulting contract

5.0 Contract Manpower Reporting.

5.1 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Air Force via a secure data collection site. The contractor is required to completely fill in all required data fields at the Air Force CMRA link on http://www.ecmra.mil.

5.2 Reporting inputs will be for the labor executed during the period of performance for each

Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported any time during the FY, all data shall be reported no later than 31 October of each calendar year. Contractors may direct questions to the CMRA help desk.

5.3 Uses and Safeguarding of Information: Information from the secure web site is considered to be proprietary in nature when the contract number and contractor identity are associated with the direct labor hours and direct labor dollars. At no time will any data be released to the public with the contractor name and contract number associated with the data.

5.4 User Manuals: Data for Air Force service requirements must be input at the Air Force CMRA link. However, user manuals for government personnel and contractors are available at the Army

CMRA link at http://www.ecmra.mil.

5.5 Contractor shall not include proprietary markings on any of the deliverables that would preclude unlimited use and/or distribution by the Government. Contract deliverables shall not be separately priced.

6.0 Combating Trafficking in Persons

6.1 Trafficking in Persons (TIP) is a worldwide problem posing a transnational threat involving violations of basic human rights. The DoD has a zero tolerance policy for TIP. As part of the

2013 National Defense Authorization Act, the Pentagon is required to take action against any contractor engaging in any activities related to labor trafficking, sex trafficking and child soldiering. The contractor should familiarize its employees with TIP by going to the DoD CTIP site at: http://ctip.defense.gov/Home.aspx. The contractor should immediately report all suspicious activity of its employees to the COR or CO.