Performance_Work_Statement.pdf

PERFORMANCE WORK STATEMENT

FOR

PHYSIATRIST, PAIN MANAGEMENT

WRIGHT PATTERSON MEDICAL TREATMENT FACILITY

Personal Service

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.

TABLE OF CONTENTS

1. General

1.1 Description of Work

1.2 Qualifications

1.3 Administrative

1.4 Orientation, Training, Performance

1.5 Availability of Personnel

1.6 Absences

1.7 Conduct

1.8 Conflict of Interest

1.9 License and Credentialing Review

1.10 Responsibilities and Procedures

1.11 Continuing Medical Education

1.12 Security Requirements

2. Health

2.1 Preventative, Prophylactic, and Follow-up Procedures

2.2 Medical Records

2.3 Immunizations Waivers/Exemptions

2.4 Pregnant Employees

2.5 Communicable Diseases

3. Government Furnished Property

3.1 Government Provided

3.2 Emergency Contract HCP Healthcare

3.3 Space Used

3.4 Uniforms

4. Specific Tasks

5. Services Summary

6. General Information

6.1 Voluntary Protection Program

6.1.1 Definitions

6.1.1.2 Applicable Contractor

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

6.1.1.4 Total Case Incidence Rate (TCIR)

6.1.2 Requirements

6.1.2.1 Voluntary Protection Program (VPP)

6.1.2.2 Safety and Health Plan

6.1.2.3 Safety and VPP Roles and Responsibilities

6.1.2.4 Total Case Incidence Rate (TCIR)

6.1.2.5 Quality Control Plan

6.1.2.6 Establish VPP

7. Contract Manpower Reporting

7.1 Labor Hour Reporting

7.2 Labor Execution

7.3 Safeguarding of Information

7.4 User Manuals

7.5 Proprietary Markings

8. Combating Trafficking in Persons

8.1 Trafficking in Persons (TIP)

9. Maximum Compensation

PERFORMANCE WORK STATEMENT

PHYSIATRIST, PAIN MANAGEMENT

1. GENERAL

1. 1 DESCRIPTION OF WORK The contactor shall provide the service of one (1) Full Time

Equivalent (FTE) Board Certified PHYSIATRIST, Pain Management for the Pain Management

Clinic, 88th Medical Group, Wright Patterson AFB, Ohio. Skilled in the management of chronic pain with experience using a multidisciplinary approach and with 24 months of experience after receipt of Board Certification within 5 years.

1.2 QUALIFICATIONS. Healthcare Provider (HCP) performing on this contract shall have at a minimum:

1.2.1 Doctorate degree from an accredited college approved by the Council in Medical Education and Hospitals of the American Medical Association or Doctor of Osteopathy from a college accredited by the American Osteopathic Association.

1.2.2 Have and maintain a valid unrestricted current medical license in one of the 50 states, the

District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands and be able to obtain clinical privileges to practice medicine with the applicable Medical Treatment

Facility (MTF) Credentials Committee.

1.2.3 The physician must be board-certified in Physiatry and a Pain Medicine fellowship is highly desirable. Must have sufficient experience in chronic pain management to allow independent performance of pain management procedures. The HCP must obtain their Pain

Management Certification within a period of 12 months or a replacement candidate shall be provided with no lapse in coverage.

1.2.4 The Contractor HCP shall also have and maintain a current Drug Enforcement

Administration (DEA) registration number (certificate). License must correspond to DEA registration number.

1.2.5 Graduates of foreign medical schools are required to possess both a medical license and other certification by the Educational Commission for Foreign Medical Graduates (ECFMG) or

5th Pathway.

1.2.6 Current Basic Cardiac Life Support (BCLS), and advance cardiac life support (ACLS) certifications. The Contractor is responsible for maintaining these certifications in a current status at all times while performing services under this contract.

1.2.7 All contract HCPs shall be able to read, write, and speak English well enough to effectively communicate with patients and other HCPs.

1.2.8 Contract HCP shall be required to meet Continuing Medical Education (CME) requirements as commensurate with their license. The Government will not reimburse for these costs.

1.2.9 The contract HCP shall have received Occupational Safety and Health Administration

(OSHA) required training for the position in which they will perform, and that training currency is maintained. Documentation of such training shall be provided to the Contracting Officer’s

Representative (COR).

1.2.10 The HCP shall have no records or convictions involving any form of chemical dependency, previous convictions of felonious nature, or any adverse actions pending by any Board of Medicine.

1.2.11 Any required MTF identification will be provided by the MTF.

Contractor Identification. All contractor/subcontractor personnel shall be required to wear AF-approved or provided picture identification badges so as to distinguish themselves from

Government employees. When conversing with Government personnel during business meetings, over the telephone or via electronic mail, contractor/subcontractor personnel shall identify themselves as such to avoid situations arising where sensitive topics might be better discussed solely between Government employees.

Contractors/subcontractors shall identify themselves on any attendance sheet or any coordination documents they may review. Electronic mail signature blocks shall identify their company affiliation. Where practicable, contractor/subcontractors occupying collocated space with their

Government program customer should identify their work space area with their name and company affiliation.

1.3 ADMINISTRATIVE

1.3.1 Neither uniformed personnel, nor Government civilian, shall be employed under this contract.

1.3.2 Composite Health Care System (CHCS) and Armed Forces Health Longitudinal

Technology Application (AHLTA). The government will provide training to contract HCP in CHCS/AHLTA for procedures/documentation that the medical activity’s staff is required to use. Access to such patient data systems is an “Automated Data Processing Sensitive” position requiring compliance with AR 380-19 and AR 380-67. Refer to Addendum “ADP

Security Requirements” of FAR clause 52.212-4, for further guidance.

1.3.2.2 The Government will furnish up to 8 hours of paid training in the use of the

CHCS/AHLTA system. The Contractor will schedule training during in-processing. Required training will be paid by the Government. The training will be performed by the Government.

1.3.3 The Contactor shall ensure that all contract HCP comply with the local installation requirements for vehicle registration and operation on the military facility. Any vehicles operated by the Contractor or its employees in performance of this contract must have the minimum liability coverage required by the state on which the installation is located.

1.3.4 Performance Evaluation Meetings. The Contractor or representative shall meet with the

COR, and other Government personnel at least quarterly and as requested.

1.3.5 Quality Control Program. Contractor shall develop and maintain a quality control program to ensure 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 is to be delivered not later than 15 days after contract award to COR for acceptance.

1.3.6 Point of Contact: The Contractor shall provide a point of contact who shall be responsible 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 COR 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 15 calendar days prior of the primary point of contact’s last day.

1.3.8 Replacement of HCP. The Contractor shall replace the permanent HCP so that the vacancy will not exceed 10 consecutive business days. In the case of serious illness, injury or death of a credentialed HCP, the Contractor shall replace the permanent HCP such that the vacancy will not exceed 30 calendar days. For all other cases when replacing the HCP, the consecutive calendar days begin when the HCP terminates employment. The replacement HCP must begin work within 10 business days after the previous credentialed HCP departed the position.

1.3.9 Substitute or Temporary Coverage. The Contractor shall substitute the HCP whenever a temporary absence is expected to exceed 10 consecutive calendar days.

1.3.10 Unplanned Closures. In the event of an unplanned closure of the facility due to natural disasters, military emergency or severe weather, the contracted HCP will be allowed to bill the

Government if the following two conditions exist:

- Local base policy and base access procedures prevented the HCW from performing duties at the place of performance. The HCP will be considered mission essential in accordance with

DODI 3020.37.

- Contracted HCP was scheduled to work (e.g., HCP was not on scheduled absence)

1.4 ORIENTATION, TRAINING, PERFORMANCE

1.4.1 Prior to working, contract HCP will be provided a Government paid orientation to familiarize with the policies and procedures of the MTF. Orientation attendance will be required of all contract HCPs and will be scheduled by the Contracting Officer’s Representative (COR) or

Department Chief during normal duty hours.

1.4.2 The contract HCP shall be knowledgeable of the policies and procedures of their specific place of duty and of the medical activity. The contract HCP shall receive any staff training required by the MTF as a precondition/condition to performance. Such training may include instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training shall be conducted during the scheduled shift of the contract HCP.

1.4.3 Annual Training. All contractor employees shall attend annual training classes at the MTF.

Annual training shall include but not be limited to safety, Quality Assurance, 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 5 business days of training completion. The

Government may elect to provide unique Government training to contract HCP who are performing services under this contract. If the Government elects to provide such training, the

Government will provide such training at no additional expense to the contract or to the contract

HCP.

1.4.4 Specialty Training. The Government may elect to provide specialty training to contract

HCPs at Government expense.

1.4.5 Performance: The Contractor shall begin full performance of the contract requirements on the first day of the period of performance specified in the contract award. It is critical that privileges be granted the contract HCP prior to the period of performance to meet the contract requirements by the commencement date. Therefore, no later than 10 calendar days after receiving the award, the Contractor shall submit completed credentials application to the COR for submission to the Credentials Committee.

1.5 AVAILABILITY OF PERSONNEL/PERFORMANCE EVALUATION MEETINGS

1.5.1 Contractor will work the following schedule: 0730-1630 hours Monday thru Friday, 40 regular hours per week; 1,920 hours per year, with a maximum of 200 overtime hours as needed for a total of 2120 hrs. The Contractor needs to reside with 50 miles of Wright Patterson Air

Force Base. Alternate schedule shall be approved by the Department Chief of the Pain

Management Clinic.

1.5.1.2 No labor hours are required on federal holidays or planned MTF closure days as the pain management clinic will be closed.

1.5.1.3 The Contractor is authorized 1 hour unbillable for lunch, depending on patient census.

1.5.1.4 The Government reserves the right to verify the hours worked by HCP to include implementing sign in/sign out procedures or using a time clock as appropriate.

1.5.1.5 The Contractor or his representative shall meet with the COR and other Government personnel at least quarterly, and as requested.

1.6 ABSENCES

1.6.1 Absences. The HCP may request and based upon the recommendation of the COR and the

Department Chief, a reduction in contract performance requirements up to a maximum of 20 working days (scheduled or unscheduled) due to illness, continuing medical education, and other justified reasons per 12 month contract period. Absences are unpaid. The Department Chief of

Pain Clinic will determine when absences are justified. The number of consecutive days authorized for scheduled or unscheduled absences will be at the discretion of the Department

Chief or their designated representative based on the workload with coordination through the

COR.

1.6.1.2 Unscheduled Absences. The Health Care Provider shall notify the appropriate supervisor or his/her designee within one (1) hour of scheduled reporting duty time if he/she is sick and cannot report to work as scheduled due to an emergency absence. Unscheduled allowances are not a contractual allowance but such requests may be approved as indicated by being mutually beneficial to the Contractor and the Government. The number of consecutive days authorized for scheduled or unscheduled absences will be at the discretion of the Department Chief based on the workload with coordination through the COR.

1.6.1.3 A reduction in the hourly requirements under this provision is non-performance and is therefore not compensable under the contract. Absences in excess of the approved 20 working days may be subject to termination of the contract for default.

1.6.1.4 Closures. During anticipated or unanticipated clinic closures, the Contractor will only be paid for hours actually worked.

1.7 CONDUCT

1.7.1 The contract HCP shall record the time worked according to MTF procedures.

1.7.2 The Chief of the Department where services are being performed, or his/her representative, will define the scope of practice. Contract HCPs shall not introduce new procedures or services without prior approval of the department chief or representative. In disagreements or deviation from established or new protocols, the department chief, or representative, will be the deciding authority.

1.7.3 Contract HCPs shall comply with MTF policies regarding personal appearance and conduct.

1.7.4 Contract HCPs shall abide by federal and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and healthcare staff as may be necessary for security and personnel reliability programs. They shall also abide by federal and local MTF regulations concerning the confidentiality of patient’s records, as embodied in federal statues including the Privacy Act of 1974 and the Health Insurance

Portability & Accountability Act of 1996. All regulations referenced are available for review from the COR, MTF, of the Contracting Officer. All medical records and reports will remain the property of the Government.

1.7.5 Contract HCPs shall abide by Medical Treatment Facility bylaws, The Joint Commission, Department of Defense and Medical Department regulations with regard to Utilization Review and Quality Assurance directives, including, but not limited to, in-service training, maintenance of records, performance evaluation, and release of medical information.

1.7.6 Inquiries. The Contractor or HCP shall not respond to any media inquires. Any inquires from the media, third parties, or public agencies shall be immediately relayed to the COR, who will relay them to the Hospital Public Affairs Officer or, after duty hours, the Administrative

Officer of the Day (AOD). There shall be no interviews, comments, or any other response without the knowledge and approval of the MTF Commander. Other than routine inquires from external agencies, all other inquires and complaints shall be brought to the attention of the contract HCPs Government supervisor.

1.7.7 Smoking Policies within the MTF. The Contractor shall ensure that all employees comply with the U.S. Army Medical Command and MTF smoking policies while performing services under this contract.

1.7.8 Resolve Performance Issues: The Contractor shall maintain a performance management plan that demonstrates the ability to adequately resolve MTF and patient complaints regarding

HCP which satisfy Government concerns

1.8 CONFLICT OF INTEREST

1.8.1 The contract HCP shall not bill the patient for services rendered under this contract. The

Contractor/contract employee shall be prohibited from receiving compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract, at the rate specified.

1.8.2 The Contractor or contract employee shall not, while performing services under this contract, advise, recommend, or suggest to persons eligible to receive medical care at

Government expense that such persons should receive care from the Contractor or contract employee at any place other than as designated under this contract.

1.8.3 Confidentiality of Information. Unless otherwise specified, all financial statistical, personnel, and/or technical data which is furnished, produced, or otherwise available to the

Contractor/HCP during the performance of this contract are considered confidential business information and shall not be for purposes other than performance of work under this contract.

The Contractor/HCP shall not release any of the above information without prior written consent of the Contracting Officer. The Contractor/contract employee shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication.

1.8.4 Contract employees are not prohibited by reason of their employment under this contract from conducting private practice provided there is no conflict with the performance of services under this contract. The contracting officer will unilaterally resolve any issues concerning potential conflicts.

1.8.5 The Contractor of contract employee shall not use Government facilities or other

Government property in connection with conducting a private practice.

1.8.6 Confidentiality of Medical Records: The contract employee shall ensure that the confidentiality of medical records is maintained at all times and that information is disclosed only as permitted by the Privacy Act and Air Force Regulations. Diagnostic images and records required or generated in the performance of this contract will be maintained under the control of the MTF.

1.8.7 All films, evaluations, and other records of patients will remain property of and subject to the exclusive control of the U.S. Government. All reports and documents prepared by the

Contractor in fulfillment of this contract will become the property of the U.S. Government.

1.9 LICENSE AND CREDENTIALS REVIEW OR PRIVLEGING

1.9.1 Credentialed HCP shall be subject to the credentialing and privileging requirements of AFI

44-119, Clinical Performance Improvement, to include adverse actions. The credentials of all health care providers shall be reviewed and privileges granted as outlined in AFI 44-119, Clinical Performance Improvement.

1.9.2 The Chief of the Medical Staff, or his/her representative, shall define the clinical privileges for all credentialed HCP during the credentialing process. All credentialed HCP 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.

1.9.3 Employee Credentials. Contractor employee credentials shall be submitted to COR no later than 10 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.

1.9.4 The Contractor shall obtain all paperwork, reference letters, work history and application forms IAW AFI 44-119 as required by the MTF credentialing process. The MTF staff will not assist the Contractor in obtaining any information necessary to credential the HCP. The

Contractor shall make all proposed credentialed HCP available for interview (via telephone) by the MTF during the credentialing process. The Government has the right to deny candidates submitted to fill the contract position if the Government does not believe the candidate can meet the performance requirements of this contract.

1.9.6 In the event of an adverse action as identified by AFI 44-119, the Government

Representative shall notify the Contracting Officer’s Representative (COR) as soon as possible when the necessity to exercise such authority becomes apparent. The Government representative’s written statement advising the Contractor of an adverse action involving a HCP, 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

1.9.7 Prescriptions. Credentialed HCP 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 HCP on substitutions of generic drugs. Credentialed HCP shall follow the MTF procedures when prescribing drugs.

1.9.8 Referrals and Consults. Credentialed HCP shall follow DOD, Air Force and MTF regulations and policies when arranging for a referral or consult.

1.9.9 The MTF Commander must grant privileges to contract employees for which credentialing is required prior to employees providing any services. The privileging process shall be in accordance with all requirements mandated by the Air Force. The privileges granted by the MTF will be sufficient to allow for performance of all specific tasks identified in this contract. Any failure to meet these requirements is considered nonperformance and the basis for termination for cause.

1.9.10 The Contractor shall not employ any individual to provide direct healthcare services whom, within 5 years prior to employment:

1.9.10.1 Has had his/her clinical privileged limited, suspended, or revoked by any healthcare facility, public or private, anywhere in the world.

1.9.10.2 This prohibition does not apply to any individual whose clinical privileges, although originally limited, suspended or revoked by a healthcare facility were subsequently fully reinstated by the healthcare facility.

1.9.10.3 Limitation of clinical privileges, as used in this paragraph, refers to a partial withdrawal/reduction of clinical privileges as a result of a determination that or pending investigation to determine whether an individual has engaged in unprofessional conduct or substandard medical practice or is incompetent to perform certain medical practices.

1.9.10.4 Is the subject of current or pending hearing or appeal brought by a healthcare facility, public or private, anywhere in the world, may result in the limitation, suspension, or revocation of the individual’s clinical privileges.

1.9.10.5 Requirements for privileging are the same for replacement contract employees as for contract employees they are replacing.

1.9.10.6 The MTF Commander is the sole authority that can revoke or otherwise restrict the privileges of any contract employee who he/she determines is not qualified to perform the contract services.

1.10.1 Responsibility and Procedures.

1.10.2.1 If any suit or action is filed or any claim is made against the contract HCP which occurred as a result of work performed by the HCP under this contract, the HCP shall immediately notify the Contractor and the Contracting Officer (CO) and the department chief and promptly furnish them copies of all pertinent papers received.

1.10.2.2 The HCP shall cooperate with the Government, without further compensation, in the processing, review, settlement, or defense of the suit, action, or claim; and, authorize

Government representatives to settle or defend the claim and to represent the HCP in, or take charge of, any litigation involved in such an action. The contract HCP may, at the contract

HCP's own expense, participate in defense of such claim or litigation.

1.11 CONTINUING MEDICAL EDUCATION (CME) REQUIREMENTS. Health care providers registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME shall be obtained at no additional cost to the Government and shall be reported to the COR annually on the first normal duty day in

January for the previous calendar year. Periodic CME may be conducted at the MTF and will be available, at no cost, to any health care provider desiring to attend.

1.12 SECURITY REQUIREMENTS 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.

1.12.1 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.

1.12.2 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.

1.12.3 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.

1.12.4 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.

1.12.5 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.

2. HEALTH: All contract HCP performing services under this contract shall comply with all health and immunization requirements at the time of initial request for clinical privileges and annually thereafter. Backup/replacement contract HCPs shall be required to provide equally current certification of health at the time of initial request for clinical privileges, and annually thereafter. The expense for all physical examinations to comply with the health requirements shall be borne by the Contractor at no additional cost to the Government.

The requirements for new employees are as follows:

- 2 Negative TB Test’s (CDC Guidance) - The 2 negative TB Test are required if a member hasn’t had a test within 12 months of starting a new position. If they have had one within 12 months they only need one Neg PPD.

- Positive Titer for Measles, Mumps, Rubella (MMR) or Two MMR Shots

- Positive Titer for Varicella or Two Varicella Shots

- Current T-DAP Shot (good for 10 years)

- Current Flu Shot

This is all covered under MDGI 48-107 Para 1.3.

2.1 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.

2.2 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.

2.3 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.

2.4 PREGNANT EMPLOYEES. All Contractor pregnant employees should report the pregnancy to the Contractor. The Contractor shall notify Public Health of the pregnancy within

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. This is in accordance with AFI 48-148 “Ionizing Radiation Safety” and AFH

48-125 “The Air Force Dosimetry Program”.

2.5 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.

3. GOVERNMENT FURNISHED EQUIPMENT, PROPERTY, AND SERVICES.

3.1.1 The Government will provide use of all available MTF facilities and support services, materials, publications and forms, and equipment required for contract performance (except as designated in the contract). Personal long distance calls are not authorized. The Government will provide an MTF identification badge and a Common Access Card (CAC). While performing work under this contract, he/she shall wear a Government-furnished, visible identification badge on the front of the outer clothing. Contractor personnel must comply with MTF policy regarding the badges and identification cards. No Government Furnished Property will be provided under this contract.

3.2 Emergency Contract HCP Healthcare. The MTF will provide emergency healthcare for injuries occurring while on duty. The Contractor shall reimburse the Government for such services.

3.3 Any space used by contract HCPs in performance of this task order may be used for other purposes during their absence. Items of clothing, personal effects, or equipment may not be able to be secured at all locations. The Government will not incur any liability for theft, damage to, or loss of such personal items.

3.4 Uniforms. The Government will furnish the HCP with appropriate scrubs and white coat for use in the MTF only. Contract HCPs shall wear appropriate civilian attire to and from the MTF.

The contract HCP shall present a neat and professional appearance at all times while on duty.

The appearance of contract personnel will be governed by the current MTF dress and appearance policy. Contract employees shall wear special protective clothing and shoe covers, when required, which shall be supplied by MTF. In all cases, the Contractor shall conform to the established personal appearance policy of the MTF.

4. SPECIFIC TASKS. The Physiatrist-Pain Management HCP shall:

4.1 Specialize in clinical and diagnostic use of physical agents and exercises to provide physiotherapy for physical, mental, and occupational rehabilitation of patients.

4.1.2 Examine patients, utilizing electro diagnosis and other diagnostic procedures to determine need for and extent of therapy. Assess the patient’s pain by examining the location, intensity, and duration of the pain.

4.1.3 Prescribe medications and administers treatment, using therapeutic methods and procedures, such as light therapy, diathermy, hydrotherapy, iontophoresis, and cryotherapy.

4.1.4 Instruct other medical personnel in nature and duration or dosage of treatment, and determines that treatments are administered as specified.

4.1.5 Prescribe exercises designed to develop functions of specific anatomical parts or specific muscle groups.

4.1.6 Recommend occupational therapy activities for patients with extended convalescent periods and for those whose disability requires change of occupation.

4.1.7 Document exam results, treatment plans and expected outcomes. Develops short and long term plans for patient to reach their goals.

4.1.8 Monitor the pain management effects including medications given and spinal injections.

4.1.9 Work in a team environment or consult with other medical professionals and departments as a part of patients overall care.

4.1.10 Perform the full range of pain management procedures. These are to include cervical, thoracic and lumbar spinal injections. The Physiatrist Pain Physician should also be experienced with disc access procedures, vertebral augmentation, novel minimally invasive surgical procedures, the trial, implantation and maintenance of implantable pain therapies, to include spinal cord stimulators and intrathecal drug delivery devices.

4.1.11 Perform the full range of inpatient and outpatient, acute and chronic evaluation, management, and consultation for pain management patients and shall be skilled in the medication management of chronic pain.

4.1.12 Administer appropriate diagnostic and therapeutic nerve blocks in the treatment of acute and chronic pain.

4.1.13 Be responsible for the management and maintenance of catheters and infusions for analgesia for acute and chronic pain syndromes.

4.1.14 Coordinate placement of a catheter or infusion device, administer the test-dose of medication to determine correct catheter or infusion device placement and to establish a safe analgesic level for acute or chronic pain relief.

4.1.15 Specialize in clinical and diagnostic use of physical agents and exercises to provide physiotherapy for physical, mental, and occupational rehabilitation of patients.

4.1.16 Examine patients, utilizing electro diagnosis and other diagnostic procedures to determine need for and extent of therapy. Assess the patient’s pain by examining the location, intensity, and duration of the pain.

4.1.17 Prescribe and administer treatment, using therapeutic methods and procedures, such as light therapy, diathermy, hydrotherapy, iontophoresis, and cryotherapy.

4.1.18 Instruct other medical personnel in nature and duration or dosage of treatment, and determines that treatments are administered as specified.

4.1.19 Work with Physical Therapist to develop functions of specific anatomical parts or specific muscle groups and rehab programs.

4.1.20 Recommend occupational therapy activities for patients with extended convalescent periods and for those whose disability requires change of occupation.

4.1.21 Document exam results, treatment plans and expected outcomes. Develops short and long term plans for patient to reach their goals.

4.1.22 Monitor the pain management effects including medications given and spinal injections.

4.1.23 Work in a team environment or consult with other medical professionals and departments as a part of patients overall care.

5. Services Summary

Performance Objective PWS para. Performance Threshold

Health /Immunization requirements met initial and annually 2/2.3 Zero (0) defects

Replacement of Healthcare Provider

1.3.8 Zero (0) defects

Substitute or Temporary Coverage 1.3.9 Zero (0) defects

Employee available during required hours and work schedule submitted on time

1.5.1 Zero (0) defects

Employee has proper credentials 1.9 Zero (0) defects

CME Requirements 1.11 Zero (0) defects

Patient treatment plans submitted for patient goal obtainment and in a timely manner

4.1.7 Zero (0) defects within the

month

Provide a high level of quality service 4. Zero (0) defects

Execute/Perform specific tasks

4. Zero (0) defects

Works in a team environment 4.1.9 Zero (0) defects

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.

6.0 GENERAL INFORMATION

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

Protection Program (VPP).

6.1.1 Definitions

6.1.1.2 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).

6.1.1.3 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.

6.1.1.4 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.

6.1.2 Requirements

6.1.2.1 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.

6.1.2.2 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:

6.1.2.3 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.

6.1.2.4 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.

6.1.2.5 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.

6.1.2.6 The Contractor shall establish these VPP requirements for all subcontractors who qualify as applicable Contractors under the resulting contract

7.0 Contract Manpower Reporting.

7.1 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.

7.2 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.

7.3 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.

7.4 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.

7.5 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.

8.0 Combating Trafficking in Persons

http://www.ecmra.mil/

8.1 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.

9.0 MAXIMUM COMPENSATION

The total amount of compensation paid to an individual direct health care provider in any year cannot exceed the full time equivalent annual rate as specified in 10 U.S.C. 1091 and pursuant to

DODI 6025.5. Effective 21 January 2000, the maximum amount the Government is allowed to pay for these personal services is $400,000 per year. The fully-burdened hourly rate submitted for task order award may exceed the full time equivalent annual rate as long as the amount paid directly to the individual direct health care provider does not exceed the full time equivalent annual rate as specified in 10 U.S.C. 1091.

END OF WORK STATEMENT