H92222-18-R-0010_Amendment_1.pdf

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AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

See Schedule.

1. CONTRACT ID CODE PAGE OF PAGES

1 39

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 20-Apr-2018

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X H92222-18-R-0010

X 9B. DATED (SEE ITEM 11)

26-Mar-2018

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer X is extended, is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE

RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

20-Apr-2018

CODE

HQ USSOCOM

SOF AT&L-KI

7701 TAMPA POINT BLVD

TAMPA FL 33621-5323

H92401 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE H92400

FACILITY CODECODE

EMAIL:TEL:

H92222-18-R-0010

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 30 - BLOCK 14 CONTINUATION PAGE

The following have been added by full text:

DESCRIPTION OF AMENDMENT

The purposes of Amendment 0001 are to;

a) Extend proposal submission due date in SF33 Block 9 to 1 May 2018 at 12:00 pm EDT

b) Update/correct clauses in Sections I, K, and L

c) Make minor administrative corrections to citing of incorrect PWS paragraphs, regulations, and/or number of OCONUS locations in Sections H.4, H.9, and M.3.1

d) Incorporate RFP Att 2 – PWS REV 1 and update references from TESA to Troop Care

Status Accreditation (TCSA) in paragraph 6.1.2 and minor change to SDS Section 3.0

e) Update RFP Sections H.8 and L.1.3 with TCSA references.

f) Add further clarification regarding relocation reimbursement for OCONUS personnel in

Section H.6

g) Clarify the timeline requirements in Section H.11 and incorporates PWS Appendix 3-

REV 1 (1 additional line added) regarding the submission of credentialing packages.

h) Incorporate RFP Att 1 - DD 254 REV 01 and update Section L.4.1 (removed the requirement for secret safeguarding)

i) Make administrative changes to Sections L.0.2 and L.4.2 as well as an updated Section L

Table 1 (to add Table title)

j) Update Section L.3.0 and incorporate Attachment 3, Price Matrix - REV 1 (Instructions

Tab only), to address the use of “composite or blended rates” IAW DFARS provision

252.216-7002

k) Add additional clarification in Section L.2.1.1 regarding references and points of contacts

l) Add additional clarification in Section L.2.1.2 regarding the submission of SB reports

(294/295)

As a result of Amendment 0001, the following RFP Documents have been updated:

1. H92222-18-R-0010 Amendment 1 (Sections H, I, K, L, and M)

2. RFP Attachment 1 DD254 (Now REV 1 Dated: 16 April 2018)

3. Attachment 2 PWS (Now REV 1 Dated 19 April 2018)

4. PWS Appendix 3 (Now REV 1 Dated 19 April 2018)

5. Attachment 3 Price Matrix (Now REV 1 Dated 19 April 2018)

SECTION A - SOLICITATION/CONTRACT FORM

The required response date/time has changed from 30-Apr-2018 03:00 PM to 01-May-2018 12:00 PM.

SECTION H - SPECIAL CONTRACT REQUIREMENTS

The following have been modified:

SPECIAL CONTRACT REQUIREMENTS

H.1 Personal Services

H.2 Limitation on Amount of Compensation for Personal Services

H.3 Non-Compete Provisions

H.4 Work Period and Authorized Holidays

H.5 Billable Hours

H.6 Billable Materials (Travel and ODCs)

H.7 Limitations on Indirect Cost Rates for the Billable Materials (H.6)

H.8 OCONUS Support

H.8.1 Synchronized Pre-deployment and Operational Tracker (SPOT)

H.8.2 Theater Business Clearance

H.9 Contractor Identification and Security Requirements

H.10 Conduct of Personnel

H.11 License Verification, Credential Review or Privileging (If Applicable) and Selection Process

H.12 Memorandums of Agreement (MOA) and Specific Medical Quality Assurance Regulations

H.13 Substitution of Personnel

H.14 HCP Background Investigation Requirements (Applicable to Support to Families only)

H.14.1 Crime Control Act of 1990 Requirement

H.14.2 Contractor Requirements

H.14.3 Government Responsibilities

H.15 Health Insurance Portability and Accountability Act (June 12)

H.15.1 General Use and Disclosure Provisions

H.15.2 Specific Use and Disclosure Provisions

H.15.3 Obligations of the Government

H.15.4 Permissible Requests by the Government

H.15.5 Terminations

H.15.6 Miscellaneous

H.16 Small Business Participation

H.17 Reserved

H.18 5652.216-9004 Procedures for Issuing Delivery Orders under Single Award, Indefinite Delivery-

Indefinite Quantity Contracts (2003)

H.18.1 General

H.18.2 Option exercises at TO level

H.18.3 Task Order Completion

H.19 5652.237-9001 – Key Personnel Requirements

H.20 TO Ombudsman

H.21 Use of Contractor Support/Advisory Personnel (2015)

H.22 Official Use of Government Motor Vehicles

H.1 Personal Services. The services required under this contract are considered personal in nature. The services shall be acquired under the authority of 10 United States Code 1089 and 10 United States Code 1091. All clauses contained within Section H of this RFP are required to get incorporated into any resultant subcontract.

H.2 Limitation on Amount of Compensation for Personal Services. Under the provisions of 10 U.S.C. 1091 and

DoDI 6025.5, “Personal Services Contracting”, implemented 6 January 1995, the total amount of compensation paid to an individual direct healthcare provider in any year cannot exceed the annual rate of $400,000 as specified in 3

U.S.C. 102.

H.3 Non-Compete Provisions.

The use of non-compete conditions in employment agreements or in subcontracts (to prevent loss of personnel by the contractor) effective only during the period of the contract performance is acceptable. However, the use of non-compete conditions in employment agreements and/or in subcontracts that prevent employees and/or subcontractor employees of the incumbent team from being interviewed by, employed, or accepting offers of employment and/or subcontracts by potential competitors on the follow-on contracts is unacceptable. It hinders the government's ability to accomplish the mission of providing medical care to beneficiaries. Awardee, and their subcontractors, may not include such conditions in employment agreements and/or subcontracts.

H.4 Work Period and Authorized Holidays. An on-site work period of 40 hours Monday through Friday has been established for this contract for the majority of all required support and IAW PWS 2.4.7. The contractor shall notify the COR when a scheduled employee cannot fill a shift due to illness or emergency. Notification shall be as early as possible, but no later than 2 hours after start of scheduled shift.

Due to security restrictions, Contractors will not be permitted to work after normal duty hours, Saturday, Sunday or legal holidays for on-site support unless authorized by the Contracting Officer or the Cognizant COR and

Government personnel will be present.

January 1st

3rd Monday of January

3rd Monday of February

Last Monday of May

July 4th

1st Monday of September

2nd Monday of October

November 11th

4th Thursday in November

December 25th

When one of the above designated legal holidays falls on a Sunday, the following Monday will be observed as a legal holiday. When a legal holiday falls on a Saturday, the preceding Friday is observed as a holiday by U.S.

Government Agencies.

H.5 Billable Hours. IAW FAR 52.232-7 Payments Under Time-and-Materials and Labor-Hour Contracts, time shall be calculated by multiplying the appropriate fully burdened hourly rates prescribed in the Schedule by the number of direct labor hours worked after the employee has been selected for employment (including 21 days of orientation). The Government does not consider the time spent on in-person interviews (unless for a current employee under the contract), training required to meet minimum qualification/licensure requirements outlined in

PWS Appendix 1, mandatory annual training requirements required as part of licensure or credentialing renewal, or continuing education (CE) requirements as required by assigned Military Treatment Facility (MTF) or other source of clinical oversight as direct hours billable under this contract (Reference PWS Section 2.2).

H.6 Billable Materials (Travel and ODCs). IAW FAR 16.601(a), Other Direct Costs shall be billable at cost as

“Materials”.

The Material CLIN, will only be utilized for payment of the following billable expenses; travel and related expenses to cover Government directed unique training, Government directed certifications above and beyond those required to meet the minimum qualification requirements outlined in PWS Appendix 1, travel to and from in-person interviews (for those positions identified in PWS Appendix 2 as requiring mandatory in-person interviews only), travel to support multiple locations in the same geographical area, and relocation expenses (for OCONUS positions only). Relocation expenses will be limited to those expenses allowable for all Government civilian employees IAW the Joint Travel Regulation (JTR) and Department of State Standardized Regulations (DSSR).These include the initial relocation to the OCONUS location and the return to CONUS upon completion of performance at that location for a period of 3 years or longer* and for whom have not had their employment terminated on the basis of security clearance revoked, credentials/licensures revoked, violations of Conduct of Personnel (H.10), violations of

HIPPA (H.15) or any other termination outlined in H15.5. All anticipated expenses under this CLIN shall be submitted to the COR or other designated Government representative for approval prior to any expenditures taking place.

*NOTE: For those incumbent employees under contract H92222-13-D-0004 that have completed 3 years or longer, this time will count as performance under this contract, however, in addition to the 3 years they must have also completed at least 1 year from the date of the initial TO POP start (planned as 1 Mar 2019).

The Government does not consider the travel or expenses associated with non-mandated personnel interviews, training required to meet minimum qualification/licensure requirements outlined in PWS Appendix 1, required visas, immunizations, mandatory annual training requirements required as part of licensure or credentialing renewal, or continuing education (CE) requirements as required by assigned MTF or other source of clinical oversight as direct costs billable under this CLIN (Reference PWS Section 2.2).

H.7 LIMITATIONS ON INDIRECT COST RATES FOR THE BILLABLE MATERIALS (H.6)

a) Pursuant to FAR 42.707, an indirect cost rate ceiling is incorporated into the contract. "Indirect cost" is defined as set forth at FAR 31.001 and 31.203. "Indirect cost rate" is defined as set forth at FAR 42.701.

b) Notwithstanding the clauses of this contract entitled "ALLOWABLE COST AND PAYMENT" (FAR 52.216-7) and

“PAYMENTS UNDER TIME-AND-MATERIALS AND LABOR-HOUR CONTRACTS” (52.232-7), the allowable indirect cost under this contract shall be obtained by applying limitations on indirect cost rates to bases agreed upon by the parties, as specified below.

c) Allowability of costs and acceptability of cost allocation methods shall be determined in accordance with FAR

Subpart 31.2 in effect on the date of this contract, as limited by the indirect cost rate ceiling established by this clause.

d) For the contract performance period (defined as 9 Oct 2018 - 8 Oct 2026), the indirect cost rates for the Material

CLIN (as defined in H.6) contained in the Contractor's accepted contract proposal shall be incorporated into this clause as limitations on indirect cost rates for each corresponding ordering year.

Indirect Rate Indirect Cost Rate Ceiling

Total Indirect Burden Material CLIN OY 1 X%

Total Indirect Burden Material CLIN OY 2 X%

Total Indirect Burden Material CLIN OY 3 X%

Total Indirect Burden Material CLIN OY 4 X%

Total Indirect Burden Material CLIN OY 5 X%

Total Indirect Burden Material CLIN OY 6 X%

Total Indirect Burden Material CLIN OY 7 X%

Total Indirect Burden Material CLIN OY 8 X%

e) The Government will not be obligated to pay any additional amount should any final indirect cost rates exceed the indirect rates incorporated into this clause as a result of increased indirect pool costs incurred. In the event any of the

Contractor's final indirect cost rates are less than the indirect cost rates incorporated into this clause as a result of decreased indirect pool costs incurred, the incorporated rates shall be reduced to conform with the lower rates.

Adjustments due to actual indirect base costs incurred may be upward or downward.

f) The limitations on indirect cost rate shall not change any monetary ceiling, contract obligation, or specific cost allowance or disallowance provided for in this contract.

g) The limitations on the indirect cost rate shall apply to all work performed under the contract, and to all change orders and supplemental agreements, including changes due to growth, supplemental, emergent and new work during the entire PoP.

h) Notwithstanding any of the terms of this requirement, should the Contractor initiate a change to its accounting systems which would alter the composition of any overhead base or pool affected by this requirement, the Contracting

Officer and Contractor shall negotiate to determine the indirect cost rate ceilings to be applied to the new overhead pools, provided that no agreement shall be made which would increase the costs paid by the Government under this contract.

i) Unreimbursed costs resulting from application of the provisions of this clause shall not be charged to any other direct or indirect cost account in such a manner as to result in recoupment of the unreimbursed costs on this or any other Government contract or assistance agreement.

H.8. OCONUS Support. Over the life of this contract, the contractor shall be required to provide full-time support

OCONUS. In addition to the required full-time support, the contractor may be required to support OCONUS TDY’s and deployments, as approved. The contractor shall comply with any theater business clearance and contract administration requirements set forth by the geographic combatant commander and host nation.

Bilateral agreements that govern the status of contractor employees, criminal jurisdiction, and taxation, as well as country clearance requirements vary by country and are subject to change. Procedures and requirements, by Area of

Responsibility (AOR) and country can be found at https://www.acq.osd.mil/dpap/pacc/cc/areas_of_responsibility.html and the DoD Foreign Clearance Guide:

https://www.fcg.pentagon.mil/fcg.cfm.

(a) For work performed in Germany, eligibility for logistics support or base privileges of contractor employees is governed by U.S.-German bilateral agreements. Follow the procedures at Army in Europe Regulation 715-9, available at http://www.eur.army.mil/g1/content/CPD/docper/docper_germanyLinks.html under “AE Regs &

Resources.” The contractor shall ensure the Troop Care Status Accreditation (TCSA) requirements and application process are completed.

(b) For work performed in the United Kingdom, visas are required before PCSing to the UK. Failure to obtain a UK visa before arriving in the UK can result in denied entry or deportation. The UK visa, sometimes referred to as

“entry stamp”, “entry visa”, “entry clearance”, “entry clearance stamp”, or “entry clearance visa” (which is separate from Country, Theater, or Special Area Clearance) must be obtained from the UK and is required for DoD-sponsored contractors and eligible family members.

(c) For work performed in Japan and Korea reference the Foreign Clearance Guide. For Japan, currently worked performed under this contract are covered by SOFA. For Korea, the U.S. Forces Korea (USFK) Policy

Guidance/Instructions must be followed (Reference Section I - Contract Clauses SOFA Korea Clause).

H.8.1 Synchronized Pre-deployment and Operational Tracker (SPOT). All contractor personnel authorized to accompany U.S. Armed Forces deployed outside the United States must be accounted for in the Synchronized Pre-deployment and Operational Tracker (SPOT) Program located at https://spot.altess.army.mil/. Per DFARS 252.225-

7040. All prime contracts will be pre-loaded in SPOT by the KO. All contractors will be required to input the LOA requests per task order (TO), per employee in SPOT and send to the applicable COR for that TO. After COR approval the KO will finalize and sign the LOA in SPOT.

https://www.acq.osd.mil/dpap/pacc/cc/areas_of_responsibility.html https://www.fcg.pentagon.mil/fcg.cfm https://spot.altess.army.mil/

The prime contractors will each have a Point of Contact that will process the LOAs within the SPOT system. The

COR will be assigned as the Government Authority and the Contracting Officer (KO) approves the LOA within the system. A complete SPOT guide will be provided via email to all prime contractors for assistance.

The basic process for LOA's is three steps:

Step 1: COR registers in SPOT in the role of Government Authority and lists the Contracting Officer as the sponsor.

Step 2: All prime contracts will be loaded in SPOT by SOF AT&L-KH; we will pre-load authorizations, privileges per the contract, etc. and ensure all CORs are in the SPOT system.

Step 3: An LOA is requested as part of creating a deployment (from contractor) at the TO level. The LOA is assigned to a Government Authority user (the COR).

Step 4: The Government Authority (COR) reviews the LOA inbox and authorizes the LOA.

Step 5: The Contracting Officer then reviews the LOA, inserts the accounting data from the TO, and approves.

Once the KO approves the LOA it is digitally signed and available to be reviewed and printed.

H.8.2 Theater Business Clearance. In accordance with DoD Policy and the CENTCOM Contracting Command

(formerly the JCC-I/A), Theater Business Clearance (TBC) is required for contractor support in Iraq, Afghanistan, Pakistan, and Kuwait. TBC approval will be obtained by the Government prior to modifying the basic contract to include this support. No action is required on the part of the prime contractor to receive approval. Specific clauses for contractor support covered under a TBC will be added with the contract modification if support in these areas is required.

H.9 Contractor Identification and Security Requirements

a. The Contracting Officer intends to issue TOs whose scope of effort will be in support of classified programs. In order to be eligible to provide support to classified programs, prime contractors must possess a Top Secret facility clearance as outlined in PWS Section 4.0. Individuals performing work under resultant TOs must comply with applicable program security requirements which will require personnel security clearances up to and including Top

Secret. Specific TOs may also require individual personnel to have access to Sensitive Compartmented Information

(SCI) or ICD 704 eligibility, Nuclear Command and Control (NC2), and possibly Special Access Programs (SAP), Special Access Requirements (SAR) and Special Technical Operations (STO) accesses.

b. Where classified information/data is involved, the contractor shall comply with the “National Industrial Security

Program Operating Manual (NISPOM)” and the DD Form 254 (Contract Security Classification Specification) that is included as an attachment in Section J. (Ref FAR 52.204-2)

c. The contractor will be required to comply with all security requirements enforced by the applicable sponsoring

Government agency. In accordance with FAR 52.204-9 Personal Identity Verification of Contractor Personnel, contractor personnel shall have at minimum a favorable National Agency Check with Inquiries (NACI) completed before being permitted access to any Government automated information technology system.

d. When directed by the Contracting Officer, the contractor shall remove any employee who endangers national security.

e. Contractor employees shall obtain and display identification/security badges to obtain access to any Government installation and any buildings used by the contractor. Contractor employees shall wear a Government-issued badge while in Government facilities. For both picture and non-picture badges, the contractor shall submit all required information (date of visit, name, PCO, SSAN, Category (Ktr=Industry), and Clearance Information) to the Security

Management Office (SMO) and notify the PCO that a badge request has been submitted via JPAS. For annual badge renewals or multiple person requests it is recommended that the names submitted to the SMO and PCO be grouped by type of badge (i.e. picture badge or non-picture badge). Note: Please only submit requests for picture badges for those contractors that will be in a Government facility regularly (i.e. two to three times or more per week). Contractor employees are required to clearly identify themselves as a contractor at all times whether in person or on the telephone. Further, sub-contractors must identify their respective prime contractors. If a contractor employee leaves the company or moves to a different agency for support under this contract they will be required to

"check-out" with their Government COR and turn their badge into the SMO and clear all computer systems to which they have access.

f. Security clearances will be processed IAW established procedures, and will be the responsibility of the contractor.

However, the Personnel Security Management Office for Industry (PSMO-I) and the DoD Consolidated

Adjudication Facility (DoD CAF) shall have and exercise full and complete control over granting, denying, withholding, or terminating security clearances for contractor employees. Contract personnel granted an interim or temporary security clearance may be permitted to begin work upon request of the SOCOM Component and with written permission from the KO. However, this shall incur no obligation on behalf of the Government to grant any of these personnel permanent clearances if the subsequent background investigation does not recommend the clearance. The typical processing times for security clearances vary depending on level of clearance and individual circumstances. Typically, if the individual possesses no clearance and requires a Secret clearance, the process takes approximately 12 months and if the clearance level is currently Secret requires Top Secret, it will take approximately 18 months.

An Interim Security clearance is based on the completion of minimum investigative requirements (ref http://www.dss.mil/psmo-i/indus_psmo-i_interim.html) and granted on a temporary basis, pending the completion of the full investigative requirements for the final secret clearance. Interim Security clearances can be issued quickly, but are not sufficient for access to special categories of classified information, such as COMSEC, NATO, and restricted data.

g. The contractor’s employees are prohibited from possessing weapons, firearms or ammunition, on themselves or within their contractor-owned vehicle or privately owned vehicle while on any Government installation except IAW

252.225-7040 - CONTRACTOR PERSONNEL AUTHORIZED TO ACCOMPANY U.S. ARMED FORCES

DEPLOYED OUTSIDE THE UNITED STATES (JAN 2009).

H.10 Conduct of Personnel. The Contractor, including assigned personnel, performing services on a military installation shall be guided by and shall observe and comply with all applicable rules, regulations, directions and requirements pertaining to conduct of personnel on the military installation as prescribed by the Commander of the military installation during the performance of the required services. The Contractor further agrees to recognize the authority of the responsible military Commander to suspend, restrain or restrict the activities of Contractor personnel whenever in the Commander’s judgment such action is deemed necessary for the protection of personnel and equipment under the Commander’s military jurisdiction.

The MTF Commander or Privileging Authority Chief has the prerogative to hold in abeyance, to deny, or to summarily suspend clinical privileges/practice when there is a reasonable cause to doubt the health care personnel’s competence to practice or for any cause affecting the safety of patients or others. Army Regulation (AR) 40-68 outlines the adverse clinical privileging and practice actions for privileged personnel and adverse practice actions and peer review for non-privileged personnel.

H.11 License Verification, Credential Review or Privileging (If Applicable) and Selection Process. Some personnel will require personal interviews in addition to the credentialing process. Those positions required to have face-to-face interviews are clearly marked within the PWS Appendix 2. Several positions do not require face-to-face interviews by Government representatives, but will require telephonic or VTC interviews and an electronic submission of the resumes for review and concurrence by the applicable COR.

The following labor categories are considered Health Care Providers (HCP) and will be required to obtain practice privileges from the servicing medical treatment facility or identified privileging authority at their assigned installation: Clinical Psychologists, Operational Psychologists, Licensed Clinical Social Workers, Physical

Therapists, Psychiatric-Mental Health Nurse Practitioners, Nurse Case Managers, Neuropsychologists, Psychometrist, and Performance Dieticians. The credentialing package submission will not be provided to the local privileging authority until after the individual has been approved by the COR for selection. The contractor shall provide complete credentials packages not later than 10 days after being notified of Government selection.

All requirements for those personnel requiring credentialing shall adhere to the guidance outlined with DoDI

6025.13, “MEDICAL QUALITY ASSURANCE (MQA) AND CLINICAL QUALITY MANAGEMENT IN THE

MILITARY HEALTH SYSTEM (MHS). The detailed credentialing processes will vary by location and

Component since they must comply with the privileging authority at their assigned installation. For Army

Installations, Army Regulation 40-68 is applicable, for Navy Installations, BUMEDINST 6320.66E is applicable, and for Air Force Installations, AFI 44-119 is applicable. The contractor is responsible for adhering to the regulation that is applicable to the location.

The contractor shall perform all primary source verifications (PSV) and include all verifications with the credentials package. The contractor shall obtain all paperwork, letters of reference, approvals, work history, etc. required by the credentialing or licensure verification processes. The privileging authority staff will not assist the contractor in obtaining any needed information for initial credentialing. The contractor is responsible for the current competence of HCPs used to provide health care services under this contract.

Privileges are facility specific and the department chair or service chief develops the criteria to award privileges.

The contractor shall ensure that all HCPs follow the privileges requirements of the applicable area MTF that they will receive privileges from (currently 26 different locations). The contractor shall request from the appropriate TO

COR, documentation requirements for privileges or for license verification, as required by the position, for each

HCP. The contractor shall ensure that HCPs who require privileging do not provide health care services until they have been granted privileges by the cognizant privileging authority. However, upon written request, contract personnel may be permitted to begin work and start unit in-processing in a limited capacity with written permission from a COR while awaiting final credentialing.

The Credentials Committee may have questions which they will wish to present to the contractor’s HCPs. The

Credentials Committee should submit all questions in writing to the COR. The COR will submit them to the contractor to obtain answers. The contractor shall answer questions presented by the Credentials Committee in writing.

If the contractor adds additional or replacement HCPs during the contract period, the same qualification standards, credentialing/privileging and health requirements shall apply.

The Contractor shall not submit resumes for Government approval for any HCP who, within 5 years prior to employment has had his/her clinical privileges limited, suspended, or revoked by any health care facility, public or private, anywhere in the world.

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

(b) 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.

(c) This prohibition includes an individual that is the subject of a current or pending hearing or appeal brought by any health care facility, public or private, anywhere in the world, which may result in the limitation, suspension or revocation of the individual’s clinical privileges.

H.12 Memorandums of Agreement (MOA) and Specific Medical Quality Assurance Regulations. In addition to the Service Guidance and credentialing requirements, USSOCOM is entering into Memorandums of Agreement with the Defense Health Agency (DHA). Once finalized, the contractor shall comply with applicable terms in the

MOA and copies of these agreements will be provided to the contractor.

In addition to the Component specific instructions outlined within H.11, certain DoD regulations and instructions are applicable to this requirement for all components; DoDI 6025.13, DoDI 6025.5, DOD 6025.18-R, DoDD 6000.6, and DoDD 6025.6.

H.13 Substitution of Personnel. The contractor agrees to initiate performance of this contract using only the employees whose professional qualifications have been determined technically acceptable by the Government.

During TO performance, no personnel substitutions shall be made by the contractor without the express consent of the COR or in accordance with a procedure specified by the Contracting Officer. All substitution requests will be processed in accordance with this clause.

No personnel substitutions shall be permitted during the first 60 days of TO performance, unless they are necessitated by a worker's unexpected illness, injury, death or termination of employment. Should one of these events occur, the contractor shall promptly notify the COR and provide the information required in the paragraph below. After the initial 60 day period, all substitution requests shall be submitted, in writing, at least 30 days prior to the planned change of personnel. All such requests must provide the information required by the paragraph below.

The contractor shall demonstrate that the substitute worker(s) possess professional qualifications that are equal to or higher than the qualifications in PWS Appendix 1 and provide to the Government all requirements IAW PWS

Section 2.4.

H.14 HCP Background Investigation Requirements (Applicable for Support to Families only)

H.14.1. Crime Control Act of 1990 Requirement. Section 21 of the Crime Control Act of 1990, 42 U.S.C. 13041, as amended by section 1094 of Public Law 1-02-190, requires every facility operated by the Federal Government (or operated under contract with the Federal Government) that hires (or contracts to hire) individuals involved in the provision of child care services to assure that all existing and newly-hired employees undergo a criminal background check. The term "child care services" is defined to include health and mental health care (to families).

H.14.1.2. Contractor Requirements. It is the contractor’s responsibility to ensure its employees undergo proper criminal history background checks by providing the Government support, cooperation, and active assistance throughout the process. In accordance with 42 U.S.C. 13041(d) the contractor shall ensure that employment applications for potential HCPs contain a question asking whether the individual has ever been arrested for or charged with a crime involving a child, and if so, requiring a description of the disposition of the arrest or charge.

The application shall further state that it is being signed under penalty of perjury, with the applicable Federal punishment for perjury stated on the application.

Within the PWS 6.1.1 Phase-In Period or within 14 days of an identified vacancy, the contractor and all contractor employees shall provide all reasonable and necessary assistance to the Government to facilitate and complete the background investigation. To initiate the process for a background investigation, the Contractor shall ensure each

HCP reports to the COR for specific MTF processing instructions, completes the appropriate portion of the NACI

SF 85P, and obtains fingerprints for submittal to the Office of Personnel Management (OPM).

Contractor employees who have previously received a background check must provide proof of the check or obtain a new one. Upon receipt of the results of a background check, the contractor agrees to undertake a personnel action in accordance with 42 U.S.C. 13041(c), when appropriate.

Contractor employees shall have the right to obtain a copy of any background check pertaining to them and to challenge the accuracy and completeness of the information contained in the report.

H.14.1.3 Government Responsibilities. The Government shall conduct criminal background checks on all individuals providing child care services under this contract based on fingerprints obtained by a Government law enforcement office (e.g., local, state, federal, etc.) and a completed SF 85P form (Questionnaire for Public Trust

Positions).

The COR shall identify the appropriate DoD Component for billing purposes and the appropriate security point of contact and/or installation commander who will receive the background results.

With written recommendation from the Commander, and the approval of the Contracting Officer, a contractor employee with a background investigation pending completion may be permitted to perform work under this contract prior to the completion of the background check, provided the employee is within sight and continuous supervision of an individual with a successful background check.

H.15 Health Insurance Portability and Accountability Act (June 12). In accordance with DoD 6025.18-R

“Department of Defense Health Information Privacy Regulation,” January 24, 2003, the Contractor meets the definition of Business Associate. Therefore, a Business Associate Agreement is required to comply with both the

Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security regulations. This clause serves as that agreement whereby the Contractor agrees to abide by all applicable HIPAA Privacy and Security requirements regarding health information as defined in this clause, and in DoD 6025.18-R and DoD 8580.02-R, as amended. Additional requirements will be addressed when implemented.

(a) Definitions. As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DoD 6025.18-R or DoD 8580.02-R.

Individual has the same meaning as the term “individual” in 45 CFR 160.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g).

Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part

160 and part 164, subparts A and E.

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

160.103, limited to the information created or received by the Contractor from or on behalf of the Government pursuant to the Contract.

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

Required by Law has the same meaning as the term “required by law” in 45 CFR 164.103.

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

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

Terms used, but not otherwise defined, in this Clause shall have the same meaning as those terms in 45 CFR

160.103, 160.502, 164.103, 164.304, and 164.501.

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

(c) The Contractor shall use appropriate safeguards to prevent use or disclosure of the Protected Health

Information other than as provided for by this Contract.

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

(e) The Contractor shall, at their own expense, take action to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Clause. These mitigation actions will include as a minimum those listed in the

TMA Breach Notification Standard Operating Procedure (SOP), which is available at:

http://www.tricare.mil/tma/privacy/breach.aspx.

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

http://www.tricare.mil/tma/privacy/breach.aspx

(g) The Contractor shall report to the Government any use or disclosure of the Protected Health Information not provided for by this Contract of which the Contractor becomes aware.

(h) The Contractor shall ensure that any agent, including a subcontractor, to whom it provides Protected Health

Information received from, or created or received by the Contractor, on behalf of the Government, agrees to the same restrictions and conditions that apply through this Contract to the Contractor with respect to such information.

(i) The Contractor shall ensure that any agent, including a subcontractor, to whom it provides electronic

Protected Health Information, agrees to implement reasonable and appropriate safeguards to protect it.

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

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

164.524.

(k) The Contractor shall make any amendment(s) to Protected Health

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

(l) The Contractor shall make internal practices, books, and records relating to the use and disclosure of

Protected Health Information received from, or created or received by the Contractor, on behalf of the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner reasonably designated by the Government or the Secretary, for purposes of the Secretary determining the Government’s compliance with the Privacy Rule.

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

(n) The Contractor shall provide to the Government or an Individual, in time and manner reasonably designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

H.15.1 General Use and Disclosure Provisions. Except as otherwise limited in this Clause, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the HIPAA Privacy Rule, the HIPAA

Security Rule, DoD 6025.18-R or DoD 8580.02-R if done by the Government.

H.15.2 Specific Use and Disclosure Provisions.

(a) Except as otherwise limited in this Clause, the Contractor may use Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

(b) Except as otherwise limited in this Clause, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the

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

(c) Except as otherwise limited in this Clause, the Contractor may use Protected Health Information to provide

Data Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B).

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

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

H.15.3 Obligations of the Government. Provisions for the Government to Inform the Contractor of Privacy

Practices and Restrictions

(a) The Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520.

(b) The Government shall provide the Contractor with any changes in, or revocation of, permission by

Individual to use or disclose Protected Health Information, if such changes affect the Contractor’s permitted or required uses and disclosures.

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

Information that the Government has agreed to in accordance with 45 CFR 164.522.

H.15.4 Permissible Requests by the Government. The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the HIPAA Privacy Rule, the HIPAA Security Rule, or any applicable Government regulations (including without limitation, DoD 6025.18-R and DoD 8580.02-R) if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by H.15 and its subparts.

H.15.5 Terminations

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

(b) Effect of Termination.

(1) If this contract or task orders has records management requirements, the records subject to the

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

(2) If this contract or task orders does not have records management requirements, except as provided in paragraph (3) of this section, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of the Contractor. The Contractor shall retain no copies of the Protected Health

Information.

(3) If this contract or task orders does not have records management provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the

Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected Health Information.

(c) The respective rights and obligations of Business Associate Agreement Remains in effect and survives the termination of the contract.

H.15.6 Miscellaneous.

(a) Regulatory References. A reference in this Clause to a section in DoD 6025.18-R, DoD 8580.02-R, Privacy

Rule or Security Rule means the section currently in effect or as amended, and for which compliance is required.

(b) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the

Government to comply with DoD 6025.18-R, DoD 8580.02-R, the HIPAA Privacy Rule or the HIPAA Security

Rule.

H.16 Small Business Participation. All offerors (both Small and Other Than Small Businesses) are required to comply with the requirements of this clause.

Due to the personal services nature of the requirements, a subcontracting plan as defined in FAR 52.219-9 is not required; however, the magnitude of this contract may require many business concerns to team, partner, and/or subcontract with other business concerns (large and small). Therefore, the Government has set a small business subcontracting requirement of 15% of total contract dollars for this contract. The contractor will be required to meet and maintain this requirement throughout the life of the contract. The contractor shall submit a Standard Form (SF)

294 Subcontracting Report for Individual Contract and the Summary Subcontract Report (SSR), using the Electronic

Subcontracting Reporting System (eSRS) at http://esrs.gov . The contractor’s meeting of the minimum small business subcontracting requirements identified below will be evaluated by the Government within the annual

Contractor Performance Assessment Reporting System (CPARS). Failure to meet the requirement may result in negative comments and affect your overall performance rating in CPARS which will be utilized as part of a determination of past performance compliance for exercising the option period on the basic contract.

CATEGORY MINIMUM REQUIREMENT

Small Business 15%

Small Disadvantaged 5% (included in the overall 15% total, not in addition to)

The small business(es) must be registered in the System for Award Management

(https://www.sam.gov/portal/SAM/#1). It is recommended that the Dynamic Small Business Search

(http://dsbs.sba.gov/dsbs/search/dsp_dsbs.cfm) be utilized as well.

The prime Contractor is responsible for providing timely notification to the Government of any acquisition or mergers involving the prime contractor to include the potential impact on this contract.