HT001421R0006.pdf

SEE ADDENDUM

(No Collect Calls)

HT001421R0006

b. TELEPHONE NUMBER

(703) 275-6348

8. OFFER DUE DATE/LOCAL TIME

12:00 AM 15 Feb 2021

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

04-Feb-2021

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

HT00149. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

EDGAR DUCHEMIN

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

1 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.X

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

DHA CONTRACTING OFFICE-(NCR-CD) HT0014

8111 GATEHOUSE ROAD

2ND FLOOR

FALLS CHURCH VA 22042

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE HT0017 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

WALTER REED NAT. MIL. MED. CTR (WRNMMC)

AKIBA HILL

8901 WISCONSIN AVE BLDG #54

BETHESDA MD 20889-5600

TEL: 301-319-5123 FAX:

FAX:

TEL: SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$12,000,000

NAICS:

621111

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF92

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 55 Days General Pediatric Surgeon (on call)

FFP

General Pediatric Surgeon (on call). This is a personal service requirement for an On-Call Pediatric Surgeon at Walter Reed National Military Medical Center, Bethesda, MD. Contractors are to perform in accordance with the terms and conditions of the contract and the included Performance Work Statement (PWS).

Compensation for each Health Care Provider (Employees) shall not exceed $400,000 per year or $208.33/hour in accordance with Title 10 USC Section 1091, Department of Defense, Health Affairs, Defense Health Agency Procedural Instruction 6025.5, Personal Service Contracts, dated October 11, 2016. Services required beyond 55 days shall require a bilateral modification endorsed by both parties. THE GOVERNMENT WILL

ONLY PAY FOR ACTUAL DAYS COVERAGE IS PROVIDED.

FOB: Destination Q523

NET AMT

1001 55 Days OPTION General Pediatric Surgeon (on call)

FFP

General Pediatric Surgeon (on call). This is a personal service requirement for an On-Call Pediatric Surgeon at Walter Reed National Military Medical Center, Bethesda, MD. Contractors are to perform in accordance with the terms and conditions of the contract and the included Performance Work Statement (PWS).

Compensation for each Health Care Provider (Employees) shall not exceed $400,000 per year or $208.33/hour in accordance with Title 10 USC Section 1091, Department of Defense, Health Affairs, Defense Health Agency Procedural Instruction 6025.5, Personal Service Contracts, dated October 11, 2016. Services required beyond 55 days shall require a bilateral modification endorsed by both parties. THE GOVERNMENT WILL

ONLY PAY FOR ACTUAL DAYS COVERAGE IS PROVIDED.

2001 55 Days OPTION General Pediatric Surgeon (on call)

FFP

General Pediatric Surgeon (on call). This is a personal service requirement for an On-Call Pediatric Surgeon at Walter Reed National Military Medical Center, Bethesda, MD. Contractors are to perform in accordance with the terms and conditions of the contract and the included Performance Work Statement (PWS).

Compensation for each Health Care Provider (Employees) shall not exceed $400,000 per year or $208.33/hour in accordance with Title 10 USC Section 1091, Department of Defense, Health Affairs, Defense Health Agency Procedural Instruction 6025.5, Personal Service Contracts, dated October 11, 2016. Services required beyond 55 days shall require a bilateral modification endorsed by both parties. THE GOVERNMENT WILL

ONLY PAY FOR ACTUAL DAYS COVERAGE IS PROVIDED.

3001 55 Days OPTION General Pediatric Surgeon (on call)

FFP

General Pediatric Surgeon (on call). This is a personal service requirement for an On-Call Pediatric Surgeon at Walter Reed National Military Medical Center, Bethesda, MD. Contractors are to perform in accordance with the terms and conditions of the contract and the included Performance Work Statement (PWS).

Compensation for each Health Care Provider (Employees) shall not exceed $400,000 per year or $208.33/hour in accordance with Title 10 USC Section 1091, Department of Defense, Health Affairs, Defense Health Agency Procedural Instruction 6025.5, Personal Service Contracts, dated October 11, 2016. Services required beyond 55 days shall require a bilateral modification endorsed by both parties. THE GOVERNMENT WILL

ONLY PAY FOR ACTUAL DAYS COVERAGE IS PROVIDED.

4001 55 Days OPTION General Pediatric Surgeon (on call)

FFP

General Pediatric Surgeon (on call). This is a personal service requirement for an On-Call Pediatric Surgeon at Walter Reed National Military Medical Center, Bethesda, MD. Contractors are to perform in accordance with the terms and conditions of the contract and the included Performance Work Statement (PWS).

Compensation for each Health Care Provider (Employees) shall not exceed $400,000 per year or $208.33/hour in accordance with Title 10 USC Section 1091, Department of Defense, Health Affairs, Defense Health Agency Procedural Instruction 6025.5, Personal Service Contracts, dated October 11, 2016. Services required beyond 55 days shall require a bilateral modification endorsed by both parties. THE GOVERNMENT WILL

ONLY PAY FOR ACTUAL DAYS COVERAGE IS PROVIDED.

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 POP 01-MAR-2021 TO

28-FEB-2022

N/A WALTER REED NAT. MIL. MED. CTR

(WRNMMC)

AKIBA HILL

8901 WISCONSIN AVE BLDG #54

BETHESDA MD 20889-5600

301-319-5123

HT0017

1001 POP 01-MAR-2022 TO

28-FEB-2023

N/A (SAME AS PREVIOUS LOCATION)

2001 POP 01-MAR-2023 TO

29-FEB-2024

N/A (SAME AS PREVIOUS LOCATION)

3001 POP 01-FEB-2024 TO

28-FEB-2025

N/A (SAME AS PREVIOUS LOCATION)

4001 POP 01-MAR-2025 TO

28-FEB-2026

N/A (SAME AS PREVIOUS LOCATION)

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government 1001 Destination Government Destination Government 2001 Destination Government Destination Government 3001 Destination Government Destination Government 4001 Destination Government Destination Government

ADDENDUM TO 52.212-4

(w) The non-FAR Part 12 discretionary FAR, DFARS, and LOCAL clauses included herein are incorporated into this contract either by reference or in full text. If incorporated by reference, see clause 52.252-2 herein for locations where full text can be found.

STATEMENT OF WORK

PART 1

1.0 GENERAL INFORMATION

1.1 This is a personal services contract in accordance with Title 10 U.S.C. Section 1091, DOD Instructions 6025.5 to provide for on-call Pediatric Surgeon services at the Walter Reed National Militayr Medical Center (WRNMMC), Division of Pediatric Surgery. The Government shall exercise supervision and control over the contract service provider(s) performing the services herein. The contract service provider(s) shall be accountable to the Government.

Contracted employees shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for Patients. The contractor’s employee(s) shall abide by relevant WRNMMC rules, regulations and by laws, including Medical Staff By Laws, as well as applicable Department of Defense (DoD) regulations governing such things as medical records. This on-call Pediatric Surgeon position is to perform in accordance with industry best practices, applicable to DoD guidance.

1.2 Description of services/introduction: The contractor shall provide personnel necessary to perform on-call Pediatric Surgeon support to the WRNMMC Division of Pediatric Surgery, Bethesda, MD as defined in this Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.

1.3 Background:

1.4 Objectives: Contractor shall accomplish all tasks stated in the Performance Work Statement (PWS). Specific objectives for the on-call Pediatric Surgeon are located within Part 5 ‘Specific Task’.

1.5 Scope: The contractor shall provide personnel services. The Contractor shall provide Direct Health Care Provider (DHCP) services in support of WRNMMC Division of Pediatric Surgery. See Part 5 “Specific Task”

1.6 Period of Performance (PoP): The base period of performance shall be 1 March 2021 to 28 February 2022.

There will be four subsequent Option Years to follow.

Base Year 03/01/2021 – 02/28/2022 Option Year I 03/01/2022 – 02/28/2023 Option Year II 03/01/2023 – 02/29/2024 Option Year III 03/01/2024 – 02/28/2025 Option Year IV 03/01/2025 – 02/28/2026

1.7.1 Place of performance: The work to be performed under this contract will be performed at Walter Reed National Military Medical Center (WRNMMC), Bethesda, MD 20889, Division of Pediatric Surgery.

1.7.2 Recognized Federal holidays: The contractor is not required to perform services on the following holidays.

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Independence Day Christmas Day

1.7.3 Hours of operation: ON-CALL. The estimated total number of on-call shifts is five (5) 24-hour periods per month or as deemed necessary by MTF Medical Chief. The Government will prepare specific schedules at least four weeks in advance. However, unforeseen circumstances (IAW 1.7.4.1 below) may not allow for advanced scheduling, and the HCP shall provide coverage not to exceed 55 days per year. When on duty, the HCP shall provide pediatric surgeon on-call coverage. The HCP shall function as the primary attending for all MTF pediatric surgery in-patients. The HCPs shall manage and care for these patients and provide oversight to the pediatric surgery patients. The HCP shall also be the primary Pediatric Surgeon to the Pediatric floor, Emergency Department, Neonatal Intensive Care Unit (NICU), and Pediatric Intensive Care Unit (PICU). When on duty, on-call coverage services are required 24-hours per day until the government-designated representative is present to take over the service. Coverage hours for services begin at 0700 and end at 0700 the next morning. For weekend coverage, the

HCP shall make verbal contact on patient status with the government-designated representative by 0600 Monday morning. THE GOVERNMENT WILL ONLY PAY FOR DAYS WHEN COVERAGE IS PROVIDED.

When on duty, the HCP shall be available to provide pediatric surgeon services on an on-call/call back basis, answering telephone questions and reporting to the MTF. When Government personnel have planned absences or are subject to mobilization and deployment, the HCP shall be available to provide on-call coverage with prior notice and agreement of schedules. When on duty, the HCP shall be available via Government-provided telephone or pager. Upon receipt of the Government's initial page during on-call, the HCP shall reply telephonically within fifteen (15) minutes and shall report to the MTF within forty-five (45) minutes of notification. Depending on the nature of the on-call request, the HCP may or may not be required to report to the MTF. The MTF estimates that the HCP will respond, on average, of up to 8-14 calls per month during on-call, and the total number of actual call back occurrences (return to the MTF) is appropriately one (1) to five (5) times per month. However, on-call services are variable and depend on the current level of pediatric surgeon staff and their availability to share on-call services.

1.7.4 Emergency Services: (If applicable) On occasion, services may be required to support an activation or exercise of contingency plans outside of the normal duty hours.

1.7.4.1 Scheduled follow-up patient care (continuity of care): is necessary for patients following their discharge from the hospital.

First line supervision is by the Division Head or his/her relief as appropriate. Middle Management is by the Department Head for the unit or his/her relief and executive management is by the DCN or his/her relief.

1.7.5 Conduct: Contractor personnel shall adhere to standards of conduct as established by the DHA Commander.

1.8 Contractor travel: Reserved

1.9 Other Direct Costs (ODC): Reserved

1.10 Quality

1.10.1 Quality Control (QC): The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s quality control program is the means by which the work complies with stated requirements. The Quality Control Plan (QCP) shall be incorporated in the contractor’s proposal. A comprehensive written QCP shall be submitted to the KO and COR within 5 working days when changes are made thereafter. After acceptance of the Quality Control Plan (QCP) the contractor shall receive the contracting officer’s (KO) acceptance in writing of any proposed change to his QC system. See Technical Exhibit 1 - Performance Requirements Summary.

1.10.2 Quality assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan provides a systematic method for the Government to evaluate performance and to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.11 Contractor personnel

1.11.1 Common Access Card (CAC) requirements: The contractor shall complete or provide to the Government all information required per the DHA CAC request process, current version 2.1, January 2018, or more recent when updated. See process attached in Section Part 7.1 of the PWS. A CAC is the standard identification for eligible DoD contractor personnel.

1.11.2 Contractor training. The contractor shall complete all requirements, training, and forms per the DHA’s Onboarding Checklist for Contractor Employees, current edition February 2018 or more recent when updated. See the form at https://info.health.mil/sites/DOP/OnboardingCtr/Contractor_OnBoarding_Checklist.pdf.

1.11.3 Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured.

1.11.4 Key control: The Contractor shall establish and implement methods of making sure all keys/key cards issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons. NOTE:

All references to keys include key cards. No keys issued to the Contractor by the Government shall be duplicated.

The Contractor shall develop procedures covering key control that shall be included in the QCP. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The Contractor shall immediately report any occurrences of lost or duplicate keys/key cards to the KO.

1.11.4.1 In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the KO, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the Contractor.

1.11.4.2 The Contractor shall prohibit the use of Government issued keys/key cards by any persons other than the Contractor’s employees. The Contractor shall prohibit the opening of locked areas by Contractor employees to permit entrance of persons other than Contractor employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the KO.

1.11.5 Lock combinations: The Contractor shall establish and implement methods of ensuring that all lock combinations are not revealed to unauthorized persons. The Contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations. These procedures shall be included in the Contractor’s QCP.

1.12 Key personnel (Contractor): On Call Pediatric Surgeon

1.13 Data rights: Reserved

1.14 Reporting

1.14.1 Non-Disclosure Agreement (NDA): All DHA Government contractor personnel who will obtain access to proprietary, classified, or confidential information or any information release of which is protected or governed by law or regulation associated with DHA acquisitions shall be required to complete and sign a DHA Contractor NDA (DHA Form 49) prior to beginning work on the subject contract. The Contractor shall execute an NDA on behalf of the company and shall ensure that all staff assigned to, including all subcontractors and consultants, or other personnel performing on contract/Task order execute an NDA protecting the procurement sensitive information of the Government and the proprietary information of other contractors. The NDA shall be executed not later than first day of employment and to be renewed upon exercising a contract option period. Assignment of staff who has not executed this statement or failure to adhere to this statement shall constitute default on the part of the Contractor.

The contractor shall maintain originally signed NDAs of individual employees and provide copy to the COR.

1.14.2 Contracting Officer Representative (COR): The COR will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract;

perform inspections necessary in connection with contract performance; maintain written and oral communications with the Contractor concerning technical aspects of the contract; issue written interpretations of technical requirements, including Government drawings, designs, specifications; monitor Contractor's performance and notifies both the KO and Contractor of any deficiencies; coordinate availability of government furnished property;

and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting contract.

1.14.3 Post award conference/periodic progress meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The KO, COR, and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the KO will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues.

These meetings shall be at no additional cost to the government.

PART 2

2.0 DEFINITIONS, ACRONYMS, AND APPLICABLE PUBLICATIONS

2.1 Definitions:

2.1.1 Category D: Information Technology and Telecommunications Services (called D-Services)

2.1.2 Category R: Support (Professional/Administrative/Managements) Services (called R-Services)

2.1.3 Contracting Officer (KO): A person with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.1.4 Contracting Officer’s Representative (COR): An individual, including a contracting officer’s technical representative (COTR), designated and authorized in writing by the contracting officer to perform specific technical or administrative functions. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.5 Personal services contract means a contract that, by its express terms or as administered, makes the contractor personnel appear to be, in effect, Government employees.

2.1.6 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance. The Government may either prepare the quality assurance surveillance plan or require the offerors to submit a proposed quality assurance surveillance plan for the Government’s consideration in development of the Government’s plan.

2.2 Acronyms:

ACOR Alternate Contracting Officer's Representative ADP Automated Data Processing AHA American Hospital Association AHLTA Armed Forces Health Longitudinal Technology Application AR Army Regulation AMA American Medical Association AOD Administrative Officer of the Day AO Authorizing Official ATO Authority to Operate BCLS Basic Cardiac Life Support BLS Basic Life Support CAP Cloud Access Point CCFR Code of Federal Regulations CHAMPUS Civilian Health and Medical Program of the Uniformed Services CDRL Contract Data Requirement List CIO Chief Information Officer CJCSM Chairman of the Joint Chiefs of Staff Manual CND SP Computer Network Defense Service Provider CNSS Committee on National Security Systems CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTR Contracting Officer's Technical Representative CS Contract Specialist CSP Cloud Service Provider CUI Controlled Unclassified Information DD 254 Department of Defense Contract Security Requirement List (if applicable) DFARS Defense Federal Acquisition Regulation Supplement DHA Defense Health Agency

DISA Defense Information Systems Agency DOD Department of Defense DoDI Department of Defense Instruction EULA End User License Agreements.

FAR Federal Acquisition Regulation FedRAMP Federal Risk Authorization and Management Program HIT Health Information Technology iRAPT Invoicing, Receipt, Acceptance, and Property Transfer (formerly Wide Area Work Flow) IA Information Assurance IAVM Information Assurance Vulnerability Management IS Information System KO Contracting Officer MCAA Medical Center Alterations and Additions MEDCEN Medical Center MEDCOM Medical Command MEDDAC Medical Department Activity MHS Military Health System MTF Military Treatment Facility NDA Non-Disclosure Agreement NIST National Institute of Standards and Technology OCI Organizational Conflict of Interest OCONUS Outside Continental United States (includes Alaska and Hawaii) ODC Other Direct Costs OIC Officer-in-Charge OMB Office of Management and Budget OTSG Office of The Surgeon General, U.S. Army OSHA Occupational Safety & Health Association P-ATO Provisional Authorization to Operate PA Provisional Authorization PAD Patient Administration Division PCS Psychiatry Continuity Services PDH-CPG Post Deployment Health Evaluation and Management - Clinical Practice

Guidelines PDHRA Post-Deployment Health Re-Assessment PHI Protected Health Information PII Personally Identifiable Information PIPO Phase In/Phase Out PL Public Law PKI Public Key Infrastructure POC Point of Contact PoP Period of Performance PPIMS Past Performance Information Management System PPSM Ports, Protocols, and Services Management PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Plan RMF Risk Management Framework RFP Request for Proposal RMC Regional Medical Command SAR Security Assessment Report SF Standard Form SRP Soldier Readiness Processing

SP Special Publication SRG Security Requirements Guide(s) STIG Security Technical Implementation Guide(s) TA Trusted Agent TAB Therapeutic Agents Board TE Technical Exhibit TOS Terms of Service

2.3 Applicable Publication:

APPLICABLE PUBLICATIONS (CURRENT EDITIONS) All applicable directives and publications {advisory or mandatory}, and supplements or amendments to these directives and publications will be current when furnished to the contractor. Directives will be available to contractor upon request. Current issues of many DA publications and many forms can be accessed at www.usapa.army.mil. DOD publications and forms can be accessed at http://www.defenselink.mil.

The Contractor must abide by all applicable regulations, publications, manuals, and local policies and procedures written in this PWS. Publications and forms not on the websites can be obtained from the MTF.

The Contractor is required to follow all mandatory documents to the extent they apply to this contract. Any such changes to mandatory publications that cause a change in the scope of performance will not be implemented by the Contractor until the Contracting Officer issues a modification in writing.

PART 3

3.0 GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3.1 Services: The Government may or may not provide personnel to escort/guide the Contractor to perform services in accordance with this PWS. The Government will provide: Government Training / Orientation.

Staff Orientation - New Employee. Contractor employees shall participate in all staff orientation and/or training.

Contractor employees may need to attend a government-sponsored initial orientation to familiarize them with policies and procedures. Orientation attendance will be scheduled by the COR. Such orientation may include instruction on automated processing, standard operating procedures, local in-services, quality improvement policies, communications, and occupational exposure to blood borne pathogens, safety programs, etc.

Annual Training Updates. Contractor employees may be required to complete annual training.

HIPAA Privacy and Security Training (HIPAA 101). Contractor may be required to complete the On-Line Web-based Training Modules within the first 30 days of performance.

In addition to the specified courses listed above, Contractor employees are required to attend or complete on-line any Department of Defense, Army, or Federal Government directed courses. Contractor employees are required to participate in all mandatory training.

Government unique training. The government may elect to provide unique government training to contract employees 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 contractor or to the contract employee. When directed by the contracting officer, contract employees shall attend all such training in a paid status as part of the normal services required and billed under the contract. Such training shall require a performance commitment by the contractor and the contractor shall reimburse the government (by means of a reduction in an invoice) if a contract employee fails to satisfy the performance commitment after the contract employee receives the unique government training. The amount of the reimbursement shall be the prorated cost of training, calculated based on the total cost of the training and the number of months by which the contract employee fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first.

3.2 Facilities: The Government will provide facilities required for contract performance. This encapsulates the necessary workspace for the contractor staff to provide the support outlined in the PWS to include desk space, telephones, computers, and other items necessary to maintain an office environment. Space used by contract employees in performance of services may be used for other purposes during their absence. Items of clothing, personal effects, or equipment cannot be secured during their absence. The Government will not incur any liability for theft, damage to, or loss of such personal items. Contract employees shall keep Government furnished supplies, equipment and work areas in a safe, orderly and clean condition. Contract employees shall notify the Government whenever maintenance of equipment is required. Contract employees shall abide by all MTF and Government requirements for physical security of Government property and equipment.

3.3 Utilities: The Government will provide all utilities in the facilities necessary for the contractor’s use in performance of tasks outlined in this PWS. The Contractor shall instruct employees in utilities conservation practices. The contractor shall be responsible for operating under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount to accomplish cleaning vehicles and equipment.

3.4 Equipment: The Government will provide telephones, computers, and other items necessary to maintain an office environment and enable the contractor to provide the services needed. Items issued will remain the property of the Government and will not be removed from the hospital. They are to be used, turned in, or disposed of as directed. Telephones, facsimile machines, copiers and computer equipment are authorized for transaction of official Government business only and shall not be used for personal business. Personal long distance calls are not authorized and the cost of all personal long distance calls made may be deducted from the Contractor’s invoice payments. Telephones, facsimile machines and computer equipment are subject to communications security monitoring at all times.

Pagers. If pagers are issued, the Contract employee shall safeguard the pagers from loss, theft or destruction, and must display the pager for a scheduled or unscheduled control inspection. The Contractor shall be required to reimburse the Government for lost pagers. The cost of replacement of pagers may be deducted from payments to the Contractor.

3.5 Materials: The Government will provide Standard Operating Procedures (SOP) and Policies, Publications and all supporting materials to complete tasks in the PWS.

3.6 Protective Clothing. The MTF will supply special protective clothing and shoe covers when required. Health Care Providers are required to provide uniforms.

3.7 Contract employees may be issued keys. The Contract employee shall safeguard the keys from loss, theft or destruction, and must display all keys signed for at scheduled or unscheduled key control inspections. The Contractor shall be required to reimburse the Government for lost keys, or lockset (if locksets are required to be replaced) as a result of lost keys. The cost of replacement of keys/locksets may be deducted from payments to the Contractor.

3.8 Items issued will remain the property of the Government and will not be removed from the hospital. They are to be used, turned in, or disposed of as directed.

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

PART 4

4.0 CONTRACTOR FURNISHED ITEMS AND SERVICES

4.1 General: The Contractor shall provide services required to perform work listed under Section 5 of this PWS.

4.2 Secret Facility Clearance: Reserved

4.3 Materials: Reserved

4.4 Equipment: Reserved

4.5 Facilities: Reserved

4.6 Certificates/licenses/training shall be maintained in a current status at all times while performing services under this contract. If at any time during the contract the contract employee does not renew any of the required certifications/licenses/training prior to the expiration date, he/she will not be allowed to work at a Military Treatment Facility, Hospital, or Clinic. This expense shall be borne by the Contractor and will not excuse the Contractor from fulfilling the requirements under this contract.

PART 5 SPECIFIC TASKS

Position Qualification Statement:

All contract Health Care Providers (HCPs) provided by the Contractor shall meet the qualifications for that specialty and perform essentially the same functions, within the scope of acceptable for their technical professional discipline and standard, as those required by DOD or government service technical professionals of similar experience and in similar duty assignments. Contract employee practices/productivity will be compared to that of other Contract employees assigned to the same medical center.

The Government has the right to test the contract employee the first day of the contract and any time during contract performance to determine whether the contract employee can perform all contract-required skills. If the contract employee cannot perform all those skills, the Government activity may request that the contract employee be replaced with a contract employee that can perform all the contract-required skills.

5.1 Basic Services: The contractor shall provide personnel necessary to perform on-call Pediatric Surgeon support to the WRNMMC Division of Pediatric Surgery, Bethesda, MD as defined in this Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract. Key Personnel: On-Call Pediatric Surgeon.

5.2 Specific Tasks:

Labor Catergory: On Call Pediatric Surgeon (CLIN X001):

Contractor Qualifications: The Contractor personnel must meet or exceed the following qualification criteria:

Degree/Education/Certification:

1. Physician will have successfully completed an Undergraduate Program, Medical School (M.D.or

D.O.), Internship, and Residency Program

2. Eligible surgeons should be Board Certified/Board Eligible in Pediatric Surgery by the American Board of Surgery and current Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) if required by the client

Experience:

1. Minimum of one (1) year experience within preceding three (3) years in the specialty.

Licensure:

1. Valid unrestricted medical license in at least one (1) state, territory or commonwealth of the U.S. and will at a minimum be Board Eligible

Other Qualifications

1. Shall be able to read, write, speak and understand English well enough to effectively communicate with all patients and other health care providers.

2. Shall be knowledgeable of equipment and supply terminology and skill sufficient to identify and use necessary equipment and supplies properly and to communicate proper use with nurses, medical staff, patients, and family members.

3. Shall be sufficiently skilled to teach patients proper self-care and to motivate patients and family members to continue the procedures for promoting rapid healing.

4. Shall be knowledgeable and possess skills necessary to provide care appropriate to any age-related needs of the patients. The Contract HCP shall demonstrate knowledge of the principles of growth and development appropriate to the appropriate patient population served: Infants, Children, and Adolescent.

5. Shall be a U.S citizen.

6. Shall have documentation of current Drug Enforcement Agency number.

7. The Contract HCP shall demonstrate skills in interviewing, examination, assessment, and management of patients with general medical and surgical health problems. Seriously ill patients shall be managed in consultation with or by direct referral to specialty physicians.

8. The health care provider serving in this position must reside within a 65-mile radius of

WRNMMC.

Specific Duties/Tasks The Contractor Shall Perform:

The Contract On-Call Pediatric Surgeon shall perform full range of medical services to diagnose, treat, and manage patients care as required, and in strict compliance with standing orders and protocols set forth by the MTF to include, but not limited to, the following: a. The Contract HCP shall perform the following procedures, as required, and in strict compliance with standing orders and protocols set forth by the MTF to include, but will not necessarily be limited to the following:

1. The pediatrician surgeon shall be capable of performing the full range of general pediatric surgical services.

2. Prepare and review case histories and obtain data through interviews of patients.

3. Examine patients and determine required x-ray examinations, and clinical laboratory tests. Medical care shall be provided to all beneficiaries authorized care in AR 40-3.

4. Interpret tests results and evaluate findings.

5. Prescribe specific medication(s), diet, treatment modalities and oversee nursing personnel in providing appropriate care to the patient.

6. Work under the general professional direction of the Chief Pediatric Surgical Services.

7. Be prepared to make recommendations regarding changes on policy or programs as they affect professional services in the specialized area of Pediatric Medicine.

8. Make necessary rounds to inpatients, as needed.

9. Provide consultation services for members of the MTF staff for purposes of specialty area training. As required, the contracted HCP will serve in a teaching capacity to staff members assigned to the MTF and ambulatory clinics.

10. The Contracted HCP is responsible for maintaining accurate clinical records and receiving consultations and laboratory work of specific patients.

11. Provide advice and opinions upon request by the Chief, Pediatric Surgery or the referring physician in support of patient care and treatment.

12. Provide a Statement on Evaluation of Fitness IAW AR-40-501 and provide timely completion of Medical Evaluation Board (MEB) dictation and paperwork.

13. The Contract HCP shall be responsible for providing medical care during the required work hours, including routine call, as designated by the medical treatment facility (MTF), and shall provide immediate evaluation and management of emergent problems as they occur. Contractor shall complete medical charting within 72 hours of patient visit IAW JC guidelines.

14. The Contract HCP shall assume additional administrative or clinical duties as requested or needed to ensure sustainment of normal clinic operations and ensure compliance with JC standards, to include, but not limited to, managing daily schedules, reviewing and disposition consults, monitoring appointment utilization and patient access to care, conducting mandatory clinical training, monitoring clinic supplies and equipment, ensuring enforcement of clinic SOPs and standards, conducting monthly peer review and attend staff meetings.

Schedule and Duty Hours: Staffing and scheduling Applicable to Pediatric Surgeon - Surgery Department

1. ON-CALL. The estimated total number of on-call shifts is five (5) 24-hour periods per month or as deemed necessary by MTF Medical Chief. The Government will prepare specific schedules at least four weeks in advance. However, unforeseen circumstances (IAW paragraph b. below) may not allow for advanced scheduling, and the HCP shall provide coverage not to exceed 55 days per year; provided a bilateral modification is agreed to by both parties increasing the number of days. When on duty, the HCP shall provide pediatric surgeon on-call coverage. The HCP shall function as the primary attending for all MTF pediatric surgery in-patients. The HCPs shall manage and care for these patients and provide oversight to the pediatric surgery patients. The HCP shall also be the primary Pediatric

Surgeon to the pediatric floor, Emergency Department, Neonatal Intensive Care Unit (NICU), and Pediatric Intensive Care Unit (PICU). When on duty, on-call coverage services are required 24-hours per day until the government-designated representative is present to take over the service. Coverage hours for services begin at 0700 and end at 0700 the next morning. For weekend coverage, the HCP shall make verbal contact on patient status with the government-designated representative by 0600 Monday morning. THE GOVERNMENT WILL ONLY PAY FOR DAYS WHEN COVERAGE

IS PROVIDED.

2. When on duty, the HCP shall be available to provide pediatric surgeon services on an on-call/call back basis, answering telephone questions and reporting to the MTF. When Government personnel have planned absences or are subject to mobilization and deployment, the HCP shall be available to provide on-call coverage with prior notice and agreement of schedules. When on duty, the HCP shall be available via Government-provided telephone or pager. Upon receipt of the Government's initial page during on-call, the HCP shall reply telephonically within fifteen (15) minutes and shall report to the MTF within forty-five (45) minutes of notification. Depending on the nature of the on-call request, the HCP may or may not be required to report to the MTF. The MTF estimates that the HCP will respond, on average, of up to 8-14 calls per month during on-call, and the total number of actual call back occurrences (return to the MTF) is appropriately one (1) to five (5) times per month. However, on-call services are variable and depend on the current level of pediatric surgeon staff and their availability to share on-call services.

3. First line supervision is by the Division Head or his/her relief as appropriate. Middle Management is by the Department Head for the unit or his/her relief and executive management is by the DCN or his/her relief.

PART 6

6.0 INFORMATION TECHNOLOGY & SECURITY

6.1 All work under this contract is unclassified.

6.2 The Automated Data Processing/Information Technology (ADP/IT) levels and position sensitivity designation for positions under this contract is: (Requirement must be checked in order to be a requirement for this PWS.)

6.2.1. ADP/IT II: Non-critical sensitive position

6.3 PII/PHI, and Federal information requirements (refer to Clause Section for DHA Procedures, Guidance and Information 224.90 if applicable).

6.4 Training.

6.4.1 Contractor employees performing cybersecurity / cyberspace functions shall comply with the following requirements:

6.4.1.1 Training: All contractor and associated subcontractor employees working Cybersecurity (Information Assurance (IA))/Cyberspace functions must comply with DoD training requirements in Department of Defense Directive (DoDD) 8140.01, and DoD 8570.01-M.

6.4.1.2 Certification: Per DoDD 8140.01, Defense Federal Acquisition Regulation Supplement (DFARS) 252.239- 7001, contractor employees supporting Cybersecurity (Information Assurance)/Cyberspace functions shall be appropriately certified upon contract/task order award. The baseline certification as stipulated in DoD 8570.01-M must be completed prior to the beginning of their contract support services. In addition, the contractor shall comply with Computing Environment (CE) certification requirements as specified in the contract. CE certifications shall be obtained within the timelines specified in DoD 8570.01-M.

6.4.2 Privileged user requirements: All contractor employees with privileged user status must comply with the requirements of DHA-Administrative Instruction (AI) 081, Employee use of Information Technology.

6.5 General Cybersecurity requirements – Information Systems

6.6 Risk Management Framework (RMF) for DoD IT: N/A

6.7 Commercial Cloud Computing Services: N/A

PART 7

7.0 ATTACHMENTS/TECHNICAL EXHIBIT LISTING

ATTACHMENT 1

SUPPLEMENT TO THE PWS

1. Removal of Contractor employees:

1.1 Removal of Contractor employees. At any time during the performance of this contract, the Contracting Officer may direct the contractor to immediately remove any Contractor employee whose actions or impaired state raises reasonable suspicion that clear and present danger of physical harm exists to a patient, other Contractor employees, and government personnel or to the impaired individual. This provision will be used in emergency situations only and not for the purpose of bringing performance issues or other non-urgent concerns to the attention of the contractor. The Contractor must replace removed employees within 15 days, or as agreed upon with the Contracting Officer.

1.2 If the need for a removal occurs, the Contracting Officer will contact the contractor's point of contact and direct the contractor to remove that individual from the military facility and to not use that individual to perform any healthcare services required under this contract until the issue has been resolved by the Contracting Officer. The contractor shall formally meet with the Contracting Officer to discuss further action in accordance with the WRNMMC Quality Assurance and Inspection (QA&I) Plan and Army Regulation AR 40–68 Medical Services Clinical Quality Management (AR 40-68, dated 22 May 2009). A review of the basis for removal will be made by the Contracting Officer within three (3) working days following the Contracting Officer’s directed removal.

1.3 If, after any investigation deemed necessary by the Contracting Officer and discussions with the contractor's representative, the Contracting Officer concludes that the Contractor employee’s impairment requires permanent removal from performance under the contract, the Contracting Officer will notify the contractor that permanent removal is required. In the event of disagreements between the government and the contractor's representative concerning matters of impaired Contractor employees, the decision of the Contracting Officer will be final. During the period between the removal and the final decision of the Contracting Officer, the contractor shall provide a backup/replacement Contractor employee in accordance with the terms and conditions of this contract

2. Conflict of Interest:

2.1 Contractor employees shall not use services rendered pursuant to this agreement as a part of a study, research grant, or publication without the prior written consent of the WRNMMC Director.

2.2 Contractor employees shall not bill the patient, an insurer, or anyone else for services rendered.

2.3 Contractor employees shall not, while performing services under this contract advise, recommend, or suggest to persons eligible to receive medical care at Army expense that such persons should receive care from the Contractor at any place other than at the WRNMMC. The Contractor will not refer any patients to any company or service to which they have a direct or indirect involvement (including partnership programs and ancillary services not offered by the WRNMMC).

2.4 Contractor shall not introduce new procedures or changes in standing operating procedures without first coordinating with the Contracting Officer, who then will coordinate with the COR and the Chief of Services.

2.5 Contractor is not prohibited by reason of his/her employment under this contract from conducting private practice, if there is no conflict with the performance of services under this contract.

2.6 Contractor shall not use Government facilities or other Government property in connection with conducting a private practice.

2.7 The Contractor employee who is an employee of the Department of Defense (DoD), either military or civilian, shall not be employed unless such person seeks and…