N62645-17-R-0004_0002.docx

N6264517R0004

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:

QUESTIONS & ANSWERS

1. The shift language for SLIN 0004DJ has been revised, see attached for a revised copy of the SOW.

2. Question 20: C.7.11.2 lists 92-100 hours of orientation for non-coverage positions. Para C.7.11.6 states that orientation for coverage positions shall be addressed in the Task Order. Some of Statements of Work in attachment 4 for coverage position address the specific amount of hours required for orientation; while some only state that “Each HCW providing service under this contract or resultant Task Orders shall undergo an orientation and shall complete mandatory Navy and Department of Defense (DOD) on-line training as required.” Will the Government issued revised statements of work for those coverage SLINs that do not address the amount of orientation hours required for the HCW?

a. Answer 20: The general orientation requirements outlined in the RFP, see Section C.7.11.2., apply to all HCWs. Section C has been revised to indicate that additional orientation requirements for coverage positions shall be addressed in the Task Order, see attached.

3. Question 21: SLIN 0004BF and SLIN 0004BG statement of work para 4.6.1 states orientation shall not take place during regularly scheduled shift coverage. Does this restriction include the sedation training required in para 5.1 of these SLINs? Will the contractor HCW receive the sedation training during a regularly scheduled shift that is invoiced as regularly scheduled work hours?

a. Answer 21: Sedation training is not part of orientation. If required, sedation training will be provided during normal working hours. The SOWs that mention sedation training have been revised to reflect this, i.e., SLINs 0004BF, 0009BA, 0004BG, 0004DK, 0004HA, and 0008HA.

4. Question 22: If a position such as CLIN 0003EA in Lot E has two separate locations, will the HCW be compensated for travel time and expenses between the two locations?

a. Answer 22: The locations mentioned in the SOW for SLIN 0003EA are in the same facility. As a reminder, travel will be reimbursed as specified in the RFP, see Section C.11. Travel shall not be conducted prior to the appropriate funding being added by modification to Contract Line Item 0008 in Section B of the appropriate task order. As indicated in the RFP, see Section C.5.13., each HCW will be assigned to a primary location; however, unless otherwise specified in the task order, the Government retains the right to assign the HCW to another location within a fifty (50) mile commuting radius of their assigned MTF. Healthcare workers shall receive notification two (2) weeks prior to reassignment to locations within a fifty (50) mile limit.

5. Question 23: Lot A, SLIN 0002AF and Options. The qualifications require that the LCSW have at least two years of post-graduate supervised experience within the last three years. This qualification would normally be required in a recent master’s level graduate as opposed to an experienced licensed clinical social worker and would limit the pool of candidates. Please consider revising the qualifications to match those required in SLIN 0002AG, LCSW (two years of post-masters experience as a clinical social worker within the last three years). If not, please clarify the reasons for the difference in qualifications.

a. Answer 23: The qualifications have been revised, see attached for a revised copy of the SOW for SLIN 0002AF.

6. Question 24: Lot D, SLIN 0004DL and Options. The qualifications require that the RN have one year of experience working in a hospital-based surgical outpatient clinic setting. Please consider adding experience in an inpatient medical/surgical setting or free-standing outpatient surgery center.

a. Answer 24: The qualifications have been revised, see attached for a revised copy of the SOW for SLIN 0004DL.

7. Question 25: Lot E, SLIN 0004EJ and Options. The site of service for the LPN position is located in the Oncology Clinic and requires experience in an outpatient acute care or ambulatory care center. Please clarify why there is an additional requirement for six months of experience caring for patients with diabetes mellitus. Can this additional requirement be removed?

a. Answer 25: This requirement was removed, see attached for a revised copy of the SOW for SLIN 0004EJ.

8. Question 26: Page 21, C.8.3.7, Marriage and Family Therapist: Would the government consider revising the requirement for Clinical Membership in the AAMTF to allow a qualified therapist to obtain the membership within six months of beginning service provision? Maintaining this requirement upon hire will significantly limit the pool of qualified candidates.

a. Answer 26: The Government has considered this request; however, the requirement will remain as is.

9. Question 27: Page 21, C.8.3.8, Occupational Therapist: Would the government consider revising and deleting the requirement for certification from the National Board for Certification in Occupational Therapy, Inc. as occupational therapists with baccalaureate degrees are not eligible to receive the certification. Additionally, this certification is not widely recognized in the field. Maintaining this requirement will significantly limit the pool of available candidates.

a. Answer 27: The qualifications for this position have been revised to indicate that a Master’s degree is required, see attached for a revised copy of Section C.

10. Question 28: Page 21, C.8.3.9.2, Optometrist: Can you clarify the statement “The HCW is responsible for complying with applicable licensing regulations”? Is this in regard to the State in which they maintain their license or are they required to be licensed in the state in which they will be provide services under this contract?

a. Answer 28: As indicated in the RFP, see Section C.8.3.9.2., the HCW shall possess and maintain a current, unrestricted license to practice optometry in any one (1) of the fifty (50) States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S. Virgin Islands. The applicable licensing regulations relate to the state in which the HCW maintains their license.

11. Question 29: Page 24, C.8.5.3, Registered Nurse, Case Manager (RNCM): Would the government consider expanding the educational requirements to include registered nurse with associate’s degrees? Limiting the requirement to registered nurses with baccalaureate degrees significantly limits the pool of qualified candidates.

a. Answer 29: The Government has considered this request; however, the requirement will remain as is.

12. Question 30: Page 27, C.8.6.12, MRI Technologist: Would the government consider revising the requirement to allow candidates with certification as an MRI Technologist only to qualify? The certification for the MRI specialty is a primary certification pathway through the AART and many technologists enter the field directly as an MRI technologist. Requiring dual certification as a radiologic technologist and an MRI technologist will significantly limit the pool of qualified candidates.

a. Answer 30: The qualifications for this position have been revised, see attached for a revised copy of Section C.

13. Question 31: Reference: C.3. SCHEDULES, ABSENCES, AND LEAVE – How does the Navy intend to address the Executive Order (EO) 13706, Establishing Paid Sick Leave for Federal the contractor must provide employees with 1 hour of paid sick leave for every 30 hours they work, up to 56 hours of paid sick leave each year. Will contractors still be able to bill the Navy for these hours as they currently do for other absences (Holiday and Vacation)?

a. Answer 31: Contractors are responsible for complying with FAR 52.222-62. As indicated in the RFP, HCWs shall accrue personal leave, which is to be used for both planned (vacation) and unplanned (sickness) absences, see Section C.3.1. for more information. Leave for coverage positions is discussed in the RFP, see Section C.3.2.

14. Question 32: 52.222-62, p. 120, This solicitation incorporates the new sick leave EO 13706. Will these additional sick leave hours be considered billable?

a. Answer 32: See the answer to Question #31.

15. Question 33: 52.222-62, p. 120, Since there is potential for more sick leave, will these additional hours need to be backfilled? If these hours need to be backfilled, will the backfilled hours be billable? If these hours are billable, will the hours per FTE need to be increased to incorporate the additional backfilled hours?

a. Answer 33: See the answer to Question #31.

16. Question 34: Will Executive Order 13706 (Paid Sick Leave for Workers on Federal Contracts) apply to this contract? Please advise.

a. Answer 34: See the answer to Question #31.

17. Question 35: In section C.3.1, you state the following:

C.3. SCHEDULES, ABSENCES, AND LEAVE. Each task order will specify the work schedule of each HCW. The Government will administer the leave provisions in this Section.

C.3.1. Unless otherwise specified in a task order, eight (8) hours of personal leave are accrued by each HCW at the end of every eighty (80) hour period worked, unless conditions specified in Section C.3.1.11., below, apply. The HCW shall be compensated by the Government for these periods of authorized planned absence. This leave shall be used for both planned (vacation) and unplanned (sickness) absences. The specific work schedule for an individual HCW who accrues leave will be scheduled in advance by the Government supervisor (or designee) specified in the task order. Any changes in the schedule shall be coordinated between the individual HCW and the Government.

Per the U.S. Department of Labor Wage and Hour Division Final Rule: Executive Order 13706, Establishing Paid Sick Leave for Federal Contractors On September 30, 2016, the Department of Labor published a final rule to implement Executive Order 13706, Establishing Paid Sick Leave for Federal Contractors. Executive Order 13706 was signed by President Barack Obama on September 7, 2015, and requires parties that enter into covered contracts with the Federal Government to provide covered employees with up to 7 days of paid sick leave annually, including paid leave allowing for family care. The final rule describes the categories of contracts and employees covered by the Executive Order; the rules and restrictions regarding the accrual and use of paid sick leave; the obligations of contracting agencies, the Department of Labor, and covered Federal contractors under the Order; and the remedies and enforcement procedures to implement the Order’s requirements.

Are the seven (7) days Paid Sick Leave (considered unplanned) a part of the “eight (8) hours of personal leave are accrued by each HCW at the end of every eighty (80) hour period worked”, or in addition to these accrued hours? How does this Executive Order impact C.3.1, if at all?

Answer 35: See the answer to Question #31.

18. Question 36: Section C.3.1., Schedules, Absences and Leave. Unless otherwise specified in a task order, eight hours of personal leave are accrued by each HCW at the end of every eighty hour period worked. Will FAR Clause 52.222-62 Paid Sick Leave Under Executive Order 13706 be incorporated into this solicitation? This clause applies to employees covered by the Service Contract Act and requires one hour of sick leave accrual for every 30 hours worked.

a. Answer 36: See the answer to Question #31.

19. Question 37: Lot A, SLIN 0001AA is for a psychiatrist. Please advise.

a. Answer 37: See the response to Question #1 in Amendment 0001.

20. Question 38: 0004 Is there any provision for Acupuncture. If there is an applicable area I have overlooked, please advise.

a. Answer 38: Acupuncturist is a labor category identified in Section C; however, offerors are reminded that each contract awardee will be awarded a minimum of one lot. Each lot contains various labor categories crossing multiple labor bands. In addition, as noted in Section L, if an offeror does not submit pricing for all CLINs of all lots, the offeror’s entire proposal may be rejected.

SECTION C - DESCRIPTIONS AND SPECIFICATIONS

The following have been modified:

STATEMENT OF WORK

NOTE 1: The use of Commanding Officer/Commander means: Commanding Officer/Commander or other activity head, or designated representative, e.g., Contracting Officer’s Representative (COR) or Department Head, of the activity designated in a particular task order.

NOTE 2: The term Contractor means the offeror identified in block 15A of Standard Form 33 and its Health Care Workers (HCWs) who are providing services under task orders placed under the contract.

NOTE 3: The term HCW refers to the individual(s) providing services under the contract.

NOTE 4: The term MTF refers to the Military Treatment Facility or other federal medical treatment facility at which services are performed. For services provided at non-Navy site, the credentialing and security requirements may differ than those stated herein.

NOTE 5: The term Contracting Officer’s Representative (COR) refers to the Government employee appointed in writing by the Contracting Officer to serve as technical liaison between the Government and the Contractor.

NOTE 6: Psychological Health and Traumatic Brain Injury Program (PH/TBI). The program seeks to address gaps in the case available for the prevalent injuries among combatants from the global war on terrorism. Through adoption of risk-based staffing models and a uniform, best practice standard of care across the Department of Defense (DoD) Military Health System, the program seeks to ensure easy, rapid access to PH and TBI care for all beneficiaries and to ensure that the transition across networks of care recognizes the unique care coordination and case management requirements for PH and TBI patients.

NOTE 7: Wounded, Ill, and Injured (WII). The program seeks to address gaps in the care available for the prevalent injuries and illnesses among service members retiring for active duty in Iraq and Afghanistan as well as the difficulties of transitioning from military to veteran status. The WII Program is directed by the President, Congress, and the Department of Defense and addresses concerns about the quality and availability of medical, mental health, and dental care services. Through adoption of risk based staffing models and a uniform, best practice standard of care across DoD, the program seeks to ensure easy, rapid access to care for all beneficiaries and to ensure that the transition across networks of care recognizes the unique care coordination requirements for WII patients. The WII program focuses on studies, case managers, inspections, policies, care and treatment to injured and ill services members, and other initiatives to improve the management of wounded personnel.

NOTE 8: Post Deployment Health Re-Assessment (PDHRA). The Post-Deployment Health Reassessment (PDHRA) Program is a program mandated by the Assistant Secretary of Defense for Health Affairs in March 2005 and designed to identify and address health concerns, with specific emphasis on mental health, that have emerged over time since deployment.

NOTE 9: Medical Home Port (MHP). The Medical Home Port program is a new model of patient and family-centered health care delivery for primary care that is team based, comprehensive, and designed to fully meet the complete primary care health and wellness needs of patients.

C.1. This Statement of Work (SOW) applies to all positions encompassed within the contract. Specific Statements of Work for the Government’s requirements ordered from the maximum order quantities in Section B, Contract Line Item Number (CLIN) 0001 through 0009, are provided in Section L Attachment 4. Subsequent quantities shall be ordered in accordance with Section H.

C.1.1. The Contractor shall provide HCWs in accordance with the terms and conditions of the contract and each task order issued under the contract.

C.1.2. Contractor services shall be provided for the treatment of active duty military personnel, their dependents, eligible DoD civilian employees, and other eligible beneficiaries designated by the Government.

C.2. SUITS ARISING OUT OF MEDICAL MALPRACTICE

C.2.1. The HCWs are serving at the MTF under a personal services contract entered into under the authority of Section 1091 of Title 10, United States Code (U.S.C.). Accordingly, Section 1089 of Title 10, United States Code shall apply to personal injury lawsuits filed against the HCW(s) based on negligent or wrongful acts or omissions incident to performance within the scope of this contract.

C.2.2. The HCWs are not required to maintain medical malpractice liability insurance. In the event of a claim or lawsuit relating to the HCW's performance of duties under this contract, the parties shall follow the procedures established in SECNAVINST 6300.3A, a copy of which can be viewed at https://doni.documentservices.dla.mil/default.aspx.

C.2.3. HCWs providing services under the contract shall be rendering personal services to the Government and shall be subject to day-to-day supervision and control by Government personnel. Supervision and control is the process by which the individual HCW receives technical guidance, direction, and approval with regard to a task(s) within the requirements of this contract.

C.2.4. The personal services contract does not create an employer-employee relationship between the Government and any corporation, partnership, business association, or other party or legal entity with which the individual HCW may be associated.

C.3. SCHEDULES, ABSENCES, AND LEAVE. Each task order will specify the work schedule of each HCW. The Government will administer the leave provisions in this Section.

C.3.1. Unless otherwise specified in a task order, eight (8) hours of personal leave are accrued by each HCW at the end of every eighty (80) hour period worked, unless conditions specified in Section C.3.1.11., below, apply. The HCW shall be compensated by the Government for these periods of authorized planned absence. This leave shall be used for both planned (vacation) and unplanned (sickness) absences. The specific work schedule for an individual HCW who accrues leave will be scheduled in advance by the Government supervisor (or designee) specified in the task order. Any changes in the schedule shall be coordinated between the individual HCW and the Government.

C.3.1.2. Each HCW shall adhere to MTF/Government supervisor policies and procedures for requesting leave, including requirements for advance notice. Requests by HCWs for taking accrued leave are subject to approval by the Government supervisor (or designee). Leave shall be used in quarter hour increments.

C.3.1.3. Unless otherwise negotiated between the Contracting Officer, the MTF, and the Contractor as specified in the contract or applicable task order, the MTF will administer a HCW’s leave granted as a function of this contract and observance of federal holidays in accordance with the guidelines for federal civil service employees.

C.3.1.4. Contractors and HCWs shall ensure that leave requests are submitted with sufficient time in advance to allow the Government supervisor to adequately plan for adequate staffing levels. Unless otherwise specified in a Task Order, all accrued leave shall be used within ninety (90) days following the completion of a Task Order if a Logical Follow-on (LFO) Task Order, as defined in Section H.2., has been issued or within the first (1st) ninety (90) days of the exercised option period under a Task Order. If a Logical Follow-on Task Order is not issued or if an option period under a Task Order is not exercised, all unused leave shall be either used by the end of the Task Order or option period of performance or forfeited. If leave is carried over beyond the completion date of the Task Order (i.e. to be used in the subsequent ninety (90) days), the Government reserves the right to require the HCW to provide the Government supervisor and COR with a schedule for the use of that leave not later than the first (1st) workday of the Logical Follow-on Task Order or not later than the first (1st) workday of the exercised option period of the Task Order. HCWs shall not presume that their leave schedule has been approved unless notified, in writing, by the Government supervisor. The Government will make every effort to accommodate all leave requests; however, the Commanding Officer reserves the right to unilaterally deny these leave requests to meet the demand for patient care.

C.3.1.5. The Government will compensate the Contractor for periods of authorized absence. The Contractor shall, in turn, compensate the HCW for periods of authorized absence.

C.3.1.6. If the HCW is absent for three (3) or more consecutive unplanned days, the Commanding Officer may require written documentation from a qualified health care provider that the HCW is free from communicable disease. The Government reserves the right to examine and/or re-examine any HCW who meets this criterion.

C.3.1.7. Military Leave. The Contractor shall provide military leave to HCW’s in accordance with the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA 38. U.S.C. 4301-4335).

C.3.1.8. Administrative leave may be granted for HCWs selected to serve jury duty. Requests for administrative jury duty leave shall be submitted to the Commanding Officer in the same manner as personal leave is requested. The HCW is required to provide the Commanding Officer with as much written notice as possible prior to reporting for jury duty, and is responsible for supplying documentation regarding the necessity for and length of absence for jury duty. A HCW whose position is deemed critical by the Commanding Officer may be issued a written request for the court to excuse the HCW from jury duty. The HCW shall be compensated by the Contractor for these periods of authorized administrative leave. No individual HCW will be granted more than fifteen (15) days of administrative leave for jury duty per period of performance; in those instances where a contract HCW who accrues leave is anticipated to be in jury duty status in excess of fifteen (15) days, the Contractor shall provide a replacement worker.

C.3.1.9. In the event that a task order allows a leave accrual position to be staffed by part-time individuals, no leave will be accrued by any individual who works fewer than forty (40) hours during a two (2) week invoice period, unless otherwise specified in the task order. This clause does not apply to labor categories covered by the Service Contract Labor Standards.

C.3.1.10. All accrued leave shall be forfeited without compensation or reimbursement at the expiration or termination of a task order or the contract or at the voluntary or involuntary separation of a contract HCW. The only exception to this is in the case of a logical follow-on task order or exercise of an option period, which includes a provision for carry over from the expiring task order of a specified maximum leave balance for a defined period. See Section C.3.1.4.

C.3.1.10.1. In the event that the HCW gives notice of employment termination, all accrued leave must be used within that notice period, or forfeited. The Government will not extend the HCWs termination date to accommodate unused leave balances.

C.3.1.11. Holidays. Unless otherwise specified in the task order, requirements for holiday work are defined in each task order. Compensation for holidays will be managed as follows:

C.3.1.11.1. Full-time and Part-time HCWs. Each full-time or part-time individual HCW who accrues personal leave will also receive a paid holiday benefit. If additional federal holidays are created as a result of an Executive Order, the benefit will also be extended to the HCW. The Government will compensate the Contractor for the number of hours the HCW is normally scheduled to work on the day on which holiday is observed. The Contractor shall fully compensate the HCW for the number of hours the HCW is normally scheduled to work on the holiday observance.

C.3.1.11.2. The government will not compensate the contractor for a holiday benefit if the HCW is not normally scheduled for duty on the day a holiday is observed. For example, a HCW who works ten (10) hours per day, Tuesday through Friday, will not receive compensation for a Monday holiday, since the HCW is not normally scheduled to work on Mondays.

C.3.1.11.3. The Government supervisor will review, and approve on a case-by-case basis, HCW requests for schedule changes that remove the HCW from a holiday schedule. The Government supervisor will approve the requests as appropriate to the circumstance.

C.3.1.11.4. If the Government requires the services of a HCW who is not normally scheduled to work on a day of a holiday observance, the Government will compensate the Contractor for the hours worked and the Contractor shall compensate the HCW. In addition, the HCW will receive compensatory time equal to the number of hours worked on the holiday.

C.3.1.11.5. Part-time HCWs who do not accrue leave do not accrue a holiday benefit or a holiday created by Executive Order. The Government will compensate the Contractor only for the number of hours the HCW actually works.

C.3.1.11.6. In no instance will the Government provide holiday compensation or compensatory time in excess of twelve (12) hours for each holiday observance.

C.3.2. Replacement coverage. Positions will be designated in the applicable Task Order. The Contractor shall be responsible for administering the leave for individuals filling coverage positions.

C.3.2.1. The Contractor shall have sufficient qualified reserve personnel so that all services are provided in the event a HCW scheduled to work becomes ill, resigns, is terminated, or is otherwise unavailable to work. Contract requirements are not mitigated by inclement weather.

C.3.2.2. If a HCW becomes ill or is otherwise unable to fulfill his/her obligation to work, (s)he shall notify the Contractor who in turn shall notify the COR.

C.3.2.3. The Contractor is responsible for replacing a HCW who, for any reason, misses more than two (2) hours of a shift.

C.3.2.4. The Contractor shall provide replacement coverage by a HCW who meets the minimum HCW contract qualifications and is approved for work (i.e., has been credentialed and privileged, as appropriate, and has satisfactorily completed orientation).

C.3.2.5. The Contractor shall prepare the schedule of workers for all positions for which replacement coverage is required. Unless otherwise specified in the Task Order, the specific schedule for each two (2) week period shall be provided to the Government supervisor one (1) month in advance of the two (2) week period. The schedule shall be complete and include the name of the specific individual(s) who will provide the required coverage.

C.3.3. Provisions for all HCWs.

C.3.3.1. Administrative Leave. For unusual and compelling circumstances (e.g., weather emergencies) in which the Commanding Officer either excuses all facility personnel from reporting to work or dismisses all personnel early, the Commanding Officer is authorized to grant administrative leave to the HCW. This administrative leave may be compensated leave. Personnel who occupy “essential” positions may be required to remain on duty or return to the MTF in order to maintain continuity of patient care services.

C.3.3.2. Furlough. Unless otherwise authorized by a defense appropriations bill, Contractors shall not be reimbursed by the Government for services not rendered during a Government furlough. In the event of a Government furlough, the Commanding Officer will determine which HCWs are considered essential and therefore must report to work. HCWs deemed essential shall be compensated for services rendered during a furlough. All other HCWs shall be furloughed until the Government shutdown ends or they are notified by the Contracting Officer’s Representative that they have become essential HCWs.

C.3.3.3. A HCW with a bona fide medical emergency occurring while on duty, or with an on-the-job injury, will be provided stabilizing medical care according to the procedures of the MTF. The Contractor shall reimburse the Government for all medical services provided unless the HCW is otherwise entitled to Government medical services.

C.3.3.4. In the instance where the Government directs the HCW to remain on duty in excess of their scheduled shift due to an unforeseen emergency or to complete patient treatment where lack of continuity of care would otherwise jeopardize patient health, the HCW shall remain on duty. The HCW will be given an equal amount of compensatory time to be scheduled upon mutual agreement of the HCW and the Commanding Officer. This provision is not intended to apply to the time required to complete routine tasks (e.g., completion of paperwork or routine administrative tasks at the end of a shift) which are to be completed as part of the shift. HCWs shall use compensatory time within two (2) pay periods and prior to the end of the task order.

C.3.3.4.1. At Naval Medical Center Portsmouth only, the compensatory time shall be used within a two week timeframe, unless otherwise specified in the task order.

C.3.3.5. HCWs providing services shall (unless otherwise specified in the task order) receive uncompensated meal breaks of thirty (30) minutes when assigned an eight (8) hour or ten (10) hour shift and up to sixty (60) minutes when assigned a twelve (12) hour shift. The HCW’s shift will be extended between thirty (30) and sixty (60) minutes, respectively, to constitute a full eight (8), ten (10) or twelve (12) hours of on-site service. This includes extending the work shift beyond the scheduled clinic closing time to complete patient care and administrative duties. No shift shall exceed thirteen (13) hours unless otherwise specified in the task order.

C.3.3.6. HCWs may receive one (1) compensated work break in the morning and one (1) in the afternoon, work load permitting, at the discretion of the Government. Neither break shall exceed fifteen (15) minutes or be taken with the intention of extending the lunch break, or in conjunction with the start or end of a shift.

C.3.3.7. Continuing Education. The Commanding Officer may also grant authorization for planned absences to allow the HCW to attend continuing education courses. This is in addition to the personal leave specified above. The Government may compensate the HCW for these periods of authorized absence if the continuing education course(s) are determined to be a necessary expense by the Government.

C.3.3.8. Training necessary to maintain the professional qualifications required by the contract (e.g. Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), etc.) may be available at the MTF and/or through Military Training Network on a space available basis. HCWs participating in such training shall not be in a contract duty status, i.e. training hours are not paid hours of service. Failure of the HCW to obtain training on a space available basis does not release the Contractor from the contract requirement.

C.3.3.9. Due to the nature of medical personal services which require Government supervision, the need for HCW access to Composite Health Care System (CHCS), Essentris, Armed Forces Health Longitudinal Technology Application (AHLTA), and patients that present only at the MTF, this contract does not lend itself to allow HCWs to telework.

C.3.3.10. On-call. On-call service requirements are variable and depend on the current level of Government staff and their ability to share on-call services. Specific on-call requirements will be specified in the individual Task Orders. HCWs will be compensated as specified in Section B of the task order.

C.3.3.11. HCWs providing service in support of Naval Medical Center Portsmouth shall work a minimum of sixteen (16) hours per month.

C.4. FAILURE AND/OR INABILITY TO PERFORM

C.4.1. Should a HCW who accrues leave in accordance with Section C.3.1 be unable to perform duties under any Task Order due to medical or physical disability for more than thirteen (13) consecutive days, that individual’s performance under the Task Order may be suspended by the Contracting Officer until such medical or physical disability is resolved. If performance under the Task Order is so suspended, no reimbursement shall be made to the Contractor for the affected HCW so long as performance is suspended.

C.4.2. Any HCW demonstrating impaired judgment will be removed from providing health care services. The Government reserves the right to remove any employee who, in the judgment of a licensed physician, is impaired by drugs or alcohol.

C.4.3. Any HCW with alcohol or drug abuse problems may be allowed to return to work under the terms of this contract only with prior written approval from the Commanding Officer.

C.5. GENERAL PROVISIONS FOR HCWS.

C.5.1. HCWs shall comply with Executive Order 12731, October 17, 1990, (55 Fed. Reg. 42547), Principles of Ethical Conduct for Government Officers and Employees, and shall also comply with DoD and other Government regulations implementing this Executive Order.

C.5.2. HCWs shall be neat, clean, well groomed, and in appropriate clothing when in patient care and public areas. All clothing shall be free of visible dirt and stains and shall fit correctly. Fingernails shall be clean and free from dirt, and hair shall be neatly trimmed and combed. HCWs shall display an identification badge, which includes the HCW’s full name and professional status (furnished by the Government) on the right breast of the outer clothing. Security badges provided by the Government shall be worn when on duty. In addition to the identification badge, the HCWs shall identify themselves as contract personnel in all meetings, telephone conversations, and formal and informal written correspondence with Government personnel.

C.5.3. HCWs shall become acquainted with and obey all station regulations, shall perform in a manner to preclude the waste of utilities, and shall not use Government resources (i.e. copiers, telephone, and computers, etc.) for personal business. All motor vehicles operated on these installations by HCWs shall be registered with the base security service according to applicable directives. Eating by HCWs is prohibited in patient care areas/clinics and is restricted to designated areas. Smoking is prohibited in all clinic facilities.

C.5.4. The Contractor and all HCWs shall comply with all installation checkout processes. These processes include returning Government property, i.e., identification badges, pagers, cellular phones, etc., to the MTF upon a HCW’s last day of service. Failure to do so promptly may result in delay of payment to the Contractor.

C.5.5. Except as provided in this clause and in Section H, HCWs are not prohibited from conducting a private practice of their professions or from engaging in other employment. However, the HCWs shall not, simultaneously with performance under this contract, engage in other employment that creates a conflict of interest, violates federal law (see Section H), or potentially compromises the quality of their work under this contract. Further, such private practice or other employment shall not be conducted during those hours in which the HCW is required to render services under this contract. HCWs shall make no use of the Government facilities or property provided under this contract in connection with other employment. (Navy Medicine (NAVMED) P-117, Chapter 1, Article 1-22 applies (http://www.med.navy.mil/directives/Pages/NAVMEDP-MANMED.aspx).

C.5.6. While on duty, HCWs shall not advise, recommend, or suggest to individuals authorized to receive services at Government expense that such individuals should receive services from the HCW when (s)he is not on duty, or from a partner or group associated in practice with the Contractor, except with the express written consent of the Commanding Officer. The Contractor shall not bill individuals entitled to those services rendered pursuant to this contract.

C.5.7. The Secretary of the Navy has determined that the illegal possession or use of drugs and paraphernalia in a military setting contributes directly to military drug abuse and undermines Command efforts to eliminate drug abuse among military personnel. The policy of the Department of the Navy (including the Marine Corps) is to deter and detect drug offenses on military installations. Measures to be taken to identify drug offenses on military installations, and to prevent introduction of illegal drugs and paraphernalia, include routine random inspection of vehicles while entering or leaving, with drug detection dogs when available, and random inspection of personal possessions on entry or exit. If there is probable cause to believe that a HCW has been engaged in use, possession, or trafficking of drugs, the HCW may be detained for a limited period of time until he/she can be removed from the installation or turned over to local law enforcement personnel having jurisdiction. When illegal drugs are discovered in the course of an inspection or search of a vehicle operated by a HCW, the HCW and vehicle may be detained for a reasonable period of time necessary to surrender the individual and vehicle to appropriate civil law enforcement personnel. Action may be taken to suspend, revoke, or deny clinical privileges as well as installation driving privileges. Implicit with the acceptance of this contract is the agreement by the HCW to comply with all federal and State laws as well as regulations issued by the Commanding Officer of the military installation concerning illegal drugs and paraphernalia.

C.5.8. All financial, statistical, personnel, and technical data which are furnished, produced, or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. Such data shall not be released by the Contractor without prior written consent of the COR. Presentation of any statistical or analytical materials, or reports based on information obtained from studies covered by this contract, will be subject to review and approval by the COR before publication or dissemination.

C.5.9. The Contractor shall comply with all applicable federal, state, and local laws, Department of Defense, Department of Navy, Bureau of Medicine and Surgery, and MTF instructions and policies.

C.5.10. Contract staff shall participate in executing the Emergency Preparedness Plan (drills and actual emergencies) as scheduled by the MTF (typically semiannually). A MTF personnel re-call list with personal contact information for all military, civil service, and Contractor staff is required to prepare in advance for an actual emergency. Upon commencement of performance, the Contractor shall provide the COR with a list of personal contact information for a designated Contractor representative as well as all Contractor staff performing services. The Contractor shall provide an updated list to the COR bimonthly. Should an emergency occur that will affect the HCW shifts, the designated Contractor representative and the HCWs will be contacted. In the event of an actual emergency, essential Contractor personnel may be required to remain on duty or to return to duty in order to maintain continuity of patient care services.

C.5.11. HCWs providing services under this contract shall arrive for each scheduled shift in a well-rested condition.

C.5.12. HCWs who demonstrate a health or safety risk to patients or staff may be immediately removed from service. In the event of such a removal, the Contracting Officer will request a corrective plan of action from the Contractor and may issue a stop work order while the Contractor's response, Contractor's implementation of the plan, and/or any Government investigation is pending. Removal of a HCW for the reasons above does not mitigate the Contractor's obligations under this contract.

C.5.13. Each HCW will be assigned to a primary location; however, unless otherwise specified in the task order, the Government retains the right to assign the HCW to another location within a fifty (50) mile commuting radius of their assigned MTF. Healthcare workers shall receive notification two (2) weeks prior to reassignment to locations within a fifty (50) mile limit.

C.6. PERSONNEL QUALIFICATIONS. The Contractor shall provide personnel having the specified minimum levels of training and experience. General qualifications that apply to all HCWs are given in Section C.7. Specific qualifications for various labor categories are given in Section C.8. Additional and/or supplemental qualifications specific to a particular Task Order are contained in the applicable Task Order. Additional/supplemental qualifications may include, but are not limited to, experience or other professional certifications appropriate to the particular labor category.

C.7. GENERAL QUALIFICATIONS THAT APPLY TO ALL HCWS THROUGHOUT THE DURATION OF THE CONTRACT.

C.7.1. HCWs shall read, write, speak, and understand the English language fluently and maintain good communication skills with patients and other health care personnel.

C.7.2. HCWs shall be physically capable of standing and/or sitting for extended periods of time and physically capable of performing all services required under the task order.

C.7.3. HCWs shall be in good standing and under no sanction or suspension by the Federal Government.

C.7.4. In order to carry out the duties required by the contract, all HCWs will be required to access Navy information technology networks/systems containing sensitive information. Only HCWs who are United States (U.S.) citizens can be granted access to Department of Navy (DON) Information Technology networks/systems and sensitive information (see Section H clause SUP 5252.204-9400 Contractor Unclassified Access to Federally Controlled Facilities, Sensitive Information, Information Technology (IT) Systems or Protected Health Information (July 2013) and Section J, Attachment AA List of Acceptable Documents to Establish U.S. Citizenship).

C.7.5. HCWs shall represent an acceptable malpractice risk to the Government.

C.7.6. HCWs shall be in good standing, and under no restrictions, with the state licensure board in any state in which a license is held or has been held within the last ten (10) years.

C.7.7. Each HCW shall possess and maintain current certification in either the American Heart Association Basic Life Support (BLS) for Healthcare Providers or American Heart Association Healthcare Provider Course. HCWs who do not hold current certification must acquire certification prior to initiating contract performance. Web based classes do not meet these standards. Other certification may be acceptable as specified in the task order. Certification cards must display the American Heart Association or Military Training Network emblem. A copy of the Bureau of Medicine and Surgery (BUMED) BLS instruction (INST) (BUMEDINST 1500.15E CH-1) is available at http://www.med.navy.mil/directives/Pages/BUMEDInstructions.aspx.

C.7.8. HCWs shall be current with and have completed all continuing education requirements specified by their professional licensure or certification. All continuing education documentation shall be submitted to the COR.

C.7.9. Occupational Health

C.7.9.1. Sixty (60) days or less prior to performance of services by the HCW, the HCW shall obtain, at Contractor expense, documentation of required immunizations and physical testing, and a statement from the HCW's licensed medical practitioner or a report of a physical examination. The physical examination and immunization documentation shall indicate that the HCW is free from mental or physical impairments that would restrict the HCW from providing the services described herein. The requirements are provided on the HEALTH EXAMINATION AND IMMUNIZATION/SCREENING REQUIREMENT FORM, the current version of which is available at: http://www.med.navy.mil/sites/nmlc/public_docs/Physical%20Exam%20and%20Immunization%20Form.pdf.

The Contractor shall always obtain the current version from the web page and shall have the form completed in its entirety in accordance with its instructions. The facility shall identify any incumbent HCWs who are not required to complete this documentation after contract award. Declinations shall only be permitted based on either the HCW’s religious convictions or medical contraindications (as documented by a qualified health care provider). The Hepatitis B vaccine declination can be found at http://www.osha.gov/SLTC/etools/hospital/hazards/bbp/declination.html.

C.7.9.1.1. Except for those workers who decline Hepatitis B vaccine as given above, the Hepatitis B requirements given in HEALTH EXAMINATION AND IMMUNIZATION/SCREENING REQUIREMENT FORM provide that a HCW must either show a positive titer or demonstrate persistent non-response to the vaccine. A HCW may be approved for service at the MTF prior to achieving a Hepatitis B positive titer or demonstrating a persistent non-response according to the following provisions:

C.7.9.1.1.1. A HCW must receive the first (1st) vaccination of his/her initial vaccination series prior to commencing service under the contract and must complete the series not later than six (6) months after commencing service and, if a negative titer is obtained, must complete the second (2nd) series within another six (6) months; or

C.7.9.1.1.2. A HCW who has completed his/her initial series and obtained a negative titer must commence his/her second (2nd) vaccine series prior to commencing service and must complete the second (2nd) series not later than six (6) months after commencing service.

C.7.9.1.2. HCWs approved according to the provisions above will be considered persistent non-responders until there is evidence to the contrary and will be counseled by a licensed practitioner regarding the implications of non-response.

C.7.9.1.3. If a HCW fails to comply with the applicable schedule above, the Contractor shall replace the HCW if so directed by the Contracting Officer.

C.7.9.2. Except as provided in Section C.7.9.3 and C.7.9.4. below, no medical tests or procedures required by the contract may be performed in the MTF. Expenses for all required tests and/or procedures shall be borne by the Contractor at no additional expense to the Government.

C.7.9.3. HCWs shall agree to undergo personal health examinations and such other medical and dental examinations at any time during the term of this contract, as the Commanding Officer may deem necessary for preventive medicine, medical surveillance, performance improvement, or privileging purposes. These examinations will be provided by the Government. If the Contractor chooses, these examinations may be provided by private physician or dentist, at no expense to the Government.

C.7.9.4. It is essential that HCWs be vaccinated annually against influenza according to BUMED and Centers for Disease Control and Prevention (CDC) guidelines aimed at reducing the impact of influenza disease in health care settings. The Government will provide the influenza vaccine free of charge. If the HCW chooses to be immunized by the Government, the HCW shall sign a waiver releasing the Government from legal liability in accordance with local procedures and policies. Alternately, the HCW may obtain the vaccine at another facility, with the HCW bearing the total cost, and provide proof of vaccination to the Government. If the HCW declines vaccination, a signed declination form shall be provided to the Government in accordance with CDC recommendations and MTF policies.

C.7.9.5. HCWs who do not show a positive antibody titer after immunization and appear to have a "non-immune" status must report varicella exposure to the COR. In accordance with CDC Recommendations, such HCWs may be removed from patient care duties beginning on the tenth (10th) day following exposure and remain away from work for the maximum incubation period of varicella (twenty one (21) days). In this instance, personnel under this contract who accrue leave will be considered to be in a leave status.

C.7.9.6. Prior to reporting for service at a MTF, each contract HCW shall be screened at Contractor expense for risk of exposure to tuberculosis (TB) as part of the Health Examination and Immunization/Screening Requirement Form in C.7.9.1. If the HCW is determined to have a low risk of exposure, no further screening or testing is required under this contract. The initial screening may be waived, at the discretion of the MTF, if the Contractor provides evidence of a prior low risk assessment by a licensed physician. If the initial screening results in a determination that the HCW has an increased risk of exposure to TB, the Contractor is responsible for ensuring that the HCW receives targeted screening and testing in accordance with CDC Guidelines for Health-Care Settings and submitting timely records of subsequent screening or testing to the COR.

C.7.9.7. BLOODBORNE PATHOGEN ORIENTATION PROGRAM. HCWs shall participate in the Command’s Bloodborne Pathogen Orientation Program. The HCW shall also participate in all required annual training and in periodic training for all procedures that have the potential for occupational exposure to bloodborne pathogens.

C.7.9.8. MANAGEMENT OF HIV POSITIVE HCWs. Human Immunodeficiency virus (HIV) positive HCWs will be managed in accordance with the current CDC guidelines and Section 503 of the Rehabilitation Act (29 U.S.C. 793) and its implementing regulations (41 Code of Federal Regulations (CFR) Part 60-741).

C.7.9.9. PREVENTION OF THE TRANSMISSION OF THE HIV VIRUS. HCWs shall comply with the CDC’s “Universal Precautions” for the prevention of the transmission of the HIV virus.

C.7.9.10. MANAGING THE…