4.02 N6817120Q2022 RFQ.pdf

SEE ADDENDUM

(No Collect Calls)

N6817120Q2022 28-Feb-2020

b. TELEPHONE NUMBER

39-095-86-5721

8. OFFER DUE DATE/LOCAL TIME

12:00 PM 11 Mar 2020

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

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 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.

N681719. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

DANA M. RAINS

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

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

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

N6610120RCPA700

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

NAVSUP FLC SIGONELLA PURCHASING OFFICE

PSC 812 BOX 3560,

CODE 200

FPO AE 09627-3560

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 N66101 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

NAVAL HOSPITAL ROTA

COMMANDING OFFICER

US NAVAL HOSPITAL ROTA, SPAIN PSC 819 BOX 18

FPO AE 09645

TEL: FAX:

FAX:

TEL: SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$8,000,000

NAICS:

621399

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 OF56

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.

N6817120Q2022

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 2,080 Hours Full Time Medical Clerk

FFP

Full Time Medical Clerk as per SOW

FOB: Destination

PURCHASE REQUEST NUMBER: N6610120RCPA700

PSC CD: Q802

NET AMT

1001 2,080 Hours OPTION Full Time Medical Clerk

FFP

Full Time Medical Clerk as per SOW

FOB: Destination

2001 2,080 Hours OPTION Full Time Medical Clerk

FFP

Full Time Medical Clerk as per SOW

FOB: Destination

3001 1,040 Hours OPTION Medical Clerk (6 month extension)

FFP

Full Time Medical Clerk as per SOW (6 month extension)

FOB: Destination

PWS

PERFORMANCE WORK STATEMENT (PWS)

CLEAR AND LEGIBLE REPORTING SERVICES AT NAVAL HOSPITAL ROTA SPAIN

Part 1

General Information

1. GENERAL: This is a non-personnel services contract to provide clear and legible reporting service. The

Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.1 Description of Services/Introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform clear and legible reporting service as defined in this Performance Work Statement except for those items specified as government furnished property and services.

1.2 Background: Implementation of the next generation Tricare contracts (T-3) has necessitated changes in referral/consultation processing. The tracking, managing and obtaining of results (commonly referred to as clear and legible reports, (CLRs)), for referrals to and from civilian providers, is the sole responsibility of the respective medical treatment facility (MTF). Additionally, MTFs must provide reports for care rendered within the MTF, as a result of a Right of First Refusal, to the referring civilian provider.

The Joint Commission requires that all referrals be tracked and accounted. The Accreditation Association for

Ambulatory Health Care requires that reports, histories and physicals, progress notes and other patient information

(such as laboratory reports, x-ray readings, operative reports, and consultations) are reviewed and incorporated into the record in a timely manner. Network providers must provide clearly legible reports (CLRs)—which include consultation reports, operative reports and discharge summaries—to the referring military treatment facility (MTF).

The CLRs contain a patient's identifying information such as date of birth, name, sponsor SSN, etc. The requirement to submit CLRs applies to care referred from an MTF and assists the MTF in meeting The Joint Commission requirements

1.3 Objectives:

Support is required to provide administrative support services to facilitate processing of Clear and Legible

Reporting requirements.

Support uniform business office

Support access to Care Objectives

Support Quality patient care

1.4 Scope: The scope of the services involves the administrative review of all incoming CLRs for accuracy, completeness, and legibility and posting of consultation reports for patients referred both to and from civilian network providers. Services include if an incoming report does not meet the CLR standards, the civilian physician's office must be contacted for an acceptable report. The contractor shall notify MTF providers when a CLR is posted;

monitor timelines of incoming CLRs. During the initial contract period of performance the contractor shall initiate chase for delinquent CLRs. The contractor shall provide CLR receipts validation and shall cross-check referral authorizations against claims adjudicated. The contractor shall accomplish the contractor shall ensure that all network referral CLRs have correct disposition or are annotated as a non-appointed referral. The contractor shall track all consult updates or status changes per the TRICARE contractor’s referral authorization process, and shall track and document customer feedback in CHCS/AHLTA/Referral Tracking databases/Audio Communicator

Reports.

1.4.1 SPECIFIC TASKS:

1.4.1.1 Basic Services. The contractor shall provide administrative support services to facilitate processing of Clear and Legible Reporting requirements at Navy Medical Treatment Facilities

1.4.1.2 Performance Requirements.

i. The contractor shall complete referrals within the Medical Treatment Facility (MTF); shall identify problem areas and provide guidance to staff to correct errors; and shall advise MTF RMC (Referral Management Center) staff on referral tracking procedures

ii. All specialty care and Right of First Refusal (ROFR) referrals/consults shall be managed per current TMA

(Tricare Management Activity), Tricare Regional Contractor, and MTF referral management policies and guidance.

All specialty care referrals will be appointed to the MTF/Direct Care System within prescribed ATC Standards or referred to the local network.

iii. Complete routine periodic reports that include, for example, percentage of referrals that are verified or closed correctly, and ensure all referrals that are deferred to the network are appropriately closed, i.e. results obtained or facility administratively closed the referral.

iv. The contractor shall properly document patient responses in CHCS, AHLTA, and the Referral Management

System/Referral Management System Tracking Reports; shall provide notification to the referring provider of patient requests to cancel referrals.

v. The contractor shall retrieve referrals sent from the TRICARE Regional Contractor and apply processes necessary for acceptance or denial by the MTF. The contractor should proactively seek assistance when indicated by guidelines, Standard Operating Procedures and/or when questions arise. The contractor shall maintain a customer centered focus in all activities.

vi. The contractor shall contact civilian provider offices to determine if patient was seen and if so, acquire referral results; shall properly close referrals in CHCS and the Referral Management System/Referral Management System

Tracking Reports appropriately and shall forward an informational advisement of the referral status to the initiating

MTF provider or PCM (Primary Care Manager). If patient is not seen in a civilian office, the contractor shall contact the patient to assist the patient in completing their care. Contacts shall be documented per MTF instruction.

vii. The contractor shall assist with the return of completed consult reports to civilian providers for patients seen within the MTF under the Right of First Refusal (ROFR). ROFRs shall be processed within the time limits outlined in the TRICARE Operations Manual, Chapter 8, section 5.

viii. The contractor shall establish/maintain suspense files for referrals deferred to network and shall compile and maintain data for reporting and tracking purposes.

ix. Automated systems utilized include CHCS, DEERS, and TRICARE Managed Care Support Contractor databases. The contractor shall use electronic fax or other designated systems to receive and download all results generated by the TRICARE Contractor to meet contract requirements. The contractor shall use various software applications to record, retrieve, correct, merge, query or print data and/or reports and shall maintain files on contact information for civilian medical facilities.

1.5 Period of Performance: The period of performance shall be for one (1) Base Year of 12 months and two (2)

12-month option years.

1.6 General Information

1.6.1 Recognized Holidays: Services will not be required on local Holidays and Special Liberty (96) Leave, etc.

Contractor shall not to be reimbursed for days not requiring services.

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

1.6.2 Hours of Operation: The contractor is responsible for conducting business, between the hours of 0730 to 1630

Monday thru Friday except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings. The contractor will not be reimbursed when the government facility is closed for the above reasons.

1.6.3 Place/Period of Performance: The work to be performed under this contract will be performed at Naval

Hospital Rota Spain, Official Referral Office. The period of performance shall be for one (1) Base Year of 12 months and two (2) 12-month option years.

1.6.4 Type of Contract: The government will award firm fixed price contract.

1.6.5 Security Requirements: Contractor personnel performing work under this contract must have a favorable

National Agency Check (NAC) at time of the quote submission, and must maintain the level of security required for the life of the contract. All contractor personnel with access to PII must complete an SF86. The Navy Command’s

Security Manager will forward the required forms to Office of Personnel Management (OPM) for processing. Once the investigation is complete, the results will be forwarded by OPM to the Department of Navy (DON) Central

Adjudication Facility (CAF) for an eligibility determination.

1.6.5.1 Medical Contractor Access to Federally Controlled Facilities and/or Unclassified Sensitive Information or

Unclassified IT Systems (DEC 2011) This clause applies to contractor employees requiring physical access to any area of a federally controlled base, facility or activity and/or requiring access to Privacy Act information on a DoD computer/network. It is the responsibility of the command/facility where the work is performed to ensure compliance.

1.6.5.2 Each contract health care worker providing services at a Navy command under this contract is required to obtain a Common Access Card. Additionally, depending on the level of computer/network access, that contract health care worker will also require a successful investigation as detailed below.

1.6.5.3 Homeland Security Presidential Directive (HSPD)-12, requires government agencies to develop and implement Federal security standards for Federal employees and contractors. The Deputy Secretary of Defense

Directive-Type Memorandum (DTM) 08-006 – “DoD Implementation of Homeland Security Presidential Directive

– 12 (HSPD-12)” dated November 26, 2008 (or its subsequent DoD instruction) and Navy implementing memorandum dated May 28, 2010 direct implementation of HSPD-12. This clause is in accordance with HSPD-12 and its implementing directives. Per HSPD-12 and implementing guidance, all contract health care workers working at a federally controlled base, facility or activity under this clause will require a Common Access Card.

1.6.5.4 In accordance with SECNAV M-5510.30, contractors who require access to DoD networks are categorized as IT-I, IT-II, or IT-III. This clause applies to contractors who require IT-II privileged access to a DoN or DoD unclassified computer/network; the IT-II level, defined in detail in SECNAV M-5510.30, includes positions which require access to information protected under the Privacy Act, to include Protected Health Information (PHI) . All contract health care worker positions under this contract require access to Privacy Act protected information and are therefore categorized as no lower than IT-II.

1.6.5.4.1 To obtain a favorable determination, each contractor employee must have a favorably completed National

Agency Check with Local Credit Checks (NACLC) which consists of a NACI including a FBI fingerprint check plus credit and law enforcement checks. Each contractor employee is required to complete:

• SF-86 Questionnaire for National Security Positions (or equivalent OPM investigative product)

• Two FD-258 Applicant Fingerprint Cards

• Original Signed Release Statements

System Authorization Access Request Navy (SAAR-N)

The Contractor’s Security Representative shall ensure that each contractor employee pending assignment shall accurately complete the required forms for submission to the Navy Command Security Manager. Failure to provide the required documentation at least 30 days prior to the contract start date shall result in delaying the contract award.

To maintain continuing authorization for an employee to access Privacy Act information on a DoD unclassified computer/network, the contractor shall ensure that the individual employee has a current requisite background investigation. The Contractor’s Security Representative shall be responsible for initiating reinvestigations as required and ensuring that background investigations remain current (not older than 10 years) throughout the contract performance period. The Contractor’s Security Representative shall screen the investigative questionnaires for completeness and accuracy and for potential suitability/security issues prior to submitting the request to the Navy

Command’s Security Manager. Forms and fingerprint cards may be obtained from the Navy Command’s Security

Manager. The Navy Command’s Security Manager will forward the required forms to OPM for processing. Once the investigation is complete, the results will be forwarded by OPM to the DOD Central Adjudication Facility

(CAF) for an eligibility determination.

The contractor shall ensure that all employees requiring access to IT systems/networks complete annual Information

Assurance (IA) training, and maintain a current requisite background investigation.

The vendor selected individual shall in-process with the Navy Command’s Security Manager and Information

Assurance Manager upon arrival to the Navy command and shall out-process prior to their departure at the completion of the individual’s performance under the contract. Completion and approval of a System Authorization

Access Request Navy (SAAR-N) form is required for all individuals accessing Navy Information Technology resources. The SAAR-N shall be forwarded to the Navy Command’s Security Manager at least 30 days prior to the contract start date by Contractor’s Security Representative.

1.6.5.4.2 Denial of access. Upon receipt of required forms, the Navy Command’s Security Manager will review the submitted documentation for completeness and accuracy prior to submitting it to the Office of Personnel

Management (OPM). Suitability/security issues identified by the Navy may render the contract employee ineligible for the assignment. An unfavorable determination made by the Navy is final (subject to SF 86 appeal procedures) and such a determination does not relieve the contractor from meeting any contractual obligation under the contract.

If contractor employees already possess a current favorably adjudicated investigation, the Navy Command’s

Security Manager will use the Visit Authorization Request (VAR) via the Joint Personnel Adjudication System

(JPAS). The contractor shall include the IT Position Category per SECNAV M-5510.30 for each employee designated on a VAR. The VAR requires annual renewal for the duration of the employee’s performance under the contract. Denial of physical or system access does not relieve the contractor from the requirement to execute performance under the contract within the timeframes specified in the contract. Contractors shall plan ahead in processing their employees and subcontractor employees. The contractor shall insert this clause in all subcontracts when the subcontractor is permitted to have physical access to a federally controlled facility and/or access to a federally-controlled information system/network and/or access to government information.

1.6.5.4.3 Interim access. The Navy Command's Security Manager may authorize issuance of a CAC card and interim access to a DoN or DoD unclassified computer/network upon a favorable review of the SF-86 questionnaire and advance fingerprint results. When the results of the investigation are received and a favorable determination is not made, contractor employees working on the contract under interim access shall be removed immediately and will no longer be authorized to work on the contract.

1.6.5.5 HIPAA privacy and security business associate agreement Department of Defense. In accordance with DoD

6025.18-R “Department of Defense Health Information Privacy Regulation,” January 24, 2003, the Contractor meets the definition of Business Associate. Therefore, a Business Associate Agreement is required to comply with both the

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

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

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

Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160 and part 164, subparts A and E.

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

160.103, limited to the information created or received by the Contractor from or on behalf of the

Government pursuant to the Contract.

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

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

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

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

164 subpart C.

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

CFR 160.103, 164.501 and 164.304.

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

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

Information other than as provided for by this Contract.

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

(e) The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the

Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Clause.

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

(g) The Contractor shall report to the Government any use or disclosure of the Protected Health

Information not provided for by this Contract of which the Contractor becomes aware.

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

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

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

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

(j) The Contractor shall provide access, at the request of the Government, and in the time and manner reasonably designated by the Government to Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524.

(k) The Contractor shall make any amendment(s) to Protected Health Information in a Designated Record

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

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

Protected Health Information received from, or created or received by the Contractor, on behalf of the

Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner reasonably designated by the Government or the Secretary, for purposes of the Secretary determining the Government’s compliance with the Privacy Rule.

(m) The Contractor shall document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an

Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR

164.528.

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

Protected Health Information in accordance with 45 CFR 164.528.

General Use and Disclosure Provisions

Except as otherwise limited in this Clause, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health

Information would not violate the HIPAA Privacy Rule, the HIPAA Security Rule, DoD 6025.18-R or DoD

8580.02-R if done by the Government.

Specific Use and Disclosure Provisions

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

Contractor.

(b) Except as otherwise limited in this Clause, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of the information has been breached.

(c) Except as otherwise limited in this Clause, the Contractor may use Protected Health Information to provide Data Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B).

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

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

Obligations of the Government

Provisions for the Government to Inform the Contractor of Privacy Practices and Restrictions

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

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

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

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

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

Permissible Requests by the Government

The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the HIPAA Privacy Rule, the HIPAA Security Rule, or any applicable

Government regulations (including without limitation, DoD 6025.18-R and DoD 8580.02-R) if done by the

Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause.

Termination

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

(b) Effect of Termination.

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

(2) If this contract does not have records management requirements, except as provided in paragraph (3) of this section, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to Protected

Health Information that is in the possession of subcontractors or agents of the Contractor. The

Contractor shall retain no copies of the Protected Health Information.

(3) If this contract does not have records management provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected Health Information.

Miscellaneous

(a) Regulatory References. A reference in this Clause to a section in DoD 6025.18-R, DoD 8580.02-R, Privacy Rule or Security Rule means the section currently in effect or as amended, and for which compliance is required.

(b) Survival. The respective rights and obligations of Business Associate under the “Effect of Termination” provision of this Clause shall survive the termination of this Contract.

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

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

Security Rule.

1.6.5.6 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.

1.6.5.7 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 Quality Control Plan. 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 Contracting Officer.

1.6.5.7.1. In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the

Contracting Officer, 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.

1.6.5.7.2. 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 Contracting Officer.

1.6.5.8 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 Quality Control Plan.

1.6.6 Qualifications:

a. High School Diploma or equivalency certificate.

b. Two letters of recommendation.

c. Possess or able to obtain a CONFIDENTIAL Clearance.

d. Locally available for at least two years.

e. Proficiency with database inputs, queries, searches and reports.

f. Demonstrated fluency with the Microsoft Office Suite.

g. Be a US Citizen only.

h. Possess access to Naval Station Rota, Spain.

i. Demonstrated ability to type 50+ words per minute.

j. Fluent in the Host Nation medical language both verbally and written

k. Authorized to work on NAVSTA Rota, Spain

1.6.7 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 contracting officer, Contracting Officers Representative (COR), and other

Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer 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.

1.6.8 Identification of Contractor Employees: All contract personnel attending meetings, answering Government telephones, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are

Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed. Contractor is required to wear I.D badge that states contractor status and full name and office.

1.6.9 Data Rights: The Government has unlimited rights to all documents/material produced under this contract.

All documents and materials, to include the source codes of any software, produced under this contract shall be

Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the contractor without written permission from the Contracting Officer. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other

Government rights.

1.6.10 Organizational Conflict of Interest: Contractor and subcontractor personnel performing work under this contract may receive, have access to or participate in the development of proprietary or source selection information

(e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational Conflict of Interests (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the

Contracting Officer to avoid or mitigate any such OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may effect other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the OCI.

PART 2

DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.1.1. CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.2. CONTRACTING OFFICER. A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.3. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4. DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.1.5. DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.1.6. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.7. PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.1.8. QUALITY ASSURANCE. The government procedures to verify that services being performed by the

Contractor are performed according to acceptable standards.

2.1.9. QUALITY ASSURANCE Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.11. SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.1.12. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.12. WORK WEEK. Monday through Friday, unless specified otherwise.

2.2. ACRONYMS:

ACOR Alternate Contracting Officer's Representative

AFARS Army Federal Acquisition Regulation Supplement

AR Army Regulation

CCE Contracting Center of Excellence

CFR Code of Federal Regulations

CONUS Continental United States (excludes Alaska and Hawaii)

COR Contracting Officer Representative

COTR Contracting Officer's Technical Representative

COTS Commercial-Off-the-Shelf

DA Department of the Army

DD250 Department of Defense Form 250 (Receiving Report)

DD254 Department of Defense Contract Security Requirement List

DFARS Defense Federal Acquisition Regulation Supplement

DMDC Defense Manpower Data Center

DOD Department of Defense

FAR Federal Acquisition Regulation

HIPAA Health Insurance Portability and Accountability Act of 1996

KO Contracting Officer

OCI Organizational Conflict of Interest

OCONUS Outside Continental United States (includes Alaska and Hawaii)

ODC Other Direct Costs

PIPO Phase In/Phase Out

POC Point of Contact

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 Program

TE Technical Exhibit

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. The Government will provide adequate working space in Government facilities, all equipment (e.g., desk, chair, computer, printer, copier, telephone, etc.), utilities, janitorial services and expendable operating supplies for the duration of this task order. The contractor shall maintain the assigned office space in a neat and orderly manner.

Personal or company use of phones, utilities, computers, printers, copiers, etc., not directly related to required services is strictly prohibited. Contractor shall not remove any government-furnished equipment or supplies from the worksite without the express written permission of the Contracting Officer’s Representative or his/her designated representative.

PART 4

SPECIFIC TASKS

4. SPECIFIC TASKS: The vendor shall perform the specific tasks associated with this contract, as outlined in section 1.4.1 of this document.

PART 5

APPLICABLE PUBLICATIONS

5. APPLICABLE PUBLICATIONS (CURRENT EDITIONS)

5.1. The Contractor must abide by all applicable regulations, publications, manuals, and local policies and procedures.

Mandatory Compliance List

Document Source No./Version Title http://www.med.navy.mil/policy-guidance/Documents/NAVMED%20POLICY%2009-

004.pdf

12 Mar 2009 Access to Care Management Policy for Navy

Medicine Treatment Facilities http://manuals.tricare.osd.mil/

2008 Tricare Programs Manual

Chapter 7 and Chapter 8, Section 5.

guidance/Pages/PG2011.aspx

2011 Supplement to NAVMED Policy 11-002 - Entering CLR Results in AHLTA ver. 2 guidance/Pages/PG2011.aspx

2011 Implementation Of The Integrated Clinical

Database (ICBD)/Referral Management

System Tracking Report (RMSTR) For Clear And Legible Reporting (CLR)

PART 6

ATTACHMENT/TECHNICAL EXHIBIT LISTING

6.0 Attachment/Technical Exhibit List:

6.1 Attachment 1/Technical Exhibit 2 – Deliverables Schedule

7.1. 6.2 Attachment 2/Technical Exhibit 3 – Estimated Workload Data http://www.med.navy.mil/policy-guidance/Documents/NAVMED%20POLICY%2009-004.pdf http://www.med.navy.mil/policy-guidance/Documents/NAVMED%20POLICY%2009-004.pdf http://www.med.navy.mil/policy-guidance/Documents/NAVMED%20POLICY%2009-004.pdf http://manuals.tricare.osd.mil/ http://www.med.navy.mil/policy-guidance/Pages/PG2011.aspx http://www.med.navy.mil/policy-guidance/Pages/PG2011.aspx http://www.med.navy.mil/policy-guidance/Pages/PG2011.aspx http://www.med.navy.mil/policy-guidance/Pages/PG2011.aspx

TECHNICAL EXHIBIT 1

DELIVERABLES SCHEDULE

PERFORMANCE

ELEMENT

PERFORMANCE

REQUIREMENT

SURVEILLANCE

METHOD

ACCEPTABLE

QUALITY LEVEL

INCENTIVES/

DISINCENTIVES

Personnel Qualified staff provided within the timeframes specified in the task orders.

Verification by the

Government POC.

> 95% of the task order start dates are met by staff qualified to meet the specified task objectives.

Past performance will be considered in determining best value for future task order awards.

Contract Deliverables Contract deliverables furnished as prescribed in the

PWS, CDRLs, and task orders.

Verification by the

Government POC.

> 95% of deliverables submitted timely and without rework required.

Past performance will be considered in determining best value for future task order awards.

Overall Contract

Performance

Overall contract performance of sufficient quality to earn a Satisfactory

(or higher) rating in the COR's annual performance report.

Assessment by the

Government POC.

All performance elements rated

Satisfactory (or higher).

Past performance will be considered in determining best value for future task order awards.

Invoices

Invoices in accordance with contract procedures are timely and accurate.

Review and acceptance of the invoice

100% of the invoices are timely and accurate.

Past performance will be considered in determining best value for future task order awards.

TECHNICAL EXHIBIT 2

ESTIMATED WORKLOAD DATA

MONTH TOTAL PER MONTH MONTH TOTAL PER MONTH

MAR-16 101 JAN-17 229

APR -16 143 FEB-17 231

MAY-16 207 MAR-17 202

JUN-16 149 APR-17 228

JUL-16 187 MAY-17 254

AUG-16 199 JUN-17 201

SEP-16 189 JULY-17 236

OCT-16 319 AUG-17 247

NOV-16 236

DEC-16 143

ECMRA

CONTRACTOR MANPOWER REPORTING LANGUAGE for PWS/SOW "The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Naval Hospital in Rota Spain via a secure data collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013. Contractors may direct questions to the help desk at help desk at: http://www.ecmra.mil/''.

INVOICES AND PAYMENTS:

Refer to WAWF Clause 252.232-7006.

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

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 POP 23-MAR-2020 TO

22-MAR-2021

N/A NAVAL HOSPITAL ROTA

COMMANDING OFFICER

US NAVAL HOSPITAL ROTA, SPAIN PSC

819 BOX 18

FPO AE 09645

N66101

1001 POP 23-MAR-2021 TO

22-FEB-2022

N/A (SAME AS PREVIOUS LOCATION)

2001 POP 23-MAR-2022 TO

22-MAR-2023

N/A (SAME AS PREVIOUS LOCATION)

3001 POP 23-MAR-2022 TO

22-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

http://www.ecmra.mil/ http://www.ecmra.mil/

CLAUSES INCORPORATED BY REFERENCE

52.204-7 System for Award Management OCT 2018

52.204-13 System for Award Management Maintenance OCT 2018

52.204-16 Commercial and Government Entity Code Reporting JUL 2016

52.204-17 Ownership or Control of Offeror JUL 2016

52.204-18 Commercial and Government Entity Code Maintenance JUL 2016

52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.204-24 Representation Regarding Certain Telecommunications and

Video Surveillance Services or Equipment.

DEC 2019

52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

AUG 2019

52.212-1 Instructions to Offerors--Commercial Items OCT 2018

52.225-14 Inconsistency Between English Version And Translation Of

Contract

FEB 2000

52.225-25 Prohibition on Contracting with Entities Engaging in Certain

Activities or Transactions Relating to Iran-- Representation and Certifications.

AUG 2018

52.232-18 Availability Of Funds APR 1984

52.232-39 Unenforceability of Unauthorized Obligations JUN 2013

52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.237-3 Continuity Of Services JAN 1991

252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7002 Requirement to Inform Employees of Whistleblower Rights SEP 2013

252.204-7003 Control Of Government Personnel Work Product APR 1992

252.204-7008 Compliance With Safeguarding Covered Defense Information

Controls

OCT 2016

252.204-7012 Safeguarding Covered Defense Information and Cyber

Incident Reporting

DEC 2019

252.204-7015 Notice of Authorized Disclosure of Information for Litigation

Support

MAY 2016

252.204-7016 Covered Defense Telecommunications Equipment or Services

-- Representation

DEC 2019

252.204-7017 Prohibition on the Acquisition of Covered Defense

Telecommunications Equipment or Services -- Representation

DEC 2019

252.204-7018 Prohibition on the Acquisition of Covered Defense

Telecommunications Equipment or Services

DEC 2019

252.222-7002 Compliance With Local Labor Laws (Overseas) JUN 1997

252.225-7041 Correspondence in English JUN 1997

252.225-7043 Antiterrorism/Force Protection Policy for Defense

Contractors Outside the United States

JUN 2015

252.225-7048 Export-Controlled Items JUN 2013

252.228-7006 Compliance With Spanish Laws and Insurance DEC 1998

252.229-7000 Invoices Exclusive of Taxes or Duties JUN 1997

252.229-7005 Tax Exemptions (Spain) MAR 2012

252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

DEC 2018

252.232-7007 Limitation Of Government's Obligation APR 2014

252.232-7008 Assignment of Claims (Overseas) JUN 1997

252.232-7010 Levies on Contract Payments DEC 2006

252.233-7001 Choice of Law (Overseas) JUN 1997

252.233-7001 Choice of Law (Overseas) JUN 1997

252.237-7010 Prohibition on Interrogation of Detainees by Contractor

Personnel

JUN 2013

252.244-7000 Subcontracts for Commercial Items JUN 2013

252.247-7023 Transportation of Supplies by Sea FEB 2019

CLAUSES INCORPORATED BY FULL TEXT

52.204-20 Predecessor of Offeror (JUL 2016)

(a) Definitions. As used in this provision--

Commercial and Government Entity (CAGE) code means--

(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics

Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity;

or

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement…