OCONUS Dental Services Draft PWS.pdf

PERFORMANCE WORK STATEMENT

DENTAL SERVICES

OCONUS

1. SCOPE OF WORK.

1.1. GENERAL. The contractor shall provide dental services of a nature and scope described in this Performance Work Statement (PWS) in accordance with (IAW) the precepts of the American Dental Association (ADA), The Joint Commission (JC) Manual, American Association of Orthodontists, American Association of Pediatric Dentistry, and the professional standards at the Dental Activity (DENTAC) where services are provided. The contractor shall perform all dental services IAW ethical, professional, and technical standards. The contractor shall provide services to eligible beneficiaries of the military health care system as authorized by Army Regulation (AR) 40-400, Patient Administration, 8 July 2014.

1.2. This contract is a personal services contract that allows an employer-employee relationship between the Government and the individual contract health care providers (HCPs) only to the extent necessary for providing the healthcare services required under this contract. The performance of healthcare services by the individual contract health care providers under a personal services contract are subject to day-to-day supervision and control by healthcare facility personnel comparable to that exercised over military and civil service health care providers engaged in comparable healthcare services. Any personal injury claims alleging negligence by the individual contract health care providers within the scope of the health care provider’s performance of the personal services contract shall be processed by Department of Defense (DoD) in the same manner as claims alleging negligence by DoD military or civil service health care providers. The 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 contract health care provider may be associated. The authority for this contract is 10 United States Code 1089 and 10 United States Code 1091.

1.2.1. Professional Liability.

1.2.1.1. Pursuant to 10 USC 1089(a), DoD shall process any personal injury claim alleging negligence by the health care provider (HCP) within the scope of the HCP’s performance under this contract as claims alleging negligence by DoD military or civil service HCP. The contractor or HCP is not required to maintain medical malpractice liability insurance, and the Government will not reimburse or otherwise pay for such insurance should any be purchased.

1.2.2. Responsibility and Procedures.

1.2.2.1. If any suit or action is filed or any claim is made against the contract HCP, which occurred as a result of work performed by the HCP under this contract, the HCP shall immediately notify the contractor, the contracting officer and the chief of the appropriate services and promptly furnish them copies of all pertinent documents received.

1.2.2.2. The contractor and contract HCP shall cooperate with the government, without further compensation, in the processing, review, settlement, or defense of the suit, action, or claim; and authorize government representatives to settle or defend the claim and to represent the HCP in, or take charge of, any litigation involved in such an action.

The contract HCP may, at the contract HCP’s own expense, participate in defense of such claim or litigation.

1.3. To support the DoD base redevelopment and realignment initiatives, it may be necessary to delete or add specialties and/or locations to this contract as required, including dental specialists not currently listed in this PWS.

Changes in current requirements shall be executed by modification to the basic contract.

1.4. The contractor shall comply with OTSG/MEDCOM Policy Memo 16-033, OTSG/MEDCOM Policy Memo 16- 033, Sexual Harassment/Assault Response and Prevention (SHARP) Program, 29 March 2016. The SHARP reporting requirements apply only to knowledge obtained by contractor personnel while performing services under this contract.

1.4.1 The contractor shall require all Contract Service Providers (CSP) with knowledge of an incident of sexual assault occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

1.4.2.The contractor shall require all CSPs with knowledge of an incident of sexual harassment occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

2. GENERAL QUALIFICATIONS:

2.1. All services provided herein shall be provided by various dentists and ancillary personnel. All personal services contract health care providers must maintain a current, active, valid and unrestricted license or authorizing document from any U.S. state, District of Columbia; or U.S. territory or jurisdiction to provide health care within the scope of practice for a specific health care discipline. All contractor employees performing under this contract shall be capable of performing the full range of dental services commensurate with the dental specialty designated.

2.1.1. All contract employees shall speak, read, and write the English language well enough to effectively communicate with all eligible beneficiaries of the military health care system and other care providers.

2.2 General Dentists. Shall be graduates of accredited dental schools approved by the Commission on Dental Accreditation (CODA) of the American Dental Association (ADA) with either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. Shall possess a current, active, valid, and unrestricted license in at least one of the 50 states, and/or the District of Columbia, the Commonwealth of Puerto Rico, or territories of the United States. The license must remain current, active, valid, and unrestricted during the life of the contract. Drug Enforcement Administration (DEA) certification is not required; however, providers possessing a DEA registration number (certificate) current at the time of contract award must provide documentation (renewal is not mandatory).

Shall have practiced dentistry for at least two (2) years on a full time basis and have practiced for a minimum of one

(1) year within the past three (3) years or be a recent (1- year) graduate of an accredited postgraduate dentistry-training program.

2.2.1. Scope of General Dentist practice. Performs a full range of professional dental treatment to include treatment of commonly encountered dental diseases or dental health problems requiring standard corrective, restorative or preventive measures such as single and multiple tooth extractions, restoration of simple and compound cavities with standard and prescribed material, prosthodontics such as crowns, dentures and bridges. Strictly adheres to patient safety standards. Documents patient treatment in the dental treatment record and utilizes the Corporate Dental Application (CDA) to enter patient specific workload, readiness status and patient scheduling.

2.3. Orthodontists. Shall be graduates of a dental specialty training program that is accredited by the CODA of the ADA. Shall possess a current, active, valid, and unrestricted license in at least one of the 50 states, and/or the District of Columbia, the Commonwealth of Puerto Rico, or territories of the United States. The license must remain current, active, valid, and unrestricted during the life of the contract. Drug Enforcement Administration (DEA) certification is not required; however, providers possessing a DEA registration number (certificate) current at the time of contract award must provide documentation (renewal is not mandatory). Shall have been employed for at least one (1) year on a full-time basis in the practice of orthodontics and have practiced orthodontics for a minimum of one (1) year within the past three (3) years.

2.3.1 Scope of orthodontic practice. Responsible for the diagnosis, prevention and treatment of dental and facial irregularities. Diagnoses, prevents, intercepts and corrects malocclusion and neuromuscular/skeletal abnormalities of the developing or mature orofacial structures. Applies knowledge of orthodontics and dentofacial orthopedics to straighten teeth and align jaws. Strictly adheres to patient safety standards. Documents patient treatment in the dental treatment record and utilizes the CDA to enter patient specific workload, readiness status and patient scheduling.

2.4. Pediatric Dentists. Shall have completed at least a 2-year residency, in an ADA-accredited DDS or DMD postgraduate program in pediatric dentistry. Shall possess a current, active, valid, and unrestricted license in at least one of the 50 states, and/or the District of Columbia, the Commonwealth of Puerto Rico, or territories of the United States. The license must remain current, active, valid, and unrestricted during the life of the contract. Drug Enforcement Administration (DEA) certification is not required; however, providers possessing a DEA registration number (certificate) current at the time of contract award must provide documentation (renewal is not mandatory).

Shall have been employed for at least one (1) year on a full-time basis as a pediatric dentist and have practiced for a minimum of one (1) year within the past three (3) years. Shall provide the full scope of care, to include both nitrous oxide and conscious sedation. Shall be capable of performing pediatric dental services in an operating room and be certified in both Basic Life Support (BLS) and Pediatric Advanced Life Support (PALS).

2.4.1 Scope of Pediatric Dentist practice. Applies knowledge of child psychology, oral pathology, pharmacology, radiology, pediatric specific restorative and surgical techniques, interceptive orthodontic diagnosis and procedures, and child development to provide comprehensive treatment and therapeutic oral health care for infants and children through adolescence. Performs advanced diagnostic and surgical procedures to include appropriate restorative techniques such as stainless steel crowns, pulp therapy to include pulpotomy, pulpectomy, and apexigenesis, fixed and removable space maintainer design, fabrication, and insertion, early interceptive orthodontic appliance design, fabrication, and insertion of appliances such as TPA’s, RPE’s, LLA’s, W appliances, and Quad-Helix, appliance treatment for habits such as digit sucking and tongue thrusting, and frenectomy and mucocele surgical treatment Manages oral/facial trauma. Cares for patients with special needs to include mental, physical, and emotional handicaps. Administers oral conscious sedation, inhalation analgesia, and provides dental care with general anesthesia administered by qualified personnel. Provide dental services for child patients undergoing medical procedures such as chemotherapy or bone marrow transplant that require dental involvement in the multidisciplinary medical care of the patient. Provides dental expertise to multidisciplinary medical treatment teams, and provides appliance design, fabrication, and insertion for craniofacial anomaly patients to include cleft palate patients.

Documents patient treatment in the dental treatment record and utilizes the CDA to enter patient specific workload, and patient scheduling.

2.5. Dental Hygienists. Shall have an Associate's Degree or Bachelor’s Degree depending on the program. Shall have successfully completed a dental hygiene program accredited by the Commission on Dental Accreditation (CODA) of the American Dental Association (ADA). Shall be certified in radiography as required by 42 CFR Part

75. Shall have local anesthesia certification from an ADA CERP course. Shall have a minimum of one (1) year experience in dental hygiene within the past three (3) years. Shall have a current, full, active, and unrestricted license as a Dental Hygienist.

2.5.1. Scope of dental hygiene practice. Complete comprehensive dental and periodontal charting that includes a detailed description and evaluation of the gingiva and periodontium. Refer patients who have abnormalities to include cavities, defective fillings, suspicious growths, or periodontal disease to a dentist. Remove biofilm plaque and calculus from teeth both coronal and apical to the gingival margin using dental instruments. Apply desensitizing and other topical agents to treat abnormalities to include caries prevention, gingivitis and oral ulceration. Provide comprehensive oral hygiene instruction. Take impressions. Polish restorations and apply pit and fissure sealants. Chair side dental assisting when directed by the Officer-In-Charge of the dental clinic. Check and maintain instruments to insure working condition. Clean, sharpen, and sterilize instruments. Documents patient treatment in the dental treatment record and utilizes the Corporate Dental Application to enter patient specific workload, readiness status and patient scheduling.

2.6. All contract dentists and dental hygienists shall be certified in BLS prior to beginning performance at the DENTAC. Certification shall be kept current throughout the term of the contract. Effective July 15, 2008, BLS certification training must be approved by the American Heart Association (AHA). The requirement for AHA approved BLS certification applies to all BLS renewals for existing dentists and dental hygienists and for all new hires. Current BLS certification for existing dentists and dental hygienists will be honored through the end of the term of their certification period. The U.S. Government, at no cost to the contract dentists or dental hygienists, may provide BLS refresher training and ACLS and/or PALS training, for pediatric dentists, during scheduled or regular duty hours. If this is unavailable, the HCP is responsible for obtaining the training elsewhere at the expense of the contractor.

2.7. Waiver Process for Experience Requirement. The local Credentials Committee or DENTAC Commander may approve any exceptions to the experience requirements on a case-by-case basis. Notify the COR and KO regarding any exceptions.

2.8. Production requirements. General dentists, dental specialists and dental hygienists will be required to maintain an average monthly production per quarter is within 10% of the production goals published annually by the G3/5/7 Dental Directorate, see attachment 16. Documentation of workload will follow the G3/5/7 Dental Directorate’s annual coding guidance.

3. PERSONNEL.

3.1. Contractor’s Representative. At least 10 calendar days prior to commencement of services, the contractor shall provide, in writing, the name of the contractor's representative for coordination and implementation of contract services to the contracting officer and the COR. Additionally, the representative shall be available during duty hours to discuss with the COR any problem that may arise concerning contract matters relating to daily operations of the contract. The contractor's representative shall not schedule meetings with other contract employees during their scheduled duty hours. The Government will not incur any additional financial liability to the contractor for any such meetings.

3.1.1. Changes in the contractor’s representative at any time after contract commencement shall require the contractor to notify the contracting officer and the COR within five working days prior to the change. Such notification shall be in writing and shall state the name of the new representative.

3.1.2. The contractor shall advise the COR 30 calendar days in advance of any staffing changes that develop, such as vacations, continuing dental education, or meetings that could impact patient scheduling.

4. EMPLOYMENT CRITERIA.

4.1. The contractor shall not employ any individual to provide dentistry/dental hygiene services in the Army medical/dental treatment facilities who:

4.1.1. Has had his or her professional license suspended or revoked by a state licensing organization, notwithstanding that the individual holds a valid license from another state(s).

4.1.2. Is the subject of a current or pending proceeding or appeal, which may result in the limitation, suspension, or revocation of the individual's clinical privileges.

4.1.3. Has had his or her other clinical privileges limited, suspended, or revoked by any health care facility.

However, the contractor may employ such person if the subject dentist's clinical privileges were restored by the limiting institution or upon a finding by the contractor that the dentist has remedied the deficiencies in his or her professional qualifications that resulted in the restriction on his or her clinical privileges. The final decision will be made by the DENTAC Commander.

4.1.4. The contractor shall not employ active duty military nor government civilian employees to perform services under this contract.

4.2. Personal Hygiene. The contractor employees shall maintain a professional appearance at all times while providing services under this contract.

4.2.1. Personal protective equipment (nonprescription glasses, over garments, masks, etc.) worn by contractors during patient care will be provided by the government. Scrubs, which are the required uniform, may or may not be provided by the government. A badge provided by the contractor shall be worn on the scrubs. It shall be placed on either the right or left breast pocket area. The badge shall be of black background with white lettering and shall clearly display the name of the employee, e.g.

Dr. Last name.

Company Name________________________ (See para 9.10.)

4.3. HEALTH AND IMMUNIZATION REQUIREMENTS

4.3.1. All contract providers performing health care services under this contract shall comply with the Health and Immunization requirements identified below at the time of initial request for clinical privileges and annually thereafter.

a. All contractor service performing direct health care services under this contract shall receive a general physical examination prior to commencement of services. The contractor shall provide the Contracting Officer's Representative, 10 calendar days before beginning services under this contract, a physical examination certificate for each individual direct health care provider who will provide services. The certification shall state the date on which the physical examination was completed and the name of the physician who performed the examination. This certification shall be signed by the physician performing the examination. A physical examination administered more than 45 days prior to performance of the contract will not be considered adequate. The physical examination shall include the following:

(1) A history to show that Direct Health Care provider has completed a primary series of immunization with tetanus and diphtheria toxoids and that a booster dose is current (within the past 10 years).

(2) A test for the hepatitis (Type B) virus with documentation of the results. A profile shall be established to show immune status to hepatitis. Non-immune Health Care Workers (lacking anti-HB(c) or anti-HB(s)) shall be required to complete an immunization series with a Hepatitis-B vaccine (e.g., Recombivax, Engerix).

(3) The physical examination shall also document serologic evidence of immunity to measles and rubella or to provide documentation of immunization with measles, mumps and rubella (MMR) vaccine using the following guidelines:

(a) Employees born before 1957 without documentation of previous vaccination with MMR should receive one dose.

(b) Employees born in or after 1957 who have received one dose of MMR previously shall receive one booster dose.

(c) Employees born in or after 1957, without documentation of any previous vaccination with MMR, should receive two doses of vaccine, separated by no less than one month.

(4) Contractor's health care providers shall be screened for tuberculosis by a tuberculin skin test using the Mantoux technique. A skin test result of 10 mm of induration or more shall be required to have a chest roentgenogram and an evaluation performed to document an assessment of the patient (status of infection- active, inactive; need for preventive treatment or not as determined by age, history of BCG (Bacillus Calmette-Guerin) vaccination; duration of skin test positively, etc).

(a) If all of the immunizations and tests set forth in the preceding paragraphs have not been completed, the contractor shall issue a certificate providing evidence of immunizations and tests that have been completed or started and shall provide a schedule for the completion of unfinished immunizations and lab tests.

After the schedule is completed, the contractor must provide an updated and complete certificate.

(b). All contractor personnel performing direct health care services under this contract, who experience a parenteral (e.g., needle-stick or cut) or mucous membrane exposure (e.g., splash to the eye or mouth) to blood or bloody body fluids, shall receive prompt treatment. The medical treatment facility (MTF) will evaluate the source of exposure for risk of Hepatitis-B, Hepatitis-C, and Human Immunodeficiency virus (HIV) and will provide a report of the findings to the contractor and the contract provider. It shall be the contractor's responsibility to provide appropriate treatment as needed to possibly include Tetanus-Diphtheria booster, Immune Globulin, Hepatitis-B vaccine booster, or Hepatitis-B Immune Globulin. The contractor shall be responsible for providing the contract employee with initial testing and if the source of exposure was unknown, positive, or considered at high risk for HIV infection, follow-up testing 3, 6, and 12 months after exposure. In the event of a confirmed or highly suspected parenteral exposure to HIV, the contractor shall insure that the contract provider receives appropriate counseling and is referred immediately to a private infectious disease specialist for consideration of any experimental therapy (e.g., AZT). The Government may require the contractor to provide evidence of the status of treatment and testing of the individual provider under the contract.

(c). Failure to meet the requirements stated herein, or when test results determine a contract provider has a contagious disease, the KO may, upon the advice of the MTF commander or his clinical staff, determine that such provider is not an acceptable individual to perform services under this contract.

4.3.2. Consistent with Department of Defense Assistant Secretary for Health Affairs Memorandum dated 23 October 1996, the Advisory Committee on Immunization Practices recommendation dated 25 Nov 2011, and the Defense Health Agency, Immunization Healthcare Branch Hepatitis B Infection Information Paper dated 3 November 2015, all direct patient care service providers shall provide medical certification verifying completion of the full three part Hepatitis B vaccination or laboratory proof of immunity prior to beginning work under the contract.

4.3.3. Influenza Immunization. All contract HCPs shall receive an annual Fall influenza immunization unless documented by a physician to be medically contradicted. The MTF will provide the influenza immunization to the contract HCPs, in accordance with the MTF immunization schedule and policy. The contractor is responsible for ensuring that all HCPs participate in the MTF influenza immunization program. If the MTF is unable to provide the immunization, the HCP is responsible for obtaining the immunization elsewhere at the expense of the contractor. "

4.4. NACI. Background checks are mandatory for those personnel involved in the delivery of health care to children under the age of 18. The government requires criminal background checks on all contract HCPs (if appropriate) in accordance with DoD Directive 5200.2-R and the procedures set forth in, DoDI 1402.5, dated 19 Jan 1993. The contractor is responsible for ensuring background check submittals are initiated (if appropriate) in accordance with the PWS prior to HCP departing CONUS commencing with services at the DENTAC. Background checks include a review of personnel and security records, a Federal Bureau of Investigation fingerprint check and State Criminal History Repositories checks of residencies listed on employment or certification applications.

4.4.1. Providers whose job descriptions require a Care National Agency Check and Inquiries (CNACI) must have one completed before relocating to Country. Line of Sight is no longer an acceptable substitute for a CNACI or until a CNACI is obtained. Under no circumstances will a contractor relocate for a job without approval of the following processes: DOCPER or Italian equivalent, NACI or equivalent, CNACI if required, and credentialing.

4.4.2. If the contract HCP has a DoD affiliation such as living or working on an installation, or is a family member of active duty military, an Installation Record Check (IRC) shall be conducted by DoD component personnel at the installation level. IRC is not required on individuals without DoD affiliation. Upon favorable completion of the IRC, an individual may be selected to provide services to a minor under line-of-sight supervision (LOSS) until the required background checks are completed. Line-of-sight supervision is defined at DoDI 1402.5.

4.4.3. HCPs may be employed under the contract pending completion of the background checks provided the DENTAC uses line-of-sight supervision while minor children are in the care of that individual. The contract HCP shall be within line-of-sight supervision of a staff person whose background check has been successfully completed, or in the presence of the child’s parent or guardian.

4.4.4. All clearance requests shall be submitted IAW the applicable directives specific to the MTF or DENTAC.

The name and address of the COR shall be included in the request as the recipient of the results.

4.4.5. Contract HCPs have the right to obtain a copy of the background check report. Contract HCPs should contact their appropriate company representative or the COR to obtain a copy of background check reports.

4.4.6. If the contractor has previously received a background check, proof of the check shall be provided or a new one obtained. (A new investigation is required if a break in service to the DoD results in a time lapse of more than two years.)

4.4.7. All expenses incurred in the conduct of any criminal history background check is the responsibility of the Contractor.

4.5. National Agency Check for Trustworthiness (NACT). A NACT is required for each Contractor employee, as the government considers each Contractor employee to be in an Information Technology (IT) Sensitive Position with access to the DoD computer network. Compliance with Public Law 100-235, DoD Directive 8500.01E, DoD 5200.2-R and AR 380-67-Personnel Security Program, 24 Jan 14 is mandatory for IT Sensitive Positions. The preferred method for the submission of fingerprints is via digital fingerprint machine through the Defense Manpower Data Center (DMDC) Secure Web Fingerprint Transaction (SWFT +) System. Digital fingerprints may be submitted at Army security offices. If digital fingerprints are not possible, a candidate must submit ink prints on the Standard Form 85P and the FD258 Version Applicant Finger Print Card. The use of hard copy fingerprint cards will delay the security review. Preparation and submission of the NACT shall be at the expense of the Government, upon commencement of services. If preparation and submission of the NACT to OPM is required by the contractor, the Government will reimburse the contractor for the cost of the NACT. The contractor shall advise their employees that a positive report is needed as a condition of employment under this contract. If the results of the NACT check result in derogatory findings, the Contractor shall be responsible for and pay all costs associated with the NACT check. The Government will not reimburse these costs.

4.5.1. Homeland Security Presidential Directive -12 (HSPD-12) directs and establishes a timeline for all contractors to initiate or have a successfully adjudicated National Agency Check with Written Inquiries or other Office or Personnel Management (OPM) or National security community investigation on record. Per the directive the NACI requirements should be followed in accordance with the OPM guidance.

a. In accordance with HSPD-12 guidance all contract agencies must have the following statement in all contracts: “All contractors/subcontractors supporting non-classified contracts which require access to Federal government facilities and/or federally controlled information systems are required to have a favorably approved National Agency Check with Inquires (NACI) NLT 27 Oct 2007”.

b. This requirement should coincide with the contract and be evaluated at contract renewal. Compliance to this directive is immediate.

c. Personal Identity Verification of Contractor Personnel: the contractor shall comply with agency personal identity verification procedures identified in the contract that Implement HSPD-12, Office of Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

4.6. Removal of Contract HCPs. At any time during the performance of this contract, the KO or COR may direct the contractor to immediately remove any contract HCP whose actions or impaired state raises reasonable suspicion that clear and present danger of physical harm exists to a patient, other contract HCPs, government personnel, or to the impaired individual. This provision will be used in emergency situations only and not for the purpose of bringing performance issues or other non-urgent concerns to the attention of the contractor.

4.6.1. The KO, COR, may direct the Contractor to immediately remove any Contractor staff for reasons other than posing danger of physical harm, such as posing a threat to the security or good order and discipline of the Government workplace.”

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

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

4.6.4. The Commander has the prerogative to hold in abeyance, to deny, or to summarily suspend clinical privileges/practice when there is a reasonable cause to doubt the health care provider’s competence to practice or for any cause affecting the safety of patients or others. AR 40-68-Clincal Quality Management, 22 May 2009 outlines the adverse clinical privileging and practice actions for privileged personnel and adverse practice actions and peer review for nonprivileged personnel.

4.6.5. In accordance with Army Regulation 40-68, Clinical Quality Management, and Health Affairs Policy 05-002, all Health Care Providers who furnish billable health services or those who initiate or receive referrals are required to obtain a National Provider Identifier (NPI)-Type 1. All general dentists, dental specialty providers, and hygiene providers (Registered Dental Hygienists and Expanded Function Dental Assistants) must have NPI numbers before they can begin patient care. Additionally, the information in the National Plan and Provider Enumeration System (NPPES) must be up to date with correct addresses and proper provider taxonomy. The primary taxonomy code should reflect the majority of the dental workload the provider will be performing for the contract.

5. CONTINUITY OF SERVICES.

5.1. Hours. The services provided under this contract shall be on a 40-hour per week basis. The local DENTAC Commander shall establish the routine operating hours of the dental clinic(s). Dental services may be scheduled between (6:00 a.m.) 0600 hrs and (10:00 p.m.) 2200 hrs Monday through Friday, excluding U.S. Federal holidays.

Depending on mission requirements services may occasionally be scheduled on weekends.

5.1.2. General Dentists, Pediatric Dentists, Orthodontists, and Dental Hygienists can be scheduled an 8-hour minimum or 12-hour maximum workday. No contract HCP shall work any additional hours beyond the normal 80 hours in a two-week period unless the COR has pre-approved all of the proposed additional hours. These hours are subject to the normal hourly bill rate as established in the contract.

5.2. Scheduled/Unscheduled Absences (Routine Hours). The contractor may request and coordinate with the COR up to a maximum of 80 hours of scheduled or unscheduled absences due to illness, continuing education, and other justified reasons per full-time provider per 12 month contract period and notify the COR as applicable. The COR will track all scheduled and unscheduled absences (non-performance) for each provider and will notify the KO as soon as practical. All absences not directly approved shall constitute an unscheduled absence. The contractor shall provide backup coverage for all scheduled absences in excess of twenty (20) consecutive workdays at no additional cost to the Government.

5.3. For unscheduled absences, the contractor shall notify the COR and OIC within the first two (2) hours of the duty day if the contract HCP is unable to report to work.

5.4. The contractor shall only be compensated for actual hours worked by the employee. No overtime will be authorized without prior coordination with the COR.

5.5. VERIFICATION. The U.S. Government reserves the right to verify the hours worked by contractor personnel.

The method is at the discretion of the DENTAC.

5.6. U.S. Federal Holidays. The following is a list of legal federal holidays as referred to elsewhere in the contract:

New Year’s Day, January 1st Martin Luther King's Birthday, 3rd Monday in January Presidents Day, 3rd Monday in February Memorial Day, Last Monday in May Juneteenth, June 19th Independence Day, July 4th Labor Day, 1st Monday in September Columbus Day, 2nd Monday in October Veteran's Day, November 11th Thanksgiving Day, 4th Thursday in November Christmas Day, December 25th

NOTE: Any of the above holidays falling on a Saturday will be observed on the preceding Friday; holidays falling on a Sunday will be observed on the following Monday. Any holidays that are declared by Presidential Executive Order shall be observed in the same manner as the holidays listed above. If the area in which a contract employee is scheduled to work is closed due to the holiday and the employee is not required to report in, payment will not be made for those hours. Closures of the installation due to inclement weather or other such acts of God shall be handled in the same manner.

5.6. Closures. During anticipated closure of the facility due to Command declared training holidays or unplanned closure of the facility due to natural disasters, military emergencies, severe weather, or otherwise, the contractor shall not invoice the Government for services not performed and the Government will not be liable to the contractors for any such closures.

5.6.1. Training Holidays. For contract providers, training holidays are considered normal workdays unless the Government is unable to provide a suitable workplace IAW paragraph 11.1.2. To promote access to care, the Contractor will ensure that contract providers are available to work on Government designated training holidays unless excused for leave. To accommodate scheduled training holidays when no suitable workplace is available, and with the prior approval of the contract provider’s DENTAC OIC or NCOIC, the Contract Provider may work a revised schedule IAW paragraph 5.1.2.

5.6.1.1. The Government strives to keep clinics open as a benefit to patients and employees who want to work on a Government designated training holiday. There is no guarantee that a clinic will be open as there is no Government requirement to keep a clinic open on a training holiday. Therefore, the Government cannot guarantee that a HCP will be able to work on all declared training holidays.

6. QUALITY ASSURANCE.

6.1. Performance Measures.

6.1.1. Outcome. The contractor shall provide qualified personnel who will fulfill the requirement to provide dental care services at a standard enabling Army dental clinics, or other operational elements, to provide such services at a high level of quality.

6.1.2. Standards. The contractor shall not allow the fill rate to drop below 95% for General Dentists and Hygienists and 90% for Orthodontists and Pediatric Dentists. The contractor shall have a replacement employee in place and performing services within 90 calendar days after the COR or KO notifies the contractor of the need to fill a vacancy; Substantiated patient complaints – maximum of 2 per year per provider; No provider initiated cancellations of treatments except as medically required by patient. All providers shall be within 10% of the production goals established by the G 3/5/7 Dental Directorate. Other performance evaluation factors will be monitored that are not quantified by numerical measurements which include: contractor providing personnel exceeding the minimum qualification standards; Provider and contractor relationship with dental clinic/government contracting personnel; Compliance with clinic policy and procedures.

6.1.3. How Measured. Department/clinic supervisory personnel will monitor provider performance through direct observation, government information systems and records, patient records, customer service information, contractor reports and timesheets.

6.1.4. Performance by the contractor and the quality of services rendered plus any documentation or written material in support thereof shall be subject to continuous inspection, surveillance, and review for acceptance by the COR.

6.1.5. The COR will monitor contractor compliance and evaluate services performed in conjunction with input from designated government representatives. It is accepted that the provision of quality health care involves the knowledge, skill, and professional judgment of the general dentist, dental hygienist, pediatric dentist, and orthodontist concerned. The examination, diagnosis, and treatment of injuries and illness involve a myriad of factors, which do not necessarily lend themselves to specific objective criteria. Acceptable standards of care are normally judged by outcome, productivity, prognosis, and patient satisfaction.

6.1.6. Fill Rates. Fill rates are calculated separately for general dentists, dental hygienists, pediatric dentists, and orthodontists and monitored by the COR. The monthly fill rate is defined as a percentage based on the total number of requirements (FTE) filled in each respective group, at each geographical location, divided by the total number of provider requirements (FTE) needed in each respective group at each geographical location. Fill rates will be calculated each month and an average taken of each respective group, at each geographical location, during the period of performance. The fill rate will be rounded up to the next highest number.

6.1.7. SERVICE DELIVERY SUMMARY.

Performance Objective

PWS

paragraph Reference

Performance Method

Performance Threshold

Fulfill any additional follow-on requirements (task orders) and employee replacements within

90 calendar days.

8.1. COR maintain Log 95% of the time

Submit complete credentials applications and TCSA documentation no later than 60 calendar days after notification.

8.1. COR maintain Log

95% of the time

Submit Pre-employment packets and TCSA documentation no later than 60 calendar days after notification.

8.2. COR maintain Log 95% of the time

Fill Rate

6.1.2.

6.1.6. COR maintain Log

95% for General Dentists/Hygienists and 90% for Orthodontists and Pediatric Dentists

Substantiated Complaints

6.1.2. COR maintain Log Maximum of 2 per year

per provider

Submit Monthly Status Report on 5th business day.

10.2. COR maintain Log 90% of the time

Average monthly production per quarter is within 10% of the

Dental Directorate’s published productivity goals

6.1.2 COR maintain Log 95% of the time

6.1.8. Remedies. If the performance thresholds are not met in the above service delivery summary, the government will document the contractor’s past performance and may terminate the contract in accordance with FAR Clause 52.212-4—Contract Terms and Conditions—Commercial Items.

7. CREDENTIAL REVIEWS/PRIVILEGING.

7.1. General: Privileges are granted by Commanders of Army DENTACs. As a prerequisite to performance under the resultant contract, the contract HCP dentists performing the services must be privileged by the DENTAC commander where the services are performed. Therefore, compliance with the privileging requirements as stated in this section and Technical Exhibits A and B are essential to the Performance under the contract. Once the HCP has met all privileging requirements as outlined in Exhibits A and B, the DENTAC Commander shall approve and sign Exhibit D, allowing the HCP to perform his or her duties.

7.2. The privileging process is subject to the provisions of AR 40-68, Clinical Quality Management; 22 May 09 and any subsequent changes to that regulation or any successor regulations that might evolve. The Credentials Committee established at each DENTAC is the sole agency authorized to accept applications for privileges submitted by the contractor to the COR and to make recommendations to the commander on the granting of privileges. The point of contact will vary at each DENTAC. The DENTAC Commander is the final authority for approving or denying clinical privileges for all contract HCPs.

7.3. Only complete credentials applications will be accepted by the government for processing. Incomplete applications, that is, those that do not fully comply with the requirements in Technical Exhibit A, will be returned to the contractor without action. A clear delineation of the deficiencies which render the credentials application incomplete will be furnished. The COR will notify the contractor of incomplete credentials submissions within two

(2) working days of receipt.

7.3.1. Return of an incomplete application for completion is not a waiver of the requirement to submit a complete application. Repetitive submissions of incomplete applications will be considered a failure to perform satisfactorily.

7.3.2. The government will expeditiously: (1) review the completed applications, (2) review primary source verification, (3) perform all other required review and verification, (4) submit completed applications to the Credentials Committee, (5) submit the Credentials Committee recommendations to the Commander, (6) obtain the Commander's decision, and (7) advise the contractor of the action taken.

7.3.3. The DENTAC Commander or their designated representative will notify the Contractor and COR by e-mail transmission when privileging action has been determined. Normally notification will be within 15 calendar days of receipt of the credentials package and application for privileges.

7.3.4. All matters and materials concerning privileging initiated by either the DENTAC or the contractor shall be directed through the COR.

7.3.5. The contractor is not required to submit completed credentials applications for incumbent contract dentists who are privileged at DENTACS at the time of the award of the contract or completed pre-employment packets for all incumbent ancillary personnel performing at the DENTACS. However, this does not preclude the requirement for submission of the Technical Expert Status (TE) and Troop Care Status (TC) applications (for Germany) as referenced in paragraph 8.1 and section 10.5 below or other contract specific information required for overseas duty.

7.4. The DENTAC Commander is the sole authority who can revoke or otherwise restrict the privileges of any contract HCP whom he/she determines is not qualified to perform the contract services and will be governed by the procedures in AR 40-68-Clinical Quality Management, 22 May 09.

7.4.1. Action that suspends, revokes, places in abeyance, or otherwise restricts the privileges of contract HCPs will result in those HCPs not being authorized to perform under the contract. Such action does not excuse the contractor from performing. Termination of privileges will be rendered in writing and become effective three (3) calendar days after the contractor receives them. The contracting officer and the contractor shall be notified by the COR as soon as possible when the necessity to exercise such authority becomes apparent.

7.4.2. Adverse clinical privileging/practice actions on contract HCP privileges, once action is taken by the DENTAC Commander, are appealable locally by the contract HCP under the provisions of AR 40-68-Clinical Quality Management, 22 May 09.

7.4.3. The contractor shall ensure that upon termination or transfer of any contract provider who is granted privileges identified above, action is taken simultaneously with termination of employment to ensure that said contract provider ceases to have access to the above privileges. The Contractor shall ensure that identification passes or other documents pertinent to and/or peculiar to the contract or privileges there under are turned over to the issuing office upon termination or transfer of any contract HCP. The contractor shall require a written receipt of such return and shall immediately forward a copy to the KO and COR.

8. CONTRACTOR’S RESPONSIBILITIES.

8.1. Credentials and TC/TE Applications. The Contractor is required to begin full performance of contract requirements, any follow-on requirements and employee replacement within 90 calendar days after notification/receipt (facsimile or e-mail transmission authorized) of contract/task order award or modifications.

Therefore, no later than 60 calendar days after notification, the Contractor shall submit completed credentials applications and Troop Care Status Accreditation (TCSA) documentation on those HCPs who will be performing services under this contract to the COR. (TCSA is only required in Germany). The timeframes involved for the credentialing process and the TC and TE requirements do not count toward the contractor’s 90-day obligation for performance as long as the contractor meets the requirements of paragraphs 8.1.2, 8.1.3, and 10.9 below. After notification of delineation of privileges or TC and TE approval (whichever is later), the contractor has a maximum of 30 calendar days to begin on-site performance.

8.1.1. The contractor shall submit a curriculum vitae (CV) or resume (as appropriate) in advance of the credential application and TCSA documentation to the COR on those proposed providers, during the 60 calendar days after notification as referenced in paragraph 8.1 above. This will ensure that HCPs will meet the qualifications to be credentialed.

8.1.2. The contractor shall take specific action, including Primary Source Verification, to ensure that contract HCP applications submitted for privileging have the required prerequisites and do not have disqualifying impediments for privileges at the DENTAC. This is the non-delegable responsibility of the contractor.

8.1.3. The contractor shall affirmatively expend effort to review applications submitted to the DENTAC to ensure that they are complete and comply with the requirements of this section and Technical Exhibit A. An individual HCP may not submit an application directly to the COR and absent the contractor's assurance of review, the application will be returned without action.

8.1.4. Backfill. The identical application submission procedures and requirements, as referenced in paragraph 8.1 above, are required for contract HCPs who are proposed as backfill providers.

8.1.5. The contractor shall perform ongoing monitoring in accordance with Technical Exhibit B.

8.1.6. The dentist must sign a Statement of Affirmation. Reference Attachment 11

8.2. Pre-employment Packets. Pre-employment packets and TCSA documentation shall be submitted to the COR for all dental hygienists no later than 60 calendar days after notification/receipt (facsimile or e-mail transmission authorized) of contract/task order award or modifications. (TCSA is only required in Germany.) The packet shall consist of name, social security number, graduation diploma from an accredited dental hygiene program that qualifies them to obtain a state license, a state license, BLS certification, copy of curriculum vitae (with applicable dates of employment, name and address of the facility where employed), and physical examination certificate as identified within the schedule.