Performance Work Statement_8 December 2020.pdf

PERFORMANCE WORK STATEMENT

ANESTHETIST SERVICES

WILLIAM BEAUMONT ARMY MEDICAL CENTER

1.0. INTRODUCTION:

The Contractor shall provide health care employees in support for the Anesthesia Department for William Beaumont Army Medical Center (WBAMC), Fort Bliss, TX. The services will be of a nature and scope described in the paragraphs below.

1.1 (12) Certified Registered Nurse Anesthetist (CRNA) and (2) Physician – Anesthesiology.

1.2 The quality of care provided by the Contractor HCP shall be of a quality meeting or exceeding currently recognized national standards as established by the Joint Commission (JC), American Medical Association (AMA) and National Board of Medical Examiners (NBME), and established principles and ethics of the medical profession. Contractor employees shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association's Bill of Rights for Patients. The Contractor HCP shall abide by the Medical Treatment Facility (MTF) rules, regulations and bylaws, including Medical Staff Bylaws, as well as applicable Department of Defense and Army regulations.

The primary purpose of these positions is to provide Anesthesia services in accordance with industrial best practices applicable to Department of Army and Department of Defense guidance and in accordance with their medical licensure.

2.0 GENERAL INFORMATION:

2.1 It is expressly agreed and understood that this is a non-personal services contract, as defined in Federal Acquisition Regulation (FAR) 37.401, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor's professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The Contractor shall maintain during the term of the contract liability insurance by a responsible insurance carrier.

2.2 Professional Liability: The government will not be liable for malpractice allegations against contract HCP’s based upon performance of this contract. The contractor shall be required to carry malpractice insurance for its contract HCP’s at a level stated in the solicitation and included in any resulting contract for subject acquisition in tailored FAR Clause 52.237-7. Upon contract award, the contractor shall provide evidence of insurance demonstrating the required coverage prior to commencement of performance. In accordance with Federal Acquisition Regulation (FAR) Clause 52.2237-7, the contractor will indemnify the Government for any liability producing act or mission by the contract HCPs and agents occurring during contract performance. If the contractor uses subcontractor in the performance of this contract, the contractor is required to ensure that its subcontractors maintain and provide proof of medical liability insurance, and any subcontract for healthcare services contain the requirements for FAR 52- 237.7, including the maintenance of medical liability insurance.

2.3 Responsibility and Procedures: If any suit or action is filed or any claim is made against the Contractor 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.

2.4 Reserved

2.5 Confidentiality / HIPAA: The Contractor HCP shall abide by AR 40-3 and AR 40-66 concerning the nature of limited privileged communication between patient and health care provider for security and personnel reliability programs. The Contractor HCP shall abide by AR 40-66 concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Drug and Alcohol Act, Public Law 92-129 and HIPAA. The Contractor HCP shall direct all requests for medical information on patients to the Chief, Patient Administration Division. The Contractor HCP shall not release any medical or personal information on a patient without first receiving written approval from the government. Government will provide the regulations upon request by the Contractor HCP.

2.6 Removal of Contractor HCPs:

2.6.1 At any time during the performance of this contract, the Contracting Officer or COR may direct the contractor to immediately remove any Contractor HCP whose actions or impaired state raises reasonable suspicion that clear and present danger of physical harm exists to a patient, other Contractor 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.

2.6.2 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 to not use that individual to perform any healthcare services required under this contract until the issue has been resolved to the satisfaction of the Contracting Officer. 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. A review of the basis for removal will be made by the Contracting Officer within 3 working days after the COR directed the removal.

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

2.6.4 The Hospital Director 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 outlines the adverse clinical privileging and practice actions for privileged personnel and adverse practice actions and peer review for non-privileged personnel.

2.7 Conflict of Interest:

2.7.1 Contractor HCP shall not use patient care rendered pursuant to this agreement as a part of a study, research grant, or publication without the prior written consent of the MTF Director.

2.7.2 Contractor HCP shall not bill the patient, an insurer, or anyone else for services rendered. The Contractor HCP is prohibited from receiving compensation of any kind for eligible patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract, at the rate specified in the contract.

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

2.7.4 Contractor HCP shall not introduce new medical procedures or changes in standing operating procedures without first coordinating with the Chief of Services.

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

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

2.7.7 Contractor HCP shall not be an employee of the United States Government if the employment would create a conflict of interest. The Contractor HCP who is an employee of the Department of Defense, either military or civilian, shall not be employed unless such person seeks and receives approval in accordance with DoD 5500.7-R and MEDCOM Reg 600-3.

3.0 SCOPE OF WORK:

3.1 The Contractor shall provide qualified personnel necessary to perform Anesthesia services in accordance with industrial best practices applicable to Department of Defense guidance and in accordance with their medical licensure. The Government designated official is the department Chief or his/her designated representative.

3.2 The Contractor shall comply with all applicable laws, rules and regulations, including but not limited to those included in Section 6.0 of the PWS.

4.0 ADDITIONAL INFORMATION/REQUIREMENTS:

4.1 SAFETY REQUIREMENTS:

4.1.1 The Contractor HCP shall maintain safety and health standards compliant with requirements of the Occupational Safety and Health Administration (OSHA).

4.1.2 CRIME CONTROL ACT OF 1990: No performance under this contract will be allowed without full compliance with the Crime Control Act of 1990 and Department of Defense Instruction 1402.5 dated 19 January 1993. All contract providers having access to Government computer systems and/or providing care to children (17 years of age and under) must be subject of a favorable background investigation. Background checks will be based on fingerprints of individuals obtained by a law enforcement officer and inquiries will be made, based on the Standard Form 86-P completed by the contract provider through the Federal bureau of Investigation (FBI) and state criminal history repositories

4.2 SECURITY REQUIREMENTS:

4.2.1 The MTFs are restricted access military installations. HCPS shall not begin performance until the complete documentation for a Personnel Background Investigation has been submitted. An Identification (ID) badge, the Common Access Card (CAC) and the vehicle registration will not be issued until complete documentation has been submitted to the appropriate Installation, MTF, or other Security Manager(s), as required at the facility. The CAC card is required for access to Government computer databases and also is presented to the security guards when entering the military installation. If a background investigation results in an unfavorable finding, the COR or Contracting Officer will notify the contractor and the contractor employee will not be granted access to the facility, will not be allowed to perform services at the facility, and must return identification badges, CAC cards, and other items previously issued by the government.

4.2.2 Upon award of the contract, the contractor will immediately contact the COR for processing procedures to meet the security requirements, for information needed to access the installation/MTF initially, as well as in- processing forms.

4.2.3 SECURITY/ (IT) REQUIREMENTS:

4.2.3.1 In accordance with (JAW) Army Regulation 525-13, paragraph 5-19, all prospective contract HCPs will undergo a verification process to determine the trustworthiness and suitability prior to being granted access to federal property. Limited access with escort may be granted (at the installation's discretion) for an interim period while investigations are being conducted.

4.2.3.2 IAW AR 25-2 and HSPD-12, Installation Security Office will submit all background investigations on prospective contract HCPs requiring Common Access Cards (CAC), network access.

4.2.3.3 Upon notification, the Provost Marshal Office will conduct background checks on all other contract HCP personnel when there isn't a requirement for CAC and/or IT requirements in the contract.

4.2.3.4 Complete disclosure of any past incidents in the contract HCP professional duties or of incidents which might be considered to impact his/her professional standing, such as charges (unless acquitted) involving felonies or misdemeanors (other than minor traffic violations), is a necessary part of the competency process. This disclosure must also specifically include reports of any actions, claims, charges, of malpractice ever brought against the contract HCP (either individually or as a part of a group), as well as the outcome (or current status) of any such case. The MTF will evaluate any such incident and determine whether it should be disqualifying.

4.2.3.5 Contract HCP is advised to make full disclosure under this paragraph as a condition of employment. Failure to make a full disclosure will result in a determination that the provider's services were unsatisfactory.

4.2.3.6 The HCP may be removed permanently or temporarily from service under the contract if at any time during the contract period it is discovered that the contract HCP is currently pending charges or at the MTF Director’s desecration, concerning suitability, it is in the best interest of the Government.

4.2.4 SECURITY IDENTIFICATION BADGES:

4.2.4.1 Contract HCP shall comply with the local installation and MTF personnel identification and access requirements. The Contractor is responsible for absences of Contractor HCP due to expired identification and access documents.

4.2.4.2 Each Contractor HCP shall wear a visible Security ID badge provided by the MTF or the Military Installation in accordance with their guidance. The badge must show the full name, title and, if required, the word "Contractor" on the front of the badge.

4.2.4.3 The contractor shall be responsible for ensuring all HCPs renew ID, CAC, and access documents in a timely manner. Absences due to the loss or expiration of such badges shall not relieve the contractor of its obligation to perform the health care services required under this contract.

4.2.4.4 The contract HCP shall immediately report lost or stolen security badges to the COR.

4.2.4.5 Contractor HCP shall turn in the MTF badge, Common Access Card (CAC), and Civilian ID Card to the COR upon termination or temporary removal of their services under this contract.

4.2.5 VEHICLE REGISTRATION:

4.2.5.1 The contractor/contract HCPs shall comply with the requirements for vehicle registration and operation on the hospital installation. The contractor and contract HCPs must register their vehicles with the security office. The contractor shall comply with the parking policy.

4.2.5.2 All vehicles, with or without a DoD decal, are subject to search. Contract HCPs may encounter long delays for vehicle inspection and ID checks upon entering and exiting the installation. The Government will not reimburse the contractor for time spent at installation checkpoints. Contract HCPs must plan accordingly and report to work at their appointed place of duty at their scheduled duty time.

4.2.5.3 Contract HCPs shall follow procedures for removal and turn-in of the vehicle parking pass upon termination of services under this contract.

4.3 SAFEGUARDING MATERIAL AND CONFIDENTIALITY INFORMATION:

4.3.1 The contractor shall be responsible for safeguarding all Government property provided or obtained in connection with this contract. The contractor shall safeguard information of a confidential or sensitive nature. Neither the contractor nor any of its contract HCPs shall disclose or cause to be disseminated any information concerning the operation of the MTF that could result in or increase the possibility of a breach in security or interrupt the continuity of operations or which breaches the requirements of the Federal Privacy Act of 1974. However, the contractor and/or contractor HCPs may be required to provide testimony in legal or administrative procedures. Such participation must be consistent with the disclosure requirements imposed in this contract and coordinated with the contracting officer.

4.3.2 The contract HCP under this contract shall have access to and/or process information requiring protection under the Privacy Act of 1974. These positions are considered "Automated Data Processing (ADP) Sensitive" positions. Compliance with DoD Directive 5200.2, DoD 5200.2-R, AR 25-2 and AR 380-67 (for Army), and applicable regulations for other services, is mandatory for ADP Sensitive positions.

4.3.3 Unless otherwise specified, all financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the contractor and/or contractor HCPs during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of health care services under this contract. The contractor and/or contractor HCPs shall not release any of the above information without prior written consent of the KO.

The contractor and contract HCPs shall prepare medical records, forms and documents as required, in accordance with the regulations and established guidelines listed in the contract and those established by the MTF Director.

4.3.4 The contractor and contract HCPs shall abide by federal and local MTF regulations and requirements concerning the nature of privileged communication between patients and the HCP as may be necessary for security and personnel reliability programs. They shall also abide by federal and local MTF regulations concerning the confidentiality of patient records, to include but not limited to the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act (HIPAA) of 1996. All regulations referenced are available for review from the COR, MTF, or the KO. All medical records and reports will remain the property of the Government.

4.4 MEDIA INQUIRIES: The contractor shall not respond to any media inquiries. All inquiries from the media shall be immediately relayed to the COR who will relay them to the MTF Director. There shall be no interviews, comments, or any other response without the knowledge and approval of the MTF Director.

4.5 STANDARDS OF PERFORMANCE:

4.5.1 The government requires that the contractor shall provide technically competent certified personnel who will provide services at an acceptable national standard of productivity, patients per hour, patient satisfaction, and quality of chart review enabling the MTF to provide a high level of quality health care.

4.5.2 JC Standards. Contractor shall take part in Department and MTF programs as required to meet JC standards.

4.5.3 Other performance evaluation factors will be monitored that are not quantified by numerical measurements which include: contractor providing personnel exceeding the minimum qualification standards; patient customer service comments; provider relationship with consultants; and contractor relationship with hospital staff/government contracting personnel; compliance with hospital policy and procedures.

4.5.4 Performance Reports will be provided by the COR monthly to the Contracting Officer to ensure acceptable performance of the contract. The Contractor can request copies also be forwarded to the assigned Contractor POC. The Contractor POC will receive notice of UNACCEPTABLE PERFORMANCE within 7 days of the COR becoming aware of any unacceptable performance and will report it to the Contracting Officer.

4.5.5 The Contractor shall be responsible for the security of all patient information.

4.5.6 Neither the Contractor nor any of its contract service providers shall disclose or cause to disseminate any information concerning operations of military activities. Such action(s) could result in violation of the contract and possible legal actions.

4.5.7 All inquiries, comments or complaints arising from any matter observed, experienced, or learned of as a result of or in connection with the performance of this contract, the resolution of which may require the dissemination of official information, shall be directed to the contracting officer representative (COR) and the contracting officer.

4.5.8 The Contractor shall only conduct business with designated government personnel listed as points of contact (POCs). Names of authorized personnel shall be provided to the Contractor by the Government, in writing, and updated as necessary throughout the contract period. The contractor must designate the point of contact prior to the start of contract performance.

4.5.9 U.S. Government records, copies of original results and reports, verified original data, corrected data, and corrected supporting final reports are maintained by the Contractor, but remain the property of the U.S. Government. These files/results must be surrendered to the COR.

4.5.10 Outcome: The government requires that the contractor provide qualified personnel who shall fulfill the performance requirements at a standard that meet DoD benchmarks for the Anesthesia Department which enables the MTF to provide a high level of quality health care.

4.5.11 Government Quality Assessment and Improvement (QA&I):

4.5.11.1 The Government will monitor the Contractor's performance under this contract using the quality improvement/assessment procedures established by MTF. Additionally, the Contractor's performance is subject to scheduled and unscheduled review by a Quality Assurance Evaluator as defined by the MTF QA Plan & AR 40-68.

4.5.11.2 Quality Control (QC). The Contractor shall maintain a complete Quality Control Plan that shall ensure the requirements of the contract are provided as specified. Within thirty (30) calendar days after contract award, a comprehensive QCP shall be submitted electronically to the COR and within five (5) working days when changes are made thereafter.

4.5.12 Productivity Standards: Acceptable measures include:

4.5.12.1 Meet DoD Physician - Anesthesiology. This may include Relative Value Units (RVU), encounter volume, and encounter coding.

4.5.12.2 A maximum of 2 substantiated patient complaints per year per contract employee, but if a complaint is particularly offensive the contract employee may be removed immediately.

4.5.12.3 Department/clinic supervisory personnel will monitor Contractor and employee performance through Government information systems, records, patient records, customer service information, Contractor reports and time sign-in/out sheets. Contractor performance will be monitored the same as other military and Government physicians with respect to MTF and department quality improvement processes.

4.5.12.4 Contractor shall maintain a fill rate of 98% for all scheduled hours.

4.5.13 Trusted Associate Sponsorship System (TASS):

4.5.13.1 The contractor shall comply with agency personal identity verification procedures identified in the contract or which otherwise implement Homeland Security Presidential Directive-12 (HSPD-12), Office of Management and budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

4.5.13.2 The contractor shall ensure all subcontractors comply with agency personal identity verification procedures when the subcontractor is required to have physical access to a federally-controlled facility or access to a Federal information system.

4.5.13.3 The contractor shall ensure compliance with the provisions set forth below. For purposes of FAR Clause 52.204-9 and personal identity verification procedures, the Government will designate a Trusted Agent (TA), and the contractor shall designate a Facility Security Officer (FSO), for this contract. The Government reserves the right to amend or supplement these provisions pursuant to the Changes clause in the contract.

4.5.13.4 In-processing Requirements: Contractor personnel are prohibited from performing services under this contract absent compliance with the in-processing requirements set forth below.

4.5.13.5 For every contract service provider, the FSO shall provide the following information to the TA for input into the Defense Enrollment Eligibility Reporting System / Real-time Automated Personnel Identification System (DEERS/RAPIDS):

Last Name First Name Middle Name Social Security Number Date of Birth E-mail Address (may be either the e-mail address of the incoming individual or the FSO).

4.5.13.6 The DEERS/RAPIDS Systems will send a notice to the e-mail address provided IAW the above requirement, in which the contract service provider's user ID and password are provided. In the event the e-mail message is sent to the FSO, the FSO shall notify the contractor of the contract service provider's user ID and password.

4.5.13.7 The contract service provider shall log into the DEERS/RAPIDS System, and submit an application for acceptance into the System, using the user ID and password provided.

4.5.13.8 The application will be accepted, returned, or rejected by the TA. Notice as to whether the application has been accepted, returned or rejected will be provided to the individual's e-mail address provided within 48 hours after submission. If the application is returned or rejected, the contract HCP shall contact the TA and comply with the TA's guidance to attempt to correct and resolve the issues.

4.5.13.9 Upon approval of the application, the contract service provider shall receive an e-mail sent to the address provided stating the Common Access Card (CAC) application was approved and to proceed to the Verifying Office (VO) with two forms of identification with one containing a photo to obtain a CAC.

For CAC issuance, a DD2842 must be completed and taken by the individual with two forms of ID. The e-mail will contain a Uniform Resource Locator (URL) to download the form. Acceptable forms of ID are: Driver's License, Social Security Card, Military ID, Birth Certificate, and passport.

4.5.13.10 Revalidation Requirements: The TA is required to revalidate all contract service providers, in the DEERS/RAPIDS System, every six (6) months. In the event revalidation is denied, the CAC credentials shall be revoked and the Card will not be useable to login, and the HCP will be unable to perform contract requirements.

4.5.13.11 Prior to performing services under this contract, Employees must complete in-processing procedures through the Contract Support Office. In-processing procedures will also include obtaining a Government supplied DACH/FBCH security badge initiated through the MEDDAC.

4.5.13.12 Out-processing Requirements. When a contract HCP's performance under this contract/task order ceases; the contractor or FSO shall provide written notice to the TA. The TA will remove the contract HCP from the DEERS/RAPIDS System. The contractor shall ensure the contract service provider’s CAC, Government issued badges, ID cards and vehicle decals are turned in to the Government IAW the MTF's out-processing procedures and further guidance from the Contracting Officer.

4.5.13.13 MTF in/out-processing checklist: When commencing work under this contract, the contract service providers shall obtain in-processing checklist(s) from the COR or designated office. All contract service providers are required to complete the applicable items on the checklist and turn it in to the designated office. Upon termination or resignation, the contract service providers shall complete an out-processing checklist and returns it to the designated office.

4.5.13.14 IDENTIFICATION OF PRIVACY ACT. This contract requires the development of a system of records in accordance with the Privacy Act of 1974.

4.6 SCHEDULE/PERIOD OF PERFORMANCE

4.6.1 OVERTIME IS NOT AUTHORIZED

4.6.2 The HCP(s) duty schedule will be such as to accommodate the 24/7operations (including Federal Holidays and Government Designated training holidays). To maintain staff privileges at WBAMC, each contract HCP must work an average of four shifts per month during each period of performance (twelve month period). Contractor shall be required to work 8-24 hours shifts. Contract providers shall not be scheduled to work any shift within a minimum of 8 hours of completing a previous work shift at WBAMC or at any other military or civilian treatment facility.

4.6.3 Contractor is required to provide services during eight to twelve-hour shifts per day, seven days per week. MTF reserves the right to reduce or increase the number of shifts as necessary to meet the needs of the government as determined by the Department Chief or his/her designee.

4.6.4 The HCP may be required to work beyond the end of the shift while providing patient care in emergent and extenuating circumstances. The HCP shall remain on duty, if necessary, until the replacement HCP arrives. He/she shall ensure that continuity of care is provided to the patient and Extended Shift Hours will be used for direct patient care only. The contract provider will not receive additional compensation for working beyond his/her shift in order to accomplish administrative tasks.

Note: Extended Shift hours will be billed as regular hours.

4.6.5 In order to provide continuity of operations throughout each day, the number and length of breaks shall be coordinated with the other Anesthesia Board Runner or its representative; as time permits. Work hours and days will be determined by the MTF. Schedules are subject to change due to cancellations, hospital staff changes, organization day, emergencies, exodus, training holidays and unexpected events. The Contractor shall only be paid for actual hours worked.

4.6.6 The Contractor shall provide full coverage for the required hours of performance.

4.6.7 Hours worked do not include travel time to reach the MTF or other place of performance.

4.6.8 Unscheduled Shifts. Occasionally the government may ask for coverage of additional shifts to be added for a given month of service. When required, those shifts will be provided to the Contractor approximately two weeks prior to the month to be worked. If the contractor cannot or does not fill any shift-fills, added on by the government after the contractor meets his submission date, it will not count against the contractor in evaluating performance for that month. These hours will be invoiced under the unscheduled hours.

4.6.9 Substitute HCWs. If the Contractor substitutes permanent HCWs for a temporary period of time, the substitute shall meet the same qualification standards and health requirements. Substitutions will be required when the permanent HCW is unavailable for more than 10 calendar days.

4.6.10 The Contractor HCP may be required to extend the duty hours to ensure completion of the scheduled patient treatment or in cases of emergencies. Contractor HCP shall be paid the contract hourly rate until the Contractor HCP leaves the MTF premise. Hours worked do not include travel to and from the MTF.

4.6.11 Unscheduled Absences. If the HCP becomes ill while on duty, or is otherwise unable to fulfill his/her obligation to work, the Contractor shall ensure the Department Chief or his/her designee are notified as soon as possible. In cases of unscheduled absences or illness prior to the beginning of the shift, the Contractor shall ensure the Department Chief or his/her designee are notified within the first hour prior to each duty day that the HCP is unable to report to work. The Contractor is required to provide a replacement HCP for unscheduled absences longer than 24 hours. The HCP shall not be tardy and/or have an unscheduled absence without a valid reason more than two times per period of performance (12 month period); otherwise, it can be considered grounds for immediate removal.

4.6.12 Facility Closures: During anticipated closure of the facility due to Command declared training holidays, administrative leave granted to the entire government staff, or other closure, Contractor HCPs may not be required to perform services, unless specifically scheduled. In the event of unplanned closure of the facility due to natural disasters, military emergency, or severe weather, contract workers who are scheduled to work shall not report to work unless notified differently. If required by the Department Chief contract employees deemed essential personnel will be required to report for duty during Facility Closures.

4.6.13 Continuity of Services: The Contractor shall provide full coverage for the hours of performance shown in the contract. The Contract physicians shall not end/his/her workday without completing or transferring patient car responsibilities to the incoming physician in writing.

4.6.14 Federal Holidays: The Contractor will not be paid on federal holidays unless Contractor HCP is scheduled to work on a holiday and will be paid for hours worked at the hourly rate established in the

4.6.15 Holidays: The following is a list of legal federal holidays as referred to elsewhere in the contract/task order. Contractor HCP may be required to work on legal holidays as determined by the Department Chief.

New Year's Day, January 1st Martin Luther King's Birthday, 3rd Monday January President's Day, 3rd Monday in February Memorial Day, Last Monday in May Independence Day, July 4th

Labor Day, 1St Monday in September

Columbus Day, 2nd Monday in October Veteran's Day, November 1 1th 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 Contractor HCP 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.

4.6.16 The Contractor HCP may be required to extend the duty hours to ensure completion of the scheduled patient treatment or in cases of emergencies. Contractor HCP shall be paid the contract hourly rate until the Contractor HCP leaves the MTF premise. Hours worked do not include travel to and from the MTF.

4.6.17 By the fifth day (5th) of each month the Contractor shall submit a report to the COR or designated GOV POC of the hours worked by the HCPs for the previous month.

4.6.18 POINT OF CONTACT: No Later than three business days after contract award, the contractor shall provide both the Contracting Officer and the COR the name, local telephone number and designation letter of the individual who shall act as the Contractor's designated representative. The designation letter shall include any limitations on the Contractor's designated representative ability to bind the Contractor to changes and/or adjustments. The Contractor's designated representative shall be responsible for the overall management and coordination of the contract with the designated COR. The Contractor’s representative may be a staff member performing services under this contract. However, the provider shall not perform administrative duties as project manager while scheduled to provide patient care. The contract representative will not be reimbursed for time spent performing on-site administrative duties when he/she is not performing in the capacity of MD/DO. The Contractor's representative shall meet (may be telephone) with the COR as requested to discuss any problems with the performance of the Contractor's providers. Problems experienced by the Government with the Contractor's performance will be discussed and resolved. Unresolved problems will be referred to the KO for resolution.

4.6.19 INTERVIEWS: There will be no interviews conducted by government personnel.

4.6.20 PERFORMANCE QUALITY: The Contractor shall establish and maintain a complete Quality Control Plan (QCP) that shall ensure the requirements of the contract are provided as specified in Section 5 of the PWS. Within thirty calendar days after contract award a comprehensive QCP shall be submitted electronically to the COR and within 5 working days when changes are made thereafter.

4.6.21 PHASE IN /PHASE OUT PERIOD: To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the Contractor shall have personnel on board, during the thirty (30) days phase in/ phase out periods.

4.7 PERSONAL APPEARANCE:

4.7.1 The Contractor shall present a neat and clean appearance.

4.7.2 All outer clothing shall be laundered or dry cleaned as appropriate, well-fitting and fresh each workday.

4.7.3 Shoes shall cover the foot to meet sanitation and safety requirements. Open-toe shoes or sandals shall not be worn.

4.7.4 Fingernails shall be clean and not extend one quarter of an inch beyond the flesh tips. Acrylic nails or overlays are prohibited.

4.7.5 Hair shall be neatly groomed. The length and bulk of hair shall not be unkempt, or of extreme appearance.

4.7.6 Contractors shall wear dresses, pants or slacks, shirt or blouses with collar and sleeves, shoes and socks. Tank tops, cut-off pants, shower shoes or similar items of apparel are specifically prohibited. In all cases, contractor employees shall conform to the established personal appearance policy of MTF.

4.7.7 Hospital scrubs shall be worn while assigned to department duties.

4.8 HEALTH AND IMMUNIZATION REQUIREMENTS:

4.8.1 All contract providers/technologist 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. For the purposes of this paragraph, 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 containing tetanus, diphtheria and pertussis 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. A tuberculin skin test of 10 mm of induration or more will require documentation providing 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 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.

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

4.8.2 Influenza Immunization:

4.8.2.1 Contract employees shall have the current influenza immunization unless documented by a physician to be medically contraindicated or because of bonafide Religious exceptions prior to commencement of work at MTFs. The contractor will provide proof to the COR that the contractor employee has received the inoculation.

4.8.2.2 Contractor employees shall receive annual influenza immunizations thereafter when directed by the COR. The contractor will provide proof to the COR that the contractor employee has received the inoculation.

4.8.2.3 Infection Control: The contractor shall adhere to the Centers for Disease Control guidelines concerning universal precautions and Exposure Control Plans for Blood Borne Pathogens & the Management of Regulated Medical Waste, at all times while providing services under this contract. The contractor must abide with the DHCN/FBCH, MEDDAC Regulation No. 1-2, and Artificial Fingernail Regulation. The contractor shall report all PPD converters to Infection Control and comply with guidance provided. If the hospital Director determines the N95 mask (or equivalent) is necessary, the government will provide the mask, but the Contractor will provide the mask fit test at no cost to the government.

4.9 CREDENTIALED PERSONNEL DOCUMENTATION.

See Army Regulation 40-68, http://www.army.mil/usapa/epubs/pdf/40_69.pdf for list of personnel that require credentialing.

4.9.1 Certified Registered Nurse Anesthetist (CRNA) and Physician-Anesthesiology must be privileged by the Commander prior to providing services under this contract. Any failure to meet the credentialing and privileging requirements will result in the physician not being allowed to provide services under this

4.9.2 The contractor shall be required to begin full performance of the contract requirements within 90 days after award. It is absolutely critical that privileges be granted to meet the contract requirements by the commencement date. The date that the contractor begins full performance is considered the commencement date. The contractor must submit completed credentials applications on those HCP’s, and proposed backup or replacement personnel, who will be performing services under this contract to the COR for submission to the Credentials Committee. Credentials shall be submitted to COR.

4.9.3 Medical Privileges will be granted by the MTF Commander. Compliance with the privileging requirements as stated in this section is essential to the performance under this contract. Failure to meet any of these privileging requirements is considered nonperformance and may result in termination of the contract. The Contractor shall submit all required privileging requirements to the COR. The COR will forward the credential packets to the credentials office for action. The failure to submit completed credentials application packets 45 days prior to commencement of performance may result in the contract health care provider not being privileged in time to perform. Privileged Providers must provide packet and items as listed in AR 40-68.

4.9.4 Privileged Providers must provide documentation as listed on the form: Documentation Requirements for Privileging for FBCH will be provided upon contract award.

4.9.5 The Contractor shall take specific actions, including Primary Source Verification, to ensure that contract HCP applications submitted for privileging have the required requisites and do not have disqualifying impediments for privileges. This is the responsibility of the Contractor.

4.9.6 Privileging process is subject to the provision of Army Regulation (AR) 40-68.

(http://www.army.mil/usapa/epubs/pdf/r40_68.pdf) Medical services, Quality Assurance Administration, and any subsequent changes to that regulation or any successor regulations that might evolve. The Credential Committee established at the MTF is the sole agency authorized to accept applications for privileges submitted by the Contractor and to make recommendations to the Commander for the granting of privileges.

4.9.7 The MTF Commander is the sole authority that can grant, revoke or otherwise restrict the privileges of any contract employee whom he determines is not qualified to perform contract services.

4.9.8 Once privileges are granted by the MTF Commander, subsequent actions taken concerning the privileges of contract employee, including any limitation on privileges, will be governed by the procedures in AR 40-68.

4.9.9 Any actions taken by the MTF Commander that suspend, revoke, place in abeyance, or otherwise restrict the privileges of contract employee result in not being authorized to perform under the contract. A replacement contract employee, with the same qualifications, must be provided according to the terms of this contract.

4.9.10 Adverse actions on contract provider privileges, taken by the Commander, are appealable to the MTF Commander by the contract provider under the provision of AR-68. Final determination by the MTF Commander are non-appealable by the contractor.

4.9.11 Should the Contractor need to add additional providers during the contract period, the same privileging process as stated in this section shall apply for each additional provider.

4.9.12 Privileged providers must in process with the FBCH Credentials Office prior to seeing patients.

4.9.13 Privileged providers must also out-process with the Credentials Office upon leaving employment with the organization.

4.9.14 Credentials Packet. Provides detailed explanation and delineation of the documents required for the completion of an application for the MTF Credentials Committee and Commander to grant privileges to the contract employee proposed to actually perform the required contract services. The contract employee must obtain and submit a National Physician Identifier Number with the credential packet. The packet is sent to the contractor upon award.

4.9.15 Incomplete credentials application will be promptly returned to the Contractor, and will not be submitted to the Credential Committee. A clear description of the deficiencies which render the credential application will be furnished.

4.9.16 Return of an incomplete credentials application for completion is not a waiver of the requirement to submit a complete application. More than two submissions of incomplete applications will be considered a failure to perform.

4.9.17 The COR will promptly notify the contractor when privileging action has been determined. The COR may notify the contractor either in writing, or verbally (in person or by telephone) followed by written confirmation.

4.10 MOBILIZATION AND OTHER CONTINGENCY PLANNING:

4.10.1 The Contractor HCP may be expected to fill in for mobilized (deployed) staff. Such demands could require extended work hours and expansion of the contract workforce.

4.10.2 To ensure the Government operations can progress with no or only minimal disruption, the Contractor HCP shall anticipate the possibility of a mobilization or similar emergency and identify the steps it will need to take to rapidly expand its contract capabilities to meet the emergency.

4.11 CONTRACTOR EMPLOYEE FURNISHED SERVICES/SUPPLIES:

4.11.1 The Contractor HCP shall furnish all personnel and services to comply with the requirements of this contract, except where specifically identified as government-furnished supplies and services.

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

4.11.3 HEPA Mask Fitting Test. All personnel performing patient care services under this contract shall abide by the Respiratory Protection standards (including the HEPA Mask Fit Testing) as stated in MEDDAC Reg 385-1, at no additional cost to the government.