Performance Work Statement Medical-dental.pdf

United States Merchant Marine Academy (USMMA) Performance Work Statement for the Provision of

Medical, Dental, Counseling Services for Midshipmen

TABLE OF CONTENTS

BASIC SERVICES

A. Organization B. Background C. Scope of Work D. Place of Performance E. Performance Schedule (Medical, Dental, Counseling) F. Period of Performance (Base+ Four (4) Options) G. Performance Standards H. Security Requirements I. Medical/Health Communications / Qualifications / Personnel J. Vacation/Time-off, Replacement and/or Transition of Position(s) K. Required Reports & Documents L. Work Attire/Dress Code M. Certifications/Training N. Operations

Weekend Services (every weekend)

Holiday Schedule Irregular Operations Interference with Normal Functions Notice of Government Delays

REQUIREMENTS &

DELIVERABLES

I. ON-SITE SERVICES PROFESSIONAL HEALTHCARE SUPPORT SERVICES

(Medical / Health Staff)

II. OTHER REQUIRED ON-SITE PERSONNEL & SERVICES

A. Equipment Assessment B. Infection Control Assessment C. Orthopedic Team Physician & Orthopedic Consultant

III. ON-SITE MEDICAL SUPPLIES AND EQUIPMENT

A. Government Furnished Property B. Contractor Furnished Supplies & Equipment

DELIVERABLES (continued)

IV. MISSION SUPPORT REQUIREMENTS AND DELIVERABLES

A. Professional Guidance & Consultation for the Department of Physical Education & Athletics B. Pharmacy Services C. On-Site Diagnostic Lab Services D. Examinations for Sea Duty, U.S. Coast Guard Licensing, Reserve/Active Duty

Commissioning E. Operation of "Sick Call" Daily F. Provision of 24 hour, 7 days Weekly, 365 Days Access to Mental Health Resources G. Provision for Culture of Trust, Transparency and Support

V. INSPECTION OF SUPPLIES AND SERVICES

A. Contractor Statements B. Contractor's Quality Control Program C. Government Quality Assurance D. Contractor's Responsibilities and Insurance Requirements E. Fully Insurance Reimbursed Hospital-Based Medical/Health Services

VI. SAFETY REQUIREMENTS

A. Disposal of Hazardous Waste B. Control & Disposal of Hazardous Chemicals

VII. CONTRACTOR NOTIFICATIONS

A. Organizational Conflicts of Interest B. Incidents C. Tort Claims

VIII. DATA GATHERED OR CREATED IN PERFORMANCE OF CONTRACT (USMMA

Owned Data)

IX. PATIENT INFORMATION

A. Patient Scheduling System B. Patient Rights C. Patient Satisfaction Survey D. Nondiscrimination in Services Provided to Beneficiaries

DELIVERABLES (continued)

X. OFFSITE MEDICAL / HEALTH SERVICES

XI. DEFINITION OF TERMS

XII. CONTRACT ADMINISTRATION

XIII. CONTRACT CLAUSES

52.252-02 Claims Incorporated by Reference (Feb 1988)

52.217-8 Option to Extend Services (NOV 1999)

52.217-9 Option to Extend the Term of the Contract

(MAR 2000)

52.237-3 Continuity of Services (JAN 1991)

52.237-7 Indemnification & Medical Liability Insurance (JAN 1997)

Tar 1252.237-70

BASIC SERVICES

A. Organization

The Maritime Administration (MARAD)/U.S. Merchant Marine Academy (USMMA) is a federal service academy that educates and graduates leaders of exemplary character who are inspired to serve the national security, marine transportation, and economic needs of the United States as licensed Merchant Marine Officers and commissioned officers in the Armed Forces.

B. Background

The Code of Federal Regulations, 46 CFR 310.62 requires Midshipmen at the USMMA to receive limited medical and dental care. For the purposes of this statement of work (SOW), limited medical and dental care is defined as healthcare provided using any appropriate contractor healthcare personnel, equipment and supplies that can be reasonably made available on site at the USMMA Department of Health Services (hereby referred to as DHS).

Referrals of Midshipmen to offsite healthcare facilities become an insurance billable event (with exception to supportive laboratory and diagnostic work associated with onsite diagnosis and treatment needs). Therefore, the contractor must make every reasonable attempt to provide care for Midshipmen at DHS with the goal to eliminate off site referrals when determined clinically safe to do so to meet the CFR 310.62 requirements and prevent unnecessary insurance billing, co-pays and excess use of off-site facilities, such as the emergency room. The Contractor is required to provide a quality assurance (QA) process to ensure that Midshipmen are not referred off site for care that can be rendered on site at USMMA. As part of the request for proposals (RFP), the contractor response should include, in addition to this QA process, a remedy for Midshipmen who are financially impacted from having provided payment (co pays) for care that could have been rendered on site at USMMA.

C. Scope of Work

Healthcare professionals (medical, dental, behavioral and emergency medical services) and administrative support staff will provide limited medical and dental care services for the Midshipmen. When determining the appropriate needs of healthcare professional staff and/or healthcare administrative support staff the Government needs for meeting the mission of USMMA will prevail. All medical/dental diagnostic equipment, lab services and medical/dental recurring supplies used to examine, diagnose, render invasive or non-invasive intervention and care of the Midshipmen at USMMA shall be supplied by the prospective contractor.

The medical/dental staff will examine, diagnose, and render invasive or non-invasive intervention and care for an estimate of 1000 Midshipmen, male: approximately 80% and female: approximately 20%.

D. Place of Performance

U.S. Merchant Marine Academy / Department of Health Services Patten Hall 300 Steamboat Road Kings Point, NY 11024

E. Performance Schedule

Medical Services: Sunday thru Saturday (Note-Staffing is reduced to one Physician Assistant, one Registered Nurse, one Medical Office Assistant or equivalent on Saturday- Sundays) Hours of Operation: Monday through Friday 7:00am-3:30pm, Saturday/Sunday 9:00am-5:30pm

Dental Services: Monday through Friday Hours of Operation requested: 7:00am-3 :30pm.

Counseling/Mental Health Services: Sunday thru Saturday (Note-Staffing is reduced to one Counselor on Saturday-Sundays) Hours of Operation requested: 7:30am-4 :30pm Monday through Friday, Saturday/Sunday 9:00am-5:30pm

For all scheduled days of services provided, Medical, Dental and Counseling Services will include sick call hours, scheduling routine sea duty, commissioning and licensing physical examinations of Midshipmen. The Contractor/COR will work to ensure Midshipmen are provided notice and knowledge that these specific services are available. The use of weekend schedule time will be a priority over week day scheduling whenever possible to avoid academic and regimental conflicts.

The contractor cannot exceed the number of hours agreed upon for weekday and weekend schedules without approval from the COR.

F. Period of Performance (Base+ Four (4) Options)

The contract shall cover a Base period (2026-2027 from date of award through 12 consecutive months. The contract will be incrementally funded. There will be Four (4) one year options (2027-2031) allowing the Government to unilaterally extend the contract period for 12 months each. The option periods are subject to the availability of funds which will be available upon concurrent agreement between the contractor and the government.

G. Performance Standards

During the performance of the contract, the contractor shall remain continuously cognizant of the fact the services provided within the buildings and surrounding areas at USMMA represent services performed that reflect upon the United States Government. It is essential that contractor employees and services performed do not in any way bring discredit upon the

USMMA.

Professional interaction while performing patient care, treatment plan development and management of sea duty, and achieving U.S. Coast Guard and Commissioning medical milestones will be tempered by compassion and empathy for Midshipmen, USMMA Federal employees and/or other contract staff. Contract staff are required to support the Academy's core values and promote a culture that unites the campus community with a shared vision.

USMMA Core values are:

RESPECT: Promote an environment where inclusion, multiculturalism and diversity are encouraged and valued. Communicate effectively and engage in healthy relationships. Maintain the highest level of professionalism as it relates to behavior and interpersonal skills.

HONOR: Be honest and trustworthy and maintain the highest level of integrity.

Take responsibility and accountability for your actions and for those under your leadership. Demonstrate courage and stand up for the honor of others.

SERVICE: Generate the highest levels of trust, unity and pride in all Academy undertakings. Consider the needs of others before your own self-interest. Engage in leadership opportunities that contribute to our Nation's maritime and military interests, and our community.

For the purposes of maintaining contractual integrity, contract staff may not engage in work requested by any USMMA employees unless the work is approved as within the scope of the contract by the Contracting Officer (CO) or the Contracting Officer Representative

(COR).

The contractor will designate, in writing, who shall be responsible for the competent performance of all services as specified in this SOW. The reasonable expenses must be agreed upon by the CO prior to the removal for convenience. A removal for cause does not subject Government to any liability.

The request for removal of a contract staff employee will only be made by the MARAD Office of Acquisitions, through the COR/DHS Director. No other MARAD individual is authorized to do this.

Quality Assurance Surveillance Plan

1. Introduction

This Quality Assurance Surveillance Plan (QASP) is designed to provide the Maritime Administration (MARAD) and The United States Merchant Marine Academy (USMMA) with an effective surveillance method of monitoring and evaluating the contractor’s performance pursuant to the requirements listed in the Performance Work Statement (PWS) for deliverance of Healthcare professionals (medical, dental, behavioral and emergency medical services), equipment, supplies, pharmacy, laboratory and administrative support staff to provide limited medical and dental care services for the Midshipmen at The United States Merchant Marine Academy (USMMA).

From Federal Acquisition Regulation (FAR) Part 37.601, performance-based contracting methods are intended to ensure that the required performance quality levels are achieved and that the total payment is related to the degree that services performed, or outcomes achieved meet contract standards. The QASP shall focus on the level of performance, rather than the methodology used by the contractor to achieve that level of performance.

2. Purpose

The QASP provides a means for evaluating whether the contractor is meeting the performance standards/quality levels identified and to ensure that the Government pays only for the level of services received.

This QASP defines the roles and responsibilities of all members of the integrated project team, identifies the performance objectives, identifies the performance quality level standards, and describes the methods of surveillance to identify quality levels for monitoring and evaluating the Contractor’s performance. It is intended to be a dynamic and variable document based on the Contractor’s performance throughout the contract. Flexibility allows for the method to change and the level of surveillance to increase or decrease over time depending on the level of confidence in the Contractor’s performance.

This QASP is based on the premise that the contractor, not the Government, is responsible for the management and quality control actions needed to meet the standards of the contract.

The contractor is responsible for performing the requirements of the contract and for providing quality control measures to ensure that contract requirements are met.

3. Roles and Responsibilities

3.1. Contracting Officer

The Contracting Officer (CO) will have overall responsibility for overseeing the contractor’s performance. The CO shall be responsible for monitoring the Contractor’s performance in the areas of contract compliance and contract administration. The CO will review the COR or designee’s written inspections and assessments of the contractor’s performance and resolve any discrepancies that may arise between the contractor and COR or their designee.

3.2. Contracting Officer’s Representative

The Contracting Officer’s Representative (COR) is responsible for monitoring, assessing, recording, and reporting on the performance of the contractor. The COR is responsible for technical administration of the project and ensures proper government surveillance of the contractor’s performance. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf. Any changes that the contractor deems may affect contract price, terms, or conditions shall be referred to the CO for action. The COR will have the responsibility for completing quality assurance monitoring forms used to document the inspection and evaluation of the contractor’s work performance.

4. Methods of Surveillance

The method of surveillance is based on the performance criteria of the contract terms and specifications. Each requirement will describe the tasks to be performed and the acceptable quality level for successful performance. To minimize the performance management burden, simplified surveillance methods shall be used by the Government to evaluate contractor performance when appropriate, which may be on a daily, weekly, monthly, quarterly, semi-annual, or annual basis.

MARAD intends to monitor and evaluate the contractor’s performance based on any or all the following surveillance methods:

4.1. Validated User / Customer Feedback

Relies on the user of the service to identify deficiencies. Also combines elements of user complaints and random inspection to solicit user interviews. Feedback is investigated and validated to help focus on areas that may require further action. Customer feedback may be obtained either from the results of formal customer satisfaction surveys or from random customer complaints.

4.2. Random Inspection

Evaluates by randomly selecting and inspecting outputs. There is no set percentage or minimum/maximum number of assessments conducted. The quantity of assessments will be based on findings and performance.

4.3. Unscheduled Inspection

Any aspect of the contractor’s performance may be inspected at any time during the period of performance of the contract. Variation of random inspection, however, inspection is taken when a pattern of performance deficiencies is suspected or when there are concerns that need attention.

4.4. Periodic Inspection

Surveillance tasks that do not require 100 percent inspection and performed at specific intervals of daily, weekly, monthly, quarterly, semi-annually, or annually that anticipates task perceived as user critical.

4.5. 100% Inspection / Direct Observation

Surveillance of all the work and generated documentation.

5. Performance Requirements Summary

To enhance clarity, an evaluation rating for acceptable quality levels is determined based on a standard for successful performance and will be defined as follows for the assessment of contractor performance:

• Exceptional o Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the performance standard being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

• Very Good o Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the performance standard being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

• Satisfactory o Performance meets contractual requirements. The contractual performance of the performance standard contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

• Marginal o Performance does not meet some contractual requirements. The contractual performance of the performance standard being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

• Unsatisfactory o Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the performance standard contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Required Tasks and Outputs /

Reference

Performance Standard / Minimum

Requirement

Acceptable Quality Levels

Surveillance Method

Incentive Vs.

Dis-incentive-

Requirements & Deliverables, “I”

On Site Professional Healthcare Support

Services Contract Manager

Contractor conducts independent management analysis and review of all program deliverables to assess program effectiveness, efficiency, and adequacy of internal controls

Validated User/Customer

Feedback, Random

Inspection, Unscheduled Inspection, Periodic Inspection, Direct Observation

Exercise of option period;

Satisfactory

CPARS

Vs.

Non-exercise of

Option;

Removal of poor performing staff;

termination of contract, unsatisfactory

CPARS

Required Tasks and Outputs / Reference

Performance Standard / Minimum

Requirement

Acceptable Quality Levels

Surveillance Method

Incentive Vs.

Dis-incentive-

Requirements & Deliverables “I”

On Site Professional Healthcare Support Services

All Positions Under Contract

In accordance with stipulated positional requirements, contractor participates in

USMMA

activities/staff discussions outlined by the COR and contract, related to provision of care, insurance management, development/pr esentation of educational/inf ormational programs in support Midshipmen

Feedback, Random

Inspection, Unscheduled Inspection, Periodic Inspection, Direct Observation

Exercise of Option Period;

Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, unsatisfactory

CPARS

wellbeing on campus and at sea. Provision of guidance related to infection control, management of general medical situations impacting Midshipmen population.

Midshipmen are made to feel welcomed and are treated respectfully by all contract staff.

Required Tasks and Outputs / Reference

Performance Standard / Minimum

Requirement

Acceptable Quality Levels

Surveillance Method

Dis-incentive

Basic Services “K” –

Required Reports & Documents

Monthly reports, any requested patient care reports (such as types of visits, number of visits, Patient volume, etc.),are provided to the COR. Progress of assigned contract tasks and activities are monitored regularly for on time delivery and accuracy.

Status updates are provided to the COR and

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, demonstrate all active tasks being performed under contract are on track/meeting customer needs.

Required Tasks and Outputs /

Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

Deliverables III, A

Government Furnished Property / Equipment / Facilities

All materials provided by the Government during this service will remain the property of the Government and will be returned on completion of the service.

The contractor will maintain government provided property in a neat orderly condition, undamaged.

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

Deliverables III, B

The contractor will (at cost plus

Feedback, Satisfactory

Contractor Furnished supplies/Property / Equipment shipping/handli ng), inspect, maintain and replace as needed all medical, surgical, dental or other health care related supplies and equipment necessary to properly examine, diagnose, provide treatment, assess patient care needs and level of care required. This includes supplies or equipment to be used for treatment provided on site. • The contractor is responsible for ensuring all supplies and equipment meet all appropriate ongoing regulatory requirements for patient care use. The contractor will develop and/or maintain a campus wide automated external defibrillator

(AED)

Random Inspection, Unscheduled Inspection, Periodic Inspection, Direct Observation

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, Program. The contractor may be required to provide telephone, printer/copier/f ax machines and desktop computers for the contract staff that must operate independent of

USMMA

utilities and/or Information Technology Support, including server systems.

All equipment, services and supplies must be reviewed and approved prior purchase by the COR.

Required Tasks and Outputs / Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

Basic Services, “D”

Place of Performance

The primary place of performance will be onsite USMMA/in person for 98% of contract performance needs.

Telework at the contractor or contractor personnel’s designated site is used when approved by

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, COR and is appropriate (such as for sea duty contact when Midshipmen cannot be seen in person).

Required Tasks and Outputs / Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

“E”, Performance Schedule, “N”, Operations, Deliverables “I”

Staffing is Available for all Positions According to Contracted Hours of Operations

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, unsatisfactory

CPARS

Required Tasks and Outputs / Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

Deliverables “IV”, D

Physical examinations for Sea, Licensing & Commissioning

Adherence with stipulated timelines per

USMMA

needs. All physicals are conducted, reviewed and submitted in accordance with USMMA completion dates

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

Deliverables “IV”, D

Physical examinations for Sea, Licensing & Commissioning

Accuracy of information collection/repo rting by examining providers on all official government forms used to record requested findings obtained during physical examinations for Sea, Licensing & Commissionin g

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, unsatisfactory

CPARS

Required Tasks and Outputs / Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

Basic Services “I”

Medical/Health Communications

Requests for services from external

USMMA

departments are brought to the attention of the COR and the contractor shall not take action unless such services are approved by the COR as

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, contract relevant.

CPARS

Required Tasks and Outputs / Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

Basic Services “I”

Medical/Health Communications, Urgent outpatient care:

clinical information, safety and location are communicated back to USMMA staff for accountability as determined by the COR

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, unsatisfactory

CPARS

Required Tasks and Outputs / Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

Safety Requirements “VI, A & B

Patient Safety, Hazardous Waste/Chemicals Management

Patient safety incident investigations, conclusions and findings, patient complaints and corrective actions are reported to the

COR.

Contractors corrective actions are appropriate and yield positive outcomes.

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, unsatisfactory

CPARS

Required Tasks and Outputs / Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

Deliverables

Offsite Medical / Health Services “X”

Access to care, all patients, to all services onsite and offsite is timely for matriculation needs and continuum of care

For all services, patients must be seen by a provider in a timely manner as contractually specified.

This includes all onsite and offsite

USMMA

specialty care services, patient must be able to schedule an appointment with an offsite specialist in a timely manner.

For all diagnostic services, patient must be able to schedule an appointment for a routine diagnostic test in a timely manner.

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal of poor performing staff;

termination of contract, unsatisfactory

CPARS

Required Tasks and Outputs / Reference

Performance Standard / Minimum Requirement

Acceptable Quality Levels

Surveillance Method

“G”, “H”, “I”, “L”, “M”

Employee Qualifications, Dress codes, security, contract

Contract employees meet all educational, experience, license & credentials required to perform

Feedback, Random Inspection, Unscheduled Inspection, Periodic Inspection, Satisfactory

CPARS;

Vs.

Non-exercise of Option;

Removal employee professionalism services under this contract.

All contract employees adhere to required dress codes, government security requirements and conduct themselves in a professional supportive manner.

Direct Observation of poor performing staff;

termination of contract,

6. Analysis of Surveillance Results

The performance thresholds recognize the contractor is not unrealistically perfect and unforeseen and uncontrollable issues do occur. Surveillance is to be objective, fair, and consistently reasonable in evaluating the contractor’s performance against the standards.

Impact on contractor payments is not applicable. Non-conforming services may result in non-conforming reports issued and a potential negative Contractor Performance Assessment Reporting System (CPARS) narrative.

All tasks that are considered to have unacceptable performance shall be substantiated, documented, and submitted to the contractor. Single minor defects will not require corrective action; however, the contractor should be notified that a minor defect has been noted in a service performed. The CO and/or COR may discuss with the contractor an event or trend that indicates unacceptable performance. Trends that show repeated minor defects in services should be brought to the attention of the contractor. For the first incident, a verbal notification should be made to the contractor. For repeated events with no effort of correction, written notification should be made. The contractor shall identify the plan of action, or the corrective action taken to bring performance up to the acceptable quality level within the time allotted by the CO or COR. The CO has final say in the corrective action.

H. Security Requirements

The U.S. Merchant Marine Academy campus is considered a secure government facility;

therefore, visitors to the USMMA must have a valid driver's license and will check in with guards at the entrance gate.

The COR will notify the Contractor of any changes to the position sensitivity level for personnel performing under the contract. The COR will also coordinate with MARITIME ADMINISTRATION Security Division concerning any adjustments to the position sensitivity levels. If any adjustments are made the COR will notify the Contractor of the requirements thereof.

Recognizing that work performed under this contract supports the Midshipmen Program of the USMMA, any legal action taken by patients (Midshipmen) against healthcare providers performing work associated with this statement of work shall be addressed and resolved via a mutually agreed upon legal channel of authority as set forth between the government and the contractor.

Before initiating performance of work under this contract, the contractor shall provide a list of all current employees who shall perform the work under this contract. The list will include the full name for each employee. The contractor will notify the COR in writing of any changes, additions or deletions in the list within thirty days of any changes.

The government retains the right, at no cost to the government, to require removal and replacement of any contract employee found to have violated any terms of the SOW/RFP or have performed their role under this contract in an unacceptable manner. In the event the USMMA has any reason to be dissatisfied with the qualifications, conduct, or performance of any person employed by the contractor, the USMMA will notify the contractor and the contractor shall investigate the matter and take appropriate corrective action as warranted. The contractor shall provide in writing to the CO/COR all final outcomes regarding findings and actions taken. The reasonable expenses must be agreed upon by the CO prior to the removal for convenience. A removal for cause does not subject Government to any liability.

Contract employees shall conspicuously display on their person an identification badge which shall include the full name of the employee. All contract employees will submit to a government conducted background check at the expense of the government. Employees failing to meet or maintain government requirements under this background check will not be allowed to perform services at USMMA under this contract.

The government is not responsible for reimbursement of hours for any potential contract employees while they are undergoing governmental conducted background checks as they are not yet authorized or cleared to perform services under the contract until successfully passing the background check.

Reimbursement will commence for hours worked on the first day the individual(s) can report for their contracted schedule after successfully completing the required background check. The COR will notify the contract designee when background checks are completed.

At the request of the USMMA or at the discretion of the contractor, and at no cost to the government, the contractor shall investigate any formal patient complaint, or report of unsatisfactory or inadequate medical treatment performed by a contractor employee.

I. Medical/Health Communications, Qualifications, Personnel

Statement of Work for the Provision of

• Communications The CO and/or COR shall provide guidance to the Contractor regarding names, position titles and phone numbers of authorized Government personnel. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that any requests for services are brought to the attention of the COR and the contractor shall not take action unless such services are approved by the COR. The contractor must communicate with the COR at all times regarding matters relevant to ongoing patient care and services rendered (including but not limited to commissioning, licensing, injuries, illnesses, Midshipmen absences due to health services actions, etc.) prior to discussing the aforementioned with academy staff unless otherwise indicated by the COR. Responses to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor. Additionally, activity performed without authorization shall be subject to any necessary corrective action as agreed to between USMMA and the contractor.

• Employee Qualifications

The USMMA reserves the right to restrict any contractor employee from performing services under this contract who do not meet the required qualifications for the services they are required to perform, and who violates Federal regulations or are identified as a potential threat to the security, safety, health and/or operational mission of the USMMA and its population.

The restriction of such contractor personnel shall not relieve the contractor from performing all the required services, in accordance with all terms, conditions, and schedules contained herein.

The Contractor shall furnish qualified personnel as required by contract specifications below to accomplish all services under this contract.

Contractor personnel performing services to the USMMA shall at all times conduct themselves in a professional manner, maintain personal hygiene, wear clean, neat uniforms and be identified by having the company name, and employee name affixed to the uniform. The Contractor shall be responsible for furnishing all, personnel, equipment and supplies, uniforms, nametags and/or badges for performance of services under this contract at no additional charge to the Government.

Employee identifications shall be worn in clear view above the waist. All Contractor personnel performing contract services shall meet the qualifications as specified in this contract, as well as any qualifications required by Federal, State, County and local government entities from the place in which they operate. Contractor personnel shall meet these qualifications at all times while performing services within this contract.

During the contract period of performance, if the Contractor proposes to add-on or replace personnel to perform contract services, the Contractor shall submit the required evidence of training, certifications, licensing and any other qualifications to the designated COR. At no time shall the Contractor utilize add-on or replacement personnel to perform contract services who do not meet the qualifications under the terms and conditions of this contract.

Within seven (7) days after receipt of award notification, the contractor shall provide evidence of required training, certifications, licensing and any other qualifications of any personnel performing services under this contract. The initial documentation shall be provided to the CO, Statement of Work for the Provision of

Contract Specialist (CS) and COR.

All contractor personnel sRhall attend all refresher continuing education, or advance training programs as required by the local or state government entity in which service is rendered.

• Personnel

Contractor personnel authorized and approved to perform services under this contract are considered to be Key personnel and shall not be removed or replaced without the prior written approval of the CO and COR.

Should the Contractor need to remove or replace any individual from the contract (e.g., promotion, attrition, firing, long-term illness, death, etc.) they shall notify the COR and CO in writing immediately upon realizing that a change is imminent. The Contractor shall provide 30-day written notification which explains the following:

o Why the removal or replacement is necessary;

o The name of the individual(s) being removed or replaced;

o The expected date the change is to occur;

o A plan for maintaining current support and/or a plan for transitioning support; and o Any other important information.

The resume(s) of the proposed replacement(s) and/or substitute(s) shall be submitted for COR and CO review and assessed in order for the background/security check procedures to begin. The proposed replacement's qualifications and experience shall be at least equal to those of the individual(s) being replaced. The CO will notify the Contractor upon completion of COR and CO review. •

. The reasonable expenses must be agreed upon by the CO prior to the removal for convenience. A removal for cause does not subject Government to any liability.

The request for removal will only be made by the MARAD/Office of Acquisitions through the CO/COR/Department of Health Services (DHS)/Director. (Note: No other MARAD individual is authorized to do this). In the event MARAD has any reason to be dissatisfied with the qualifications, conduct, or performance of any person employed by the contractor, the DHS Director will notify the contractor and the contractor shall investigate the matter and take appropriate corrective action as warranted.

J. Vacation/Time off, Replacement and/or Transition of Position(s)

The COR will determine whether position(s) are critical or non-critical. The Government will inform the contractor if a replacement is necessary. If the Government chooses to back-fill the position(s), staff flexibility will be taken into consideration.

During the position transitional period, human resources (HR) must conduct appropriate investigations for individual(s) to obtain a security clearance that may take 6 weeks (60 to 90 days) to approve a position(s).

K. Required Reports and Documents

Within seven (7) days after contract award the contractor shall provide the following:

a) Contractor Personnel Roster - In this document, contractor shall identify the employee -

• Name

• Position

• Title, and

• Work assignment area

b) Thereafter, any personnel changes shall be submitted within two (2) business days after the changes occur.

c) Certification of Minimum Liability Insurance Coverage - A certificate of insurance as evidence of insurance

d) Coverage is required prior to providing any services to the beneficiaries. Contractor shall provide the required proof of credentials within 10 calendar days after award and prior to providing any services. Thereafter, all changes shall be submitted within seven (7) days after changes occur.

e) The contractor and/or any of its agents who personally performed health services under the terms of this contract shall submit to the Academy via the COR, a USMMA Record of Services providing a summary of the service(s) rendered to the Midshipmen. A monthly report shall include: patients treated (both inpatient and outpatient) during the month, emergency department visits, and number and type of services provided.

f) At the request of the Academy or at the discretion of the contractor and at no cost to USMMA, contractor shall investigate any formal patient complaint, or report of unsatisfactory or inadequate treatment performed by a member(s) of the contract provided on-site health services staff and Corrective action, if appropriate, will be handled in accordance with contractor policy. A written summary of any corrective action will be provided to the Academy.

L. Work Attire/Dress Code

The contractor shall furnish apparel appropriate and necessary for the performance of this work.

This may include, but is not limited to lab coats, scrubs or other patient care garments.

All work attire must be freshly laundered, well-fitting and changed daily in accordance with all infection control standards as recognized by the Joint Commission guidelines or another regulatory agency. The higher standard for infection control for health care apparel shall prevail.

It is the financial and operational responsibility of the contractor to provide work attire at no cost to the government and without interruptions to services.

M. Certifications/Training

Medical, Dental, Counseling Services for Midshipmen

All employees performing work under this contract must be current in all NY State Licensing, Board of Health certifications and training requirements including, but not limited to infection control, blood borne pathogens, cardiopulmonary resuscitation (CPR) where appropriate and all other patient care related training. It is the financial and operational responsibility of the contractor to provide this training at no cost to the government and without interruptions to services.

N. Operations

• Weekend Services

Health services will be performed every weekend (Saturday and Sunday). The Contractor will provide evidence to the COR demonstrating structure of week end services that include staffing and operations for sick call hours, scheduling routine sea duty, commissioning and licensing physical examinations of Midshipmen. The Contractor/COR will work to ensure Midshipmen are provided notice and knowledge that these specific services are available. The use of weekend schedule time will be a priority over week day scheduling whenever possible to avoid academic and regimental conflicts.

The contractor cannot exceed the number of hours agreed upon for weekday and weekend schedules without approval from the COR.

• Holiday Schedule

Medical and health care contract services shall not be provided during periods that the Academy is closed even when significantly small groups of Midshipmen are on board except as otherwise determined by the COR, based on Academy needs. This includes:

o All Federal Holidays (see www.opm.gov) o Periods between academic trimesters and/or summer leave breaks o When small groups of Midshipmen remain on board for special events / athletic practice or contests o Fall semester break o One week prior to December 25 and all business days between December 25 and the return of Midshipmen from winter recess; and o Spring semester break and any business days after official commencement day in June through one day prior to the arrival of new incoming Midshipman Candidates.

The Academy may reduce operational times / hours accordingly for some / all listed on site medical/health services staff, up to and including eliminating some or all work days and/or hours within the regular Monday through Friday schedule during these periods.

In instances where a position/job title is vacated due to an absence related to vacation, illness or long-term leave, at the request of the government, the contractor shall provide a replacement

Medical, Dental, Counseling Services for Midshipmen with comparable credentials. Replacement personnel shall be afforded adequate orientation and be familiar with the day-to-day operations of the DHS.

• Irregular Operations

The Contractor will occasionally be required to provide clinical and non-clinical health care staffing support for events which exceed the normal negotiated work hours. Examples of these events include, but are not limited to closing of USMMA for a weather event, issues contributing to a limited operating status, natural disasters, a life safety event requiring health care provider assistance, unscheduled patient care requirements that exceed normal negotiated operational hours and Indoctrination operational support (Indoctrination is an annual event lasting a period of 3 - 4 weeks when all new students, known as Plebe Candidates arrive and participate in intensive physical training and academic orientation).

Any of the events and the associated hours more than the normal negotiated work schedule may be subject to overtime costs with no minimal hours worked requirement with exception to expanded operational hours associated with Indoctrination. Indoctrination expanded work hours are pre-arranged and all reasonable efforts must be made to avoid scheduling contract employees is excess of normally worked straight time hours within any given pay period.

In all cases, the number of hours worked by the contractor in excess to negotiated normal operational hours are subject to approval or disapproval by the CO/COR before they are worked.

Exceptions may apply if it is demonstrated that delays related to obtaining approval may severely and negatively affect the health and well-being of a patient.

Staffing levels will also be subject to approval of the CO/COR in negotiation with the contractor to assure that staffing levels will be sufficient. If emergencies will require contract employees to stay at the Academy overnight, USMMA will make a reasonable attempt to provide beds or cots for rest. Food will be made available for cost through existing USMMA Food Services.

Services provided are for Midshipmen in attendance at USMMA however, in life threatening emergencies, contractor medical personnel may be called on to provide standard emergency lifesaving procedures for anyone presenting to DHS.

• Interference with Normal Functions

The Contractor's personnel are required to interrupt their work at any time so as not to interfere with the normal functioning of the facility, including utility services, fire protection systems and passage of facility patients, personnel, equipment and emergency and/or service carts. These interruptions should only be occasional. Any interruptions considered to be excessive should be brought to the attention of the CO and COR.

• Notice of Government Delays

In the event the Contractor encounters difficulty in meeting performance requirements, or when it anticipates difficulty in complying with the contract or any Delivery order delivery schedule or date, or whenever the Contractor has knowledge that any actual or potential situation is delaying or threatens to delay the timely performance of this contract or of a Delivery order, the

Contractor shall immediately notify the CO and the COR, in writing.

The notice shall give pertinent details, provided; however, that this data shall be informational only in character and that receipt thereof shall, in no event, be construed as a waiver by the Maritime Administration of any delivery schedule or date or of any rights or remedies provided by law or under this contract.

REQUIREMENTS

DELIVERABLES

I. ON-SITE PROFESSIONAL HEALTHCARE SUPPORT SERVICES

Any provider of services to Midshipmen shall be insured by the contractor for malpractice/liability. Proof of this insurance and cost shall be provided as part of any offer. The contractor will provide methodologies used to maintain current certifications in NY State for infection control, blood borne pathogens, cardiopulmonary resuscitation (CPR).

Any Physician assigned to the Academy shall be Board-certified licensed by the New York State Board of Medicine/ Education Department (Office of Professions) having met education, examination and experience requirements as stipulated by same. The physician shall provide services to the USMMA for the purposes of rendering on-site medical services to the Regiment of Midshipmen. The physician must be clinically experienced within a medical scope of practice that includes, but is not limited to patients up to the age of 24. The physician should be familiar with patient care practices typically seen in internal medicine/family practice and have a minimum of 3 or more years of experience.

The Academy must ensure the continuing medical fitness of all Midshipmen at USMMA by authority of Title 46 CFR 310.56 and Superintendent Instruction 2014-09. The Physician contractor shall perform tasks which include the following:

• Provides medical leadership for all contracted healthcare providers and staff.

• Plans, develops, and implements an ambulatory medical care facility providing health services to include preventive, diagnostic, routine and emergent outpatient care.

• Provides guidance to Midshipmen Counseling & Personal Development and the mental health and dental professionals at DHS, as well as the COR.

• Examines and provides ambulatory medical care to Midshipmen. Interfaces with all medical and surgical consultants, to coordinate off site healthcare referrals & outcomes for Midshipmen.

• Reviews and implements Midshipmen immunization programs and periodic physical examinations of Midshipmen according to USMMA milestones for Sea Duty, US Coast Guard Licensing & Commissioning into the Armed Services.

• Assists in the development and administration of preventative medicine lectures and

Medical, Dental, Counseling Services for Midshipmen

• discussions with Midshipmen pertaining to safe health behaviors, practices and personal hygiene while assigned to sea duty or when on board USMMA.

• Works with the leadership of the Academy and interface as appropriate with Naval, Coast Guard and Defense Departments.

• Reviews and evaluates physical qualifications and standards for Midshipmen in consultation with the Department of Defense Medical Examination Review Board (DODMERB), the Department of the Navy's Bureau of Medicine and Surgery and the United States Coast Guard National Maritime Center.

• Communicates effectively with health services and/or non-medical personnel (administrative, faculty, and family members) concerning the health and wellbeing of Midshipmen. Communications required may be oral or written. Communications may involve corresponding with providers and organizations/agencies off the Academy grounds, at sea or in remote foreign health facilities.

• Ensures access to emergency care and inpatient care as appropriate.

• Serves as the Academy's principal medical consultant and liaison in establishing, authorizing, coordinating and maintaining effective health care support for Midshipmen

• Provides and coordinates general medical oversight to Emergency Medical Services (EMS) staff. Serves as Medical Director for the EMS Squad

• Oversees the preparation of the medical components of the Academy's DHS Standard Operating Procedure Manual. The Medical, Mental Health and Counseling, Dental, and Ambulance/Emergency Medical Services of DHS shall undergo periodic inspection and evaluation by formal accrediting health organizations, Department of Health of the State of New York, or by federal agencies assessing occupational and safety programs.