PWS DBRFC.pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR

Developmental and Behavioral Health Nurse Coordinator

(Clinical Coordinator) at the 86TH MEDICAL GROUP

Developmental and Behavioral Family

Readiness Center (DBFRC)

AT THE 86TH MEDICAL GROUP

4 June 2021

TABLE OF CONTENTS

Subject Page

1.0 DESCRIPTION OF SERVICES 3

2.0. SPECIFIC REQUIREMENTS 3

3.0. SERVICES SUMMARY (SS) 6

4.0. GENERAL INFORMATION 7

5.0. APPENDICES 15

5.1. APPLICABLE PUBLICATIONS AND FORMS 15

5.5. WORKLOAD ESTIMATE 16

5.6. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT

(HIPAA) OF 1996 16

1.0 DESCRIPTION OF SERVICES.

1.1 OVERVIEW OF SERVICES. This contract is a Personal Services Contract (PSC) and is intended to create an employer-employee relationship between the Government and the individual Health Care Providers (HCP) only to the extent necessary for providing the healthcare services required under this contract. The performance of healthcare services by the individual HCP under a personal services contract is subject to day-to-day supervision and control comparable to that exercised over military and civil service HCP engaged in comparable healthcare services.

Pursuant to 10 USC 1089(a), any personal injury claims alleging negligence by the individual HCP within the scope of the HCP performance of the personal services contract shall be processed by DoD in the same manner as claims alleging negligence by Department of Defense (DoD) military or civil service HCP. The contract does not create an employer-employee relationship between the Government and any corporation, partnership, business association or other party or legal entity with which the HCP may be associated. The authority for this contract is 10 United States

Code 1091. These services are considered to be non-mission essential as defined by DoDI 1100.22.

1.2. This requirement is in support of the 86th Medical Group’s (MDG) DBFRC. The Contractor shall be qualified to perform services in accordance with (IAW) this Performance Work Statement (PWS), and The Joint Commission

(TJC)). Relocation costs, if applicable, shall be included in the price of the service.

1.3. BACKGROUND INFORMATION. Increased developmental-behavioral requirements are significantly impacting Exceptional Family Member Program (EFMP) decisions. Especially for assignments to remote locations.

This limits/reduces Airmen/Unit Readiness by decreasing the number of eligible members available for PCS overseas or to other austere locations. The goal of the DBFRC initiative is to leverage innovation to connect families in isolated and medically constrained environments to developmental services, and increase the pool of eligible candidates to PCS to these remote locations.

1.4. PERSONNEL REQUIREMENTS: The Contractor shall provide a qualified Registered Nurse (RN) Clinical

Coordinator to perform day-to-day control at the 86th Medical Group, Ramstein Air Base, as identified in paragraph

2.1.

2.0. SPECIFIC REQUIREMENTS. The Clinical Coordinator shall:

2.1. Provide wrap around care of the patient and their family with developmental or behavioral needs by facilitating communication with patients and/or parents, Primary Care Manager (PCM) and the rest of the medical team to assist families and at-risk patients. Part of this duty includes, but not limited to gathering information about past medical history, living conditions, family dynamics, physical, psychosocial and cultural backgrounds which may influence medical treatment plan adherence and provision of safe, efficient, cost-effective care.

2.1.1. Assess developmental status of pediatric patients with parents through a developmental screening tool such as the Child Developmental Inventory.

2.1.2. Coordinate the distribution of psychological assessments such as the Post Traumatic Stress Disorder (PTSD) checklist, Generalized Anxiety Disorder (GAD-7), Vanderbilt, Child Depression Inventory, Conners’ or other assessments as determined by DBFRC or PCMH team as appropriate.

2.1.3. Identify patients who are at risk for complex care needs.

2.1.4. Complete and document initial assessments of each case expeditiously, as required by the patient need. In general, initial assessments will be completed within seventy two (72) hours of initial intake of consult or the first business day following a weekend or holiday.

2.1.5. Review consults and assessment with DBFRC team to determine priorities of care needed and coordinate these cares with the patient’s PCM.

2.1.6. Complete and document an individualized care plan for each patient accepted in DBFRC within five (5) business days and discusses plan with appropriate care givers.

2.1.7. Provide patient/family with resources of available support groups, therapies, and other community resources tailored to their location, age, and diagnosis.

2.1.8. Arrange for services requiring coordination across health care teams to eliminate duplication and fragmentation of services and to conserve health benefit dollars and maximize the use of all available resources.

2.1.9. Collaborate with providers, families, patients and involved providers to evaluate patient’s needs and to ensure patients are receiving adequate services to meet their needs.

2.1.10. With the assistance of additional administrative staff gather past medical reports/data for the review before patient’s initial and subsequent evaluation(s) with a member of the DBFRC.

2.1.11. Act as a mediator or a facilitator between schools and patients with individualized learning programs.

2.1.12. Contact patient/family to assess the patient’s condition and ability to follow the treatment plan.

2.1.13. Counsel parents and assess effectiveness of medication, behavior, activities of daily living and communicates information to the pediatric developmentalist or PCM, as appropriate.

2.1.14. Prepare documentation and plan of care for patients moving to other assignments in order to provide continuity of care. Work collaboratively with the EFMP to ensure smooth transition and warm handoff to receiving duty station

2.1.15. Identify problems, anticipate complications and intervene to avoid them, providing health instruction to the patient and family, and referring the patient back to the provider or other health team members as appropriate.

2.1.16. Complete medical record documentation and entry to tracking logs as required by the Military Treatment

Facility (MTF) policies and guidelines.

2.1.17. Acts as a liaison between MTF and family to facilitate care for patients in the TRICARE network of providers.

2.1.18. Collaborate with providers and other appropriate members of the medical team to discuss the patient’s course of progress and needs.

2.1.19. Assess nutritional status of patients, if needed, to determine the need for further interventions or evaluation.

2.1.20. Build and maintain excellent working relationships with MTF, clinical staff, civilian providers, and area schools.

2.1.21 Develop a process for assessing departmental goals and outcomes.

2.1.22. Provide feedback to others in the department to facilitate improvements and change.

2.1.23. Participate in staff education programs to promote clinical competencies and education for DBFRC-related topics.

2.1.24 Participate in quality improvement projects to promote innovation and excellence in clinical care, especially for DBFRC priority areas.

2.1.25. May provide nursing care in alternate duty sections during contingency operations, including but not limited to health pandemics, combat operations, or local/national disasters. This position will act in a supportive role under the direct supervision of an experienced health care professional when resources must surge to meet situational demands. Execution of contingency operations will be coordinated through DBFRC leadership.

2.2. EDUCATION AND TRAINING OF CLINICAL COORDINATOR. Contractor employee shall meet the following minimum qualifications:

2.2.1. Current unrestricted Registered Nurse license in any of the 50 states in the US or outlining US territories.

2.2.2. BSN graduate of an accredited nursing program.

2.2.3. Pediatric experience is required.

2.2.4. Minimum of two (2) years’ experience in professional nursing or case management for adults, children, families; or pediatric psychiatric experience within the last four (4) years.

2.2.5. Case Management certification and experience is highly desired.

2.2.6. Pediatric development or mental health experience preferred.

2.2.7. Demonstrated competency in performance of core case management skills.

2.2.8. Demonstrated competency in assessing psychosocial needs of patient and family.

2.2.9. Demonstrated ability to work autonomously to accomplish tasks.

2.2.10. Demonstrate a working knowledge of Depression, Anxiety, PTSD, ADD, ADHD, Bipolar, ODD, OCD, Autism, behavioral issues, learning difficulties.

2.2.11. Demonstrate competency skills in administering developmental and behavioral health assessments.

2.2.12. Demonstrate competency in assessing tests/reports/evaluations and presenting them to other health care providers.

2.2.13. Demonstrate expertise in resolving complicated healthcare, social, interpersonal and financial patient situations.

2.2.14. Demonstrate ability to apply critical thinking.

2.2.15. Demonstrate ability to build strong relationships with clients, family, MTF, civilian providers and community agencies.

2.2.16. Excellent organization and goal prioritization skills.

2.2.17. Excellent negotiation skills.

2.2.18. Excellent verbal and written communication skills.

2.3. TRAVEL REQUIREMENT. The contractor may be required to go to TDY locations outside of their communities which include other military treatment facilities (MTF) within the U.S. Air Forces in Europe (USAFE) area of responsibility on as needed basis. USAFE locations include: Ramstein and Spanghdahlem AB, Germany, Lakenheath AB, UK, Incirlik AB, Turkey, Aviano AB, Italy, Moron, Spain, and Lajes, Portugal. The exact number of TDYs is currently unknown but may be expected to travel 20% of the time. The U.S. Government will advise the contractor a minimum of 10 calendar days in advance of the TDY. Arrangements for and costs of all travel, transportation, meals, lodging, and incidentals are the responsibility of the contractor. Costs for these expenses will be reviewed and certified by the Contracting Officer's Representative (COR) and approved by the Contracting

Officer. All travel and transportation shall utilize commercial sources and carriers provided the method used for the appropriate geographical area results in reasonable charges to the U.S. Government. The U.S. Government will not pay for business class or first-class travel. Lodging and meals shall be reimbursed in accordance with the standard per diem rates in the DOD Joint Travel Regulation (JTR). There may be circumstances when the JTR authorizes a discretionary travel and transportation expense, but the task order remains silent. In such circumstances, the expense is not allowable and will not be reimbursed. Reimbursable costs will be reviewed by the COR and certified by the

CO. All TDY costs will be submitted for reimbursement within 60 days of the end of the TDY.

2.4. LICENSE VERIFICATION AND CREDENTIALS REVIEW OR PRIVILEGING:

2.4.1. The contractor shall follow the applicable sections of Air Force Instruction (AFI) 44-102 Medical Care

Management for all health care services provided in the Medical Treatment Facility (MTF). Contractor shall submit applications for the credentialing process for those contract personnel who will render full-time performance under this contract. The contractor shall ensure the contract personnel meet the requirements of the PWS before submitting the credentialing/privileging package to the 86th MDG Contracting Officer Representative (COR).

2.4.2. The contractor shall request from the COR, documentation requirements for license verification as required by the position for each contract personnel.

2.4.3. The COR will provide immediate fax, telephonic notification or e-mail notice to the contractor of the results of the credentials evaluation for the award of privileges. The COR will annotate/document the date/time the contractor was advised of denial or award of privilege for providers. Any and all time and expense incurred relative to presentation of the required credentials packet and the application for clinical privileges will be at the contractor’s expense. All credentialing packets submitted by the contractor in the fulfillment of duties under this contract shall become and remain the property of the U.S. Government.

2.4.4. If the contractor adds additional/or replacement contract personnel during the contract period, the same qualification standards, credentialing/privileging and health requirements shall apply.

2.4.5. The contractor shall not use any individual to provide direct health care services under this contract if that individual, within the past five years:

2.4.5.1. Has had his/her clinical privileges limited, suspended, or revoked by any healthcare facility, public or private, anywhere in the world.

2.4.5.2. Is the subject of a current or pending hearing or appeal brought by any health care facility, public or private, anywhere in the world, which may result in the limitation, suspension, or revocation of the individual’s clinical privileges.

2.4.6. This prohibition does not apply to any individual whose clinical privileges, although originally limited, suspended or revoked by a health care facility, were subsequently fully reinstated by the health care facility.

2.4.7. Limitation of clinical privileges, as used in this paragraph, refers to a partial withdrawal/reduction of clinical privileges as a result of a determination that, or pending investigation to determine whether an individual has engaged in unprofessional conduct or substandard medical practice or is incompetent to perform certain medical practices.

2.4.8. Contract personnel shall not introduce new procedures or services without prior approval of the Department

Chief or representative. If disagreements or deviations from protocols or procedures occur, the Department Chief or representative shall be the deciding authority.

3.0 SERVICES SUMMARY (SS).

SS #

Performance Objective PWS Para

Performance

Threshold

Method of

Assessment

SS 1

Assess developmental status of pediatric patients with parents through a developmental screening tool.

2.1.2.

25 assessments per quarter.

Quarterly Inspection

SS 2 Completes and documents initial assessments of each case expeditiously, as required by the patient need.

2.1.5.

Initial assessment to be completed within 72 hours of initial intake of consult or the first business day following a weekend or holiday.

Quarterly Inspection

SS 3

Obtain school documentation, medical records, and/or assessments prior to consultation appointments.

2.1.11 7 business days before appointments.

Periodic Inspection

4.0. GENERAL INFORMATION.

4.1 CONTRACTOR REPRESENTATIVE. The Contractor shall designate to the Contracting Officer (CO), in writing, a primary point-of-contact for contract implementation, coordination and administration not later than ten

(10) business days after receiving notice of contract award. The Contractor shall notify the CO of changes in the primary point-of-contact at least ten (10) work days prior to any change. All notifications shall be in writing and shall state the name and contact information for the point-of-contact. The Contractor representative may reside/be located outside of Germany (i.e in the United States), but shall be available by telephone or email from 0700 to 1600

Central European Time.

4.2 DOCUMENTATION. The Contractor shall provide the Contracting Officer’s Representative (COR) the required documentation for all support services personnel within ten (10) business days of contract award notification to comply with required performance periods of the contract by taking into consideration that the DoD

Contractor Personnel Office (DOCPER) process may take up to 18 weeks for completion.

4.3 CONFLICT OF INTERESTS. Contractor personnel shall not bill patients for services rendered under this contract. Contractor personnel shall not request or accept compensation of any kind for patients treated, procedures performed, or any other actions performed. Contractor personnel shall not, while performing services under this contract, advise, recommend, or suggest to persons eligible to receive medical care at U.S. Government expense that such persons should receive care from the Contractor at any place other than as designated under this contract.

4.4 CONFIDENTIALITY OF INFORMATION. Unless otherwise specified under this contract, all financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. The Contractor shall not release any of the above information without prior written consent of the CO. The Contractor shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication.

4.5 MEDIA AND OTHER INQUIRIES. The Contractor or Contractor personnel shall not respond to any media inquiries. Any inquiries from the media, third parties, or public agencies shall be immediately relayed to the COR, who will relay them to the Medical Treatment Facility (MTF) Public Affairs Officer or, after duty hours, to the

Administrative Officer of the Day. There shall be no interviews, comments, or any other response without the prior knowledge and approval of the MTF Commander. Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the COR.

4.6. PHYSICAL DEMANDS:

4.6.1. Work is a combination of sitting and standing, walking from the office to nursing unit/clinic and to other departments/services inside the MTF.

4.6.2. Must be able to pass employment physical exam as directed.

4.7. WORKING ENVIRONMENT:

4.7.1. Work is performed in a military healthcare setting; may be exposed to communicable disease.

4.7.2. Occasional travel to supported locations may be required

4.8. DRESS CODE. Contract employees are required to be neatly dressed, properly groomed, and dressed appropriately for the type of work he/she will be performing. The United States Air Force

MTF requires that he/she dress according to accepted standards of professionalism and good taste.

4.9. REMOVAL OF CONTRACTOR PERSONNEL. At any time during the performance of this contract, the

CO or Contracint Officer Reresentative (COR) may direct the contractor to immediately remove any contractor personnel whose actions or impaired state raises reasonable suspicion that clear and present danger of physical harm exists to a patient, other contractor personnel, and 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. If the need for a removal occurs, the COR will contact the contractors point-of-contact and direct the contractor to remove that individual from the MTF and to not use that individual to perform any services required under this contract until the issue has been resolved by the CO. A review of the basis for removal will be made by the CO within three (3) working days after the COR directed the removal.

If, after any investigation deemed necessary by the CO and discussions with the contractor’s representative, the CO concludes that the contractor personnel’s impairment requires permanent removal from performance under the contract, the CO 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 the impaired contractor personnel, the decision of the CO will be final. During the period of time between the removal and the final decision of the CO, the contractor shall provide back-up/replacement contractor personnel IAW the terms and conditions of this contract.

4.10. Services are approvable under NORTH ATLANTIC TREATY ORGANIZATION (NATO) STATUS OF

FORCES AGREEMENT (SOFA) Status accreditation under Article 72 or 73.

4.10.1. AUTHORIZATION OF CONTRACT PERSONNEL. An individual who has: (1) been hired as a consequence of this contract, (2) is a full-time (40 hours per week or more) contract employee, (3) is employed in a

Host Nation country (4) is a national (citizen) of or an ordinary resident of the United States provided that the contract employee is not also a Host Nation country (local) resident (i.e., a dual citizen), or (5) a U.S. citizen or a citizen of a

North Atlantic Treaty Organization (NATO) country other than the Host Nation and provided that the contract employee is not an ordinary resident of the Host Nation. The representative host country U.S. Government shall make the determination of a contract employee’s status with respect to being an ordinary resident. Authorized Contractor personnel and their authorized dependents will be granted privileges consistent with those granted members of the civilian component of the U.S. Forces.

4.10.2. AUTHORIZATION OF CONTRACT PERSONNEL DEPENDENTS. Authorized dependents include the

Contractor personnel’s: lawful spouse, unmarried child, stepchild, or a lawfully adopted child who will reside in the host country with the Contractor personnel. (Child is defined as: has not passed his/her 21st birthday or, if past, is incapable of self-support because of mental or physical incapability that existed before that birthday and is dependent on the contractor for over one-half of his/her support.) The benefits listed below, if available, are generally extended as noted without special financial consideration due to the U.S. Government. In such cases the U.S. Government does not charge for use of these benefits, and the contract price should not be inflated by the value of these benefits. Should any of the below needed benefits not be available, negotiations will be conducted with the Contractor and consideration determined.

4.10.3. LOGISTICAL SUPPORT. The U.S. Government will provide individual logistical support for Contractor personnel and authorized dependents to the extent available and as authorized by NATO Status of Forces Agreement

(SOFA) Supplementary Agreement Article 72, and foreign regulations; by current applicable international agreements, arrangements, policies; and the local Installation Commander. The duration of the initial individual logistic support authorization may be subject to a time limitation. Prior to expiration of the initial logistical support authorization (if and as applicable), the COR and Contractor shall expedite/process the individual Renewal/Authorization in sufficient advance to ensure continuation of logistical support. Logistical support is provided only for those Contractor personnel that are providing services solely for U.S. Forces. Logistical support, if granted, will only be provided to authorized, full-time (40 hours per week) Contractor and authorized dependents as defined in paragraphs 4.6 and 4.6.1.

The following logistical support will be provided to applicable Contractor personnel:

1) Commissary

2) Army Air Force Exchange Service

3) Armed Forces Recreation Facilities

4) Class VI (alcoholic beverages, including rationed items)

5) Legal assistance (on a space available basis)

6) Local government transportation for official government business (non-tactical vehicle)

7) Local Moral/Welfare Recreation Services

8) Military Banking facilities

9) Military postal services

10) Officer and NCO Club memberships

11) Mortuary services

12) Privately Owned Vehicle (POV) authorization

13) Housing office (Note: Limited. These services are limited to translation assistance and an explanation of host-country rental laws and utility and telephone services)

14) Petroleum, Oils, and Lubricants (POL) purchases

15) Transient billets on space available basis

16) Messing Facilities at remote sites only (reimbursable)

17) Army Continuing Education Services

18) Credit union facilities

19)* Dependent Schools, on space available, tuition paying basis

20) Medical/Dental on a reimbursable basis. Dental on emergency basis only

21) Pet and firearm registration and control

22) NATO status of Forces Agreement stamp (subject to approval of Host nation Customs Authority)

23) Customs exemptions

*Note: The Government will not pay for tuition

4.11. “BACO-90”. The term “BACO-90” is a short-hand way of referring to the "Request for Confirmation of

Exemption from the Requirement to Obtain a Work Permit" in Germany from the Bundesagentur für Arbeit (BA) in

Stuttgart. It allows the contractor employee to work in a temporary duty (TDY) status for periods not to exceed 90 days in any 12-month period starting with the first day of entry into Germany/Schengen Zone and ending with the date of exit. Once 90 days are exhausted, the contractor employee has to exit the Schengen Zone! A “BACO-90” is initiated by the contractor (the company, usually HR), scanned and emailed to the Bundesagentur für Arbeit (BA) in

Stuttgart, Email address: Stuttgart.007-OS@arbeitsagentur.de. The form can be found at https://www.europeafrica.army.mil/contractor/

4.12. EMERGENCY HEALTHCARE FOR CONTRACTOR PERSONNEL. The MTF will provide emergency health care for injuries or life threatening medical emergencies occurring while on duty under the provisions of Air

Force Manual (AFMAN) 41-210. (See 5.1 – Applicable Forms and Publications). In emergencies, transportation in

U.S. Government ambulances may be furnished by the U.S. Government on a reimbursable basis. The Contractor shall reimburse the U.S. Government for such services as billed by the MTF.

4.13 CONTRACTOR PERSONNEL PRIVATE PRACTICE. Contractor personnel are prohibited by reason of their employment under this contract from conducting private practice. The CO will unilaterally resolve any issues concerning potential conflicts.

mailto:Stuttgart.007-OS@arbeitsagentur.de

4.14. Neither uniformed personnel nor U.S. Government civilian employees shall be employed to perform services under this contract.

4.15 OVERSEAS REQUIREMENTS. The Contractor is responsible for ensuring all country clearances, passports, visas, and accreditations required by the Host Nation are obtained prior to employment of individuals under this contract. Documentation requirements are subject to change as SOFAs change. In the event a proposed Contractor employee is denied Host Nation approval, accreditation, and/or permission, the prospective awardee shall submit like documentation for another nominee. The Contractor will be responsible for obtaining the appropriate country specific requirements, and will coordinate this with the CO or COR. The Contractor shall provide written notification to the

CO and the COR within 24 hours of becoming aware of accredited Contract personnel no longer performing duties requiring accreditation/clearances/permissions. The Contractor shall recognize that Host Nation authorities may conduct on-site inspections at any time in the Contractor personnel’s work area for the purpose of verifying the status of positions and Contractor personnel and appropriate visas or permissions. The Contractor shall assume all costs related to submission of required documentation. At the time of preparation of this contract, applicable information and forms for placement of Contractor personnel in Germany may be accessed at the DOCPER and U.S. Department of State websites. (See 5.1 – Applicable Forms and Publications)

4.16 CONTRACTOR PERSONNEL HEALTH REQUIREMENTS. Contractor personnel and dependents shall be up to date on immunizations required or recommended by the U.S. Department of Health and Human Services for travel to the Host Nation. (See 5.1 – Applicable Forms and Publications) The U.S. Government will not reimburse the

Contractor for this expense. Contractor personnel providing services under this contract shall receive a pre-employment physical examination prior to commencement of work and annually thereafter. Certification shall be provided to the COR that Contractor personnel have completed medical evaluation required no later than seven (7) business days prior to commencement of work . This certification shall state the date on which the examination was completed, the doctor’s name that performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: “(name of contractor employee) is suffering from no contagious diseases to include but not limited to Tuberculosis and Hepatitis.” Per Occupational Safety Health

Administration (OSHA) requirements, all Contractor personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity to Hepatitis B infection. (See 5.1 – Applicable Forms and Publications) Personnel who sign declinations may change their minds at any time and receive the Hepatitis B vaccine without penalty. It is the

Contractor’s responsibility to report all information necessary to assure hospital records can be maintained correctly, and therefore comply with the OSHA and Center for Disease Control (CDC) health records requirement. (See 5.1 –

Applicable Forms and Publications)

4.17 ABUSE OF PRIVILEGES. The U.S. Government retains the right to withdraw privileges as a result of

Contractor or Contractor personnel’s abuse of privileges at no additional cost to the U.S. Government. The Contractor shall ensure that, upon termination or transfer of any Contractor personnel who is granted privileges identified above, action is taken simultaneously with termination of employment to ensure that said Contractor personnel ceases to have access to the above privileges. The Contractor shall ensure that identification passes or other documents pertinent to and/or peculiar to the contract or privileges hereunder are turned over to the issuing office upon termination or transfer of any Contractor personnel. The Contractor shall require a written receipt of such return and shall immediately forward a copy to the CO.

4.18 RELATIONSHIP OF THE PARTIES, RESPONSIBILITY AND PROCEDURES

4.18.1. Professional Liability:

4.18.1.1. Pursuant to 10 USC 1089(a), the Department of Defense shall process any personal injury claim alleging negligence by the contractor within the scope of the contractor’s performance of this contract as claims alleging negligence by DOD military or civil service employees. The contractor is not required to maintain medical malpractice liability insurance, and the U.S. Government will not reimburse or otherwise pay for such insurance should any be purchased.

4.18.2. Responsibility and Procedures:

4.18.2.1. If any suit or action is filed or any claim is made against the Contractor personnel, which occurred as a result of work performed by the contractor under this contract, the contractor shall immediately notify the COR and the

Contracting Officer and the chief of the appropriate services and promptly furnish them copies of all pertinent papers received.

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

The Contract personnel may, at the Contractor personnel's own expense, participate in defense of such claim or litigation.

4.19 ADMINISTRATIVE CHECKS AND REQUIREMENTS.

4.19.1 Tier 1 (T1) Background Investigation. Since personnel under this contract will have access to Non-

Sensitive government information and/or process information requiring protection under the Privacy Act of 1974, these positions are considered Low Risk Positions. Compliance with DoD Manual 5200.2, _AFMAN 16-1405 and

Homeland Security Presidential Directive 12 (HSPD-12) is mandatory for these positions. (See 5.1–Applicable

Forms and Publications) A Tier 1 (T1) back- ground investigation is required for all personnel under this contract.

The Contractor shall fully adhere with the provisions of referenced publications by having each of their employees who are performing under this contract initiate and complete a T1. T1 investigation requests for employee will be submitted through the Suitability/Fitness Security Office, Ramstein AB, Germany. Member will be fingerprinted and required to complete the appropriate forms (Standard Form 85, Questionnaire for Non-sensitive Positions, any state release forms, and OF 306 Declaration for Federal Employment. (See 5.1–Applicable

Forms and Publications) The contractor shall advise employee that a favorable suitability/fitness determination is required as a condition of employment under this specific contract. The employee shall apply for the T1 prior to start of performance. The government is solely responsible for the cost associated with the initiation, application and completion of the T1 investigation with exceptions for expenses incurred for Police Checks for “local hire” personnel.

4.19.2 CRIMINAL HISTORY BACKGROUND CHECK (CHBC). CHBC are required for Contractor personnel involved in the delivery of healthcare to children under the age of 18 on a frequent and regular basis, as stated in Department of Defense Instruction (DoDI) 1402.5, Enclosure 5. (See 5.1 – Applicable Forms and

Publications) The Contractor shall ensure that the personnel follows local MTF policy to provide fingerprints on a properly completed Standard Form 87, Fingerprint Card for Federal Employees. (See 5.1 – Applicable Forms and

Publications) The procedures for completing the required CHBC are outlined in the DoDI 1402.5. (See 5.1 –

Applicable Forms and Publications)

4.19.3 PENDING COMPLETION OF T1. The Contractor personnel may provide contract services prior to completion of background investigation. The Contractor understands that the MTF Commander may allow the

Contractor personnel to temporarily occupy non-sensitive positions pending T1. The Contractor personnel will be immediately removed from the position if at any time the T1 receives unfavorable adjudication, or if other unfavorable information that would affect the T1 becomes known. Pending completion of State Criminal History Records Check

(SCHRC) the Air Force Surgeon General requires close clinical supervision and full compliance with existing DoD

Directives, Instructions, and other guidance on quality assurance, risk management, licensure, personnel orientation and certification verification. The MTF Commander will determine what constitutes “close clinical supervision” for individuals whose T1/SCHRC are pending, either supervised practice ensuring protection of patients under the age of

18 or line-of-sight supervision (i.e., chaperoned by an individual whose background investigation has been successfully completed) at all times when caring for these patients.

4.20 COMMON ACCESS CARD. Common Access Card (CAC) is a DOD-mandated program affecting military, DOD civilians and eligible Contractors. The Contractor shall comply with the requirements of this program. Visit the website for more information: https://www.cac.mil/.

4.21 HOURS OF OPERATION. The healthcare services are to be performed at the 86th MDG, Ramstein Air Force

Base, Germany. The 86th MDG’s normal business hours are 0730-1630 hours Monday through Friday, excluding

U.S. Federal holidays. Except for USAFE Family Days (see paragraph 4.22.1 below) the contract employee shall https://www.cac.mil/ work no more than 80 hours within a two-week time period, not to exceed 10 hours a day, with one uncompensated hour off for lunch. (During the absence of other team nurses due to illness, leave or deployment, the contracted nurse shall also work various shifts or augment clinical nursing supports as stated in paragraph 2.2.2.5. The contractor personnel may see an estimated 8 patients per day. (See Attachment 1, Workload Estimates).

4.22. HOLIDAYS. The following is a list of legal federal holidays. Any federal holiday falling on a Saturday will be observed on the preceding Friday, holidays falling on a Sunday will be observed the following Monday.

U.S. Holidays:

January 1 New Year’s Day

3rd Monday in January Martin Luther King, Jr. Day

3rd Monday in February Washington’s Birthday

Last Monday in May Memorial Day

July 4 Independence Day

1st Monday in September Labor Day

2nd Monday in October Columbus Day

November 11 Veterans Day

4th Thursday in November Thanksgiving Day

December 25 Christmas Day

4.22.1. CLOSURES. There are USAFE-AFAFRICA Family Days, Presidential Executive Orders, Goal

Days, or other command-declared closures, that the MTF will be closed and the Contractor will not be required to provide services. Therefore, the Contractor shall advise its personnel accordingly and treat these situations as determined appropriate. The USAFE-AFAFRICA Family Days are scheduled by the USAFE-

AFAFRICA Commander. Goal Days are scheduled on the discretion of the 86AW Commander.

4.22.1.1 In the event of unplanned closure of the MTF due to natural disaster, military emergency, pandemic conditions, severe weather, security threat, or a facility-related problem that prevents the contractor’s personnel from performing services under this contract, these contractor’s employees shall follow the same departure and reporting directions given to Government personnel and the contractor shall treat its employees as they determine appropriate.

The contractor shall not seek additional payments from the Government for any expenses incurred by the contractor as a result of any such unplanned closure.

4.23. ABSENCES. The contractor may request, and the COR may approve, based upon the recommendation of the section chief or from personal knowledge, a reduction in contract performance requirements up to a maximum of 20 working days 8 hours per day, scheduled or unscheduled, due to illness, leave, and other justified reasons per 12-month contract performance period. The contractor shall notify the COR of any absences that are justified and the

COR will track the number of days the contractor is absent. The number of consecutive days for scheduled or unscheduled absences will be at the discretion of either the MTF commander, section chief, or COR based on workload with coordination through the COR. It is the contractor‘s responsibility to approve any absences of the contractor personnel and to coordinate absences with the section chief and/or COR. The contractor shall provide back-up coverage for all scheduled or unscheduled absences in excess of twenty (20) workdays per 12-month contract performance period at no additional cost to the government. Replacement contractor employee may work in a temporary duty status (TDY) and be exempt from obtaining a work permit. This process is referred to as a Request for Confirmation of Exemption from the Requirement to Obtain a Work Permit and is commonly called the “fax-back” process. It must be completed before the employee arrives or begins work in Germany. Application under the fax-back process is mandatory for contractor employees performing work in Germany in a TDY status.

Contractor employees who arrive in Germany using this process will not be issued a CAC with privileges and will not receive individual logistics support, but may be eligible for an installation pass.

4.23.1. Teleworking is not authorized, except as follows: Alternate Place of Performance - As determined by the COR, contractor employees may be required to work at an alternate place of performance (e.g., home, the contractor's facility, or another approved activity within the local travel area) in cases of unforeseen conditions or contingencies (e.g., pandemic conditions, exercises, government closure due to inclement weather, etc.).

Contractor shall prepare all deliverables and other contract documentation utilizing contractor resources. The MTF will issue the Contractor a government laptop to facilitate teleworking needs. To the extent possible, the contractor shall use best efforts to provide the same level of support as stated in the PWS/SOW. Contractor will report any limiting factors in performance due to telework to the COR.

4.24 CONTRACTOR ORIENTATION AND NEW PERSONNEL REQUIREMENTS.

4.24.1 GENERAL TRAINING. Contractor personnel shall abide by all MTF standards, rules, and procedures.

All contractor personnel performing services at the MTF are required to complete initial and annual refresher

HIPAA, Anti-terrorism/Force Protection (AT/FP), and safety training as provided by the MTF for its personnel. The contractor will be held accountable for ensuring that the personnel comply with health information privacy and security policies and procedures. The government will also provide training on government provided forms and equipment, universal precautions, initial orientation, and continuing training. Contractor personnel shall participate in evaluation of the quality and effectiveness of activities and services of the unit.

4.24.2 ORIENTATION TRAINING. The Contractor shall ensure that all contractor personnel participate in the government provided MTF orientation program for newly assigned personnel within the first two weeks of performance start. Orientation training will be conducted during normal hours of operation, and will be scheduled by the Functional Requirements Evaluation Designee (FRED). Orientation shall include training on the following:

4.24.2.1. Regulations specific to the professional specialty, the hospital and Air Force policy and procedures.

4.24.2.2. Instructions on automation processing, quality assurance policies, and other information systems (if applicable).

4.24.2.3. Local in-service, and safety briefings as they apply to the position.

4.24.2.4. Training on electronic medical records to include but not limited to CHCS and AHLTA.

4.24.3. GOVERNMENT PROVIDED TRAINING/ANNUAL TRAINING:

4.24.3.1. HIPAA – initial and annual certification training (See 5.1 – Applicable Forms and Publications

4.24.3.2. On-the-job-training (work center/patient safety, waste disposal, fire prevention etc.)

4.24.3.3. Cyber Security Awareness

4.24.4. CONTRACTOR PROVIDED TRAINING. It is the contractors responsibility to ensure their employees receive all training and licenses required for initial certifications (if any) and to ensure their personnel stays current.

4.24.5. SPECIFIC TRAINING. All Registered Nurses must maintain BLS certification and any CEU licensure requirements for any state in the US or any US territory in which licensed.

4.24.6. COMPUTER TRAINING. Contractor personnel who have any interaction with the MTF computer systems must receive training for the applicable system(s). The COR will coordinate the necessary computer training. The training will be on-site and during normal hours of operation. This training will be at no cost to the Contractor. Access to patient data systems is an "Automated Data Processing Sensitive" position requiring compliance with AFI 31-501

(See 5.1 – Applicable Forms and Publications). The Contractor shall comply with agency personal identity verification procedures that 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. (See 5.1 – Applicable Forms and Publications)

4.25. COMMANDER’S TOBACCO USE GUIDANCE. The Air Force recognizes equal work breaks (when these breaks are permitted) for tobacco users and non-tobacco users. The MTF will have a smoke free medical campus with only one authorized smoking area for buildings 2114, 2121 and 2182.

Tobacco use is prohibited in government vehicles, inside buildings and within 50 feet of building‘s direct service entryway. The spitting of such non-smoking tobacco products into cups, cans, or any type of container within the above-restricted areas is prohibited.

4.26 U.S. GOVERNMENT-SHARED PROPERTY, INFORMATION AND SERVICES:

4.26.1. Government furnished property under this contract will be furnished to Contractor employees at no cost and shall be used only in performance of services under this contract.

4.26.2. The Government will provide the Contractor access to Air Force directives, MTF policies and procedures prior to start of contract performance date.

4.26.3. Facilities: During the hours of performance under this contract, the Contractor employees shall have the use of office space available.

4.26.4. Equipment and Supplies: Available equipment and office supplies for the performance of services under this contract, such as desk, chair, lighting, computer, printer, FAX machine, phone, copier, paper, folders, file cabinets, etc.

4.26.5. Electronic Documentation: As available at the local MTF, a standardized electronic documentation system or electronic medical record will be provided, such as, but not limited to CHCS and AHLTA.

4.26.6. Directives/Forms/Work Files: Unless noted otherwise, all required Air Force and Department of Defense directives, forms and other work files applicable to the MTF MM Program/Services will be furnished by the

Government and will be retained by the Government.

4.27. CONFORMANCE WITH ENVIRONMENTAL MANAGEMENT SYSTEMS. The Contractor shall perform work under this contract consistent with the relevant environmental policy and objectives identified in the installation environmental management system (EMS) applicable for your contract. The Contractor shall perform work in a manner that conserves water, energy and other resources to the maximum extent feasible and ensure minimum production of waste as possible, giving preference to recycling and reutilization opportunities.

Furthermore, the Contractor shall give preference to less toxic materials whenever available and still reliable for their work. In the event an environmental nonconformance or noncompliance of host nation and USAF environmental laws and regulations associated with the contracted services is identified, the contractor shall take corrective and/or preventative actions. In the case of a noncompliance, the Contractor shall respond and take corrective action immediately. In the case of a nonconformance, the Contractor shall respond and take corrective action based on the time schedule established by the EMS Coordinator. In addition, the Contractor shall ensure that their employees are aware of the environmental management system on base and how these requirements affect their work performed under this contract. All on-site contractor personnel shall receive the installation EMS awareness level information.

4.28. CONFORMANCE WITH ENVIRONMENTAL REQUIREMENTS. The contractor shall perform all work in accordance with applicable German and US Air Force environmental laws, regulations and operating standards, including but not limited to the Final Governing Standards (FGS) for Germany. The contractor shall be immediately capable of understanding and addressing environmental laws and regulations as they pertain to work performed under this contract.

The FGS for Germany and other important environmental laws & requirements are applicable for all contractors working on base.

4.29. SERVICE CONTRACT REPORTING (SCR). The contractor is required to report ALL contractor labor hours (including subcontractor labor hours). While inputs may be reported at any time during the fiscal year (FY), all data must be reported no later than 31 October of each year.

5.0. APPENDICES.

5.1. APPLICABLE PUBLICATIONS AND FORMS. Supplements or amendments to listed publications and/or forms from any organizational level may be issued during the life of this contract. Should any publication or form revision cause a change in the contractor’s processes, procedures and/or standards of operation, the contractor shall advise the CO of such changes in writing within 30 days of receipt of the publication or form revisions. Publications and forms are available electronically through the internet and are maintained by the government.

DoD Directives can be found at http://www.dtic.mil/whs/directives/corres/dir.html . Regulations are followed by a “-R” (e.g., DoD 6025.18-R) and can be located on the website by clicking on “Publications” instead of

“Directives.”

5.2. DEPARTMENT OF DEFENSE (DoD) REGULATIONS/MANUALS

INSTRUCTIONS/DIRECTIVES

PUB NO. TITLE

DoD 5400.11-R Department of Defense Privacy Program

DoDD 5200.2 Personnel Security Program

DoDD 5400.11 DoD Privacy Program

DoDD 5500.07 Standards of Conduct

DoDD 8190.1 Defense Logistics Management Standards (DLMS)

DoDD 8500.01E Information Assurance

DoDI 1402.5 Background Checks on Individuals in DoD Child Care Services Programs

DoDI 3020.41 Contractor Personnel Authorized to Accompany the U.S. Armed Forces

DoDI 6015.23 Delivery of Healthcare at Military Treatment Facilities: Foreign Service Care; Third

Party Collection; Beneficiary Counseling and Assistance Coordinators (BCACs)

DoDI 6025.20 Medical Management (MM) Programs in Direct Care Systems (DCS) & Remote

Areas

DoDI 6040.42 Medical Encounter and Coding at Military Treatment Facilities

DoDI 6040.43 Custody and Control of Outpatient Medical Records

5.3. The Air Force’s E-Publishing site (http://www.e-publishing.af.mil) will be used to obtain Air Force

Instructions.

AIR FORCE INSTRUCTIONS/MANUALS

PUB NO. TITLE

AFMAN 41-210 TRICARE Operations and Patient Administration

AFI 33-332 Air Force Privacy and Civil Liberties Program

AFI 33-322 Records Management Program

AFI 33-364 Records Disposition – Procedures and Responsibilities

AFI 31-501 Personal Security Program Management

AFI 33-200 Air Force Cybersecurity Program Management

AFI 33-115 Air Force Information Technology (IT) Service Management

AFI 40-102 Tobacco Free Living

AFI 44-119 Medical Quality Operations…