PWS_SPD_OR_Techs_DRAFT.pdf

PERFORMANCE WORK STATEMENT (PWS)

CENTRAL STERILE SUPPLY TECHNICIANS (SPD TECHS)

SURGICAL TECHNOLOGISTS (OR TECHS)

CARDIOTHORACIC SURGICAL TECHNOLOGISTS (CT SURG TECHS)

1. GENERAL

1.1. This is a personal services contract (as defined by Federal Acquisition Regulation (FAR) Subpart

37.104) and is intended to create an employer-employee relationship between the Government and the individual contract Health Care Providers (HCPs) only to the extent necessary for providing the health care services required under the contract. The performance of health care services by the individual HCPs under a personal services contract are subject to day-to-day supervision and control by health care facility personnel comparable to that exercised over military and civil service HCPs engaged in comparable health care services. Any personal injury claims alleging negligence by the individual HCPs within the scope of the HCP’s performance of the personal services contract shall be processed by DoD in the same manner as claims alleging negligence by DoD military or civil service HCPs. 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 1089 and 10 United States Code 1091.

1.2. DESCRIPTION OF WORK. The contractor shall provide the services of Central Sterile Supply

Technicians (also known as SPD Techs), Surgical Technologists General (also known as OR Techs) and

Cardiothoracic Surgical Technologists (also known as CT Surg Techs)) for the Brooke Army Medical

Center (BAMC), Fort Sam Houston, Texas. These positions have been designated as Emergency Essential

Personnel and shall be required to report to work IAW Medical Treatment Facility (MTF) policy. The contract HCPs shall possess qualifications meeting or exceeding currently recognized national standards as established by The Joint Commission (TJC). Contract HCPs shall provide the highest consideration to patient dignity and observe the precepts of the American Hospital Association’s “Bill of Rights for

Patients”. Services provided under this contract shall be as comprehensive as Government-supplied facilities, equipment, and support services permit.

1.3. PERIOD OF PERFORMANCE. Services are required by the Department of Operative Services

(DOPS) for a 12-month Base Year (01 October 2022 through 30 September 2023), plus four (4) 12-month

Option Periods (through 30 September 2027).

2. PERFORMANCE MEASURES

2.1. OUTCOME. The contractor shall provide qualified personnel to fill the requirement of Central Sterile

Supply Technicians (also known as SPD Techs), Surgical Technologists (also known as OR Techs) and

Cardiothoracic Surgical Technologists (also known as CT Surg Techs)) at a standard enabling the MTF to maintain a high level of quality.

2.2. ACCEPTABLE MEASURES. The contractor must have a fill-rate of at least 80% of requested shifts, a turnover rate not to exceed 25%, and no more than two (2) substantiated patient complaints in any twelve-month period against any one (1) HCP. Other performance evaluation factors that will be monitored but that are not quantified by numerical measurements include: contractor providing personnel exceeding the minimum qualification standards; patient customer service comments; provider and contractor relationship with hospital staff/government contracting personnel; compliance with hospital policy and procedures.

2.3. PERFORMANCE MEASUREMENTS. The Government shall monitor each HCP’s performance under this contract using the PWS Quality Assurance Surveillance Plan (QASP), Defense Health Agency

Procedure Manual (DHAPM) 6025.13 volumes 1-7 (specifically volumes 3 & 4), and any other MTF standards. In the absence of guidance in the DHAPM 6025.13, the contractor shall use the AR 40-68 for reference. Additionally, HCP’s performance will be monitored by Chief, Department of Operative Services

(DOPS) or his/her designated representative, the Contracting Officer Representative (COR) through government information systems and records, patient records, peer review, Quality Assurance/Risk

Management programs, customer service information, contractor reports, monitoring of scheduled shift fill-rates, timesheets, compliance with installation and hospital policies/procedures, and any other means necessary to ascertain that contracted services are being accomplished in accordance with the terms if the contract. Other methods may be implemented at the Government’s discretion.

3. QUALIFICATIONS. In addition to the minimum contractual qualifications listed below, the contract

HCPs under this contract shall have sufficient experience and the ability to perform the tasks and procedures listed in this PWS. Contract HCP providing services shall meet the following:

3.1. CENTRAL STERILE SUPPLY TECHNICIANS (SPD TECHS). HCPs must have a minimum of one (1) year experience within the last 10 years providing services as a Central Sterile Supply Technician

(also known as SPD Tech) or Surgical Technologists (also known as OR Techs). While providing services under this contract, HCP’s are required to comply with any applicable state laws concerning their profession.

3.1.1. Must exercise a positive, helpful demeanor, display courtesy and tact frequently under stressful conditions and duress at an accelerated pace due to life threatening patient situations. Constant standing, walking, lifting and bending is required. HCPs may be exposed to highly contagious/infectious blood borne pathogens and radiation from portable x-ray and continuous fluoroscopy equipment.

3.1.2. Must have and maintain current certification in Basic Cardiac Life Support (BCLS) certified by the

American Heart Association or American Red Cross standards. This certification shall be maintained in a current status at all times while performing services under this contract.

3.1.3. Shall be able to read, write, and speak English well enough to effectively communicate with all patients and other health care providers.

3.1.4. Shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to a variety of patients from diverse backgrounds.

3.1.5. The contractor shall ensure HCPs receive Occupational Safety and Health Administration (OSHA) required training for the position in which they will perform, and that training currency is maintained.

Documentation of such training shall be provided to the COR.

3.1.6. Position requires access to Department of Defense computer systems; therefore, provider shall be a

U.S. Citizen or otherwise meet the requirements of AR 25-2.

3.2. SURGICAL TECHNOLOGISTS GENERAL (OR TECHS). HCPs must have a minimum of one

(1) year experience within the last three (3) years providing services as a certified Surgical Technologist

(also known as OR Tech). While providing services under this contract, HCP’s are required to comply with any applicable state laws concerning their profession.

3.2.1. HCPs must have and maintain current certification from the National Board of Surgical Technology and Surgical Assisting (NBSTSA) as a Certified Surgical Technologist (CST). This certification shall be maintained in a current status at all times while performing services under this contract.

3.2.2. Must exercise a positive, helpful demeanor, display courtesy and tact frequently under stressful conditions and duress at an accelerated pace due to life threatening patient situations. Constant standing, walking, lifting and bending is required. HCPs may be exposed to highly contagious/infectious blood borne

3.2.3. Must have and maintain current certification in Basic Cardiac Life Support (BCLS) certified by the

American Heart Association or American Red Cross standards. This certification shall be maintained in a

3.2.4. Shall be able to read, write, and speak English well enough to effectively communicate with all

3.2.5. Shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that

3.2.6. The contractor shall ensure HCPs receive Occupational Safety and Health Administration (OSHA) required training for the position in which they will perform, and that training currency is maintained.

3.2.7. Position requires access to Department of Defense computer systems; therefore, provider shall be a

3.3. CARDIOTHORACIC SURGICAL TECHNOLOGISTS (CT SURG TECH) HCPs must have a minimum of one (1) year experience within the last three (3) years providing services as a certified Surgical

Technologist with additional training in Cardiothoracic (CT) procedures (open heart procedures). While providing services under this contract, HCP’s are required to comply with any applicable state laws concerning their profession.

3.3.1. HCPs must have and maintain current certification from the National Board of Surgical Technology and Surgical Assisting (NBSTSA) as a Certified Surgical Technologist (CST). This certification shall be maintained in a current status at all times while performing services under this contract.

3.3.2. Must exercise a positive, helpful demeanor, display courtesy and tact frequently under stressful conditions and duress at an accelerated pace due to life threatening patient situations. Constant standing, walking, lifting and bending is required. HCPs may be exposed to highly contagious/infectious blood borne

3.3.3. Must have and maintain current certification in Basic Cardiac Life Support (BCLS) certified by the

American Heart Association or American Red Cross standards. This certification shall be maintained in a

3.3.4. Shall be able to read, write, and speak English well enough to effectively communicate with all

3.3.5. Shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that

3.3.6. The contractor shall ensure HCPs receive Occupational Safety and Health Administration (OSHA) required training for the position in which they will perform, and that training currency is maintained.

3.3.7. Position requires access to Department of Defense computer systems; therefore, provider shall be a

3.4. CERTIFICATION & RE-CERTIFICATION. It is a condition of this contract that all certifications required in the PWS remain current during the life of the contract. Certifications required by these qualifications are the responsibilities of the Contractor and will be obtained at no cost to the Government.

4. SPECIFIC TASKS

4.1. CENTRAL STERILE SUPPLY TECHNICIANS (SPD TECHS). Assist with decontamination, cleaning, assembling, packaging, sterilization, storage and issuing of medical/surgical instrument sets, instruments and supplies.

4.1.1. Provide wards, clinics and other users with sterile supplies and other SPD issued items. Process instrument sets delivered from wards and clinics and reissue them as required.

4.1.2. Maintain established supply levels and rotation of supplies.

4.1.3. Clean the Sterilization/Processing/Distribution work areas per SPD standard operating procedures.

4.1.4. Issue SPD supplies to sections and outpatients and properly complete hand receipts.

4.1.5. Check supplies processed in SPD for expiration and proper packaging.

4.1.6. Assist with the issuing, exchange and restocking of Crash Carts.

4.1.7. Deliver broken medical items to Medical Maintenance.

4.1.8. Receive supplies from logistics (100% inventory of supplies).

4.1.9. Check medical supplies for serviceability.

4.1.10. Assist with function check of sterilization equipment.

4.1.11. Fold linen.

4.1.12. Issue outpatient medical supplies to patients and properly complete paperwork in the outpatient room.

4.1.13. Assemble surgical case carts as directed by the daily operating room schedule or by request from the operating room service.

4.1.14. Operate sterilizers, washer/sterilizers, sonic baths, sterrad sterilizers, cart washers and other equipment items crucial to the processing of surgical sets and supplies.

4.1.15. Maintain required SPD specific documentation to include sterilizer logs, equipment issue logs, case cart and crash cart documentation.

4.1.16. Assemble case carts with surgical instrumentation and supplies for operating room and clinic use.

4.2. SURGICAL TECHNOLOGISTS GENERAL (OR TECHS). This list of duties is not intended to establish either a maximum or minimum acceptable level of effort or be an inclusive listing of anticipated duties. Health care personnel provided by the contractor shall perform essentially the same services as those required by any Army or government service health care professional of similar experience, in similar duty assignments and within their scope of practice. The HCPs may be designated by Brooke Army Medical

Center to assist in learning, leading and providing orientation and other activities as deemed appropriate by

DOPS. Contract personnel shall attend and participate in reports, patient care conferences, learn conferences, and ward staff conferences as deemed appropriate by the head nurse.

4.2.1. The duties and specific tasks arc listed below are not inclusive but shall be applicable to the HCP.

4.2.2. HCPs must possess expertise in the theory and application of sterile and aseptic technique and combines the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures.

Surgical procedures range from routine (appendectomy, myringotomy, herniorrhapy) to complex high risk

(neurosurgery, thoracic, cardiovascular, orthopedics) or trauma (vehicular accidents, gunshot, knife wounds) cases. HCPs must be able to circulate the full range of surgical procedures performed in the operating room at Brooke Army Medical Center. Performs surgical scrub and utilizes personal protective equipment.

4.2.3. HCPs must function as a sterile member of the surgical team who passes instruments, sutures and sponges during surgery. After performing the surgical scrub, they don gown and gloves and prepare the sterile setup for the appropriate surgical procedure. They must be proficient at the entire gamut of processing, sterilizing and packaging surgical instrumentation for use in surgical procedures. This individual must be able to anticipate the needs of surgeons, pass instruments, provide sterile items in an efficient manner and practice aseptic technique wherever and whenever indicated. They may also perform the role of the circulator (under the direct supervision of a RN).

4.2.4. Exercise the universal precautions set forth by the Centers for Disease Control when providing direct patient care and/or indirect patient care involving possible exposure to contaminated items at BAMC.

4.2.5. Transport patients from hospital units to the OR assuring safe transportation of the patient. Screen patients prior to transport to ensure preoperative medications have been given, jewelry, dentures and any prosthetic devices have been removed. Check patient chart and identification band for completeness.

Comfort patients fearing surgery. Contact with family and significant others are to provide information, counseling, emotional support, alleviate anxiety, fear and stress concerning patient condition and/or prognosis.

4.2.6. Documents all patient care given and the progress of the patient utilizing BAMC's documentation standards in the patient's medical record manually and/or electronically.

4.2.7. Performs a vast array of direct patient care procedures to include but are not limited to: range of motion exercises, lifting, turning, transporting and positioning patients and securing patients as required.

4.2.8. Orient and train newly assigned personnel and students. Explain OR procedures and requirements identify and explain use of surgical instruments and equipment, sterilization techniques and aseptic procedures.

4.2.9. HCPs will observe, monitor and report findings to restore health and to prevent complications and deterioration in conditions such as respiratory distress, neurovascular and neurologic compromise, hemorrhage, sepsis, cardiac and vascular emergencies and requires emergent corrective action within the scope of practice.

4.2.10. Follow perioperative nursing care plan in preparing patients and OR. May be required to shave operative areas.

4.2.11. Responsible for quality assurance/risk management and responds to breaches of standard procedures which compromise the patient or staff members. May also serve as a project officer for select committees and participate in research projects that are consultative in nature and involve sharing information, gathering data for new or existing technologies.

4.2.12. Accounts for sponges, needles, blades, and instruments during the procedure and participates with counts at prescribed times during the procedure with the OR Nurse. Also measures blood and fluid loss.

4.2.13. Assists surgeons with complex or potentially life-threatening procedures and assists

Anesthesiologists and Anesthetists during induction and throughout procedure.

4.2.14. Hand instruments to the surgeon during the procedure by anticipating the surgeon's needs and assist with application of dressings.

4.2.15. Select, assemble and organize required supplies, equipment and instruments for specific surgical procedure in accordance with operative work sheets, physician preference card and/or conferring with physician or charge nurse.

4.2.16. Obtain sterile supplies, sutures, dressings, linens, blood, medications, solutions, instruments, etc.

for the specific procedure. Open instrument sets, pour solutions, set up and adjust equipment such as electric coagulator, electric bone saw and drill, operate microscope, air power drills, defibrillators and resuscitators, make suction connections and adjust operating lights.

4.2.17. Clean OR after surgery, remove and dispose of soiled and/or contaminated materials, change linen, washes, disassembles, sterilize and reassemble instruments.

4.2.18. Replenish sterile packs and general supplies and restock shelves after using existing supplies.

4.2.19. Set up and perform first echelon maintenance on all OR equipment.

4.3. CARDIOTHORACIC SURGICAL TECHNOLOGISTS (CT SURG TECH). This list of duties is not intended to establish either a maximum or minimum acceptable level of effort or be an inclusive listing of anticipated duties. Health care personnel provided by the contractor shall perform essentially the same services as those required by any Army or government service health care professional of similar experience, in similar duty assignments and within their scope of practice. HCPs may be designated by

Brooke Army Medical Center to assist in team leading and providing orientation and other activities as deemed appropriate by DOPS. Contract personnel shall attend and participate in reports, patient care conferences, team conferences, and ward staff conferences as deemed appropriate by the head nurse.

4.3.1. The duties and specific tasks are listed below are not inclusive but shall be applicable to HCPs.

4.3.2. HCPs must possess expertise in the theory and application of sterile and aseptic technique and combines the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures. The primary specialty required for this position is a surgical technologist who has additional training and is proficient with scrubbing Cardiothoracic Surgical Procedures (examples but not limited to, open hearts, heart valve procedures, thoracic cases, etc.) in the operating room(OR), OR Hybrid Vascular Suite and the

Cardiac Cath Lab. Proficiency in additional OR surgical procedures range from routine (appendectomy, myringotomy. herniorrhapy) to complex high risk (neurosurgery, thoracic, cardiovascular, orthopedics) or trauma (vehicular accidents, gunshot, knife wounds) cases. HCPs must be able to circulate the full range of surgical procedures performed in the operating room at Brooke Army Medical Center. Performs surgical scrub and utilizes personal protective equipment. The CT Surg Tech’s primary place of duty will be in the main OR, with assignments to the Cardiac Cath Lab as required to support CT surgery cases performed in the Cath Lab suite.

4.3.3. HCPs must function as a sterile member of the surgical team who passes instruments, sutures and sponges during surgery. After performing the surgical scrub, they don gown and gloves and prepare the sterile setup for the appropriate surgical procedure. They must be proficient at the entire gamut of processing, sterilizing and packaging surgical instrumentation for use in surgical procedures. This individual must be able to anticipate the needs of surgeons, pass instruments, provide sterile items in an efficient manner and practice aseptic technique wherever and wherever indicated. They may also perform the role of the circulator (under the direct supervision of a RN).

4.3.4. Exercise the universal precautions set forth by the Centers for Disease Control when providing direct patient care and/or indirect patient care involving possible exposure to contaminated items at BAMC.

4.3.5. Transport patients from hospital units to the OR assuring safe transportation of the patient. Screen patients prior to transport to ensure preoperative medications have been given, jewelry, dentures and any prosthetic devices have been removed. Check patient chart and identification band for completeness.

Comfort patients fearing surgery. Contact with family and significant others are to provide information, counseling, emotional support, alleviate anxiety, fear and stress concerning patient condition and/or prognosis.

4.3.6. Documents all patient care given and the progress of the patient utilizing BAMC's documentation standards in the patient’s medical record manually and/or electronically.

4.3.7. Performs a vast array of direct patient care procedures to include but are not limited to: range of motion exercises, lifting, turning, transporting and positioning patients and securing patients as required.

4.3.8. Orient and train newly assigned personnel and students. Explain OR procedures and requirements identify and explain use of surgical instruments and equipment, sterilization techniques and aseptic procedures.

4.3.9. HCPs will observe, monitor and report findings to restore health and to prevent complications and deterioration in conditions such as respiratory distress, neurovascular and neurologic compromise, hemorrhage, sepsis, cardiac and vascular emergencies and requires emergent corrective action within the

4.3.10. Follow perioperative nursing care plan in preparing patients and OR. May be required to shave operative areas.

4.3.11. Responsible for quality assurance/risk management and responds to breaches of standard procedures which compromise the patient or staff members. May also serve as a project officer for select committees and participate in research projects that are consultative in nature and involve sharing information, gathering data for new or existing technologies.

4.3.12. Accounts for sponges, needles, blades, and instruments during the procedure and participates with counts at prescribed times during the procedure with the OR nurse. Also measure blood and fluid loss.

4.3.13. Assists surgeons with complex or potentially life-threatening procedures and assists anesthesiologists and anesthetists during induction and throughout procedure.

4.3.14. Hand instruments to the surgeon during the procedure by anticipating the surgeon's needs and assist with application of dressings.

4.3.15. Select, assemble and organize required supplies, equipment and instruments for specific surgical procedure in accordance with operative work sheets, physician preference card and/or conferring with physician or charge nurse.

4.3.16. Obtain sterile supplies, sutures, dressings, linens, blood, medications, solutions, instruments, etc.

for the specific procedure. Open instrument sets, pour solutions, set up and adjust equipment such as electric coagulator, electric bone saw and drill, operate microscope, air power drills, defibrillators and resuscitators, make suction connections and adjust operating lights.

4.3.17. Clean OR after surgery, remove and dispose of soiled and/or contaminated materials, change linen, washes, disassembles, sterilize and reassemble instruments.

4.3.18. Replenish sterile packs and general supplies and restock shelves after using existing supplies.

4.3.19. Set up and perform first echelon maintenance on all OR equipment.

5. HOURS OF PERFORMANCE

5.1. HCPs shall perform services on a schedule established by the Chief, DOPS or his/her designated representative, in coordination with the COR.

5.1.1. The contractor shall have HCPs available to provide services Sunday through Saturday from 0001 to

2400 daily (i.e., 24 hours per day, seven days per week) as required by the established schedule, which may include weekdays, weekends, federal holidays, training holidays, or other planned/unplanned closures.

When directed by the Government, HCPs shall remain on-duty to complete patient treatment where lack of continuity of care would otherwise jeopardize patient health. This provision is not intended to apply to the time required to complete routine tasks (e.g., completion of paperwork or routine administrative tasks at the end of a shift) which are to be completed as part of the normal work schedule.

5.1.2. HCPs will normally work 32-40 hours per week on rotating shifts. HCPs will be required to provide services for various times consisting of 8/10/12-hour shifts, with 12 being the maximum number of shift hours to be scheduled within a 24-hour period. Each shift will also consist of either a 30 or 45-minute lunch, which may vary depending on the Section and specific shift assigned. The Government maintains the right to make unplanned or unannounced work schedule changes to meet operational needs.

5.1.3. At times during low workload the Chief, DOPS may release HCPs from a scheduled work shift, or reassign them anywhere within the MTF to perform similar duty assignments within the same scope of practice. Only hours worked within the MTF will be compensated.

5.2. REGULAR HOURS. Each HCP will be required to provide 1,920 regular work hours over a 12-month period (average of 160 monthly). Regular Hours do not include Federal Holidays worked.

5.3. OVERTIME / HOLIDAY HOURS. In addition to Regular Hours worked, HCPs may be scheduled to work Overtime (OT) and/or a Federal Holiday (HOL). OT hours are considered in excess of 40 hours per work week.

5.4. PAGER HOURS. CT Surg Techsare required to provide on-call services on rotating shifts. Each

HCP shall respond by telephone within 15 minutes after receipt of a pager notification.

5.5. CLOSURES. During a planned closure of the facility due to training, holiday or unplanned closure due to unusual and compelling circumstances (e.g., natural disasters, military emergencies, severe weather), the Contractor will only be compensated for actual hours the HCP provided services.

5.6. SCHEDULED ABSENCES. HCPs will provide the Chief, DOPS or his/her designated representative and the COR with 30-day’s notice prior to any planned absence. No backup personnel will be required during absence. The contractor shall not invoice for periods when not performing services.

5.7. UNSCHEDULED ABSENCES. In the event a HCP is unable to perform on an assigned duty day, he/she shall notify the Chief, DOPS or his/her designated representative and the COR no later than 0600 hours (6:00 A.M.) on the duty day to be missed.

6. ADMINISTRATIVE

6.1. Active-duty military or Government civil service employees shall not be used as either a consultant or contract HCP provider in matters related to this contract.

6.1.2. Each day that services are performed, HCPs may be required to sign-in their time of arrival and departure on a log sheet that will be maintained at a designated area. These attendance logs are for the sole use of government officials to ensure compliance with FTE hours and will not be provided to the contractor for any reason and/or purpose. Under no circumstances will Government employees sign or verify a HCP’s timesheet for the Contractor.

6.2. ORIENTATION & TRAINING. Newly in-processed HCPs shall be required to complete New

Employee Orientation (NEO) training which is provided by the MTF. Thereafter, all HCPs shall be required to complete mandatory training to meet competency requirements. Orientation and annual training requirements are a condition of employment for which the contractor will be compensated at the base rate provided in the contract. All HCPs shall also participate in orientation to their work area and maintain a competency file (which is different from a credentials file) at the worksite in accordance with TJC standards.

6.3. COMPUTER TRAINING. As a condition of employment, HCPs must possess basic computer skills as they will have interaction with the hospital computer systems, in which the MTF will provide training for any MTF-specific computer systems. The training will be on-site, and during normal duty hours. This training will be at no cost to the contractor.

6.4. GOVERNMENT REQUIRED TRAINING. The Government may elect to provide unique training to contract HCPs who are performing services under this contract. If the Government elects to provide such training, the Government will provide such training at no additional expense to the contractor or to contract

HCPs. When directed by the Contracting Officer (KO), contract HCPs shall attend all such training in a paid status as part of the normal services required and billed under the contract.

6.5. HCPs shall wear the MTF-issued identification badge on their outer garment at all times while providing services at the MTF, unless directed otherwise by protocol (such as in the Operating Room).

Upon termination of work from this contract, HCPs are required to return the MTF-issued identification badge and Common Access Card (CAC) to the COR, and out-process through the activities identified by the COR.

6.6. The use of non-compete conditions in employment agreements (to prevent loss of personnel by the contractor) effective only during the period of the contract performance is acceptable. However, the use of non-compete conditions in employment agreements that prevent employees of the incumbent from being employed, or accepting offers of employment by the new contractor to the follow-on contracts is unacceptable. It hinders the government’s ability to accomplish the mission of providing medical care to beneficiaries. Inclusion of such conditions in an employer’s employment agreement will result in an offeror’s proposal being unacceptable. Awardee, and their subcontractors, shall not include such conditions in employment agreements while performing under this contract.

6.7. MONTHLY REPORT. The contractor shall provide a monthly report that identifies the contract and task order number, the reported month in reference, the required number of FTEs, the number of filled positions, and the number of vacant positions. In addition, the contractor shall provide an explanation for each of the unfilled positions including why it is not filled and remedies to correct the situation. This report shall be submitted on the first business day of each month to both the KO and COR.

7. CONTRACTOR VERIFICATION SYSTEM (CVS)

7.1. The Contractor shall comply with agency personal identity verification procedures identified in the contract 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.

7.2. The Contractor shall comply with agency personal identity verification procedures in all subcontracts when the subcontractor is required to have physical access to a federally-controlled facility or access to a

Federal information system.

7.3. The Contractor shall ensure compliance with the provisions set forth below. For purposes of FAR

Clause 52.204-9, the Government will designate a Trusted Agent (TA), and the Contractor shall designate a Facility Security Officer (FSO), for this contract. The Government reserves the right to amend or supplement these provisions pursuant to the Changes clause in the contract.

7.4. ON-BOARDING & IN-PROCESSING REQUIREMENTS. Contractor personnel are prohibited from performing services under this contract absent compliance with the MTF’s on-boarding and in-processing requirements, which will average 60-90 days for completion. All Security Investigative

Requirements must be coordinated through the COR. This includes all document/packet submissions, as well as scheduled appointments.

7.5. OUT-PROCESSING REQUIREMENTS. When a HCP’s performance under this contract ceases, the Contractor shall provide written notice to the COR. HCPs are required to return any MTF-issued identification badges and Common Access Card (CAC) to the COR, and out-process through the activities identified by the COR.

8. CONDUCT

8.1. The contract service providers shall comply with MTF policies regarding personal appearance and conduct. The service providers shall maintain a neat, well-groomed appearance at all times to facilitate credibility with patients. Hospital scrubs are to be worn during the performance of services and will not be worn to and from home and work.

8.2. The contract service provider shall abide by federal and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and the contract service provider as may be necessary for security and personnel reliability programs. The contract service providers shall also abide by federal and local MTF regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability &

Accountability Act of 1996. All regulations referenced are available for review from the COR, MTF, or the

Contracting Officer. All medical records and reports will remain the property of the government.

8.3. The contract service providers shall abide by MTF bylaws, JC, DoD and Medical Department regulations with regard to Utilization Review and Quality Assurance directives, including, but not limited to, in-service training, maintenance of records, performance evaluation, and release of medical information.

8.4. The contract service providers shall make use of all appropriate equipment, supplies, and services made available by the Government and shall make referrals and seek consultations, as deemed necessary, for the optimal care of the patients.

8.5. The MTF is a non-smoking facility. Smoking is permitted outside in designated areas. Those contract service providers that appear to be impaired shall be removed immediately.

8.6. INQUIRIES. The contractor and HCPs 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 Hospital Public Affairs Officer or, after duty hours, to the Administrative Officer of the Day (AOD).

There shall be no interviews, comments, or any other response without the 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 supervisor of the department in which the contract service provider works.

9. CONFLICT OF INTEREST

9.1. The contract service providers shall not bill a patient for services rendered under this contract. The contract service providers shall be prohibited from receiving compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract, and at the rate specified.

9.2. The contract service providers shall not, while performing services under this contract, advise, recommend or in any way suggest to persons eligible to receive medical care at Government expense that such persons should receive care from the contractor and/or contract service providers at any place other than the MTF.

9.3. CONFIDENTIALITY OF INFORMATION. Unless otherwise specified, 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 and/or contract service providers shall not release any of the above information without prior written consent of the Contracting

Officer. The contractor and/or contract service providers shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication unless authorized by the appropriate MTF personnel. The contract service providers shall prepare medical records, forms, and documents as required, in accordance with the regulations and established guidelines listed in the contract.

9.4. The contract service providers are not prohibited by reason of their employment under this contract from conducting a private practice provided there is no conflict with the performance of services under this contract. The contracting officer will unilaterally resolve any issues concerning potential conflicts. In the event a contract service provider under this contract does conduct a private practice, he/she shall not make use of any Government facilities or other Government property in connection with such practice.

10. CONTRACTOR PERSONNEL

10.1. The contractor shall designate, in writing, at least five (5) working days prior to commencement of services, an on-site representative for contract coordination and implementation. Changes in the on-site representative, at any time after the contract commencement, shall require the contractor to notify the contracting officer of the new authorized representative five working days prior to said change. This notification shall be in writing and shall state the name of the new on-site representative.

10.1.1. The contractor’s representative shall meet with the COR at the MTF on a monthly basis or as requested by the COR to discuss any issues or concerns. Problems experienced by either party will be discussed and resolved. Unresolved problems will be referred to the contracting officer for resolution.

10.2. COMMENCEMENT OF SERVICES / CONTINUITY OF SERVICES. The Government prefers that the contractor fill requirements with permanent, full-time providers due to the nature of the health care provider and patient relationship.

10.3. REPLACEMENT PERSONNEL. The contractor will be required to provide a permanent replacement for any HCP who has an unscheduled absence in excess of 45 consecutive work days. The replacement shall commence with required services within 60-90 calendar days of written notification by the designated site representative that the primary provider has exceeded the authorized forbearance period.

To ensure required commencement of replacement services, the contractor shall submit completed documentation required for Security and credentials packets (based on site requirements) within 30 calendar days of required notification.

11. QUALITY ASSESSMENT & IMPROVEMENT (QA&I). The Government shall monitor the contractor’s performance under this contract using the QA&I procedures established by the MTF and pursuant to addendum 52.212-4. Additionally, the contractor’s performance is subject to scheduled and unscheduled review by the QA&I Committee defined in the MTF’s quality assurance plan and AR 40-68.

12. INSPECTION

12.1. The inspection and acceptance point for all services rendered under this contract will be defined by the Chief, DOPS in coordination with the COR. The HCP’s performance, the quality of services rendered, and any documentation or written material in support of same, shall be subject to continuous inspection, surveillance and review for acceptance by the KO or designated representative. Any services rendered by

HCPs to patients or interaction with military/civilian personnel deemed unprofessional/threatening/dangerous by the Chief, DOPS or his/her designated representative will be considered as grounds for immediate removal and termination under the Termination for Cause clause.

Quality Assurance procedures established by the MTF shall be used for continuous monitoring.

12.2. Patient complaints on services provided by the HCP are taken very seriously at the MTF, and as such will be considered a part of the inspection process. The Chief, DOPS and COR will review all complaints.

13. PERFORMANCE REQUIREMENTS SUMMARY (PRS)

PERFORMANCE

OBJECTIVES

REFERENCE

ACCEPTABLE

QUALITY LEVEL

METHOD OF

SURVEILLANCE

Provide a High

Level of Quality

Service

PWS Section 2.2 No more than two (2)

Substantiated

Customer

Complaints per provider in any 12-month period

Substantiated Customer

Complaints & Peer Review;

Monitored by Chief, DOPS and

COR

Maintain Professional

Licenses &

Certifications

PWS Section 3.4 100% Compliance;

at all times

100% Inspection

Comply w/

Health &

Immunization

Requirements

PWS Supplement

Section 9

Comply w/

AT/OPSEC

Requirements

PWS Section 14.1

Acceptable Measures PWS Section 2.2 Overall Fill Rate >

80%; Turnover Rate <

25%

A. 100% Inspection: Exactly as title implies – inspecting a requirement every time it occurs.

B. Customer Complaint: A customer complaint is a valid complaint when the Quality Assurance

Surveillance Plan (QASP), after a thorough investigation, determines that 100% of Medical Standards of

Care have not been met.

C. Other PRS Items: The Government will periodically evaluate all other items in the PWS (i.e.

Exercises, Data Submission, etc.).

D. If any of the services do not conform with contract requirements, the Government will require the contractor to take necessary action to ensure that future performance conforms to contract requirements.

14. SITE SECURITY

14.1. ANTITERRORISM (AT) LEVEL I TRAINING / OPERATIONS SECURITY (OPSEC)

REQUIREMENTS. All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 30 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within 30 calendar days after completion of training by all employees and subcontractor personnel. AT level I awareness training is available at the following website: http://jko.jten.mil. Per AR 530‐1 Operations

Security, the contractor employees must complete Level I OPSEC Awareness training. New employees must be trained within 30 calendar days of their reporting for duty and annually thereafter.

http://jko.jten.mil/

14.2. iWATCH TRAINING. The contractor and all associated sub‐contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance with the results reported to the COR NLT 30 calendar days after contract award.

14.3. INVESTIGATIONS REQUIREMENTS. The Contractor shall ensure all personnel performing under the contract are required to maintain a minimum of a favorably adjudicated Tier 1 (T1) formerly known as National Agency Check with written Inquires (NACI) for IT Level III access or Tier 3 formerly known as a National Agency Credit and Law Check (NACLC) for IT-II access. The contractor must coordinate with the Contracting Officer Representative (COR) to initiate the Request for Personnel Security

Action prior to performance start date. U.S. Citizenship will be verified by presenting original or certified copy of birth certificate, certificate of citizenship/naturalization issued by INS, or born aboard certificate

(Form FS-240 or DS-1350) or a valid U.S. Immigration Form 1-151 and Alien Registration Card ("Green

Card") and is completed investigation document(s) to the BAMC Personnel Security Office at the time of in processing for all contract personnel assigned to the contract. In order to maintain the security requirements any derogatory information, to include law enforcement issues, mental health issues, or alcohol/drug related issues must be reported to the COR and to the BAMC Personnel Security Office.

14.3.1. Access and general protection/security policy and procedures. Contractor and all associated sub‐ contractors employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency

Services or Security Office. Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204‐9, Personal Identity Verification of Contractor Personnel) as directed by

DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

14.4. FREEDOM OF INFORMATION ACT PROGRAM (FOIA & PRIVACY ACT). The contractor shall comply with DOD Regulation 5400.7-R, DOD Freedom of Information Act Program requirements.

The Freedom of Information Act sets policy and procedures for the disclosure of records to the public and for marking handling transmitting and safeguarding For Official Use Only materials.

14.5. THREAT AWARENESS REPORTING PROGRAM. For all contractors with security clearances.

Per AR 381‐12 Threat Awareness and Reporting Program (TARP), contractor employees must receive annual TARP training by a CI agent or other trainer as specified in 2‐4b.

14.6. REMOVAL OF CONTRACT EMPLOYEE. The government reserves the right to require immediate temporary or permanent removal of any individual whose actions raise reasonable suspicion that patient care or services may be compromised in any way or that pose a threat of harm to other contractor/government personnel or self. The employee may be required to submit to drug/alcohol testing.

The government reserves the right to require temporary or permanent removal of any individual who refuses testing. Notification of all removals will be made by the Contracting Officer Representative (COR).

Removal of any individual does not relieve the contractor of any performance requirement.

14.7. PHYSICAL SECURITY. The contractor shall comply with all Force Protection Condition (FPCON) procedures, Random Antiterrorism Measures (RAMS) and local search/identification requirements.

14.8. INFORMATION ASSURANCE (IA) / INFORMATION TECHNOLOGY (IT) TRAINING. All contractor employees and associated sub‐contractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01‐M and

AR 25‐2 within six months of appointment to IA/IT functions.

14.9. KEYS & LOCK COMBINATIONS. The contractor shall abide by all current BAMC key control and lock combination procedures. The Contractor shall be responsible for any keys issued to the employee.

The keys shall not be duplicated. The Contractor shall ensure that its employee’s not allow government-issued keys be used by personnel other than those currently authorized. No unauthorized personnel shall be allowed entry into the locked area. Keys shall not be used to open work areas for personnel other than personnel engaged in performance of their duties, unless authorized by the Government functional area chief. The employee shall use keys issued to them to secure/open areas only as directed by the COR and/or functional area chief. Lost keys and/or locks shall be reported to the issuing party and COR immediately upon recognition of the loss. The COR shall notify the PMO of the lost key. The employee shall be responsible for the replacement costs of any lost keys and any associated locks. Reimbursement shall be provided before the Government replaces lost keys or performs re-keying.

14.10. KEY CONTROL. The contractor shall safeguard all keys issued by the government and insure they are used only by authorized contractor personnel. The contractor shall not duplicate issued keys and shall report lost keys to the contracting officer immediately the contractor will be charged for lost keys, re-keying, and lock replacement as applicable.

14.11. SITE SAFETY. Shall be in accordance with the primary contract. The contractor shall submit a project specific Site Safety and Health Plan, complying with the requirements of EM 385-1-1 for review and approval within 30 days of task order award.

15. SECURITY

15.1. For contractors requiring Common Access Card (CAC). Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014‐05. The contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a

DoD facility and access, via logon, to DoD networks on‐site or remotely; (2) Remote access, via logon, to a DoD network using DoD‐approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non‐DoD federally controlled facilities on behalf of the…