MSSI RFP 3-8-2011 FINAL.docx

Solicitation SAQMMA11-R-0010, Amendment 002 February 9, 2011March 9, 2011

Department of State Health Care Service Support in Iraq

Table of Contents

M.9 Solicitation Amendments ……………………………………………………………118

ATTACHMENT M. Price Volume Instructions………………………140 Electronic file (See FedBizOps)—Compliance Checklist/Pricing Tables

SECTION B. Supplies or Services and Prices/Costs

B.1 Price Summary

The Contractor shall provide the pricing for all labor categories, NTE Travel, Other Direct Costs (ODC), General and Administrative (G&A) Costs. The Contractor is not authorized to charge a fee on Defense Base Act Insurance, Travel, or Other Direct Costs.

B.2 Type of Contract

This will be a single award IDIQ contract with task orders issued in accordance with the ordering procedures set forth in Special Provision H.12. Orders will be on a firm fixed price basis to the extent practicable. The Other Direct Costs, and Travel, and Defense Base Act (DBA) Insurance line items of the task order will be on a reimbursable basis. The government will award a separate task order for Program Management as well as orders for the individual sites. Contract types for the individual task orders will fall under one or more of the following, depending on the type, complexity, and urgency of the task order requirement: fixed-price, cost-reimbursement, labor-hour, and time-and-materials. Some task orders may be performance-based. Performance-based requirements, when applicable, will be conveyed and administered at the task order level. The first task order under this contract will be for Program Management. This task order will be awarded within 30 days of award of the basic contract, The Government, through the issuance of task order(s) or otherwise, shall pay a one-time minimum of $100,000 (inclusive of all direct costs, indirect costs, and profit/fee) within the contract’s five-year period of performance (base year plus four option years).

The maximum for the contract’s five-year period of performance (base year plus four option years) shall be any quantity or combination of supplies and services not exceeding $1,000,000,000 (inclusive of all direct costs, indirect costs, and profit/fee).

B.3 Labor Categories

Section C, Descriptions/Specifications/Performance Work Statement, contains the specific tasks for which the Contractor shall determine personnel requirements needed in the performance of this contract. The Contractor will utilize the appropriate labor categories for each of the positions and assign a fixed price for these categories (Attachment A – Labor Categories). If additional categories are proposed and/or required the contract will be modified after award to include the additional labor position(s). The additional rates will be priced by comparing the new category to the established rates in terms of complexity and skill level(s) required.

B.3.1 Reimbursable Materials (Other Direct Costs)

The Contractor shall be reimbursed for all non-expendable supplies and equipment (hereby referred to as material) required to operate and sustain the health care facilities. For any single item in excess of US $5,000, prior written approval must be obtained from the COR. The Contractor shall e-mail a request for approval to purchase the items along with a short justification.

In the event the Government requests the Contractor purchase Reimbursable Materials, the Contractor shall provide 2-3 competitive offeror quotes for all purchases exceeding US $3,000 in support of the purchase, as well as a written justification if the Contractor selects other than the lowest priced quote. The quotes shall serve as a determination of fair and reasonable pricing by the Contracting Officer.

SECTION C. Descriptions/Specifications/Performance Work Statement

C.1 Purpose and Objectives

This is a non-personal services contract to provide Health Services Support to U.S. personnel, contractors, and authorized foreign nationals in Iraq. The Contractor will provide trained and certified health care professionals and administrative service support to U.S. and U.S. sponsored beneficiaries working and residing in Iraq. The Contractor will staff, operate, equip, and supply health care facilities in locations prescribed by the Department of State to meet operational requirements as identified in this Performance Work Statement. Mission capable status (all sites listed in table C.1) is 1 December 2011. Mission capable means that the contractor is able to perform all requirements under this PWS.

For the purposes of this PWS, the term Embassy refers to the Embassy, Consulate, and all other entities under the COM control.

C.2 Background

The health care support mission will transition from the U. S. Department of Defense to the U. S. Department of State over a period of time as denoted in Attachment B. Transition Timeline, beginning on or about June 2011 with transfer completed by December 2011. After the U.S. military forces withdraw from Iraq, the U.S. Embassy and constituent posts and sites will be comprised of approximately 14,000 to 17,000 personnel under the U.S. Ambassador which includes U.S. Government civilians, military and local national employees; and supporting Contractors (U.S., third country, and local national). All U.S. and third country personnel will require medical care. Local nationals will be treated only in emergencies or for work related injuries. Extraordinary circumstances may result in treatment of some Iraqi nationals at the direction of the COM, however it is expected that this would be a rare occurrence.

The Department of State will establish a network of Contractor operated facilities in three regional support areas (see Attachment C for map of the facility locations and support regions) consisting of seven Health Units (HUs), one large Diplomatic Support Hospital (DSH), and three small DSHs that provide patient care. A description of the capabilities required of each of the three types of facilities may be found in the Scope of Work of this PWS. Health care facilities will be in secure compounds within each of the three geographical support regions with general logistics, utilities, and housing support provided by separate contracts.

The Contractor will be responsible establishing facilities as indicated in Table C.1 below:

Table C.1 Facility Type, Locations, and Population Supported

Type Estimated Population at Risk

Tikrit Sather (Baghdad)

HU

Large DSH 200 – 300 1600 – 1800*

Umm Qasr

HU

100 – 200

* Location population requiring primary care; DSH will also serve as the surgical referral center for an additional population of 5,000

C.3.1.1. Demand for Services. The Contractor will establish and provide primary health care as well as resuscitative surgical care in accordance with U.S. or equivalent medical standards on a 24 hour basis, 365 days of the year to Chief of Mission (COM) personnel, a population consisting of approximately 14,000 adult personnel. This is a predominantly male, middle-aged, civilian work force. Specific beneficiary eligibility will be determined by the COM or his or her designee. The contractor will continue to treat non-Chief of Mission personnel (active duty military, NATO personnel, Department of Defense civilians, and contractors) through the end of December 2011 or until the final draw down. Local nationals will be treated if injured or ill on the job; otherwise, locals will be treated only on an emergency basis and if authorized by the Chief of Mission. In the International Zone, contractors generally take care of their own personnel. Outsize the International Zone and Union III, this contract includes health care of contractors.

C.3.1.2. Physical Structures. Physical structures have been identified at all Health Unit (HU) locations. The U.S. Government will be responsible for any modifications required, and such modifications may be done before, during, or after arrival of the Contractor. They will be serviceable for initial use. The Diplomatic Support Hospitals (DSH) are existing facilities at Basrah, Sather, and Kirkuk. Modifications of extant DSH facilities will be the responsibility of the U.S. Government and may be done before, during or after the contractor’s arrival. A facility will need to be constructed or supplied in Mosul. In no circumstances is the Contractor responsible for construction of facilities.

C.3.1.3. Travel to and From Iraq. The contractor will be responsible for bringing people into the country. The Government will transport contractor personnel from the airport to their sites. All in-country official travel will be provided by the Government.

C.3.2 Health Unit (HU) Capabilities.

The Contractor shall provide on-site primary, urgent and initial emergency care for general medical, surgical, orthopedic, gynecologic (GYN) and mental health conditions; triage, stabilize and evacuate patients to the next level of medical care; and keep up to two patients in the HU for up to 24 hours until stabilized or medically evacuated. Staffing shall be continuous and uninterrupted; coverage for illness and vacations shall be the responsibility of the Contractor.

The Contractor shall designate a medical director for appropriate medical oversight at each facility. This medical director shall be named in the resultant task orders. Routine care shall be provided during regular working hours, and on an emergency basis after normal working hours based on COM requirements. At least one physician with expertise in all aspects of emergency care shall be available 24 hours daily. All providers shall be licensed to U.S. or equivalent standards and physicians shall be qualified by U.S. or equivalent specialty boards. All primary care providers (Physician(s), Physician Assistants, Nurse Practitioners) shall hold current credentials in trauma care (e.g. ATLS, CALS or equivalent) and cardiac care (ACLS or equivalent).

The Contractor shall also provide the following supplies and services at each HU facility:

· Medical and medical emergency equipment.

· Basic formulary and vaccines to include, but not limited to thrombolytic therapy.

· Medical supplies.

· Laboratory equipment and supplies and maintenance thereof, Clinical Laboratory Improvement Act (CLIA) waived lab capabilities to include, but not limited to: basic hematology, blood chemistries, urine analysis, cardiac enzymes, d-dimer testing.

C.3.3 Small Diplomatic Support Hospital DSH Capabilities.

In addition to the capabilities outlined above for a HU facility, the Contractor shall establish a medical/trauma care hospital with the following capabilities:

· Basic x-ray, diagnostic ultrasound (to include Focused Abdominal Sonogram for Trauma (FAST) Right Upper Quadrant (RUQ), renal, OB (tubal pregnancy), GYN, testicular, and Deep Vein Thrombosis (DVT) evaluations).

· Appropriate number of trauma bays in the emergency medical and trauma unit for care and stabilization.

· Overnight bed capabilities for up to four patients (8 beds total ( 4 ICU beds + 4 regular beds))

· Post operative / intensive care capabilities for up to four patients to be stabilized until medically evacuated

· One operating room table with anesthesia and supplies.

· Laboratory with blood bank.

· Computerized Tomography (CT) Scanner with the capability to conduct non-contrast, contrast (oral and IV), and the ability to do PA-grams (ideally with venous run-off).

Staffing shall reflect that necessary to manage a single surgical patient with the required operating room (OR) techs, nurses, anesthetists and the possibility of multiple injured or ill patients. The professional staff, when time permits, shall be integral to all aspects of the facility. Physicians, surgeons, anesthetists, OR tech, EMTs, laboratory technologist and nurses shall meet the requirements outlined below in the Staffing section.

C.3.4 Large Diplomatic Support Hospital (DSH) Capabilities.

Sather Air Base will have the same common items as the Small DSH facilities and Health Units, but will have:

· staffing that reflects the requirements to manage two surgical patients and the possibility of multiple injured or ill patients

· staffing to include competency in performing and interpreting ECG stress tests

· possess a total of 2 OR tables with anesthesia and supplies

· overnight bed capabilities for up to six patients (12 beds total (6 ICU beds + 6 regular beds))

· post operative / intensive care capabilities for up to six patients to be stabilized until medically evacuated

· It is anticipated that full occupancy would be a rare occurrence.

C.3.5 Hours of Operations.

HU: It is anticipated that routine services and primary care will be offered at the Consulate and other locations during regular hours as determined by COM (e.g. 08:00 until 18:00). The Health Unit staff is expected to respond to after-hour and weekend calls, though patients may be referred to the Health Unit the following day in accordance with good practice standards. Patients shall be seen promptly if circumstances warrant. In the event that a patient needs to be “boarded” overnight, the Health Unit staff should make appropriate adjustments to their staffing pattern.

DSH: DSHs will operate on a 24 hour, 365 day schedule. It is anticipated that routine services and primary care will be offered at the DSHs during regular hours as determined by COM (e.g. 08:00 until 18:00). For after-hours and weekends, one staff member shall be available in the DSH at all times; the remaining DSH medical staff will be immediately available (< 5 minute response time) to respond to after-hour and weekend emergency calls. When patients need to be boarded post-operatively; until stabilized, evacuated or discharged, the DSH will be staffed accordingly to safely meet inpatients’ needs.

C.3.6 Program Management Support

The Contractor shall provide all necessary personnel, administrative, financial, and managerial resources necessary for the support of this contract. The Contractor shall use proven methodologies that assure that all activities are identified, documented, and tracked so that the contract will continuously be evaluated and monitored for timely and quality service. The Contractor shall deliver the monthly status report to the Contracting Officer’s Representative (COR) referenced in paragraph G.1.

C.3.7 Monthly Status Reports

The Contractor shall provide a Monthly Status Report (MSR) that briefly summarizes, by task order, the management and technical progress to date, as well as provides the current accounting information indicated below. The Contractor shall provide at a minimum the following information:

· Status of all activities/requirements by program,

· Progress against milestones and estimated cost,

· Deliverables submitted for the period,

· Name, rate, and total billed hours by individual,

· Travel costs,

· ODC costs, and

· Base Act Insurance

The Contractor shall reconcile the MSR with invoices such that they can be matched month by month.

C.4 Description of Work / Services

C.4.1 Medical Treatment - Resuscitative, General Surgical Care and Medical Care

If return to quarters is not anticipated within 96 hours of surgery or medical admission, patients will be medically evacuated for onward treatment and medical care, environmental conditions permitting.

C.4.1.1 Emergency Response.

Within Embassy Compounds. When there is an emergency within a DoS support area due to a medical condition, the Tactical Operations Center (TOC) shall arrange for medical response and transportation to the nearest health care facility. Medical attendants during evacuation will be provided by the Government, if required. The response is part of another contract and not a requirement of this contract. However the Contractor shall receive the patient from the responding Contractor and render care.

Outside Embassy Compounds. When there is an emergency outside a DoS support area due to a medical condition, the Tactical Operations Center (TOC) shall arrange for medical response and transportation to the nearest health care facility. The response is part of another contract and not a requirement of this contract. However the Contractor shall receive the patient from the responding Contractor and render care.

Medical Evacuation within Iraq. When a patient’s medical condition requires a transfer to a general surgical team located at a DSH, the designated medical director will notify the TOC and place a request for evacuation. The medical director will also inform the TOC if there is a requirement for additional medical equipment or requirement for en route medical care. The TOC will make the necessary coordination with the MEDEVAC team and will provide them the patient’s information and any additional requirements for medical equipment. The transfer will be documented via the 9-line evacuation form used by DoD (see Attachment D for sample), or a similar form containing the same data.

Medical Evacuation from Iraq. The medical director at the DSHs will be responsible for making the determination that medical evacuation out of Iraq is necessary. Contract employees will be evacuated IAW the cognizant Contractor’s standard operating procedures. For U.S. government direct hire employees the medical director will contact the Regional Medical Officer in Baghdad, who will make arrangements for the medical evacuation. For all other contractors, each contractor will hold private medical evacuation insurance. In all medical evacuation cases, the RSO will be involved in the evacuation coordination and decision process.

Mental Health Evacuation from Iraq. Government direct hire mental health cases will be evacuated to Washington in accordance with current Department of State guidelines, in coordination with the Regional Medical Officer (RMO) and the Regional Medical Officer / Psychiatrist (RMO/P). Contractor mental health cases will be evacuated in accordance with policies established by the contractor’s/patients' medical evacuation insurance company.

C.4.2 Dental

Dental services, if ordered, will be limited to performance at the Sather Facility for emergency general dentistry for all COM designated personnel in Iraq. The Contractor shall provide emergency dental services at the Sather DSH within the scope of practice of general dentistry to eligible patients. Patients will be moved using Embassy resources.

C.4.3 Public Health

Although this contract may require coordination with other contracts for performance of specific services, primary responsibility for performance of the following services will reside with other contracts and are not the responsibility of this contract:

Medical Waste Disposal Food and Water Point Inspection / Testing Pest / Vector Control Cafeteria Inspections

This contract shall require tracking and reporting of occupational injuries, disease trends (e.g. influenza-like illness), blood-borne pathogen and needle stick exposure programs, periodic health education and disease prevention programs and other services in accordance with industry standards and as determined by the Department of State.

C.4.4 Medical Logistics.

C.4.4.1 Medical Supplies. The Contractor shall be responsible for all supply chain management processes to support the operations of health care facilities. This includes determining what pharmaceuticals, medical supplies, and medical equipment are required to sustain patient care operations. Patients will be responsible for obtaining maintenance medications. The Contractor shall find their own sources for material ordered and must ensure that they only use U.S. FDA or European Medicines Agency (EMA) approved products in the delivery of health care. The Department of Defense supply chain is to be used as a back-up only. The Contractor is responsible for any import fees, tariffs, and /or taxes imposed by Iraq as well as completion of all the cross border documentation required as part of this contract.

Other contracts will provide medical waste disposal, laundry services, equipment disposal, oxygen tank refills; trash collection; hazard material management and general housekeeping. The Contractor will be responsible for coordinating these services and for general supply ordering and replenishment.

C.4.4.2 Equipment. The Contractor shall be responsible for identifying the necessary equipment and outfitting each of the health care facilities with the equipment and supplies required to provide health care support and maintain basic operations. Specific requirements will be contained on the individual task orders. Communications systems and equipment will be provided by the Government.

C.4.4.3 Biomedical Equipment Maintenance and Repair. The Contractor is responsible for maintenance and services to include calibration and repair of all medical equipment, including CT scanners, utilized under this contract.

C.4.4.4 Mortuary Affairs. The Contractor shall notify American Embassy - Baghdad Human Resources and the RSO upon the death of a patient. Another contract will provide mortuary services. The Contractor shall have custody of remains until other arrangements can be made. Remains may be held for 24-48 hours. Contractor may release the bodies of local nationals to their families unless otherwise notified by the Chief of Mission.

C.4.4.5 Housekeeping. The Contractor shall perform cleaning and sanitization requirements above the standard housekeeping cleaning to meet the Centers for Disease Control and Prevention (CDC) guidelines for environmental infection control in health care facilities. Any specialized housekeeping requirements for operating rooms will be the Contractor’s responsibility.

C.4.4.6 Blood and Blood Products. The Contractor will staff the large DSH at Sather with at least one Medical Technologist or Medical Laboratory Scientist who will have oversight responsibility for blood management at the large and small DSH facilities. The small DSH facilities will have a lab technician who will be trained to perform emergency cross-matching. Each DSH will have the ability to receive, inventory, store, thaw and transfuse as needed up to 10 units of a combination of O positive and O negative blood (20 units in the large DSH) and up to 6 bags of a combination of AB and AO Fresh Frozen Plasma (12 at the large DSH). The Contractor will maintain an inventory of supplies needed to provide transfusion services. Transfusion of blood products will be done in accordance with common nursing practice standards at the direction of one of the General Medical or Surgical Officers.

The Government will make blood products available at no cost through Al Udeid Air Force Base, Qatar. The Contractor will be responsible for periodic (monthly or more often as needed) retrieval of these products, transportation to the DSH and redistribution to the smaller DSHs, to be performed in accordance with standards prescribed by the American Association of Blood Banks and the FDA for transport and storage of blood products. The provision of this supply by the Department of Defense is contingent upon each small DSH reporting to the large DSH daily blood product inventory; the large DSH shall then report that information daily to the DoD Blood Service (details to be provided at a later date).

A Mass Casualty Incident could result in an immediate need for blood and blood products in excess of the supply at hand. In case of an emergency immediately requiring blood and blood products beyond what is available as noted in the preceding paragraphs, each DSH will have the capacity to perform fresh whole blood collection and transfusion. This capacity, often referred to as a “walking blood bank”, should include the solicitation of potential volunteers well in advance of an emergency, appropriate screening at the time of solicitation, rapid HIV, HBV and HCV donor screening at the time of collection, necessary collection bags and filters and adherence to a well-defined protocol. It is understood that such a program would constitute an extraordinary measure to be used only under extraordinary circumstances. Contractor should provide in detail the plan to establish, implement and follow-up such a program.

C.4.4.7 Inpatient Meals. The DSH overnight beds are not supported by a catering service. The DSH medical or administrative staff, at the direction of the responsible General Medical Officer, will hand carry each meal (breakfast, lunch, dinner, snack) from the dining facility operated by another contractor to the DSH inpatient ward and return trays or dispose of trash accordingly.

C.5 Medical Communications and Automation Support.

The Contractor will provide computers, peripherals, and automation support required to meet the health care requirements described in this PWS. Internet connectivity for the purposes of conducting work under this contract will be the responsibility of the Contractor. Anything that maintains patient data becomes the property of the Government.

The Contractor will provide a solution for transmission of CT and other digital images from other locations to the Sather-based radiologist for “real time” (emergency) readings and non-emergency readings. An example of one such solution already in use in Iraq by the Department of Defense is MEDWEB. The Contractor may consider, but is not required to use, this particular provider.

Any PC connected to OpenNet (the DoS unclassified secure system) has to be purchased by DoS and remains DoS property. The Contractor cannot connect a personal or corporately owned computer to OpenNet. This restriction also applies to computers with HIPAA (Health Insurance Portability and Accountability Act of 1996) covered data.

C.5.1 Patient Administration.

Department of State will provide a proof of eligibility for access to health care.

C.5.2 Medical Records.

The Contractor will establish a medical record for all personnel for whom it provides health care. The Contractor shall provide either a paper or electronic medical record that must at a minimum contain personal patient information (name, age, date of birth, sex) assigned organization or company, chief complaint, date of complaint, applicable prior health care screening information such as allergies, and recent physician provided health care. Health care forms used shall be Health Insurance Portability & Accountability Act (HIPAA) compliant. Health Care Providers (HCPs) will document care delivered and follow up care required.

C.5.3 Patient Tracking.

For all patients requiring over-night care or medical evacuation, the Contractor will establish patient tracking processes and procedures that will account for the patient locations within the health care delivery network.

C.5.4 Patient Reporting.

The Contractor will provide periodic status reports as determined by the RMO in Baghdad. The RMO will be advised of any patients with life threatening illness, loss of life, and/or potential threat to the Embassy community. Additional reporting requirements may be provided with each task order.

The Contractor shall submit a staffing plan that is in concert with their technical approach with the individual task order(s).

C.6.2 Reserved.

C.6.3 Staff Medical Fitness.

The Contractor shall provide technically competent Health Care Providers (HCPs) that are “medically and dentally fit” in the time frame stated in the task order award notice. A qualified candidate shall not have a medical condition that would constitute a direct threat to the health or safety of the individual or others, or that, with or without a reasonable accommodation, would prevent the individual from performing the duties of the job. Individuals requiring maintenance medication are responsible for bringing sufficient quantities for the duration of their stay The Contractor’s assessment of a candidate’s medical fitness to perform the duties of the job should include consideration of available information regarding:

(1) The candidate’s medical condition, including the likelihood of contagion, and the effect of that condition on the candidate’s ability to perform the duties of the job in a safe, efficient and effective manner;

(2) The likelihood that the candidate may require access to medical facilities or treatment, medication or supplies on an emergent or frequent basis overseas; and, if so, whether such facilities, treatment, medication and supplies are available and safely accessible at the overseas location(s) where the job will be performed;

(3) The likelihood that working in such overseas locations may result in adverse effects upon the candidate’s medical condition or treatment;

(4) Any applicable host-nation requirements or restrictions relating to the candidate’s medical condition that may prevent, impede or interfere with the candidate’s ability to perform the duties of the job in such overseas locations; and

(5) Any other relevant factors.

All services shall be provided in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations. Contract HCPs shall have the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for patients.

C.6.4 Credentialing.

The Contractor is responsible for confirming that all licenses, certifications and registry requirements are current and valid. The Contractor will exercise due diligence to confirm recommendations, prior administrative action against a licensee and/or criminal history.

The Contractor will ensure that for all HCPs:

· Licenses are in good standing, are without restrictions, and are kept current through the period of employment.

· ACLS and ATLS will be current throughout the period of employment. A 90-day window is permitted for recertification.

· Physicians and Primary Care Providers shall be licensed in the United States or Canada; physicians and primary care providers licensed elsewhere will be considered on a case-by-case basis.

· All health care providers and medical support staff shall be proficient in the ability to speak, write and communicate in English.

· All health care providers and medical support staff shall demonstrate proficiency in the use of basic word processing programs

· All health care providers and medical support staff shall have recent clinical experience in patient care, including at least 6 months out of the past year.

The Contractor shall:

· Be responsible for ensuring each HCP or HU employee is screened and credentialed prior to hiring of the individual, including confirmation of licenses, certifications, license restrictions, malpractice claims, prior loss of privileges, and any criminal history. References shall be contacted for each individual proposed. The DoS Office of Medical Services will conduct a review of the credentialing process periodically.

· Notify the COR of any unplanned staff turnover

· For Primary Health Providers and other Physicians, including the General Medical Officer, General Surgical Officer, Nurse Practitioner and Physician Assistant, present their credential files to the RMO for confirmation of credentials and final hiring approval

· Ensure that the HCPs are properly trained and certified prior to arrival in theater and that they stay proficient while providing health care.

C.6.5 Training and Certifications.

C.6.5.1. Professional Education. The Contractor will provide staff that meet the training requirements, (including HIPAA training) and possess the certifications stipulated in the descriptive paragraphs that follow for each type of position. The Contractor is responsible for maintaining a database of credential qualifications and ensuring that staff members are trained and certified before they deploy. The government will periodically inspect the Contractor’s credentialing system to ensure that only qualified personnel provide health care or support to health care under this contract.

C.6.5.1. Pre-Deployment Counter Terrorism Training. U.S. Contractor personnel in Iraq in excess of 30 days shall complete the a two week pre-deployment Foreign Affairs Counter Terrorism (FACT) training prior to travel to Iraq for work on this contract. Contractor will provide such training, either directly or through a third party. The requirement applies to all contractor personnel, prime and subcontractors. Specific course elements include:

· Combat first aid training

· Weapons familiartization (M4, M9, Beretta, Glock, AK-47)

· Defensive tactics, including counter-terrorism driving

· Improvised explosive device (IED) recognition

· Surveillance detection training

· Hostage survival and personnel recovery

C.6.6 Position Descriptions

The Government of Iraq, Ministry of the Interior, is releasing a list of partner countries whose nationals will be allowed to provide services. The list of approved countries will be provided as an amendment to the solicitation.

C.6.6.1 General Medical Officer

Please be advised that all health care providers shall be licensed in accordance with Section C.6.4.

· Emergency Medicine Specialist (defined by current board certification) with a broad interest and experience in providing primary care across the range of office-based specialties including, but not limited to, GYN, dermatology, ENT, pulmonary, cardiovascular, ophthalmology, orthopedics, psychology and gastroenterology. Current ATLS and ACLS are required; recent completion of Tactical Combat Casualty Care or comparable advanced trauma course featuring “live tissue” or exceptional simulation training is desirable.

Or

· Family Medicine Specialist (defined by current board certified or equivalent board certification) with interests as defined above and with an interest, additional training and practice experience to include the broad range of gynecologic, medical, surgical, orthopedic, psychiatric and trauma emergencies. Current ATLS and ACLS are required; recent completion of Tactical Combat Casualty Care or comparable advanced trauma course featuring “live tissue” or exceptional simulation training is desirable.

Or

· Internal Medicine Specialist (defined by current board certified or equivalent board certification) with interests as defined above and with an interest, additional training and practice experience to include the broad range of gynecologic, medical, surgical, orthopedic, psychiatric and trauma emergencies. Current ATLS and ACLS are required; recent completion of Tactical Combat Casualty Care or comparable advanced trauma course featuring “live tissue” or exceptional simulation training is desirable.

C.6.6.2 General Surgical Officer. U.S. or Canadian board certified or recently ABS qualified General Surgeon with interest, training and experience managing the full range of emergency surgical cases including vascular, neurologic, orthopedic and soft-tissue, as well as the full-range of general surgical cases including abdominal, urologic, vascular and soft-tissue. Current ATLS is required; recent completion of Tactical Combat Casualty Care or comparable advanced trauma course featuring “live tissue” or exceptional simulation training is desirable. Completion of a trauma fellowship will merit particular consideration.

C.6.6.3 Physician Assistants, Adult or Family Nurse Practitioners (Primary Care Providers). Nurse Practitioners will hold current national certification by the AANP or ANCC and hold and maintain a current unrestricted licensure from any state during the period of employment. Physician Assistants will hold national certification by the NCCPA and hold and maintain a current unrestricted license from any state during the period of employment.

C.6.6.4 General Anesthesiologist. (defined by current board certification) Experience managing critical patients (medical and surgical) in a medically austere environment is expected, including – but not limited to – ventilator and respiratory care, pain management, general and regional anesthesia and sedation, consultative services for CRNAs and other services within the scope of practice as requested by the General Surgical Officer, General Medical Officer, Nurse Practitioner and Physician Assistant.

C.6.6.5 General Radiologist. (defined by current board certification) The radiologist will assist with all procedures within his or her scope of practice including, but not limited to, contrast injections, sonography, and abscess drainage. In addition, the radiologist will serve as a consultant for all other locations in Iraq.

C.6.6.6 Emergency Medical Technicians, Registered Nurses, Vocational Nurses. The Contractor shall utilize additional care providers in all medical facilities to assist with patient administration; vital signs; post operative, intravenous, and intramuscular medications; cardiopulmonary resuscitation and resuscitative trauma care; along with other duties as determined by the primary medical providers (physicians, nurse practitioners and Physician Assistants) that do not exceed the scope of practice.

· All EMTs shall be listed in the National Registry or holding a current unrestricted license in the US or Canada.

· RNs and VNs shall hold current and unrestricted licenses, in good standing, in any U.S. State or Canada and without restrictions.

· All EMTs, RNs and VNs must hold current BLS certification; advanced certification (e.g. ATLS, ACLS), where applicable to the position, is desirable.

C.6.6.7 Specialty Nursing / Technical Staff. The Contractor shall use specialty service providers where required, including Operating Room RNs (with or without operating room certification) and Certified Surgical Technologists. All specialty and technical staff shall hold current and unrestricted licenses, in good standing, and, where required, current certification(s). Anesthetists must hold current certification as a CRNA and maintain an unrestricted license in good standing from any state.

C.6.6.8 Biomedical Equipment Technician. - The Contractor shall provide biomedical equipment technicians (BMET) that will provide maintenance and services to include calibration of all medical equipment including CT scanners (both government furnished equipment and Contractor medical equipment) within their assigned region. The Contractor proposed BMET qualifications shall include a high school degree, associate’s degree (preferred), and a trade school program (i.e. military training, technical school, etc.) with 5–7 years experience.

C.6.6.9 Medical Technologist. The Medical Technologist will be credentialed as an MLS(ASCP cm) or MLS(ASCP) cm eligible or certified by the Canadian Society for Medical Laboratory Science (CSMLS).

C.6.6.10 Medical Laboratory Technician. The Laboratory Technician will hold certification as a medical laboratory technician through the American Society for Clinical Pathology (ASCP), the American Medical Technologists (AMT), the National Credentialing Agency for Laboratory Personnel (NCALP) or the Board of Registry of the American Association of Bioanalysts (AAB). Laboratory technicians certified by non-US entities and/or non-Canadian entities will be reviewed and approved on a case by case basis.

C.6.6.11 Dentist. The Contractor shall provide a dentist that is a graduate of an accredited dental school in the United States, holds a current and unrestricted dental license from any of the States, and has at least three years experience after licensure as a general dentist.

SECTION D. Packaging and Marking

D.1 Data Packaging Requirements

D.2 Marking of Reports

All reports delivered by the Contractor to the Government under this contract shall prominently show on the cover of the report:

(a) Name and Business address of the Contractor;

(b) Contract number and delivery order number, if applicable;

(c) Date of report;

(d) Program office(s); and

(e) Individual Task Order Number.

The Contractor shall not place its name, brand, or logo on any signs, maps, drawings or items identified as Government property in support of this contract without written approval from the Contracting Officer.

D.3 Report Requirements

(a) Additional delivery Information may be contained on the individual task order.

(b) All reports shall be submitted in Microsoft Office Format.

(c) Quarterly, Semi-Annual and Annual Reports shall be submitted on a CD.

(d) Reports shall not contain proprietary or restrictive language or markings.

D.4 Warranty Notification

In accordance with FAR 46.706(b)(5), the Contractor shall stamp or mark the supplies delivered, or otherwise furnish notice with the supplies, of the existence of a warranty, if any. Sufficient information shall be presented for supply personnel and users to identify warranted supplies. Warranty information shall include the terms and duration of the warranty and the name and telephone number of the Contracting Officer to be notified if the supplies are found to be defective.

SECTION E. Inspection and Acceptance

The Contractor is responsible for performing or having performed all inspections and tests necessary to substantiate that the supplies or services furnished under this contract conform to the contract requirements including any technical requirements for the specified manufacturers’ parts.

E.1 Inspection Clauses

The following contract clauses are incorporated by reference and have the same force and effect as if they were incorporated in full text.

E.2 Acceptable Levels of Performance

This provision will be implemented at the task order level.

When the Contractor fails to provide the services required by orders issued under this contract, the Government shall annotate the contract record of the deficiency for use in the annual appraisal and past performance record IAW the Quality Assurance and Surveillance Plan (QASP). Unless the deficiencies were not reasonably discoverable by the Government, the Government will notify the Contractor and request a plan for correcting the nonconformance.

If…