SOW_Academic Medical Center Support 08052024.pdf

REVISED August 5, 2024

STATEMENT OF WORK (SOW)

Academic Medical Center Support Statement of Work

Part 1

GENERAL INFORMATION

1. INTRODUCTION: The US Secret Service Rowley Training Center (RTC) is the authority for the development, administration, approval and coordination of all emergency medical operations, emergency medical training and emergency services training within the Secret Service. It directs, authorizes, researches, develops, implements, and reviews all activities, policies, and procedures relative to emergency medical care, medical support operations, personnel, training, equipment, and vehicles utilized in the application of emergency medicine. ESS staff maintains custody and control of all certified provider medical certifications, licenses and training files. It also assists the senior management of the Secret Service in the development and delivery of emergency services measures.

1.1 Background: RTC manages this program through the Emergency Services Section

(ESS). ESS is licensed under the Maryland Institute of Emergency Medical System as an operational and educational jurisdiction in the State of Maryland. All medical activities of the Emergency Services Staff are under the purview of the Medical Director, a licensed, practicing emergency medicine physician, meeting the requirements of this statement of work, assigned by the academic medical center. The vendor assigned Medical Director in collaboration of the SAIC of JJRTC is the authorizing entity for all training, protocols, equipment, consultation, and treatment provided within the Secret Service. USSS ESS paramedics/ registered nurses and EMTs function under the medical direction of the assigned Medical Director, regardless of their physical location or assignment, all of which are considered to be federal jurisdictions.

1.2 Objectives:

• Provide medical direction for USSS Law Enforcement Responders and 400+

USSS Emergency Medical Clinicians

• Provide access to 24/7 telephonic EMS medical control for USSS emergency medical clinicians

• Provide training to USSS Emergency Medical Clinicians

• Establish protocols for USSS emergency and operational medical providers

• Provide physician support for NSSE and domestic and foreign travel as needed

1.3 Scope: Academic Medical Center Support Statement of Work

The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform medical direction, emergency and operational medical training, and physician support of NSSE and foreign and domestic travel as needed defined in this Statement of

Work except for those items specified as Government furnished property and services.

The contractor shall accomplish:

• Be a university affiliated academic medical center

• Designate a physician Medical Director and Deputy Medical Director

• Provide staff of physicians who can meet criteria established in the SOW and travel in support of NSSEs, domestic, and foreign protective missions

• Provide physicians qualified to support training of EMS operational programs

1.4. Task Heading: - Revised to incorporate highlighted section below:

Academic Medical Center

• Must be geographically located in the Baltimore-Washington metropolitan area

• Provide physicians who o Are Maryland licensed and capable of satisfying the Maryland

Institute of Emergency Medical Services Systems, Title 30, Subtitle

03, and Chapter 03 requirements for Medical Director o Must be board certified by the American Board of Emergency

Physicians (ABEM) with EMS subspecialty preferred o Can successfully pass USSS background check and be eligible to obtain security clearance

• Shall provide a Maryland licensed physician capable of satisfying the

Maryland

Institute of Emergency Medical Services Systems Title 30, Subtitle 03 and

Chapter 03 requirements for Medical Director. The director shall have 5 years’ experience operating as an Operational, Educational and Tactical medical director. This physician shall meet the Maryland Tactical Physician criteria as defined in Maryland Medical Protocol Tactical EMS Program standards. Medical Director will review, and provide guidance to the SAIC-

RTC relative to all Service Emergency Medicine operations, policies and training. Medical Director will authorize or make recommendation to limit or restrict Emergency Medicine practice of all Service employees.

• Shall provide the assigned Medical Director and select support physicians with vehicle(s) capable of emergency response. Train and qualify the assigned Medical Director and support physicians in emergency vehicle operations. Provide one physician for medical response and support in the

Baltimore Washington metropolitan area for 24 hours with 8 hours notification. The vehicle provided must be able to transport the physician and equipment from hospital base to various service locations and be equipped

(including flashing lights and siren) to respond under emergency conditions.

• Provide hospital clinical site with access to, or capability to teach:

o Patient simulation capability with high fidelity manikins o A cadaver lab o Hospital supervised/staffed ambulance meeting Maryland Critical

Care Transport standards capable of mentoring USSS Emergency

Medical Clinicians and providing continuing skill development o Preceptors and access to the emergency department for facilitation of clinical training of USSS emergency medical providers

• Provide a minimum of 350 hours educational support with hours reported to the COR.

o Minimum educational hours for programs:

▪ Emergency Medical Technician (Basic and Advanced)-80 hours

▪ Emergency Medical Technician Skills Refresher-50 hours

▪ Operational medicine Expanded Scope- 60 Hours

▪ Initial Casualty Extraction-40 Hours

▪ Rescue Swimmer-16 hours

• Provide a minimum of 250 of administrative and operational medical direction with hours reported to the COR.

• Provide 40-hour paramedic refresher for ESS staff that meets National

Registry of EMT standards as well as instructional support for other USSS

Emergency Medical Clinicians and classes.

• Provide a designated call center capable of providing 24 hour a day 7 day a week telephonic EMS medical control for USSS emergency medical providers by the Medical Director, or on-call designee(s).

• Provide a clinical facility within a 30-mile radius of RTC for pre-trip training, logistics and personnel preparation

• Provide on-site support services at RTC 40 hours annually for major event /

COOP

support to include the Medical Director, medical support tent capable of handling four (4) critically ill personnel, and two (2) ambulances licensed to function at the Advanced Life Support level supervised by the academic medical center.

• Provide a clinical admission site with at least a level 1 trauma center, Emergency Department and urgent care capabilities in the Baltimore-

Washington metropolitan area.

• Shall provide licensure required for USSS to obtain medications, equipment and supplies through the emergency Services Section at RTC.

• Provide formulary and licensure necessary for the USSS to obtain supplies and medicines utilized during the trip from US licensed academic medical centers. The Medical Director will maintain direct oversight over all medications and equipment and supplies utilized by the USSS. The USSS will be charged for the cost of supplies and medications that are used in support of the protective visit that were not available in the medical travel kit.

Costs for the items will be reimbursed through USSS voucher reimbursement.

• Shall provide licensure required for USSS to obtain medications, equipment and supplies through the Emergency Services Section at RTC.

• Shall provide Maryland Critical care level transport ambulances for

Operational support and training. At least one ambulance should be available within one hour of notification to transport a service employee or other from locations, or hospitals with in the Baltimore Washington Metropolitan area.

• Shall provide for OPO approved foreign and domestic medical support missions physicians with tactical and operational and capable of functioning in austere and dangerous protective missions. These missions may range from a sole physician supporting an individual detail, to working with service

EMT’s and Emergency Services Specialist large protective movements and

National Special Security Events.

o The Physicians may work continuously without relief, working in remote and austere conditions. The physicians shall function within and around USSS protection and necessary defensive equipment (gas mask, ballistic vest etc.) and the expertise to survive a traditional or nonconventional assault. Physicians shall have expertise in utilizing defensive equipment and should have training in how to respond during a hazardous materials incident, bombing or attack scenario.

The physicians shall take direction from the lead USSS supervisor and function within the protective detail or assignment under their immediate direction. The physicians shall be available to travel as assigned, shall work shift work, be willing to travel for up to 10 or more days, and be on call 24hrs per day during the term of the contract.

o The academic medical center will be required to provide a travel physician meeting the identified criteria with a minimum of 2 weeks notification. The academic medical center will train and certify

Emergency Services Specialists to act as a back-up if a Physician is not available for a mission. The USSS shall notify the academic medical center of potential protective trips at the most within 30 days in advance, if possible. If that is not possible, the academic medical center will be given at least two weeks’ notice to secure a physician for an OPO mission.

o Provide physician support for Candidate Nominee Operations Support at the request of OPO. Physician support would include 24/7 coverage with board certified emergency medicine physicians to accompany

Secret Service protective detail. Designated physicians will provide on-site medical standby for the protectee 24 hours per day, seven days per week for urgent and emergency medical conditions should they arise and provide care as appropriate. Physicians shall provide on-site medical direction for Secret Service emergency medical assets and personnel, as well as provide clinical interface between local EMS and hospital resources as needed.

o The academic medical center shall bill only for traveling physician services performed which will not exceed a total of 120 days per year at a daily rate.

o Provide after action reports on all foreign and domestic travel assignments with 7 days of completion of detail.

• Provide medical threat assessment as requested by ESS or OPO.

• Provide EMS protocols in electronic format.

• Shall provide information regarding the cost and availability of air ambulance to the area of travel. The academic medical center will be expected to assist the USSS in coordinating the use of this type of Service.

The academic medical center will not be responsible for providing or paying for any part of the air ambulance service.

Medical Director and Deputy Medical Director

• Physicians selected through the Title 5, Chapter 1, Subchapter B, Schedule A

213.3102 shall meet all of the support / training physician requirements and be capable of satisfying the Maryland Tactical Physician requirement as defined in Maryland Medical Protocols.

• Contractor shall provide Maryland licensed physicians for the position of

Medical Director and Deputy Medical Director, satisfying the Maryland

Institute of Emergency Medical Services Systems Title 30, Subtitle 03 and

Chapter 03 Requirements for Medical Director.

• The assigned Medical Director shall have at minimum of 10 years of documented experience as an operational, educational and tactical medical director, to include medical oversight of;

o Maryland EMS Operational and Educational Jurisdictions o Federal Law Enforcement Medical Programs o National Special Security Events o Maryland Critical Care Transport Program

This physician shall meet the Maryland Tactical Physician criteria as defined in Maryland Medical Protocols Tactical EMS Optional Supplemental

Program standards. The Medical Director will review and provide guidance to the SAIC-RTC relative to all USSS Emergency Medicine operations, policies and training. The Medical Director will authorize or make recommendations to limit or restrict the practice of all USSS emergency medicine providers.

• The assigned Deputy Medical Director shall have at minimum of 5 years of experience as an operational, educational and tactical medical director, to include medical oversight of;

o Maryland EMS Operational and Educational Jurisdictions o Federal Law Enforcement Medical Programs o National Special Security Events o Maryland Critical Care Transport Program

This physician shall also meet the Maryland Tactical Physician criteria as defined in Maryland Medical Protocols Tactical EMS Optional Supplemental

Program standards. The Deputy Medical Director will assist the Medical

Director with all responsibilities above, plus perform other duties as assigned by the Medical Director.

• The designated Medical Director and/or Deputy Medical Director shall provide direct medical oversight of all USSS providers, Law Enforcement

Responders, EMTs and Emergency Services Specialists operating under the

Medical Director’s license. USSS personnel will not provide emergency care under the direction of other unaffiliated physicians or agencies nor authorize others to function in an emergency medical capacity for the Secret Service without authorization of the assigned Medical Director in collaboration with the SAIC of JJRTC.

• The designated Medical Director and/or Deputy Medical Director shall review and approve all the USSS/ESS medical equipment, to include individual aid bags, First Aid/Trauma (FAT) kits, AEDs, EMT supplies and equipment, and Emergency Services Specialists supplies and equipment. The assigned Medical Director will provide guidance as to the development and utilization of all USSS vehicles that may be utilized for patient care or transportation.

• The designated Medical Director and Deputy Medical Director shall have full-time faculty appointments in the University-affiliated medical center and be physically located in the Baltimore Washington metropolitan area.

• The designated Medical Director and Deputy Medical Director will possess and maintain unrestricted medical licensure in the State of Maryland, Maryland Controlled Drug Substance (CDS) licensure, as well DEA licensure.

• The designated Medical Director and Deputy Medical Director must be board certified by the American Board of Emergency Physicians (ABEM).

• The designated Medical Director and Deputy Medical Director shall have the ability to successfully complete USSS background checks and obtain security clearances.

Physician Staff

• Physicians assigned by the contracted academic medical center to work on this contract shall be Maryland licensed physicians capable of satisfying the

Maryland Institute of Emergency Medical Services Systems, Title 30, Subtitle 03 and Chapter 03 requirements for Medical Director.

• Must be board certified by the American Board of Emergency Physicians

(ABEM).

• Can successfully complete USSS background checks and obtain national security clearances.

Possess and maintain unrestricted medical licensure in the State of Maryland, Maryland Controlled Drug Substance (CDS) licensure, as well DEA licensure.

• Can physically carry and walk continuously for 200 yards with 50 lbs of gear. Get in and out of vehicles to include sport utility vehicles without assistance. Fly long distances on various types of aircraft. Must be able to operate on rescue boats in moderate to heavy seas.

• Must be capable of wearing gas masks and Tyvek hazardous materials attire for one-hour periods. Must be capable of wearing ballistic gear for extended periods of time.

• Successfully complete or have previously completed a one-week orientation program at JJRTC.

REVISED - Medical Direction and Support: Contract Modification Expanded

Statement of Work – Continue per Section 1.4

Overview

The United States Secret Service has an emergency requirement for expanded medical direction and support of its ongoing protective mission specific to the remainder of the current presidential campaign. Protective Operations has elected to establish a modification to the current medical direction contract. A modification of the current contract provides an extension of the contractors clinical and operational expertise, emergency medical direction and support. The contractor is both uniquely and best able to provide these services in the most expeditious manner. This modification delineates additional work supplemental to that which is contained within the Secret Service’s existing contract with the Johns Hopkins University (JHU).

Period of Performance

Work under this modification shall be initiated on September 6, 2024, and completed on

November 10, 2024.

Place of Performance

JHU physicians shall be positioned by the Secret Service in close proximity to its protectee, including at his residence(s), and will travel with the protectee at all times in conjunction with the protective detail.

Services Required

JHU will continuously deploy one emergency medicine physician for the duration of the performance period to accompany a Secret Service protective detail. Designated physicians will provide on-site medical standby for the protectee 24 hours per day, seven days per week for urgent and emergency medical conditions should they arise and provide care as appropriate. Physicians shall provide on-site medical direction for Secret

Service emergency medical assets and personnel, as well as provide clinical interface between local EMS and hospital resources as needed.

Personnel Requirements

The Secret Service understands that JHU will likely need to provide continuous in person emergency medicine physician coverage through a series of weeklong rotational physician assignments. In general, the agency’s expectation is that these rotations will take place Sunday through Sunday unless extraordinary circumstances arise which will require approval from the COR and/or designee(s).

JHU physicians shall be board certified or board eligible in emergency medicine and under the overall management and supervision of the Department of Emergency

Medicine, Division of Special Operations. Physicians selected by JHU should have experience working in the law enforcement operational environment. Physicians shall possess clinical credentialing and have medical liability insurance coverage to the standards of JHU. JHU shall not utilize students or residents for the purposes of this requirement.

JHU physicians will be expected work in conditions commensurate with Secret Service protective detail personnel. Generally, uniforms shall be business attire to include suits, collared shirts, and dress shoes.

Medical Oversight

Medical direction and oversight of the deployed JHU physicians shall remain under the overall supervision of the current Secret Service Emergency Medical Director and

Deputy Emergency Medical Director as designated by JHU. The Emergency Medical

Director(s) shall be the principal intermediaries between JHU and protective detail logistical personnel and be involved in pre-deployment preparation of JHU physicians.

The Emergency Medical Director(s) shall review protective detail medical pre-plans

(including hospital surveys) and be involved in decisions related to medical equipment and medications. Additionally, the Emergency Medical Director(s) shall remain available for remote consultation with the deployed physicians 24 hours per day, seven days per week as necessary for the duration of this requirement.

1.5 General Information

1.5.1 Date of Delivery: The contractor shall be ready to fully execute work by August 1, 2023 REVISED per MODIFICATION POP updated above.

1.5.2 Place of Delivery: RTC

Attn: Barry Frasier

9200 Powder Mill Rd

Laurel, MD 20708

1.5.3 Hours of Operation: The contractor is responsible for conducting business, between the hours of 0800-1600 CST (-6 UTC) Monday through Friday except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings or as directed by the program manager or detail leader for protective mission.

1.5.4 Type of Contract: Firm Fixed Price Contract.

1.5.5.1 Privacy Act: Personnel who have access to Privacy Information shall adhere to the Privacy Act, Title 5 of the U.S. Code, Section 552a and applicable agency rules and regulations.

1.5.5.2 Physical Security: The contractor shall be responsible for safeguarding all

Government equipment, information and property provided for contractor use.

1.5.5.3 Key Personnel: The contractor shall provide a point of contact (POC) who shall be responsible for the overall management of the contract on behalf of the contract agency. The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer. The POC or alternate shall have full authority to act for the contractor on all contract matters.

1.5.5.4 Identification of Contractor Employees: All contract personnel attending meetings, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed.

1.5.6. Contractor Travel : The physician shall be reimbursed for all travel expenses during trips with the protective details. All travel shall be reimbursed in accordance with the Federal Joint Travel Regulations. Receipts shall be provided to the COR to verify amount of reimbursement. Contractor will be authorized travel expenses consistent with

FAR 31.205-46, the substantive provisions of the Federal Travel Regulation (FTR), and the limitation of funds specified in this contract. All travel requires Government approval/authorization and notification to the COR.

1.5.7 Other Direct Costs : N/A

1.5.8 Data Rights : N/A

1.5.9 Organizational Conflict of Interest: Contractor and subcontractor personnel performing work under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational

Conflict of Interests (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer to avoid or mitigate any such OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the

Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may affect other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the

OCI.

PART 2

DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.1.1. CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the Government. The term used in this contract refers to the prime.

2.1.2. CONTRACTING OFFICER (C.O.). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the Government. Note: The only individual who can legally bind the

Government.

2.1.3. DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.1.4. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key

Personnel listed in the SOW. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.5. MEDICAL DIRECTION. Expert guidance and oversight provided by a physician meeting the statement of work criteria. Includes the extension and definition of emergency medicine practice and licensure to those authorized by the selected medical director.

2.1.6. OFFLINE. Refers to the meetings, protocols, education, quality assurance audits, and reviews program development and other administrative and collaborative activities of typical medical direction.

2.1.7. ONLINE. Refers to direct physician communication with a rescuer regarding medical protocol and guidance.

2.1.5. PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.2. ACRONYMS:

CFR Code of Federal Regulations

CO Contracting Officer

CONUS Continental United States (excludes Alaska and Hawaii)

COOP Continuity of Operations

COR Contracting Officer Representative

COTS Commercial-Off-the-Shelf

CPFF Cost Plus Fixed Fee

EMT Emergency Medical Technician

ESS Emergency Services Section

FAR Federal Acquisition Regulation

FFP Firm Fixed Price

GFP Government Furnished Property

HSAR Homeland Security Acquisition Regulation

LH Labor Hour

NCR National Capital Region

NSSE National Special Security Event

OCI Organizational Conflict of Interest

OCONUS Outside Continental United States (includes Alaska and Hawaii)

ODC Other Direct Costs

OPO Office of Protective Operations

PIPO Phase In/Phase Out

POC Point of Contact

PM Program Manager

RTC Rowley Training Center

SOW Statement of Work

TE Technical Exhibit

TM Time and Material

TPOC Technical Point of Contact

USSS United States Secret Service

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Services: The Government will provide travel arrangements and booking. The physician traveling shall be reimbursed for all travel expenses during trips with the protective detail. All travel shall be reimbursed in accordance with the Federal Joint

Travel Regulations. Receipts shall be provided to the COR to verify amount of reimbursement. The government shall also provide the traveling physician with one day of pay for preparation, planning, and coordination of medical support logistics when supporting OPO foreign and domestic missions.

3.2 Facilities: N/A

3.3 Utilities: N/A

3.4 Equipment: The Government will provide medical supplies and medical equipment as designated by the academic medical center and approved by the SAIC of RTC. This includes, but not limited to:

3.4.1. USSS approved gas mask and Tyvek hazardous material attire for the medical director and support physicians.

3.4.2. USSS approved equipment for field operations with specialty teams.

3.5 Materials: The Government will provide policies, inspection, and reporting mechanisms to insure USSS personnel are not endangering the medical director’s, or other support physicians, and the academic center’s licensure.

Government Furnished Materials

The Secret Service will provide all medical equipment, supplies, and medications to be utilized by JHU physicians during deployments including initial loadout and resupply as needed. The Secret Service shall issue any identification materials and personal protective equipment deemed necessary for use by deployed JHU physicians. All travel related expenses including airfare, accommodations, and M&IE expenses (per diems) shall be provided by the government, reimbursable to deployed physicians.