W81K00-16-T-0026-0002_Amendment.pdf

W40M USA MEDCOM HCAA

SOUTHERN REG CONTR OFC

POC: ANTHONY D. BROWNER

36000 DARNELL LOOP

FORT HOOD TX 76544

0010791513

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

THIS AMENDMENT HEREBY CHANGES THE SIZE STANDARD TO A SERVICE-DISABLED VETERAN OWNED SMALL BUSINESS (SDVOSB). A

PRE-PROPOSAL CONFERENCE IS SCHEDULED FOR 9:30AM CST ON 18 FEB 2016; CALL IN #(210) 249-4234 & ACCESS CODE 76074#.

A. The Purpose of this Amendment is to four-fold: 1) Change the Size Standard for this requirement; the Unrestricted status has been changed to a SDVOSB set-aside, 2) To add clauses and provisions to this Solicitation w hich w ere omitted, 3) Update the Performance

Work Statement (PWS) based on corrections and information that w as originally omitted from the original PWS, and 4) Change the acquisitionfrom a LPTA to Tradeoff as show n in the revised 52.212-2 changes.

B. The Closing Date for this requirement is hereby extended to: 4 March 2016 @10:00AM CST. The due date for the for Past Performance

Questioners has been extended to 22 February 2016 @ 10:00 AM CST. Due to these changes the Period of Performance is affected and therefore changed to 1 June 2016 - 30 September 2020.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 51

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 11-Feb-2016

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W81K00-16-T-0026

X 9B. DATED (SEE ITEM 11)

12-Jan-2016

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer X is extended, is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE

RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

11-Feb-2016

CODE

W40M USA MEDCOM HCAA

SOUTHERN REG CONTR OFC

3551 ROGER BROOK DR BLDG 3600

FORT SAM HOUSTON TX 78234-6200

W81K00 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE W81K00

FACILITY CODECODE

EMAIL:TEL:

W81K00-16-T-0026

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 30 - BLOCK 14 CONTINUATION PAGE

The following have been added by reference:

52.204-10 Reporting Executive Compensation and First-Tier

Subcontract Awards

OCT 2015

52.219-27 Notice of Service-Disabled Veteran-Owned Small Business

Set-Aside

NOV 2011

52.222-46 Evaluation Of Compensation For Professional Employees FEB 1993

52.237-2 Protection Of Government Buildings, Equipment, And

Vegetation

APR 1984

52.237-3 Continuity Of Services JAN 1991

The following have been added by full text:

REVISED PWS

PERFORMANCE WORK STATEMENT

CARL R. DARNALL ARMY MEDICAL CENTER, FORT HOOD, TX

1. GENERAL.

1.1. This is a personal services contract (as defined by FAR Subpart 37.104) and is intended to create an employee relationship between the Government and the individual 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.

1.1.1.1. The location for these positions are for North Fort Hood which is located in Gatesville, Texas a remote site about 30 miles from main post with limited facilities. The Government will not reimburse any travel cost. The contractor shall provide personal services of competent providers to augment or supplement the staffing at Army military treatment facilities referred to as: Health Readiness Platform (HRP) in association with the CRDAMC to provide services that contributes to a stable workforce providing quality services due to surges in workload, deployments and civilian personnel vacancies.

1.1.1.2. All services shall be provided in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations, Joint Commission (JC) standards, applicable Department of

Defense (DoD) and service specific regulations, directives, and policies, and HRP policies, procedures, and job descriptions. Contract employees shall give the highest regard to patient dignity and observe the precepts of the

American Hospital Association's Bill of Rights for Patients. The contract health care provider shall provide services in conjunction with other non-contract providers to include military and non-military physicians, nurse practitioners, clinical psychologists, social workers, counselors, physician assistants, registered and licensed practical nurses, and support personnel. All contract health care providers provided by the contractor shall perform essentially the same functions, within the scope of acceptable practice, as those required by Army or government service health care professionals of similar experience and in similar duty assignments.

1.1.1.3. As part of the managed care network, the providers may be required to interface with network participants, including other government contractors in order to appropriately manage services for the beneficiaries. Contact with other government contractors will be for the sole purpose of coordinating patient care.

1.1.1.4. Contract providers shall perform services under the control and general supervision of the department chief or his/her designated government representative.

1.1.2. Performance Measures.

1.1.2.1. The Contractor shall provide qualified personnel who will fulfill the requirement to provide services at a standard enabling the HRP to provide such services at a high level of quality.

1.1.2.2. Standards. Acceptable measures include: position fill rate-95%; employee turnover rate-< 25% per year;

substantiated patient complaints-max 2 per year, per provider; no provider-initiated cancellation of treatments except as medically required by patient, or provider illness or emergency leave. This will only be done if there are no other providers to see the patients scheduled. Other performance evaluation factors will be monitored that are not quantified by numerical measurements which 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.

1.1.2.3. The Contracting Officer's Representative (COR) will monitor the HCP's performance with input from the Chief of the Department or his or her designated government representative utilizing the contract Quality Assurance Plan, through government information systems and records, patient records, customer service information, contractor reports, monitoring of scheduled shift fill rates, time sheets, patient/customer comments, compliance with installation and hospital policy and procedures, and any other means necessary to ascertain that contracted services are being accomplished in accordance with the terms of the contract.

1.2. QUALIFICATIONS.

OPTOMETRY TECHNICIAN

1.2.1. Certification Requirements: Must have and maintain a current, active, valid, unrestricted certification in one of the 50 states in the U.S., the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin

Islands.

1.2.2. Experience. There is no minimum work experience required for the Optometry Technicians.

1.2.3. Life support training. Must have and maintain current certification in Basic Cardiac Life Support (BCLS) certification during the contract period of performance. Certifications must be obtained through an American Heart

Association approved training program.

1.2.4. All contract HCPs shall be able to read, write, and speak English well enough to effectively communicate with patients and other HCPs.

1.2.5. The contractor shall ensure contract HCPs have received 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 Contracting Officer’s Representative (COR).

1.2.6. The HCP shall be able to type and have had experience using computers, but will not be required to type a certain amount of words per minute. The HRP will provide computer training on the hospital computer systems.

Failure to learn the computer systems within a reasonable time period shall be grounds for immediate removal of the provider.

OPTOMETRIST

1.2.7. Certification Requirements: Must have and maintain a current, active, valid, unrestricted certification in one of the 50 states in the U.S., the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin

1.2.8. Experience. There is no minimum work experience required for the Optometrist.

1.2.9. Life support training. Must have and maintain current certification in Basic Cardiac Life Support (BCLS) certification during the contract period of performance. Certifications must be obtained through an American Heart

1.2.10. All contract HCPs shall be able to read, write, and speak English well enough to effectively communicate with patients and other HCPs.

1.2.11. The contractor shall ensure contract HCPs have received Occupational Safety and Health Administration

(OSHA) required training for the position in which they will perform, and that training currency is maintained.

1.2.12. The HCP shall be able to type and have had experience using computers, but will not be required to type a certain amount of words per minute. The HRP will provide computer training on the hospital computer systems.

Failure to learn the computer systems within a reasonable time period shall be grounds for immediate removal of the

PHYSICIAN ASSISTANT

1.2.13. Licensure and Certification Requirements: Must possess a minimum of a Baccalaureate Degree from an accredited university within respective profession. Must also possess current Board Certification by the National

Commission of Certification of Physician Assistants (NCCPA). Applicable diploma and proof of membership in the

NCCPA is required. Must have and maintain a current, active, valid, unrestricted license in one of the 50 states in the U.S., the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands.

1.2.14. Must have or obtain a current, valid Drug Enforcement Administration (DEA) registration number prior to performing the contract services. Any change to the DEA requirements to obtain a valid DEA registration number is applicable when the incumbent's existing DEA registration expires. Notwithstanding AR 40-68, Paragraph 4-8a (or

AFI 44-119, Paragraphs 4.2.1 and 4.2.5), personal services contractors must have and maintain a current, active, valid, unrestricted state license to practice medicine in one of the 50 states in the United States, or the District of

Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands, as required to obtain or renew a

DEA registration number under the then-effective DEA rules.

1.2.15. Must be able to obtain and maintain privileges at Carl R Darnall Army Medical Center (CRDAMC) through approval of the Credentials Committee.

1.2.16. Must have successfully completed a formal and valid general Physician Assistant training program that is accredited by the Accreditation Review Commission on Education for the Physician Assistant (or previously recognized accrediting body) and acceptable to the DA.

1.2.17. Experience: Have a minimum of one year of experience within the last three years routinely practicing as a

Physician Assistant (PA). One year of experience for a PA will be in the form of ambulatory or hospital based service.

1.2.18. Life support training: Must have and maintain current certification in Basic Cardiac Life Support (BCLS) certification during the contract period of performance. Certifications must be obtained through an American Heart

1.2.19. Health Care Professionals trained in foreign countries are eligible to practice in the AMEDD in their respective disciplines if the appropriate requirements are met. (The term, “international” replaces the previously used term, “foreign."

1.2.20. Must be able to complete and maintain a National Agency and Local Check (NACLC) background investigation.

1.2.21. All contract HCPs shall be able to read, write, and speak English well enough to effectively communicate

1.2.22. Contract HCPs shall be required to meet Continuing Medical Education (CME) requirements of 100 hours of

CME every 2 years in order to maintain current NCCPA certification. The government will not reimburse for these costs.

1.2.23. The contractor shall ensure contract HCPs have received Occupational Safety and Health Administration

(OSHA) required training for the position in which they will perform, and that training currency is maintained.

1.2.24. The providers shall be able to type and have had experience using computers, but will not be required to type a certain amount of words per minute. The government will provide computer training on the hospital computer systems. Failure to learn the computer systems within a reasonable time period shall be grounds for immediate removal of the provider.

1.2.25. Must possess the competencies to enter/retrieve medical information in various government database systems.

1.2.26. The Contractor HCP shall complete any mandatory annual medical/government required training.

1.2.27. Must accurately enter actual work hours into the Defense Medical Human Resources System Intranet

(DMHRSi) every other week on the date specified by the COR or designated Government representative.

NURSE PRACTITIONER

1.2.28. Licensure and Certification Requirements: Must have and maintain a current, active, valid, unrestricted

Nurse Practitioner license in one of the 50 states in the U.S., the District of Columbia, the Commonwealth of Puerto

Rico, Guam, or the U.S. Virgin Islands. License must correspond to DEA registration number. In addition, the FNP must possess a license (or other authorizing document) for advanced practice issued by either the State Board of

Nursing granting the FNP license or another State.

1.2.29. Must have or obtain a current, valid Drug Enforcement Administration (DEA) registration number prior to performing the contract services. Any change to the DEA requirements to obtain a valid DEA registration number is applicable when the incumbent's existing DEA registration expires. Notwithstanding AR 40-68, Paragraph 4-8a (or

AFI 44-119, Paragraphs 4.2.1 and 4.2.5), personal services contractors must have and maintain a current, active, valid, unrestricted state license to practice medicine in one of the 50 states in the United States, or the District of

Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands, as required to obtain or renew a

DEA registration number under the then-effective DEA rules.

1.2.30. Have a minimum of one year of experience (within the past four years) of routinely practicing as a family nurse practitioner.

1.2.31. Life support training: Must have and maintain current certification in Basic Cardiac Life Support (BCLS) certification during the contract period of performance. Certifications must be obtained through an American Heart

1.2.32. Health Care Professionals trained in foreign countries are eligible to practice in the AMEDD in their respective disciplines if the appropriate requirements are met. (The term, “international” replaces the previously used term, “foreign."

1.2.33. Certification as a Nurse Practitioner (NP) must be an achieved certification by a nationally recognized certifying body (for example, American Nurse Credentialing Center (ANCC) or American Academy of Nurse

Practitioners). Appropriate to the specialty area of practice. Certification will be maintained for the duration of the individual’s advanced clinical practice.

1.2.34. Be a graduate of an accredited master’s level or doctoral program acceptable to the Department of the Army

(DA) that prepared the FNP with additional knowledge and skills to practice in their clinical specialty. The FNP practices according to his/her specialty, the ANA Standards of Clinical Nursing Practice for Nurse Practitioners, and as determined by the organizational mission and scope of care and services.

1.2.35. A Bachelor of Science in Nursing (BSN) degree is required at a minimum; however, a Master of Science in

Nursing (MSN) degree is preferred.

1.2.36. Must be able to complete and maintain a National Agency and Local Check (NACLC) background investigation.

1.2.37. All contract HCPs shall be able to read, write, and speak English well enough to effectively communicate

1.2.38. Contract HCPs shall be required to meet Continuing Medical Education (CME) requirements of 100 hours every two years in order to maintain current NCCPA certification. The government will not reimburse for these costs.

1.2.39. The contractor shall ensure contract HCPs have received Occupational Safety and Health Administration

(OSHA) required training for the position in which they will perform, and that training currency is maintained.

1.2.40. The providers shall be able to type and have had experience using computers, but will not be required to type a certain amount of words per minute. The government will provide computer training on the hospital computer systems. Failure to learn the computer systems within a reasonable time period shall be grounds for immediate removal of the provider.

1.2.41. Must possess the competencies to enter/retrieve medical information in various government database systems.

1.2.42. The Contractor HCP shall complete any mandatory annual medical/government required training.

1.2.43. Must accurately enter actual work hours into the Defense Medical Human Resources System Intranet

(DMHRSi) every other week on the date specified by the COR or designated Government representative.

CERTIFIED NURSE ASSISTANT

1.2.44. Certification Requirements: Must have and maintain a current, active, valid, unrestricted certification in one of the 50 states in the U.S., the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin

1.2.45. Experience. There is no minimum work experience required for the CNAs.

1.2.46. Life support training. Must have and maintain current certification in Basic Cardiac Life Support (BCLS) certification during the contract period of performance. Certifications must be obtained through an American Heart

1.2.47. All contract HCPs shall be able to read, write, and speak English well enough to effectively communicate

1.2.48. The contractor shall ensure contract HCPs have received Occupational Safety and Health Administration

(OSHA) required training for the position in which they will perform, and that training currency is maintained.

1.2.49. The HCP shall be able to type and have had experience using computers, but will not be required to type a certain amount of words per minute. The HRP will provide computer training on the hospital computer systems.

Failure to learn the computer systems within a reasonable time period shall be grounds for immediate removal of the

1.3. SPECIFIC TASKS.

Optometrist:

1.3.1. Contract Optometrist providing services under this contract shall perform the same clinical duties as those required of any military or government civil service physicians of similar experience assigned to the same unit at the

HRP. The quality of service shall meet or exceed reasonable standards of professional practice as determined by the same authority that governs physician services in the same discipline. Contract Optometrist shall perform within the scope of clinical privileges granted by the HRP and the overall demand for services. Productivity is expected to be comparable to that of other providers with the same scope of practice. Workload will be scheduled by the treatment facility. Caseload includes scheduled and unscheduled requirements for care. Any cancellation of patient schedules requires approval of Chief, Department Of Operational and Deployment Medicine. Optometrist shall have sufficient training/experience to be able to perform the required duties which include, but not limited to the following:

1.3.1.1. Shall perform specialized ocular diagnostic procedures that shall include, but not be restricted to, dilated retinal examination, cycloplegic refraction, gonioscopy, and visual field analysis by automated perimetry, and corneal topography.

1.3.1.2. Shall perform all aspects of comprehensive primary care optometry including the following:

1.3.1.3. All aspects of routine and specialty contract lens care.

1.3.1.4. Coordinate with other departments of the medical center staff to provide complete care to patients.

1.3.1.5. Technically supervise care provided by military and civilian support personnel including refracting technicians.

1.3.1.6. Provide and document medical advice to patients by telephone as appropriate and in accordance with HRP protocols.

1.3.1.7. Attend periodic meetings of department staff to review and evaluate the care and treatment provided to patients. Review compliance with the HRP quality control program and the standing operating procedures of the

HRP. Participate in clinical and quality review processes as determined by the CRDAMC policy.

1.3.1.8. Participate in clinical research directed by the Department Chief.

1.3.1.9. Provide clinical education and instruction to optometry students, residents, and visiting clinicians rotating through the Ophthalmology Services of CRDAMC.

1.3.1.10. Perform administrative tasks associated with the clinical operation in accordance with those of a credentialed provider.

1.3.1.11. Provide postoperative patient care.

1.3.1.12. Referral criteria on ocular pathology will be provided by CRDAMC. If the CRDAMC Optometrist is unavailable to consult on an ocular emergency, the patient should be referred to the CRDAMC Emergency Room.

1.3.1.13. Take part in clinic Quality Assurance Program as required to meet the standards of the Joint Commission on Accreditation of Healthcare Organizations.

1.3.1.14. Provide clinical direction to supporting government personnel assigned to their area during the performance of clinical procedures.

1.3.1.15. Consult with supervisor and/or colleagues, which are normally available, regarding problems either professional or administrative.

1.3.1.16. The Contractor HCP shall complete any mandatory annual medical/government required training.

1.3.1.17. Must accurately enter actual work hours into the Defense Medical Human Resources System Intranet

(DMHRSi) every other week on the date specified by the COR or designated Government Representative.

1.3.1.18. Must provide notice to the Department Chief and/or designated representatives of any event which may impact patient appointment scheduling 45 days in advance.

Optometry Technician:

1.3.1.2. Contract Optometry Technician services under this contract shall perform the same clinical duties as those required of any military or government civil service physicians of similar experience assigned to the same unit at the

HRP. The quality of service shall meet or exceed reasonable standards of professional practice as determined by the same authority that governs physician services in the same discipline. Contract Optometry Technician shall perform within the scope of clinical privileges granted by the HRP and the overall demand for Ophthalmology services.

Productivity is expected to be comparable to that of other providers with the same scope of practice. Workload will be scheduled by the treatment facility. Caseload includes scheduled and unscheduled requirements for care. Any cancellation of patient schedules requires approval of Chief, Department Of Operational and Deployment Medicine.

Optometry Technician shall have sufficient training/experience to be able to perform the required duties which include, but not limited to the following:

1.3.2.1. Shall assist in the preoperative evaluation of surgical patients, to include diagnostic tests such as corneal topography, pachymetry, and refractions.

1.3.2.2. Providing preoperative services, including setting up the operating room, providing appropriate equipment and instruments, and providing a sterile environment for surgery:

1.3.2.3. Prepare the laser machine for the specified procedure and assists the surgeon in operating the laser.

1.3.2.4. Assist the optometrist and ophthalmologist in all aspects of routine and specialty contact lens care.

1.3.2.5. Provide postoperative support by disposing of all contaminated supplies, sterilizing instruments, send damaged or broken equipment or instruments for servicing or replacement, and initiating incident reports (reports completed, reviewed, and signed by a surgeon).

1.3.2.6. Perform postoperative refractions and diagnostic testing under the supervision of the optometrist or ophthalmologist.

1.3.2.7. Provide and document assistance to patients by telephone as appropriate and in accordance with HRP

1.3.2.8. Attend periodic meetings or department staff meetings to review and evaluate the case and treatment provided to patients.

1.3.2.9. Perform administrative tasks associated with the clinical operations in accordance with the skills of an

Optometry Technician results. Observe patient closely until condition stabilizes. Recognize and report abnormalities to the charge nurse. Assist and support the patient during such procedures.

Physician Assistants/Nurse Practitioner:

1.3.3. Contract Physician Assistants and Nurse Practitioners provide services under this contract shall perform the same clinical duties as those required of any military or government civil service physicians of similar experience assigned to the same unit at the HRP. The quality of service shall meet or exceed reasonable standards of professional practice as determined by the same authority that governs physician services in the same discipline.

Contract Physician Assistants and Nurse Practitioners shall perform within the scope of clinical privileges granted by the HRP and the overall demand for Department of Operational and Deployment Medicine (DODM) services.

Productivity is expected to be comparable to that of other providers with the same scope of practice. Workload will be scheduled by the Health Readiness Platform (HRP). Caseload includes scheduled and unscheduled requirements for care. Any cancellation of patient schedules requires approval of Chief of the Department of Operational and

Deployment Medicine or designated government representative.

1.3.3.1. The Physician Assistants and Nurse Practitioners shall have sufficient training/experience to be able to perform the required duties which include, but not limited to the following:

1.3.3.2. Responsible for maintenance of the highest standards of professional care in the treatment of patients and in the teaching and training of residents and technicians. Prepare and document appropriate history, physical examinations and diagnosis. Maintain documentation of all treatment provided in accordance with hospital directives and prepare such records and reports as may be required by the contract. Ensure all documentation and reports are legible.

1.3.3.3. Responsible for a full range of diagnostic examinations, the development of treatment plans when indicated and delivery of treatment within the personnel and equipment capabilities of the Health Readiness Platform.

Exercises full responsibility for professional diagnosis and technical decisions. Request and interpret laboratory tests, procedures and consultation as considered appropriate. Follow-up of abnormal reports is the responsibility of the ordering health care provider. All abnormal x-ray and lab reports received on patients seen by the contract health care provider shall be reviewed. Each report shall be reviewed within one week of its receipt or sooner based on clinical presentation.

1.3.3.4. Participates in the examination, evaluation, and disposition of patients in the outpatient clinic.

1.3.3.5. Participates in inpatient clinical and teaching rounds.

1.3.3.6. As Physician Assistants and Nurse Practitioners examines, diagnoses, and treats or prescribes course of treatment for patients having disorders, malformations, diseases, and/or injuries.

1.3.3.7. The Physician Assistants and Nurse Practitioner’s shall provide special knowledge, skills, and professional capability in Family Practice and clinical care practice management. These include:

1.3.3.8. Coordination with other departments of the medical facility staff to provide complete care to patients.

1.3.3.9. Provide and document medical advice to patients by telephone as appropriate and in accordance with HRP

1.3.3.10. Provide clinical direction to supporting government personnel assigned to their area during the performance of clinical procedures.

1.3.11. Provide consultation services for members of the hospital staff for purposes of specialty area training.

1.3.12. Consult with Officer in Charge (OIC) and/or colleagues, which are normally available, regarding problems either professional or administrative.

1.3.13. Responsible for the provision of mandated medical surveillance and preventive services

1.3.14. Responsible for the quality and the timeliness of treatment records and reports required to document procedures performed and care provided.

1.3.15. Participates in local clinical education programs and in clinical staff quality improvement functions as prescribed by Chief, Department of Operational and Deployment Medicine (DODM).

1.3.16. Attend periodic meetings of Department of Operational and Deployment Medicine (DODM) staff to review and evaluate the care and treatment provided to patients.

1.3.17. Comply with the HRP quality control program and the standing operating procedures of the HRP.

1.3.18. Participate in clinical and quality review processes as determined by hospital policy.

1.3.19. Comply with the HRP quality control program and the standing operating procedures of the HRP.

1.3.3.20. The HCP duties shall consist of, but not limited to their training and experience to adequately diagnose and treat acute diseases and injuries to include but not limited to:

Skin Pulmonary System

Head Gastrointestinal System

Eyes Musculoskeletal System

Ears, Nose & Throat Genitourinary System

Behavior Health Reproductive System

Psycho-social Lymphatic System

Neck Central Nervous System

Cardiovascular System Endocrine System

1.3.3.21. Become familiar with the hospital formulary and prescribe pharmaceuticals according to the drugs listed.

1.3.3.22. Generate and maintain proper medical records on beneficiaries to whom treatment is provided IAW AR

40-66, Medical Records. All records generated in the performance of this contract remain the property of the government.

1.3.23. Follow the established operating procedures of the HRP were services are being provided. Comply with the

HRP quality control program and the standing operating procedures of the HRP.

1.3.3.24. Provide preceptorship of residents and students who may be scheduled for call with delegation of duties and responsibilities only as appropriate for the type of resident (e.g., FP vs Peds) and level of training (intern vs resident) of the resident. Note: individual skills and abilities will occasionally have to be taken into consideration.

1.3.3.25. Military Planner Data Viewer (MPDV). This computer system is a readiness database system for read and writes tasks being implemented at the SRP/PDHRA site.

Certified Nurse Assistants:

1.3.4. Certified Nurse Assistant providing services under this contract shall perform essentially the same clinical duties as those required of a military or government civil service nurse assistant of similar experience and in similar duty assignments. The quality of service shall meet or exceed reasonable standards of professional practice.

1.3.4.1. Perform a variety of paraprofessional nursing care for family based health care sites. Take vital signs at designated intervals, note deviations, and call unusual changes to the attention of the charge nurse.

1.3.4.2. Observe IV infusions to alert professional staff of changes or problems and discontinue as required and directed.

1.3.4.3. Perform routine urine tests.

1.3.4.4. Check incision dressings for abnormalities.

1.3.4.5. Provide basic nursing tasks with daily personal and hygiene care.

1.3.4.6. Assist patients from bed to wheel chair and escort patient to various health care sites as needed.

1.3.4.7. Assist the provider with patient examinations. Set up examination room, and open sterile packs and instrument trays. Accomplish preoperative procedures, and drape and position the patient as appropriate. Anticipate need for and pass instruments to the provider. Take specimen, complete the lab request, and take to the lab and pick up results. Observe patient closely until condition stabilizes. Recognize and report abnormalities to the charge nurse.

Assist and support the patient during such procedures.

1.3.4.8. Measure and record foley output, NG drainage, and urine output. Initiate emergency action and administer

CPR as required.

1.3.4.9. Record vital signs on TPR graphic records procedures accomplished, and observations. Admit patients taking and recording history for the purpose of establishing a medical chart. Receive patients from various areas within the health care sites.

1.3.4.10. Perform housekeeping and maintenance duties to include general cleaning care of patient’s unit to include bed and furniture, restock supplies and rotate dated supplies, pass linen to patients, clean and exchange equipment.

1.4. ADMINISTRATIVE

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

1.4.2. 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 on 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. Awardees, and their subcontractors, may not include such conditions in employment agreements while performing under this contract.

1.4.3. The Contractor shall ensure that all contract HCPs comply with the local installation requirements for vehicle registration and operation on the military facility. Any vehicle operated by the contractor or its employees in performance of this contract must have the minimum liability coverage required by the state in which the installation is located.

1.4.4. Health. All contract HCP performing services under this contract shall comply with the health and immunization requirements as stated in the Supplement to the PWS entitled “Health and Immunization

Requirements”, at the time of initial request for clinical privileges and annually thereafter. If back up/replacement providers are required, then backup/replacement contract HCPs shall be required to provide equally current certification of health at the time of initial request for clinical privileges, and annually thereafter. The expense for all physical examinations to comply with the health requirements shall be borne by the contractor at no additional cost to the government.

1.4.5. REPORTS. The contractor shall provide to the contracting officer reports required to monitor performance on this contract/task order.

1.4.5.1. Monthly Reports. Fill/Vacancy Report. The contractor shall provide a monthly report on the fill and vacancy rates on each contract/task order. This report will identify the contract/task order number, the contract effective date, and the number of FTEs under the contract/task order, the number of filled positions and the number of vacancies. In addition, the contractor shall provide a brief explanation as to why the position is not filled and what is being done to correct the situation. This report shall be submitted on the first of each month after the effective date, or the first

Monday of the month should the first fall on a weekend.

1.4.6. ORIENTATION AND TRAINING. When commencing work under this contract, the contract HCP shall obtain an in-processing checklist from the Contract Officer’s Representative (COR) located at building 36001, Resource Management Division, CRDAMC (location subject to change). All contract personnel are required to complete the applicable in-processing items on the checklist and turn the completed form in to the designated office.

Upon completion of the duty assignment, the contract HCP must complete an out-processing checklist and return it to the designated office.

1.4.6.1. CRDAMC Orientation. Contract HCP will be provided a government paid orientation to familiarize contract

HCP with the policies and procedures of the HRP. Orientation attendance will be required of all contract HCP during normal duty hours and will be scheduled by the Contracting Officer’s Representative (COR), or the

Department Chief or his/her government designee.

1.4.6.2. Computer Training. Contract HCP who have any interaction with the HRP computer systems must receive training for the applicable system. The COR or appropriate government designee will coordinate computer training.

The training will be on-site and during normal duty hours. This training will be at no cost to the contractor. These systems may include but are not limited to:

1.4.6.2.1. Composite Health Care System (CHCS). The government will provide training to contract CHCS and/or other procedures that the medical activity's staff is required to use. Access to such patient data system is an

“automated Data Processing Sensitive” position requiring compliance with AR 380-19 and AR 380-67. Ref to addendum to FAR clause 52.212-4(ab), “ADP Security Requirements” for further guidance.

1.4.6.2.2. Armed Forces Health Longitudinal Technology Application (AHLTA) which was formerly known as

Composite Healthcare Computer System (CHCS). AHLTA contains the HRP’s appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the HRP.

1.4.6.2.3. Ambulatory Data System (ADS). This computer system produces forms on which the providers identify the appropriate billing codes for diagnoses and procedures for each patient.

1.4.6.2.4. Essentris Inpatient Medical Record (Essentris). This computer system is an electronic medical record

(EMR) system that is used by DoD Medical Treatment Facilities to document inpatient care provided by providers, nurses, and health care support staff.

1.4.6.2.5. Mobilization Planning Data View (MPDV). This readiness data base system is currently utilized by

National Guard and Reserve processing units for mobilization and will be used in a trial basis for Active Duty units.

The system allows the command visibility of individuals as well as the units overall deployable readiness status.

1.4.6.3. The contractor shall ensure that contract HCP is knowledgeable of the policies and procedures of their specific place of duty and of the medical activity. The contractor shall ensure contract CNA receive any staff training required by the HRP as a precondition/condition to performance. Such training may include instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training shall be conducted during the scheduled shift of the contract Phlebotomists.

1.4.6.4. The government may elect to provide unique government training to contract HCP 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 the contract HCP. When directed by the contracting officer, contract HCP shall attend all such training in a paid status as part of the normal services required and billed under the contract. If determined by the contracting officer, such training may require a performance commitment by the contractor and the contractor shall reimburse the government (by means of a reduction in an invoice) if a contract

HCP fails to satisfy the performance commitment after the HCP receives the unique government training. The amount of the reimbursement shall be the prorated cost of the training, calculated based on the total cost of the training and the number of months by which the contract HCP fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first.

1.4.7. SECURITY.

1.4.7.1. Vehicle Registration. The Health Readiness Platform’s (HRP) are located on restricted access military installations. The Contractor/contract employee shall comply with the local installation requirements for operation on the military installation. Any vehicle operated by the contractor/contract employee in performance of this service must have the minimum liability coverage required by the state in which the installation is located. A valid driver’s license, government-furnished civilian identification, proof of insurance and current registration must be present in the vehicle at all times while entering a military installation.

1.4.7.1.1. All vehicles are subject to physical search. Contract employees may encounter long delays for vehicle inspection and identification checks upon entering and exiting the installation. The government will not reimburse the contractor for time spent at installation checkpoints. Contract employees should plan accordingly and report to work at their scheduled duty time, at their appointed place of duty within the HRP.

1.4.7.1.2. Reserved.

1.4.7.2. Contract HCP shall comply with installation and HRP personnel identification and access requirements. The contractor is responsible for absences of contract HCP due to expired identification and access documents.

1.4.7.3. Keys. The contractor shall be responsible for any keys issued by the government to contract HCP for use in the HRP. The keys shall not be duplicated. The contractor shall be financially responsible for the replacement of any lost keys and any associated locks. Lost keys and/or locks shall be reported to the issuing party, or

Department/Clinic Chief, and COR immediately upon recognition of the loss. No unauthorized personnel shall be allowed entry into the locked area. Contract HCP shall lock all areas for which they possess a key when they are not using the area and at the close of the work period.

1.4.7.4. Safeguarding Material. The contractor shall be responsible for safeguarding all government property provided for contractor use. The contractor shall safeguard information of a confidential or sensitive nature. Neither the contractor nor any of its contract HCP shall disclose or cause to be disseminated any information concerning the operation of the HRP that could result in or increase the likelihood of the possibility of breach of security or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974.

However, the contractor may be required to provide testimony or disposition in cases of due process action.

1.4.8. Safety. Contract HCP shall comply with all installation safety regulations. Such regulations include, but are not limited to, general safety, fire prevention, and waste disposal. Copies of these regulations are on file in the medical activity safety office or may be obtained through the COR.

1.4.9. Contracting Officer’s Representative (COR). The COR will be appointed in writing by the Contracting

Officer after the contract is awarded. The Contracting Officer will provide a copy of this designation and COR contact information to the Contractor.

1.4.10. Contractor Representative. The Contractor shall designate, in writing, a primary point of contact for contract coordination and implementation. Changes in the primary point of contact, at any time, shall require the Contractor to notify the Contracting Officer (KO) of the new representative five working days prior to the change. This notification shall be in writing and shall state the name and contact information for the new point of contact.

1.4.11. Security Identification Badges. The contractor and contract health care provider shall comply with the local installation and HRP personnel identification and access requirements.

1.4.11.1. Each contract health care provider shall wear a visible Security badge ID, provided by the HRP or the

Military Installation, on the front of his/her outer clothing. The badge will show the full name, title and if required by the Military and “Contractor” identification on the front. The COR will provide the paperwork to request ID badges. The contractor is responsible for absences of contract HCP to expired identification and access documents.

1.4.11.2. The contract HCP shall immediately report any lost or stolen badges to the COR.

1.4.11.3. The contract HCP shall turn in the HRP badge and Civilian ID Card to the Security and Badge Office, COR, or his/her designated representative upon termination of their services under this contract.

1.4.12. SUBMITTALS. The contractor shall ensure all contract specific requirements paragraphs such as Education and Training Requirements, Privileging Requirements, National Agency Check Requirements, Health and

Immunizations Requirements, and viewing HRP Facility Safety Orientation material are accomplished prior to performance.

1.4.12.1. The information provided may be used for input into the HRP's Consolidated Personnel Database (CPDB).

All information given by the HCP will be protected by the Privacy Act of 1974 (PL 93-579). This information is necessary to assure hospital records can be maintained correctly, therefore complying with Joint Commission on the

Accreditation of Healthcare Organization (JCAHO), Occupational Safety and Health Association (OSHA) and

Center for Disease Control (CDC).

1.4.13. POLICIES, PROCEDURES and REGULATION COMPLIANCE. The contractor will be responsible for following all HRP policies, procedures, regulations in support of Occupational Safety Health Alliance (OSHA), Joint Commission on Accreditation of Health Care Organization (JCAHO), and other national, state, and local policies that regulate the health care industry. Policies and procedures may be obtained by contacting the COR.

1.5. HOURS OF PERFORMANCE.

1.5.1. Duty Hours: Duty Hours: Duty hours shall be as set forth by the applicable Department Chief or his/her designated government representative. The Contractor shall provide services for work weeks averaging 40 work hours consisting of average of five 8-hour work days, scheduled Monday through Sunday. Possible shift may be scheduled between the hours of 6:00 a.m. to 9:00 p.m. A 1-hour unpaid break will be given during the shift as determined by the clinic.