Amendment_0002_FEDBIZOPS.pdf

W40M USA HLTH CONTRACTING ACT

REGIONAL HEALTH CONTRACT OFF CENTRAL

POC: ANTHONY D. BROWNER

36000 DARNELL LOOP

FORT HOOD TX 76544

0011275579

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

A. The purpose of this amendment is three-fold: 1) Post Questions and Answ ers (See Attachment), 2) Change PWS language in Supplement Section #9 from "psychiatrist" to "physician", and 3) Change hours on CLIN 1001AC from "1920 hrs" to "1440 hrs" to reflect the correct hours for nine months only.

B. All other solicitation terms and conditions remain the same; the Due Date for Receipt of Proposals is NOT extended.

See SUMMARY OF CHANGES

1. CONTRACT ID CODE PAGE OF PAGES

1 26

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

16C. DATE SIGNED

BY 13-Feb-2019

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 W81K0019Q0067

X 9B. DATED (SEE ITEM 11)

06-Feb-2019

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 is extended, X 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 1 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

13-Feb-2019

CODE

W40M USA HLTH CONTRACTING ACT

REGIONAL HEALTH CONTRACT OFF CENTRAL

2539 GARDEN AVENUE

JBSA FT SAM HOUSTON TX 78234-0000

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

4. REQUISITION/PURCHASE REQ. NO.

CODE W81K00

FACILITY CODECODE

EMAIL:TEL:

W81K0019Q0067

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 30 - BLOCK 14 CONTINUATION PAGE

The following have been added by full text:

QUESTIONS AND ANSWERS

1. Will the experience and past performance of parent or subsidiary companies to the Prime Offeror be evaluated if the proposal shows that a sister company lending its experience and past performance has made a firm commitment to have a meaningful involvement in contract performance?

-Teaming Agreements, Partnerships and/or Joint Ventures – past performance will be considered.

2. Are there any additional requirements that a prime offeror must address in its proposal response in order to utilize parent or subsidiary company experience and past performance if the proposal shows that a sister company lending its experience and past performance has made a firm commitment to have a meaningful involvement in contract performance?

-Teaming Agreements, Partnerships and/or Joint Ventures must be officially documented.

3. Are there specific or special evaluation criteria for rating the experience and past performance of a prime offeror who utilizes parent or subsidiary company experience and past performance if the proposal shows that a sister company lending its experience and past performance has made a firm commitment to have a meaningful involvement in contract performance?

-Evaluation criteria will not be altered for the reason of utilizing past performance experience of any Teaming Agreements, Partnerships and/or Joint Ventures.

4. Please confirm that the government will evaluate a Prime’s subcontractor Past Performance as unknown? In a Joint-Venture, do both companies receive equal consider for the evaluation of their past performance?

-In a teaming agreement, partnership and/or joint venture the prime will receive equal consideration.

5. Attachment 2 on p. 78 requests PPQs to be returned by 2/10/19. Is that correct or should it be the same date as the due date 2/20/19?

-Amendment 0001 extended PPQ due date to 2/15/2019.

6. In terms of the order of the RFQ response, are offerors to respond to proposal in the outline A-E under “II ADMINISTRATIVE” of the RFP?

-Does not matter.

7. In addition to Past Performance contact information, are offerors to provide details on the relevancy of the Past Performance submitted?

-Per the evaluation criteria in the solicitation: "Relevant" is defined as "for the same or similar services".

8. Can the government elaborate on why the 5th CRNA is needed to start 1 Jan 2020? Does the government anticipate an increase in mission requirements or some other reason?

-Mission Requirements.

9. Regarding scheduling and overtime, is the statement that "overtime consists of any hours worked in excess of 40 hours in one seven (7) day period" specifically intended to preclude the contract HCPs from performing (for an example) two 24-hour shifts in a 7 day period (not consecutive)? Or is the specific scheduling/shifts left to the discretion of the Chief, Anesthesia Services or his/her designated representative?

-Please refer to the solicitation PWS Section 4.3.

10. Does the government require prime source verification and re-privileging on incumbent HCPs?

-No.

11. The solicitation mentions back-up personnel. Will the government entertain pre credentialing and privileging of CRNAs for this purpose?

-Yes.

12. On page 69 of the solicitation under "Health and Immunization Requirements", the requirement for a general physical examination specifically uses the term "psychiatrist". Will the government entertain changing the verbiage to say "physician"?

-Yes; this should be “physician” and will be changed prior to award.

13. At any time will the CRNA be required to work independently without supervision?

-CRNA’s will always work independently however; oversite will always be present.

14. Will the government consider a sign on and retention bonus for the CRNA’s?

-The government is not considering incentives at this point.

15. How long have the current CRNA incumbents been on this contract?

-There are incumbents, the vice contract has been in place for five years.

16. Is a technical required on this solicitation to show capabilities?

-No technical approach is required.

17. In 8.1.7.13. All contractor personnel shall attend newcomers training at the start of their employment at the MTF and quarterly training thereafter. Is this training paid and are the hours for any new hire orientation/in processing billable to the government?

-Yes.

18. How many training days anticipated through a one year span and are they billable to the government?

-Training is billable, no estimated number of days are not available.

19. For incumbent employees are physical examinations required at the beginning of this contract and other than tetanus and flu how often are immunization updates required?

-Incumbents are covered as long as they have not had a break in service of more than 60 days. All new employees are required to have a physical.

20. What are the current Behavioral Health Training requirements for the CRNAs?

-None

21. Will the Government pay for hours & travel if any, for this this training?

-No

22. Is the 24 hour shift to be performed in-house?

-Yes; when needed.

23. Is this training billable to the Government by the contractor?

-Government required Training is billable.

24. Will approved overtime hours be billed against the “Excess Hours” CLIN?

-Yes.

25. Will this requirement be met during normal duty hours?

-Yes.

26. Do current incumbents meet the requirements of the new PWS?

-Yes.

27. Is the current contracted invoiced monthly or semi-monthly?

-Semi-monthly.

28. What is the normal span of time for facility credentialing and security approval?

-One year initial and two years re-credentialing.

29. What is the total number of OBGYN cases at CRDMC per year to include epidural rates?

- 250-300 per year

30. During periods of OR/Preop coverage will the CRNA will be medically directed by an Anesthesiologist? If so, who administers the induction agents?

- CRNAs are never medically directed. Any applicants must be fully capable of independent practice. Since they are not medically directed, the CRNA will be administering their own induction agents.

31. Is there an incumbent currently performing these services?

-Yes.

32. If there is an incumbent, who is it? What is the current contract value and contract number?

-Government civilian or military.

33. Are all of the positions currently filled?

- Yes.

34. What department(s) are the CRNAs working?

-Department of Anesthesia.

35. Will the government consider offering a sign-on/retention bonus for the personnel providing services under this contract requirement?

-No incentives for this requirement.

36. Should there be a compensation plan submitted for the CLINs r/t (4) FTEs, (1) FTE and Excess hours? This would be a total of 3 compensation plans.

-Yes.

37. Just to confirm, there are no excess hours required for the (1) FTE position?

-Excess hours are available for all FTE’s.

38. Section II-Administration Section E - Should that read FAR 52,212-3? Is the offeror required to submit that clause with the offer?

-Yes.

39. What is the email file capacity that can be submitted to the government?

-I have no idea, would be advisable to separate if needed.

40. Previous contracts at Fort Hood had a CLIN for sign-on / retention bonuses, will that be added to this contract?

-No.

41. Would a Physician Assistant be consider relevant past performance since it is similar services?

-Yes.

42. For the CRNA that starts in the 1 Option year, January 1 2020. Is there an incumbent for that position?

-Yes.

43. Are all the positions currently filled?

-Yes.

44. For CLIN 1001AC: The POP is from Jan 1, 2020 through Sep 30, 2020 which is 9 months, but hours provided is 1920 hrs. Should it be 1440 hr?.

-Yes; please price your hourly rate and the total hours will be corrected/adjusted on the award document.

Thanks

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

SUBCLIN 1001AC

The pricing detail quantity has decreased by 480.00 from 1,920.00 to 1,440.00.

DELIVERIES AND PERFORMANCE

The following Delivery Schedule item for SUBCLIN 1001AC has been changed from:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

POP 01-JAN-2020 TO

30-SEP-2020

N/A W2M5 CARL R DARNALL ARMY MED C

POP SEE LINE ITEM(S)

MEDICAL SUPPLY OFFICER DACH

BLDG 36065 SANTE FE AVE

FORT HOOD TX 76544-5063

FOB: Destination

W45XTR

To:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

POP 01-JAN-2020 TO

30-SEP-2020

N/A W2M5 CARL R DARNALL ARMY MED C

POP SEE LINE ITEM(S)

MEDICAL SUPPLY OFFICER DACH

BLDG 36065 SANTE FE AVE

FORT HOOD TX 76544-5063

FOB: Destination

W45XTR

The following have been modified:

PWS

PERFORMANCE WORK STATEMENT

CERTIFIED REGISTERED NURSE ANESTHETISTS

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 employer-employee relationship between the Government and the individual health care providers 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 HCPs may be associated. The authority for this contract is 10 United States Code 1089 and 10 United States Code 1091.

1.2. DESCRIPTION OF WORK. The contractor shall provide the services of Certified Registered Nurse Anesthetists (CRNA) at the Carl R. Darnall Army Medical Center (CRDAMC), Fort Hood, Texas, as required by this performance work statement (PWS) and in accordance with the terms and conditions of the basic contract and task order. The Period of Performance (POP) for four (4) of the five (5) FTE’s will start on 1 April 2019 to 30 September 2023 and one (1) additional FTE will begin on 1 January 2020; and all five (5) FTE’s will remain until the end of the contract period through 30 September 2023. The contract will have a base period plus four (4) 12-month option periods. The Certified Registered Nurse Anesthetists shall be responsible for following all MTF policies, procedures, regulations in support of Occupational Safety Health Alliance (OSHA), Joint Commission, and other national, state, and local policies that regulate the health care industry and Radiology profession. Policies and procedures may be obtained by contacting the Contracting Officer's Representative (COR).

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. Contract with other government contractors will be for the sole purpose of coordinating patient care.

1.4. Contract providers shall perform services under the control and general supervision of the Chief, Anesthesia Services, or his/her designated representative.

PERFORMANCE MEASURES

2.1. Outcome. The contractor will provide qualified personnel who will fulfill the requirement to provide primary care services at a standard enabling the MTF to provide such services at a high level of quality.

2.2. Standards. Acceptable measures include: fill rate-95%; employee turnover rate-30% per year; substantiated patient complaints-max 2 per year per provider; no provider initiated cancellations of treatments except as medically required by patient. Other performance evaluation factors will be monitored that are not quantified by numerical measurements which include: not prescribing medications not on hospital formulary; contractor providing personnel exceeding the minimum qualification standards; no inappropriate prescriptions; patient customer service comments;

provider and contractor relationship with hospital staff/government contracting personnel; compliance with hospital policy and procedures.

2.3. How Measured. Department/clinic supervisory personnel will monitor provider performance through government information systems and records, patient records, customer service information, contractor reports, and time sheets.

QUALIFICATIONS

The contract providers shall have the required experience and documented current competence in the specified clinical setting to perform the tasks and procedures identified in paragraph 5. All nurses shall meet the following minimum qualifications.

3.1. Be a graduate of a National League of Nursing accredited school of nursing.

3.2. Be a graduate of an approved anesthesia program accredited by the Council on Accreditation of Nurse Anesthetists.

3.3. Have and maintain certification by the Council on Certification of Nurse Anesthetist.

3.4. Shall have current Basic Cardiac Life Support (BCLS) in accordance with hospital policy. This certification shall be maintained in a current status at all times while performing services under this contract at the HCP’s or contractor’s expense.

3.5. Have and maintain a valid, unencumbered state license, with no limitations, stipulations, or pending adverse action, in any state in the United States, District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S.

Virgin Islands.

3.6. Have experience in the delivery of and monitoring of all types of anesthesia utilized in the delivery of obstetrical and surgical anesthesia (general endotracheal, subarachnoid block and epidural, and IV regional techniques).

3.7. Have current experience (3 months or more in the past 12 months) providing epidural anesthesia (labor epidurals).

3.8. It is a condition of this contract that all certifications required in this statement of work remain current during the life of the contract.

3.9. Continuing Education. Ensure that annual continuing education of all employees is sufficient to maintain certifications required by their certifying organizations and local credentials requirements.

HOURS OF PERFORMANCE

4.1. The majority of contract CRNA duties will be performed in the area of obstetrical anesthesia; to include, but not limited to epidural anesthesia for elective, non-elective, and emergency obstetrical procedures. The remaining hours of service shall be performed as necessary to provide anesthesia services in the operating room and other areas of the hospital.

4.2 Nursing Services. Services may include, 8, 12, 16 or 24-hour shifts, 7 days per week, including weekends, training holidays, and federal holidays. Services shall average of 40 hours per week. At no time shall an individual CRNA perform consecutive 24-hour shifts.

a. Examples of shifts are: 8 hour shift is from 6:30am – 2:30pm, 12 hours is 6:30am – 6:30pm and 16 hours is 6:30am – 10:30pm.

4.3. Scheduling: At least 45 calendar days prior to the first day of each quarter the Chief, Anesthesia Services or his designated scheduler, will provide the COR/contractor a calendar-type schedule of required shifts for the following quarter. The schedule for a particular month will be completed and returned to the COR/Chief, Anesthesia Services at least 30 days prior to the beginning of that month. A 24-hour notice of change will be accepted for emergencies such as serious illness, family emergency, or accident.

4.4. These time sheets are for the sole use of government officials to ensure compliance with FTE hours and will not be provided to the contractor for any reason and/or purpose. In addition, under no circumstances will Government employees sign or verify the contractor’s time sheets for the contractor’s health care providers.

4.5. CLOSURES

During anticipated or unanticipated clinic closures, the contractor will only be paid for hours actually worked. In the event of unplanned facility closure due to natural disaster, military emergency, severe weather, or facility-related problem that prevents the contractor's personnel from performing under this contract, these contractor's employees shall follow the same departure and reporting directions given to government personnel. The contractor shall not submit an invoice or otherwise seek additional payment from the Government for any expenses incurred by the contractor as a result of any such unplanned closure. The contract HCP will only be paid for actual hours worked.

4.6. The contract HCP shall attend any Behavioral Health training as required by Operations Order 07-34.

4.7. Overtime/Extended Shift: Overtime consists of any hours worked in excess of 40 hours in one seven (7) day period. Contractor personnel may be required to work beyond the end of their shift if there are still personnel to be processed at that time. Overtime request will depend on the mission’s need at the time of surge. Approval to work beyond ones shift must be obtained in writing from the designated Government Representative and so annotated on the sign-in sheet or the extension may not be compensated. Signing in early does not constitute an extended shift.

Extended time will be calculated as follows: 10 to 20 minutes = ¼ hour; 21 to 40 minutes = ½ hour; 41 to 59 minutes = ¾ hour; and 60 minutes = 1 hour. Overtime/extended hours are those hours exceeding 40 hours in a one week period. Overtime/extended time will be used for direct patient care only.

5. SPECIFIC DUTIES

5.1. Contract CRNAs providing services under this contract shall perform the same clinical duties as those required of any military or government civil service nurse of similar experience and in similar duty assignments. The duties for all nurses shall consist of, but not limited to, the following:

5.2. Monitor anesthesia care, management of patient anesthesia experience, and performing preoperative evaluations and preparations; administering Spinal, Epidural, Bier Block, Axillary Block, and other regional anesthesia, and general anesthetics; monitoring patient reactions to anesthesia and surgery, managing fluid therapy, and performing post-operative evaluations.

5.3. Advising anesthesiologist or attending physician of adverse reactions necessitating non-delegated medical decisions; takes appropriate actions as directed or required.

5.4. Maintain all required records

5.5. Use the composite health care system for keeping records, ordering of ancillary procedures, ordering of medications, entering orders, and performing other required patient record functions.

5.6. Adhere to the Centers for Disease Control guidelines concerning universal precautions and the MTF infection control program at all times while providing services under this contract.

5.7. Ensure cleanliness and maintenance of anesthesia equipment.

5.8. Indicate responsibility for the contents and correctness of all prepared reports/forms by affixing his/her own signature to the documents and validating their contents.

5.9. Attend professional staff conferences/meetings and other appropriate professional activities as requested by the Chief, Anesthesia Services. Meetings will be held during scheduled work hours.

5.10. Serve as a resource person and assist with the training of other staff personnel, act as clinical adjunctive faculty for student nurse anesthetists in their clinical phase, to include phase II anesthesia students, in vein puncture and intravenous therapy, respiratory care, and anesthesia.

5.11. Comply with all safety requirements of the MTF and OSHA.

5.12. Prepare service reports and collect data.

5.13. Participate in government Quality Assessment and Improvement Activities 5.14. Participate in special studies on quality of care within the Anesthesia Service.

ADMINISTRATIVE

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

6.1. Contractor and subcontractors shall not include or use non-compete provisions with respect to the performance of Government medical service contracts in their employment, consultant, or third part contact agreements (hereafter agreements) with their Health Care Providers (HCPs) which are effective beyond the period of contract performance, base period and exercised option periods included. Non –compete provisions shall not prevent HCPs from being interviewed, employed, or accepting offers of employment or making other arrangements with potential competitors for follow-on contracts. Additionally, non-compete provisions shall not prevent HCPs from accepting offers of employment or making other arrangements with any contractors who provide services to the Government, or from accepting offers of employment with the US Government, following the period of contract performance. In additional to any other remedies available to the Government, inclusion of such non-compete or similar conditions in agreements with HCPs may result in offeror’s proposal being determined unacceptable, termination of any awarded contract or contract, and an entry in the Contractor Performance Assessment Reporting System (CPARS) performance evaluation. Preventing HCPs from accepting these offers will hind the Government’s ability to accomplish the mission of providing medical care to its beneficiaries.

6.2. 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.

6.3. HEALTH. All contract HCPs performing services under this contract shall comply with the health and immunization requirements as stated in the supplement of the performance work statement entitled “Health and Immunization Requirements”, at the time of initial request for clinical privileges and annually thereafter.

6.4. REPORTS. The contractor shall provide to the contract specialist reports required to monitor performance on this contract.

6.5. Shall be able to read, write, and speak English well enough to effectively communicate with patients and other healthcare providers.

6.6. 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 MTF 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.

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

6.7.1. Each contract health care provider shall wear a visible Security badge ID, provided by the MTF 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 due to expired identification and access documents.

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

6.7.3. The contract HCPs shall turn in the MTF 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.

Fill/Vacancy Report. The contractor shall provide a weekly report on the fill and vacancy rates of this contract. This report will identify the contract number, the contract effective date, the number of FTEs under the contract, 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 Tuesday of every week, until the position has been filled and the provider has commenced work.

ANTITERRORISM/OPERATIONS SECURITY

7.1. Contractor and all associated sub-contractor's employees shall comply with applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also provide all information required for background checks to meet installation and MTF access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or MTF Security Office. Contractor workforce must comply with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes. The contractor is responsible for absence of contract HCPs due to expired identification and access documents.

7.2. All contractor employees, to include subcontractor employees, requiring access to Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 30 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within 35 calendar days after completion of training by all employees and subcontractor personnel. AT Level I awareness training is available at the following website:

https://atlevell.dtic.mil/at

7.3. iWATCH Training. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program. All HCPs will view the Match video on the CRDAMC PMO website. All HCPs must understand to contact 288-COPS if any suspicious activity is observed. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance with the results reported to the COR NLT 30 calendar days after contract award.

7.4. Per AR 530-1, Operations Security, new contractor employees must complete Level I OPSEC training within 30 calendar days of their reporting for duty. All contractor employees must complete annual OPSEC awareness training.

7.5. (IT) training. All contractor employees and associated sub-contractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter.

7.6. A criminal history background check shall be required for all HCPs under this contract. Provided personnel must agree to sign documentation allowing the government to conduct such checks as deemed required by the CRDAMC Personnel Security Office.

8.1. LICENSE AND CREDENTIALS REVIEW OR PRIVILEGING

8.1.7.1. The MTF Commander must grant privileges to contract HCPs for which credentialing is required prior to HCPs providing any services. The privileging process shall be in accordance with all requirements in ARs 4066 and 40-68, as amended. The privileges granted by the MTF will be sufficient to allow for performance of all specific tasks identified in this contract. Information on the credentialing/privileging process is contained in chapter 4 of AR 40-68. Any failure to meet these requirements is considered nonperformance and the basis for termination for cause.

8.1.7.2. The contractor shall request from the COR documentation requirements for privileging for each contract HCP. Required documentation shall be completed and returned to the COR within 45 calendar days of the provider accepting the position. The contractor shall perform all primary source verifications and include all verifications with the credentials. The Contractor shall obtain all paperwork, letters of reference, approvals, work history, etc.

required by the MTF credentialing process. MTFs will not assist the contractor in obtaining any needed information.

8.1.7.3. Should the contractor need to add additional/or replacement providers during the contract period, the same qualification standards, credentialing and health requirements shall apply.

8.1.7.4. The Credentials Committee may have questions which they will wish to present to the contractor's provider verbally or in writing. The Contractor's provider shall answer questions presented by the Credential's Committee either verbally or in writing.

8.1.7.5. If at time of contract award and subsequent performance, the provider whose credentials have been reviewed by the Credentials Committee is no longer available to provide required contract services, the contractor shall provide a candidate whose credentials are clearly equal or greater than those of the original candidate within 30 days after the contractor receives notification that provider will no longer be available or is no longer available.

8.1.7.6. The MTF Credentials Committee will maintain control of the credentialing/privileging aspects for all providers who will be providing independent healthcare services at the MTF or under our auspices.

8.1.7.7. No contract provider shall provide services under this contract without prior approval of the Commander as recommended by the MTF Credentials Committee.

8.1.7.8. Contractor shall investigate, verify, maintain and submit documentation of curriculum vitae for each provider proposed to provide services at the MTF. Proof of original documentation of degrees and licensure shall be presented and prime source verified. All periods of training must be supported by copies of training certificates.

Contractor shall provide documentation of all continuing health education certification. This submission must occur prior to any provider performing work under this contract.

- Legible copies of education degrees/diplomas qualifying the provider to perform as a provider, and of any required postgraduate training certificates involving the intended area of work (such as internship, residency, etc.). All copies must be certified that it is a true copy of the original.

- Legible copies of all current state licenses, professional certification cards, basic certification card, plus additional Cardiac Pulmonary Resuscitation (CPR) requirements for that specialty, any current DEA certificate, and any specialty or subspecialty boards and/or fellowship certificates. In addition, a complete list of all licenses ever held, with explanations of any that are not current or which have been subject to disciplinary action will be provided.

Once initial privileges have been granted, the Contractor shall ensure providers maintain such licensure/required certification and provide copies of renewed documents in support of same.

- A curriculum vitae accounting for all periods of time subsequent to obtaining the initial qualifying professional degree/training, and including date of birth, to permit any required query of the National Practitioner Data Bank.

- Proof of current competence (within 6 months) and experience in the area of work will be provided in the form of at least two reference letters from the sources listed below; and names, mailing addresses and telephone numbers will be provided to permit direct reference query. Reference letters must be received on letterhead paper directly from the author to the MTF (or to the contractor if it's a corporation, vice an individual). Letters should address the provider's professional competence, experience, quality of care, relations with patients and staff members, any personal problems or mental/physical health problems that have interfered with any professional practice, and previous participation in medical staff functions/compliance with medical staff bylaws and number and type of procedures performed.

- Letter from the chief of staff, clinic administrator, professional supervisor, or department head of any hospital or clinic at which the provider holds current privileges or with which the provider is clinically associated.

- Letter from a peer practitioner having personal knowledge of the provider's professional standing, character and ability, or from the president or secretary of the local professional society.

- Letter from the director or faculty member of any professional training program, if the provider has participated in such training program within the last year.

- Statement by the provider regarding physical and mental health, to include any history of substance abuse.

Statement of involvement in malpractice cases and claims, including a brief description of the facts of any case settled on behalf of the provider, and a history of any disciplinary action taken by hospitals, state licensure boards, or other government agencies. At a minimum, DA Form 5754-R will be used for this purpose; it will be completed upon initial application for privileges, and at the time of privilege renewal.

8.1.7.9. Unless otherwise required, the Contractor shall submit completed credentials packets for any additional providers 45 calendar days from the provider accepting the position. Once initial privileges are granted, not less than 90 days prior to expiration, the MTF will provide renewal documents to the contractor for completion by the provider; completed forms will be returned to the Credentials Coordinator at least 45 calendar days prior to the expiration of previous privileges. Affiliate privileges are granted for the first year based upon their expiration date and every two years afterwards.

8.1.7.10. The credentialing documents specified in the above paragraphs will be provided to the Contractor through the COR by the Credentials Coordinator in photocopy-ready state. The Contractor shall reproduce forms as necessary. The Contractor shall submit all completed forms and documentation specified above to the Credentials Coordinator.

8.1.7.11. Presentation of a provider to the MTF by the Contractor shall, on a continuous basis, constitute evidence that the contractor has investigated and verified all information presented to the MTF for the purpose of provider credentialing. During the term of the contract, the contractor shall notify the Credentials Coordinator at the MTF within 72 hours upon becoming aware of any information which may compromise a contract provider's credentials at the MTF. This shall include, but is not limited to, information linking a contract provider with chemical dependence, misdemeanor, felony, or medical malpractice. This information shall be reviewed by the MTF Credentialing Committee and may result in the rescinding of credentials. The MTF Credentialing Committee is the sole agency authorized to recommend to the Commander that a particular contract provider be granted privileges.

The Commander of the MTF is the final authority for approving/denying clinical privileges to any and all contract providers.

8.1.7.12. If the credentials of any provider are revoked, he/she shall not be permitted to continue practicing medicine at the MTF. Such action will not relieve the Contractor from responsibility to perform the services required by this contract. The contractor shall provide a candidate whose credentials are clearly equal to or greater than those of the original candidate within 30 days after the contractor receives notification that a provider's credentials have been revoked.

8.1.7.13. All contractor personnel shall attend newcomers training at the start of their employment at the MTF and quarterly training thereafter. All contractor personnel shall participate in orientation to their work area and maintain a competency file (which is different from a credentials file) at the worksite (JC standards).

9. DEFINITIONS/ACRONYMS.

9.1. DEFINITIONS. Following is a list of basic definitions.

9.1.1. ANCILLARY PERSONNEL: This includes all HCPs with the exception of Medical Doctors (MD) and Doctors of Osteopathy (DO).

9.1.2. BACKUP PERSONNEL: Pre-approved contract HCPs designated to move into the position of the primary contract HCP to perform required services for the duration of his/her absence.

9.1.3. BENEFICIARIES OF THE MILITARY HEALTHCARE SYSTEM. Those individuals entitled to care at the MTF in accordance with AR 40-3 and AR 40-400.

9.1.4. CLINICAL PRIVILEGES: Authorization by the government to provide specific patient care and treatment services in the organization, within well-defined limits, based on the individual's license, education, training, experience, competence, judgment and physical and mental health.

9.1.5. COMPOSITE HEALTHCARE SYSTEM (CHCS): An automated medical information system which will provide integrated support for the functional work centers of inpatient and outpatient care facilities, patient administration, patient appointments and scheduling, nursing, laboratory, pharmacy, radiology, and clinical dietetics.

9.1.6. CONTINUING EDUCATION. Education beyond initial professional preparation relevant to the type of patient care delivered in the organization, provides current knowledge relevant to the field of practice and is related to findings from quality assurance activities.

9.1.7. CONTRACTING OFFICER: A person with the authority to enter into, administer, and/or terminate Contracts/Modifications and make related determinations and findings.

9.1.8.

CONTRACTING OFFICER'S REPRESENTATIVE (COR): A government employee selected and designated in writing by the Contracting Officer to act as his/her designated representative in administering a contract.

9.1.9. FACILITIES: Building, equipment and supplies necessary for the implementation of services by personnel.

9.1.10. MILITARY TIME is on a 24-hour clock, e.g.

8:00 a.m. - 0800 9:10 a.m. – 0910 Noon – 1200 9:10 p.m. – 2110 Midnight – 2400 12:01 a.m. – 0001

9.1.11. MILITARY DATES are written as: October 10, 2010 – 10 Oct 10

9.1.12. NEW CONTRACT HCP. A new contract HCP for purposes of accreditation includes contract HCPs under new contracts, including contract HCPs previously accredited Troop Care or Technical Expert status under other contracts; new applicants proposed for hire; and contract HCPs who changed positions within the same contract. Contract HCPs shall work full-time, principal duties shall be troop care or technical expert qualifying duties, and said contract HCPs shall serve the U.S. Forces exclusively in order to be granted Troop Care or Technical Expert status.

9.1.13. ORDERING CONTRACTING OFFICER. A Contracting Officer designated to place contracts against an existing contract.

9.1.14. PHYSICIAN: Medical healthcare providers possessing a doctorate degree as a Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.).

9.1.15. PRIVILEGING PROCESS: Process established by the MTF and AR 40-68 for granting clinical privileges to HCPs.

9.1.16. QUALITY ASSESSMENT AND IMPROVEMENT. Those actions taken by the Government to check services to determine if they meet the requirements of the TJC, U.S. Army Medical Command, quality assurance and risk management program, and ensure that the contract HCPs comply with the terms and conditions of the contract.

9.1.17. QUALITY CONTROL. Those actions taken by a contractor to control the performance of services to ensure that they meet the requirements of the contract.

9.1.18. REPLACEMENT PERSONNEL: Contract HCPs selected to fill a position for the duration of the contract period that was previously occupied by another contract HCP.

9.1.19. SCHEDULED ABSENCE: Prearranged absences from performance of contractual services by contract personnel. These absences, whether taken for vacations or continuing medical education, etc. is scheduled/arranged in advance.

9.1.20. TRAINING HOLIDAY: A day off in addition to holidays only for the Military personnel.

The Contractor personnel will observe the policy spelled out on his/her contract.

9.1.21. TRICARE: A regionalized, tri-service, contractor-supported, DoD-managed healthcare system.

9.1.22. UNSCHEDULED ABSENCE: Absences from performance of contractual services by contract personnel that are not scheduled/arranged in advance, regardless of whether the absences are caused by illness or for other reasons.

9.2. Acronyms:

9.2.1 ABEM – American Board of Emergency Medicine

9.2.2 AC - Active Component

9.2.3 ACGME – Accreditation Council for Graduate Medical Education

9.2.4 ACLS – Advance Cardiac Life Support

9.2.5 ACO - Administrative Contracting Officer

9.2.6 ACOR -Alternate Contracting Officer’s Representative

9.2.7 ADP - Automated Data Processing

9.2.8 ADS – Ambulatory Data System

9.2.9 AHLTA – Armed Forces Health Longitudinal Technology Application

9.2.10 AR – Army Regulation

9.2.11 ACLS – Advance Cardiac Life Support

9.2.12 BCLS – Basic Cardiac Life Support

9.2.13 BLS - Basic Life Support

9.2.14 CCQAS - Centralized Credentials Quality Assurance System

9.2.15 CFR - Code of Federal Regulations

9.2.16 CHAMPUS - Civilian Health and Medical Program of the Uniformed Services

9.2.17 CHCS - Composite Health Care System

9.2.18 CLIN – Contract Line Item Number

9.2.19 CME - Continuing Medical Education

9.2.20 CONUS - Continental United States

9.2.21 COR – TMA’s Contracting Officer’s Representative

9.2.22 CPR – Cardiopulmonary Resuscitation

9.2.23 CQI - Continuous Quality Improvement

9.2.24 CQM - Clinical Quality Management

9.2.25 CQMP - Clinical Quality Management Program

9.2.26 DA – Department of the Army

9.2.27 DCCS - Deputy Commander for Clinical Services.

9.2.28 DEA - Drug Enforcement Administration.

9.2.29 DEM – Department of Emergency Medicine

9.2.30 DOD - Department of Defense.

9.2.31 DODI - Department of Defense Instruction

9.2.32 ECFMG - Educational Commission for Foreign Medical Graduates

9.2.33 EFT - Electronic Funds Transfer

9.2.34 EKG - Electrocardiogram.

9.2.35 EMG - Electromyography

9.2.36 FAR - Federal Acquisition Regulation

9.C.2.1.37 FBI - Federal Bureau of Investigation

9.2.38 FL - Form Letter

9.2.39 FTE - Full Time Equivalent.

9.2.40 HCP – Health Care Provider

9.2.41 HIPAA - Health Insurance Portability & Accountability Act of 1996

9.2.42 HSC – Health Services Command

9.2.43 ICTB-Inter-Facility Credentials Transfer Brief

9.2.44 IMR-Individual Medical Record

9.2.45 IRC - Installation Record Check

9.2.46 IV - Intravenous.

9.2.47 TJC – The Joint Commission.

9.2.48 KO - Contracting Officer.

9.2.49 MEDCEN – Medical Center

9.2.50 MEDCOM - Medical Command

9.2.51 MEDDAC - Medical Department Activity

9.2.52 MTF - Medical Treatment Facility

9.2.53 LOSS - Line of Sight Supervision

9.2.54 NACI - National Agency Check with Inquiries

9.2.55 NCOIC - Noncommissioned Officer in Charge

9.2.56 Reserved

9.2.57 NPDB - National Practitioner Data Bank

9.2.58 OCONUS - Outside the Continental United States

9.2.59 OIC - Officer in Charge

9.2.60 OSHA - Occupational Safety and Health Administration

9.2.61 PA - Physician Assistant

9.2.62 PAD - Patient Administration Division

9.2.63 PALS – Pediatric Advance Life Support

9.2.64 Pam - Pamphlet

9.2.65 PCF – Practitioner’s credentials file

9.2.66 PCO - Procurement Contracting Officer/Procuring Contracting Officer

9.2.67 PENS – Percutaneous Electrical Nerve Stimulation

9.2.68 PL - Public Law

9.2.69 PPIMS - Past Performance Information Management System

9.2.70 PSV - Primary source verification

9.2.71 PTE – Part Time Equivalent

9.2.72 PWS - Performance Work Statement

9.2.73 QA - Quality Assurance

9.2.74 QA&I - Quality Assurance & Improvement

9.2.75 QC – Quality Control

9.2.76 QI - Quality Improvement

9.2.77 RFQ - Request for Quote

9.2.78 SF - Standard Form

9.2.79 Deleted

9.2.80 SRP - Soldier Readiness Processing

9.2.81 TAB - Therapeutic Agents Board

9.2.82 TJC-The Joint Commission

9.2.83 USPS - United States Postal Service

9.3. GOVERNMENT FURNISHED PROPERTY.

9.3.1. The Government will provide use of all available MTF facilities and support services, materials, publications and forms, and equipment required for contract performance (except as designated in the contract). Contract HCPs shall keep government furnished supplies, equipment, and work areas in a safe, orderly and clean condition.

Contract HCPs shall notify the Government whenever maintenance of equipment is required. Personal long distance calls are not authorized.

9.3.2. Emergency Contract HCP Healthcare. The MTF will provide Emergency healthcare for injuries occurring while on duty. The contractor shall reimburse the government for such services

9.3.3. The Government will provide an MTF identification badge and a Common Access Card (CAC) to qualified HCPs. While performing work under this contract, he/she shall wear a government-furnished, visible identification badge on the front of the outer clothing. Contractor personnel must comply with MTF policy regarding the badges and identification cards.

9.3.4. Any space used by contract HCPs in performance of this Contract may be used for other purposes during their absence. Items of clothing, personal effects, or equipment may not be able to be secured at all locations. The government will not incur any liability for theft, damage to, or loss of such personal items.

9.3.5. Personal Protective Equipment (PPE). Contract employees shall wear special protective clothing and shoe covers, when required, which shall be supplied by MTF. In all cases, the contractor shall conform to the established personal appearance policy of the MTF.

9.4. CONTRACTOR FURNISHED SUPPLIES/SERVICES:

9.4.1. Uniforms. The Contractor shall furnish or ensure that all contract HCPs have appropriate uniforms/smocks.

Contract HCP’s shall wear appropriate civilian attire to and from the MTF. The appearance of contract personnel will be governed by the current MTF dress and appearance policy.

9.4.2. Nametags. The contractor shall furnish and ensure that the contract HCP has a nametag which shall be worn on outer clothing garment identifying him/her by name, degree, as a contract Health Care Provider (HCP), specialty, and Company (if any).

Example:

John Doe, MD Contract Family Practice (Specialty) Physician (XYZ Company)

9.4.3. Rubber Stamp: The contract HCP shall provide a self-inking rubber stamp (if required) for authenticating…