W81K00-21-Q-0047-0001.pdf

0011540465

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 to revise paragraph 1.7.1 of the Performance Work Statement.

B. Deep Brain Stimulation Electrode Monitoring is hereby deleted from this solicitation.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 11

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

16C. DATE SIGNED

BY 24-Feb-2021

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 W81K0021Q0047

X 9B. DATED (SEE ITEM 11)

27-Jan-2021

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

23-Feb-2021

CODE

W40M USA HLTH CONTRACTING ACT

REGIONAL HEALTH CONTRACT OFF CENTRAL

2539 GARDEN AVENUE

FT SAM HOUSTON TX 78234-0000

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

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W81K0021Q0047

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

The following have been modified:

PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT (PWS)

Intraoperative Neuromonitoring (IOM):

Brooke Army Medical Center, Department of Surgery

1. Scope of Contract.

1.1. The Contractor shall provide the non-personal services of Intraoperative Neurophysiological Monitoring to patients at Brooke Army Medical Center, Fort Sam Houston, TX in accordance with the terms and conditions of this contract.

1.2. The Contractor shall abide by medical treatment facility (MTF) rules, regulations and bylaws, including applicable standing operating procedures established by the MTF. The Contractor will be required to register with the vendor credentialing company the MTF utilizes for vendor management. The quality of care shall meet or exceed all recognized standards established by The Joint Commission (TJC).

1.3. Place of Performance: The work to be performed under this contract will be performed within the San Antonio Military Health System. It is expected that the majority, if not all cases, will be performed at Brooke Army Medical Center, JBSA-FSH, TX.

1.4. NON-PERSONAL SERVICES. This requirement is for Non-Personal services.

Personnel rendering the services are not subject, either by the contract terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees.

Non-Personal where Provider is physically performing within MTF:

Non-personal service HCWs requiring licensure shall have and maintain a current, valid, unrestricted license specific to the position (with no limitations, stipulations or pending adverse actions) in the U.S. jurisdiction within which the HCW is performing as outlined in the applicable regulation or instruction at the place of performance. All licenses must be unencumbered and remain in effect during the duration of the HCW performance on the contract. Specifically, this non-personal services contract requires that the contract health care providers maintain a current, active, valid and unrestricted license to practice medicine in the state of Texas.

It is expressly agreed and understood that this is a non-personal services contract, as defined in Federal Acquisition Regulation (FAR) 37.401, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor's professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The Contractor shall maintain during the term of the contract liability insurance by a responsible insurance carrier.

Professional Liability: The government will not be liable for malpractice allegations against contract HCP's based upon performance of this contract. The contractor shall be required to carry malpractice insurance for its contract HCP's at a level stated in the solicitation and included in any resulting contract for subject acquisition in tailored FAR Clause 52.237-7.

IF an apparent successful offeror, the contractor shall provide evidence of insurability concerning medical liability insurance prior to contract award. Upon contract award, the contractor shall provide evidence of insurance demonstrating the required coverage prior to commencement of performance. In accordance with Federal Acquisition Regulation (FAR) Clause 52.237-7, the contractor will indemnify the Government for any liability producing act or mission by the contract HCPs and agents occurring during contract performance. If the contractor uses subcontractor in the performance of this contract, the contractor is required to ensure that its subcontractors for provision of healthcare services contain the requirements for FAR 52-237.7, including the maintenance of medical liability insurance.

1.5. MINIMAL CONTRACT EMPLOYEE QUALIFICATIONS:

1.5.1. A certificate in Neurophysiologic Intraoperative Monitoring (CNIM) through the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET), or certification from the American Board of Neurophysiologic Monitoring (ABNM). Additionally, at least 12-weeks training in Intraoperative Neurophysiological monitoring is required. The contractor will provide copies of certificates and renewals during the life of the contract to the Contracting Officer Representative (COR).

1.5.2. Completion of HIPAA Compliance training.

1.6. CONDUCT

1.6.1. Contractors shall comply with MTF policies regarding personal appearance, and personnel Identification and access requirements.

1.6.2. Contractor shall abide by federal and local MTF regulations and requirements concerning the nature of Limited privileged communication between patients and the Contractor as may be necessary for security and personnel reliability programs. The Contractor shall also abide by federal and local MTF regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act of 1996. All medical records and reports will remain the property of the Government.

1.7. TASKS AND DELIVERABLES

1.7.1. Specific Tasks: The monitoring system and personnel shall be able to perform / monitor, to an acceptable level, as determined by the surgeon based on unique clinical case requirements, the following intraoperative neuromonitoring services:

• Somatosensory Evoked Potentials (SSEPs)

• Brainstem Auditory Evoked Responses (BAERs)

• Motor Evoked Potentials

• Recurrent Laryngeal Monitoring

• Delta Wave (D-Wave) Monitoring for spinal cord tumors and related cases

• Cranial Nerve Monitoring (3-12)

• Intraoperative EEG

• Brain Motor-Sensory Cortical Phase Reversal

• Pedicle Screw Stimulation

• Monitors the activity of nerves as they exit the spinal column

1.7 2 In accordance with (IAW) Army Regulation 735-5, Property Accountability

Policies, paragraph 3-3, the Government may provide a place for storage of the equipment and would be responsible if the equipment is lost, damaged or stolen while stored at the facility. The vendor is responsible for securing its equipment while it is ‘in use’ and in the vendor’s possession in the hospital. If the Government agrees to allow the storage of the equipment on-site, the Government will set-up a system to ensure the equipment is properly documented to include who signs it out, and who signs it in. The Contractor shall be fully responsible for the security and maintenance of their equipment.

1.7.3. The Contractor shall provide a technical representative who meets the Minimum Qualifications to perform the following:

Anatomical and prep direction of pad/myotome placement on patient.

Set up and self-testing of equipment and leads.

Direction in use of equipment and diagnostic features interoperatively for the entire length of procedure.

Technical information affecting the interpretation of data.

Monitor the patient and defer interpretation to the Staff Surgeon.

Keep the Surgeon and Anesthesiologist informed at all times during a procedure of the patients neurophysiological status.

Provide an in-service regarding their system to the MTF operating room staff every six months.

Perform all duties in such a manner that they meet all TJC standards.

1.7.4. For routine cases, the Contractor will be notified at least 48 hours in advance of a case requirement. The Contractor will be in place at the MTF at least two hours before the scheduled surgery. The technical representative shall be in place at the MTF for emergency unscheduled surgeries within 2 hours after placement of call. The Government will provide a list of people that will be authorized to place service calls.

1.7.5. Disposables will be ordered as needed for surgical cases and delivered to the MTF within two days from Placement of call.

1.7.6. The Contractor will provide a local phone number or a toll free number for placement of calls on a 24-hour basis.

1.8. Hours of Operation: The service will be provided 24 hours a day, seven days a week depending on Surgery requirements. The Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.9. Recognized Holidays: The following are recognized federal holidays. The contractor will be required to perform appropriate monitoring for urgent/emergent cases as necessary; routine cases will typically not be scheduled on the following recognized holidays.

New Year’s Day Labor Day

Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day

Memorial Day Thanksgiving Day Independence Day Christmas Day

1.10. Quality Assurance Surveillance Plan.

1.10.1. The following minimum Quality Assurance Surveillance Plan (QASP) applies. The Government may modify inspection methods at its discretion.

Requirement: Provide and maintain system IAW paragraph 1.6.1.

Performance Standard: 100% of time Method of Surveillance: 100% Inspection Remedy for Non-Performance: Notify Contractor and Contracting Officer Requirement: Provide Technical Representative IAW paragraph 1.6.5 for emergency and routine cases.

Performance Standard: Comply at least 95% of the time.

Method of Surveillance: 100% Inspection Remedy for Non-Performance: Notify Contractor and Contracting Officer Requirement: Provide all disposables for neuromonitoring IAW 1.6.6 Performance Standard: Comply at least 95% of the time.

Method of Surveillance: 100% Inspection Remedy for Non-Performance: Notify Contractor and Contracting Officer

Standard Measurement Past Performance

Assessment 99% to 100% Excellent Document Past Performance 96% to 98% Very Good Assessment Report, Paying 95% Satisfactory Particular attention to 91% to 94% Marginal performance that exceeds 90% or less Unsatisfactory the standard.

1.11. Contractor Manpower Reporting (CMR) Contractor Manpower Reporting. The Office of the Assistant Secretary of the Army (Manpower & Reserve Affairs) operates and maintains a secure Army data collection site where the Contractor will report ALL Contractor manpower (including subContractor manpower) required for performance of this contract. If required the Contractor is required to completely fill in all the information in the format using the following web address https://beta.SAM.gov. The required information includes:

1) Contracting Office, KO, COR;

2) Contract number, including task and delivery order number;

3) Beginning and ending dates covered by reporting period;

4) Contractor name, address, phone number, e-mail address, identity of

Contractor employee entering data;

5) Estimated direct labor hours (including sub-Contractor);

6) Estimated direct labor dollars paid this reporting period (including sub-Contractor);

7) Total payments (including sub-Contractor);

8) Predominant Federal Service Code (FSC) reflecting Services provided by

Contractor (and separate predominant FSC for each sub-Contractor if different);

9) Contractual title associated with the Unit Identification Code (UIC) for the Army Requiring Activity (the Army Requiring Activity is responsible for providing the Contractor with its UIC for the purposes of reporting this information);

10) Locations where Contractor and sub-Contractors perform the work (specified by zip code in the United States and nearest City, Country, when in an overseas location, using standardized nomenclature provided on website);

11) Presence of deployment or contingency contract language; and,

12) Number of Contractor and sub-Contractor employees deployed in theater this reporting period (by country).

The reporting period will be the period of performance not to exceed 12 months ending September 30 of each Government fiscal year and must be reported by 31 October of each calendar year. The Contractor shall notify the COR by the 5th working day of November of each Government fiscal year whether or not they have completed this report. If the COR is unavailable, the Contractor will notify the KO.

1.12. OPERATIONAL SECURITY (OPSEC) REQUIREMENT

1.12.1. Investigation Requirements. The contractor providing service under this contract is required to initiate and document the new employee’s Electronic-Questionnaires for Investigations Processing (e-QIP) and coordinate, or validate through the SAMMC Security Manager’s Office all background investigation requirements needed for employment at SAMMC, or in SAMMC organizations. Clearances will be validated using the Joint Personnel Adjudication System (JPAS) when a new employee begins in-processing after contract is awarded. The SF 85P Questionnaire for Public Trust Positions is to be completed and printed and electronic copies (downloaded from internet program) are to be hand carried to the SAMMC Security Manager prior to performance. The Contractor shall have proof of U.S. citizenship (certified copy of birth certificate or naturalization papers) or a valid U.S.

Immigration Form 1-151 and Alien Registration Card ("Green Card"). As a minimum, the contractor providing service requiring operating government-furnished workstations that have access to Department of Defense e-mail and requiring unescorted entry to a restricted area/Controlled Areas, must successfully complete a National Agency Check (NAC). The contractor shall coordinate and schedule appointments with the SAMMC Security Manager prior to performance. The SAMMC security manager will initiate the Request for Personnel Security Action, review the security questionnaire and request a Local File Check from the Provost Marshall prior to scheduling an appointment with the Security Specialists to submit the e-QIP for processing. This security questionnaire must be completed and processed by the SAMMC Personnel Security Office prior to contract performance. The contractor is responsible for monitoring the coordination and completion of the scheduled appointment date and time with the Security Manager.

1.12.2. Freedom of Information Act Program (FOIA and Privacy Act). The contractor shall comply with DOD Regulation 5400.7-R, DOD Freedom of Information Act Program requirements. The Freedom of Information Act sets policy and procedures for the disclosure of records to the public and for marking handling transmitting and safeguarding For Official Use Only materials.

1.12.3. Reporting Requirements. The contractor shall comply with DoD 5200.2-R, January 1987, Personnel Security Program and AR 380-67, 9 September 1988, Department of the Army Personnel Security Program Regulation. Contractor shall report to the SAMMC Security Manager any information or circumstances which may pose a threat to DOD or contractor personnel, resources, or DOD information.

1.12.4. Removal of contract employee. The Government reserves the right to require immediate temporary or permanent removal of any individual whose actions raise reasonable suspicion that patient care or services may be compromised in any way or that pose a threat of harm to other contractor/government personnel or self.

Notification of all removals will be made by the Contracting Officer Representative (COR). Removal of any individual does not relieve the contractor of any performance requirement.

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

1.12.6. Government Computer Access Requirements. If this contract requires contractor personnel to have access to government computers, contractor personnel requiring access to government computers shall successfully complete, a National Agency Check (NAC), before obtaining access to the computer. These investigations shall be submitted by the government at no additional cost to the contractor. Common Access Cards (CACs) for Contractor Personnel are required which is hereby incorporated by reference if not otherwise included. The contractor shall comply with Homeland Security Policy Directive (HSPD)-12, Policy for Common Identification Standard for Federal Employees and Contractors and Federal Information Processing Standard 201.

1.12.7. Keys and Lock Combinations. The contractor shall abide by all current key control and lock combination procedures The Contractor shall be responsible for any keys issued contractor. The keys shall not be duplicated. The Contractor shall ensure government-issued keys are not by personnel other than those currently authorized. No unauthorized personnel shall be allowed entry into the locked area. Keys shall not be used to open work areas for personnel other than personnel engaged in performance of their duties, unless authorized by the Government functional area chief. The contractor shall use keys issued to them to secure/open areas only as directed by the COR and/or functional area chief. Lost keys and/or locks shall be reported to the issuing party and COR immediately upon recognition of the loss. The COR shall notify the PMO of the lost key. The contractor shall be responsible for the replacement costs of any lost keys and any associated locks.

Reimbursement shall be provided before the Government replaces lost keys or performs re-keying.

1.13. ANTI-TERRORISM (AT) REQUIREMENTS

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

1.13.3. Security Requirements: Work under this contract is UNCLASSIFIED. The Contractor Shall Comply with all applicable DoD security regulation and procedures during the performance of this contract. The Contractor shall not disclose and must safeguard procurement sensitive information, computer systems and data, Privacy Act data, and Government personnel work products obtained or generated in the performance of this contract. Contractor will be issued by the Government a Common Access Card (CAC) which is required for access to Government computer databases and entrance to the installation. Additionally, contractor must be issued a special identification card issued by SAMMC PMO Badge and ID Office prior to reporting for duty. The Contractor shall be responsible for the control and safe keeping of all Government issued IDs and ensure all badges are returned to the COR upon termination of the contract. The Contractor shall ensure he or she is aware that in the event either of the Government IDs are lost or stolen that they are to advise the PM or alternate immediately upon discovery. The Contractor shall ensure that the COR is notified the same day the report of an ID lost or stolen.

1.13.4. The Government shall conduct criminal background checks on the contractor in accordance with the procedures set forth in Public Law 100-235, DoD Directive

5200.28, DoD Directive 5200.2-R, DoDI 1402.5. and submit to the PM or the Alternate. The Contractor is responsible for completing the SF86, Authorization for Release of Information form and ensures all background check submittals are initiated in accordance with this PWS prior to employees providing services at BAMC facilities. Background checks shall be based on fingerprints of individuals obtained by qualified Government law enforcement or security personnel, inquiry’s conducted through the Federal Bureau of Investigation (FBI) and the State Criminal History Repository check, and a local Installation Record Check., if required. The procedures for completing the required background check are outlined in the Department of Defense Instruction (DoDI) 1402.5. Government will not allow the contractor to start work until clearance of criminal background check has been completed.

1.13.5. Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use at the end of each business day. The Contractor shall ensure all government facilities, equipment, and materials shall be secured at the close of each duty day.

1.13.6. Antiterrorism (AT) / Operations Security (OPSEC) Requirements: For OPSEC to be effective, all Contractors must be aware of OPSEC and understand how OPSEC complements traditional security programs. All personnel must know how to apply and practice OPSEC in the performance of their daily tasks. OPSEC must become a mindset of all Contractors and be performed as second nature. To accomplish this level of OPSEC vigilance, OPSEC training programs must be action and job-oriented, enabling the workforce to put into practice the knowledge and tactics, techniques, and procedures (TTPs) they learned in training. Training should maximize the use of lessons learned to illustrate OPSEC objectives and requirements. In order to ensure accomplishment of training, the Government will include OPSEC training as a part of their organization’s annual training guidance. Contractor must complete Level I OPSEC and AT Awareness training within 30 calendar days of reporting to duty in according to Army Regulation 530-1 and 525.13. AT Level I awareness training is also available at https://atlevel1.dtic.mil/at.

1.13.7. iWATCH Training: The Government will brief contractor on the local iWATCH program. This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to their COR. Contractor must complete iWATCH training within 30 calendar days of reporting to duty.

1.14. HEALTH AND IMMUNIZATION REQUIREMENTS

1.14.1. All contract Healthcare Providers (HCPs) performing direct healthcare services under this contract shall receive a general physical examination prior to commencement of services.

The contractor shall provide the Contracting Officer's Representative, 10 calendar days before beginning services under this contract, a physical examination certificate for each individual HCP who will provide services. The certification shall state the date on which the physical examination was completed and the name of the physician who performed the examination. The physician performing the examination shall sign this certification. For the purposes of this paragraph, a physical examination administered more than 45 days prior to performance of the contract will not be considered adequate. The physical examination shall include the following:

a. Reserved.

b. A history to show that HCP has completed a primary series of immunization with tetanus and diphtheria toxoids and that a booster dose is current (within the past 10 years).

c. A test for immunity to the hepatitis (Type B) virus with documentation of the results. A profile shall be established to show immune status to hepatitis. Non-immune Healthcare Workers (lacking anti-HB(c) or anti- HB(s)) shall be required to complete an immunization series with a Hepatitis-B vaccine (e.g., Recombivax, Engerix).

d. Serologic evidence of immunity to measles and rubella or documentation of immunization with measles, mumps, and rubella (MMR) vaccine using the following guidelines:

1) Employees born before 1957 without documentation of previous vaccination with MMR should receive one dose.

2) Employees born in or after 1957 who have received one dose of MMR previously shall receive one booster dose.

3) Employees born in or after 1957 without documentation of any previous vaccination with MMR should receive two doses of vaccine, separated by no less than one month.

e. Serologic evidence of immunity to varicella or documented history of illness or immunization.

f. For personnel who do not have proof of having completed a primary series, completion with enhanced potency inactivated poliovirus vaccine (eIPV) is recommended. Reliable history of spending early childhood and attending elementary schools in the United States since may suffice as clinical history of polio immunization, but requires physician documentation in the record of the history and examination.

g. Contractor's HCPs shall be screened before employment and annually for tuberculosis by a tuberculin skin test using the Mantoux technique. (The TINE test is disallowed as a substitute.) A skin test result of 10 mm of indurations or more shall be required to have a chest roentgenogram and an evaluation performed. A tuberculin skin test of 10 mm of indurations or more will require documentation providing an assessment of the patient (status of infection- active, inactive; need for preventive treatment or not as determined by age, history of BCG (Bacillus Calmette-Guerin) vaccination; duration of skin test positivity, etc).

h. If all of the immunizations and tests set forth in the preceding paragraphs have not been completed, the contractor shall issue a certificate providing evidence of immunizations and tests that have been completed or started and shall provide a schedule for the completion of unfinished immunizations and lab tests. After the schedule is completed, the contractor must provide an updated and complete certificate. Failure to complete the immunizations as scheduled may be grounds for the Contracting Officer, upon the advice of the MTF commander or his clinical staff, to determine that such contract HCP is not an acceptable individual to perform services under this contract.

i. The Contracting Officer, with the explicit case-by-case approval of the MTF commander, is empowered to make exceptions to these requirements, for example, in the event of vaccine shortage or bona fide religious exceptions, but nothing herein shall be construed as an imperative or directive upon the Contracting Officer to make such exceptions.

2. All contract HCPs performing direct healthcare services under this contract, who experience a parenteral (e.g., needle-stick or cut) or mucous membrane exposure (e.g., splash to the eye or mouth) to blood or bloody body fluids, shall receive prompt treatment.

The medical treatment facility (MTF) will evaluate the source of exposure for risk of Hepatitis-B, Hepatitis-C, and Human Immunodeficiency virus (HIV) and will provide a report of the findings to the contractor and the contract HCP. It shall be the contractor's responsibility to provide appropriate treatment as needed to possibly include Tetanus- Diphtheria booster, Immune Globulin, Hepatitis-B vaccine booster, or Hepatitis- B Immune Globulin. The contractor shall be responsible for providing the contract HCP with initial testing and if the source of exposure was unknown, positive, or considered at high risk for HIV infection, follow-up testing 3, 6, and 12 months after exposure. In the event of a confirmed or highly suspected parenteral exposure to HIV, the contractor shall insure that the contract HCP receives appropriate counseling and is referred immediately to a private infectious disease specialist for consideration of any post exposure prophylaxis (e.g., AZT).

The Government may require the contractor to provide evidence of the status of treatment and testing of the individual contract HCP under the contract.

3. All contract HCPs shall receive the current influenza immunization unless documented by a physician to be medically contraindicated.

4. Failure to meet the requirements stated herein, or when test results determine a contract HCP has a contagious disease, the Contracting Officer may, upon the advice of the MTF commander or his clinical staff, determine that such contract HCP is not an acceptable individual to perform services under this contract.

5. All contract HCP’s performing services under this contract shall comply with the health and immunization requirements as stated herein at the time of initial request for clinical privileges and annually thereafter. 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.

(End of Notice)

SMOKING POLICIES WITHIN MEDICAL TREATMENT FACILITIES (MTFs)

The Contractor shall ensure that all employees comply with the U.S. Army Medical Command and MTF smoking policies while performing services under this contract.

Smoking restrictions will apply at any location or building where health care activities are performed under this contract.

MOBILIZATION AND CONTINGENCY PLANNING

a. In the event of a general or limited mobilization of reserve forces or an emergency, which impacts upon contract performance, the contractor will be expected to promptly take whatever measures are needed to meet any new demands placed upon it. Such demands could require increases in Contractor-furnished property, as well as extended work hours and expansion of the contract work force.

b. To ensure that Government operations which depend upon the services provided hereunder can proceed with no or minimal disruption, the contractor shall during the life of this contract anticipate the possibility of a mobilization or similar emergency and the steps it will need to take to rapidly expand its contract capabilities to meet the emergency.

The following have been deleted:

ATTACHMENT #1

(End of Summary of Changes)