Revised_Attach 6_Performance Work Statement (PWS)_22-R-0002_18 Feb 2022.pdf

Attachment 6 W81K00-22-R-0002

Hospitalist and Nocturnist Physicians

Brooke Army Medical Center (BAMC), JBSA Fort Sam Houston, Texas

Performance Work Statement (PWS)

18 February 2022

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 Provider (HCP) only to the extent necessary for providing the health care services required under the contract. The performance of health care services by the individual HCP 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 HCP 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. DESCRIPTION OF WORK.

The contractor shall provide services to fulfill the equivalent of seven (7) FTE Hospitalist and two (2) Nocturnists (both are trained Internal Medicine Physicians) for duty at Brooke Army Medical Center (BAMC), JBSA Fort Sam Houston, Texas. Services shall be provided as required by this Performance Work Statement (PWS) and in accordance with the terms and conditions of this PWS and any resulting contract. The contractor shall be competent, qualified and adequately trained to perform assigned duties.

1.1.1.1 The contractor shall provide the personal services to fulfill the equivalent of seven (7) FTE Hospitalist and two (2) Nocturnists Physicians that will be performed in support of the Department of Medicine (DOM) in any hospital location to include the inpatient wards, emergency department or outpatient clinics, to enable the provision of medicine services in accordance with the terms and conditions of this contract.

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 MTF 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 physicians, nurse practitioners, 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 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 provider 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. Contractor shall perform services under the control and general supervision of the Chief of the Department of Medicine or his/her designated government representative.

1.1.1.5. Healthcare Provider Compensation: In no case shall the total amount of compensation paid to an individual in any year under a Personal Services Contract exceed the full time equivalent rate of $400,000.00 (to include bonuses and incentives) based on Title 10 U.S.C. Section 1091 or the FTER or $208.33 as established under DoD Instruction 6025.5.

1.1.2. PERFORMANCE MEASURES

1.1.2.1. Outcome. The contractor shall fulfill the requirement of a qualified Hospitalist and Nocturnist at a standard enabling the MTF to provide medicine services at a high level of quality.

1.1.2.2. Standards. Acceptable measures include: no more than two substantiated patient complaints in any twelve-month period; and no physician initiated cancellations of treatments except as medically required by patient or provider illness or emergency leave (and approved by government supervisor or designee). Other performance evaluation factors that will be monitored but that are not quantified by numerical measurements include: 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.

1.1.2.3. The Contracting Officer’s Representative (COR) will monitor the contractor’s performance with input from the Chief of the Department Medicine 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.

The contractor shall have the required experience and documented current competence in the clinical setting to perform the tasks and procedures identified in paragraph 5. The contractor shall meet all licensing/certification requirements to perform as a Hospitalist and Nocturnist in accordance with requirements of the contract. The contractor shall meet the following minimum qualifications.

1.2.1. License Requirements. Shall have and maintain a valid, unrestricted license to practice medicine from one of the 50 states, District of Columbia, Puerto Rico, Guam, or US Virgin Islands and shall be able to obtain clinical privileges to practice medicine with the applicable MTF credentials committee.

1.2.2. Certification Requirements. All certifications shall be maintained in a current status at all times while performing services under this contract at the contractor’s expense. The contractor:

1.2.2.1. Shall be a physician Doctor of Medicine or a Doctor of Osteopathy who is board certified in Internal Medicine by the American Board of Internal Medicine.

1.2.2.2. Shall have current Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) by way of an American Heart Association approved training program.

1.2.2.3. The physician must meet all the required credentials and stipulations of practice as described in the hospital Medical Staff Bylaws.

1.2.2.4. 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 DHA-PM 6025.13, Volume 4, 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.

1.2.3. Experience/Expertise. The contractor:

1.2.3.1. Must be a graduate of an Internal Medicine program accredited by the ACGME and have a minimum of two years of recent experience in inpatient consult medicine or inpatient ward attending, or at least 6 months of general internal medicine outpatient experience in the past 12 months, or a combination of inpatient and outpatient experience for at least 4 months in the last 12 months.

1.2.4. Communication Skills. The contractor:

1.2.4.1. Shall be able to read, write, and speak English well enough to effectively communicate with all patients and other health care providers.

1.2.4.2. Shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to a variety of patients from diverse backgrounds.

1.2.5. Training. The contractor:

1.2.5.1. Shall be required to meet Continuing Medical Education (CME) requirements of the American Medical Association or the American Osteopathic Association. The government will not reimburse for these costs.

1.2.5.2. Shall have the Occupational Safety and Health Administration (OSHA) required training for the position in which he or she will perform, and that training currency is maintained. Documentation of such training shall be provided to the Contracting Officer’s Representative (COR).

1.2.5.3. Shall maintain proficiency in all applicable hospital systems including IMPAX, CHCS, ESSENTRIS, AHLTA, speech recognition, windows operating systems and other common office applications and systems that may be added to the Hospitalist and Nocturnist role in order to function effectively and remain current.

1.2.6. Position requires access to Department of Defense computer systems, therefore contractor shall be a U.S. Citizen or otherwise meet the requirements of AR 25-2.

1.2.7. The contractor shall be able to perform all duties with minimal clinical supervisor or guidance. The contract HCP shall consult the Chief of the Department of Medicine, or designee, when issues cannot be resolved.

1.3. ADMINISTRATIVE

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

1.3.2. Reserved.

1.3.3. Reserved.

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

1.3.5. Reserved.

1.3.6. ORIENTATION AND TRAINING. When commencing work under this contract, the contractor shall obtain an in-processing checklist from the COR. All contract personnel are required complete the applicable in-processing items on the checklist, to include obtaining background checks in a sealed envelope from the Bexar county police and sheriff’s office and turning in the completed forms to the designated office. Upon completion of the duty assignment, the contractor must complete an out-processing checklist and return it to the designated office.

1.3.6.1.1. MTF Orientation. Contractor will be provided a government paid orientation to familiarize contractor with the policies and procedures of the MTF. Orientation attendance will be required of the contractor during normal day time hours and will be scheduled by the Contracting Officer’s Representative (COR), or the Department Chief or his/her government designee. Hospital orientation will be conducted during day time hours and will not be scheduled on the same day as an evening shift requirement.

1.3.6.1.2. Contractor shall complete Level I Operations Security Compliance (OPSEC) training within thirty (30) calendar days of reporting to duty.

1.3.6.1.3. Computer Training. Contractor who will have any interaction with the MTF 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:

1.3.6.1.4. Composite Health Care System (CHCS). The government will provide training to the contractor in the CHCS and/or other procedures that the medical activity's staff is required to use. Access to such patient data systems is an "Automated Data Processing Sensitive" position requiring compliance with AR 380-19 and AR 380-

67. Refer to supplement to the performance work statement “ADP Security Requirements” for further guidance.

1.3.6.1.5. Armed Forces Health Longitudinal Technology Application (AHLTA) which was formerly known as Composite Healthcare Computer System (CHCS). AHLTA contains the MTF’s appointment scheduling program, pharmacy, lab, and all other ordering systems and is interlinked with other departments in the MTF.

1.3.6.1.6. 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.

1.3.6.1.7. 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.

1.3.6.1.8. The contractor shall be knowledgeable of the policies and procedures of his or her specific place of duty and of the medical activity. The contractor shall receive staff training required by the MTF 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 contractor.

1.3.6.1.9. The government may elect to provide unique government training to contractor who is 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. When directed by the contracting officer, contractor 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 shall reimburse the government (by means of a reduction in an invoice) if a contractor fails to satisfy the performance commitment after the contractor 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 contractor 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.

1.3.6.1.10. In accordance with Operations Order 07-34 (Integration of Behavioral health in Primary Care), contractor shall complete Behavioral Health training, if required.

1.3.7. SECURITY.

1.3.7.1 Vehicle Registration. The MTFs are located on restricted access military installations. The Contractor shall comply with the local installation requirements for vehicle registration and operation on the military installation.

Any vehicle operated by the contractor in performance of this service must have the minimum liability coverage required by the state in which the installation is located. Contractor must register his or her vehicle with the office responsible for vehicle registration to gain access onto the military installation. A valid driver’s license, government-furnished civilian identification, proof of insurance and current registration must be presented to the at the Visitor Information Office located at the Main Gate, at which time a temporary vehicle pass will be issued. The COR will provide a Memo during in processing with the contract information that the contractor can take to the Visitor Information Office and a 3-month DoD decal will be issued. The decal shall be placed on the vehicle’s front windshield in accordance with instructions.

1.3.7.1.1. All vehicles, with or without a DoD decal, are subject to search. Contractor 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. Contractor should plan accordingly and report to work at their scheduled duty time, at their appointed place of duty within the MTF.

1.3.7.1.2. Contractor shall follow installation procedures for removal and turn-in of the vehicle decal upon completion of services.

1.3.7.2. Contractor shall comply with installation and MTF personnel identification and access requirements. The contractor is responsible for absences due to expired identification and access documents such as Common Access Card (CAC).

1.3.7.3. Reserved.

1.3.7.4. 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. The contractor shall not disclose or cause to be disseminated any information concerning the operation of the MTF 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.

1.3.8. Safety. Contractor 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.

1.3.9. Contracting Officer 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.

1.3.10. Reserved.

1.3.11. Security Identification Badges. The contractor and contractor healthcare provider (HCP) shall comply with the local installation and MTF personnel identification and access requirements.

1.3.11.1. Contractor/HCP 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 any absence due to expired identification and access documents.

1.3.11.2. The contractor shall immediately report any lost or stolen badges to the COR.

1.3.11.3. The contractor shall turn in the MTF badge and Common Access Card (CAC) to the Security and Badge Office, COR, or his/her designated representative upon termination of his or her services under this contract.

1.3.12. 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 MTF Facility Safety Orientation material are accomplished prior to performance.

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

All information given by the contractor 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 the Joint Commission (JC), Occupational Safety and Health Association (OSHA) and Center for Disease Control (CDC).

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

1.4. HOURS OF PERFORMANCE.

1.4.1. The place and hours of performance shall be determined by the Internist supervisor per guidance from the Chief, Department of Medicine. The Hospitalist duty hours are primarily daytime and early evening hours, typically from 0600-1800, but the contractors may be required to work other shifts depending on patient demand and the needs of the government. Shifts will be determined based on academic schedule, workload and teaching/attending duties and may include shifts of up to 16 hours per day; work periods of up to four weeks; and inpatient ward attending coverage of up to 10 academic blocks (each block is 4 weeks in duration), weekends, and federal holidays. The Nocturnist duty hours are primarily evening and overnight hours, typically from 1800-0600, but the contractors may be required to work other shifts depending on patient demand and the needs of the government. Shifts will be determined based on academic schedule, workload and teaching/attending duties and may include shifts of up to 16 hours per day; work periods of up to four weeks; and inpatient ward attending coverage of up to 10 academic blocks (each block is 4 weeks in duration), weekends, and federal holidays. The contractor shall be available to provide services Sunday through Saturday. (seven days per week) to include week days, federal holidays, training holidays, and weekends IAW schedule provided by the Internist supervisor per guidance from the Chief, Department of Medicine. At no time should the contract physician exceed the maximum billable work hours during the year. The contract physician must be available for telephonic or in-person bedside consultation for inpatient care when on shift.

1.4.2. The contractor shall perform services on a schedule established by the Department of Medicine, Internal Medicine Service Chief or his/her designated representative. Services will be provided at the place determined by the Internist supervisor per guidance from the Chief, Department of Medicine or his designated representative. Hours scheduled for shifts do not include travel time involved in reaching the MTF.

1.4.3. Call Back Service. Call-back service is defined as actual patient care performed in the hospital when the contractor is called back to provide care at the MTF. The contractor shall be available by telephone within 10 minutes of the page being sent and shall be prepared to provide telephone consultation and or return to the MTF to provide on-site assistance (call back service) within 30 minutes of notification by telephone or Government Furnished Pager. The contractor shall provide a telephone number that is available 24 hours a day.

1.4.3.1. On-call Schedule. On-Call services are aligned with daily schedules and will be performed in accordance with a schedule determined by the Chief, Internal Medicine Services and will be staffed on a rotating basis with government military/civilian/contract Internal Medicine or Internal Medicine Sub-Specialty physicians. When on schedule, the contractor shall be in attendance of, actively participate in, and provide technical guidance of all general invasive procedures performed during their scheduled duty hours (days, evening, nights, and weekends). The contractor shall actively participate in and may be called to be in attendance of urgent/emergent or high volume inpatient internal medicine care provided.

1.4.3.2. DELETED

1.4.4. Absences.

1.4.4.1. Scheduled Absences. The contract physician is expected to give a minimum of 90 days’ notice of anticipated scheduled absence. The request will be considered and approved within the confines of maintaining adequate service, which may be affected by prior leave requests by other staff. Absences shall be scheduled at least ninety (90) days in advance and mutually agreed upon by the Department Chief, contractor, and COR.

1.4.4.2. Unscheduled Absences. As defined in section 2.1 shall be called into the COR or designated Government representative by the contractor 4 hours prior to start of scheduled shift that he/she are unable to report to work. The vendor is responsible for providing coverage of unanticipated absences within 2 hours of start of shift.

1.4.5. Emergency Essential Position. Hospitalist and/or Nocturnists are considered emergency essential positions when scheduled for any inpatient shift.

1.4.6. Closures: During anticipated closure of the facility due to command declared training holidays or unplanned closure of the facility due to natural disasters, military emergencies, severe weather, or otherwise, the contractors will only be paid for the actual hours worked. Contractor will not report to work or be paid for closure periods unless specifically required to perform services during facility closures.

1.4.7. The contractor shall be rested and fully physically and mentally capable of performing the duties required under this contract. The contractor shall not have worked the 8 hours prior to beginning services at BAMC. unless the contractor was on-call.

1.4.8. The Government reserves the right to verify the hours worked by the contractor by implementing sign-in/sign-out procedures or by any other means including the use of a time clock. The Government will pay only for hours actually worked in BAMC or in a scheduled call status. Attendance logs are for the sole source 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.

1.5. CONDUCT.

1.5.1. The chief of the department where services are being performed, or his/her representative, will define the scope of practice. Contractor shall not introduce new procedures or services without prior approval of the Department Chief or representative. In disagreements or deviations from established or new protocols, the Department Chief, or representative, will be the deciding authority.

1.5.2. Contractor shall comply with MTF policies regarding personal appearance and conduct.

1.5.3. 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. They 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 regulations referenced are available for review from the COR or MTF. All medical records and reports will remain the property of the government.

1.5.4. Contractor shall abide by MTF bylaws, JC, DoD and Medical Department regulations with regard to Utilization Review and Quality Assurance directives, including, but not limited to, in-service training, maintenance of records, performance evaluation, and release of medical information. Contractor shall make use of all appropriate equipment; supplies and services made available by the government and shall make referrals and seek consultations, as deemed necessary, for the optimal care of the patients.

1.5.5. Inquiries. Contractor shall not respond to any media inquiries. Any inquiries from the media shall be immediately relayed to the COR, who will relay them to the MTF Commander. There shall be no interviews, comments, or any other response without the knowledge and approval of the MTF Commander. Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the contractor.

1.6. CONFLICT OF INTEREST.

1.6.1. The Contractor shall not bill the patient for services rendered under this contract. The Contractor shall be prohibited from receiving compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract, at the rate specified.

1.6.2. The Contractor shall not, while performing services under this contract, advise, recommend, or suggest to persons eligible to receive medical care at Government expense that such persons should receive care from the Contractor at any place other than as designated under this contract.

1.6.3. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. The Contractor shall not release any of the above information without prior written consent of the Contracting Officer. The Contractor shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication.

1.6.4. Contractor is not prohibited by reason of their employment under this contract from conducting private practice provided there is no conflict with the performance of services under this contract. The Contracting Officer will unilaterally resolve any issues concerning potential conflicts.

1.6.5. The Contractor shall not use Government facilities or other Government property in connection with conducting a private practice.

1.7. LICENSE AND CREDENTIALS REVIEW OR PRIVILEGING

1.7.1. The MTF Commander must grant privileges to the Contractor for which credentialing is required prior to providing any services. The privileging process shall be in accordance with all requirements in DHA-PM 6025.13, Volume 4, 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 DHA-PM 6025.13, Volume 4. Any failure to meet these requirements is considered nonperformance and the basis for termination for cause.

1.7.2. The Contractor shall request from the COR documentation requirements for privileging. 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. The Contractor shall perform all primary source verifications and include all verifications with the credentials.

1.7.3. Reserved

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

1.7.5. Reserved

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.

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

1.7.8. Contractor shall verify, maintain and submit documentation of curriculum vitae. 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 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. Letters should address 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.

1.7.9. Unless otherwise required, the Contractor shall submit completed credentials packet 45 calendar days prior to projected start date. 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.

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.

1.7.11. Contractor shall, on a continuous basis, constitute evidence that the Contractor has 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 of any information which may compromise the Contractor’s credentials at the MTF. This shall include, but is not limited to, information linking a Contractor 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 the Contractor be granted privileges. The Commander of the MTF is the final authority for approving/denying clinical privileges to any and all Contractors.

1.7.12. Reserved

1.7.13. Contractor shall attend newcomers training at the start of their employment at the MTF and quarterly training thereafter. Contractor 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).

1.8. PROFILE APPLICATION PACKETS.

1.8.1. The Contractor shall submit Profile Application Packet to the COR for review prior to beginning performance.

Application packet shall include the following: education history, certifications (BCLS), certifications with expiration and license number, employment history/resume, health exam date, type of specialty, and immunization history.

Contractor shall monitor profile packets and provide updated information with appropriate credentials on a continuous basis. The COR will approve or disapprove the application packet(s) within five (5) business days. A personal interview will not be conducted by the MTF.

1.9. COMMENCEMENT OF SERVICES/CONTINUITY OF SERVICES. The Contractor shall provide full-time health care provider (HCP) services for the duration of this contract.

1.9.1. COMMENCEMENT OF REQUIRED SERVICES FOR PRIVILEGED PROVIDERS. To ensure required commencement of services, the Contractor shall submit complete credentials packets (based on site requirements) within 15 calendar days of award.

2. DEFINITIONS/ACRONYMS.

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

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

2.1.2. 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.

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

2.1.4. 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.

2.1.5. 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.

2.1.6. 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.

2.1.7. CONTRACTING OFFICER: A person with the authority to enter into, administer, and/or terminate contracts/task orders and make related determinations and findings.

2.1.8. 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.

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

2.1.10. 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

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

2.1.12. 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 H C P s shall serve the U.S. Forces exclusively in order to be granted Troop Care or Technical Expert status.

2.1.13. ORDERING CONTRACTING OFFICER. A Contracting Officer designated to place task orders against an existing contract.

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

2.1.15. PRIVILEGING PROCESS: Process established by the MTF and DHA-PM 6025.13, Volume 4 for granting clinical privileges to HCPs.

2.1.16. 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.

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

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

2.1.19. 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.

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

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

2.1.21. TRICARE: A regionalized, tri-service, Contractor-supported, DoD-managed healthcare system.

2.1.22. 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.

2.2. Acronyms:

2.1.1 ABEM – American Board of Emergency Medicine

2.1.2 AC - Active Component

2.1.3 ACGME – Accreditation Council for Graduate Medical Education

2.1.4 ACLS – Advance Cardiac Life Support

2.1.5 ACO - Administrative Contracting Officer

2.1.6 ACOR -Alternate Contracting Officer’s Representative

2.1.7 ADP - Automated Data Processing

2.1.8 ADS – Ambulatory Data System

2.1.9 AHLTA – Armed Forces Health Longitudinal Technology Application

2.1.10 AR – Army Regulation

2.1.11 ACLS – Advance Cardiac Life Support

2.1.12 BAMC-Brooke Army Medical Center

2.1.13 BCLS – Basic Cardiac Life Support

2.1.14 BLS - Basic Life Support

2.1.15 CCQAS - Centralized Credentials Quality Assurance System

2.1.16 CFR - Code of Federal Regulations

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

2.1.18 CHCS - Composite Health Care System

2.1.19 CLIN – Contract Line Item Number

2.1.20 CME - Continuing Medical Education

2.1.21 CONUS - Continental United States

2.1.22 COR – Contracting Officer’s Representative

2.1.23 CPR – Cardiopulmonary Resuscitation

2.1.24 CQI - Continuous Quality Improvement

2.1.25 CQM - Clinical Quality Management

2.1.26 CQMP - Clinical Quality Management Program

2.1.27 DA – Department of the Army

2.1.28 DCCS - Deputy Commander for Clinical Services.

2.1.29 DEA - Drug Enforcement Administration.

2.1.30 DEM – Department of Emergency Medicine

2.1.31 DOD - Department of Defense.

2.1.32 DODI - Department of Defense Instruction

2.1.33 ECFMG - Educational Commission for Foreign Medical Graduates

2.1.34 EFT - Electronic Funds Transfer

2.1.35 EKG - Electrocardiogram.

2.1.36 EMG - Electromyography

2.1.37 FAR - Federal Acquisition Regulation

2.1.38 FBI - Federal Bureau of Investigation

2.1.39 FL - Form Letter

2.1.40 FTE - Full Time Equivalent.

2.1.41 HCP – Health Care Provider

2.1.42 HIPAA - Health Insurance Portability & Accountability Act of 1996

2.1.43 HSC – Health Services Command

2.1.44 ICTB-Inter-Facility Credentials Transfer Brief

2.1.45 IMR-Individual Medical Record

2.1.46 IRC - Installation Record Check

2.1.47 IV - Intravenous.

2.1.48 TJC – The Joint Commission.

2.1.49 KO - Contracting Officer.

2.1.50 MEDCEN – Medical Center

2.1.51 MEDCOM - Medical Command

2.1.52 MEDDAC - Medical Department Activity

2.1.53 MTF - Medical Treatment Facility

2.1.54 LOSS - Line of Sight Supervision

2.1.55 NACI - National Agency Check with Inquiries

2.1.56 NCOIC - Noncommissioned Officer in Charge

2.1.57 NP - Nurse Practitioner

2.1.58 NPDB - National Practitioner Data Bank

2.1.59 OCONUS - Outside the Continental United States

2.1.60 OIC - Officer in Charge

2.1.61 OSHA - Occupational Safety and Health Administration

2.1.62 PA - Physician Assistant

2.1.63 PAD - Patient Administration Division

2.1.64 PALS – Pediatric Advance Life Support

2.1.65 Pam - Pamphlet

2.1.66 PCF – Practitioner’s credentials file

2.1.67 PCO - Procurement Contracting Officer/Procuring Contracting Officer

2.1.68 PENS – Percutaneous Electrical Nerve Stimulation

2.1.69 PL - Public Law

2.1.70 PPIMS - Past Performance Information Management System

2.1.71 PSV - Primary source verification

2.1.72 PTE – Part Time Equivalent

2.1.73 PWS - Performance Work Statement

2.1.74 QA - Quality Assurance

2.1.75 QA&I - Quality Assurance & Improvement

2.1.76 QC – Quality Control

2.1.77 QI - Quality Improvement

2.1.78 RFQ - Request for Quote

2.1.79 SF - Standard Form

2.1.80 SRP - Soldier Readiness Processing

2.1.81 TAB - Therapeutic Agents Board

2.1.82 TJC-The Joint Commission

2.1.83 USPS - United States Postal Service

3. GOVERNMENT FURNISHED PROPERTY.

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). Contractor shall keep government furnished supplies, equipment, and work areas in a safe, orderly and clean condition. Contractor shall notify the Government whenever maintenance of equipment is required. Personal long distance calls are not authorized.

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

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

3.4. Any space used by the Contractor 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.

3.5. Personal Protective Equipment (PPE). Contractor 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.

4. CONTRACTOR FURNISHED SUPPLIES/SERVICES:

4.1. Uniforms. The Contractor shall furnish appropriate uniforms/smocks. Contractor shall wear appropriate civilian attire to and from the MTF. The appearance of the Contractor will be governed by the current MTF dress and appearance policy.

4.2. Nametags. The contractor shall furnish 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 Hospitalist/Nocturnist (XYZ Company)

4.3. Rubber Stamp: The contractor shall provide a self-inking rubber stamp (if required) for authenticating medical charts and prescriptions. At a minimum, the stamp shall identify him/her by name, degree, as a contractor HCP and specialty as per the example given in paragraph 4.2.

5. SPECIFIC TASKS.

The physician shall be able to perform the following, but not be limited to, the following tasks/duties:

5.1 Serves primarily as a Hospitalist and/or Nocturnist for inpatient general medicine wards during day time / evening hours. Also serves as attending physician on consultation service and provide care in internal medicine clinic as directed by the Chief, Department of Medicine. Cares for inpatients that have both acute and/or chronic illnesses, provides consultation to and acts as an interface with other physicians throughout BAMC. Majority of work will involve inpatient Internal Medicine admissions serving as staff of record while assisting, teaching, supervising and evaluating house staff and medical students. Daily work involves management of complicated medical problems such as infection, hypertension, peptic ulcer disease, thyroid disorders, diabetes, arthritic conditions, etc. Examine patients, take histories, perform physical examinations, order laboratory tests, make definitive diagnoses and prescribe treatment to meet needs of patients, and refer as appropriate to specialty/subspecialty care.

5.2. Manage full spectrum of care for all patients. Ensure return reply from consultant on patient referral consultations. Admit patients to the hospital when appropriate. Monitor and manage care for patients as they move through the system to ensure cost-effective care. Notify patients of abnormal reports.

5.3. Prepare and document appropriate history, physical examinations, and preoperative diagnosis. Maintain documentation of all treatment provided IAW hospital directive and prepare such records and reports as may be required. The physician shall use the inpatient and outpatient electronic health records systems to document patient treatment and submit orders.