W81K00-22-R-0005 ADMENMENT 00001POSTED 30 MARCH.pdf

W81K0022R0005

W40M USA HLTH CONTRACTING ACT

REGIONAL HEALTH CONTRACT OFF CENTRAL

POC: YAKITA MCCLURKIN

3551 ROGER BROOK DR BLDG 3600

FORT SAM HOUSTON TX 78234-6200

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

The purpose of this admendment is to correct CLIN 0001AA to reflect 46,080 and PWS section 4.1 to reflect CMT.

1. CONTRACT ID CODE PAGE OF PAGES

1 31

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

16C. DATE SIGNED

BY 30-Mar-2022

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 W81K0022R0005

X 9B. DATED (SEE ITEM 11)

10-Mar-2022

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

30-Mar-2022

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 W81K00

FACILITY CODECODE

EMAIL:TEL:

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

SUBCLIN 0001AA

The pricing detail quantity has increased by 42,012.00 from 4,068.00 to 46,080.00.

DELIVERIES AND PERFORMANCE

The following Delivery Schedule item for SUBCLIN 0001AA has been changed from:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

POP 01-OCT-2022 TO

30-SEP-2023

N/A BROOKE ARMY MEDICAL CENTER

BROOKE ARMY MEDICAL CENTER

3551 ROGER BROOKE DRIVE

SAN ANTONIO TX 78234

FOB: Destination

W81NTE

To:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

POP 01-OCT-2022 TO

30-SEP-2023

N/A BROOKE ARMY MEDICAL CENTER

BROOKE ARMY MEDICAL CENTER

3551 ROGER BROOKE DRIVE

SAN ANTONIO TX 78234

FOB: Destination

W81NTE

The following have been modified:

PERFORMANCE WORK STATEMENT

Performance Work Statement (PWS) Personal Cardiac Monitor Technicians (CMT) Services for the San Antonio Military Health Systems (SAMHS)

1. GENERAL.

1.1. Personal Services. This is a personal services contract and is intended to create an employer-employee relationship between the Government and the individual Cardiac Monitor Technicians (CMT) to the extent necessary for providing the health care services required under the contract. The performance of health care services by the individual contract service provider 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

CMTs engaged in comparable health care services. Any personal injury claims alleging negligence by the individual CMT within the scope of the CMT’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 CMTs. 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 CMT may be associated. The authority for this contract is Title 10 United States Code 1089 and Title 10 United States Code 1091.

1.1.1. The contractor CMTs shall cooperate with the government, without further compensation, in the processing, review, settlement, or defense of the suit, action, or claim; and authorize government representatives to settle or defend the claim and to represent the CMT in, or take charge of, any litigation involved in such an action. The contract CMT may, at the contract CMT’s own expense, participate in defense of such claim or litigation.

1.1.2. All persons performing work under the contract shall be and shall remain employees of the contractor and not employees of the government.

1.1.3. Professional Liability. Pursuant to 10 USC 1089(a), DoD shall process any personal injury claim alleging negligence by the CMT within the scope of the CMT’s performance under this contract as claims alleging negligence by DoD military or civil service CMT. If any suit or action is filed or any claim is made against the CMT, which occurred as a result of work performed by the CMT under this contract, the CMT shall immediately notify the contractor who will in turn notify the contracting officer’s representative (COR) and the contracting officer (KO) and promptly furnish them copies of all pertinent documents received. The contractor or CMT is not required to maintain medical malpractice liability insurance, and the Government will not reimburse or otherwise pay for such insurance should any be purchased.

1.2. Background. The mission of the military healthcare system (MHS) is to enhance our Nation’s security by ensuring the nation has a healthy military force capable of providing the full range of military operations supported by a combat ready healthcare system sustaining the health of DoD beneficiaries. Health care services for eligible MHS beneficiaries are provided at military treatment facilities (MTFs) located on or near military installations or posts. Hospitals offer more complex, resource-intensive secondary care (e.g. inpatient care, surgery under anesthesia) and primary care at outpatient clinics inside and outside the hospital. Medical Centers offer tertiary (sophisticated diagnosis/treatment of any ailment), secondary, and primary care, hospital services, preventive services, blood bank, and outpatient services. In addition, Medical Centers offer graduate medical education programs for physicians and other training programs for nursing and ancillary personnel.

1.2.1. Currently, the SAMHS is supported by direct care Military Treatment Facilities (MTFs) located at Fort Sam Houston, Port San Antonio and Camp Bullis, Texas.

1.3. Scope of Work. The Contractor shall provide patient cardiac monitoring support services at Brooke Army Medical Center (BAMC).

1.3.1. BAMC is a level one trauma center and currently provide trauma support for 50% of San Antonio’s trauma care. BAMC has the Institute of Surgical Research, the Burn Center, and the Center for the Intrepid to support America’s Wounded Warriors; as well as provides the maternal child services and neonatal intensive care unit.

BAMC provides the full spectrum of services associated with level one trauma centers and robust Graduate Medical Education Programs. In addition, both sites provide training sites for multiple medical training programs for enlisted and officer medical specialties.

1.3.2. Contractor CMTs shall provide monitoring services to any area of BAMC a patient is ordered to receive centralized cardiac monitoring; to include, but, not limited to: Critical Care, Medical/Surgical, Peri-Operative, Burn Unit, Mother/Baby Units, Psychiatric Units, and In Patient areas of the MTF.

1.3.3. All services shall be provided in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations, The Joint Commission standards and Accreditation Association for Ambulatory Health Care (AAAHC), applicable Department of Defense (DoD), Army specific regulations, directives, and policies, and MTF specific policies, procedures, and job descriptions. The CMT shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for Patients.

1.3.4. The Contractor CMTs 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 CMTs shall perform essentially the same functions, within the scope of acceptable practice for the specific specialty or position, as those required by the MTFs or government service health care professionals of similar experience and in similar duty assignments.

1.4. The contractor shall ensure that all CMTs providing services under this contract shall be United States Citizens;

able to read, write, and speak English well enough to effectively communicate with all parties and other health care providers. The CMTs shall be computer literate to ensure patient information is documented in MTF computerized systems.

1.5. The CMTs 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.

1.6. The contractor CMTs shall be capable of constant standing, walking, lifting and bending. In addition, the CMTs may be exposed to highly contagious/infections disease, radiation from portable x-ray, and continuous fluoroscopy equipment.

1.7. The CMTs shall have the required education, training, experience and documented current competence in the required specialty position description. All CMTs must have a minimum of one (1) year experience as an EKG/Cardiac Monitor Technician prior to employment by the Contractor.

1.8. Life Support Training. All CMTs must possess and maintain current course completion documentation for basic life support (BLS) through an American Heart Association and/or Red Cross approved training program.

1.9. All CMTs shall maintain all certification requirements and meet all continuing education requirements of the U.S. jurisdiction in which they are licensed to practice.

1.10. The contractor shall ensure that the CMT abides by all MTF standards, rules, and procedures including requirements for any licensure, credentialing and quality assurance requirements. Such regulations include, but are not limited to, general safety, fire prevention, waste disposal, infection control, the Joint Commission and AAAHC, and patient safety initiatives.

1.11. Certification Verification and Credentials Review.

1.11.1. The contractor shall follow DHA-PM 6025.13, Volume 4, for all health care services provided in the MTFs.

DHA-PM 6025.13, Volume 4, Complete credentials or profile packages shall be submitted at least 10 days prior to in-processing.

1.11.2. The contractor shall perform all primary source verifications and include all verifications with the credentials package or competency assessment folder information for non-privileged staff in accordance with guidance. The contractor shall obtain all paperwork, letters of reference, approvals, work history, etc. required by the MTF credentialing or licensure verification processes. The MTF staff will not assist the contractor in obtaining any needed information for initial credentialing. The contractor is responsible for the current competence of CMTs used to provide health care services under this contract.

1.11.3. Certification documentation. All CMTs under a personal services contract must maintain a current active EKG/Cardiac Monitor Technician Certificate.

1.11.4. When the contractor experiences delays in recruiting or submitting credentials or profile packages, the contractor shall notify the KO and COR immediately. The KO will evaluate the situation to determine if an extension of the dates is appropriate. If an extension is not approved, the Government may terminate the contract for default or seek other remedies as appropriate.

1.12. Health and Immunization Requirements. All CMTs, to include part-time (PRN) CMTs, performing services under this contract shall comply with the health and immunization requirements identified below at the time of initial request for credentials review and annually thereafter. Documentation shall be submitted by the Contractor with the credentialing or profile packages of their CMTs. The expense for all physical examinations and immunizations to comply with the health requirements shall be borne by the contractor at no additional cost to the government.

1.12.1. All CMTs performing services under this contract shall be immunized against seasonal influenza infection annually unless there is a documented medical or religious reason not to be immunized. The contractor shall submit proof of immunization or documented medical or religious reason not to be immunized, at the time of initial request for credentials review and annually thereafter.

1.12.1. All contractor CMTs services under this contract shall receive a general physical examination prior to commencement of services. The contractor shall provide the COR, 10 calendar days before beginning services under this contract, a physical examination certificate for each contract CMT 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. This certification shall be signed by the physician performing the examination. 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:

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

1.12.1.2. A test for the hepatitis (Type B) virus with documentation of the results. A profile shall be established to show immune status to hepatitis. Non-immune Health Care 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).

1.12.1.3. The physical examination shall also document serologic evidence of immunity to measles and rubella or to provide documentation of immunization with Measles, Mumps and Rubella (MMR) vaccine using the following guidelines:

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

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

1.12.1.3.3. 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.

1.12.1.4. Contractor's CMT shall be screened for tuberculosis.

Two-Step Tuberculin Skin Testing is required for new employees able to take the skin test. If the employee’s first TB Skin Test (PPD) is negative, a second TB Skin Test will be placed from one to three weeks later, read and documented. If the first TB Skin Test is positive the employee will be referred to Army Public Health Nursing, for military or the Occupational Health Nurse for further evaluation and possible treatment for Latent Tuberculosis Infection (LTBI).

1.12.1.5. Documentation of immunity for Varicella, i.e., vaccination date or serum titer.

1.12.1.6. 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.

1.12.1.4.2. All contractor CMTs performing direct health care services under this contract, who experience a parenteral (e.g., needle-stick or cut) or mucous membrane (e.g., splash to the eye or mouth) exposure to blood or bloody body fluids, shall receive prompt treatment. The MTF will evaluate the source of exposure for risk of communicable diseases and will provide a report of the findings to the contractor and the CMT. The contractor shall provide treatment and therapies in accordance with the U.S. Centers for Disease Control and Prevention (CDC).

1.13. Criminal Background Check Requirement. (MANDATORY if at any time the provider will have the opportunity to be alone with children under the age of 18.) The Government will conduct criminal background checks and complete SF85P Questionnaire for National Security Positions for CMT's providing child care services under this contract. The Government will use the procedures set forth in the most current version of Public Law 100- 235, DoD Directive 5200.28 Enclosure 6 paragraph E6.4.1.2, DoD Directive 52002-R, DODI 1402.5. Upon favorable completion of the NAC, the CMT may be selected to provide services to a minor child under Line-Of- Sight Supervision until the required background checks are completed. If the CMT has previously received a background check, proof of the check shall be provided or a new one obtained. (A new investigation is required if a break in service to the Department of Defense results in a time lapse of more than two (2) years). Line-Of-Sight Supervision is defined at Enclosure 5 of DODI1402.5. The CMT may be employed under the contract pending completion of the background checks provided the activity uses line-of-sight supervision while minor children are in the care of that CMT. The CMT shall be within line-of-sight supervision of a staff person whose background check has been successfully completed or is in the presence of the child's parent or guardian. The contractor shall ensure that as a condition of employment. The individuals providing services under this contract meet the requirements of the Crime Control Act of 1990, as amended, by successfully completing a Criminal History Background Check consisting of a Federal Bureau of Investigation (FBI) fingerprint check and State Criminal History Repository check. The procedures for completing the required background check are outlined in the Department of Defense Instruction (DODI) 1402.5, dated January 19, 1993; Subject: Criminal History Background Checks on Individuals in Child Care Services; Enclosure 6, paragraph D, Government Contract Employees. (DODI 1402.5 is available on the Internet at: http://web7.whs.osd.mil/dodiss/instructions/ins2.html)

1.13.1. If the contract CMT has a DoD affiliation such as living or working on an installation (within 5 years) or is a family member of active duty military, an Installation Record Check (IRC) shall be conducted by DoD Component personnel at the installation level. No IRC is required on individuals without DoD affiliation. Upon favorable completion of the IRC, an individual may be selected to provide services to a minor child under line-of-sight supervision until the required background checks are completed.

1.13.2. Personnel may be employed under the contract pending completion of the background checks provided the activity uses Line-Of-Sight Supervision (LOSS) while minor children are in the care of that individual. The contract provider shall be within line-of-sight supervision of either military health care personnel, or an individual who has received an approved background check, or is in the presence of the child's parent or guardian.

1.13.3. All background clearance requests (SF85P) shall be submitted by the contractor prior to placement of the employee at the work site. The name and address of the COR shall be included in each request as the recipient of the results. Unfavorable results that indicate risk to safe and/or effective delivery of services will constitute grounds for dismissal of the employee. Decisions regarding dismissal of an employee for unfavorable results of a background check are the sole responsibility of the KO.

1.13.4. The individual contract provider has the right to obtain a copy of the background check report from the COR and, if desired, to challenge the accuracy and completeness of the information in the report.

1.13.5. Contractor personnel who have previously received a background check shall provide proof of the check or obtain a new one. A new investigation is required if a break in service to the Department of Defense results in a time-lapse of more than 3 years.

1.14. Profile Application Packets. Full performance is critical and shall begin no later than 45 days after receiving a task order. Therefore, no later than 10 business days prior to the start of work, the contractor shall submit profile packets on each employee who shall be performing services under this contract to the appropriate COR. The contractor shall coordinate with the COR on the method of transmission (i.e. electronic, hard copy) of the profile application packets. In the event the COR elects to receive only electronic copies of the profile packet, the contractor shall maintain all original documents. Depending on the individual position, the profile packages may be reviewed by department chiefs, supervisors, flight commanders, or clinical nurse officers in charge, as determined by the organizational structure of the department to which the CMT would be assigned. The COR will notify the contractor within five business days if the proposed contract service provider has been approved or disapproved.

1.14.1. The profile application packets shall provide the following information:

1.14.1.1. Completed Centralized Credentials Quality Assurance System (CCQAS) data entry form;

1.14.1.2. Primary source verification of state licenses with expiration date, license number, name and contact information for individual performing primary source verification attesting to direct state verification and the method of verification;

1.14.1.3. Education history with primary source verification of college attended/degree, (RNS must be a graduate of an Associate Diploma or Baccalaureate degree from an accredited school of nursing and provide a copy of the transcripts);

1.14.1.4. Certifications: BLS and EKG/CMT

1.14.1.5. Contractor conducted Criminal History Background Check;

1.14.1.6. Employment history and resume;

1.14.1.7. Immunization status and health examination date; and

1.14.1.8. Skills assessment checklists, competency assessments, medication examinations, telemetry examinations, or any other skills verification necessary for specialty and location (specifics will be outlined in the task orders).

1.15. U.S. Citizenship (copy of birth certificate or naturalization papers required). CMTs performing under this contract must be U.S. citizens. In addition, if a contractor personnel fails to meet the citizenship requirements stated herein the contractor shall not hold the government liable for not allowing performance under this contract."

1.16. MTF Hours of Operation

1.16.1. Hospitals and medical centers provide services 24 hours a day, 365 days a year (366 days during leap years) including holidays. Clinics have designated operating hours and their normal hours of operation will be outlined in the task orders.

1.16.2. Recognized Holidays. The following is a list of legal federal holidays. Any of the federal holidays falling on a Saturday will be observed on the preceding Friday, holidays falling on a Sunday will be observed on the following Monday. Contract employees may be required to work on legal holidays as determined by the department chief and stated on the contract.

New Year’s Day, January 1st Martin Luther King’s Birthday, 3rd Monday in January President’s Day, 3rd Monday in February Memorial Day, Last Monday in May Juneteenth National Independence Day, June 19th Independence Day, July 4th

Labor Day, 1st Monday in September Columbus Day, 2nd Monday in October Veteran’s Day, November 11th Thanksgiving Day, 4th Thursday in November Christmas Day, December 25th

1.16.3. 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 contractor will only be paid for the actual hours that were worked.

1.16.4. In accordance with DoDI 3020.37, and Office of the Surgeon General Memorandum, Application of DoDI 3020.37, Continuation of Essential DoD Contractor Services During Crises to MEDCOM Contracts, dated 18 Nov 2009, the contractor provided services that have been determined to be essential contractor services in support of the mission essential functions are: emergency room staffing, operating room staffing, and in-patient and support staffing. Continued performance will be directed by the Contracting Officer.

1.17. Hours of Performance

1.17.1. Reserved

1.17.2. The contractor shall provide CMTs to support a 7 day/week, 24 hour/day operation to include holidays. Shift times can consist of eight work hours with a non-paid 30 minute lunch or dinner break, or a 12 hour shift with a 30 minute non-paid lunch or dinner break. The maximum number of shift hours to be scheduled in a 24 hour period is 12 hours.

1.17.3. CMTs will be assigned to a centralized telemetry monitor room within BAMC. This monitoring room will have all the appropriate monitoring equipment and work stations set up and ready for patient monitoring. CMTs will be scheduled to work up to 40 hours per 7-day work week on rotating shifts BAMC work week is Sunday through Saturday, including Federal holidays. CMTs will not be scheduled for more than 40 hours in a one work week period.

1.17.4. PRN CMTs are assigned to supplement or backfill full time CMTs. CMTs may be provided the opportunity to work up to 40 hours in a one week period, but will not be guaranteed a specific number of hours.

PRN CMTs must work a minimum of two shifts per month to ensure system access and unit competency.

1.17.5. Scheduling. The MTF telemetry monitor room leader, or POC designated by BAMC leadership, will schedule all CMTs no later than two weeks in advance to start of shift and will provide the schedule to the contractor, through the COR. Any additional CMTs (PRN) that are needed beyond the original schedule must be requested through the COR to the contractor. In emergency cases of patient census increase, contractor may be required to provide additional pool CMT support staff. If the COR (as authorized by the KO) determines additional pool CMT staff is required, a notice will be provided to the contractor and the contractor shall provide additional pool CMT for the requested shift within eight hours of being notified. The contractor shall maintain additional Pool CMT staff that can be ready to backfill within eight hours of being notified in cases of patient census increase.

1.17.5.1. Scheduling Issues. The COR will communicate all scheduling issues to the Contractor’s Program Manager and centralized monitor room leader for resolution.

1.17.6. Absences and Leave. The contractor shall have sufficient qualified personnel available so that all services are provided in the event an CMT scheduled to work becomes ill, resigns, is terminated, or is otherwise unavailable to perform. All proposed substitutes/replacements (no matter when they are proposed during the performance period) shall have qualifications equal to or higher than the qualifications of the person being substituted or replaced. All proposed substitutes/replacements shall meet the identical application submission procedures specified in paragraph 1.14. prior to performing services.

1.17.6.1. Scheduled absences of contract CMTs shall be coordinated with the COR at least 30 calendar days in advance. The contractor shall notify the COR or after hours designee at least two hours prior to start of a scheduled shift when an CMT will be absent and a replacement will be provided. The contractor shall provide a qualified replacement for any CMT who is absent from duty, whether scheduled or unscheduled, within 12 hours of notification.

1.18. The use of non-compete conditions in employment agreements or in subcontracts (to prevent loss of personnel by the contractor), effective only during the period of the contract performance, is acceptable. However, the use of non-compete conditions in employment agreements and/or in subcontracts that prevent employees and/or subcontractors of the incumbent from being interviewed by, employed, or accepting offers of employment and/or subcontracts by the new contractor on the follow-on contracts is unacceptable. It hinders the government's ability to accomplish the mission of providing medical care to beneficiaries. Inclusion of such conditions in an employer's employment agreement and/or subcontracts will result in an offeror's proposal being unacceptable. Awardee, and their subcontractors, may not include such conditions in employment agreements and/or subcontracts while performing under this contract.

1.19. Conflict of Interest. The contractor or CMTs shall not bill the patient for services rendered under this contract.

The contractor or CMTs shall not request or accept 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.

1.19.1. The contractor or CMTs 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 or CMTs or from any third party at any place other than as designated under this contract.

1.19.2. 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 health care services under this contract. The contractor shall not release any of the above information without prior written consent of the KO. The contractor/CMTs shall not use patient care rendered pursuant to this contract as part of a study, research project, or publication. The CMTs shall prepare medical records, forms and documents as required, in accordance with the regulations and established guidelines listed in the contract.

1.19.3. The contractor CMTs shall abide by federal and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and the CMT 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 (HIPAA) of 1996. All regulations referenced are available for review from the MTF, COR, or the KO. All medical records and reports will remain the property of the government.

1.19.4. The contractor or CMTs shall not use Government facilities, supplies, or equipment in private practice or for any purpose other than providing the health care services required under this contract.

1.20. Contractor Key Personnel. The contractor shall notify the KO and COR of the primary point(s) of contact for contract management, coordination and administration not later than five (5) business days after receiving notice of contract award. The contractor shall notify the KO and COR of changes in the primary point(s) of contact at least five (5) business days prior to the change. All notifications shall be in writing and shall state the name and contact information for the point(s) of contact.

1.20.1. Contractor Program Manager. The contractor shall provide a full-time Program Manager(s) in the San Antonio area within 10 business days of contract award. The KO and COR shall be notified in writing and the contractor shall state the name(s) and contact information for the Program Manager(s) . The Program Manager(s) shall not be one of the contract CMTs providing services.

1.20.2. The Program Manager shall respond to telephone calls from the KO and COR within thirty minutes on a 24 hours a day, seven days a week basis.

1.20.3. The Program Manager shall meet with the COR monthly during the contract period to discuss any concerns regarding the contract execution. The COR may elect to have this meeting by telephone, video teleconference or in person and will select the time and location.

1.20.4. The contractor’s Program Manager shall be available to discuss any problems that the contractor’s personnel may be experiencing during the performance of this contract. Problems experienced by the Government with the contractor’s performance will be discussed and resolved between the contractor’s program manager and the COR.

Any unresolved problems will be referred by the contractor or COR to the KO for resolution.

1.21. Army Trusted Associated Sponsorship System (TASS)

1.21.1. The contractor shall comply with agency personal identity verification procedures that implement Homeland Security Presidential Directive-12 (HSPD-12), Office of Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

1.21.2. The contractor shall comply with agency personal identity verification procedures in all subcontracts when the subcontractor is required to have physical access to a federally controlled facility or access to a Federal information system.

1.21.3. The contractor shall ensure compliance with the provisions set forth below. For purposes of the Federal Acquisition Regulation (FAR) Clause 52.204-9, the government will designate a Trusted Agent (TA) for this contract. The government reserves the right to amend or supplement these provisions pursuant to the Changes clause in the contract.

1.21.4. The contractor is responsible for absences of CMTs due to expired identification and access documents.

Such absences shall not relieve the contractor of its obligation to perform the services required under this contract.

1.21.5. In-processing Requirements. The CMTs are prohibited from performing services under this contract absent compliance with the in-processing requirements set forth below.

1.21.6. The government will sponsor the contract CMTs for an Army Knowledge Online (AKO) account. All CMT email addresses will identify them as a contractor and use the format firstname.lastname.ctr@us.army.mil. The AKO will be discontinued by the government when the CMTs no longer require access.

1.21.7. The government TA will send a notice through the TASS to the AKO e-mail address provided IAW the above requirement. The CMT’s user ID and password will be provided in the e-mail and will be require a change at first log-in. In the event the e-mail message is not received, the contractor may request the username and password from the TA and proceed to the website https://www.dmdc.osd.mil/tass to complete the process.

1.21.8. The CMT shall log into the TASS and complete the verification process by submitting the application back tothe TA for approval.

1.21.9. The application will be accepted, returned, or rejected by the TA. Notice as to whether the application has been accepted, returned, or rejected will be provided to the CMT’s e-mail address within 48 hours after submission.

If the application is returned or rejected, the CMT shall contact the TA and comply with the TA’s guidance to attempt to correct and resolve the issue(s).

1.21.10. Upon approval of the application, the CMT will receive an e-mail stating the CAC application was approved. The applicant must then go to a RAPIDS Issuing Facility to have the government credential issued.

Effective 1 December 2011, Fort Sam Houston, Randolph Air Force Base and Lackland Air Force Base ID sections require an appointment. To make an appointment, the CMT will follow the instructions provided by the TA and contact the COR for instructions. If the CMT chooses Randolph or Lackland AFB, the supervisor or government task manager must send a visitor message prior to the CMTs arrival on-site. The CMT must present two acceptable forms of ID which may include: Driver's License, Military ID, Contractor Company ID with picture and expiration date, charge card with picture imprinted, or passport.

1.21.11 Revalidation Requirements. The TA is required to revalidate all CMTs, in the TASS, every 6 months. In the event revalidation is denied, the CAC credentials shall be revoked and the CAC will not be useable to log in.

1.21.12. Out-processing Requirements. When a CMT’s performance under this contract ceases, the CMT shall personally bring the CAC to the TA and complete the DA Form 2962. The TA will revoke the CAC from the

TASS.

1.22. Investigation Requirements. The contractor providing service under this contract is required to initiate the Electronic Personnel Security Questionnaire (EPSQ), 59th MDW/LS Contracting Services will send a CD and instructions to complete the EPSQ when a contract is awarded. SF 85P Questionnaire for Public Trust Positions is to be completed and printed and electronic copies (CD or thumb drive) are to be hand carried to the Unit Security Manager prior to performance. The Contractor shall have proof of U.S. citizenship (see PWS paragraph 1.15.) As a minimum, the contractor providing service requiring operating government-furnished workstations that have access to Air Force 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 MTF Security Manager prior to performance. The unit security manager will initiate the AF F'M 2583 Request for Personnel Security Action, review the security questionnaire and request a Local File Check from 37 SFAR prior to scheduling an appointment with the 37 Security Forces to submit the EPSQ. This security questionnaire must be completed/processed by the 37 SFS 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 Security Forces. The security questionnaire reviewed by the unit security manager will be hand carried by the CMT to the 37 SFS Personnel Security Office for processing prior to contract performance. Upon completion, the CMT must return the.AF FM.2583 to the unit security manager.

1.23. 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. Destruction and removal of these items are outlined in DOD Regulation 5400.7.

1.24. Reporting Requirements. The contractor shall comply with AFI 71-101, Volume 1, Criminal Investigations and Volume-2, Protective Service Matters, (Paragraph 1.2). Contractor shall report to the 37 Security Forces any information or circumstances which may pose a threat to DOD or contractor personnel, resources, or DOD information.

1.25. Removal of CMT. 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. The CMT may be required to submit to drug/alcohol testing. The government serves the right to require temporary or permanent removal of any individual who refuses testing. Notification of all removals will be made by the COR. Removal of any individual does not relieve the contractor of any performance requirement. At any time during the performance of this contract, the KO or COR (as authorized by the KO) may direct the contractor to immediately remove any CMT whose actions or impaired state raises reasonable suspicion that clear and present danger of physical harm exists to a patient, other CMTs, government personnel or to the impaired individual. This provision will be used in emergency situations only and not for the purpose of bringing performance issues or other non-urgent concerns to the attention of the contractor.

1.25.1. If a removal occurs, the COR will contact the KO and the contractor's representative within twenty-four (24) hours. A meeting may be required with the COR, Quality Assurance Representative and KO to discuss further action.

1.25.2. Upon conclusion of the investigation if the KO concludes that the contract CMT’s impairment requires permanent removal from the contract, the contractor will be notified. During the period of time between the removal and the final decision of the KO, the contractor shall provide a backup/replacement contract CMT in accordance with the terms and conditions of this contract. The KO will notify the Contractor if and when permanent removal is required. In the event of a disagreement between the Government and the Contractor, the decision of the KO will be final. During the period of time between the removal and the final decision of the CO, the Contractor agrees to provide a backup/replacement CMT in accordance with the terms of this contract.

1.25.3. The contractor shall not use that individual to perform any health care services required under this contract until the issue has been resolved by the KO or COR (as authorized by the KO). The contractor shall formally meet with the COR to discuss further action in accordance with the MTF, Inspection (QA&I) Plan and DHA-PM 6025.13, Volume 4, A review of the basis for removal will be made by the KO within 3 working days after the Government directed removal of the CMT.

1.25.4. When there is a reasonable cause to doubt the CMTs competence to practice or for any cause affecting the safety of patients or others, the MTF Commander has the prerogative to hold in abeyance, to deny, or to summarily suspend clinical privileges in accordance with DHA-PM 6025.13, Volume 4, which outline the adverse clinical practice actions for privileged personnel and adverse practice actions and peer review for nonprivileged providers.

1.26. Physical Security. The contractor/CMT shall comply with FPCON procedures, Random Antiterrorism Measures (RAMS) and local search/identification requirements.

1.27. Internal Operating Instructions (OI). The Contractor/CMT shall abide by the MTF's current OIs for internal circulation control, the protection of resources, and the regulated entry into controlled areas during normal, simulated, and actual emergency operations.

1.28. 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.

1.29. Keys and lock Combinations. The CMT shall abide by all current MTF key control and lock combination procedures. The Contractor shall be responsible for any keys issued to the CMT. The keys shall not be duplicated.

The Contractor shall ensure that its CMT not allow government-issued keys be used 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 CMT shall use keys issued to them to secure/open areas only as directed by the QA and/or functional area chief. Lost keys and/or locks shall be reported to the issuing party and. QA immediately upon recognition of the loss. The QA shall notify the KO of the lost key. The CMT 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.

1.29.1. 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 replacement as applicable.

1.30. The contractor shall require all CMTs with knowledge of an incident of sexual assault occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours after gaining knowledge) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

1.31. The contractor shall require all CMTs with knowledge of an incident of sexual harassment occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours after gaining knowledge) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

1.32. 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 employees 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, all Contractor employees must be issued a special identification card issued by BAMC 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 an employee or the contract end date. The Contractor shall ensure all contractor employees are 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 employee reports an ID lost or stolen. The Government shall conduct criminal background checks on all Contractor employees 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 ensuring all Contractor employees must complete the SF86, Authorization for Release of Information form and ensure 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, inquiries 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 any employees to start work until clearance of criminal background check has been completed.

1.33. 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.

1.34 Operations…