Cardiothoracic PWS 6.28.pdf

PERFORMANCE WORK STATEMENT

CARDIOTHORACIC SERVICES

1. GENERAL. This is a personal services contract (as defined by FAR Subpart 37.104) and is intended to create an employer- employee relationship between the Government and the individual health care providers (HCPs) only to the extent necessary for providing the health care services required under the contract. The performance of health care services by the individual HCPs under a personal services contract are subject to day-to-day supervision and control by health care facility personnel comparable to that exercised over military and civil service HCPs engaged in comparable health care services. Any personal injury claims alleging negligence by the individual HCPs within the scope of the HCP’s performance of the personal services contract shall be processed by Department of Defense

(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 DESCRIPTION OF WORK. The Contractor shall provide the personal services of all personnel necessary to perform Cardio-Thoracic Surgeries at William Beaumont Army Medical Center (WBAMC), Fort Bliss, TX.

Performance shall be in accordance with the Performance Work Statement (PWS) and the terms and conditions of the contract. The Contractor Personnel performing these services are hereafter referred to as HCPs.

1.2 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 or

$208.33/hour as established under USC 1091(b) and the full-time equivalency rate established under DoDI 6025.5.

1.3 PERFORMANCE MEASURES.

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

1.3.2. Standards. Acceptable measures include: position(s) shall be 100% filled within 90 days of date of award; in the event a contract service provider vacates a position, the position shall be filled within 60 days of vacancy; shift fill-rate of at least 95%; turnover rate of not more than one person per year and no more than two substantiated complaints in any twelve-month period. Substantiated patient/clinical/customer complaints-max 2 per period, per provider; no provider initiated cancellation of treatments except as medically required by patient or provider illness.

Other performance evaluation factors will be monitored that are not quantified by numerical measurements which

Include:

contractor providing personnel not meeting the minimum qualification standards; patient customer service comments;

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

1.3.3. How Measured. Department of Medicine with the input from the Cardiac Surgery Oversight Committee will monitor provider performance through government information systems and records.

1.3.4. Unscheduled absences: Last-minute shift cancellations are a detriment to the facility and a threat to the organization. If a contract provider is unable to work a scheduled shift, he/she is responsible for notifying the contractor and the contractor is responsible for providing replacement coverage. The clinic chief will be notified immediately if a contractor shift is unfilled so that he/she can arrange alternate coverage. If the Chief (or Acting

Chief) is unavailable, the OIC, followed by the Office Manager shall be notified.

1.3.5. HCP Training and In-processing. All contract providers are required to complete mandatory in-processing and training prior to being authorized to begin providing professional services. This is billable time for all contract providers privileged to work under the terms of the contract. This time does not count towards shift coverage.

2. QUALIFICATIONS. The contract HCP shall meet the following minimum qualifications:

2.1. CARDIOTHORACIC SURGEON (Heart Surgeon): All Contractor Heart Surgeons must be certified by the

American Board of Thoracic Surgery or an equivalent certifying body in another country. Heart Surgeons must have been the primary performing surgeon or first assistant to a minimum of 200 heart surgeries, the majority of which were coronary bypass surgeries. Must have been involved in all levels of peri-operative care.

2.2. CARDIOVASCULAR PERFUSIONIST: All Contractor Perfusionists must be licensed in any of the 50 states or US Territories with a minimum of 200 cases as the primary perfusionist. Must have a bachelors degree from an accredited college or university with a science emphasis. Must have graduated from an accredited college or university with a science emphasis. Must have graduated from an accredited cardiovascular perfusion education program approved by the American Board of Cardiovascular Perfusion (ABCP). Must be certified by the ABCP.

2.3. PHYSICIAN ASSISTANT (PA): Must possess a degree that is accredited by the American Review Committee.

Must have a minimum of two years’ experience as a PA. Be eligible for U.S. employment. Must be board certified by the National Commission of Certification of Physicians Assistants, maintain an active National Commission on

Certification of Physicians Assistants (NCCPA) certification. Possess and maintain current certification in advanced cardiac life support (ACLS), and pediatric advanced life support (PALS). Certifications must be obtained through the American Heart Association and/or the American Red Cross approved training program. Shall remain current and achieve required continuing education units. The contractor is responsible for maintaining CME at no additional cost to the government.

2.4. REGISTERED NURSES (RN): Must have a current license/registration/certification for the individual skill level for which the candidate is being considered. All Contactor Nurses must be licensed in any of the 50 states or

US territories with a minimum of one-year experience with heart surgery or assistance in more than 200 heart surgery cases (OR/Scrub Nurse) or more than 100 cases (Coordinating Nurse). Must have a current basic life support (BLS) certification for healthcare providers. U.S. citizenship (contractor shall verify and maintain a copy of the birth certificate or naturalization papers). Have the ability to read, write, and speak English to effectively communicate with patients and other HCPs. Have no physical restrictions regarding standing, walking, or lifting.

Have evidence of graduation from a baccalaureate, associate, or diploma program in nursing for registered nurse.

Must have completed an operating room nurse course and worked a minimum of two years in the last three years as an operating room nurse. The Contractor shall ensure that only professional RN’s with current licenses will provide inter-operative and/or post-operative nursing care. Competency folders must be current at all times, in accordance with WBAMC policy and MEDCOM regulation.

2.5. OPERATING ROOM TECHNICIAN: Must have a two year junior or community college certification as a cardiovascular technologist. The first year must include basic science and medical courses such as anatomy and chemistry. The second year must involve specialized instruction in invasive cardiology, vascular technology, or echocardiography. Current certification from the Cardiovascular Credentialing International Organization or the

American Registry of Diagnostic Medical Sonographers is required.

2.6. CARDIO-THORACIC SURGERY TEAM MEMBERS (Surgery Team):

2.6.1. All HCPs must be certified by their respective certifying boards or an equivalent body in another state.

2.6.2. The morbidity and mortality statistics for the heart surgery team and each individual surgeon must be under four percent over the course of the last five years; this data is to be made available to the WBAMC Credentials

Committee, Deputy Commander for Clinical Services, or Commander, upon request.

2.6.3. All HCPs performing services under this contract shall have current certification in Advance Cardiac Life

Support.

2.6.4. Have and maintain current Basic Life Support (BLS) certification. The American Heart Association Basic Life

Support for Healthcare Providers is the only program accepted. BLS recertification shall be maintained in a current status at all times while the HCP is performing services under this contract.

2.6.5. All HCPs shall be able to obtain privileges and be credentialed (as appropriate) by the MTF’s Credentials

Committee.

2.6.6. All HCPs shall have sufficient skills, knowledge and experience to perform the specific tasks (see Paragraph 6.

of this Performance Work Statement) listed for their specialty.

2.6.7. The HCPs shall be able to type and have had experience using computers. WBAMC will provide computer training on the WBAMC computer system. Failure to learn the computer system at WBAMC within two weeks of beginning service shall also be grounds for immediate removal of the provider.

2.7. Requirements.

2.7.1. The HCP shall be able to read, write, and speak English in a grammatically correct manner and enunciate with sufficient clarity to effectively communicate with patients and other health care providers.

2.7.2. The HCPs shall be required to meet Continuing Medical Education (CME) requirements in AR 351-3 or as determined by the provider’s State of licensure, whichever is more stringent. The Government will not reimburse for these costs.

2.7.3. The Contractor shall ensure that the HCPs have received the required Occupational Safety and Health

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

Documentation of such training shall be provided to the Contracting Officer’s Representative (COR).

2.7.4. The HCP must demonstrate sufficient computer literacy to include use of word processing, database, and spreadsheet programs, as well as possess basic typing skills sufficient to efficiently produce their own reports and correspondence. Failure to learn the computer system at WBAMC and perform actions independently within two weeks of beginning service may be grounds for immediate removal of the provider.

2.7.5. The Contractor shall not employ any individual to provide direct health care services who is listed on the

Health and Human Services (HHS) list of providers excluded from federally funded health care programs. The list may be found at http://oig.hhs.gov/fraud/exclusions.asp.

2.7.6. The following shall disqualify, at any time, any provider from consideration/performing under this contract. If none of these conditions are applicable, the contractor shall provide a letter so stating.

a provider under probation/revocation/indictment/suspension action at any time from any state, the District of Columbia, Commonwealth of Puerto Rico, Guam or U.S. Virgin Islands where the provider has/had a license;

a provider who has a documented past of sexually abusing people whether convicted or not;

a provider who has defective color vision;

a provider who is chemically (alcohol or drug) dependent or impaired;

a provider who was previously convicted of any felony;

a provider who is awaiting possible adverse action administration action by any board of medicine;

a provider who has been declined to participate in any Tricare program failure of the contractor or provider to disclose any information listed herein.

2.7.7. The HCP shall successfully complete a criminal history background check in accordance with paragraph 7.4.

2.7.8. The HCP shall be a U.S. citizen or otherwise meet the requirements of AR 25-2, Information Assurance.

2.7.9. The HCP shall have knowledge of medical privacy and confidentiality (Health Insurance Portability and

Accountability Act [HIPAA]), and accreditation standards of Accreditation Association for Ambulatory Health Care

(AAAHC) and TJC.

2.7.10. The HCP shall have a working knowledge of computer applications/software to include Microsoft Office programs, MS Outlook (e-mail) and internet familiarity.

http://oig.hhs.gov/fraud/exclusions.asp

2.7.11. The HCP shall be skillful and tactful in communicating with people who may be physically or mentally ill, uncooperative, fearful, emotionally distraught and occasionally dangerous.

2.7.12. The HCP shall demonstrate ability to apply critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations.

2.7.13. The HCP shall possess organization, problem-solving and communication skills to articulate medical requirements to patients, families/care givers, medical and non-medical staff in a professional and courteous way.

2.7.14. The HCP shall use the various clinical automation systems as required, such as, but not limited to Composite

Health Care System (CHCS), Armed Forces Health Longitudinal Technology Application (AHLTA), Ambulatory

Data System (ADS), Military Health System (MHS) Genesis, Essentris, and Defense Medical Human Resource

System – internet (DMHRSi).DHA

2.7.15. Working experience with the federal government within last 24 months is preferred but not a requirement. If the HCP has worked for the federal government in the last 24 months and had a security check, then security approval under this contract will go much faster. Otherwise it can take six weeks for security approval.

3. ADMINISTRATIVE.

3.1. Multiple providers shall not be used to provide the services for one provider. The services required shall be performed by one provider. Job splitting, sharing or alternating between multiple individuals is not allowed.

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

3.3. Use of a non-compete condition in the contractor’s employment agreement with its contract HCPs on this contract that prevents the HCPs from being employed in the MTF after the contract or task order ends, by either a follow-on contract or the government is unacceptable. It hinders the government’s ability to accomplish the mission of providing continuity of quality medical care to beneficiaries. By submitting a proposal for this contract the offeror agrees to waive enforcement of any non-compete agreements against any contract HCP that accepts an offer of employment at the MTF with the follow-on contract or the government. The contractor also agrees to not seek reimbursement for any costs related to follow-on employment from the government.

3.4. Orientation and Training.

3.4.1. Prior to working, HCPs will be provided a Government paid orientation to familiarize them with the policies and procedures of the MTF. Orientation attendance will be required of all HCPs and will be scheduled by either the

COR or the DC during normal duty hours.

3.4.2. The government reserves the right to verify the hours worked by the contract providers by implementing sign-in/sign-out procedures, requiring the contract provider to utilize a time clock should one be installed or any other method.

3.4.3. Newly hired contract providers shall be required to complete new employee orientation which is provided by the MTF. Thereafter, contract providers shall be required to complete quarterly training to meet competency requirements. Orientation and annual/or quarterly training requirements are a condition of employment for which the contractor will be compensated at the hourly rate reflected in the contract.

3.4.4. Computer Training: Contract providers who have any interaction with the hospital computer systems must receive training for the applicable system. The HCPs shall be able to type and have had experience using computers. WBAMC will provide computer training on the WBAMC computer system. Failure to learn the computer system at WBAMC within two weeks of beginning service shall also be grounds for immediate removal of the provider. These systems include but are not limited to:

3.4.5. Electronic Medical Record Keeping Systems. The Government will provide training to HCPs in the

Electronic Medical Record Keeping Systems and 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 25-2 and AR 380-67. Refer to the Additional Information section “ADP Security Requirements” in this contract for further guidance.

3.4.6. Essentris. A comprehensive clinical information system that provides comprehensive documentation services

HCPs. Essentris enables providers to review, document and manage high acuity patients through the hospital environment. An electronic program that allows worldwide documentation of inpatient records for all service member and beneficiaries, within 24 hours after patient visit.

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

AHLTA is another system which is used for charting outpatient encounters and Essentris is a third system which is used for inpatient charting.

3.4.8. 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.

3.4.9. Training for CHCS/AHLTA/Essentris/Genesis and other computer training will be scheduled through the

OIC/NCOIC of the Department. The training will be on-site and during normal duty hours. The training will be completed prior to the HCPs providing direct patient care. This training will be at no cost to the contractor.

3.4.10. AT Level I training. All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 60 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within 65 calendar days after completion of training by all employees and subcontractor personnel. AT level I awareness training is available at the following website: http://jko.jten.mil.

3.4.11. The contractor shall ensure all service providers receive Sexual Harassment/Assault Response and

Prevention (SHARP) training not later than 60 calendar days after contractor personnel begin performance under this contract. Training can be obtained either online or in person. Contractor personnel can attend SHARP training provided by MEDCOM on an every other month basis by contacting (210) 221-6118 for class date/time and availability. If the employee has an AKO account, they can access online the Team Bound Self Study course through Army Learning Management System (ALMS) at http://www.atsc.army.mil/tadlp/delivery/alms.asp.

3.4.12. The Contractor shall notify its employees of the United States Government's zero tolerance policy described in paragraph (b) of FAR clause 52.222-50 “Combating Trafficking in Persons” and the actions that will be taken against employees for violations of this policy.

3.4.13. Access and general protection/security policy and procedures. Contractor and all associated sub-contractors employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office.

Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition

(FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

3.4.14. Army Training Certification Tracking System (ATCTS) registration for contractor employees who require access to government information systems. All contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DOD Information Assurance Awareness prior to access to the IS and then annually thereafter.

http://jko.jten.mil/ http://www.atsc.army.mil/tadlp/delivery/alms.asp

3.4.15. Safety. The Contractor shall ensure that its HCPs 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. The contractor and contractor personnel shall be cognizant of and observe all requirements for handling and storing combustible supplies and materials, and daily disposal of combustible waste, trash, etc.

3.4.16. Security.

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

3.4.16.2. The Contractor shall ensure that its HCPs comply with installation and MTF personnel identification and access requirements. The Contractor is responsible for absences of HCPs due to expired identification and access documents.

3.4.16.3. The Contractor shall be responsible for any keys issued by the Government to HCPs for use in the MTF.

The keys shall not be duplicated. The Contractor shall be financially responsible for the replacement of any lost or duplicated keys and any associated locks. Lost or duplicated keys and/or locks shall be reported to the issuing party, Department Chief, or COR immediately upon recognition of the loss or duplication. No unauthorized personnel shall be allowed entry into the locked area. The Contractor shall ensure that its HCPs lock all areas for which they possess a key when they are not using the area and at the close of the work period.

3.4.16.4. Safeguarding Material. The Contractor shall be responsible for safeguarding all Government property provided for Contractor use. The Contractor shall safeguard information of a confidential or sensitive nature. Neither the Contractor nor any of its HCPs shall 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 deposition in lawsuits or other administrative, civil, or criminal proceedings.

3.4.16.5. Upon termination of work at this MTF, all contract providers are required to return the hospital identification badge and out-process through the activities identified on the out-processing checklist obtained from the COR.

3.5. INFECTION CONTROL ORIENTATION BRIEFING. The HCP is required to attend, an initial one- hour

Infection Control Orientation Briefing at the Newcomers orientation after start date at the MTF. The HCP will be required to attend and follow the annual Infection Control Training and/or Specialized Training in accordance with

Infection Control Program, MWI 44-9, Section 1-8.

3.6. Government Unique Training. The Government may elect to provide unique Government training to HCPs who are performing services under this contract. If the Government elects to provide such training, the Government will provide such training at no additional expense to the Contractor or to the HCPs. When directed by the

Contracting Officer, HCPs shall attend all such training in a paid status as part of the normal services required and billed under the contract. Such training shall require a performance commitment by the Contractor and the

Contractor shall reimburse the Government (by means of a reduction in an invoice) if a HCP fails to satisfy the performance commitment after the HCP receives the unique Government training. The amount of the reimbursement shall be the prorated cost of training, calculated based on the total cost of the training and the number of months by which the HCP fails to complete the performance commitment. The length of the performance commitment shall be

12 months or until the end of all performance under this contract, whichever occurs first. Details of any subsequent training agreement will be agreed upon by all parties, and such training agreements will be designated by modification to the contract.

3.7. Contract employees who previously received a background check and do not have a two-year break in service must get verification from Security and Intelligence Office at the MTF. All employees are required to have a record re-verification and internal record check at a minimum of every five years.

3.8. License and Credentials Review or Privileging.

NOTE: Upon award of the contract the Contractor shall immediately contact the Credentials office or COR as outlined below.

3.8.1. The Contractor shall submit a curriculum vitae (CV) or résumé (as appropriate) of the proposed provider(s) to the COR not later than (NLT) 14 days after award for review prior to beginning the credentialing process.

3.8.2. The MTF Commander must grant privileges to HCPs for whom privileging is required prior to HCPs providing any services. The privileging process shall be in accordance with all requirements Defense Health Agency

Procedures Manual (DHA-PM) 6025.13 Clinical Quality Management in the Military Health System, volume 4 and local MTF regulations provide guidance. DHA-PM 6025.13 is located at: https://health.mil/Reference-

Center/Policies. The privileges granted by the MTF will be sufficient to allow for performance of all specific tasks identified in this contract. Notification that privileges have been approved by the MTF should be received before the provider is given a start date. Any failure to meet these requirements is considered nonperformance and the basis for termination for cause.

3.8.3. Credentialing/Privileging Process.

3.8.3.1. Each HCP, except as otherwise stated in the contract, must obtain privileges from the MTF Commander, prior to beginning work. The privileging process shall be IAW all requirements in DHA-PM 6025.13. The privileges granted by the MTF must be sufficient to allow for performance of all specific tasks identified in this contract. If a

Contractor HCP is not privileged sufficiently to perform all the specific tasks in this contract, the HCP will not be allowed to provide services under this contract and the Contractor shall provide another HCP. Information on the credentialing/privileging process is in DHA-PM 6025.13.

3.8.3.2. The Contractor is responsible for completing the entire credentials packet and returning it in hard copy format NLT 30 days after completion of the Government’s review of the candidate’s (CV) or résumé (as appropriate) unless otherwise specified by the KO. Fax copies are NOT acceptable unless approved in advance by the Credentials office. Do NOT submit an incomplete package without first coordinating with the COR. The MTF will not assist the Contractor in obtaining any needed information. Additionally, the Contractor shall provide all necessary information. Do not instruct the individual provider to bring or otherwise provide information unless approval is granted by the COR. Incomplete packages delay the credentialing process resulting in delay of the provider’s start date.

3.8.3.3. Prime Source Verification is the responsibility of the Contractor. The Contractor shall provide either an original letter from the educational institution or certifying body attesting to the successful completion of specialty training or certification. Attestation of telephonic verification on Contractor letterhead is also acceptable and shall reflect the following information:

Date of verification

Name of individual and agency contacted

City, State, Phone Number and verification made (i.e., degree (type and dates))

Internship (type and dates)

Residency (name and dates of specific program)

Fellowship (name and dates of specific program)

Board certification (date certified and expiration date if applicable)

Licensure/certification/registration (current, inactive, expired) to include date granted expiration date and confirmation that the licensure/certification/registration is in good standing.

3.8.3.4. The Contractor shall verify successful credentialing/privileging with the Credentials office prior to the arrival of any provider. Again, providers may NOT begin work until the credentialing/privileging process is complete.

https://health.mil/Reference-Center/Policies https://health.mil/Reference-Center/Policies

3.8.3.5. The Contractor shall, on a continuing basis, verify all information submitted to the MTF for the purpose of credentialing/privileging. During the term of the contract, the Contractor shall notify the Credentials office upon becoming aware of any information that may compromise the provider’s credentials at the MTF. This includes, but is not limited to, information linking the provider with chemical dependency, a felony or malpractice. The information will be reviewed by the Credentialing Committee and may result in the rescinding of privileges.

3.8.3.6. Unless otherwise required, applications for clinical privileges shall be submitted not later than 30 calendar days prior to the Credentials Committee Meeting which is held on the second Tuesday of each month. Prior to documents appearing before the committee, they must be reviewed by various departments. In order for the committee to consider submissions on the date scheduled, the Contractor must submit accurate, completed packets by the time specified in the contract.

3.8.4. The Contractor shall not employ any individual to provide direct healthcare services whom, within five years prior to employment:

3.8.4.1. Has had his/her clinical privileges limited, suspended, or revoked by any healthcare facility, public or private, anywhere in the world.

3.8.4.1.1. This prohibition does not apply to any individual whose clinical privileges, although originally limited, suspended or revoked by a healthcare facility, were subsequently fully reinstated by the healthcare facility.

3.8.4.1.2. Limitation of clinical privileges, as used in this paragraph, refers to a partial withdrawal/reduction of clinical privileges as a result of a determination that or pending investigation to determine whether an individual has engaged in unprofessional conduct or substandard medical practice or is incompetent to perform certain medical practices.

3.8.4.2. Is the subject of a current or pending hearing or appeal brought by any healthcare facility, public or private, anywhere in the world, which may result in the limitation, suspension, or revocation of the individual's clinical privileges.

3.8.5. Requirements for privileging or for licensing verification are the same for replacement HCPs as for HCPs they are replacing.

3.8.6. The MTF Commander is the sole authority that can revoke or otherwise restrict the privileges of any HCP who he/she determines is not qualified to perform the contract services.

3.8.7. Once privileges are granted, subsequent actions taken concerning the privileges of HCPs, including any limitation on privileges, will be governed by the procedures in DHA-PM 6025.13. Action that suspends, revokes, places in abeyance, or otherwise restricts the privileges of the HCP results in that HCP not being authorized to perform under the contract. Such action does not excuse the Contractor from performing. A replacement HCP must be provided according to the terms of this contract.

3.8.8. Adverse actions on HCP privileges, once the Commander takes action, may be appealed locally by the HCP under the provisions of DHA-PM 6025.13, but may not be appealed by the Contractor.

3.9. For contractors requiring Common Access Card (CAC). Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014-05. The contractor employee will be issued a CAC only if duties involve one of the following:

Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely;

Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or

Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personnel Management.

3.9.1. 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 and access to a Federal information system.

3.9.2. The contractor shall ensure compliance with the provisions set forth below. For purposes of 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.

3.9.3. In-processing Requirements. Contractor employees requiring access to Government systems in order to perform services under this contract shall obtain a CAC. Proof of employment, background screening, and security clearance / favorable background check is required before a CAC will be issued authorizing access to the Installation and Government computer systems.

3.9.4. CACs may not be issued to Contractor employees unless a data record authorizing CAC issuance is resident in the Defense Enrollment Eligibility Reporting System (DEERS). The Trusted Associate Sponsor System (TASS) was developed as a secure and authorized means of entering contractor data into DEERS in addition to automating the CAC application and approval process. In order to enter contractor data into TASS, the contractor's data must be resident in an authorized source database. The Joint Personnel Adjudication System (JPAS) is that authoritative source. The Contractor's Facility Security office (FSO) shall ensure its employee(s) has a record in JPAS prior to its employee(s) requesting a CAC be issued. Personnel eligible for a CAC who are not in JPAS (i.e., certain Contractor employees, Foreign Nationals, and DoD affiliates) will be required to register at a site where an equivalent background vetting will be accomplished In Accordance With (IAW) Federal Information Processing Standard

(FIPS) 201.

3.9.5. The application will be approved, returned, or rejected by the TA. Notice as to whether the application has been approved, returned or rejected will be provided to the individual's e-mail address within 48 hours after submission. If the application is returned or rejected, the HCP shall contact the TA and comply with the TA's guidance to attempt to correct and resolve the issues.

3.9.6. Revalidation Requirements. The TA is required to revalidate all HCPs, in the DEERS/RAPIDS System, every 180 days. In the event revalidation is denied, the CAC credentials shall be revoked and the CAC will not be useable to login.

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

DEERS/RAPIDS System.

3.9.8. The contractor is responsible for absences of HCPs 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.

3.9.9. The HCPs shall immediately report any lost or stolen CACs or badges to the COR.

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

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

3.11. Contractor Representation.

3.11.1. The Contractor shall designate a representative for this contract. This representative may be employed under another contract/task order with the Contractor at the same MTF. At least ten working days prior to performance start date, the Contractor shall provide in writing to the COR, Contractor representative contact information. Changes in the contract representative, at any time after contract commencement, shall be in writing to the COR at least five working days prior to the change. If at any time there is only one HCP working in the facility for the Contractor, someone other than this HCP must be designated as the company representative and this representative may be off-site.

3.11.2. The Contractor's representative shall, at no additional cost, meet with the COR when requested by the COR 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.

Unresolved problems will be referred to the Contracting Officer for resolution.

3.11.3. The Contractor shall provide points of contact (POC) information for administration of the contract during normal business hours and after normal business hours. The POC for other than normal business hours will be contacted only in the event of emergencies. Accordingly, the named individual(s) shall possess sufficient corporate authority to effectively deal with emergency situations and the telephone number provided shall be functioning at all times other than normal business hours. If there are different POCs for different conditions, such as weekdays, weekends, holidays, clearly provide such information.

3.12. Reports. The Contractor shall submit reports to the COR as requested for use in monitoring Contractor performance. Such reports may include, but are not limited to, personnel recruitment/credential status, projected losses, HCP locations, etc.

3.13. Management Plan. NOT APPLICABLE

3.14. Weekly Progress Report. Until the HCP is performing duties at the MTF and any other period where a replacement HCP is required, the Contractor shall provide to the KO and the COR on a weekly basis a progress report indicating the candidate’s name, date identified by the Contractor, date the résumé was submitted to the

Government for review, date the credentials package was submitted to the Government, date the MTF privileged the provider and the targeted start date.

3.15. Morbidity and Mortality Report. The Contractor shall submit monthly reports to the Department Leadership

Team.

4. HOURS OF PERFORMANCE.

4.1. Normal clinic hours range from 6:00 a.m. to 6:00 p.m. Monday through Friday excluding federal holidays and some command directed training holidays. MTF also has an in-patient mission and operates a 24/7 emergency room.

Contracted services will be in support of the MTF's overall mission. For the most part, stand-bys will be scheduled to ensure operative room availability should emergent surgery is required. Most commonly, the surgery team will be required to be on stand-by for the times the MTF cardiology staff is performing cardio elective procedures during normal hours. The actual duty schedule/hours for the team, and its individual members will be determined by the

Department of Medicine Chief with approval by the COR, and coordinated with the Contractor. When it becomes necessary for the contractor to perform a surgery, it is estimated that each individual surgery will take approximately six hours plus two hours of pre-operative care and two hours of post-operative care. The head surgeon has the discretion to transfer those emergency cases if doing so is in the best interest of the patient given the acuity of the type of surgery needed.

4.1.1. The Surgery Team will be paid at a monthly rate for services performed. These services will include the actual performance of cardio-thoracic surgeries (up to 45 per year) as well as all required stand-by time. Surgeries exceeding a total of 45 per year will be compensated at the additional rate established in the negotiated price schedule.

4.1.2. As part of the surgery team pricing, note that the Coordinating (Liaison) Registered Nurse is required to be on site as .5 FTE, for 960 hours per year. The Coordinating Registered Nurse services is not separately priced, and must be included as part of the monthly rate.

4.2. In support of the MTF's 24-hour, seven day a week, in-patient and emergency department mission, contract provider shall provide off-site, on-call coverage. This call coverage, when possible, will be shared with other surgeon(s) assigned to the department, which can range from zero to one FTE. Hours scheduled for shifts do not include travel time involved in reaching the medical treatment facility. Contractor will provide the Department of

Medicine a monthly Cardiothoracic Surgery Team Member Call Roster.

4.2.1. Call Back Service: Team Members are not required to remain at WBAMC or at his/her residence while on-call but must be available by contact pager during this time. The Team Members are required to respond telephonically within 20 minutes after receiving a call and must be prepared to provide personal consultation and/or assistance within one hour, if requested. All team members must be on call at all times when not performing previously scheduled surgeries/duties to assist in emergency cases as needed at WBAMC. Historically, the surgical team has only been called to perform emergency surgical services once in the past three years.

4.2.2. Extended Hours: The Surgery Team or its individual members may be required to work beyond the end of the shift while providing patient care. Any other routine or non-urgent requests for extensions to shifts for patient care duties or mandatory training must be approved by the Department Chief or his/her designee. Extended shifts are included in the monthly rate.

4.2.3. On-call coverage: Contract provider may expect to be in an on-call status away from the MTF approximately 14 days during the calendar year exclusive of the weekend call coverage stated in 4.2.4. Commonly this call coverage will commence at 07:00 a.m. and continue for a 24 hour period. On-call shifts are included in the monthly rate.

4.2.4. Weekend On-call coverage. Contract provider may expect to be in an on-call status away from the MTF approximately two weekends per month. On weekends, coverage will commence at 4:30 p.m. on Friday and continue up to 7:30 a.m. on the following Monday (or Tuesday if Monday is a legal holiday). When paged, contractor must respond, at minimum via telephone, within 15 minutes and be capable of physically being in the

MTF within 60 minutes after telephonic communication when deemed necessary. Weekend On-call shifts are included in the monthly rate.

4.3. Hours scheduled do not include travel time involved in reaching the MTF. Signing in prior to scheduled time

(usually 6:00 a.m.) and staying past the close of business (usually 6:00 p.m.) will not be considered or paid as hours worked. The above timeframes are subject to change. Break times are not billable. The contract physician shall be prepared to be the sole provider of medical treatment and shall remain in the clinic, operating room during surgery or on the patient wards when seeing consults through the shift.

4.4. The HCP shall be rested and fully physically and mentally capable for performing the duties required under this contract. The HCP shall not have worked the 8 hours before beginning services at WBAMC.

4.5. Scheduled/unscheduled absences: Time off shall be granted at two days per month plus any federal holidays.

Time off cannot be used until earned. The days off will include vacation time, sick leave and continuing medical education (CME) purposes, training holidays, funeral leave, weddings, graduations, etc. Time off to get re-certified in BLS etc. during the term of the contract shall count against the 2 days off per month. Clinic or hospital closures caused by emergencies, exodus, training holidays and unexpected events shall count against the days off per month.

The Government will not pay for the days off per month. Scheduled absences shall be requested 14 days in advance and are subject to approval by the division chief. The days on which services will not be required will be determined by WBAMC. Unscheduled absences shall be called into the clinic by the contractor at least 24 hours before the start of the shift.

4.6. Closures and organizational activities: Given the nature of this service, the HCPs are determined to be

Emergency Essential HCPs (See DFARS Clause 252.237-7023 Continuation of Essential Contractor Services), and therefore unless directed by the Department Chief are not authorized any time off for anticipated closures due to

Command declared training holidays or during unplanned closure of the facility due to natural disasters, military emergencies, severe weather, or otherwise. Contractor shall not invoice the Government for services not performed and the Government will not be liable to the Contractors for any such closures.

4.7. The military may designate a weekday as a Training Holiday if doing so would provide a three-day or four-day holiday weekend (e.g., Thanksgiving weekend, Friday is usually a military training holiday).

4.7.1. During training holidays for active duty personnel, the clinic/facility may be closed during normal hours or open with reduced staff and operations. The HCP may still be on-call though. During training holidays, contract employees may use personal time off in accordance with the Contractor’s personnel policy or report to work if the clinic is open. Workload and mission requirements will determine whether the HCP will be required to provide services on training holidays.

4.8. Organizational Activities. During organizational activities the clinic/facility may close for normal operations and contractor services may not be required. Contract employees are not authorized to participate in accordance with

MEDCOM regulation 715-3, paragraph 9.n., except during authorized meal times or if a specific waiver is granted by the Commander, MEDCOM. The Government will only pay for work actually performed that day and not for attendance at organizational events if attendance is even permitted.

4.9. Comp-Time. Compensation time is not authorized.

4.10. The Contractor shall maintain a 95% fill rate with zero turnover during the period of performance. Fill Rate calculation shall be as follows:. # of hours worked divided by # of hours on the contract. Example: 800 hours worked/874 hours on the contract = 95% fill rate).

4.11. The government reserves the right to verify the hours worked by the HCPs by implementing sign-in/sign-out sheet, checking computer logs, use of a time clock, etc.

4.12. The Government will only pay for hours, days or units actually worked/provided. The Contractor shall only submit payment requests for hours, days or units actually worked/provided. Submitting a payment request for more than the amount due based on the number hours, days or units actually worked/provided may constitute fraud or a false claim and may result in administrative or criminal action or both.

4.13. GOVERNMENT HOLIDAYS:

The following Government Holidays are observed:

New Year’s Day, January 1

Martin Luther King Jr.’s Birthday, 3rd Monday in January

President’s Day, 3rd Monday in February

Memorial Day, Last Monday in May

Juneteenth Day, June 19

Independence Day, July 4

Labor Day, 1st Monday in September

Columbus Day, 2nd Monday in October

Veteran’s Day, November 11

Thanksgiving Day, 4th Thursday in November

Christmas Day, December 25

NOTE: Any of the above holidays falling on a Saturday will be observed on the preceding Friday; holidays falling on a Sunday will be observed on the following Monday. Any holidays that are declared by Presidential Executive

Order shall be observed in the same manner as the holidays listed above. If the area in which a contract employee is scheduled to work is closed due to the holiday declared by an Executive Order and the employee is not required to report in, payment will not be made for those hours. Closures of the installation due to inclement weather or other such acts of God shall be handled in the same manner.

5. PERSONNEL.

5.1. All contract providers shall abide by the MTF, policies, rules and ARs. All contract providers shall maintain and support the standards necessary to meet TJC and CMS (Centers for Medicare and Medicaid Services) certification. When commencing work under this contract, contract providers shall obtain an in-processing checklist from the COR. The contract provider shall wear the MTF identification badge. Upon termination of work at this

MTF, all contract providers are required to return the hospital identification badge and out-process through the activities identified on the out-processing checklist obtained from the COR.

5.1.1. MTF Authority: Contractor agrees to abide by all MTF standards, rules and procedures including requirements for any required…